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At least 1,531 records · Page 85Linked to original sources
PubMed1999

Assessment of 3-dimensional computer-generated cephalometric measurements.

The purpose of this study was to assess the reliability of 3-dimensional computer-generated linear and angular measurements produced by different computer algorithms and various combinations of cephalogram projections compared with direct and CT measurements. A computer program was written to provide 4 computer algorithms and 4 combinations of cephalogram projections generating 22 linear and 10 angular 3-dimensional measurements from 20 landmarks. A new technique to produce biplanar cephalograms from a single x-ray source using a special facebow was developed, and its reliability was assessed. Sets of lateral, frontal, and basilar cephalograms of a human dried skull were taken both with 20 radiopaque landmark markers and without markers. Paired t tests based on marker position demonstrated reliability of the facebow; there were no statistically significant differences in repositioning the skull over time using the facebow at P <.05. In the ideal situation, with minimal head rotation and landmark identification error (with the facebow and radiopaque markers), the average error of linear measurements was 1. 5 mm and 3.5(o) for the angular measurements. Subsequent trials evaluated the errors in head position (within 5(o) of head rotation) and in landmark identification (by removing all markers); two-way ANOVA with Scheffé groupings concluded that the vector intercept with manual adjustment algorithm using the lateral-frontal biplanar projection provides not only greater accuracy but also clinical practicality for both linear (mean of 2.2 mm error) and angular (mean of 4.0(o) error) measurements compared with direct or CT measurements (P <.05). The effect of landmark identification error was found to be slightly greater than the head rotation error in the accuracy of 3-dimensional linear and angular measurements (mean, 2.85 mm error for linear and 4.4(o) error for angular measurements). Lastly, this study concluded that linear measurements in the transverse direction were found to have a slightly larger error than vertical measurements. Anteroposterior measurements have the least error.

Algorithms↗
PubMed2000

Changing patterns of tonsillar squamous cell carcinoma in the United States.

OBJECTIVE: Tonsillar squamous cell carcinoma (SCC) may differ etiologically from other oral cancers. The aim of this study was to provide a detailed description of the incidence patterns of tonsillar SCC in the United States. METHODS: Population-based incidence data from the Connecticut Tumor Registry (period 1945-1994) and from the SEER program (period 1973-1995) were used to calculate age-standardized (US 1970) and age-specific incidence rates and confidence intervals (CIs). Linear regression was used to evaluate trends. RESULTS: The incidence of tonsillar SCC increased fourfold among white women in Connecticut during 1945-1994 but remained rather constant in white men. During 1973-1995, incidence rates per million person-years were considerably higher in blacks (31.6; 95% CI: 29.0-34.4 in men, and 9.6; 95% CI: 8.3-10.9 in women) than whites (14.8; 95% CI: 14.3 15.3 in men, and 6.1; 95% CI: 5.8-6.4 in women). Men, but not women, who were younger than 60 years experienced significant annual increases in tonsillar SCC incidence during 1973-1995 (2.7% in blacks and 1.9% in whites). No similar increases occurred for oral SCC at non-tonsillar sites. CONCLUSION: Incidence rates of tonsillar SCC vary considerably by sex, race and time in a way that cannot be explained by changes in tonsillectomy practices alone. Changes in environmental risk factors, including changes in smoking patterns and an increase in oral human papillomavirus infections, may have contributed.

Adult↗
PubMed1999

Assessing a public health approach to delay onset and progression of adolescent substance use: latent transition and log-linear analyses of longitudinal family preventive intervention outcomes.

This study examined the effects of the Iowa Strengthening Families Program (ISFP) and the Preparing for the Drug-Free Years program (PDFY) on young adolescent transitions from nonuse of substances to initiation and progression of substance use. Analyses incorporated 3 waves of data collected over a 2.5-year period from 329 rural young adolescents. Outcomes were analyzed by using log-linear models that incorporated substance use status frequencies derived from latent transition analyses. Effects on delayed substance use initiation were shown for both the ISFP and the PDFY at a 2-year follow-up. Also at this follow-up, the PDFY showed effects on delayed progression of use among those previously reporting initiation.

Adolescent↗
PubMed1996

A comparison of current regulations and regulatory guide governing quality control of dose calibrators.

The U.S. Nuclear Regulatory Commission recently amended its regulation governing the calibration of dose calibrators. The changes include (1) the radioactivity of radiopharmaceutical dosages that contain photon-emitting radionuclides has to be measured by a dose calibrator prior to administration to patients and human research subjects; (2) the lower end of the radioactivity limits for linearity testing has been raised to 1.1 MBq (30 microCi) to be consistent with the Nuclear Regulatory Commission Quality Management Program Requirements; and (3) the requirement for signature of the Radiation Safety Officer on the records for accuracy, linearity, and geometry dependence tests has been removed. Although these are practical amendments, further clarification of the new Nuclear Regulatory Commission regulation is required for the following issues: (1) inconsistency in individual's identification requirement for the record keeping (i.e., initials of the individual who performed the constancy check and identity of the operator for the accuracy, linearity, and geometry dependence tests); (2) whether the use of 99mTc is adequate for linearity testing when other radionuclides are being measured in the dose calibrator; and (3) lack of provision for dose calibrator adjustment when conducting the accuracy test. In addition, Nuclear Regulatory Commission Regulatory Guide 10.8 should be revised to become consistent with the Nuclear Regulatory Commission's regulation in order to assist licensees with full compliance of the requirements or recommendations.

Government Agencies↗
PubMed2003

Multi-level determinants of retention in a home-visiting child abuse prevention program.

OBJECTIVE: This exploratory study investigated how attributes from multiple domains influence retention in a voluntary home-visiting child abuse prevention program. METHOD: A sample of 1093 "at-risk" families participated in a home-visiting child abuse prevention program. A total of 71 Family Support Workers (FSWs) provided home visitation services in 12 different communities. Hierarchical general linear modeling (HGLM) was used to examine the community, home visitor, and maternal attributes that predicted retention in the program beyond 1 year. RESULTS: Multi-level analyses (HGLM) revealed significant community, home visitor, and maternal level effects. Families were less likely to remain in a home-visiting child abuse prevention program for at least 1 year if they lived in an area with high community violence. Families were more likely to remain when the home visitor received more hours of direct supervision. Older mothers were more likely to remain for at least 1 year than were younger mothers. Hispanic mothers were more likely to remain than were White non-Hispanic mothers. CONCLUSIONS: These findings demonstrate the utility of looking across multiple levels of influence when examining retention in home-visiting child abuse prevention programs. To increase retention rates home visitors will need to be adaptable to fit the needs of families in violent communities. Supervisors can influence retention rates by providing more hours of direct supervision. Other strategies that may contribute to program retention include meeting the scheduling needs of younger mothers and involving the families of younger mothers more effectively.

Adult↗
PubMed1997

Development of a new algorithm for heat transfer equation in the human body and its applications.

A computer program has been developed for the numerical analysis of thermal conditions within the human body. In this study, a cylindrical model, which consists of internal multi-layers, is adapted for the segment of the human body. For the present concentric cylindrical model we developed a new numerical solution method using a linear combination of the modified Bessel functions. By using the present computer program the internal tissue temperatures, heat fluxes and blood temperatures of the thigh, crus and foot segments are calculated. This paper describes a new algorithm solving heat transfer equation in the human body and the example of calculated results of the combination of thigh, crus and foot segments. The calculated results show the local characteristics of each segment in the human body.

Algorithms↗
PubMed1999

Effects of an entertainment-education radio soap opera on family planning behavior in Tanzania.

An entertainment-education radio soap opera introduced in Tanzania in 1993 was evaluated by means of a field experimental design in which the radio program was broadcast by seven mainland stations of Radio Tanzania. An eighth station broadcast alternative programming from 1993 to 1995, its listenership serving as a comparison area in which contemporaneous changes in family planning adoption were measured. The soap opera was subsequently broadcast nationwide from 1995 to 1997. Data about the effects of the radio soap opera were gathered in five annual surveys of about 2,750 households in the comparison and the treatment areas and from a sample of new family planning adopters in 79 health clinics. The soap opera had strong behavioral effects on family planning adoption; it increased listeners' self-efficacy regarding family planning adoption and influenced listeners to talk with their spouses and peers about contraception.

Adult↗
PubMed1996

A quality assurance program for ancillary high technology devices on a dual-energy accelerator.

Our facility has added high-technology ancillary devices to our dual-energy linear accelerator. After commissioning and acceptance testing of dual asymmetric jaws, dynamic wedge, portal imaging, and multileaf collimation (MLC), quality assurance programs were instituted. The programs were designed to be both periodic and patient specific when required. In addition, when dosimetric aspects were affected by these technologies, additional quality assurance checks were added. Positional accuracy checks (light and radiation) are done for both asymmetric jaws and MLC. Each patient MLC field is checked against the original simulation or digitally reconstructed radiographs. Off-axis factors and output checks are performed for asymmetric fields. Dynamic wedge transmission factors and profiles are checked periodically, and a patient diode check is performed for every new dynamic wedge portal. On-line imaging checks encompass safety checks along with periodic measurement of contrast and spatial resolution. The most important quality assurance activity is the annual review of proper operation and procedures for each device. Our programs have been successful in avoiding patient-related errors or device malfunctions. The programs are a team effort involving physicists, maintenance engineers, and therapists.

Engineering↗
PubMed1991

Pathogenesis and recent therapeutic approaches to graft-versus-host disease.

Effective prophylaxis of acute GVHD should bring about improved patient survival by decreasing severe infections during the first 3 months after transplantation and reducing the incidence of chronic GVHD while not compromising the quality of hematopoietic engraftment or increasing the incidence of leukemic relapse by impairing the graft-versus-leukemia effect. None of the current approaches to prevention of GVHD succeed at meeting these expectations, although postgrafting immunosuppressive therapy comes closest to the ideal. The technique of T cell depletion has been very effective in reducing the incidence of GVHD, but conditioning programs must be developed that will be more successful at eliminating host immune and malignant cells. It is doubtful that this will be achieved with systemic chemotherapy and total body irradiation. Innovative approaches such as the use of monoclonal antibodies, either alone or linked to short-lived radioactive isotopes with short linear energy transfer, promise to result in less toxic but more efficient programs, not only providing better eradication of malignant disease but also ameliorating the problem of graft failure. It is conceivable, however, that it will never be possible to kill all leukemic cells with chemoradiotherapy of any form, and the graft-versus-leukemia effect may be essential. Perhaps in the future it will be possible to distinguish lymphocytes causing the graft-versus-leukemia effect from those causing GVHD, isolate them, and use them in attempts at therapy. In the meantime, postgrafting immunosuppressive drugs are used most frequently to prevent and treat GVHD, and steadily improving survival statistics can be expected.

Bone Marrow Transplantation↗
PubMed2004

Association between patient education and health-related quality of life in patients with Parkinson's disease.

BACKGROUND: Providing patients with disease- and treatment-related information is an important role of medical staff and is now reimbursed in Japan by the national health insurance system under the rubric 'patient education'. Evaluation of the effectiveness of patient education programs is necessary to ensure that limited health care resources are used efficiently. OBJECTIVE: The objective is to determine whether educating patients with Parkinson's disease (PD) is related to better health-related quality of life (HRQOL). DESIGN: A cross-sectional study was conducted. SETTING: Members of the Japan Association of Patients with Parkinson's disease were randomly selected. PARTICIPANTS: A total of 1200 patients with PD were asked to fill in written questionnaires and replies from 762 (63.5%) were analyzed. MEASUREMENTS: The questionnaire inquired about clinical characteristics, comorbidity, symptoms of PD, complications of therapy, HRQOL, and patient education. SF-36 was used to assess HRQOL. The section on patient education comprised one question each on patient-perceived satisfaction with information provided on (1) disease condition and pathophysiology, (2) effectiveness of drug therapy, (3) adverse drug reactions, (4) publicly available financial and social resources, and (5) rehabilitation and daily activities. Patient education score was defined as the sum of the individual scores for these five questions. The relationships between scores on the SF-36 subscales and the patient education score were examined. RESULTS: More satisfaction with patient education was associated with higher scores in all SF-36 subscales except physical functioning and bodily pain. The difference in score between the most satisfied and the least satisfied patients ranged from 8.4 points on the subscales of general health and 16.7 points on the subscale of role limitation due to emotional problems. CONCLUSION: The conclusion that patient education is associated with better HRQOL in patients with PD is drawn.

Aged↗
PubMed2003

The effect of Evercare on hospital use.

OBJECTIVES: To examine the use of hospital and related medical care services of a novel managed care program using nurse practitioners (NPs) and directed specifically at long-stay nursing home residents. DESIGN: Quasi-experimental posttest design with two control groups to minimize selection bias. SETTING: Nursing homes. PARTICIPANTS: Evercare enrollees in five sites were compared with two sets of controls: nursing home residents in the same nursing homes who did not enroll in Evercare (control-in) and residents of nursing homes that did not participate in Evercare (control-out). MEASUREMENTS: Utilization data from Medicare and United Healthcare (the parent corporation for Evercare) were obtained for slightly more than 2 years. Patterns of use were assessed by calculating the monthly use rate for each group and aggregating to form annual rates. Usages addressed included hospital admissions and days, emergency room visits, therapy services, mental health services, and podiatry. Adjustments were made to correct for age, race, and sex. Because the groups differed in terms of the rate of cognitive impairment, the analysis was stratified on this variable. RESULTS: The incidence of hospitalizations was twice as high in control residents as in Evercare residents (4.63 and 4.67 per 100 enrollees per month vs 2.43 in the 15 months after census, P<.001). This difference corresponded to Evercare's use of intensive service days. The same pattern held for preventable hospitalizations (0.80 and 0.86 vs 0.28, P<.001). The pattern held when residents were stratified by cognitive status. On average, using a NP is estimated to save about $103,000 a year in hospital costs per NP. CONCLUSION: The use of active primary care provided by NPs may have prevented the occurrence of some hospitalizable events, but its major effect was allowing cases to be managed more cost-effectively.

Aged↗
PubMed1969

Some experiences in the estimation of parameters in non-linear differential equations.

The author describes a procedure developed by himself and his colleagues for obtaining estimates of the parameters of rate equations, together with information about confidence regions for the estimates. The program has been used successfully for processing results from the chemical engineering industry, with highly non-linear model systems, particularly since temperature was a variable, and the "rate constants" were non-linear combinations of other constants. In biochemical situations, in which investigations are almost always at constant temperature, the non-linearity should not be so extreme, and the procedure may well be capable of dealing with more than 5 to 7 parameters for which it is recommended.

Journal Article↗
PubMed2025

Medical genetics and genomics residency programs: Trends in applications, match rates, and matriculation from 2015 to 2024.

PURPOSE: This report analyzes Medical Genetics and Genomics (MGG) training trends from 2015 to 2024. Understanding such trends is vital for developing targeted recruitment and workforce development initiatives. METHODS: Matriculation data from the American Board of Medical Genetics and Genomics (ABMGG) and publicly available data from the National Resident Matching Program (NRMP) Main Residency and Specialty Matches were reviewed. Descriptive statistics and linear regression analysis were used to compare growth among MGG training pathways and to analyze trends. RESULTS: From 2015 to 2024, there has been a small, but not statistically significant, increase in the total number of individuals who have matched into categorical MGG, combined Pediatrics (Peds)-MGG, and combined Internal Medicine (IM)-MGG residency programs as a whole. This has been driven by an increase in the number of matches to combined Peds-MGG programs. Matriculation into training programs has exceeded the number of matches in categorical MGG as some positions have been filled outside of the NRMP Match. The average match rate for all applicants in categorical MGG (87%) has been higher than that for Peds-MGG (52%). CONCLUSION: Growth in applicants to combined programs and matriculation into residency programs after the NRMP Match has been promising; however, these increases are not enough to fulfill growing workforce demands.

Internship and Residency↗
PubMed1995

Lidocaine adrenaline tetracaine gel versus tetracaine adrenaline cocaine gel for topical anesthesia in linear scalp and facial lacerations in children aged 5 to 17 years.

STUDY OBJECTIVE: The purpose of the present study is to compare LAT gel (4% lidocaine, 1:2000 adrenaline, 0.5% tetracaine) to TAC gel (0.5% tetracaine, 1:2000 adrenaline, 11.8% cocaine) for efficacy, side effects, and costs in children aged 5 to 17 years with facial or scalp lacerations. DESIGN: Randomized, prospective, double-blinded clinical trial. SETTING: Inner-city Emergency Department with an Emergency Medicine residency program. PATIENTS OR OTHER PARTICIPANTS: Children aged 5 to 17 years with linear lacerations of the face or scalp. INTERVENTION: After informed consent was obtained patients had lacerations anesthetized with topical TAC or LAT gel according to a random numbers table. MEASUREMENTS AND MAIN RESULTS: A total of 95 patients were included in the statistical analysis with 47 receiving TAC and 48 receiving LAT. Physicians and patients/parents separately rated the overall pain of suturing using a modified multidimensional scale for pain assessment specifically for children. Patients/parents also stated the number of sutures causing pain. The power of the study to determine a ranked sum difference of 15 was 0.8. Multidimensional rating scale results and number and percentage of sutures causing pain were compared using Wilcoxon's rank sum test. According to patients no difference could be detected in percent of sutures causing pain in the LAT versus TAC group (P = .51). Using the multidimensional scale, physicians and patients/parents found LAT statistically the same as TAC in effectiveness (P = .80 for physicians and P = .71 for patients). Cost per application was $3.00 for LAT compared to $35.00 for TAC. Follow-up was accomplished in 85 of 95 participants in the study with no reported complications for either medication. CONCLUSION: LAT gel worked as well as TAC gel for topical anesthesia in facial and scalp lacerations. Considering the advantages of a noncontrolled substance and less expense, LAT gel appears to be better suited than TAC gel for topical anesthesia in laceration repair in children.

Adolescent↗
PubMed2006

The effects of two different incentives on recruitment rates of families into a prevention program.

This study experimentally manipulated two incentives for participation (monetary: paid participation for sessions and setting: group vs. individual) in a child behavior problem prevention program to analyze their effects on recruitment and retention of families. A population of 690 eligible families from 15 preschools located in socially disadvantaged neighborhoods was invited to participate in a parent training (PT) program. The study recruited parents by using advertisements that had information describing only the indicated condition (i.e., PT in group-unpaid, or PT individual-unpaid, or PT in group-paid, or PT individual-paid). Results demonstrate significant impact of payment on recruitment and initial attendance. Training setting alone (individual or group) did not significantly influence these rates. Editors' Strategic Implications: A compelling case is made for the utility of monetary incentives to increase proportions of low-income families in prevention research and programs. Evaluators and program designers should note the impressive use of the experimental design and hierarchical linear modeling to test the effects on recruitment.

Adolescent↗
PubMed1994

A program for analyzing enzyme rate data obtained from a microplate reader.

A computer program (microplate analysis [MPA] program) is described that allows manipulation of kinetic data obtained from a microplate reader. It is particularly useful for obtaining enzyme velocities from microplate data. Data can be displayed either as an 8 x 12 grid which shows all microplate wells at low resolution or as single enzyme progress curves which show the reaction time course in greater detail and allow data manipulation (single curve mode). In the single curve mode, the X-axis of the progress curves can be displayed either as discrete time points numbered from the first to the last or as real time in seconds. The program can calculate the maximum, minimum or initial reaction rate by either linear or robust regression. In the single curve mode, the user can control the range of data points included in the regression analysis and the number of data points over which the rate is averaged. In this way, the maximum (or minimum) rate within a specific range of data can be determined. The major advantage of the MPA program is that the range settings are specific to each well. This gives the user complete control over the presentation and calculation of the kinetic data. The MPA program requires an AS-CII file containing data blocks of 96 sequential absorbance readings for each time point and the time interval between successive absorbance readings.

Calibration↗
PubMed1999

Rasch analysis of the Western Ontario MacMaster questionnaire (WOMAC) in 2205 patients with osteoarthritis, rheumatoid arthritis, and fibromyalgia.

OBJECTIVE: Advances in health measurement have led to the application of Rasch Item Response Theory (IRT) analysis (Rasch analysis) to evaluate instruments measuring health status and quality of life of patients, including the Health Assessment Questionnaire and SF-36. This study investigated the extent to which the Western Ontario MacMaster osteoarthritis questionnaire (WOMAC) satisfies the Rasch model, particularly in respect to unidimensionality, item separation, and linearity. METHODS: The study included a total of 2205 patients, 1013 with rheumatoid arthritis (RA), 655 with osteoarthritis of the knee or hip (OA), and 537 with fibromyalgia. All patients completed the WOMAC as part of a longitudinal study of rheumatic disease outcomes. To examine whether the WOMAC pain and function scales each fits the Rasch model, the Winsteps program was used to assess item difficulty, scale unidimensionality, item separation, and linearity. RESULTS: Although the WOMAC worked best in OA, regardless of disorder, both the pain and function scales were unidimensional, had adequate item separation, and had a long range (25-150) of linearity in the function scale. Several functional items, however, had a high information weight fit (INFIT) statistic, indicating poor fit to the model. These items included "getting in and out of the bath" and "going down stairs." CONCLUSION: The WOMAC generally satisfies the requirements of Rasch item response theory across all disorders studied, and is an appropriate measure of lower body function in OA, RA and fibromyalgia. Although some individual items do not fit well, it is not likely that removing such items would result in more than overall minimal differences, and it will be difficult to remove traces of multidimensionality while keeping the central constructs of progressive lower body musculoskeletal abnormality intact. In addition, it is possible that a "purer", still more unidimensional instrument would be less useful in clinical trials and epidemiological studies by restricting the range of the scale.

Activities of Daily Living↗