AIM:To investigate the outcomes of pancreas-sparing duodenectomy(PSD)with regional lymph node dissection vs pancreaticoduodenectomy(PD).METHODS:Between August 2001 and June 2014,228 patients with early-stage ampullary...AIM:To investigate the outcomes of pancreas-sparing duodenectomy(PSD)with regional lymph node dissection vs pancreaticoduodenectomy(PD).METHODS:Between August 2001 and June 2014,228 patients with early-stage ampullary carcinoma(Amp Ca)underwent surgical treatment(PD,n=159;PSD with regional lymph node dissection,n=69).The patients were divided into two groups:the PD group and the PSD group.Propensity scoring methods were used to select patients with similar disease statuses.A total of 138 matched cases,with 69 patients in each group,were included in the final analysis.RESULTS:The median operative time was shorter among the patients in the PSD group(435 min)compared with those in the PD group(481 min,P=0.048).The median blood loss in the PSD group was significantly less than that in the PD group.The median length of hospital stay was shorter for patients in the PSD group vs the PD group.The incidence of pancreatic fistula was higher among patients in the PD group vs the PSD group.The 1-,3-,and 5-year overall survival and disease-free survival rates for patients in the PSD group were 83%,70%,44%and 73%,61%,39%,respectively,and these values were not different than compared with those in the PD group(P=0.625).CONCLUSION:PSD with regional lymph node dissection presents an acceptable morbidity in addition to its advantages over PD.PSD may be a safe and feasible alternative to PD in the treatment of earlystage Amp Ca.展开更多
Warhead power assessment of the anti-ship missile plays a vital role in determining the optimal design of missile, thus having important strategic research significance. However, in the assessment process, expert’s j...Warhead power assessment of the anti-ship missile plays a vital role in determining the optimal design of missile, thus having important strategic research significance. However, in the assessment process, expert’s judgement will directly affect the assessment accuracy. In addition,there are many criteria involved in the missile design alternatives. Some criteria with poor performance may be compensated by other criteria with excellent performance, and then it is impossible to find the truly optimal alternative. Aimed at solving these problems, this paper proposes a synthetical assessment process based on fuzzy hesitant linguistic term set and the Gained and Lost Dominance Score(GLDS) method. In order to improve the assessment accuracy of experts and solve the problem that experts generate different opinions, combined with the advantages of fuzzy hesitant sets and linguistic term sets, the double hierarchy hesitant fuzzy linguistic term sets are used in this paper to improve the accuracy of expert’s judgement. In order to effectively combine expert’s experience with the data of criteria, the evidence theory and entropy weight method are used to transfer the expert’s judgement to the weight. In order to avoid selecting defective alternative of missile design, the GLDS is used to fuse expert information and criteria information. Sensitivity analysis shows that the assessment process has sensitivity to some extent. However, when the fluctuation of expert’s assessment makes the fluctuation of θ in the range of-5% to 5%, the impact on the results is not quite conspicuous. The analysis of calculation result and comparative analysis show that the assessment process proposed in this paper is accurate enough, has great advantage in selecting the current and potential optimal alternative of missile design, and avoids the alternatives with low criteria performance that cannot be compensated by other criteria being selected.展开更多
Selecting which explanatory variables to include in a given score is a common difficulty, as a balance must be found between statistical fit and practical application. This article presents a methodology for construct...Selecting which explanatory variables to include in a given score is a common difficulty, as a balance must be found between statistical fit and practical application. This article presents a methodology for constructing parsimonious event risk scores combining a stepwise selection of variables with ensemble scores obtained by aggregation of several scores, using several classifiers, bootstrap samples and various modalities of random selection of variables. Selection methods based on a probabilistic model can be used to achieve a stepwise selection for a given classifier such as logistic regression, but not directly for an ensemble classifier constructed by aggregation of several classifiers. Three selection methods are proposed in this framework, two involving a backward selection of the variables based on their coefficients in an ensemble score and the third involving a forward selection of the variables maximizing the AUC. The stepwise selection allows constructing a succession of scores, with the practitioner able to choose which score best fits his needs. These three methods are compared in an application to construct parsimonious short-term event risk scores in chronic HF patients, using as event the composite endpoint of death or hospitalization for worsening HF within 180 days of a visit. Focusing on the fastest method, four scores are constructed, yielding out-of-bag AUCs ranging from 0.81 (26 variables) to 0.76 (2 variables).展开更多
An effective rapid assessment technique, called ＂P25 Scoring Method＂, has been developed and tested on 26 different case studies recently, in order to predict the collapse vulnerability of the R/C buildings. After a...An effective rapid assessment technique, called ＂P25 Scoring Method＂, has been developed and tested on 26 different case studies recently, in order to predict the collapse vulnerability of the R/C buildings. After a short description of the approach, the study presents the sensitivity study of the method to the selected structural parameters by considering incremental deviation of the final scores from the base model. Further, the methodology was applied to an additional 100 damaged buildings in order to check the reliability of the method and some necessary modifications have been applied to the algorithm after considering this larger database. The evaluation of the results has been interpreted as a beneficial guidance for local authorities. The risk bands are defined according to the final scores and the effect of changing the band-width has also been studied through a safe but an economical procedure. A satisfactory correlation of the method with real damage states is obtained and a ready-to-use methodology has been introduced for future studies.展开更多
BACKGROUND Although substantial evidence supports the advantages of cold snare polypectomy(CSP)in terms of polypectomy efficacy and reduced postoperative adverse events,few studies have examined the cost differences b...BACKGROUND Although substantial evidence supports the advantages of cold snare polypectomy(CSP)in terms of polypectomy efficacy and reduced postoperative adverse events,few studies have examined the cost differences between CSP and traditional endoscopic mucosal resection(EMR)for the treatment of intestinal polyps.AIM To compare the efficacy-cost of EMR and CSP in the treatment of intestinal polyps.METHODS A total of 100 patients with intestinal polyps were included in the retrospective data of our hospital from April 2022 to May 2023.According to the treatment methods,they were divided into EMR(n=46)group and CSP(n=54)group.The baseline data of the two groups were balanced by 1:1 propensity score matching(PSM),and the cost-effectiveness analysis was performed on the two groups after matching.The recurrence rate of the two groups of patients was followed up for 1 year,and they were divided into recurrence group and non-recurrence group according to whether they recurred.Multivariate logistic regression analysis was used to screen out the influencing factors affecting the recurrence of intestinal polyps after endoscopic resection.RESULTS Significant disparities were observed in the number of polyps and smoking background between the two groups before PSM(P<0.05).Following PSM,the number of polyps and smoking history were well balanced between the EMR and CSP groups.The direct cost incurred by the CSP group was markedly higher than that incurred by the EMR group.Concurrently,the cost-effectiveness ratio in the CSP group was substantially reduced when juxtaposed with that in the EMR group(P<0.05).Upon completion of the 1-year follow-up,the rate of recurrence after endoscopic intestinal polypectomy was 38.00%.Multivariate methods revealed that age≥60 years,male sex,number of polyps≥3,and pathological type of adenoma were risk factors for recurrence after endoscopic intestinal polypectomy(all P<0.05).CONCLUSION CSP was more cost-effective for the treatment of intestinal polyps.An age≥60 years,male sex,having a number of polyps≥3,and pathological type of adenoma are independent influencing factors for recurrence.展开更多
To investigate shoulder scoring systems used in Europe and North America and how outcomes might be classified after shoulder joint replacement. All research papers published in four major journals in 2012 and 2013 wer...To investigate shoulder scoring systems used in Europe and North America and how outcomes might be classified after shoulder joint replacement. All research papers published in four major journals in 2012 and 2013 were reviewed for the shoulder scoring systems used in their published papers. A method of identifying how outcomes after shoulder arthroplasty might be used to categorize patients into fair, good, very good and excellent outcomes was explored using the outcome evaluations from patients treated in our own unit. A total of 174 research articles that were published in the four journals used some form of shoulder scoring system. The outcome from shoulder arthroplasty in our unit has been evaluated using the constant score(CS) and the oxford shoulder score and these scores have been used to evaluate individual patient outcomes. CSs of < 30 = unsatisfactory; 30-39 = fair; 40-59 = good; 60-69 = very good; and 70 and over = excellent. The most popular shoulder scoring systems in North America were Simple Shoulder Test and American shoulder and elbow surgeons standard shoulder assessment form score and in Europe CS, Oxford Shoulder Score and DASH score.展开更多
AIM: To compare the functional outcomes of patients who underwent open surgery vs Ponseti method for the management of idiopathic clubfoot and to determine whether correlations exist between functional outcome and rad...AIM: To compare the functional outcomes of patients who underwent open surgery vs Ponseti method for the management of idiopathic clubfoot and to determine whether correlations exist between functional outcome and radiographic measurements.METHODS: A meta-analysis of the literature was conducted for studies concerning primary treatment of patients with idiopathic clubfoot. We searched PubM ed Medline, EMBASE, and the Cochrane Library databases from January 1950 to October 2011. Meta-analyses were performed on outcomes from 12 studies. Pooled means, SDs, and sample sizes were either identified in the results or calculated based on the results of each study.RESULTS: Overall, 835 treated idiopathic clubfeet in 516 patients were reviewed. The average follow-up was 15.7 years. Patients managed with Ponseti method did have a higher rate of excellent or good outcome than patients treated with open surgery(0.76 and 0.62, respectively), but not quite to the point of statistical significance(Q = 3.73, P = 0.053). Age at surgery wasnot correlated with the functional outcome for the surgically treated patients(r =-0.32, P = 0.68). A larger anteroposterior talocalcaneal angle was correlated with a higher rate of excellent or good outcomes(r = 0.80, P = 0.006). There were no other significant correlations between the functional and radiographic outcomes.CONCLUSION: The Ponseti method should be considered the initial treatment of idiopathic clubfeet, and open surgery should be reserved for clubfeet that cannot be completely corrected.展开更多
It is now well known that levels of sperm disomy correlate to levels of infertility （as well as other factors）.The risk of perpetuating aneuploidy to the offspring of infertile males undergoing intracytoplasmic sper...It is now well known that levels of sperm disomy correlate to levels of infertility （as well as other factors）.The risk of perpetuating aneuploidy to the offspring of infertile males undergoing intracytoplasmic sperm injection （ICSI） has become a hotly debated issue in assisted reproduction;however,there remain barriers to the practical implementation of offering sperm disomy screening in a clinical setting. The major barrier is the operator time taken to analyze a statistically meaningful （sufficient） number of cells. The introduction of automated ＇spot counting＇software-hardware combinations presents a potential solution to this problem. In this preliminary validation study,we analyzed 10 patients,both manually and using a commercially available spot counter. Results show a statistically significant correlation between both approaches for scoring of sperm disomy,but no correlation is found when scoring for diploid sperm. The most likely explanation for the latter is an apparent overscoring of two closely associated sperm heads as a single diploid cell. These results,and similar further studies that will ensue,help to inform cost-benefit analyses that individual clinics need to carry out in order to decide whether to adopt sperm aneuploidy screening as a routine tool for the assessment of sperm from men requiring ICSI treatment.展开更多
We introduce a new interpretation and quantitative method for computerized diplopia test. By comparing this new method to the Hess screen test, we validate its applicability among 304 patients with ocular motor nerve ...We introduce a new interpretation and quantitative method for computerized diplopia test. By comparing this new method to the Hess screen test, we validate its applicability among 304 patients with ocular motor nerve palsy. This new method shows great assistant value as the Hess screen test in making accurate diagnosis and quantitative evaluation the severity of diplopia. Furthermore, it is more convenient and suitable for daily clinical use.展开更多
[Objectives]To establish a qualitative identification and content determination method for psoralen and bergapten in the roots and leaves of Ficus pandurata,and the multi-indicator scoring method to optimize the ethan...[Objectives]To establish a qualitative identification and content determination method for psoralen and bergapten in the roots and leaves of Ficus pandurata,and the multi-indicator scoring method to optimize the ethanol extraction process for the effective parts of F.pandurata.[Methods]Qualitative identification was carried out by thin-layer chromatography(TLC)and content determination was made by high-performance liquid chromatography(HPLC);the content of psoralen and bergapten and extract yield were used as indicators,to investigate the effects of ethanol volume fraction,solid-to-liquid ratio,extraction time and extraction times on the ethanol extraction process of F.pandurata;multi-indicator scoring method was adopted,orthogonal test method was designed to optimize the extraction process,and verification test was performed.[Results]TLC chart of F.pandurata shows clear spots and good separation;the detected concentrations of psoralen and bergapten in the roots are in the range of 1.02-32.64μg/mL and shows a good linear relationship with the peak area(r=0.9997);these components have not been detected in the leaves,and the precision,RSD of stability and repeatability test is less than 2%;the average recovery rate was 99.8%-100.2%,and the RSD value is 1.12%-1.13%(n=6);the optimized extraction process is to use 50%ethanol as the extraction solvent,the solid-to-liquid ratio of 1∶10,reflux extraction of 3 times,and 1.5 h each time;the results of the three batches of verification tests show that the content of the two indicator components obtained is high,and the average value of the total amount is 0.34 mg/g(RSD=0.30%,n=3).[Conclusions]The established quality control method for F.pandurata is simple,easy,accurate and reproducible;the preferred extraction process is stable and feasible,suitable for the extraction and purification of coumarin effective parts in F.pandurata roots,so it is expected to provide references for further development of F.pandurata.展开更多
The present aim is to update, upon arrival of new learning data, the parameters of a score constructed with an ensemble method involving linear discriminant analysis and logistic regression in an online setting, witho...The present aim is to update, upon arrival of new learning data, the parameters of a score constructed with an ensemble method involving linear discriminant analysis and logistic regression in an online setting, without the need to store all of the previously obtained data. Poisson bootstrap and stochastic approximation processes were used with online standardized data to avoid numerical explosions, the convergence of which has been established theoretically. This empirical convergence of online ensemble scores to a reference “batch” score was studied on five different datasets from which data streams were simulated, comparing six different processes to construct the online scores. For each score, 50 replications using a total of 10N observations (N being the size of the dataset) were performed to assess the convergence and the stability of the method, computing the mean and standard deviation of a convergence criterion. A complementary study using 100N observations was also performed. All tested processes on all datasets converged after N iterations, except for one process on one dataset. The best processes were averaged processes using online standardized data and a piecewise constant step-size.展开更多
This article compares the size of selected subsets using nonparametric subset selection rules with two different scoring rules for the observations. The scoring rules are based on the expected values of order statisti...This article compares the size of selected subsets using nonparametric subset selection rules with two different scoring rules for the observations. The scoring rules are based on the expected values of order statistics of the uniform distribution (yielding rank values) and of the normal distribution (yielding normal score values). The comparison is made using state motor vehicle traffic fatality rates, published in a 2016 article, with fifty-one states (including DC as a state) and over a nineteen-year period (1994 through 2012). The earlier study considered four block design selection rules—two for choosing a subset to contain the “best” population (i.e., state with lowest mean fatality rate) and two for the “worst” population (i.e., highest mean rate) with a probability of correct selection chosen to be 0.90. Two selection rules based on normal scores resulted in selected subset sizes substantially smaller than corresponding rules based on ranks (7 vs. 16 and 3 vs. 12). For two other selection rules, the subsets chosen were very close in size (within one). A comparison is also made using state homicide rates, published in a 2022 article, with fifty states and covering eight years. The results are qualitatively the same as those obtained with the motor vehicle traffic fatality rates.展开更多
Clubfoot malformation is the most common serious congenital anomaly affecting the foot in children. Its treatment by the Ponseti method is simple, profitable and widely used in the world. Objective: The objective of t...Clubfoot malformation is the most common serious congenital anomaly affecting the foot in children. Its treatment by the Ponseti method is simple, profitable and widely used in the world. Objective: The objective of this study was to identify the factors of the failure of its treatment by the Ponseti method. Material and Method: We carried out a retrospective and descriptive study of cases of congenital equinus clubfoot varus at the Reference Health Care Center of Commune III of Bamako over 26 months from September 2020 to November 2022. Data were treated with the utmost anonymity. Result: This study was performed on 44 children seen for clubfoot: male (68%) and female (32%), with a sex ratio of 2.1. We obtained 13 cases of recidivism including 7 boys and 6 girls. We found 21 cases of unilateral and 23 bilateral;among which 9 recurrences were found against 4 in the unilateral forms. 85% of recurrences did not have good adherence to the splint and 62% did not come regularly for follow-up consultation. We obtained 33 children with idiopathic clubfeet (75%) with a recurrence of 24%, and 7 children with secondary clubfeet with 71 % recurrence. There was no recurrence in the postural type. Among the recurrences, 38.5% started treatment between 1 and 6 months, 23.1% from 0 to 1 month and 15.4% at 2 years and more. 85% of recurrences had a Pirani score between 4.5 to 6 at the start of treatment and 15% at a score of 2.5 to 4. Conclusion: The factors of the failure of the Ponseti method are mainly non-compliance with treatment, secondary clubfeet, and a high Pirani score at the start of treatment.展开更多
We consider the task of binary classification in the high-dimensional setting where the number of features of the given data is larger than the number of observations.To accomplish this task,we propose an adherently p...We consider the task of binary classification in the high-dimensional setting where the number of features of the given data is larger than the number of observations.To accomplish this task,we propose an adherently penalized optimal scoring(APOS)model for simultaneously performing discriminant analysis and feature selection.In this paper,an efficient algorithm based on the block coordinate descent(BCD)method and the SSNAL algorithm is developed to solve the APOS approximately.The convergence results of our method are also established.Numerical experiments conducted on simulated and real datasets demonstrate that the proposed model is more efficient than several sparse discriminant analysis methods.展开更多
Objective: to analyze the intervention effect of pediatric critical care scoring method in pediatric critical care, and then optimize and adjust the pediatric critical care method on this basis. Methods: Select our ho...Objective: to analyze the intervention effect of pediatric critical care scoring method in pediatric critical care, and then optimize and adjust the pediatric critical care method on this basis. Methods: Select our hospital in February 2020 - February 2021, 50 cases treated by critical care children, will be randomly divided into experimental group and control group two groups, one group of children, be normal processing measures, while the experimental group with the control group based on the application of pediatric critical care nursing grading method, two groups of children with all 25 cases, records of two groups of patient care. Results: after time of nursing treatment, the conditions of the two groups of patients were improved, but compared with the experimental group, the improvement of children was better than the control group, P < 0.05, which is comparable. Conclusions: for pediatric critical care in nursing in the process of application of pediatric critical care nursing grading method, can better evaluate in nursing are the existed defects and insufficiency in the implementation process, and then do it, analyzing the specific issues in nursing should be resolved defects and deficiencies, to help children better back to health, optimize the effect of nursing quality, it is worth wide application in clinic.展开更多
基金Supported by National Natural Science Foundation of China,No.81170453 and No.81301025Tianjin City High School Science and Technology Fund Planning Project,No.20120118
文摘AIM:To investigate the outcomes of pancreas-sparing duodenectomy(PSD)with regional lymph node dissection vs pancreaticoduodenectomy(PD).METHODS:Between August 2001 and June 2014,228 patients with early-stage ampullary carcinoma(Amp Ca)underwent surgical treatment(PD,n=159;PSD with regional lymph node dissection,n=69).The patients were divided into two groups:the PD group and the PSD group.Propensity scoring methods were used to select patients with similar disease statuses.A total of 138 matched cases,with 69 patients in each group,were included in the final analysis.RESULTS:The median operative time was shorter among the patients in the PSD group(435 min)compared with those in the PD group(481 min,P=0.048).The median blood loss in the PSD group was significantly less than that in the PD group.The median length of hospital stay was shorter for patients in the PSD group vs the PD group.The incidence of pancreatic fistula was higher among patients in the PD group vs the PSD group.The 1-,3-,and 5-year overall survival and disease-free survival rates for patients in the PSD group were 83%,70%,44%and 73%,61%,39%,respectively,and these values were not different than compared with those in the PD group(P=0.625).CONCLUSION:PSD with regional lymph node dissection presents an acceptable morbidity in addition to its advantages over PD.PSD may be a safe and feasible alternative to PD in the treatment of earlystage Amp Ca.
文摘Warhead power assessment of the anti-ship missile plays a vital role in determining the optimal design of missile, thus having important strategic research significance. However, in the assessment process, expert’s judgement will directly affect the assessment accuracy. In addition,there are many criteria involved in the missile design alternatives. Some criteria with poor performance may be compensated by other criteria with excellent performance, and then it is impossible to find the truly optimal alternative. Aimed at solving these problems, this paper proposes a synthetical assessment process based on fuzzy hesitant linguistic term set and the Gained and Lost Dominance Score(GLDS) method. In order to improve the assessment accuracy of experts and solve the problem that experts generate different opinions, combined with the advantages of fuzzy hesitant sets and linguistic term sets, the double hierarchy hesitant fuzzy linguistic term sets are used in this paper to improve the accuracy of expert’s judgement. In order to effectively combine expert’s experience with the data of criteria, the evidence theory and entropy weight method are used to transfer the expert’s judgement to the weight. In order to avoid selecting defective alternative of missile design, the GLDS is used to fuse expert information and criteria information. Sensitivity analysis shows that the assessment process has sensitivity to some extent. However, when the fluctuation of expert’s assessment makes the fluctuation of θ in the range of-5% to 5%, the impact on the results is not quite conspicuous. The analysis of calculation result and comparative analysis show that the assessment process proposed in this paper is accurate enough, has great advantage in selecting the current and potential optimal alternative of missile design, and avoids the alternatives with low criteria performance that cannot be compensated by other criteria being selected.
文摘Selecting which explanatory variables to include in a given score is a common difficulty, as a balance must be found between statistical fit and practical application. This article presents a methodology for constructing parsimonious event risk scores combining a stepwise selection of variables with ensemble scores obtained by aggregation of several scores, using several classifiers, bootstrap samples and various modalities of random selection of variables. Selection methods based on a probabilistic model can be used to achieve a stepwise selection for a given classifier such as logistic regression, but not directly for an ensemble classifier constructed by aggregation of several classifiers. Three selection methods are proposed in this framework, two involving a backward selection of the variables based on their coefficients in an ensemble score and the third involving a forward selection of the variables maximizing the AUC. The stepwise selection allows constructing a succession of scores, with the practitioner able to choose which score best fits his needs. These three methods are compared in an application to construct parsimonious short-term event risk scores in chronic HF patients, using as event the composite endpoint of death or hospitalization for worsening HF within 180 days of a visit. Focusing on the fastest method, four scores are constructed, yielding out-of-bag AUCs ranging from 0.81 (26 variables) to 0.76 (2 variables).
文摘An effective rapid assessment technique, called ＂P25 Scoring Method＂, has been developed and tested on 26 different case studies recently, in order to predict the collapse vulnerability of the R/C buildings. After a short description of the approach, the study presents the sensitivity study of the method to the selected structural parameters by considering incremental deviation of the final scores from the base model. Further, the methodology was applied to an additional 100 damaged buildings in order to check the reliability of the method and some necessary modifications have been applied to the algorithm after considering this larger database. The evaluation of the results has been interpreted as a beneficial guidance for local authorities. The risk bands are defined according to the final scores and the effect of changing the band-width has also been studied through a safe but an economical procedure. A satisfactory correlation of the method with real damage states is obtained and a ready-to-use methodology has been introduced for future studies.
文摘BACKGROUND Although substantial evidence supports the advantages of cold snare polypectomy(CSP)in terms of polypectomy efficacy and reduced postoperative adverse events,few studies have examined the cost differences between CSP and traditional endoscopic mucosal resection(EMR)for the treatment of intestinal polyps.AIM To compare the efficacy-cost of EMR and CSP in the treatment of intestinal polyps.METHODS A total of 100 patients with intestinal polyps were included in the retrospective data of our hospital from April 2022 to May 2023.According to the treatment methods,they were divided into EMR(n=46)group and CSP(n=54)group.The baseline data of the two groups were balanced by 1:1 propensity score matching(PSM),and the cost-effectiveness analysis was performed on the two groups after matching.The recurrence rate of the two groups of patients was followed up for 1 year,and they were divided into recurrence group and non-recurrence group according to whether they recurred.Multivariate logistic regression analysis was used to screen out the influencing factors affecting the recurrence of intestinal polyps after endoscopic resection.RESULTS Significant disparities were observed in the number of polyps and smoking background between the two groups before PSM(P<0.05).Following PSM,the number of polyps and smoking history were well balanced between the EMR and CSP groups.The direct cost incurred by the CSP group was markedly higher than that incurred by the EMR group.Concurrently,the cost-effectiveness ratio in the CSP group was substantially reduced when juxtaposed with that in the EMR group(P<0.05).Upon completion of the 1-year follow-up,the rate of recurrence after endoscopic intestinal polypectomy was 38.00%.Multivariate methods revealed that age≥60 years,male sex,number of polyps≥3,and pathological type of adenoma were risk factors for recurrence after endoscopic intestinal polypectomy(all P<0.05).CONCLUSION CSP was more cost-effective for the treatment of intestinal polyps.An age≥60 years,male sex,having a number of polyps≥3,and pathological type of adenoma are independent influencing factors for recurrence.
文摘To investigate shoulder scoring systems used in Europe and North America and how outcomes might be classified after shoulder joint replacement. All research papers published in four major journals in 2012 and 2013 were reviewed for the shoulder scoring systems used in their published papers. A method of identifying how outcomes after shoulder arthroplasty might be used to categorize patients into fair, good, very good and excellent outcomes was explored using the outcome evaluations from patients treated in our own unit. A total of 174 research articles that were published in the four journals used some form of shoulder scoring system. The outcome from shoulder arthroplasty in our unit has been evaluated using the constant score(CS) and the oxford shoulder score and these scores have been used to evaluate individual patient outcomes. CSs of < 30 = unsatisfactory; 30-39 = fair; 40-59 = good; 60-69 = very good; and 70 and over = excellent. The most popular shoulder scoring systems in North America were Simple Shoulder Test and American shoulder and elbow surgeons standard shoulder assessment form score and in Europe CS, Oxford Shoulder Score and DASH score.
文摘AIM: To compare the functional outcomes of patients who underwent open surgery vs Ponseti method for the management of idiopathic clubfoot and to determine whether correlations exist between functional outcome and radiographic measurements.METHODS: A meta-analysis of the literature was conducted for studies concerning primary treatment of patients with idiopathic clubfoot. We searched PubM ed Medline, EMBASE, and the Cochrane Library databases from January 1950 to October 2011. Meta-analyses were performed on outcomes from 12 studies. Pooled means, SDs, and sample sizes were either identified in the results or calculated based on the results of each study.RESULTS: Overall, 835 treated idiopathic clubfeet in 516 patients were reviewed. The average follow-up was 15.7 years. Patients managed with Ponseti method did have a higher rate of excellent or good outcome than patients treated with open surgery(0.76 and 0.62, respectively), but not quite to the point of statistical significance(Q = 3.73, P = 0.053). Age at surgery wasnot correlated with the functional outcome for the surgically treated patients(r =-0.32, P = 0.68). A larger anteroposterior talocalcaneal angle was correlated with a higher rate of excellent or good outcomes(r = 0.80, P = 0.006). There were no other significant correlations between the functional and radiographic outcomes.CONCLUSION: The Ponseti method should be considered the initial treatment of idiopathic clubfeet, and open surgery should be reserved for clubfeet that cannot be completely corrected.
文摘It is now well known that levels of sperm disomy correlate to levels of infertility （as well as other factors）.The risk of perpetuating aneuploidy to the offspring of infertile males undergoing intracytoplasmic sperm injection （ICSI） has become a hotly debated issue in assisted reproduction;however,there remain barriers to the practical implementation of offering sperm disomy screening in a clinical setting. The major barrier is the operator time taken to analyze a statistically meaningful （sufficient） number of cells. The introduction of automated ＇spot counting＇software-hardware combinations presents a potential solution to this problem. In this preliminary validation study,we analyzed 10 patients,both manually and using a commercially available spot counter. Results show a statistically significant correlation between both approaches for scoring of sperm disomy,but no correlation is found when scoring for diploid sperm. The most likely explanation for the latter is an apparent overscoring of two closely associated sperm heads as a single diploid cell. These results,and similar further studies that will ensue,help to inform cost-benefit analyses that individual clinics need to carry out in order to decide whether to adopt sperm aneuploidy screening as a routine tool for the assessment of sperm from men requiring ICSI treatment.
文摘We introduce a new interpretation and quantitative method for computerized diplopia test. By comparing this new method to the Hess screen test, we validate its applicability among 304 patients with ocular motor nerve palsy. This new method shows great assistant value as the Hess screen test in making accurate diagnosis and quantitative evaluation the severity of diplopia. Furthermore, it is more convenient and suitable for daily clinical use.
基金Major Medical and Health Project of Science and Technology Plan of Zhongshan City,Guangdong Province(2017B1006)Project of Traditional Chinese Medicine Bureau of Guangdong Province(20182168).
文摘[Objectives]To establish a qualitative identification and content determination method for psoralen and bergapten in the roots and leaves of Ficus pandurata,and the multi-indicator scoring method to optimize the ethanol extraction process for the effective parts of F.pandurata.[Methods]Qualitative identification was carried out by thin-layer chromatography(TLC)and content determination was made by high-performance liquid chromatography(HPLC);the content of psoralen and bergapten and extract yield were used as indicators,to investigate the effects of ethanol volume fraction,solid-to-liquid ratio,extraction time and extraction times on the ethanol extraction process of F.pandurata;multi-indicator scoring method was adopted,orthogonal test method was designed to optimize the extraction process,and verification test was performed.[Results]TLC chart of F.pandurata shows clear spots and good separation;the detected concentrations of psoralen and bergapten in the roots are in the range of 1.02-32.64μg/mL and shows a good linear relationship with the peak area(r=0.9997);these components have not been detected in the leaves,and the precision,RSD of stability and repeatability test is less than 2%;the average recovery rate was 99.8%-100.2%,and the RSD value is 1.12%-1.13%(n=6);the optimized extraction process is to use 50%ethanol as the extraction solvent,the solid-to-liquid ratio of 1∶10,reflux extraction of 3 times,and 1.5 h each time;the results of the three batches of verification tests show that the content of the two indicator components obtained is high,and the average value of the total amount is 0.34 mg/g(RSD=0.30%,n=3).[Conclusions]The established quality control method for F.pandurata is simple,easy,accurate and reproducible;the preferred extraction process is stable and feasible,suitable for the extraction and purification of coumarin effective parts in F.pandurata roots,so it is expected to provide references for further development of F.pandurata.
文摘The present aim is to update, upon arrival of new learning data, the parameters of a score constructed with an ensemble method involving linear discriminant analysis and logistic regression in an online setting, without the need to store all of the previously obtained data. Poisson bootstrap and stochastic approximation processes were used with online standardized data to avoid numerical explosions, the convergence of which has been established theoretically. This empirical convergence of online ensemble scores to a reference “batch” score was studied on five different datasets from which data streams were simulated, comparing six different processes to construct the online scores. For each score, 50 replications using a total of 10N observations (N being the size of the dataset) were performed to assess the convergence and the stability of the method, computing the mean and standard deviation of a convergence criterion. A complementary study using 100N observations was also performed. All tested processes on all datasets converged after N iterations, except for one process on one dataset. The best processes were averaged processes using online standardized data and a piecewise constant step-size.
文摘This article compares the size of selected subsets using nonparametric subset selection rules with two different scoring rules for the observations. The scoring rules are based on the expected values of order statistics of the uniform distribution (yielding rank values) and of the normal distribution (yielding normal score values). The comparison is made using state motor vehicle traffic fatality rates, published in a 2016 article, with fifty-one states (including DC as a state) and over a nineteen-year period (1994 through 2012). The earlier study considered four block design selection rules—two for choosing a subset to contain the “best” population (i.e., state with lowest mean fatality rate) and two for the “worst” population (i.e., highest mean rate) with a probability of correct selection chosen to be 0.90. Two selection rules based on normal scores resulted in selected subset sizes substantially smaller than corresponding rules based on ranks (7 vs. 16 and 3 vs. 12). For two other selection rules, the subsets chosen were very close in size (within one). A comparison is also made using state homicide rates, published in a 2022 article, with fifty states and covering eight years. The results are qualitatively the same as those obtained with the motor vehicle traffic fatality rates.
文摘Clubfoot malformation is the most common serious congenital anomaly affecting the foot in children. Its treatment by the Ponseti method is simple, profitable and widely used in the world. Objective: The objective of this study was to identify the factors of the failure of its treatment by the Ponseti method. Material and Method: We carried out a retrospective and descriptive study of cases of congenital equinus clubfoot varus at the Reference Health Care Center of Commune III of Bamako over 26 months from September 2020 to November 2022. Data were treated with the utmost anonymity. Result: This study was performed on 44 children seen for clubfoot: male (68%) and female (32%), with a sex ratio of 2.1. We obtained 13 cases of recidivism including 7 boys and 6 girls. We found 21 cases of unilateral and 23 bilateral;among which 9 recurrences were found against 4 in the unilateral forms. 85% of recurrences did not have good adherence to the splint and 62% did not come regularly for follow-up consultation. We obtained 33 children with idiopathic clubfeet (75%) with a recurrence of 24%, and 7 children with secondary clubfeet with 71 % recurrence. There was no recurrence in the postural type. Among the recurrences, 38.5% started treatment between 1 and 6 months, 23.1% from 0 to 1 month and 15.4% at 2 years and more. 85% of recurrences had a Pirani score between 4.5 to 6 at the start of treatment and 15% at a score of 2.5 to 4. Conclusion: The factors of the failure of the Ponseti method are mainly non-compliance with treatment, secondary clubfeet, and a high Pirani score at the start of treatment.
基金supported by the National Natural Science Foundation of China(No.12271097)the Key Program of National Science Foundation of Fujian Province of China(No.2023J02007)+1 种基金the Central Guidance on Local Science and Technology Development Fund of Fujian Province(No.2023L3003)the Fujian Alliance of Mathematics(No.2023SXLMMS01)。
文摘We consider the task of binary classification in the high-dimensional setting where the number of features of the given data is larger than the number of observations.To accomplish this task,we propose an adherently penalized optimal scoring(APOS)model for simultaneously performing discriminant analysis and feature selection.In this paper,an efficient algorithm based on the block coordinate descent(BCD)method and the SSNAL algorithm is developed to solve the APOS approximately.The convergence results of our method are also established.Numerical experiments conducted on simulated and real datasets demonstrate that the proposed model is more efficient than several sparse discriminant analysis methods.
文摘Objective: to analyze the intervention effect of pediatric critical care scoring method in pediatric critical care, and then optimize and adjust the pediatric critical care method on this basis. Methods: Select our hospital in February 2020 - February 2021, 50 cases treated by critical care children, will be randomly divided into experimental group and control group two groups, one group of children, be normal processing measures, while the experimental group with the control group based on the application of pediatric critical care nursing grading method, two groups of children with all 25 cases, records of two groups of patient care. Results: after time of nursing treatment, the conditions of the two groups of patients were improved, but compared with the experimental group, the improvement of children was better than the control group, P < 0.05, which is comparable. Conclusions: for pediatric critical care in nursing in the process of application of pediatric critical care nursing grading method, can better evaluate in nursing are the existed defects and insufficiency in the implementation process, and then do it, analyzing the specific issues in nursing should be resolved defects and deficiencies, to help children better back to health, optimize the effect of nursing quality, it is worth wide application in clinic.
