Microvasculature of the retina is considered an alternative marker of cerebral vascular risk in healthy populations.However,the ability of retinal vasculature changes,specifically focusing on retinal vessel diameter,t...Microvasculature of the retina is considered an alternative marker of cerebral vascular risk in healthy populations.However,the ability of retinal vasculature changes,specifically focusing on retinal vessel diameter,to predict the recurrence of cerebrovascular events in patients with ischemic stroke has not been determined comprehensively.While previous studies have shown a link between retinal vessel diameter and recurrent cerebrovascular events,they have not incorporated this information into a predictive model.Therefore,this study aimed to investigate the relationship between retinal vessel diameter and subsequent cerebrovascular events in patients with acute ischemic stroke.Additionally,we sought to establish a predictive model by combining retinal veessel diameter with traditional risk factors.We performed a prospective observational study of 141 patients with acute ischemic stroke who were admitted to the First Affiliated Hospital of Jinan University.All of these patients underwent digital retinal imaging within 72 hours of admission and were followed up for 3 years.We found that,after adjusting for related risk factors,patients with acute ischemic stroke with mean arteriolar diameter within 0.5-1.0 disc diameters of the disc margin(MAD_(0.5-1.0DD))of≥74.14μm and mean venular diameter within 0.5-1.0 disc diameters of the disc margin(MVD_(0.5-1.0DD))of≥83.91μm tended to experience recurrent cerebrovascular events.We established three multivariate Cox proportional hazard regression models:model 1 included traditional risk factors,model 2 added MAD_(0.5-1.0DD)to model 1,and model 3 added MVD0.5-1.0DD to model 1.Model 3 had the greatest potential to predict subsequent cerebrovascular events,followed by model 2,and finally model 1.These findings indicate that combining retinal venular or arteriolar diameter with traditional risk factors could improve the prediction of recurrent cerebrovascular events in patients with acute ischemic stroke,and that retinal imaging could be a useful and non-invasive method for identifying high-risk patients who require closer monitoring and more aggressive management.展开更多
BACKGROUND:As advocated in advanced trauma life support and prehospital trauma life support protocols,cervical immobilization is applied until cervical spine injury is excluded.This study aimed to show the difference ...BACKGROUND:As advocated in advanced trauma life support and prehospital trauma life support protocols,cervical immobilization is applied until cervical spine injury is excluded.This study aimed to show the difference in optic nerve sheath diameter(ONSD)between patients with and without a cervical collar using computed tomography(CT).METHODS:This was a single-center,retrospective study examining trauma patients who presented to the emergency department between January 1,2021,and December 31,2021.The ONSD on brain CT of the trauma patients was measured and analyzed to determine whether there was a difference between the ONSD with and without the cervical collar.RESULTS:The study population consisted of 169 patients.On CT imaging of patients with(n=66)and without(n=103)cervical collars,the mean ONSD in the axial plane were 5.43±0.50 mm and 5.04±0.46 mm respectively for the right eye and 5.50±0.52 mm and 5.11±0.46 mm respectively for the left eye.The results revealed an association between the presence of a cervical collar and the mean ONSD,which was statistically significant(P<0.001)for both the right and left eyes.CONCLUSION:A cervical collar may be associated with increased ONSD.The effect of this increase in the ONSD on clinical outcomes needs to be investigated,and the actual need for cervical collar in the emergency department should be evaluated on a case-by-case basis.展开更多
AIM:To present the 1-year results of a prospective cohort study investigating the efficacy,potential mechanism,and safety of orthokeratology(ortho-k)with different back optic zone diameters(BOZD)for myopia control in ...AIM:To present the 1-year results of a prospective cohort study investigating the efficacy,potential mechanism,and safety of orthokeratology(ortho-k)with different back optic zone diameters(BOZD)for myopia control in children.METHODS:This randomized clinical study was performed between Dec.2020 and Dec.2021.Participants were randomly assigned to three groups wearing ortho-k:5 mm BOZD(5-MM group),5.5 mm BOZD(5.5-MM group),and 6 mm BOZD(6-MM group).The 1-year data were recorded,including axial length,relative peripheral refraction(RPR,measured by multispectral refractive topography,MRT),and visual quality.The contrast sensitivity(CS)was evaluated by CSV-1000 instrument with spatial frequencies of 3,6,12,and 18 cycles/degree(c/d);the corneal higher-order aberrations(HOAs)were measured by iTrace aberration analyzer.The one-way ANOVA was performed to assess the differences between the three groups.The correlation between the change in AL and RPR was calculated by Pearson’s correlation coefficient.RESULTS:The 1-year results of 20,21,and 21 subjects in the 5-MM,5.5-MM,and 6-MM groups,respectively,were presented.There were no statistical differences in baseline age,sex,or ocular parameters between the three groups(all P>0.05).At the 1-year visit,the 5-MM group had lower axial elongation than the 6-MM group(0.07±0.09 vs 0.18±0.11 mm,P=0.001).The 5-MM group had more myopic total RPR(TRPR,P=0.014),with RPR in the 15°–30°(RPR 15–30,P=0.015),30°–45°(RPR 30–45,P=0.011),temporal(RPR-T,P=0.008),and nasal area(RPR-N,P<0.001)than the 6-MM group.RPR 15–30 in the 5.5-MM group was more myopic than that in the 6-MM group(P=0.002),and RPR-N in the 5-MM group was more myopic than that in the 5.5-MM group(P<0.001).There were positive correlations between the axial elongation and the change in TRPR(r=0.756,P<0.001),RPR 15–30(r=0.364,P=0.004),RPR 30–45(r=0.306,P=0.016),and RPR-N(r=0.253,P=0.047).The CS decreased at 3 c/d(P<0.001),and the corneal HOAs increased in the 5-MM group(P=0.030).CONCLUSION:Ortho-k with 5 mm BOZD can control myopia progression more effectively.The mechanism may be associated with greater myopic shifts in RPR.展开更多
BACKGROUND The maximum outer diameter(MOD)of the appendix is an essential parameter for diagnosing acute appendicitis,but there is space for improvement in ultrasound(US)diagnostic performance.AIM To investigate wheth...BACKGROUND The maximum outer diameter(MOD)of the appendix is an essential parameter for diagnosing acute appendicitis,but there is space for improvement in ultrasound(US)diagnostic performance.AIM To investigate whether combining the ratio of the cross diameters(RATIO)of the appendix with MOD of the appendix can enhance the diagnostic performance of acute appendicitis.METHODS A retrospective study was conducted,and medical records of 233 patients with acute appendicitis and 112 patients with a normal appendix were reviewed.The MOD and RATIO of the appendix were calculated and tested for their diagnostic performance of acute appendicitis,both individually and in combination.RESULTS The RATIO for a normal appendix was 1.32±0.16,while for acute appendicitis it was 1.09±0.07.The cut-off value for RATIO was determined to be≤1.18.The area under the receiver operating characteristic curve(AUC)for diagnosing acute appendicitis using RATIO≤1.18 and MOD>6 mm was 0.870 and 0.652,respectively.There was a significant difference in AUC between RATIO≤1.18 and MOD>6 mm(P<0.0001).When comparing the combination of RATIO≤1.18 and MOD>6 mm with MOD>6 mm alone,the combination showed increased specificity,positive predictive value(PPV),and AUC.However,the sensitivity and negative predictive value decreased.CONCLUSION Combining RATIO of the appendix≤1.18 and MOD>6 mm can significantly improve the specificity,PPV,and AUC in the US diagnosis of acute appendicitis.展开更多
Based on the investigation data of 12 Haloxylon ammodendron plots in the south edge of Gurbantunggut Desert, Fuzzy distribution was introduced into the study of Haloxylon ammodendron base diameter structure fitting ac...Based on the investigation data of 12 Haloxylon ammodendron plots in the south edge of Gurbantunggut Desert, Fuzzy distribution was introduced into the study of Haloxylon ammodendron base diameter structure fitting according to the consistency between the characteristics of Fuzzy distribution function and the distribution series of cumulative percentage of stand base diameter, and the fitting precision and effect of Fuzzy distribution function were discussed. The root mean square error RMSE and determination coefficient R<sup>2</sup> values showed that Fuzzy-Γ<sub>1</sub>, Fuzzy-Γ<sub>2</sub>, Fuzzy-Γ<sub>3</sub>, Fuzzy-Γ<sub>4</sub> had good fitting performance, among which Fuzzy-Γ<sub>1</sub> had relatively high fitting precision, and its parameters were closely related to stand age and density, Fuzzy-Γ<sub>2</sub> distribution function was the second, and Fuzzy-Γ<sub>4</sub> distribution function had the worst fitting effect. By introducing a parameter c from the similarity of four distribution function formulas, a generalized Fuzzy distribution function Fuzzy-Γ<sub>5</sub> is obtained. This function shows the highest fitting accuracy. Most of the values of parameter c are near 1 or 2, which shows that the diameter distribution is mainly approximate to Fuzzy-Γ<sub>1</sub> and Fuzzy-Γ<sub>2</sub>.展开更多
Managing mature Douglas-fir[Pseudotsuga menziesii(Mirb.)Franco]stands to emulate the structural complexity of natural old-growth forest requires identifying structural targets at the sub-stand level at which neighborh...Managing mature Douglas-fir[Pseudotsuga menziesii(Mirb.)Franco]stands to emulate the structural complexity of natural old-growth forest requires identifying structural targets at the sub-stand level at which neighborhood dynamics and patchy disturbance shape structure.We therefore sought to describe the archetypal shapes of predominant sub-stand diameter distribution types(DDTs)observed in natural tree neighborhoods in stands comprising a chronosequence(ca.120-450+yrs)encompassing mature,vertical diversification,and horizontal diversification development stages.The ten 1.0 ha stands are located in the southcentral Oregon Cascades,USA.Building on the known spatial position of each tree,natural tree neighborhoods were identified using the floating neighborhood approach based on spatial tessellation connecting neighboring trees at the first-(mean 61 m2)through fifth-(mean 2058 m2)order scales.Cluster analysis was then used to objectively identify the most predominant DDTs among the relative tree size distributions observed in the trans-scale neighborhoods within each stand.Repeated measures regression was used to classify each DDT to one of six observed archetypal shapes:negative exponential,unimodal,rotated sigmoid,bimodal,concave,or multi-modal.Only three of the 81 observed DDTs deviated by<10%from the stand average,while every stand had at least one DDT that deviated by>50%(maximum 83%).Within each stand,five to ten predominant DDTs were observed,which deviated from the stand average by 30-48%and were characterized by two to five different archetypal shapes.Consequently,in some stands the majority of tree neighborhoods were best characterized by a different shape from that assigned at the stand level.Deviation from the stand average increased from the youngest stand in the mature development stage through the middle stands in the vertical diversification stage to the oldest stands in the horizontal diversification stage.The complexity of DDT shapes tended to increase along the chronosequence(from negative exponential and uniform toward concave and multi-modal),with shape richness highest mid-sequence and evenness peaking in the oldest stands.The high diversity of sub-stand structural complexity reduces the utility of standlevel diameter distributions as old-growth restoration targets.However,the presence in early-sequence stands of sub-stand diameter distributions common to later-sequence stands may facilitate active management at the neighborhood level to promote future old-growth condition.Restoration of substand diameter structures would likely require combining spatial perspectives,such as by augmenting tree-level croptree management with diameter distribution targets for the resulting tree neighborhoods.展开更多
Current techniques of forest inventory rely on manual measurements and are slow and labor intensive.Recent developments in computer vision and depth sensing can produce accurate measurement data at significantly reduc...Current techniques of forest inventory rely on manual measurements and are slow and labor intensive.Recent developments in computer vision and depth sensing can produce accurate measurement data at significantly reduced time and labor costs.We developed the ForSense system to measure the diameters of trees at various points along the stem as well as stem straightness.Time use,mean absolute error(MAE),and root mean squared error(RMSE)metrics were used to compare the system against manual methods,and to compare the system against itself(reproducibility).Depth-derived diameter measurements of the stems at the heights of 0.3,1.4,and 2.7 m achieved RMSE of 1.7,1.5,and 2.7 cm,respectively.The ForSense system produced straightness measurement data that was highly correlated with straightness ratings by trained foresters.The ForSense system was also consistent,achieving sub-centimeter diameter difference with subsequent measures and less than 4%difference in straightness value between runs.This method of forest inventory,which is based on depth-image computer vision,is time efficient compared to manual methods and less computationally and technologically intensive compared to Structure-from-Motion(SFM)photogrammetry and ground-based LiDAR or terrestrial laser scanning(TLS).展开更多
The diameter distribution of trees in a stand provides the basis for determining the stand’s ecological and economic value,its structure and stability and appropriate management practices.Scots pine(Pinus sylvestris ...The diameter distribution of trees in a stand provides the basis for determining the stand’s ecological and economic value,its structure and stability and appropriate management practices.Scots pine(Pinus sylvestris L.)is one of the most common and important conifers in Turkey,so a well-planned management schedule is critical.Diameter distribution models to accurately describe the stand structure help improve management strategies,but developing reliable models requires a deep understanding of the growth,output and constraints of the forests.The most important information derived by diameter distribution models is primary data on horizontal stand structure for each diameter class of trees:basal area and volume per unit area.These predictions are required to estimate the range of products and predicted volume and yield from a forest stand.Here,to construct an accurate,reliable diameter distribution model for natural Scots pine stands in the Türkmen Mountain region,we used Johnson’s SBdistribution to represent the empirical diameter distributions of the stands using ground-based measurements from 55 sample plots that included1219 trees in natural distribution zones of the forests.As an alternative,nonparametric approach,which does not require any predefined function,an artificial intelligence model was constructed based on support vector machine methodology.An error index was calculated to evaluate the results.Overall,both Johnson’s SB probability density function with a three-parameter recovery approach and the support vector regression methodology provided reliable estimates of the diameter distribution of these stands.展开更多
Quadratic mean diameter is the most frequently reported descriptor of the diameter distribution of forests.As such,it is often used as an indicator of forest stand structure,developmental stage,and ecological and econ...Quadratic mean diameter is the most frequently reported descriptor of the diameter distribution of forests.As such,it is often used as an indicator of forest stand structure,developmental stage,and ecological and economic potential.However,quadratic mean diameter can be heavily influenced by the presence or absence of large numbers of small stems in lower canopy strata,and it is also sensitive to left-truncation of the diameter distribution,making its interpretation across inventories with different protocols challenging.Here,we examine three alternative expressions of stand diameter:the arithmetic and quadratic mean diameter of the thickest 100 trees per hectare,and the basal area-weighted mean diameter.Using data from the United States Forest Inventory and Analysis program for New York and New England,these alternative expressions showed closer correlation with multiple stand structural variables than did quadratic mean diameter,including merchantable cubic and board foot volume per hectare,aboveground live tree carbon per hectare,and total number of live and dead standing trees greater than 40 cm diameter at breast height per hectare(previously proposed as an index of old-growth structure).Arithmetic and quadratic mean diameter of the thickest 100 trees per hectare showed nearly identical performance,and the strongest correlations across the board.We develop closed-form expressions for these variables when the diameter distribution is a Weibull,and illustrate their behavior relative to quadratic mean diameter for that situation.While the reasons for prevalence of quadratic mean diameter as an indicator remain valid,we suggest that these alternative measures should be more widely reported and analyzed to give a more informative depiction of stand structure and development in complex forests.展开更多
Background: Accurate determination of gestational age has become important for deciding the appropriate time for termination of the pregnancy as well as to monitor the fetal growth during the entire period of pregnanc...Background: Accurate determination of gestational age has become important for deciding the appropriate time for termination of the pregnancy as well as to monitor the fetal growth during the entire period of pregnancy. Objective: The aim of the study was to assess whether the trans-cerebellar diameter, placental thickness or combining both of them is more accurate for assessment of gestational age in the 3<sup>rd</sup> trimester of pregnancy. Patients and Methods: This is a cross sectional study conducted at outpatient Clinic and Obstetric ward, Ain Shams University Maternity Hospital, over a period of six months from March 2019 to September 2019. One hundred pregnant women were recruited according to inclusion criteria either from outpatient clinic or were admitted in obstetric ward Ain Shams Maternity Hospital to find out the most accurate fetal biometric measurement in the third trimester either trans-cerebellar diameter placental thickness or both compared to reliable LMP (last menstrual period) dates confirmed by crown rump length (CRL) in the first trimester. Results: Trans-cerebellar diameter mean ± SD was 46.0 ± 3.5 with range 38.2 - 51.7. The mean of placental thickness was 39.6 ± 7.1 with range 22.8 - 54.3. Placental thickness had highest determination (0.813) for last menstrual period followed by trans-cerebellar diameter (0.802). Combining trans-cerebellar diameter and placental thickness increased determination (0.902) for last menstrual period. Conclusion: Combined use of trans-cerebellar diameter and placental thickness in the third trimester of pregnancy is a reliable indicator for gestational age in women whose last menstrual period is unreliable or unknown, but placental thickness had higher accuracy than trans-cerebellar diameter.展开更多
BACKGROUND Delay in treatment of raised intracranial pressure(ICP)leads to poor clinical outcomes.Optic nerve sheath diameter(ONSD)by ultrasonography(US-ONSD)has shown good accuracy in traumatic brain injury and neuro...BACKGROUND Delay in treatment of raised intracranial pressure(ICP)leads to poor clinical outcomes.Optic nerve sheath diameter(ONSD)by ultrasonography(US-ONSD)has shown good accuracy in traumatic brain injury and neurosurgical patients to diagnose raised ICP.However,there is a dearth of data in neuro-medical intensive care unit(ICU)where the spectrum of disease is different.AIM To validate the diagnostic accuracy of ONSD in non-traumatic neuro-critically ill patients.METHODS We prospectively enrolled 114 patients who had clinically suspected raised ICP due to non-traumatic causes admitted in neuro-medical ICU.US-ONSD was performed according to ALARA principles.A cut-off more than 5.7 mm was taken as significantly raised.Raised ONSD was corelated with raised ICP on radiological imaging.Clinical history,general and systemic examination findings,SOFA and APACHE 2 score and patient outcomes were recorded.RESULTS There was significant association between raised ONSD and raised ICP on imaging(P<0.001).The sensitivity,specificity,positive and negative predictive value at this cut-off was 77.55%,89.06%,84.44% and 83.82% respectively.The positive and negative likelihood ratio was 7.09 and 0.25.The area under the receiver operating characteristic curves was 0.844.Using Youden’s index the best cut off value for ONSD was 5.75 mm.Raised ONSD was associated with lower age(P=0.007),poorer Glasgow Coma Scale(P=0.009)and greater need for surgical intervention(P=0.006)whereas no statistically significant association was found between raised ONSD and SOFA score,APACHE II score or ICU mortality.Our limitations were that it was a single centre study and we did not perform serial measurements or ONSD pre-and post-treatment or procedures for raised ICP.CONCLUSION ONSD can be used as a screening a test to detect raised ICP in a medical ICU and as a trigger to initiate further management of raised ICP.ONSD can be beneficial in ruling out a diagnosis in a low-prevalence population and rule in a diagnosis in a high-prevalence population.展开更多
Diameter is the next authentication,authorization and accounting protocol currently developed in the IETF AAA working group ,which will replace the widely and successfully deployed Radius protocol. In the paper ,the m...Diameter is the next authentication,authorization and accounting protocol currently developed in the IETF AAA working group ,which will replace the widely and successfully deployed Radius protocol. In the paper ,the motivations and backgrounds of Diameter protocols are firstly introduced. The following is a detailed description of the Diameter base protocol and its applications,such as mobile IP,NASREQ. Then the comparisons and analysis between Diameter and Radius are given.展开更多
基金supported by the Youth Fund of Fundamental Research Fund for the Central Universities of Jinan University,No.11622303(to YZ).
文摘Microvasculature of the retina is considered an alternative marker of cerebral vascular risk in healthy populations.However,the ability of retinal vasculature changes,specifically focusing on retinal vessel diameter,to predict the recurrence of cerebrovascular events in patients with ischemic stroke has not been determined comprehensively.While previous studies have shown a link between retinal vessel diameter and recurrent cerebrovascular events,they have not incorporated this information into a predictive model.Therefore,this study aimed to investigate the relationship between retinal vessel diameter and subsequent cerebrovascular events in patients with acute ischemic stroke.Additionally,we sought to establish a predictive model by combining retinal veessel diameter with traditional risk factors.We performed a prospective observational study of 141 patients with acute ischemic stroke who were admitted to the First Affiliated Hospital of Jinan University.All of these patients underwent digital retinal imaging within 72 hours of admission and were followed up for 3 years.We found that,after adjusting for related risk factors,patients with acute ischemic stroke with mean arteriolar diameter within 0.5-1.0 disc diameters of the disc margin(MAD_(0.5-1.0DD))of≥74.14μm and mean venular diameter within 0.5-1.0 disc diameters of the disc margin(MVD_(0.5-1.0DD))of≥83.91μm tended to experience recurrent cerebrovascular events.We established three multivariate Cox proportional hazard regression models:model 1 included traditional risk factors,model 2 added MAD_(0.5-1.0DD)to model 1,and model 3 added MVD0.5-1.0DD to model 1.Model 3 had the greatest potential to predict subsequent cerebrovascular events,followed by model 2,and finally model 1.These findings indicate that combining retinal venular or arteriolar diameter with traditional risk factors could improve the prediction of recurrent cerebrovascular events in patients with acute ischemic stroke,and that retinal imaging could be a useful and non-invasive method for identifying high-risk patients who require closer monitoring and more aggressive management.
文摘BACKGROUND:As advocated in advanced trauma life support and prehospital trauma life support protocols,cervical immobilization is applied until cervical spine injury is excluded.This study aimed to show the difference in optic nerve sheath diameter(ONSD)between patients with and without a cervical collar using computed tomography(CT).METHODS:This was a single-center,retrospective study examining trauma patients who presented to the emergency department between January 1,2021,and December 31,2021.The ONSD on brain CT of the trauma patients was measured and analyzed to determine whether there was a difference between the ONSD with and without the cervical collar.RESULTS:The study population consisted of 169 patients.On CT imaging of patients with(n=66)and without(n=103)cervical collars,the mean ONSD in the axial plane were 5.43±0.50 mm and 5.04±0.46 mm respectively for the right eye and 5.50±0.52 mm and 5.11±0.46 mm respectively for the left eye.The results revealed an association between the presence of a cervical collar and the mean ONSD,which was statistically significant(P<0.001)for both the right and left eyes.CONCLUSION:A cervical collar may be associated with increased ONSD.The effect of this increase in the ONSD on clinical outcomes needs to be investigated,and the actual need for cervical collar in the emergency department should be evaluated on a case-by-case basis.
基金Supported by Education Department Foundation of Sichuan Province(No.15ZA0262).
文摘AIM:To present the 1-year results of a prospective cohort study investigating the efficacy,potential mechanism,and safety of orthokeratology(ortho-k)with different back optic zone diameters(BOZD)for myopia control in children.METHODS:This randomized clinical study was performed between Dec.2020 and Dec.2021.Participants were randomly assigned to three groups wearing ortho-k:5 mm BOZD(5-MM group),5.5 mm BOZD(5.5-MM group),and 6 mm BOZD(6-MM group).The 1-year data were recorded,including axial length,relative peripheral refraction(RPR,measured by multispectral refractive topography,MRT),and visual quality.The contrast sensitivity(CS)was evaluated by CSV-1000 instrument with spatial frequencies of 3,6,12,and 18 cycles/degree(c/d);the corneal higher-order aberrations(HOAs)were measured by iTrace aberration analyzer.The one-way ANOVA was performed to assess the differences between the three groups.The correlation between the change in AL and RPR was calculated by Pearson’s correlation coefficient.RESULTS:The 1-year results of 20,21,and 21 subjects in the 5-MM,5.5-MM,and 6-MM groups,respectively,were presented.There were no statistical differences in baseline age,sex,or ocular parameters between the three groups(all P>0.05).At the 1-year visit,the 5-MM group had lower axial elongation than the 6-MM group(0.07±0.09 vs 0.18±0.11 mm,P=0.001).The 5-MM group had more myopic total RPR(TRPR,P=0.014),with RPR in the 15°–30°(RPR 15–30,P=0.015),30°–45°(RPR 30–45,P=0.011),temporal(RPR-T,P=0.008),and nasal area(RPR-N,P<0.001)than the 6-MM group.RPR 15–30 in the 5.5-MM group was more myopic than that in the 6-MM group(P=0.002),and RPR-N in the 5-MM group was more myopic than that in the 5.5-MM group(P<0.001).There were positive correlations between the axial elongation and the change in TRPR(r=0.756,P<0.001),RPR 15–30(r=0.364,P=0.004),RPR 30–45(r=0.306,P=0.016),and RPR-N(r=0.253,P=0.047).The CS decreased at 3 c/d(P<0.001),and the corneal HOAs increased in the 5-MM group(P=0.030).CONCLUSION:Ortho-k with 5 mm BOZD can control myopia progression more effectively.The mechanism may be associated with greater myopic shifts in RPR.
文摘BACKGROUND The maximum outer diameter(MOD)of the appendix is an essential parameter for diagnosing acute appendicitis,but there is space for improvement in ultrasound(US)diagnostic performance.AIM To investigate whether combining the ratio of the cross diameters(RATIO)of the appendix with MOD of the appendix can enhance the diagnostic performance of acute appendicitis.METHODS A retrospective study was conducted,and medical records of 233 patients with acute appendicitis and 112 patients with a normal appendix were reviewed.The MOD and RATIO of the appendix were calculated and tested for their diagnostic performance of acute appendicitis,both individually and in combination.RESULTS The RATIO for a normal appendix was 1.32±0.16,while for acute appendicitis it was 1.09±0.07.The cut-off value for RATIO was determined to be≤1.18.The area under the receiver operating characteristic curve(AUC)for diagnosing acute appendicitis using RATIO≤1.18 and MOD>6 mm was 0.870 and 0.652,respectively.There was a significant difference in AUC between RATIO≤1.18 and MOD>6 mm(P<0.0001).When comparing the combination of RATIO≤1.18 and MOD>6 mm with MOD>6 mm alone,the combination showed increased specificity,positive predictive value(PPV),and AUC.However,the sensitivity and negative predictive value decreased.CONCLUSION Combining RATIO of the appendix≤1.18 and MOD>6 mm can significantly improve the specificity,PPV,and AUC in the US diagnosis of acute appendicitis.
文摘Based on the investigation data of 12 Haloxylon ammodendron plots in the south edge of Gurbantunggut Desert, Fuzzy distribution was introduced into the study of Haloxylon ammodendron base diameter structure fitting according to the consistency between the characteristics of Fuzzy distribution function and the distribution series of cumulative percentage of stand base diameter, and the fitting precision and effect of Fuzzy distribution function were discussed. The root mean square error RMSE and determination coefficient R<sup>2</sup> values showed that Fuzzy-Γ<sub>1</sub>, Fuzzy-Γ<sub>2</sub>, Fuzzy-Γ<sub>3</sub>, Fuzzy-Γ<sub>4</sub> had good fitting performance, among which Fuzzy-Γ<sub>1</sub> had relatively high fitting precision, and its parameters were closely related to stand age and density, Fuzzy-Γ<sub>2</sub> distribution function was the second, and Fuzzy-Γ<sub>4</sub> distribution function had the worst fitting effect. By introducing a parameter c from the similarity of four distribution function formulas, a generalized Fuzzy distribution function Fuzzy-Γ<sub>5</sub> is obtained. This function shows the highest fitting accuracy. Most of the values of parameter c are near 1 or 2, which shows that the diameter distribution is mainly approximate to Fuzzy-Γ<sub>1</sub> and Fuzzy-Γ<sub>2</sub>.
基金funded by USDA National Institute of Food and Agriculture Hatch Appropriations[#PEN04639,Accession#1015105,EZ]。
文摘Managing mature Douglas-fir[Pseudotsuga menziesii(Mirb.)Franco]stands to emulate the structural complexity of natural old-growth forest requires identifying structural targets at the sub-stand level at which neighborhood dynamics and patchy disturbance shape structure.We therefore sought to describe the archetypal shapes of predominant sub-stand diameter distribution types(DDTs)observed in natural tree neighborhoods in stands comprising a chronosequence(ca.120-450+yrs)encompassing mature,vertical diversification,and horizontal diversification development stages.The ten 1.0 ha stands are located in the southcentral Oregon Cascades,USA.Building on the known spatial position of each tree,natural tree neighborhoods were identified using the floating neighborhood approach based on spatial tessellation connecting neighboring trees at the first-(mean 61 m2)through fifth-(mean 2058 m2)order scales.Cluster analysis was then used to objectively identify the most predominant DDTs among the relative tree size distributions observed in the trans-scale neighborhoods within each stand.Repeated measures regression was used to classify each DDT to one of six observed archetypal shapes:negative exponential,unimodal,rotated sigmoid,bimodal,concave,or multi-modal.Only three of the 81 observed DDTs deviated by<10%from the stand average,while every stand had at least one DDT that deviated by>50%(maximum 83%).Within each stand,five to ten predominant DDTs were observed,which deviated from the stand average by 30-48%and were characterized by two to five different archetypal shapes.Consequently,in some stands the majority of tree neighborhoods were best characterized by a different shape from that assigned at the stand level.Deviation from the stand average increased from the youngest stand in the mature development stage through the middle stands in the vertical diversification stage to the oldest stands in the horizontal diversification stage.The complexity of DDT shapes tended to increase along the chronosequence(from negative exponential and uniform toward concave and multi-modal),with shape richness highest mid-sequence and evenness peaking in the oldest stands.The high diversity of sub-stand structural complexity reduces the utility of standlevel diameter distributions as old-growth restoration targets.However,the presence in early-sequence stands of sub-stand diameter distributions common to later-sequence stands may facilitate active management at the neighborhood level to promote future old-growth condition.Restoration of substand diameter structures would likely require combining spatial perspectives,such as by augmenting tree-level croptree management with diameter distribution targets for the resulting tree neighborhoods.
基金funded in part by the United States Department of Agriculture Forest Service,Northern Research Station,USDA Hardwood Tree Improvement and Regeneration CenterUSDA National Institute of Food and Agriculture McIntire Stennis project (IND011523MS)。
文摘Current techniques of forest inventory rely on manual measurements and are slow and labor intensive.Recent developments in computer vision and depth sensing can produce accurate measurement data at significantly reduced time and labor costs.We developed the ForSense system to measure the diameters of trees at various points along the stem as well as stem straightness.Time use,mean absolute error(MAE),and root mean squared error(RMSE)metrics were used to compare the system against manual methods,and to compare the system against itself(reproducibility).Depth-derived diameter measurements of the stems at the heights of 0.3,1.4,and 2.7 m achieved RMSE of 1.7,1.5,and 2.7 cm,respectively.The ForSense system produced straightness measurement data that was highly correlated with straightness ratings by trained foresters.The ForSense system was also consistent,achieving sub-centimeter diameter difference with subsequent measures and less than 4%difference in straightness value between runs.This method of forest inventory,which is based on depth-image computer vision,is time efficient compared to manual methods and less computationally and technologically intensive compared to Structure-from-Motion(SFM)photogrammetry and ground-based LiDAR or terrestrial laser scanning(TLS).
基金supported by Turkish General Directorate of Forestry。
文摘The diameter distribution of trees in a stand provides the basis for determining the stand’s ecological and economic value,its structure and stability and appropriate management practices.Scots pine(Pinus sylvestris L.)is one of the most common and important conifers in Turkey,so a well-planned management schedule is critical.Diameter distribution models to accurately describe the stand structure help improve management strategies,but developing reliable models requires a deep understanding of the growth,output and constraints of the forests.The most important information derived by diameter distribution models is primary data on horizontal stand structure for each diameter class of trees:basal area and volume per unit area.These predictions are required to estimate the range of products and predicted volume and yield from a forest stand.Here,to construct an accurate,reliable diameter distribution model for natural Scots pine stands in the Türkmen Mountain region,we used Johnson’s SBdistribution to represent the empirical diameter distributions of the stands using ground-based measurements from 55 sample plots that included1219 trees in natural distribution zones of the forests.As an alternative,nonparametric approach,which does not require any predefined function,an artificial intelligence model was constructed based on support vector machine methodology.An error index was calculated to evaluate the results.Overall,both Johnson’s SB probability density function with a three-parameter recovery approach and the support vector regression methodology provided reliable estimates of the diameter distribution of these stands.
基金Support was provided by the New Hampshire Agricultural Experiment Station.This is Scientific Contribution Number 2978supported by the USDA National Institute of Food and Agriculture,McIntire-Stennis Project 7003549
文摘Quadratic mean diameter is the most frequently reported descriptor of the diameter distribution of forests.As such,it is often used as an indicator of forest stand structure,developmental stage,and ecological and economic potential.However,quadratic mean diameter can be heavily influenced by the presence or absence of large numbers of small stems in lower canopy strata,and it is also sensitive to left-truncation of the diameter distribution,making its interpretation across inventories with different protocols challenging.Here,we examine three alternative expressions of stand diameter:the arithmetic and quadratic mean diameter of the thickest 100 trees per hectare,and the basal area-weighted mean diameter.Using data from the United States Forest Inventory and Analysis program for New York and New England,these alternative expressions showed closer correlation with multiple stand structural variables than did quadratic mean diameter,including merchantable cubic and board foot volume per hectare,aboveground live tree carbon per hectare,and total number of live and dead standing trees greater than 40 cm diameter at breast height per hectare(previously proposed as an index of old-growth structure).Arithmetic and quadratic mean diameter of the thickest 100 trees per hectare showed nearly identical performance,and the strongest correlations across the board.We develop closed-form expressions for these variables when the diameter distribution is a Weibull,and illustrate their behavior relative to quadratic mean diameter for that situation.While the reasons for prevalence of quadratic mean diameter as an indicator remain valid,we suggest that these alternative measures should be more widely reported and analyzed to give a more informative depiction of stand structure and development in complex forests.
文摘Background: Accurate determination of gestational age has become important for deciding the appropriate time for termination of the pregnancy as well as to monitor the fetal growth during the entire period of pregnancy. Objective: The aim of the study was to assess whether the trans-cerebellar diameter, placental thickness or combining both of them is more accurate for assessment of gestational age in the 3<sup>rd</sup> trimester of pregnancy. Patients and Methods: This is a cross sectional study conducted at outpatient Clinic and Obstetric ward, Ain Shams University Maternity Hospital, over a period of six months from March 2019 to September 2019. One hundred pregnant women were recruited according to inclusion criteria either from outpatient clinic or were admitted in obstetric ward Ain Shams Maternity Hospital to find out the most accurate fetal biometric measurement in the third trimester either trans-cerebellar diameter placental thickness or both compared to reliable LMP (last menstrual period) dates confirmed by crown rump length (CRL) in the first trimester. Results: Trans-cerebellar diameter mean ± SD was 46.0 ± 3.5 with range 38.2 - 51.7. The mean of placental thickness was 39.6 ± 7.1 with range 22.8 - 54.3. Placental thickness had highest determination (0.813) for last menstrual period followed by trans-cerebellar diameter (0.802). Combining trans-cerebellar diameter and placental thickness increased determination (0.902) for last menstrual period. Conclusion: Combined use of trans-cerebellar diameter and placental thickness in the third trimester of pregnancy is a reliable indicator for gestational age in women whose last menstrual period is unreliable or unknown, but placental thickness had higher accuracy than trans-cerebellar diameter.
文摘BACKGROUND Delay in treatment of raised intracranial pressure(ICP)leads to poor clinical outcomes.Optic nerve sheath diameter(ONSD)by ultrasonography(US-ONSD)has shown good accuracy in traumatic brain injury and neurosurgical patients to diagnose raised ICP.However,there is a dearth of data in neuro-medical intensive care unit(ICU)where the spectrum of disease is different.AIM To validate the diagnostic accuracy of ONSD in non-traumatic neuro-critically ill patients.METHODS We prospectively enrolled 114 patients who had clinically suspected raised ICP due to non-traumatic causes admitted in neuro-medical ICU.US-ONSD was performed according to ALARA principles.A cut-off more than 5.7 mm was taken as significantly raised.Raised ONSD was corelated with raised ICP on radiological imaging.Clinical history,general and systemic examination findings,SOFA and APACHE 2 score and patient outcomes were recorded.RESULTS There was significant association between raised ONSD and raised ICP on imaging(P<0.001).The sensitivity,specificity,positive and negative predictive value at this cut-off was 77.55%,89.06%,84.44% and 83.82% respectively.The positive and negative likelihood ratio was 7.09 and 0.25.The area under the receiver operating characteristic curves was 0.844.Using Youden’s index the best cut off value for ONSD was 5.75 mm.Raised ONSD was associated with lower age(P=0.007),poorer Glasgow Coma Scale(P=0.009)and greater need for surgical intervention(P=0.006)whereas no statistically significant association was found between raised ONSD and SOFA score,APACHE II score or ICU mortality.Our limitations were that it was a single centre study and we did not perform serial measurements or ONSD pre-and post-treatment or procedures for raised ICP.CONCLUSION ONSD can be used as a screening a test to detect raised ICP in a medical ICU and as a trigger to initiate further management of raised ICP.ONSD can be beneficial in ruling out a diagnosis in a low-prevalence population and rule in a diagnosis in a high-prevalence population.
文摘Diameter is the next authentication,authorization and accounting protocol currently developed in the IETF AAA working group ,which will replace the widely and successfully deployed Radius protocol. In the paper ,the motivations and backgrounds of Diameter protocols are firstly introduced. The following is a detailed description of the Diameter base protocol and its applications,such as mobile IP,NASREQ. Then the comparisons and analysis between Diameter and Radius are given.
