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
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
Objective: to analyze the effect and value of intervention and guidance of nursing scoring method for children with critical diseases in child care. Methods: the samples were taken from 100 critically ill children adm...Objective: to analyze the effect and value of intervention and guidance of nursing scoring method for children with critical diseases in child care. Methods: the samples were taken from 100 critically ill children admitted to our hospital from January 2020 to June 2021. According to the different nursing intervention methods, the patients were divided into the control group (routine nursing) and the research group (critical illness nursing score method intervention), with a single group of 50 cases. The data differences such as the incidence of complications, severity of illness, blood gas index and nursing satisfaction were observed and compared. Results: the total incidence rate of heart failure, potential respiratory failure, compensatory shock and irreversible organ failure in the study group was 6.00% significantly lower than that in the control group by 20.00% (P < 0.05). After the intervention, APACHE Ⅱ score and SOFA score of the two groups were lower than before the intervention, and the study group was significantly lower than the control group (P < 0.05). After the intervention, the oxygen partial pressure and carbon dioxide partial pressure of the two groups were better than before the intervention, and the research group was significantly better than the control group (p < 0.05). The satisfaction rate of the research group's family members to the nursing service was 96.00% higher than that of the control group's 84.00% (p < 0.05). Compared with the control group, the study group had higher scores in basic nursing, ward management, nursing safety and nursing documents (p < 0.05). Conclusion: the pediatric critical illness nursing score method has good intervention and guidance value for pediatric nursing, which not only can reduce the incidence of complications, but also can significantly improve the severity of the illness, blood gas indicators, and enhance the satisfaction of family members to the nursing service and the quality of nursing. It is worthy of clinical reference and promotion.展开更多
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
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
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
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
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
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
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Objective: to analyze the effect and value of intervention and guidance of nursing scoring method for children with critical diseases in child care. Methods: the samples were taken from 100 critically ill children admitted to our hospital from January 2020 to June 2021. According to the different nursing intervention methods, the patients were divided into the control group (routine nursing) and the research group (critical illness nursing score method intervention), with a single group of 50 cases. The data differences such as the incidence of complications, severity of illness, blood gas index and nursing satisfaction were observed and compared. Results: the total incidence rate of heart failure, potential respiratory failure, compensatory shock and irreversible organ failure in the study group was 6.00% significantly lower than that in the control group by 20.00% (P < 0.05). After the intervention, APACHE Ⅱ score and SOFA score of the two groups were lower than before the intervention, and the study group was significantly lower than the control group (P < 0.05). After the intervention, the oxygen partial pressure and carbon dioxide partial pressure of the two groups were better than before the intervention, and the research group was significantly better than the control group (p < 0.05). The satisfaction rate of the research group's family members to the nursing service was 96.00% higher than that of the control group's 84.00% (p < 0.05). Compared with the control group, the study group had higher scores in basic nursing, ward management, nursing safety and nursing documents (p < 0.05). Conclusion: the pediatric critical illness nursing score method has good intervention and guidance value for pediatric nursing, which not only can reduce the incidence of complications, but also can significantly improve the severity of the illness, blood gas indicators, and enhance the satisfaction of family members to the nursing service and the quality of nursing. It is worthy of clinical reference and promotion.
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.
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.
