Does the ratio of the carpal tunnel inlet and outlet cross-sectional areas in the median nerve reflect carpal tunnel syndrome severity?

Although ultrasound measurements have been used in previous studies on carpal tunnel syndrome to visualize injury to the median nerve, whether such ultrasound data can indicate the severity of carpal tunnel syndrome remains controversial. The cross-sectional areas of the median nerve at the tunnel inlet and outlet can show swelling and compression of the nerve at the carpal. We hypothesized that the ratio of the cross-sectional areas of the median nerve at the carpal tunnel inlet to outlet accurately reflects the severity of carpal tunnel syndrome. To test this, high-resolution ultrasound with a linear array transducer at 5–17 MHz was used to assess 77 patients with carpal tunnel syndrome. The results showed that the cut-off point for the inlet-to-outlet ratio was 1.14. Significant differences in the inlet-to-outlet ratio were found among patients with mild, moderate, and severe carpal tunnel syndrome. The cut-off point in the ratio of cross-sectional areas of the median nerve was 1.29 between mild and more severe（moderate and severe） carpal tunnel syndrome patients with 64.7% sensitivity and 72.7% specificity. The cut-off point in the ratio of cross-sectional areas of the median nerve was 1.52 between the moderate and severe carpal tunnel syndrome patients with 80.0% sensitivity and 64.7% specificity. These results suggest that the inlet-to-outlet ratio reflected the severity of carpal tunnel syndrome.

Using Landsat images to monitor changes in the snow-covered area of selected glaciers in northern Pakistan

Landsat satellite images were used to map and monitor the snow-covered areas of four glaciers with different aspects(Passu: 36.473°N, 74.766°E;Momhil: 36.394°N, 75.085°E; Trivor: 36.249°N,74.968°E; and Kunyang: 36.083°N, 75.288°E) in the upper Indus basin, northern Pakistan, from 1990-2014. The snow-covered areas of the selected glaciers were identified and classified using supervised and rule-based image analysis techniques in three different seasons. Accuracy assessment of the classified images indicated that the supervised classification technique performed slightly better than the rule-based technique. Snow-covered areas on the selected glaciers were generally reduced during the study period but at different rates. Glaciers reached maximum areal snow coverage in winter and premonsoon seasons and minimum areal snow coverage in monsoon seasons, with the lowest snow-covered area occurring in August and September. The snowcovered area on Passu glacier decreased by 24.50%,3.15% and 11.25% in the pre-monsoon, monsoon and post-monsoon seasons, respectively. Similarly, the other three glaciers showed notable decreases in snow-covered area during the pre-and post-monsoon seasons; however, no clear changes were observed during monsoon seasons. During pre-monsoon seasons, the eastward-facing glacier lost comparatively more snow-covered area than the westward-facing glacier. The average seasonal glacier surface temperature calculated from the Landsat thermal band showed negative correlations of-0.67,-0.89,-0.75 and-0.77 with the average seasonal snowcovered areas of the Passu, Momhil, Trivor and Kunyang glaciers, respectively, during pre-monsoon seasons. Similarly, the air temperature collected from a nearby meteorological station showed an increasing trend, indicating that the snow-covered area reduction in the region was largely due to climate warming.