An evaluation of ureteral diameter ratio and vesicoureteral reflux index in the treatment of primary vesicoureteral reflux

Objective:Vesicoureteral reflux(VUR)index is a simple,validated tool that reliably predicts significant improvement and spontaneous resolution of primary reflux in children.The aim of this study was to evaluate and compare the ureter diameter ratio(UDR)and VUR index(VURx)of patients treated with endoscopic injection(EI)and ureteroneocystostomy(UNC)methods in the pediatric age group due to primary VUR.Methods:Patients under the age of 18 years old who underwent EI and UNC with the diagnosis of primary VUR between January 2011 and September 2021 were determined as the participants.The UDR was assessed using voiding cystourethrography,and the VURx score was determined prior to treatment based on hospital records included in the study.Results:A total of 255 patients,60(23.5%)boys and 195(76.5%)girls,with a mean age of 76.5(range 13.0e204.0)months,were included in the study.EI was applied to 130(51.0%)patients and UNC was applied to 125(49.0%)patients due to primary VUR.The optimum cut-off for the distal UDR was obtained as 0.17 with sensitivity and specificity of 73.0%and 63.0%,respectively.The positive and negative predictive values were 66.0%and 70.0%,respectively.Conclusion:When the UDR and VURx score are evaluated together for the surgical treatment of primary VUR in the pediatric age group,it is thought that it may be useful in predicting the clinical course of the disease and evaluating surgical treatment options.

Added value of ratio of cross diameters of the appendix in ultrasound diagnosis of acute appendicitis

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.

Axial length/corneal radius of curvature ratio and refractive development evaluation in 3-to 4-year-old children: the Shanghai Pudong Eye Study

AIM: To measure and analysis axial length(AL)/corneal radius of curvature(CRC) ratio and other refractive parameters, provide a medical reference range for refractive development evaluation and earlier visual impairment screening of 3 to 4 y kindergarten students.METHODS: Between April and June 2017, a total of 4350 participants aged 3-to 4-year-old(8700 eyes) from 10 cluster random sampling kindergartens in Shanghai, Pudong District were involved. According to the measurement and analysis of the unaided visual acuity(VA), AL, CRC, AL/CRC ratio, astigmatism and other refractive parameters, the data distribution and reference range were obtained.RESULTS: Uncorrected VA of examined children was 0.23±0.08(logMAR, mean±SD) [95% confidence interval(CI) range ≤0.36];AL was 22.10±0.79 mm(95%CI 20.55-23.65);CRC was 7.86±0.26 mm(95%CI, 7.35-8.37);AL/CRC ratio was 2.81±0.12(95%CI, 2.57-3.05). The median of astigmatism was-0.5 D, a total of 56.3% had astigmatism <-0.50 D, 85.3%<-1.00 D, 6.7%>-1.50 D;71% were astigmatism with the rule. Eye-specific analyses were conducted. Statistical difference of VA was in right and left eyes. There were no significant differences between two eyes of AL, CRC, AL/CRC ratio and astigmatism(P>0.05).CONCLUSION: VA and AL/CRC ratio reference could be used to assess refractive development in children and screening uncorrected refractive errors or amblyopia. Astigmatism needs to be considered in the diagnosis.

Finite element analysis on the collapse of infill walls with holes and different length-to-height ratios

Wenchuan earthquake damage survey displayed the major structures of buildings suffered only small damages,but it was common that infill walls suffered heavy damages or even collapse. To study the failure forms and collapse mechanism of infill walls in an earthquake,the influence of opening or length-to-height ratio on shake-resisting capability of filling walls was analyzed,and measures to improve the anti-collapse ability of infill walls were put forwaed. The numerical simulations on collapse process in earthquake were carried out by using ABAQUS software. We used 5 single story and single span models. It is revealed that the rigidity and compressive capacity of infill walls are reduced because of the infill walls with holes and the increases of length-to-height ratios. Adding constructional columns and horizontal beams can ensure structural integrity and improve the anti-collapse ability of the wall.

Prognostic value of the echocardiographic right/left ventricular end-diastolic diameter ratio in patients with idiopathic pulmonary arterial hypertension

Background Previous studies have shown that an echocardiographic right/left ventricular end-diastolic diameter ratio(RV/LV ratio)≥0.9 is an independent predictor of poor prognosis in patients with acute pulmonary embolism. The prognostic value of the RV/LV ratio in patients with idiopathic pulmonary arterial hypertension(IPAH) is still unknown. Methods We retrospectively enrolled 95 consecutive patients with newly diagnosed IPAH and 16 of them were reevaluated by echocardiography at 3-12 months following targeted therapy.Follow-up data were obtained by telephone interviews and review of the patients’ records.Results The RV/LV ratio was in parallel with the severity of World Health Orgnization(WHO) functional class and mean right atrial pressure.The RV/LV ratio was positively correlated with total pulmonary resistance(P P P 2 saturation(P P = 0.001),weight and absence of targeted therapy were independent predictors of death.No significant changes in the RV/LV ratio before and after targeted therapy were observed. A baseline RV/LV ratio≥0.84 or a further increase in the RV/LV ratio during targeted therapy indicated a poor prognosis. Conclusions The RV/LV ratio helps to assess the severity of IPAH and serves as an independent predictor of prognosis in patients with IPAH.

The Paradigm of Surgical Ellipse Dimensions: Are the Length-to-Width Ratio of 3 to 4 and a Vertex Angle of 30&ordm;Correct?

Background: It has been postulated that elliptical cutaneous excisions must possess a length-to-width ratio of 3 to 4 and a vertex angle of 30o or less in order to be closed primarily without creating a “dog ear”. These dimensions became axiomatic in cutaneous surgery and have been taught in the apprenticeship model for years. The present article examines the validity of that paradigm. Methods: We collected data from two sources: ellipses described in the literature (57 cases);and elliptical excisions performed at the authors’ outpatient clinic (83 cases). The surgical ellipse lengths, widths, and vertex angles were analyzed, and the data were compared to a mathematical formula used to generate a fusiform ellipse. Results: The length-to-width ratio of 3 - 4 was found to be inconsistent with the recommended vertex angle of 30o. In fact, a length-to-width ratio of 3 - 4 determines a vertex angle of 48o - 63o. A 30o vertex angle is only feasible with long length-to-width ration of about 7.5. Conclusions: The paradigm that surgical ellipses should have a vertex angle of 30o with length-to-width ratio of 3 - 4 is incorrect. Evidence from actual surgical practice and from mathematical formulation shows that either the length-to-width ratio must be larger than 3 - 4 or the vertex angle must be larger than 30 degrees.

On the Elastic Vibration Model for High Length-Diameter Ratio Rocket with Attitude Control System

An elastic vibration model for high length diameter ratio spinning rocket with attitude control system which can be used for trajectory simulation is established. The basic theory of elastic dynamics and vibration dynamics were both used to set up the elastic vibration model of rocket body. In order to study the problem more conveniently, the rocket's body was simplified to be an even beam with two free ends. The model was validated by simulation results and the test data.

Migration and population structure characteristics of the small yellow croaker Larimichthys polyactis in the southern Yellow Sea

Monthly fishery survey data of the small yellow croaker Larimichthys polyactis in the southern Yellow Sea from2003 and 2013 were employed to evaluate the variation in the resource distribution and biological characteristics（especially body length and sex ratio） in the population on a decadal scale.The results indicated that the small yellow croaker migrated from the Shawai fishing ground to the Dasha fishing ground in spring and was mainly distributed in the central and western parts of the Dasha fishing ground in April and May.Larimichthys polyactis in the Dasha fishing ground migrated eastward to offshore wintering grounds in autumn and reached the central Dasha fishing ground in October and November.The small yellow croaker entered the western waters of the Shawai fishing ground in winter.A large number of age 0＋ fish occurred in the Shawai and Jiangwai fishing grounds in October of 2003 and 2013.The body lengths of the spawning stock and wintering stock in 2013 were larger than those in 2003,and the monthly sex ratios（female to male） were significantly less than 1 in both years.The monthly distribution of this fish in the southern Yellow Sea was consistent with a previous finding that ＂the stock migrated between the wintering grounds in the west of Jeju Island and the Lüsi spawning grounds＂ but tended to move more northward,with the spawning grounds extending outward.In the past decade,body length variation experienced a decline after an increase,rather than a steady decrease.The sex ratio in the single-stick stow net showed a tendency to increase over the decade,but was either less than or more than 1 depending on the fishing gear;therefore,further studies should be conducted to determine the sex structure.

Stress-strain-acoustic responses in failure process of coal rock with different height to diameter ratios under uniaxial compression

Residual coal pillars play an important role in mining the adjacent coal seam safely,managing the gobs and maintaining the stability of abandoned coal mines.The height to diameter ratio(H/D)affects the stability of residual coal pillars.In this study,uniaxial compressive tests of coal specimens with five H/D(2.0,1.5,1.0,0.8 and 0.6)were performed,and the stress,strain and acoustic emission(AE)were monitored.Results show that the uniaxial compressive strength(UCS)and peak strain increase with H/D decreasing.An empirical equation is proposed to calculate the UCS based on the H/D.The AE activities during coal failure process can be separated into four periods.The span of quiet period and rapid decline period shorten with H/D decreasing.The smaller the H/D is,the more complicated the failure characteristics of coal will be.The failure form of coal with H/D of 2.0,1.5,and 1.0 is primarily shear failure,while splitting failure along the axial direction is the mainly mode when H/D is 0.8 or 0.6.The initiation,expansion,aggregation and connection of micro-cracks can be reflected by the real-time spatial evolution of AE event points.

Effects of dietary forage to concentrate ratio and wildrye length on nutrient intake, digestibility, plasma metabolites, ruminal fermentation and fecal microflora of male Chinese Holstein calves

Twenty-eight male, weaned Chinese Holstein calves（（156.8±33.4） kg） were used to investigate the effects of dietary forage to concentrate ratio（F：C） and forage length on nutrient digestibility, plasma metabolites, ruminal fermentation, and fecal microflora. Animals were randomly allocated to four treatments in a 2×2 factorial arrangement： whole-length forage（WL） with low F：C（50：50）; WL with high F：C（65：35）; short-length forage（SL） with high F：C（65：35）; and SL with low F：C（50：50）. Chinese wildrye was used as the only forage source in this trial. The grass in the SL treatments was chopped using a chaff cutter to achieve small particle size（-50% particles 〉19 mm）. Dry matter intake（DMI） and organic matter（OM） intake was increased by increasing both F：C（P〈0.01） and forage length（FL）（P〈0.05）, while acid detergent fiber（ADF） and neutral detergent fiber（NDF） intakes were only increased by increasing the F：C（P〈0.01）. The digestibility of NDF was increased as the FL increased（P〈0.01）, and it was also affected by interaction between F：C and FL（P〈0.05）. Cholesterol（CHO）（P〈0.01）, leptin（LP）（P〈0.05）, and growth hormone（GH）（P〈0.01） concentrations in plasma were increased as dietary F：C increased. A significant increase in plasma triglyceride（TG）（P〈0.01）, insulin（INS）（P〈0.05）, and GH（P〈0.01） levels was observed with decreasing dietary FL. Ruminal p H values of calves fed with low F：C diets were significantly lower than those in high F：C treatment（P〈0.05）. Increasing the F：C enhanced ruminal acetic acid（P〈0.05） and acetic acid/propionic acid（P〈0.01）. Fecal Lactobacillus content was significantly higher, while Escherichia coli and Salmonella contents were significantly lower in WL and high F：C groups（P〈0.05）. Lower fecal scores（higher diarrhea rate） were observed in calves fed with SL hay compared to WL hay（P〈0.05）. Denatured gradient gel electrophoresis（DGGE） bands and richness index（S） were significantly affected by the interaction between F：C and FL（P〈0.05）, under high F：C, band numbers and richness index from WL group were higher than that from SL group（P〈0.05）, whereas there were no differences between WL andSL groups under low F：C（P〉0.05）. Microflora similarity was 50–73% among the different treatments. It is concluded that the WL with high F：C（65：35） diet is suitable for weaned calves.

Evaluation of axial length/total corneal refractive power ratio as a potential marker for ocular diagnosis of Marfan’s syndrome in children

AIM:To investigate whether the axial length(AL)/total corneal refractive power(TCRP)ratio is a sensitive and simple factor that can be used for the early diagnosis of Marfan’s syndrome(MFS)in children.METHODS:The relationship between the AL/TCRP ratio and the diagnosis of MFS for 192 eyes in 97 children were evaluate.The biological characteristics,including age,sex,AL,and TCRP,were collected from medical records.Receiver operating characteristic(ROC)curve analysis was performed to investigate whether the AL/TCRP ratio effectively distinguishes MFS from other subjects.The Youden index was used to re-divide the whole population into two groups according to an AL/TCRP ratio of 0.59.RESULTS:Of 96 subjects(mean age 7.46±3.28 y)evaluated,56(110 eyes)had a definite diagnosis of MFS in childhood based on the revised Ghent criteria,41(82 eyes)with diagnosis of congenital ectopia lentis(EL)were included as a control group.AL was negatively correlated with TCRP,with a linear regression coefficient of-0.36(R2=0.08).A significant correlation was found between age and the AL/TCRP ratio(P=0.023).ROC curve analysis showed that the AL/TCRP ratio distinguished MFS from the other patients at a threshold of 0.59.MFS patients were present in 24/58(41.38%)patients with an AL/TCRP ratio of≤0.59 and in 34/39(87.18%)patients with an AL/TCRP ratio of>0.59.CONCLUSION:An AL/TCRP ratio of>0.59 is significantly associated with the risk of MFS.The AL/TCRP ratio should be measured as a promising marker for the prognosis of children MFS.Changes in the AL/TCRP ratio should be monitored over time.

Preparation of Layered Potassium Titanate Whiskers with Large Length-diameter Ratio by KDC Method

Pure K2Ti4O9 whiskers were prepared by KDC（Kneading-Drying-Calcination） method with TiO2 and K2CO3 as raw materials. The influences of TiO2/K2CO3 molar ratio（RT/K）, calcination temperature（TC） and cooling process on phase composition and morphology of the whiskers were investigated by TG-DSC（thermo gravimetric-differential scanning calorimeter）, XRD（X-ray diffraction）, and SEM（scanning electron microscope）. Pure K2Ti4O9 potassium titanate whiskers with large length-diameter ratio（r）（over 250） can be obtained at RT/K = 2.9 and TC = 950 ℃.

Effects of Ⅴ/Ⅲ ratio on species diffusion anisotropy inthe MOCVD growth of non-polar a-plane GaN films

Non-polar a-plane （1120） GaN films have been grown on r-plane （1102） sapphire substrates by metal organic chemical vapour deposition. The influences of V/III ratio on the species diffusion anisotropy of a-plane GaN films were investigated by scanning electron microscopy, cathodoluminescence and high-resolution x-ray diffraction measurements. The anisotropy of a-plane GaN films may result from the different migration length of adatoms along two in-plane directions. V/III ratio has an effect on the growth rates of different facets and crystal quality. The stripe feature morphology was obviously observed in the film with a high V/III ratio because of the slow growth rate along the [1100] direction. When the V/III ratio increased from 1000 to 6000, the in-plane crystal quality anisotropy was decreased due to the weakened predominance in migration length of gallium adatoms.

Effect of Forging Ratio on Microstructure of the of the 1.5710 Grade Steel

Intensity of structural changes during forging is usually determined in dependence on the forging ratio. Forging ratio at elongation is most often calculated with use of simple relations, which are based on the change of cross section of the forged pieces. The intensity of structure development is influenced not only by the simple change of cross sections, but also by relative length of the stroke, magnitude of deformation in individual passes, manner of edging, temperature, friction and shape of anvils. The paper gives an analysis of influence of the relative length of the stroke on the forging ratio.

Platelet count/spleen diameter ratio to predict esophageal varices in Mexican patients with hepatic cirrhosis

AIM: To validate whether the platelet count/spleen size ratio can be used to predict the presence of esophageal varices in Mexican patients with hepatic cirrhosis.

Research on Two-Step Hydro-Bulge Forming of Ellipsoidal Shell with Larger Axis Length Ratio

The two-step hydro-bulge forming technique was proposed to manufacture the ellipsoidal shell with the length ratio of the long axis to the short axis larger than 1.4. A central tube was introduced into the first step of the hydro-bulge forming process to constrain the over growth of the short axis during bulging,and then the central tube was replaced with two polar plates in the second step of the hydro-bulge forming process to manufacture an integral ellipsoidal shell. It is shown that the central tube restricts the growth of the short axis and simultaneously reduces the shrunk tendency of the long axis. The wrinkling occurs due to the latitudinal compressive stress at the equator at the early stage of hydro-bulge forming. However,with the increase of internal pressure,the compressive stress areas gradually decrease and finally the tensile latitudinal stress occupies approximately the whole shell,thus the wrinkles are eliminated. A sound ellipsoidal shell with the axis length ratio of 1.8 is obtained after two-step hydro bulging.

Effects of congenital ptosis on the refractive development of eye and vision in children

AIM:To investigate the influence of unilateral congenital ptosis on the development of the eye and vision in children.METHODS:In this prospective observational study,41 patients with unilateral congenital ptosis were enrolled(age range 3-15y).The blepharoptosis was divided into 3 subgroups according to the margin reflex distance-1(MRD-1),including mild group(MRD-1>2 mm),moderate group(0<MRD-1<2 mm),and severe group(MRD-1<0 mm).The fellow eyes served as controls.All subjects underwent ocular examinations,including axial length,keratometry,and refractive error.RESULTS:The incidence of astigmatism(ptotic eyes:58.5%vs fellow eyes:24.4%,P=0.002)and magnitude of cylindrical power(ptotic eyes:-0.86±0.79 D vs fellow eyes:-0.43±0.63 D,P=0.003)differed significantly between the ptotic eyes and the fellow eyes.The spherical equivalent refraction(P=0.006),spherical power(P=0.01),cylindrical power(P=0.011),axial length-corneal radius(AL/CR)ratio(P=0.009),frequency of hyperopia(P=0.002)and astigmatism(P=0.004)were significantly different among the ptotic eye subgroups and the fellow eye group.In addition,in patients with congenital ptosis,the incidence of amblyopia is 43.9%and the incidence of anisometropia is 24.4%.More importantly,the ratio of AL/CR showed significantly positive correlation with the severity of ptosis(P=0.002).CONCLUSION:Congenital ptosis may lead to a delayed eyeball development in the aspect of AL/CR.The risk of amblyopia is also increased due to visual deprivation and aggravated anisometropia,particularly in severe ptosis case.

Second to fourth digit ratio： a predictor of adult penile ength

The second to fourth digit ratio （2D：4D） has been proposed as a putative biomarker for prenatal testosterone and covaries with the sensitivity of the androgen receptor （AR）. Both prenatal testosterone and the AR play a central role in penile growth. In this study, we investigated the relationship between digit ratio and penile length. Korean men who were hospitalized for urological surgery at a single tertiary academic centre were examined in this study, and 144 men aged 20 years or older who gave informed consent were prospectively enrolled. Right-hand second- and fourth-digit lengths were measured by a single investigator prior to measurement of penile length. Under anaesthesia, flaccid and stretched penile lengths were measured by another investigator who did not measure nor have any the information regarding the digit lengths. Univariate and multivariate analysis using linear regression models showed that only height was a significant predictive factor for flaccid penile length （univariate analysis： r=0. 185, P=-0.026; multivariate analysis： r=-0.172, P=0.038） and that only digit ratio was a significant predictive factor for stretched penile length （univariate analysis： r=-0.216, P=0.009; multivariate analysis： r=-0.201, P=0.024; stretched penile length=-9.201 xdigit ratio ＋ 20.577）. Based on this evidence, we suggest that the digit ratio can predict adult penile size and that the effects of prenatal testosterone may in part explain the differences in adult penile length.

Effect of Radial Porosity Oscillation on the Thermal Performance of Packed Bed Latent Heat Storage

Owing to its high heat storage capacity and fast heat transfer rate,packed bed latent heat storage(LHS)is considered as a promising method to store thermal energy.In a packed bed,the wall effect can impact the packing arrangement of phase change material(PCM)capsules,inducing radial porosity oscillation.In this study,an actual-arrangement-based three-dimensional packed bed LHS model was built to consider the radial porosity oscillation.Its fluid flow and heat transfer were analyzed.With different cylindrical sub-surfaces intercepted along the radial direction in the packed bed,the corresponding relationships between the arrangement of capsules and porosity oscillation were identified.The oscillating distribution of radial porosity led to a non-uniform distribution of heat transfer fluid(HTF)velocity.As a result,radial temperature distributions and liquid fraction distributions of PCMs were further affected.The effects of different dimensionless parameters(e.g.,tube-to-capsule diameter ratio,Reynolds number,and Stefan number)on the radial characteristics of HTF and PCMs were discussed.The results showed that different diameter ratios correspond to different radial porosity distributions.Further,with an increase in diameter ratio,HTF velocity varies significantly in the near wall region while the non-uniformity of HTF velocity in the center region will decrease.The Reynolds and Stefan numbers slightly impact the relative velocity distribution of the HTF-while higher Reynolds numbers can lead to a proportional improvement of velocity,an increase in Stefan number can promote heat storage of the packed bed LHS system.

Can platelet count/spleen diameter ratio be used for cirrhotic children to predict esophageal varices?

AIM To determine the laboratory and radiologic parameters, including the platelet count(PC)-to-spleen diameter(SD) ratio as a non-invasive marker that may predict the presence of esophageal varices(EV) in children with cirrhosis.METHODS Eighty-nine patients with cirrhosis, but without a history of variceal bleeding were prospectively included. The children were grouped into 6-12 and 12-18 years of age groups. These groups were also divided into 2 subgroups(presence and absence of EV). All of the patients underwent a complete biochemical and radiologic evaluation. The PC(n/mm^3)-to-SD(mm) ratio was calculated for each patient. RESULTS Sixty-nine of 98(70.4%) patients had EV. The presence of ascites in all age groups was significantly associatedwith the presence of EV. There were no differences in serum albumin levels, PC, SD and the PC-to-SD ratio between the presence and absence of EV groups in both age groups(P > 0.05). CONCLUSION Laboratory and radiologic parameters, including the PC-to-SD ratio as a non-invasive marker(except for the presence of ascites), was inappropriate for detecting EV in children with cirrhosis.