Selecting which explanatory variables to include in a given score is a common difficulty, as a balance must be found between statistical fit and practical application. This article presents a methodology for construct...Selecting which explanatory variables to include in a given score is a common difficulty, as a balance must be found between statistical fit and practical application. This article presents a methodology for constructing parsimonious event risk scores combining a stepwise selection of variables with ensemble scores obtained by aggregation of several scores, using several classifiers, bootstrap samples and various modalities of random selection of variables. Selection methods based on a probabilistic model can be used to achieve a stepwise selection for a given classifier such as logistic regression, but not directly for an ensemble classifier constructed by aggregation of several classifiers. Three selection methods are proposed in this framework, two involving a backward selection of the variables based on their coefficients in an ensemble score and the third involving a forward selection of the variables maximizing the AUC. The stepwise selection allows constructing a succession of scores, with the practitioner able to choose which score best fits his needs. These three methods are compared in an application to construct parsimonious short-term event risk scores in chronic HF patients, using as event the composite endpoint of death or hospitalization for worsening HF within 180 days of a visit. Focusing on the fastest method, four scores are constructed, yielding out-of-bag AUCs ranging from 0.81 (26 variables) to 0.76 (2 variables).展开更多
AIM:To investigate the outcomes of pancreas-sparing duodenectomy(PSD)with regional lymph node dissection vs pancreaticoduodenectomy(PD).METHODS:Between August 2001 and June 2014,228 patients with early-stage ampullary...AIM:To investigate the outcomes of pancreas-sparing duodenectomy(PSD)with regional lymph node dissection vs pancreaticoduodenectomy(PD).METHODS:Between August 2001 and June 2014,228 patients with early-stage ampullary carcinoma(Amp Ca)underwent surgical treatment(PD,n=159;PSD with regional lymph node dissection,n=69).The patients were divided into two groups:the PD group and the PSD group.Propensity scoring methods were used to select patients with similar disease statuses.A total of 138 matched cases,with 69 patients in each group,were included in the final analysis.RESULTS:The median operative time was shorter among the patients in the PSD group(435 min)compared with those in the PD group(481 min,P=0.048).The median blood loss in the PSD group was significantly less than that in the PD group.The median length of hospital stay was shorter for patients in the PSD group vs the PD group.The incidence of pancreatic fistula was higher among patients in the PD group vs the PSD group.The 1-,3-,and 5-year overall survival and disease-free survival rates for patients in the PSD group were 83%,70%,44%and 73%,61%,39%,respectively,and these values were not different than compared with those in the PD group(P=0.625).CONCLUSION:PSD with regional lymph node dissection presents an acceptable morbidity in addition to its advantages over PD.PSD may be a safe and feasible alternative to PD in the treatment of earlystage Amp Ca.展开更多
AIM: To compare the functional outcomes of patients who underwent open surgery vs Ponseti method for the management of idiopathic clubfoot and to determine whether correlations exist between functional outcome and rad...AIM: To compare the functional outcomes of patients who underwent open surgery vs Ponseti method for the management of idiopathic clubfoot and to determine whether correlations exist between functional outcome and radiographic measurements.METHODS: A meta-analysis of the literature was conducted for studies concerning primary treatment of patients with idiopathic clubfoot. We searched PubM ed Medline, EMBASE, and the Cochrane Library databases from January 1950 to October 2011. Meta-analyses were performed on outcomes from 12 studies. Pooled means, SDs, and sample sizes were either identified in the results or calculated based on the results of each study.RESULTS: Overall, 835 treated idiopathic clubfeet in 516 patients were reviewed. The average follow-up was 15.7 years. Patients managed with Ponseti method did have a higher rate of excellent or good outcome than patients treated with open surgery(0.76 and 0.62, respectively), but not quite to the point of statistical significance(Q = 3.73, P = 0.053). Age at surgery wasnot correlated with the functional outcome for the surgically treated patients(r =-0.32, P = 0.68). A larger anteroposterior talocalcaneal angle was correlated with a higher rate of excellent or good outcomes(r = 0.80, P = 0.006). There were no other significant correlations between the functional and radiographic outcomes.CONCLUSION: The Ponseti method should be considered the initial treatment of idiopathic clubfeet, and open surgery should be reserved for clubfeet that cannot be completely corrected.展开更多
We introduce a new interpretation and quantitative method for computerized diplopia test. By comparing this new method to the Hess screen test, we validate its applicability among 304 patients with ocular motor nerve ...We introduce a new interpretation and quantitative method for computerized diplopia test. By comparing this new method to the Hess screen test, we validate its applicability among 304 patients with ocular motor nerve palsy. This new method shows great assistant value as the Hess screen test in making accurate diagnosis and quantitative evaluation the severity of diplopia. Furthermore, it is more convenient and suitable for daily clinical use.展开更多
[Objectives]To establish a qualitative identification and content determination method for psoralen and bergapten in the roots and leaves of Ficus pandurata,and the multi-indicator scoring method to optimize the ethan...[Objectives]To establish a qualitative identification and content determination method for psoralen and bergapten in the roots and leaves of Ficus pandurata,and the multi-indicator scoring method to optimize the ethanol extraction process for the effective parts of F.pandurata.[Methods]Qualitative identification was carried out by thin-layer chromatography(TLC)and content determination was made by high-performance liquid chromatography(HPLC);the content of psoralen and bergapten and extract yield were used as indicators,to investigate the effects of ethanol volume fraction,solid-to-liquid ratio,extraction time and extraction times on the ethanol extraction process of F.pandurata;multi-indicator scoring method was adopted,orthogonal test method was designed to optimize the extraction process,and verification test was performed.[Results]TLC chart of F.pandurata shows clear spots and good separation;the detected concentrations of psoralen and bergapten in the roots are in the range of 1.02-32.64μg/mL and shows a good linear relationship with the peak area(r=0.9997);these components have not been detected in the leaves,and the precision,RSD of stability and repeatability test is less than 2%;the average recovery rate was 99.8%-100.2%,and the RSD value is 1.12%-1.13%(n=6);the optimized extraction process is to use 50%ethanol as the extraction solvent,the solid-to-liquid ratio of 1∶10,reflux extraction of 3 times,and 1.5 h each time;the results of the three batches of verification tests show that the content of the two indicator components obtained is high,and the average value of the total amount is 0.34 mg/g(RSD=0.30%,n=3).[Conclusions]The established quality control method for F.pandurata is simple,easy,accurate and reproducible;the preferred extraction process is stable and feasible,suitable for the extraction and purification of coumarin effective parts in F.pandurata roots,so it is expected to provide references for further development of F.pandurata.展开更多
The present aim is to update, upon arrival of new learning data, the parameters of a score constructed with an ensemble method involving linear discriminant analysis and logistic regression in an online setting, witho...The present aim is to update, upon arrival of new learning data, the parameters of a score constructed with an ensemble method involving linear discriminant analysis and logistic regression in an online setting, without the need to store all of the previously obtained data. Poisson bootstrap and stochastic approximation processes were used with online standardized data to avoid numerical explosions, the convergence of which has been established theoretically. This empirical convergence of online ensemble scores to a reference “batch” score was studied on five different datasets from which data streams were simulated, comparing six different processes to construct the online scores. For each score, 50 replications using a total of 10N observations (N being the size of the dataset) were performed to assess the convergence and the stability of the method, computing the mean and standard deviation of a convergence criterion. A complementary study using 100N observations was also performed. All tested processes on all datasets converged after N iterations, except for one process on one dataset. The best processes were averaged processes using online standardized data and a piecewise constant step-size.展开更多
Clubfoot malformation is the most common serious congenital anomaly affecting the foot in children. Its treatment by the Ponseti method is simple, profitable and widely used in the world. Objective: The objective of t...Clubfoot malformation is the most common serious congenital anomaly affecting the foot in children. Its treatment by the Ponseti method is simple, profitable and widely used in the world. Objective: The objective of this study was to identify the factors of the failure of its treatment by the Ponseti method. Material and Method: We carried out a retrospective and descriptive study of cases of congenital equinus clubfoot varus at the Reference Health Care Center of Commune III of Bamako over 26 months from September 2020 to November 2022. Data were treated with the utmost anonymity. Result: This study was performed on 44 children seen for clubfoot: male (68%) and female (32%), with a sex ratio of 2.1. We obtained 13 cases of recidivism including 7 boys and 6 girls. We found 21 cases of unilateral and 23 bilateral;among which 9 recurrences were found against 4 in the unilateral forms. 85% of recurrences did not have good adherence to the splint and 62% did not come regularly for follow-up consultation. We obtained 33 children with idiopathic clubfeet (75%) with a recurrence of 24%, and 7 children with secondary clubfeet with 71 % recurrence. There was no recurrence in the postural type. Among the recurrences, 38.5% started treatment between 1 and 6 months, 23.1% from 0 to 1 month and 15.4% at 2 years and more. 85% of recurrences had a Pirani score between 4.5 to 6 at the start of treatment and 15% at a score of 2.5 to 4. Conclusion: The factors of the failure of the Ponseti method are mainly non-compliance with treatment, secondary clubfeet, and a high Pirani score at the start of treatment.展开更多
An effective rapid assessment technique, called ＂P25 Scoring Method＂, has been developed and tested on 26 different case studies recently, in order to predict the collapse vulnerability of the R/C buildings. After a...An effective rapid assessment technique, called ＂P25 Scoring Method＂, has been developed and tested on 26 different case studies recently, in order to predict the collapse vulnerability of the R/C buildings. After a short description of the approach, the study presents the sensitivity study of the method to the selected structural parameters by considering incremental deviation of the final scores from the base model. Further, the methodology was applied to an additional 100 damaged buildings in order to check the reliability of the method and some necessary modifications have been applied to the algorithm after considering this larger database. The evaluation of the results has been interpreted as a beneficial guidance for local authorities. The risk bands are defined according to the final scores and the effect of changing the band-width has also been studied through a safe but an economical procedure. A satisfactory correlation of the method with real damage states is obtained and a ready-to-use methodology has been introduced for future studies.展开更多
提升降水量级预报精度,有助于优化灾害预警与决策支持。选取2018年1月1日至2021年1月山东省逐12 h降水观测数据和欧洲中期天气预报中心(the European Centre for Medium-Range Weather Forecasting,ECMWF)的集合预报集合平均(Ensemble P...提升降水量级预报精度,有助于优化灾害预警与决策支持。选取2018年1月1日至2021年1月山东省逐12 h降水观测数据和欧洲中期天气预报中心(the European Centre for Medium-Range Weather Forecasting,ECMWF)的集合预报集合平均(Ensemble Prediction Ensemble Mean,EPEM)结果进行72 h内逐12 h降水量级预报统计订正,然后对比ECMWF集合平均降水预报插值的原始预报(EC_EPEM)、基于EC_EPEM的输出统计(Model Output Statistics,MOS)预报(EC_EPEM_MOS)、利用最优TS(Threat Score)评分订正(Optimal Threat Score,OTS)预报(EC_EPEM_OTS)的效果。结果表明:EC_EPEM_MOS在较小量级上表现最优,但在大量级上订正效果稍差,甚至略低于EC_EPEM;EC_EPEM_OTS仅在0.1、10 mm量级上低于EC_EPEM_MOS,其他量级均为最优,尤其在较大量级上订正效果更明显。在50、100 mm大量级上,EC_EPEM_OTS在12~72 h时效订正效果均最优,这是由于EC_EPEM_OTS在稍大量级上提高订正系数使得大量级降水漏报率减小,同时对大量级降水使用较小订正系数也减小了空报率。在较小量级降水中短期预报时效除了山东中部山区外EC_EPEM_MOS表现最佳,山区EC_EPEM_OTS最佳;中等以上量级、尤其较大量级降水,山东大部分地区EC_EPEM_OTS表现最佳。EC_EPEM_MOS订正预报有效地减小了EC_EPEM的空报问题。EC_EPEM_OTS的订正效果最佳,在大范围强降雨过程中与实况降雨分布更为接近,降水总体分布把握较好。展开更多
文摘Selecting which explanatory variables to include in a given score is a common difficulty, as a balance must be found between statistical fit and practical application. This article presents a methodology for constructing parsimonious event risk scores combining a stepwise selection of variables with ensemble scores obtained by aggregation of several scores, using several classifiers, bootstrap samples and various modalities of random selection of variables. Selection methods based on a probabilistic model can be used to achieve a stepwise selection for a given classifier such as logistic regression, but not directly for an ensemble classifier constructed by aggregation of several classifiers. Three selection methods are proposed in this framework, two involving a backward selection of the variables based on their coefficients in an ensemble score and the third involving a forward selection of the variables maximizing the AUC. The stepwise selection allows constructing a succession of scores, with the practitioner able to choose which score best fits his needs. These three methods are compared in an application to construct parsimonious short-term event risk scores in chronic HF patients, using as event the composite endpoint of death or hospitalization for worsening HF within 180 days of a visit. Focusing on the fastest method, four scores are constructed, yielding out-of-bag AUCs ranging from 0.81 (26 variables) to 0.76 (2 variables).
基金Supported by National Natural Science Foundation of China,No.81170453 and No.81301025Tianjin City High School Science and Technology Fund Planning Project,No.20120118
文摘AIM:To investigate the outcomes of pancreas-sparing duodenectomy(PSD)with regional lymph node dissection vs pancreaticoduodenectomy(PD).METHODS:Between August 2001 and June 2014,228 patients with early-stage ampullary carcinoma(Amp Ca)underwent surgical treatment(PD,n=159;PSD with regional lymph node dissection,n=69).The patients were divided into two groups:the PD group and the PSD group.Propensity scoring methods were used to select patients with similar disease statuses.A total of 138 matched cases,with 69 patients in each group,were included in the final analysis.RESULTS:The median operative time was shorter among the patients in the PSD group(435 min)compared with those in the PD group(481 min,P=0.048).The median blood loss in the PSD group was significantly less than that in the PD group.The median length of hospital stay was shorter for patients in the PSD group vs the PD group.The incidence of pancreatic fistula was higher among patients in the PD group vs the PSD group.The 1-,3-,and 5-year overall survival and disease-free survival rates for patients in the PSD group were 83%,70%,44%and 73%,61%,39%,respectively,and these values were not different than compared with those in the PD group(P=0.625).CONCLUSION:PSD with regional lymph node dissection presents an acceptable morbidity in addition to its advantages over PD.PSD may be a safe and feasible alternative to PD in the treatment of earlystage Amp Ca.
文摘AIM: To compare the functional outcomes of patients who underwent open surgery vs Ponseti method for the management of idiopathic clubfoot and to determine whether correlations exist between functional outcome and radiographic measurements.METHODS: A meta-analysis of the literature was conducted for studies concerning primary treatment of patients with idiopathic clubfoot. We searched PubM ed Medline, EMBASE, and the Cochrane Library databases from January 1950 to October 2011. Meta-analyses were performed on outcomes from 12 studies. Pooled means, SDs, and sample sizes were either identified in the results or calculated based on the results of each study.RESULTS: Overall, 835 treated idiopathic clubfeet in 516 patients were reviewed. The average follow-up was 15.7 years. Patients managed with Ponseti method did have a higher rate of excellent or good outcome than patients treated with open surgery(0.76 and 0.62, respectively), but not quite to the point of statistical significance(Q = 3.73, P = 0.053). Age at surgery wasnot correlated with the functional outcome for the surgically treated patients(r =-0.32, P = 0.68). A larger anteroposterior talocalcaneal angle was correlated with a higher rate of excellent or good outcomes(r = 0.80, P = 0.006). There were no other significant correlations between the functional and radiographic outcomes.CONCLUSION: The Ponseti method should be considered the initial treatment of idiopathic clubfeet, and open surgery should be reserved for clubfeet that cannot be completely corrected.
文摘We introduce a new interpretation and quantitative method for computerized diplopia test. By comparing this new method to the Hess screen test, we validate its applicability among 304 patients with ocular motor nerve palsy. This new method shows great assistant value as the Hess screen test in making accurate diagnosis and quantitative evaluation the severity of diplopia. Furthermore, it is more convenient and suitable for daily clinical use.
基金Major Medical and Health Project of Science and Technology Plan of Zhongshan City,Guangdong Province(2017B1006)Project of Traditional Chinese Medicine Bureau of Guangdong Province(20182168).
文摘[Objectives]To establish a qualitative identification and content determination method for psoralen and bergapten in the roots and leaves of Ficus pandurata,and the multi-indicator scoring method to optimize the ethanol extraction process for the effective parts of F.pandurata.[Methods]Qualitative identification was carried out by thin-layer chromatography(TLC)and content determination was made by high-performance liquid chromatography(HPLC);the content of psoralen and bergapten and extract yield were used as indicators,to investigate the effects of ethanol volume fraction,solid-to-liquid ratio,extraction time and extraction times on the ethanol extraction process of F.pandurata;multi-indicator scoring method was adopted,orthogonal test method was designed to optimize the extraction process,and verification test was performed.[Results]TLC chart of F.pandurata shows clear spots and good separation;the detected concentrations of psoralen and bergapten in the roots are in the range of 1.02-32.64μg/mL and shows a good linear relationship with the peak area(r=0.9997);these components have not been detected in the leaves,and the precision,RSD of stability and repeatability test is less than 2%;the average recovery rate was 99.8%-100.2%,and the RSD value is 1.12%-1.13%(n=6);the optimized extraction process is to use 50%ethanol as the extraction solvent,the solid-to-liquid ratio of 1∶10,reflux extraction of 3 times,and 1.5 h each time;the results of the three batches of verification tests show that the content of the two indicator components obtained is high,and the average value of the total amount is 0.34 mg/g(RSD=0.30%,n=3).[Conclusions]The established quality control method for F.pandurata is simple,easy,accurate and reproducible;the preferred extraction process is stable and feasible,suitable for the extraction and purification of coumarin effective parts in F.pandurata roots,so it is expected to provide references for further development of F.pandurata.
文摘The present aim is to update, upon arrival of new learning data, the parameters of a score constructed with an ensemble method involving linear discriminant analysis and logistic regression in an online setting, without the need to store all of the previously obtained data. Poisson bootstrap and stochastic approximation processes were used with online standardized data to avoid numerical explosions, the convergence of which has been established theoretically. This empirical convergence of online ensemble scores to a reference “batch” score was studied on five different datasets from which data streams were simulated, comparing six different processes to construct the online scores. For each score, 50 replications using a total of 10N observations (N being the size of the dataset) were performed to assess the convergence and the stability of the method, computing the mean and standard deviation of a convergence criterion. A complementary study using 100N observations was also performed. All tested processes on all datasets converged after N iterations, except for one process on one dataset. The best processes were averaged processes using online standardized data and a piecewise constant step-size.
文摘Clubfoot malformation is the most common serious congenital anomaly affecting the foot in children. Its treatment by the Ponseti method is simple, profitable and widely used in the world. Objective: The objective of this study was to identify the factors of the failure of its treatment by the Ponseti method. Material and Method: We carried out a retrospective and descriptive study of cases of congenital equinus clubfoot varus at the Reference Health Care Center of Commune III of Bamako over 26 months from September 2020 to November 2022. Data were treated with the utmost anonymity. Result: This study was performed on 44 children seen for clubfoot: male (68%) and female (32%), with a sex ratio of 2.1. We obtained 13 cases of recidivism including 7 boys and 6 girls. We found 21 cases of unilateral and 23 bilateral;among which 9 recurrences were found against 4 in the unilateral forms. 85% of recurrences did not have good adherence to the splint and 62% did not come regularly for follow-up consultation. We obtained 33 children with idiopathic clubfeet (75%) with a recurrence of 24%, and 7 children with secondary clubfeet with 71 % recurrence. There was no recurrence in the postural type. Among the recurrences, 38.5% started treatment between 1 and 6 months, 23.1% from 0 to 1 month and 15.4% at 2 years and more. 85% of recurrences had a Pirani score between 4.5 to 6 at the start of treatment and 15% at a score of 2.5 to 4. Conclusion: The factors of the failure of the Ponseti method are mainly non-compliance with treatment, secondary clubfeet, and a high Pirani score at the start of treatment.
文摘An effective rapid assessment technique, called ＂P25 Scoring Method＂, has been developed and tested on 26 different case studies recently, in order to predict the collapse vulnerability of the R/C buildings. After a short description of the approach, the study presents the sensitivity study of the method to the selected structural parameters by considering incremental deviation of the final scores from the base model. Further, the methodology was applied to an additional 100 damaged buildings in order to check the reliability of the method and some necessary modifications have been applied to the algorithm after considering this larger database. The evaluation of the results has been interpreted as a beneficial guidance for local authorities. The risk bands are defined according to the final scores and the effect of changing the band-width has also been studied through a safe but an economical procedure. A satisfactory correlation of the method with real damage states is obtained and a ready-to-use methodology has been introduced for future studies.
