AIM： To use the cumulative sum analysis score（CUSUM） to construct objectively the learning curve of phacoemulsification competency.METHODS： Three second-year residents and an experienced consultant were monitored ...AIM： To use the cumulative sum analysis score（CUSUM） to construct objectively the learning curve of phacoemulsification competency.METHODS： Three second-year residents and an experienced consultant were monitored for a series of 70 phacoemulsification cases each and had their series analysed by CUSUM regarding posterior capsule rupture（PCR） and best-corrected visual acuity. The acceptable rate for PCR was 〈5%（lower limit h） and the unacceptable rate was 〉10%（upper limit h）. The acceptable rate for bestcorrected visual acuity worse than 20/40 was 〈10%（lower limit h） and the unacceptable rate was 〉20%（upper limit h）. The area between lower limit h and upper limit h is called the decision interval. RESULTS： There was no statistically significant difference in the mean age, sex or cataract grades between groups. The first trainee achieved PCR CUSUM competency at his 22 nd case. His best-corrected visual acuity CUSUM was in the decision interval from his third case and stayed there until the end, never reaching competency. The second trainee achieved PCR CUSUM competency at his 39^ th case. He could reach best-corrected visual acuity CUSUM competency at his 22 ^nd case. The third trainee achieved PCR CUSUM competency at his 41 st case. He reached bestcorrected visual acuity CUSUM competency at his 14 ^th case.CONCLUSION： The learning curve of competency in phacoemulsification is constructed by CUSUM and in average took 38 cases for each trainee to achieve it.展开更多
BACKGROUND Robotic pancreaticoduodenectomy(RPD)can achieve similar surgical results to open and PD;however,RPD has a long learning curve and operation time(OT).To address this issue,we have summarized a surgical path ...BACKGROUND Robotic pancreaticoduodenectomy(RPD)can achieve similar surgical results to open and PD;however,RPD has a long learning curve and operation time(OT).To address this issue,we have summarized a surgical path to shorten the surgical learning curve and OT.AIM To investigate the effective learning curve of a“G”-shaped surgical approach in RPD for patients.METHODS A total of 60 patients,who received“G”-shaped RPD(GRPD)by a single surgeon in the First Hospital of Shanxi Medical University from May 2017 to April 2020,were included in this study.The OT,demographic data,intraoperative blood loss,complications,hospitalization time,and pathological results were recorded,and the cumulative sum(CUSUM)analysis was performed to evaluate the learning curve for GRPD.RESULTS According to the CUSUM analysis,the learning curve for GRPD was grouped into two phases:The early and late phases.The OT was 480±81.65 min vs 331±76.54 min,hospitalization time was 22±4.53 d vs 17±6.08 d,and blood loss was 308±54.78 mL vs 169.2±35.33 mL in the respective groups.Complications,including pancreatic fistula,bile leakage,reoperation rate,postoperative death,and delayed gastric emptying,were significantly decreased after this surgical technique.CONCLUSION GRPD can improve the learning curve and operative time,providing a new method for shortening the RPD learning curve.展开更多
Accurate nitrogen(N)nutrition diagnosis is essential for improving N use efficiency in crop production.The widely used critical N(Nc)dilution curve traditionally depends solely on agronomic variables,neglecting crop w...Accurate nitrogen(N)nutrition diagnosis is essential for improving N use efficiency in crop production.The widely used critical N(Nc)dilution curve traditionally depends solely on agronomic variables,neglecting crop water status.With three-year field experiments with winter wheat,encompassing two irrigation levels(rainfed and irrigation at jointing and anthesis)and three N levels(0,180,and 270 kg ha1),this study aims to establish a novel approach for determining the Nc dilution curve based on crop cumulative transpiration(T),providing a comprehensive analysis of the interaction between N and water availability.The Nc curves derived from both crop dry matter(DM)and T demonstrated N concentration dilution under different conditions with different parameters.The equation Nc=6.43T0.24 established a consistent relationship across varying irrigation regimes.Independent test results indicated that the nitrogen nutrition index(NNI),calculated from this curve,effectively identifies and quantifies the two sources of N deficiency:insufficient N supply in the soil and insufficient soil water concentration leading to decreased N availability for root absorption.Additionally,the NNI calculated from the Nc-DM and Nc-T curves exhibited a strong negative correlation with accumulated N deficit(Nand)and a positive correlation with relative grain yield(RGY).The NNI derived from the Nc-T curve outperformed the NNI derived from the Nc-DM curve concerning its relationship with Nand and RGY,as indicated by larger R2 values and smaller AIC.The novel Nc curve based on T serves as an effective diagnostic tool for assessing winter wheat N status,predicting grain yield,and optimizing N fertilizer management across varying irrigation conditions.These findings would provide new insights and methods to improve the simulations of water-N interaction relationship in crop growth models.展开更多
To find out the growth and development regularity,the growth curves of Muchuan black chicken at the age of 0-21 weeks were established by Logistic,Bertalanffy and Gompertz models in this study.The results showed that ...To find out the growth and development regularity,the growth curves of Muchuan black chicken at the age of 0-21 weeks were established by Logistic,Bertalanffy and Gompertz models in this study.The results showed that all the three models can well fit the growth curve of Muchuan black chicken with a degree above 0.988,while the Gompertz model and the Bertalanffy model was the best for hens and cocks,respectively.Finally,the weight of hens and cocks were analyzed according to their corresponding high fitting models.Results showed that the inflexion age of Muchuan black chicken was 6.8-6.9 weeks old with an inflexion weight of 692.98 g in hens and 805.57 g in cocks.In conclusion,it was feasible to establish the growth curve of Muchuan black chicken with Logistic,Bertalanffy and Gompertz model.展开更多
Background:Targeted magnetic resonance(MR)with ultrasound(US)fusion-guided biopsy has been shown to improve detection of prostate cancer.The implementation of this approach requires integration of skills from radiolog...Background:Targeted magnetic resonance(MR)with ultrasound(US)fusion-guided biopsy has been shown to improve detection of prostate cancer.The implementation of this approach requires integration of skills from radiologists and urologists.Objective methods for assessment of learning curves,such as cumulative sum(CUSUM)analysis,may be helpful in identifying the presence and duration of a learning curve.The aim of this study is to determine the learning curve for MR/US fusion-guided biopsy in detecting clinically significant prostate cancer using CUSUM analysis.Materials and methods:Retrospective analysis was performed in this institutional review board-approved study.Two urologists implemented an MR/US fusion-guided prostate biopsy program between March 2015 and September 2017.The primary outcome measure was cancer detection rate(CDR)stratified by Prostate Imaging Reporting and Data System(PI-RADS)scores assigned on the MR imaging.Cumulative sum analysis quantified actual cancer detection versus a predetermined target satisfactory CDR of MR/US fusion biopsies in a sequential case-by-case basis.For this analysis,satisfactory performance was defined as>80%CDR in patients with Pl-RADS 5,>50%in PI-RADS 4,and<20%in Pl-RADS 1-3.Results:Complete data were available for MR/US fusion-guided biopsies performed on 107 patients.The CUSUM learning curve analysis demonstrated intermittent underperformance until approximately 50 cases.After this inflection point,there was consistently good performance,evidence that no further learning curve was being encountered.Conclusions:At a new center implementing MR/US fusion-guided prostate biopsy,the learning curve was approximately 50 cases before a consistently high performance for prostate cancer detection.展开更多
为提高快速路匝道区域合流冲突的识别精度,并缓解合流冲突提供决策依据,提出一种V2X(vehicle to everything)环境下基于圆风险域的交通冲突识别模型.通过V2X技术实时获取车辆位置和速度,以冲突风险时间为关键参数,分析主线车辆和匝道车...为提高快速路匝道区域合流冲突的识别精度,并缓解合流冲突提供决策依据,提出一种V2X(vehicle to everything)环境下基于圆风险域的交通冲突识别模型.通过V2X技术实时获取车辆位置和速度,以冲突风险时间为关键参数,分析主线车辆和匝道车辆的不同运动状态特性;引入风险域概念,结合车辆运动学,构建基于圆风险域冲突识别模型,进而通过两圆的位置关系表征两车之间的运动关系,实现交通冲突的识别;为细化冲突风险程度,采用累计频率曲线法判定冲突风险程度等级.仿真结果表明,采用冲突识别模型的识别率相比未采用时提高25.81%,说明该模型能有效识别匝道合流冲突,提高通行效率,并可为V2X环境下匝道合流车辆提供安全预警.展开更多
In this study, we explore the application of ACP (asymptotic curve based and proportionality oriented) Alpha Beta (αβ) Nonlinear Math to analyze arithmetic and radiation transmission data. Specifically, we investiga...In this study, we explore the application of ACP (asymptotic curve based and proportionality oriented) Alpha Beta (αβ) Nonlinear Math to analyze arithmetic and radiation transmission data. Specifically, we investigate the relationship between two variables. The novel approach involves collecting elementary “y” data and subsequently analyzing the asymptotic cumulative or demulative (opposite of cumulative) Y data. In part I, we examine the connection between the common linear numbers and ideal nonlinear numbers. In part II, we delve into the relationship between X-ray energy and the radiation transmission for various thin film materials. The fundamental physical law asserts that the nonlinear change in continuous variable Y is negatively proportional to the nonlinear change in continuous variable X, expressed mathematically as dα = −Kdβ. Here: dα {Y, Yu, Yb} represents the change in Y, with Yu and Yb denoting the upper and baseline asymptote of Y. dβ {X, Xu, Xb} represents the change in X, with Xu and Xb denoting the upper and baseline asymptote of X. K represents the proportionality constant or rate constant, which varies based on equation arrangement. K is the key inferential factor for describing physical phenomena.展开更多
文摘AIM： To use the cumulative sum analysis score（CUSUM） to construct objectively the learning curve of phacoemulsification competency.METHODS： Three second-year residents and an experienced consultant were monitored for a series of 70 phacoemulsification cases each and had their series analysed by CUSUM regarding posterior capsule rupture（PCR） and best-corrected visual acuity. The acceptable rate for PCR was 〈5%（lower limit h） and the unacceptable rate was 〉10%（upper limit h）. The acceptable rate for bestcorrected visual acuity worse than 20/40 was 〈10%（lower limit h） and the unacceptable rate was 〉20%（upper limit h）. The area between lower limit h and upper limit h is called the decision interval. RESULTS： There was no statistically significant difference in the mean age, sex or cataract grades between groups. The first trainee achieved PCR CUSUM competency at his 22 nd case. His best-corrected visual acuity CUSUM was in the decision interval from his third case and stayed there until the end, never reaching competency. The second trainee achieved PCR CUSUM competency at his 39^ th case. He could reach best-corrected visual acuity CUSUM competency at his 22 ^nd case. The third trainee achieved PCR CUSUM competency at his 41 st case. He reached bestcorrected visual acuity CUSUM competency at his 14 ^th case.CONCLUSION： The learning curve of competency in phacoemulsification is constructed by CUSUM and in average took 38 cases for each trainee to achieve it.
基金Supported by Shanxi Provincial Science and Technology Department Social Development Fund,No.201903D321144.
文摘BACKGROUND Robotic pancreaticoduodenectomy(RPD)can achieve similar surgical results to open and PD;however,RPD has a long learning curve and operation time(OT).To address this issue,we have summarized a surgical path to shorten the surgical learning curve and OT.AIM To investigate the effective learning curve of a“G”-shaped surgical approach in RPD for patients.METHODS A total of 60 patients,who received“G”-shaped RPD(GRPD)by a single surgeon in the First Hospital of Shanxi Medical University from May 2017 to April 2020,were included in this study.The OT,demographic data,intraoperative blood loss,complications,hospitalization time,and pathological results were recorded,and the cumulative sum(CUSUM)analysis was performed to evaluate the learning curve for GRPD.RESULTS According to the CUSUM analysis,the learning curve for GRPD was grouped into two phases:The early and late phases.The OT was 480±81.65 min vs 331±76.54 min,hospitalization time was 22±4.53 d vs 17±6.08 d,and blood loss was 308±54.78 mL vs 169.2±35.33 mL in the respective groups.Complications,including pancreatic fistula,bile leakage,reoperation rate,postoperative death,and delayed gastric emptying,were significantly decreased after this surgical technique.CONCLUSION GRPD can improve the learning curve and operative time,providing a new method for shortening the RPD learning curve.
基金supported by the National Key Research and Development Program of China(2022YFD2001005)the Key Research&Development Program of Jiangsu province(BE2021358)+2 种基金the National Natural Science Foundation of China(32271989)the Natural Science Foundation of Jiangsu province(BK20220146)the Jiangsu Independent Innovation Fund Project of Agricultural Science and Technology[CX(23)3121].
文摘Accurate nitrogen(N)nutrition diagnosis is essential for improving N use efficiency in crop production.The widely used critical N(Nc)dilution curve traditionally depends solely on agronomic variables,neglecting crop water status.With three-year field experiments with winter wheat,encompassing two irrigation levels(rainfed and irrigation at jointing and anthesis)and three N levels(0,180,and 270 kg ha1),this study aims to establish a novel approach for determining the Nc dilution curve based on crop cumulative transpiration(T),providing a comprehensive analysis of the interaction between N and water availability.The Nc curves derived from both crop dry matter(DM)and T demonstrated N concentration dilution under different conditions with different parameters.The equation Nc=6.43T0.24 established a consistent relationship across varying irrigation regimes.Independent test results indicated that the nitrogen nutrition index(NNI),calculated from this curve,effectively identifies and quantifies the two sources of N deficiency:insufficient N supply in the soil and insufficient soil water concentration leading to decreased N availability for root absorption.Additionally,the NNI calculated from the Nc-DM and Nc-T curves exhibited a strong negative correlation with accumulated N deficit(Nand)and a positive correlation with relative grain yield(RGY).The NNI derived from the Nc-T curve outperformed the NNI derived from the Nc-DM curve concerning its relationship with Nand and RGY,as indicated by larger R2 values and smaller AIC.The novel Nc curve based on T serves as an effective diagnostic tool for assessing winter wheat N status,predicting grain yield,and optimizing N fertilizer management across varying irrigation conditions.These findings would provide new insights and methods to improve the simulations of water-N interaction relationship in crop growth models.
基金Supported by"13thFive-year"Broiler Breeding Project of Sichuan Province(2015BAD03B03)Sichuan Science and Technology Support Program(2016NZ0034+1 种基金 2017NZ0013)National System for Broiler Production Technology(CARS-42-G04)
文摘To find out the growth and development regularity,the growth curves of Muchuan black chicken at the age of 0-21 weeks were established by Logistic,Bertalanffy and Gompertz models in this study.The results showed that all the three models can well fit the growth curve of Muchuan black chicken with a degree above 0.988,while the Gompertz model and the Bertalanffy model was the best for hens and cocks,respectively.Finally,the weight of hens and cocks were analyzed according to their corresponding high fitting models.Results showed that the inflexion age of Muchuan black chicken was 6.8-6.9 weeks old with an inflexion weight of 692.98 g in hens and 805.57 g in cocks.In conclusion,it was feasible to establish the growth curve of Muchuan black chicken with Logistic,Bertalanffy and Gompertz model.
文摘Background:Targeted magnetic resonance(MR)with ultrasound(US)fusion-guided biopsy has been shown to improve detection of prostate cancer.The implementation of this approach requires integration of skills from radiologists and urologists.Objective methods for assessment of learning curves,such as cumulative sum(CUSUM)analysis,may be helpful in identifying the presence and duration of a learning curve.The aim of this study is to determine the learning curve for MR/US fusion-guided biopsy in detecting clinically significant prostate cancer using CUSUM analysis.Materials and methods:Retrospective analysis was performed in this institutional review board-approved study.Two urologists implemented an MR/US fusion-guided prostate biopsy program between March 2015 and September 2017.The primary outcome measure was cancer detection rate(CDR)stratified by Prostate Imaging Reporting and Data System(PI-RADS)scores assigned on the MR imaging.Cumulative sum analysis quantified actual cancer detection versus a predetermined target satisfactory CDR of MR/US fusion biopsies in a sequential case-by-case basis.For this analysis,satisfactory performance was defined as>80%CDR in patients with Pl-RADS 5,>50%in PI-RADS 4,and<20%in Pl-RADS 1-3.Results:Complete data were available for MR/US fusion-guided biopsies performed on 107 patients.The CUSUM learning curve analysis demonstrated intermittent underperformance until approximately 50 cases.After this inflection point,there was consistently good performance,evidence that no further learning curve was being encountered.Conclusions:At a new center implementing MR/US fusion-guided prostate biopsy,the learning curve was approximately 50 cases before a consistently high performance for prostate cancer detection.
文摘为提高快速路匝道区域合流冲突的识别精度,并缓解合流冲突提供决策依据,提出一种V2X(vehicle to everything)环境下基于圆风险域的交通冲突识别模型.通过V2X技术实时获取车辆位置和速度,以冲突风险时间为关键参数,分析主线车辆和匝道车辆的不同运动状态特性;引入风险域概念,结合车辆运动学,构建基于圆风险域冲突识别模型,进而通过两圆的位置关系表征两车之间的运动关系,实现交通冲突的识别;为细化冲突风险程度,采用累计频率曲线法判定冲突风险程度等级.仿真结果表明,采用冲突识别模型的识别率相比未采用时提高25.81%,说明该模型能有效识别匝道合流冲突,提高通行效率,并可为V2X环境下匝道合流车辆提供安全预警.
文摘In this study, we explore the application of ACP (asymptotic curve based and proportionality oriented) Alpha Beta (αβ) Nonlinear Math to analyze arithmetic and radiation transmission data. Specifically, we investigate the relationship between two variables. The novel approach involves collecting elementary “y” data and subsequently analyzing the asymptotic cumulative or demulative (opposite of cumulative) Y data. In part I, we examine the connection between the common linear numbers and ideal nonlinear numbers. In part II, we delve into the relationship between X-ray energy and the radiation transmission for various thin film materials. The fundamental physical law asserts that the nonlinear change in continuous variable Y is negatively proportional to the nonlinear change in continuous variable X, expressed mathematically as dα = −Kdβ. Here: dα {Y, Yu, Yb} represents the change in Y, with Yu and Yb denoting the upper and baseline asymptote of Y. dβ {X, Xu, Xb} represents the change in X, with Xu and Xb denoting the upper and baseline asymptote of X. K represents the proportionality constant or rate constant, which varies based on equation arrangement. K is the key inferential factor for describing physical phenomena.
