Dimensional relationships between the sphenoid sinus, maxillary sinuses and other craniomaxillofacial structures using cone-beam computed tomography analysis.

Introduction: The study investigated dimensional relationships between the sphenoid and maxillary sinuses and other selected craniomaxillofacial structures by using traditional cephalometric and volumetric procedures based on cone beam computed tomographic (CBCT) data. Methods and Materials: A retrospective three-dimensional (volumetric) and two-dimensional (conventional cephalometric) analyses were conducted on CBCT datasets of 27 subjects who met the inclusional criteria from a sampled database of 2,290 individuals. Subjects were divided into 3 groups: (1) pre- fused spheno-occipital synchondrosis \u3c 18 years (n=8), (2) fused spheno-occipital synchondrosis \u3c 18 years (n=9), and (3) = 18 years with fused spheno-occipital synchondosis (n= 10). Results: Differences between studied groups were found for linear and angular measurement. Specific correlations were found between certain topographic and internal measurements, and some sinus dimensions and other selected craniomaxillofacial structures. Conclusion: Dimensional correlations exist between the sphenoid and maxillary sinuses and development of other selected craniomaxillofacial structures

Microgravity strategic planning exercise

The Center for Space and Advanced Technology supported a planning exercise for the Microgravity Program management at the Marshall Space Flight Center. The effort focused on the status of microgravity work at MSFC and elsewhere with the objective of preparing a goal-oriented strategic planning document which could be used for informational/brochure purposes. The effort entailed numerous interactions and presentations with Field Center programmatic components and Headquarters personnel. Appropriate material was consolidated in a draft format for a MSFC Strategic Plan

Can Emergency Medicine Residents Reliably Use the Internet to Answer Clinical Questions?

<p>Introduction: The study objective was to determine the accuracy of answers to clinical questions by emergency medicine (EM) residents conducting Internet searches by using Google. Emergency physicians commonly turn to outside resources to answer clinical questions that arise in the emergency department (ED). Internet access in the ED has supplanted textbooks for references because it is perceived as being more up to date. Although Google is the most widely used general Internet search engine, it is not medically oriented and merely provides links to other sources. Users must judge the reliability of the information obtained on the links. We frequently observed EM faculty and residents using Google rather than medicine-specific databases to seek answers to clinical questions. Methods: Two EM faculties developed a clinically oriented test for residents to take without the use of any outside aid. They were instructed to answer each question only if they were confident enough of their answer to implement it in a patient-care situation. Questions marked as unsure or answered incorrectly were used to construct a second test for each subject. On the second test, they were instructed to use Google as a resource to find links that contained answers. Results: Thirty-three residents participated. The means for the initial test were 32% correct, 28% incorrect, and 40% unsure. On the Google test, the mean for correct answers was 59%; 33% of answers were incorrect and 8% were unsure. Conclusion: EM residents’ ability to answer clinical questions correctly by using Web sites from Google searches was poor. More concerning was that unsure answers decreased, whereas incorrect answers increased. The Internet appears to have given the residents a false sense of security in their answers. Innovations, such as Internet access in the ED, should be studied carefully before being accepted as reliable tools for teaching clinical decision making. [West J Emerg Med. 2011;12(4):442–447.]</p

Economic burden prior to COPD diagnosis: A matched case-control study in the United States

BACKGROUND: In the United States, chronic obstructive pulmonary disease (COPD) diagnosis is often a lengthy process, and consequently results in delays in treatment in early stages. Disease progression and complication may result in increased levels of healthcare service use. To understand the economic burden of COPD prior to diagnosis in the U.S., trends in utilization and costs during the period before initial COPD diagnosis were compared with matched controls. METHODS: A retrospective case-control study was conducted using medical and pharmacy claims data from a large managed care health plan representing a base population of over 30 million covered lives in the U.S. COPD patients with at least 12 months of continuous enrollment and aged 40 years or older were identified (n=28,968) and matched to up to three random controls (n=81,322) by age, gender, region of plans and index date. Multivariate regression models were used to estimate average incremental service use and cost between COPD patients and controls. Moreover, trends in utilization and costs for the COPD patients were examined over 36 months before diagnosis. RESULTS: COPD patients used 1.5-1.6 times more inpatient/emergency department (IP/ED) services and office visits compared to control patients. The average incremental annual costs for IP/ED services, office visits, and medical and pharmacy services were estimated at $550,$238, $1438 and$401, respectively, after adjusting for age, gender, region and comorbid conditions. The 36-month trend analysis showed that COPD patients' healthcare utilization and costs increased gradually over time, often with a marked increase in the month before COPD diagnosis. CONCLUSIONS: COPD patients in the U.S. consumed substantial healthcare services and costs prior to diagnosis. More timely diagnosis and subsequent treatment may avoid costly healthcare utilization and unnecessary mortality and morbidity post-diagnosis

Infrared Instrumentation and Astronomy

Contains research objectives and summary of research on five research projects.Joint Services Electronics Program (Contract DAAB07-76-C-1400)M.I.T. Sloan Fund for Basic ResearchNational Aeronautics and Space Administration (Contract NAS5-23731)National Aeronautics and Space Administration (Grant NGR 22-009-526