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Biomedical subjects

J Crandall

Publications and source records attributed to J Crandall.

10 recordsLinked to original sources
PubMed2004

Pedestrian crashes: higher injury severity and mortality rate for light truck vehicles compared with passenger vehicles.

INTRODUCTION: During the last two decades changes in vehicle design and increase in the number of the light truck vehicles (LTVs) and vans have led to changes in pedestrian injury profile. Due to the dynamic nature of the pedestrian crashes biomechanical aspects of collisions can be better evaluated in field studies. DESIGN AND SETTING: s: The Pedestrian Crash Data Study, conducted from 1994 to 1998, provided a solid database upon which details and mechanism of pedestrian crashes can be investigated. RESULTS: From 552 recorded cases in this database, 542 patients had complete injury related information, making a meaningful study of pedestrian crash characteristics possible. Pedestrians struck by LTVs had a higher risk (29%) of severe injuries (abbreviated injury scale >/=4) compared with passenger vehicles (18%) (p = 0.02). After adjustment for pedestrian age and impact speed, LTVs were associated with 3.0 times higher risk of severe injuries (95% confidence interval (CI) 1.26 to 7.29, p = 0.013). Mortality rate for pedestrians struck by LTVs (25%) was two times higher than that for passenger vehicles (12%) (p<0.001). Risk of death for LTV crashes after adjustment for pedestrian age and impact speed was 3.4 times higher than that for passenger vehicles (95% CI 1.45 to 7.81, p = 0.005). CONCLUSION: Vehicle type strongly influences risk of severe injury and death to pedestrian. This may be due in part to the front end design of the vehicle. Hence vehicle front end design, especially for LTVs, should be considered in future motor vehicle safety standards.

Abbreviated Injury Scale↗
PubMed2000

Rib fracture patterns and radiologic detection--a restraint-based comparison.

This paper presents a study of the rib fracture patterns generated in simulated frontal collisions and the visibility of the rib fractures on plain film radiographs. Using 29 cadaver subjects, rib fractures were identified on oblique, lateral, and anteroposterior chest films by five radiologists independently and were compared with fractures found during a detailed necropsy. Physical, geometric, and experimental factors demonstrated an influence on the ability of a radiologist to identify rib fractures on an x-ray. Specifically, the restraint system configuration, the total number of fractures, the circumferential location of the fracture, the rib number, and the aspect (right or left) affected fracture identification. The results verify that torso belt loading produces rib fractures generally located along the path of the belt whereas superimposed airbag loading results in a more distributed and posterolateral fracture pattern. A higher proportion of rib fractures was identified on x-ray for occupants restrained by only a belt (44% of fractures) than for occupants restrained by both a belt and an airbag (24% of fractures). Overall, less than 40% of the rib fractures were detected upon an initial examination of radiographs. After being provided with the location of all fractures, detection increased to 49%. On average, occult rib fractures resulted in an average underreporting of injury severity of more than one AIS level.

Acceleration↗
PubMed1999

Baseball hardness as a risk factor for eye injuries.

BACKGROUND: Baseball is the leading cause of sports-related eye injuries in young persons. It is known that softer baseballs reduce the potential for brain and cardiac injury, but it has been speculated that softer baseballs may increase eye injuries by intruding more into the orbit. It also has been claimed that softer baseballs would change the "feel" of the game. OBJECTIVES: To determine the orbital intrusion and eye injury potential of baseballs of varying hardness, and whether a player can feel the difference between these different baseballs. MAIN OUTCOME MEASURES: Orbital force and penetration of baseballs of various hardness into an artificial orbit. Ability of subjects of varying age and baseball experience to determine the hardness of baseballs. RESULTS: The peak orbital force and force onset rate from softer baseballs, at all impact velocities, were less than the force and force onset rate from baseballs that had hardness equal to, or greater than, major league baseballs. The softest (10% of major league hardness) baseballs intruded into the orbit significantly more than balls that were 15% of major league hardness or harder. Children younger than 14 years could not differentiate balls 15% of major league hardness or harder, and adults could not differentiate 20% of major league hardness or harder from each other or from major league balls. CONCLUSION: The potential for injury to the unprotected eye from soft baseballs is significant, but not greater than that from a major league baseball. Baseballs that are 15% to 20% of major league ball hardness are recommended for youth baseball because these balls feel like major league balls, reduce the potential for brain injury and commotio cordis, cause less pain on impact, and do not increase the potential for eye injury to the unprotected player. Eye injuries in youth baseball could be minimized by the use of protective eyewear that conforms to the standard specifications of the American Society of Testing and Materials (Philadelphia, Pa), standards F910 (for batters and baserunners) and F803 (for fielders).

Adolescent↗
PubMed1996

Elevated plasma levels of vascular cell adhesion molecule-1 (VCAM-1) in diabetic patients with microalbuminuria: a marker of vascular dysfunction and progressive vascular disease.

Advanced glycation endproducts (AGEs), which accumulate in diabetic vasculature, result in enhanced expression of endothelial cell-associated vascular cell adhesion molecule-1 (VCAM-1) as well release of a soluble form of VCAM-1 (sVCAM-1) into culture supernatants. We hypothesized that sVCAM-1 in diabetic plasma might reflect early vascular perturbation in diabetic vasculopathy. Diabetic patients with microalbuminuria, a group with a high incidence of vascular complications, had increased plasma levels of sVCAM-1, approximately 1.5-fold greater than diabetic patients without microalbuminuria; P < 0.05. sVCAM-1 may be an indicator of ongoing cellular dysfunction in diabetes, as well as a dynamic surrogate marker for the effectiveness of therapeutic interventions.

Albuminuria↗
PubMed1996

Life domains and adaptive strategies of a group of low-income, well older adults.

Older adults are at increased risk for a variety of physical and functional limitations that threaten their ability to lead independent and fulfilling lives. Consequently, they stand to benefit from personalized strategies of adaptation that enable them to achieve successful outcomes in their daily activities and desired goals. In the current investigation, a qualitative descriptive methodology was used to document the perceived life domains of importance and associated strategies of adaptation of 29 residents of Angelus Plaza, a federally subsidized apartment complex in downtown Los Angeles for low-income, well older adults. On the basis of interview data, 10 life domains were identified, and within each domain, a typology of adaptive strategies was derived. The domains were activities of daily living (ADL), adaptation to a multicultural environment, free time usage, grave illness and death-spirituality, health maintenance, mobility maintenance, personal finances, personal safety, psychological well-being and happiness, and relationships with others. Although the typology should not be generalized to a geriatric population, therapists may wish to refer to it to gain a sense of the extent to which certain adaptive strategies may be applicable to the lives of particular older adults to whom they deliver services. The teaching of these adaptive strategies could then be incorporated into an individualized treatment plan. The typology also provides a broad picture of the kinds of adaptive strategies used by the older adults as a way of coping and adapting to their setting. Although some of the domains do not differ from those typically addressed in occupational therapy textbooks on geriatric care (e.g., ADL, health maintenance), others seem uniquely tailored to the specifics of the Angelus Plaza context (e.g., personal safety). Finally, certain domains emerged that may be highly relevant to older adults in most settings but are not typically the focus of occupational therapy programs (e.g., grave illness and death-spirituality, relationships with others). The emergence of these domains from our data suggests that therapists may wish to consider them more in treatment if they are convinced that they possess local relevance.

Activities of Daily Living↗
PubMed1995

Advanced glycation endproducts interacting with their endothelial receptor induce expression of vascular cell adhesion molecule-1 (VCAM-1) in cultured human endothelial cells and in mice. A potential mechanism for the accelerated vasculopathy of diabetes.

Vascular cell adhesion molecule-1 (VCAM-1), an inducible cell-cell recognition protein on the endothelial cell surface (EC), has been associated with early stages of atherosclerosis. In view of the accelerated vascular disease observed in patients with diabetes, and the enhanced expression of VCAM-1 in diabetic rabbits, we examined whether irreversible advanced glycation endproducts (AGEs), could mediate VCAM-1 expression by interacting with their endothelial cell receptor (receptor for AGE, RAGE). Exposure of cultured human ECs to AGEs induced expression of VCAM-1, increased adhesivity of the monolayer for Molt-4 cells, and was associated with increased levels of VCAM-1 transcripts. The inhibitory effect of anti-RAGE IgG, a truncated form of the receptor (soluble RAGE) or N-acetylcysteine on VCAM-1 expression indicated that AGE-RAGE-induced oxidant stress was central to VCAM-1 induction. Electrophoretic mobility shift assays on nuclear extracts from AGE-treated ECs showed induction of specific DNA binding activity for NF-kB in the VCAM-1 promoter, which was blocked by anti-RAGE IgG or N-acetylcysteine. Soluble VCAM-1 antigen was elevated in human diabetic plasma. These data are consistent with the hypothesis that AGE-RAGE interaction induces expression of VCAM-1 which can prime diabetic vasculature for enhanced interaction with circulating monocytes.

Animals↗
PubMed1986

Genetic analysis of cystic fibrosis: linkage of DNA and classical markers in multiplex families.

Linkage of cystic fibrosis (CF) to DNA and classical markers was studied in 36 families of two or three generations with at least two living affected children. Among the 79 affected children, no recombinants were detected between the disease and the markers MET and pJ3.11, previously shown to be linked to CF. No linkage between the human trypsin gene family (which appears to include at least 10 members) and CF was found, although not all genes of the trypsin family have been screened yet. In one of the CF families, recombination between MET and pJ3.11 was detected in an unaffected sib. Data from our families suggest that the gene order of markers among chromosome 7q is: (7cen;p8.33)collagen(COL1A2);DOCR1-917;paraoxonase+ ++(PON);(MET-cf-J3.11);T-cell receptor beta chain (TCRB);qter. There was no evidence for (or against) either postzygotic selection or meiotic drive to explain the high frequency of CF in Caucasian populations.

Cystic Fibrosis↗
PubMed1975

Relations among psychosocial development, locus of control, and time orientation.

The research concerned relations among development at Erikson's first six stages of psychosocial development, locus of control, and several measures of time orientation. The investigation involved 68 female and 65 male high school and university students. Development at Erikson's Stages 1,3, 4, and 5 was significantly related to the I-E Scale, with positive development being associated with internal control. Locus of control was also related to sex and age. Women were found to be more externally controlled than men. Internal control was associated with increasing age over the range from 15 to 25 years. Development at each of Erikson's first five stages was significantly correlated with one or more measures of tempiral relatedness, or integration of perceived past, present, and future time zones. Other measures of time orientation failed to show consistent relations to psychosocial development.

Adolescent↗
PubMedDate not supplied

Computer-assisted diabetes nutrition education increases knowledge and self-efficacy of medical students.

Medical students and physicians need to improve their understanding of the role of nutrition and the multidisciplinary team in diabetes care. To assist in this learning, an interactive computer program was developed that focused on prescribing diets for patients with diabetes. Parallel 10-item knowledge tests and an 8-item self-efficacy scale were used to evaluate the efficacy of the computer program among 41 third-year medical students. Mean knowledge scores increased significantly after using the computer program. Posttest knowledge scores for the medical students approached the level achieved by general practice dietitians with no diabetes specialty training. Mean self-efficacy scores increased significantly. The mean time spent on the educational component of the program was under 30 minutes. Computer-assisted diabetes nutrition education proved to be an efficient and effective method for teaching basic nutrition competencies to medical students. This program is available on the World Wide Web (http:/(/)medicine.aecom.yu.edu/diabetes/DEC.htm ) and may be a useful means for providing basic diabetes nutrition education to primary healthcare providers from a variety of disciplines as well as for medical students.

Computer-Assisted Instruction↗