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PubMedDate not supplied

Computer-aided semen analysis variables as predictors of male fertility potential.

A computer-aided semen analysis (CASA) was used to allow digitizing the motion of the spermatozoon. This procedure allows an objective means of judging semen quality, especially the translational movements of spermatozoa. Forty-three couples were included in the study. The average age of the male was 35.5 +/- 4.7 years and that of the female was 32.7 +/- 4.7 years. The average duration of infertility was 3.8 +/- 2.3 years. Using multiple linear regression analysis of 26 prognostic variables, a cluster of 8 variables significantly predicted pregnancy maximally. The 8 variables and the resultant multiple correlation coefficients were used to generate a multiple regression equation which allowed the correct separation of the population into fertile and infertile couples. The mean pregnancy predictor values of the fertile and infertile populations were significantly different using the analysis of variance.

Adult↗

PubMed1986

BMDP program for piecewise linear regression.

Piecewise linear regression has potentially broad applications in medical data analysis as well as other types of regression. Various kinds of algorithms have been proposed for finding optimum piecewise linear regressions. This paper presents a BMDP program for obtaining near optimum piecewise linear regression equations. An idea intrinsic to the method is that restricting parameter space to a discrete set makes the difficult problems become standard problems. Any software having the variable selection feature in the multiple linear regression can be used to apply the method.

Computers↗

PubMedDate not supplied

[Factors influencing variability of PSA blood concentration in patients with prostate benign hyperplasia].

Study conducted in 107 patients with prostate benign hyperplasia to establish the influence that prostate volume, age, sexual activity, extent of obstruction and presence of urethral catheter have on PSA serum levels, using a linear regression model. In simple linear regression studies, a good correlation was seen between PSA serum concentration and prostate volume calculated by transrectal ultrasound (r = 0.57), which decreases when age in used as an independent variable (r = 0.40). In multiple linear regression studies where all the variables are included, correlation increases slightly (r = 0.60), and only prostate volume and sexual activity are significant. Prostate volume in the single most influential factor on PSA levels in prostate benign hypertrophy although it is not the only parameter to be taken into account in serum level variations of this marker. Age influence can be secondary to other factors such as sexual activity.

Aged↗

PubMed1979

Modulation of the in vivo covalent binding of the carcinogen benzo(a)pyrene to rat liver DNA by selective induction of microsomal and nuclear aryl hydrocarbon hydroxylase activity.

The influence of microsomal (mAHH) and nuclear (nAHH) aryl hydrocarbon hydroxylase activity on the covalent binding of tritiated benzo(a)pyrene to rat liver DNA was evaluated in vivo. Induction of mAHH was obtained after phenobarbitone treatment (180% of control), which increased DNA binding to 210%, but left the nAHH unchanged. mAHH and nAHH were slightly induced with dieldrin (130% and 120%), but the binding remained unchanged. The increasing effect of mAHH as well as the possibly decreasing effect of nAHH induction on the binding became obvious when the data of 11 individual rats were used to solve the equation Binding = aX(mAHH) + bX(nAHH) + c. Multiple linear regression analysis resulted in positive values for a and c, a negative value for b, and a multiple correlation coefficient R = 0.82. An influence of other enzymes involved in the metabolism of benzo(a)pyrene cannot be excluded. The study shows clearly that the binding of a foreign compound to DNA in vivo is not only dependent on microsomal enzyme activities but also on nuclear activities even if the latter are considerably lower than those of microsomes.

Animals↗

PubMed1999

Correlation of activity of 2-(X-benzyloxy)-4,6-dimethoxyacetophenones with topological indices and with the Hansch equation.

The antispasmodic activities of the 2-(X-benzyloxy)-4,6-dimethoxyacetophenones (X = H, 4'-F, 4'-NO2, 4'-CH3, 4'-Cl, 3',4'-(CH3)2, 4'-OCH3, 4'-Br, 4'-C(CH3)3, 4'-OCH2C6H5) against acetylcholine-induced contraction of the guinea pig ileum were correlated with different topological indices. Good correlations were obtained through a simple regression equation with electrotopological state indices (Si) for the carbon atoms S(C1) and S(C6). Using multiple linear regression with two variables the best correlations were obtained with carbons in the 6- and 1-positions with sigma. Such results indicate that the corresponding carbon atoms play an important role in the biological activity. The equation of Hansch showed that the activity of these compounds increases when the ring substituent in the benzyloxy group are more highly electron-releasing and hydrophobic.

Acetophenones↗

PubMed1990

Biometry of the posterior lens capsule: a new method to predict pseudophakic anterior chamber depth.

The distance between the anterior corneal vertex and the posterior lens capsule was measured in 60 eyes before and three months after extracapsular cataract extraction with implantation of a posterior chamber lens. The preoperative capsule position ranged from 6.15 mm to 8.60 mm and averaged 7.64 +/- 0.47 mm (+/- SD). All posterior lens capsules had moved anteriorly following surgery. The postoperative capsule position ranged from 4.31 mm to 5.53 mm and averaged 4.93 +/- 0.29 mm. The postoperative capsule position could be predicted by the following optimized multiple linear regression equation: 2.4 + 0.011 x patient age + 0.171 x anterior chamber depth + 0.051 x axial length. The multiple correlation coefficient was 0.48. The postoperative anterior depth could be predicted with a correlation coefficient of 0.61 by subtracting both the averaged value of the clinical "laser space" and the exact central implant thickness from the estimated position of the posterior lens capsule. We suggest that this principle for predicting the postoperative anterior chamber depth may be useful for a number of lenses with different designs.

Adult↗

PubMed2004

The effect of maintenance immunosuppression medication on the change in kidney allograft function.

BACKGROUND: The optimum maintenance immunosuppression regimen for kidney transplant recipients is uncertain. In this study we determined the effect of maintenance immunosuppression medications on the rate of kidney allograft function loss defined by the annualized change in glomerular filtration rate (GFR). METHODS: We studied 40,963 first kidney only transplant recipients between 1987 and 1996 with allograft survival of at least two years in the United States Renal Data System. Linear regression methods were applied to serial GFR estimates after transplantation to determine the annualized change in GFR. Patients were classified according to the type of maintenance calcineurin and purine metabolism inhibitor received after transplantation. Multiple linear regression was used to determine the independent effect of maintenance immunosuppression medications on the annualized change in GFR (mL/min/1.73m2/year). RESULTS: Compared to patients who received cyclosporine microemulsion (Neoral), a slower decline in GFR was observed in tacrolimus-treated patients (1.60 mL/min/1.73m2/year, 95% CI 1.22-1.97, P < 0.001) and patients who did not receive calcineurin inhibitors (0.82 mL/min/1.73m2/year, 95% CI 0.08-1.56, P= 0.03). In contrast, compared to compared to patients who received Neoral, a faster decline in GFR was observed in patients who received the original oil-based formulation of cyclosporine (Sandimmune) (-0.16 mL/min/1.73m2/year, 95% CI -0.003 to -0.32, P= 0.04) and patients with unknown calcinuerin inhibitor exposure (-2.11 mL/min/1.73m2/year, 95% CI -2.27 to -1.95, P < 0.001). Compared to patients who received azathioprine, patients who received mycophenolate mofetil (MMF) had a slower decline in GFR (0.61 mL/min/1.73m2/year, 95% CI 0.14-1.08, P= 0.01) and patients with unknown purine metabolism inhibitor exposure had a faster decline in GFR (-0.61 mL/min/1.73m2/year, 95% CI -0.75 to -0.47, P < 0.001.) In a subgroup analysis of patients who received a transplant after 1993, the decline in GFR was slower for tacrolimus compared to neoral treated patients (1.64 mL/min/1.73m2/year, 95% CI 1.15-2.14, P < 0.001) but was not different for MMF compared to azathioprine-treated patients (0.24 mL/min/1.73m2/year, 95% CI -0.38-0.85, P= 0.45). CONCLUSION: Tacrolimus and MMF were the calcineurin inhibitor and purine metabolism inhibitor associated with the most favorable effects on rates of change in allograft function. Because most transplant recipients establish a low baseline level of allograft function, the effect of immunosuppression medication on GFR decline should be considered when selecting a maintenance immunosuppression regimen.

Adolescent↗

PubMed2005

Correlation of cell-mediated immunity against porcine reproductive and respiratory syndrome virus with protection against reproductive failure in sows during outbreaks of porcine reproductive and respiratory syndrome in commercial herds.

OBJECTIVE: To determine whether cell-mediated immunity against porcine reproductive and respiratory syndrome (PRRS) virus is correlated with protection against reproductive failure in sows during clinical outbreaks of PRRS in commercial herds. DESIGN: Outbreak investigation in 4 swine breeding herds. ANIMALS: 97 sows. PROCEDURES: On each farm, blood samples were collected from sows with clinical signs (abortion or increased fetal death; case sows) and from clinically normal sows (control sows). The intensity of the cell-mediated immune (CMI) response was determined by use of an interferon-gamma enzyme-linked immunospot (ELISPOT) assay. Multiple logistic regression analyses and t tests were used to compare ELISPOT assay values between case and control sows. Multiple linear regression was used to investigate associations between cell-mediated immunity and the magnitude of clinical signs. RESULTS: In 2 farms, case sows had lower ELISPOT assay values than control sows. A negative association between the intensity of the CMI response and the number of pigs born dead per litter was detected on 1 farm. In 1 farm, no association was detected between the intensity of the CMI response and protection against reproductive failure. CONCLUSIONS AND CLINICAL RELEVANCE: Evidence that a strong CMI response was correlated with protection against clinical PRRS was detected in 3 of 4 farms. However, farms and sows within farms varied considerably in their immune responsiveness and in the degree to which they were protected clinically. Increasing cell-mediated immunity within infected herds has the potential to decrease clinical reproductive disease, but only if the sources of intra- and interfarm variation in the intensity of cell-mediated immunity to PRRS virus can be identified.

Abortion, Veterinary↗

PubMedDate not supplied

Review of the development, validation, and application of predictive instruments in interventional cardiology.

Within the last few years, risk assessment has become an integral part of clinical practice, particularly for thoracic surgery and interventional procedures. Risk assessment statistical models are being used in medical decision making, quality improvement tools, and as aids to patient counseling. This literature review was conducted to evaluate the types of predictive models and outcomes measures that have been examined, and methods used in development, validation, and application of these models. A Medline search performed to identify articles (limited to human studies) published in English from 1980 to 1999 resulted in 89 articles, of which 71 were evaluable. Populations studied for model development included patients undergoing coronary artery bypass graft (CABG), percutaneous transluminal coronary revascularization (PTCR), cardiac catheterization, or stenting procedures and patients with angina or stroke. The models were equally developed from a single center versus multicenter and from retrospective databases versus prospective studies. In terms of model perspectives, only three of the models measured cost or cost-effectiveness as the outcome; the remainder considered only clinical outcomes. The most commonly reported types of predictive models were developed using logistic regression and Bayesian techniques, followed by neural networks, rule-based artificial intelligence, simultaneous equation system, and multiple linear regression. Factors to consider when developing or evaluating a predictive model include uniformity of definitions of outcomes, uniformity of definitions of variables, completeness of data, number and frequency of variables, timeliness and source of data, development population characteristics, development and testing (validation) cohorts, and calibration and discrimination. Application of these models to an individual patient can spur quality improvement efforts that can lead to dramatic, system-wide improvements in outcomes.

Cardiovascular Diseases↗

PubMedDate not supplied

Relationship between throwing mechanics and elbow valgus in professional baseball pitchers.

Valgus elbow stress leads to medial tension and lateral compression injuries in baseball pitchers of all ages. This study was undertaken to investigate the relationship between elbow stress in professional baseball pitchers and the kinematic parameters of pitching mechanics. This was done in an attempt to understand valgus extension overload better and in an effort to improve preventive and rehabilitative protocols. High-speed video data were collected on 40 professional pitchers in game situations during the 1998 and 1999 Cactus League season in Arizona, as part of Major League Baseball Spring Training. A multiple linear regression analysis was used to relate elbow valgus to kinematic parameters of pitching mechanics. The resulting analysis produced an adjusted multiple R2 value of 0.974, indicating that nearly 100% of the variance in valgus stress on the elbow was explained by the parameters in the regression equation. This ability to explain over 97% of the variance in valgus stress is significant. The parameters of pitching mechanics related to elbow valgus may be assessed and optimized, if necessary, in order to decrease the magnitude of elbow stress in pitching.

Adult↗

PubMed1996

A method for predicting the utilization of medical technology in neonatal care.

The utilization of 12 neonatal intensive care technologies was recorded in 193 patients. An index of utilization (Pu) was adopted to classify these technologies into three sub-groups corresponding to low (Pu < 15%), medium (15% < or = Pu < or = 85%), and high (Pu > 85%) intensity of use. No models were developed for technologies with high intensity of use (intravenous hydration, warming, micro-haematocrit, heart rate monitoring). Multiple linear regression was used to predict the utilization of technologies with medium intensity of use (gasometry, oxygen hood, CPAP, mechanical ventilation), and multiple logistic regression was used with the same purpose for technologies with low intensity of use (exchange transfusion, bicarbonate, adrenaline, echocardiography). Both methods yielded significant models (P < 0.05) which can be used to improve planning and management of technology in neonatal intensive care units.

Adolescent↗

PubMed1994

Temporal, kinematic, and kinetic variables related to gait speed in subjects with hemiplegia: a regression approach.

BACKGROUND AND PURPOSE: The gait speed that a patient selects is a well-known indicator of overall gait performance. The purpose of this study was to use multiple linear regression to assess the strength of association of temporal, kinematic, and kinetic gait variables with high walking speeds in patients with hemiplegia. SUBJECTS: Thirty-two subjects (20 male, 12 female) with an average age of 61 years took part in a sagittal-plane gait study of both sides of the body. METHODS: Data from cinematographic film and a force plate obtained during multiple walking trials were used in a seven-segment link-segment kinetic model of the walking subject to yield temporal, kinematic, and kinetic variables. RESULTS: Variables correlating significantly with self-selected speed included the maximum hip extension angle and the maximum hip flexion moment on the affected side, and the maximum ankle and hip powers on both sides. A stepwise regression identified variables most useful in predicting stride speed. For the affected side, these variables were the hip flexion moment, the ankle moment range, the knee moment range, and the proportion of double support. Together these variables explained 94% of the variation in gait speed. On the unaffected side, the variables were the percentage of stance phase, the maximum ankle power (push-off), and the maximum hip power (pull-off). They explained 92% of the variation in gait speed. CONCLUSION AND DISCUSSION: These results suggest that experimental studies are needed to assess the effects of treatment aimed at increasing ankle power and hip power and at decreasing the stance time on the affected side, and that these studies should be directed at obtaining a larger hip flexion moment and a larger ankle moment range on the unaffected side.

Adult↗

PubMed2005

Prediction of thoracic dimensions and spine length based on individual pelvic dimensions in children and adolescents: an age-independent, individualized standard for evaluation of outcome in early onset spinal deformity.

STUDY DESIGN: A retrospective review of spine, chest, and pelvic dimensions of normal CT scans from 1999 to 2004 was performed. OBJECTIVE: To determine age-independent predictors of spine and chest dimensions. SUMMARY OF BACKGROUND DATA: Progressive thoracic deformity is associated with early-onset spinal deformities. Patients with severe early-onset scoliosis are commonly smaller and slower to grow than normal. Newer treatment approaches emphasize spine length and chest growth. Assessing treatment outcomes is hampered by the lack of normal values appropriate for diseased children. This study establishes normal range standards of chest and spine dimensions to aid in assessment of treatment outcomes. METHODS: A total of 198 CT scans of previously healthy patients 0 to 21 years of age were measured. Measurements taken from CT scans include maximum inner chest width, anteroposterior chest depth, thoracic spine height, lumbar spine height, total spine height, and pelvic inlet width. Linear regression was applied to establish gender-specific reference ranges for spine and chest dimensions based on pelvic width. RESULTS: Chest and spine dimensions were significantly correlated with pelvic inlet width and gender (P < 0.001). Multiple linear regression indicated that pelvic inlet width provided excellent fit in establishing gender-specific normal ranges independent of age. CONCLUSION: Pelvic inlet width is an age-independent predictor of pediatric chest width and thoracic dimensions that may be used to assess thoracic and spine growth in early onset spine deformity patients.

Adolescent↗

PubMed1998

Office and laboratory blood pressures as predictors of daily blood pressure level in normotensive subjects and borderline and mild hypertensive subjects.

A series of standardized laboratory tests [10 min sitting and supine, 9 min standing, dynamic; cycle ergometer (ERG) and isometric exercise; handgrip (HG)] were performed during intra-arterial blood pressure (BP) recording in 97 healthy unmedicated men, initially classified as normotensive (NT, n = 34), borderline hypertensive (BHT, n = 29) or mildly hypertensive (HT, n = 34) by repeated office blood pressure (OBP) measurements. After testing, a 24-h intra-arterial ambulatory BP (IABP) recording was obtained while subjects performed their normal activities. Day and night periods were analysed as well as 24-h averages for systolic BP (SBP) and diastolic BP (DBP) using Pearson correlations and multiple linear regressions. In normotensive subjects, the supine SBP predicted IABP measurements best (r range 0.39-0.69, P < 0.05-0.001). In multiple regression, supine SBP explained 49% of 24-h SBP variance (F = 12.4, P = 0.001). For BHT, supine SBP was also the best predictor (r range 0.09-0.64, P NS to P < 0.001), and it explained 37% of 24-h SBP variance (F = 15.6, P = 0.0005). In HT, ERG DBP correlated best with IABP (r range 0.52-0.75, P < 0.01-0.001). ERG SBP explained 49% of 24-h SBP (F = 31.0, P = 0.0000) and ERG DBP explained 56% of 24-h DBP (F = 35.4, P = 0.0000) variance. Laboratory BP correlations were generally better with day than with night measurements. OSBP correlated moderately well with IABP in NT, and weakly in BHT and HT; ODBP instead correlated with IABP in NT and HT but not significantly in BHT. In conclusion, OBP is less closely related to IABP than laboratory BP, but even laboratory BP generally explains less than 50% of IABP variance. Stressors such as exercise are useful only in HT. For BHT, the prediction of IABP with laboratory measures was even weaker than in other groups, and thus ambulatory measurements cannot be replaced by short-duration laboratory measurements and stress tests.

Adult↗

PubMed2005

Exploring the equity of GP practice prescribing rates for selected coronary heart disease drugs: a multiple regression analysis with proxies of healthcare need.

BACKGROUND: There is a small, but growing body of literature highlighting inequities in GP practice prescribing rates for many drug therapies. The aim of this paper is to further explore the equity of prescribing for five major CHD drug groups and to explain the amount of variation in GP practice prescribing rates that can be explained by a range of healthcare needs indicators (HCNIs). METHODS: The study involved a cross-sectional secondary analysis in four primary care trusts (PCTs 1-4) in the North West of England, including 132 GP practices. Prescribing rates (average daily quantities per registered patient aged over 35 years) and HCNIs were developed for all GP practices. Analysis was undertaken using multiple linear regression. RESULTS: Between 22-25% of the variation in prescribing rates for statins, beta-blockers and bendrofluazide was explained in the multiple regression models. Slightly more variation was explained for ACE inhibitors (31.6%) and considerably more for aspirin (51.2%). Prescribing rates were positively associated with CHD hospital diagnoses and procedures for all drug groups other than ACE inhibitors. The proportion of patients aged 55-74 years was positively related to all prescribing rates other than aspirin, where they were positively related to the proportion of patients aged >75 years. However, prescribing rates for statins and ACE inhibitors were negatively associated with the proportion of patients aged >75 years in addition to the proportion of patients from minority ethnic groups. Prescribing rates for aspirin, bendrofluazide and all CHD drugs combined were negatively associated with deprivation. CONCLUSION: Although around 25-50% of the variation in prescribing rates was explained by HCNIs, this varied markedly between PCTs and drug groups. Prescribing rates were generally characterised by both positive and negative associations with HCNIs, suggesting possible inequities in prescribing rates on the basis of ethnicity, deprivation and the proportion of patients aged over 75 years (for statins and ACE inhibitors, but not for aspirin).

Journal Article↗

PubMed1990

Effect of postural stimulation on systemic hemodynamics and sympathetic nervous activity in systemic hypertension.

The contributions of the carotid sinus and cardiopulmonary baroreflexes to the interindividual variation in sympathetic nervous system activation caused by postural adaptation were indirectly assessed in 68 mild hypertensive subjects. Supine and upright plasma norepinephrine (NE), blood pressure (cuff) and cardiac output (acetylene rebreathing) were measured. Mean arterial pressure (MAP), carotid sinus pressure, stroke volume and systemic vascular resistance were calculated. Stroke volume was assumed to be proportional to the degree of stretch of cardiac mechanoreceptors, carotid sinus MAP was assumed to be proportional to carotid sinus stretch and plasma NE to reflect sympathetic nervous activity. Plasma NE correlated inversely with stroke volume (r = -0.62, p less than 10(-14] and estimated carotid sinus MAP (r = -0.33, p less than 0.0002) and positively with systemic vascular resistance (r = 0.59, p less than 10(-10]. Holding systemic vascular resistance constant by partial regression, the inverse relation between plasma NE and stroke volume remained (partial r = -0.36, p less than 0.02). Multiple linear regression yielded the equation: plasma NE (pg/ml) = 720 + 4.3 age - 5.1 stroke volume (ml) - 1.0 carotid sinus MAP (mm Hg). Substituting mean supine and upright values for stroke volume and carotid sinus MAP in this equation, it can be roughly estimated that changes in stroke volume account for as much as 60% of the postural variation in plasma NE in hypertensives, whereas only 15% of this variation is caused by changes in carotid sinus pressure. These findings suggest that cardiopulmonary baroreflexes are primary activators of the sympathetic nervous system during postural adaptation.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

PubMed2004

Respiratory findings in gun factory workers exposed to solvents.

OBJECTIVE: Gun factory workers are exposed to many solvents (toluene, acetone, butanol, xylene, benzene, trichloroethylene). We investigated whether chronic exposure to solvents had adverse effect on respiratory system. MATERIAL AND METHODS: The workers were questionnaired by modified Medical Research Council's respiratory questionnaire before morning start shift. Then physical examination and measurement of pulmonary functions by portable dry rolling spirometer were performed. The study group consisted of 1091 gun factory workers. The workers were grouped according to their smoking habits (smokers, [exposed n: 353 vs. unexposed n: 339] and non-smokers [exposed n: 58 vs. unexposed n: 341]). Asthma-related symptoms were defined as either definite asthma, probable asthma, and possible asthma. RESULTS: In non-smokers, the report of asthma-related symptoms was more prevalent in exposed workers than unexposed (39.7% vs. 21.7% OR 2.4[1.3-4.3], respectively P = 0.003). In smokers, the report of asthma-related symptoms was more common in exposed group than unexposed (50.7% vs. 42.5% OR 1.4[1.0-1.9], respectively P = 0.03). Logistic regression analysis showed that smoking (OR 2.8[2.0-3.8] P = 0.00001) and exposure to solvents (OR 1.4[1.1-1.9] P = 0.01) were independent risk factors for asthma-related symptoms, after adjusting for age. Logistic regression analysis identified that smoking (OR 3.3[2.3-4.6] P = 0.00001) was independent risk factors for chronic bronchitis. Multiple linear regression analysis of lung-function parameters (% forced expiratory volume (FEV1), FEV1/forced vital capacity, FEF(25-75)) indicated significant effects of smoking. CONCLUSION: Present study indicated significant effects of smoking and exposure to solvents, with the smoking effect being the most important on asthma-related symptoms of gun factory workers.

Adult↗

PubMed2004

Quantitative ultrasound in the assessment of skeletal status in children and adolescents.

The aim of this study was to provide normative data for quantitative ultrasound (US) through the phalanges and to evaluate the influence of age and body size on Ad-SoS (amplitude-dependent speed-of-sound). Measurements were performed in 1020 healthy Polish children ages 7 to 19 years, using a DBM Sonic 1200 (IGEA, Carpi, Italy). The Ad-SoS increased with age in all studied subjects; in girls from 1926 to 2124 m/s and in boys from 1916 to 2114 m/s. The statistically significant increases in Ad-SoS values were noted between the ages of 10 and 16 years in girls and 13 and 18 years in boys. Correlations and regressions between Ad-SoS and age and body were dependent on the phases of growth. In stepwise multiple linear regression of Ad-SoS on age and body size, the following equations were obtained: in girls, Ad-SoS (m/s)=1843 + 18 x age (years) + 2.3 x weight (kg) - 9.4 x body mass index (BMI) (kg/m2), r=0.85, standard error of estimate (SEE)=42; and, in boys, Ad-SoS (m/s)=2443 + 14 x age (years) - 3.7 x height (cm) + 8.4 x weight (kg) - 24.8 x BMI (kg/m2), r=0.83, SEE=45. In conclusion, the study showed the ability of US measurements at hand phalanges to monitor the skeletal maturation during childhood and adolescence.

Adolescent↗