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Longitudinal follow-up, resource utilization, and health disparities are top congenital heart research and care priorities. Medicaid claims include longitudinal data on inpatient, outpatient, emergency, pharmacy, rehabilitation, home health utilization, and social determinants of health-including mother-infant pairs.The New York Congenital Heart Surgeons Collaborative for Longitudinal Outcomes and Utilization of Resources linked robust clinical details from locally held state and national registries from 10 of 11 New York congenital heart centers to Medicaid claims, building a novel, statewide mechanism for longitudinal assessment of outcomes, expenditures, and health inequities.The authors included all children 18 years of age undergoing cardiac surgery in The Society of Thoracic Surgeons Congenital Heart Surgery Database or the New York State Pediatric Congenital Cardiac Surgery Registry from 10 of 11 New York centers, 2006 to 2019. Data were linked via iterative, ranked deterministic matching on direct identifiers. Match rates were calculated and compared. Proportions of the linked cohort trackable over 3, 5, and 10 years were described.Of 14,097 registry cases, 59% (n = 8,322) reported Medicaid use. Of these, 7,414 were linked to New York claims, at an 89% match rate. Of matched cases, the authors tracked 79%, 74%, and 65% of children over 3, 5, and 10 years when requiring near-continuous Medicaid enrollment. Allowing more lenient enrollment criteria, the authors tracked 86%, 82%, and 76%, respectively. Mortality over this time was 7.7%, 8.4%, and 10.0%, respectively. Manual validation revealed ∼100% true matches.This establishes a novel statewide data resource for assessment of longitudinal outcome, health expenditure, and disparities for children with congenital heart disease.

BACKGROUND: The thin-walled regions (TIWRs) of intracranial aneurysms have a high risk of rupture during surgical manipulation. They have been reported to be predicted by wall shear stress and pressure (PS) based on computational fluid dynamics analysis, although this remains controversial. In this study, we investigated whether the oscillatory shear index (OSI) can predict TIWRs. METHODS: Twenty-five unruptured aneurysms were retrospectively analyzed; the position and orientation of the computational fluid dynamics color maps were adjusted to match the intraoperative micrographs. The red area on the aneurysm wall was defined as TIWR, and if most of the regions on the color map corresponding to TIWR were OSI low (lower quartile range), time-averaged wall shear stress (TAWSS) high, or PS high (upper quartile range), each region was defined as a matched region and divided by the total number of TIWRs to calculate the match rate. In addition, the mean values of OSI, TAWSS, and PS corresponding to TIWRs were quantitatively compared with those in adjacent thick-walled regions. RESULTS: Among 27 TIWRs of 25 aneurysms, 23, 10, and 14 regions had low OSI, high TAWSS, and high PS regions (match rate: 85.2%, 37.0%, and 51.9%), respectively. Receiver operating characteristic curve analysis demonstrated that OSI was the most effective hemodynamic parameter (area under the curve, 0.881), followed by TAWSS (0.798). Multivariate analysis showed that OSI was a significant independent predictor of TIWRs (odds ratio, 18.30 [95% CI, 3.2800e102.00], P < 0.001). CONCLUSIONS: OSI may be a unique predictor for TIWRs. Low OSI strongly corresponds with TIWRs of intracranial aneurysms.

The purpose of this study was to compare factors that contribute to increased match rates into general surgery.Survey study.University of Kansas School of Medicine Campuses.A survey assessing experiences and perceptions during their surgical clerkship was sent to graduating medical students from a single university with a hybrid (academic-affiliated community-based) campus, and an academic campus. Specific questions were asked with regard to residents and attendings, procedural experiences, perceived lifestyle, and general interest in surgery before and after clerkship.The match rate into general surgery was significantly higher on the hybrid campus (14.7% vs 4.0%, p = 0.215). Factors that were positively correlated with interest in surgery included interactions with attendings (0.86) and residents (0.63), time spent in the OR (0.77), participation in the OR (0.62), and complexity of cases (0.61). Students on the hybrid campus spent more weeks on general surgery services (6 vs 4, p0.001). More students from the hybrid campus were "Not interested at all" in surgery prior to their surgery clerkship (26.5% vs 16.0). Significantly more academic students indicated they were "Not interested at all" in surgery after their surgery clerkship (52.0 vs 17.6%), while more students on the hybrid campus indicated they were "extremely interested" (29.4 vs 12.0%, p = 0.005) after their surgery clerkship.The rate of students matching into general surgery between the 2 campuses are different, with the hybrid campus having nearly 4 times the rate of students matching into general surgery. Programs may be able to increase their match rate by allowing students more opportunities to participate in the operating room, spending more time on a general surgery service, and by ensuring that medical students are included as members of the surgical team.

Tourists' need for experience activities on farms has increased over the past decade; thus, this study adopted a co-branding perspective to examine the best match between farm image and experience activities, and examined whether farm marketers can design farm experience activities based on different source. A total of 706 samples were collected. The results indicate: (1) When a farm's promotional image and the perceptions of tourists visiting that farm are the same, a higher optimal match rate between farm imagery and farm experience activities is achieved, which results in more positive tourist responses. (2) When tourists and farm operators both identify a farm's image as the same, it results in the farm's image being identified as a particular kind of farm, whether by farm operators or tourists, resulting in an optimal match rate between farm imagery and experience activities, with both resulting in a positive tourist response. This study contributes further insights into the farm marketing strategy based on these research findings.

Changes were made to the independent plastic surgery residency in 2009 to 2010 that included full prerequisite training and increased from 2 to 3 years of independent residency. The authors sought to determine subsequent match trends and predictors of a successful match.With American Council of Academic Plastic Surgeons approval, the San Francisco Match provided data for the independent match (2010-2018). Trends in the independent plastic surgery were reviewed. Applicant variables were analyzed to determine correlation with a successful match and a match at top-ranked programs using Doximity Residency Navigator.Total independent applicants per cycle decreased 18% while foreign medical school applicants increased from 19.4% to 27%. Available positions decreased from 97 to 66 (32%) and match rate decreased from 82% to 78%. Applicants who matched were from US medical schools, had higher USMLE Step 1 scores, were from University and top General surgery residencies, and averaged more interviews (p0.05). By multivariate regression, number of interviews completed (odds ratio [OR] 15.35 95% confidence interval [CI] 7.7-30.6, p0.001) and having completed prerequisite training at a university based program in addition to having graduated from an allopathic medical school (OR 1.78 95% CI 1.1-2.97, p = 0.027) were predictive of a successful match. Step 1 score ≥ 240 (OR 3.2, 95% CI 1.0-10.2, p = 0.046), Alpha Omega Alpha membership (OR 2.2, 95% CI 1.1-4.9, p = 0.048), and having completed prerequisite training at the same institution (7.6, 95% CI 2.2-25.7, p0.001) were predictive of matching at top-ranked programs.Since 2010, independent plastic surgery applicant and program participation have decreased. Greater number of interviews, university-based prerequisite training, and allopathic medical school background are variables that correlate with a successful match. Factors predictive of a match at top-ranked Doximity Residency Navigator plastic surgery programs include high Step 1 scores, Alpha Omega Alpha membership, and prerequisite training at the same institution.

Online news and social networking sites have been significantly used in recent years. There has been a lot of efforts to provide appropriate contents for the end users; however, they proved not to be effective. We believe the semantic web (as the third generation of the web) is mature enough to undertake the responsibility of generating more user-centric content. One way to exploit the semantic web's capabilities for such purpose is to construct an ontology that establishes the relationships between hashtags. In this paper, we present the construction process of a news feed system based on the hierarchical relationships of geographic hashtag. Our experiments demonstrated that our proposed semantic-based hierarchical location tagging news feed system increases the quality of the user experience as well as the publication rate of the news while boosting the content match rate to the target audiences. The proposed system of this paper can be considered as a real step towards the realization of semantic web.

Many patients who undergo endovascular aortic aneurysm repair (EVR) also undergo repeat procedures, or reinterventions, to address suboptimal device performance and prevent aneurysm rupture. Quality improvement initiatives measuring reintervention after EVR has focused on fee-for-service Medicare patients. However, because patients aged less than 65 years and those with Medicare Advantage represent an important growing subgroup, we used a novel approach leveraging a state data source that captures patients of all ages and with all types of insurance.We identified patients who underwent EVR (2011-2015) within the Vascular Quality Initiative registry and were also listed in the Statewide Planning and Research Cooperative System all-payer claims database of New York. We linked patients in the Vascular Quality Initiative to their Statewide Planning and Research Cooperative System claims file at the patient level with a 96% match rate. We compared outcomes between fee-for-service Medicare eligible, defined as age 65 or older or on dialysis, versus ineligible patients, defined as those younger than 65 and not on dialysis. Our primary outcome was reintervention. We used Cox proportional hazards regression and propensity score matching for risk adjustment.We studied 1285 patients with a median follow-up of 16 months (range, 1-57 months). The mean age was 74 years, 79% were male, and 84% of procedures were elective. Nearly one in six patients were not Medicare eligible (14%), and the remainder (86%) were Medicare eligible. Medicare-eligible patients were less likely to be male (77% vs 91%; P .001), have a history of smoking (79% vs 93%; P .001), and have a nonelective procedure (15% vs 23%; P = .013). The 3-year Kaplan-Meier rate of reintervention was 21%. We found similar rates of reintervention between Medicare-eligible patients and those who were not (19% vs 20%, log-rank P = .199; unadjusted hazard ratio [HR], 0.75; 95% confidence interval [CI], 0.49-1.16). This finding persisted in both the adjusted and propensity-matched analyses (adjusted HR, 0.82; 95% CI, 0.50-1.34; propensity-matched HR, 0.70; 95% CI, 0.36-1.37).Reintervention can be monitored using administrative claims from both Medicare and non-Medicare payers, and serve as an important outcome metric after EVR in patients of all ages. The rate of reintervention seems to be similar between older, Medicare-eligible individuals, and those who are not yet eligible.

Objective Recently, a multitude of new U.S. medical schools have been established and existing medical schools have expanded their enrollments. The National Residency Match Program (NRMP) reports that in 2016 there were 23,339 categorical residency positions offered in the match and 26,836 overall applicants with 17,789 (66.29%) of the total candidates being U.S. allopathic graduates. In view of the rapid growth of medical school graduates, the aim of this study is to determine if current trends suggest a shortage of residency positions within the next ten years. Design The total number of graduates from U.S. medical schools was obtained from the Association of American Medical Colleges (AAMC) for 2005-2014 academic years and was trended linearly for a 10-year prediction for the number of graduates. The yearly number of categorical positions filled by U.S. graduates for calendar years 2006-2015 was obtained from the NRMP and was trended longitudinally 10 years into the future. Analysis of subspecialty data focused on the comparison of differences in growth rates and potential foreseeable deficits in available categorical positions in U.S. residency programs. Results According to trended data from AAMC, the total number of graduates from U.S. medical schools has increased 1.52 percent annually (15,927 in 2005 to 18,705 in 2014); with a forecast of 22,280 U.S. medical school graduates in 2026. The growth rate of all categorical positions available in U.S. residency programs was 2.55 percent annually, predicting 29,880 positions available in 2026. In view of these results, an analysis of specific residencies was done to determine potential shortages in specific residencies. With 17.4 percent of all U.S. graduates matching into internal medicine and a 3.17 percent growth rate in residency positions, in 2026 the number of internal medicine residency positions will be 9,026 with 3,874 U.S. graduates predicted to match into these positions. In general surgery, residency positions note a growth rate of 1.55 percent. Of all U.S. graduates, 5.6 percent match into general surgery. Overall this projects 1,445 general surgery residency positions in 2026 with 1,257 U.S. graduates matching. In orthopedics with a growth rate of 1.35 percent and a match rate of 3.75 percent, there are projected to be 827 positions available with 836 U.S. graduates projected to match. Conclusions Despite the increasing number of medical school graduates, our model suggests the rate of growth of residency positions continues to be higher than the rate of growth of U.S. medical school graduates. While there is no apparent shortage of categorical positions overall, highly competitive subspecialties like orthopedics may develop a shortage within the next ten years.

Background and purpose To evaluate the impact of student pharmacist participation in a mock interview session on confidence level and preparation regarding residency interview skills. Educational activity and setting The study setting was a mock interview session, held in conjunction with student programming at the American College of Clinical Pharmacy (ACCP) Annual Meeting. Prior to the mock interview session, final year student pharmacists seeking residency program placement were asked to complete a pre-session survey assessing confidence level for residency interviews. Each student pharmacist participated in up to three mock interviews. A post-session survey evaluating confidence level was then administered to consenting participants. Following the American Society for Health-System Pharmacists (ASHP) Pharmacy Resident Matching Program (RMP), a post-match electronic survey was sent to study participants to determine their perception of the influence of the mock interview session on achieving successful interactions during residency interviews. Findings A total of 59 student pharmacists participated in the mock interview session and completed the pre-session survey. Participants completing the post-session survey (88%, n = 52) unanimously reported an enhanced confidence in interviewing skills following the session. Thirty responders reported a program match rate of 83%. Approximately 97% (n = 29) of the respondents agreed or strongly agreed that the questions asked during the mock interview session were reflective of questions asked during residency interviews. Discussion Lessons learned from this mock interview session can be applied to PGY1 residency mock interview sessions held locally, regionally, and nationally. Summary Students participating in the ACCP Mock Interview Session recognized the importance of the interview component in obtaining a postgraduate year 1 (PGY1) pharmacy residency.

We build a model to understand educational mismatch and income inequality among highly educated workers. For occupations and workers with college majors, educational mismatch negatively impacts wage but positively correlates with wage inequality. We examine different channels that contribute to wage inequality by identifying three underlying reasons behind the mismatch, namely, preference, promotion, and search friction and quantifying their impacts. Quantitatively, preference and promotion negatively contribute to an inequality increase from 1990 to 2000; match premium and search friction contribute to a 28.4% and 5.3% increase in inequality, respectively. We conclude that educational mismatch significantly affects income inequality and that this impact varies based on the underlying reasons. The study has important policy implications as it shows that policies for improving education match rate and educational signaling and less market friction can reduce wage inequality.

Background and Aims The American Society for Gastrointestinal Endoscopy (ASGE) advanced endoscopy fellowship (AEF) match offers a structured application process for AEF training in the United States. Our aim was to describe recent trends in AEF match, trainee experience, and postfellowship employment. Methods ASGE AEF match data from 2012 to 2020 were reviewed. Online surveys were sent to advanced endoscopy trainees in 2019 and 2020 to explore their perceptions about AEF training and postfellowship jobs. Results Data for 2020 showed 19% of matched applicants were women, 55% foreign medical graduates, and 17.5% U.S. visa holders. The number of AEF match applicants increased by 15.6% (90 in 2012 to 104 in 2020) and number of AEF programs increased by 23.5% (51 in 2012 to 63 in 2020). The average applicant match rate was 57% (range, 52.8%-60.6%) and position match rate 87.9% (range, 79.1%-94.6%). Ninety-one percent of trainees (n = 58) rated the quality of their training as very good/excellent; 75% of trainees participated in >300 ERCPs and 64.1% in >300 EUS cases. Seventy percent of trainees reported that advanced endoscopic procedures comprised ≤50% of their procedure volume in their first job, and 71.9% believed it was not easy to find a job after fellowship; however, 97% believed they would make the same decision to pursue AEF training again. Conclusions There has been a steady increase in the number of advanced endoscopy applicants and training positions over recent years. Most graduating fellows reported 50% or less of their upcoming clinical practice would involve advanced endoscopic procedures. Future studies are needed to further clarify employment opportunities and personnel needs for advanced endoscopists.

Background The aim of this study was to analyze the trends in the proportion of students from various educational backgrounds who matched into categorical general surgery (GS) residency positions. Methods National Resident Matching Program reports (1994 to 2014) were analyzed, and regression was used to estimate the trends for each group. Results The match rate into GS-categorical residency has remained stable; however, since 1994, we witnessed a 13% decrease in US seniors matching into GS. This has corresponded to proportional increases in matches for US citizens from international medical schools (US IMG, 1350%) and a 62% increase for non-US citizen international medical graduates (non-US IMG) into GS. In comparison, US IMG matches into all first-year postgraduate positions increased by 468%, whereas non-US IMG matches decreased by 15%. Conclusions The stable match rates into categorical GS residencies are not because of US seniors but rather because of a rise in the number of IMGs. In contrast to the decreased reliance on non-US IMGs in all other specialties, GS is accepting a larger proportion of non-US IMGs.

Estimation of the National Marrow Donor Program's Be The Match Registry 8/8 (HLA-A, -B, -C, and -DRB1) high-resolution (HR) unrelated donor (URD) match rate was determined in a prior study for each of the 4 most frequent patient race/ethnic groups in the United States: white (WH), Hispanic (HIS), Asian/Pacific Islander (API), and African American (AFA). For patients without an 8/8 HLA-matched URD, a 7/8 match, with a single allele or antigen mismatch, is often accepted by many transplant centers. A follow-up study was designed to determine the 7/8 or better match rate among the 4 major race/ethnic groups, using the same study cohort. Of previously HR tested URDs in the Be The Match Registry, 1344 were randomly selected and treated as pseudo-patients where HR testing was performed to identify a 7/8-matched URD; 98% of WH and over 80% of non-WH race/ethnic groups (HIS, API, and AFA) had at least a 7/8 match identified. In most cases after first testing to identify an 8/8-matched URD, a 7/8-matched URD was identified after typing just 1 URD. Extending criteria to identify a 9/10 match (included HLA-DQB1) showed the 9/10 absolute match rate decreased between 14% and 21% from the 7/8 match rate for the non-WH groups. This study provides a baseline 7/8 and 9/10 or better HLA match rate that can be further supplemented using the additional worldwide URD inventory. URD match rate information can equip centers in clinical planning and the education of patients seeking a life-saving therapy.

This study verifies the accuracy of failure localization by a software-based fault diagnosis technique through comparison of the failure localization by photo emission microscope (PEMS) analysis and optical beam induced resistance change (OBIRCH) analysis. To evaluate, the software-based fault diagnosis technique was applied to 14 samples of 0.18 μm-process-node products that failed mainly due to the metal line shorts. We found that this technique was able to accurately localize the failure with a high probability (85.7%). One reason, the diagnosis returned inaccurate results is the influence of the metal line short expanding to several nets in the device simultaneously due to shorts of upper and lower metal lines. The other reason is that the fail log of the failed device itself was inaccurate due to (1) the resistance value at the short point, (2) the driving force of the cells related by the shorted points, and (3) the transition timing. We determined from our study that the rank of score calculation depends more on the mismatch rate of pass patterns than on the match rate of fail patterns. When the mismatch rate of pass patterns is less than 0.04 and the score is more than 70, the software-based fault diagnosis result is reliable. Although software-based fault diagnosis is a powerful tool for failure localization, it is necessary to combine it with hardware techniques such as PEMS analysis and OBIRCH analysis to maintain the accuracy of failure localization.

Objective To investigate the potential inefficiency in allowing urology residency applicants the ability to apply to an unlimited number of programs, and to study whether an application limit would lead toward a more efficient urology match. Materials and Methods Eleven-year data from the American Urological Association were assessed to investigate whether an increase in the yearly mean number of submitted applications was associated with an increase in the yearly mean number of interviews attended or yearly match rate. A match model resembling the current match, except for an application limit, was created to assess the financial and time savings of an application limit. Results There was no statistically significant relationship between the mean number of submitted applications per applicant with the mean number of interviews an applicant attends (P = .545), match rate (P = .383), or match rate when adjusted to account for additional positions becoming available (P = .100). The cost and time savings of a urology residency match that features an application limit in our model are substantial (up to $575,000 for applicants collectively and 1639 minutes per program director). Conclusion Allowing urology residency applicants the ability to submit an unlimited number of applications is inefficient. A urology residency match program featuring an application limit would be more financially practical for applicants and engender significant time savings for program directors.

To develop differential criteria on the tongue coating thickness (TCT), and especially propose the standard for judgment on thin and thick coating in tongue diagnosis.Sixty oriental medical doctors evaluated the TCT (none, thin, and thick coating) in 50 realistic tongue photographs revealing from tip-to-root. The photographs were obtained with a digital tongue imaging system (DTIS) which measured the percentages of tongue coating on the tongue surface. We calculated the match rate which is the ratio in which the assessor's judgment is consistent with the decision standard on the tongue coating, and then 24 assessors (≥80% match rate) were selected to improve the reliability of the decision. The agreement level among 24 assessors was examined to assess the inter-rater reliability. The correlation between TCT judgments and DTIS-measured values was examined to ascertain the reliability of DTIS measurements. Finally, the assumption probability for the analysis of quantified characteristics of the tongue coating was calculated with a proportional odds model.The inter-rater reliability was assessed as moderate (κ=0.56) among 24 assessors, the level of correlation between TCT judgments and DTIS measurements in 24 assessors was relatively high (0.76, p0.01). As the analysis of the proportional odds model, 29.06% was a cut-off point to separate no coating and thin coating, 63.51% was a cut-off point to separate thin and thick coating.The differential criteria for TCT in tongue diagnosis were suggested, and particularly thick coating is defined as one that tongue coating which tongue body is invisible, occupy approximately more than two third areas on the tongue surface.

Background As part of a larger study evaluating breast cancer care, we attempted to validate our matching strategies between the National Cancer Data Base (NCDB) and ACS National Surgical Quality Improvement Program (ACS-NSQIP). Methods Using 2002–2006 data, we attempted to match cases by a three-tiered approach. Three groups resulted: (1) successfully matched, (2) NCDB case with no corresponding match in ACS-NSQIP, and (3) ACS-NSQIP case with no match in NCDB. Single institution (University of Utah) data were used for a nested validation study of the unmatched groups. Results The initial match yielded a 23.4% net match rate (rate of 8.6% at the University of Utah). In subset review of unmatched University of Utah cancer registry cases (NCDB, n = 153), 56% (n = 86) of cases had their index surgery at the University of Utah, with 15 potential matches in the unmatched ACS-NSQIP data using age and date of surgery and no potential match for 41 cases. Twenty-five remaining cases had a potential surgery date match if age was varied by 1 y with 18 confirmed matches. Review of unmatched ACS-NSQIP cases (n = 107) yielded 15 potential matches in the University of Utah cancer registry, with no potential match for 63 cases. Twenty-nine cases had a potential surgery date match if age was varied, with 26 confirmed matches. Review of ACS-NSQIP cases from 2006 for cancer status and stage revealed two cancer patients who were not in the cancer registry. Conclusions Linking ACS-NSQIP and NCDB without a captive patient population results in low overall match rates due, in part, to specific inclusion criteria and different variable definitions for each database.

The paper focuses on the past five years of National Residency Match Program (NRMP) information in the Unites States with a comparison point of twenty years ago utilized because of a referenced article. It is well known to our students going through the match that it is more competitive than in prior years. To rank enough programs for your field, take Step 2 early to maximize your score, to get quality letters and to practice mock interviews. The 99% match rate has remained steady over the past five years despite an increase in all primary care disciplines particularly Internal Medicine. Family Medicine and Internal Medicine work with, on average, about half U.S. seniors and half from other groups including Osteopathic and IMG (U.S. citizen and non-U.S. citizen). This can create a holistic experience for residents with a sharing of ideas from students from varied backgrounds. While the Supplemental Offer and Acceptance Program appear as an initial success, the student's goal should be to avoid such a step altogether. The key twenty years ago and today is the existence of appropriate numbers of resident and faculty role models. This is a stressful goal considering the demands on faculty for billing and patient care due to the shiftwork nature of the new work hours.

Using new data from a field experiment in India, we test hypotheses about micropension design in a poor population. We elicit demand for the basic micropension in addition to variants with different minimum withdrawal ages, government match rates, and options for lump sum withdrawal. A majority (80%) of respondents report interest in the micropension, and the amount they are willing to contribute would be enough to cover about 40% of expected old-age consumption. We find that prospective policyholders value the inability to access the assets until a particular age. We also find that they respond positively to the government match rate.

Background The impact of influenza immunization on expenditures for inpatient, outpatient, and professional services among elderly Medicare beneficiaries between 1999 and 2003 was examined. Methods Data were from independent annual survey samples of 175,000 beneficiaries. Response rates ranged from 64% to 71%. Survey data included beneficiaries’ demographics, education, supplemental insurance, perceived health, and influenza vaccination. Baseline measures, derived from Medicare claims for the year prior to influenza season, included service utilization, comorbidities, influenza immunization, and health status. The outcome measure was medical expenditures for acute and chronic respiratory conditions (ACRCs) for each 33-week annual influenza season. Results Total expenditures for ACRCs were lower among the immunized population during all four seasons. The amount and statistical significance of the savings varied with the severity of the virus and the vaccine match to the prevalent influenza strains. During the 1999–2000 influenza season, which had the most severe virus and a close vaccine match, average costs for ACRCs were $88 lower among immunized beneficiaries than among nonimmunized beneficiaries (equivalent to a 3.06% savings). During the 2002–2003 season, which had a less severe virus but the highest vaccine match rate, average costs for ACRCs were $103 lower for immunized beneficiaries than for nonvaccinated beneficiaries (equivalent to a 3.12% savings). The relative reduction in ACRC expenditures among vaccinated beneficiaries is attributable to less frequent use of inpatient services. Conclusions In addition to improving the health of older Americans, meeting the Healthy People 2010 influenza immunization goal of 90% among the elderly should also result in lower Medicare expenditures.

Purpose This study compares the match rate and positional accuracy of two geocoding methods: the popular geocoding tool in ArcGIS 9.1 and the Centrus GeoCoder for ArcGIS. Methods We first geocoded 11,016 Texas addresses in a case–control study using both methods and obtained the match rate of each method. We then randomly selected 200 addresses from those geocoded by using both methods and obtained geographic coordinates of the 200 addresses by using a global positioning system (GPS) device. Of the 200 addresses, 110 were case maternal residence addresses and 90 were control maternal residence addresses. These GPS-surveyed coordinates were used as the “true” coordinates to calculate positional errors of geocoded locations. We used Wilcoxon signed rank test to evaluate whether differences in positional errors from the two methods were statistically significantly different from zero. In addition, we calculated the sensitivity and specificity of the two methods for classifying maternal addresses within 1500 m of toxic release inventory facilities when distance is used as a proxy of exposure. Results The match rate of the Centrus GeoCoder was more than 10% greater than that of the geocoding tool in ArcGIS 9.1. Positional errors with the Centrus GeoCoder were less than those of the geocoding tool in ArcGIS 9.1, and this difference was statistically significant. Sensitivity and specificity of the two methods are similar. Conclusions Centrus GeoCoder for ArcGIS for geocoding gives greater match rates than the geocoding tool in ArcGIS 9.1. Although the Centrus GeoCoder has better positional accuracy, both methods give similar results in classifying maternal addresses within 1500 m of toxic release inventory facilities when distance is used as a proxy of exposure.

We examine the relationship between employer match rates in 401 (k) plans and employee saving behavior in these plans. Our analysis is based on a recent survey of 401 (k) plan sponsors. Participation rates are positively related to the match rate. Employee contributions appear to be sensitive to the match rate at low matches, but our sample is too small to identify precisely the effect of higher match rates.

Objectives: A quality assurance program is required for ultrasound unit accreditation, although the specifics for such a program are not defined. There is no known comparative benchmark for the accuracyofultrasounddiagnosis.This studydescribes one unit’s QA/QI program for gynecologic ultrasound designed both to meet accreditation requirements as well as to improve the accuracy and performance of gynecologic ultrasounds. Methods: All emergent and elective gynecologic surgeries from October 2010-December 2013 were reviewed. Patients included in our study had a formal ultrasound in our AIUM accredited department within the 12 months preceding their surgery. The ultrasound diagnoses were compared against the surgical pathology results. Amajor site match was defined as concordance between the suspected pathology seen on ultrasound that prompted surgery and final pathology. All additional pathology found intraoperatively, called secondary pathology, was also included in the review. Images from case discrepancies were reviewed regularly by interpreting physicians together with sonographers. After review, improvement recommendations and changes in practice were made. Results: There were 453 patients who had a gynecologic ultrasound and underwent surgery within the following 12 months between October 2010 and December 2013. During the study period, our unit showed an 83.0% rate of diagnostic and pathologic match for major findings. For secondary pathology, 589 results were reviewed and our unit demonstrated a 77% match rate. After instituting this review process, our accuracy of diagnosis improved from 79% in 2010 to 90% in 2013 for major site matches. Conclusions: We have described one method for conducting quality review and have shared our unit’s accuracy of diagnosis. There have been no previous studies describing an ultrasound unit’s accuracy to use for comparison, nor any recommendations on how to best conduct quality review. We hope that this will lead to further data sharing and discussion of the ultrasound QA/QI process. By opening the discussion on accuracy of gynecologic ultrasound as judged by an institution or unit, comparisons could be made to optimize safe and accurate use of ultrasound technology in the care of women.

Guidance exists on how to count matches between samples in a crime sample database but we are unable to locate a definition of how to estimate a match rate. We propose a method that does not proceed from the match counting definition but which has a strong logic.

Aim The HLA haplotype frequencies for Middle Eastern populations are not well known relative to the rest of the world. At The King Faisal Specialist Hospital and Research Center in Riyadh we have collected HLA typing information for thousands of donors and cord blood units from years of stem-cell and renal transplants with the goal of establishing a stem cell registry in the Kingdom of Saudi Arabia. We aim in this study to use these HLA typings to estimate Saudi population haplotype frequencies and in follow-on work to project HLA match rates for the Saudi population as the registry expands. Methods We calculated HLA A∼C∼B∼DRB1∼DQB1 haplotype frequencies from 2,723 Saudi donors and cord blood units typed by DNA methods, resolving phase and allelic ambiguity using the Expectation Maximization algorithm. Haplotype frequencies were estimated to the allele family level for class I loci and to high resolution at class II loci. Results The most common Saudi HLA haplotype was A∗02∼C∗06∼B∗50∼DRB1∗07:01∼DQB1∗02:02 at a frequency of 4.5%. This haplotype is also the 32nd most common haplotype in the US Caucasian population at a frequency of 0.38%. The 2nd most common Saudi haplotype was A∗02∼C∗07∼B∗07∼DRB1∗15:01∼DQB1∗06:02 at 1.7% frequency, which is also the 4th most common haplotype among US Caucasians, and within Europe is most common in Scandinavia. The 3rd most common Saudi haplotype, A∗26∼C∗07∼B∗08∼DRB1∗03:01∼DQB1∗02:01 at 1.6% frequency, is the 14th most common haplotype in US Asian Pacific Islanders at 0.64%, but is quite rare in US Caucasians (rank 466; 0.0036%). Conclusions his pilot haplotype frequency study and the match rate projection to follow will help to form a data-driven approach to the establishment of a robust stem cell registry of adult donors and cord blood units that will aid the Saudi population in need of transplant. Collection of more detailed ancestry information on Saudi donors has the potential to improve match estimates and ensure all subpopulations are well-served.

Aim Innovative single and combined marrow and solid organ transplants used to treat patients with complex disorders and diseases are now being performed by transplant physicians. This study evaluated a method for calculating the probability of finding a suitably HLA antigen-matched deceased donor for a patient being considered for such an organ transplant. Methods A Monte Carlo sampling method was developed to calculate all possible matches for a three locus HLA system (HLA-A, B and DRB1) and estimate the probability of any individual finding a N/6 HLA antigen match (N = 0, 1, … , 6) in the general population. The study began with an existing data set of 250,366 high-resolution HLA haplotypes derived from the HLA typing data of the 21 populations contained in the NMDP registry. We converted each high-resolution haplotype to an antigen equivalent haplotype, thereby creating a reduced data set of 69,750 haplotypes. By selecting an extremely large set of genotype pairs at random, we estimated the number of N/6 matches for each of the 21 populations represented in the NMDP registry. Results The bioinformatics strategy utilized in this study allowed us to produce estimates of N/6 match rates for all 21 populations represented in the NMDP registry. We extended the application of this population-based approach and HLA match rate findings by creating an NMDP web-based tool that would allow physicians to input the HLA typing and race of their patient and calculate the N/6 match rate estimates specifically related to their patient. Conclusions The estimation of N/6 HLA match rates reported in this study will be of particular interest to HLA population scientists and transplant physicians. Availability of the bioinformatics tool will provide much needed support for transplant physicians as they consider the benefits and the risks of a transplant with an N/6 matched donor, set the patient expectations regarding transplant waiting time and outcomes, and determine if alternative treatments should be considered.

Since general memory research suggests that more salient (important or prominent) items are more easily remembered, entree may play a key role in self-reports of diet. We hypothesized that children who accurately report entrees on school lunch would report the remaining items with greater accuracy than children who inaccurately report entrees. Fourth-graders from 4 schools of lower to middle socioeconomic status in one school district were randomly selected, observed eating lunch, and interviewed the next morning (n=140; 14 WM, 16 WF, 58 BM, 52 BF). Items were categorized as entree or not entree. Matches (foods observed and reported eaten), omissions (foods observed eaten but not reported) and intrusions (foods not observed eaten but reported) for the non-entree items were tallied, weighted (condiment=0.25, other meal components=0.75), and corresponding rates calculated. If a child had multiple entrees, credit was given for an accurately reported entree only if all entrees reported were matches. Match rate was defined as matches ÷ (matches+omissions) X 100; intrusion rate was defined as intrusions ÷ (matches+intrusions) X 100. A child's accuracy was deemed "acceptable" if the match rate was ⩾90% and the intrusion rate was ≤10%. Data were analyzed for match rate, intrusion rate, and match and intrusion rates combined. Thirty-one children reported entrees inaccurately while 109 children reported entrees accurately. Four of the inaccurate children (12.9%) and 24 of the accurate children (22.0%) had match rates ≥90% (p>.19, Chi-square). Seventeen of the inaccurate children (54.8%) and 74 of the accurate children (67.9%) had intrusion rates ≤10% (p>.12, Chi-square). Two of the inaccurate children (6.5%) and 19 of the accurate children (17.4%) had both match rates ≥90% and intrusion rates ≤10% (p>.10, Chi-square). In conclusion, results from this study failed to show that children who accurately report school lunch entrees report the remaining items with greater accuracy than children who inaccurately report entrees.

A study was performed to evaluate the prenatal components of the Missouri Special Supplemental Food Program for Women, Infants and Children (WIC) Program. The study used WIC prenatal participants delivering in 1980 and their offspring's birth/fetal death certificates. A 93% match rate was acquired with a final study population of 6,732. Three basic methods of overall analysis were used to acquire a comparison group: covariate analysis, standardization, and pair matching. A higher mean birth weight was noted for the WIC total and WIC non-white group when the method of analysis was covariate or standardization; the latter was statistically significant. In either instance, the amount of increase was small. A reduced low-birth-weight rate was noted for the WIC total and the WIC non-white group regardless of the method of analysis used; the differences were statistically significant for the standardization method. Duration in WIC had a positive influence on both mean birth weight and low birth weight, regardless of race. High-risk groups used for program participation also were analyzed. Overall, this study showed that WIC prenatal nutritional supplementation has a positive, though not conclusive, impact on reducing low birth weight and raising mean birth weight.