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.

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.

Alternative expressions for stand diameter in complex forests

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.

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.

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.

Accuracy assessment and error analysis for diameter at breast height measurement of trees obtained using a novel backpack LiDAR system

Background: The LiBackpack is a recently developed backpack light detection and ranging(LiDAR) system that combines the flexibility of human walking with the nearby measurement in all directions to provide a novel and efficient approach to LiDAR remote sensing, especially useful for forest structure inventory. However, the measurement accuracy and error sources have not been systematically explored for this system.Method: In this study, we used the LiBackpack D-50 system to measure the diameter at breast height(DBH) for a Pinus sylvestris tree population in the Saihanba National Forest Park of China, and estimated the accuracy of LiBackpack measurements of DBH based on comparisons with manually measured DBH values in the field. We determined the optimal vertical slice thickness of the point cloud sample for achieving the most stable and accurate LiBackpack measurements of DBH for this tree species, and explored the effects of different factors on the measurement error.Result: 1) A vertical thickness of 30 cm for the point cloud sample slice provided the highest fitting accuracy(adjusted R2= 0.89, Root Mean Squared Error(RMSE) = 20.85 mm);2) the point cloud density had a significant negative, logarithmic relationship with measurement error of DBH and it explained 35.1% of the measurement error;3) the LiBackpack measurements of DBH were generally smaller than the manually measured values, and the corresponding measurement errors increased for larger trees;and 4) by considering the effect of the point cloud density correction, a transitional model can be fitted to approximate field measured DBH using LiBackpackscanned value with satisfactory accuracy(adjusted R2= 0.920;RMSE = 14.77 mm), and decrease the predicting error by 29.2%. Our study confirmed the reliability of the novel LiBackpack system in accurate forestry inventory, set up a useful transitional model between scanning data and the traditional manual-measured data specifically for P.sylvestris, and implied the applicable substitution of this new approach for more species, with necessary parameter calibration.

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.

Stand structure and height-diameter relationship of a degraded Populus euphratica forest in the lower reaches of the Tarim River, Northwest China

Understanding stand structure and height-diameter relationship of trees provides very useful information to establish appropriate countermeasures for sustainable management of endangered forests. Populus euphratica, a dominant tree species along the Tarim River watershed, plays an irreplaceable role in the sustainable development of regional ecology, economy and society. However, as the result of climate changes and human activities, the natural riparian ecosystems within the whole river basin were degraded enormously, particularly in the lower reaches of the river where about 320 km of the riparian forests were either highly degraded or dead. In this study, we presented one of the main criteria for the assessment of vitality of P. euphrafica forests by estimating the defoliation level, and analyzed forest structure and determined the height-diameter （height means the height of a tree and diameter means the diameter at breast height （DBH） of a tree） relationship of trees in different vitality classes （i.e. healthy, good, medium, senesced, dying, dead and fallen）. Trees classified as healthy and good ac- counted for approximately 40% of all sample trees, while slightly and highly degraded trees took up nearly 60% of total sample trees. The values of TH （tree height） and DBH ranged from 0-19 m and 0-125 cm, respectively. Trees more than 15 m in TH and 60 cm in DBH appeared sporadically. Trees in different vitality classes had different distribution patterns. Healthy trees were mainly composed more of relatively younger trees than of degraded tress. The height-diameter relationships differed greatly among tress in different vitality classes, with the coefficients ranging from 0.1653 to 0.6942. Correlation coefficients of TH and DBH in healthy and good trees were higher than those in trees of other vitality classes. The correlation between TH and DBH decreased with the decline of tree vitality. Our results suggested that it might be able to differentiate degraded P. euphratica trees from healthy trees by determining the height-diameter correlation coefficient, and the coefficient would be a new parameter for detecting degradation and assessing sustainable management of floodplain forests in arid regions. In addition, tree vitality should be taken into account to make an accurate height-diameter model for tree height prediction.

Estimating Pinus palustris tree diameter and stem volume from tree height,crown area and stand-level parameters

Accurate and efficient estimation of forest growth and live biomass is a critical element in assessing potential responses to forest management and environmental change. The objective of this study was to develop models to predict longleaf pine tree diameter at breast height （dbh） and merchantable stem volume （V） using data obtained from field measurements. We used longleaf pine tree data from 3,376 planted trees on 127 permanent plots located in the U.S. Gulf Coastal Plain region to fit equations to predict dbh and V as functions of tree height （H） and crown area （CA）. Prediction of dbh as a function of H improved when CA was added as an additional independent variable. Similarly, predic- tions of V based on H improved when CA was included. Incorporation of additional stand variables such as age, site index, dominant height, and stand density were also evaluated but resulted in only small improvements in model performance. For model testing we used data from planted and naturally-regenerated trees located inside and outside the geographic area used for model fitting. Our results suggest that the models are a robust alternative for dbh and V estimations when H and CA are known on planted stands with potential for naturally-regenerated stands, across a wide range of ages. We discuss the importance of these models for use with metrics derived from remote sensing data.

Incorporating shape constraints in generalized additive modelling of the height-diameter relationship for Norway spruce

Background： Measurements of tree heights and diameters are essential in forest assessment and modelling. Tree heights are used for estimating timber volume, site index and other important variables related to forest growth and yield, succession and carbon budget models. However, the diameter at breast height （dbh） can be more accurately obtained and at lower cost, than total tree height. Hence, generalized height-diameter （h-d） models that predict tree height from dbh, age and other covariates are needed. For a more flexible but biologically plausible estimation of covariate effects we use shape constrained generalized additive models as an extension of existing h-d model approaches. We use causal site parameters such as index of aridity to enhance the generality and causality of the models and to enable predictions under projected changeable climatic conditions. Methods： We develop unconstrained generalized additive models （GAM） and shape constrained generalized additive models （SCAM） for investigating the possible effects of tree-specific parameters such as tree age, relative diameter at breast height, and site-specific parameters such as index of aridity and sum of daily mean temperature during vegetation period, on the h-d relationship of forests in Lower Saxony, Germany. Results： Some of the derived effects, e.g. effects of age, index of aridity and sum of daily mean temperature have significantly non-linear pattern. The need for using SCAM results from the fact that some of the model effects show partially implausible patterns especially at the boundaries of data ranges. The derived model predicts monotonically increasing levels of tree height with increasing age and temperature sum and decreasing aridity and social rank of a tree within a stand, The definition of constraints leads only to marginal or minor decline in the model statistics like AIC An observed structured spatial trend in tree height is modelled via 2-dimensional surface fitting. Conclusions： We demonstrate that the SCAM approach allows optimal regression modelling flexibility similar to the standard GAM but with the additional possibility of defining specific constraints for the model effects. The longitudinal character of the model allows for tree height imputation for the current status of forests but also for future tree height prediction.

Modeling of the height–diameter relationship using an allometric equation model:a case study of stands of Phyllostachys edulis

Understanding the relationship between tree height （H） and diameter at breast height （D） is vital to forest design, monitoring and biomass estimation. We developed an allometric equation model and tested its applicability for unevenly aged stands of moso bamboo forest at a regional scale. Field data were collected for 21 plots. Based on these data, we identified two strong power relationships： a corre- lation between the mean bamboo height （Hm） and the upper mean H （Hu）, and a correlation between the mean D （Din） and the upper mean D （Du）. Simulation results derived from the aUometric equation model were in good agreement with observed culms derived from the field data for the 21 stands, with a root-mean-square error and relative root-mean-square error of 1.40 m and 13.41%, respectively. These results demonstrate that the allometric equation model had a strong predictive power in the unevenly aged stands at a regional scale. In addition, the estimated average height-diameter （H-D） model for South Anhui Province was used to predict H for the same type of bamboo in Hunan Province based on the measured D, and the results were highly similar. The allometric equation model has multiple uses at the regional scale, including the evaluation of the variation in the H- D relationship among regions. The model describes the average H-D relationship without considering the effects caused by variation in site conditions, tree density and other factors.

Research on Large Depth Diameter Ratio Ultra-precision Aspheric Grinding System

In this paper, the factors of affecting surface roughness and profiles accuracy of the machined larege depth diamter ratio aspheric surfaces in ultra-precision grinding process are analyzed theoretically. An ultra-precision aspheric grinding system is then designed and manufactured. Aerostatic form is adopted to build the spindle of the workpiece, transverse guideway, longitudinal guideway and the spindle of the grinder in this system. The following specification is achieved, such as the turning accuracy of the spindle of the workpiece is 0.05 μm, radial rigidity of the spindle is GE 220N/μm, axial rigidity is GE 160 N/μm, radial rigidity of the guideway is GE 200N/μm, the highest rotational speed of the grinder is 80 000 rev/min and its turning accuracy is 0.1 μm, the resolution of linear displacement of the transverse and longitudinal guideway is 4.9 nm. Adjusting range of this adjusting mechanism is 2 mm in the Y direction, the adjusting accuracy of the precise adjusting mechanism is 0.1 μm. Micro displacement measuring system of this ultra-precision aspheric grinding adopts two-backfeed strategy, and angle displacement back-feed is realized by photoelectric encoder, it’s resolution is 655 360 pulse/rev. after 4 frequency multiplication, it’s angle displacement resolution is achieved 2 621 440 pulse/rev. Straight-line displacement is monitored by single frequency laser interferometer (DLSTAX LTM-20B, made in Japan). This CNC system adopts inimitable bi-arc step length flex CN interpolation algorithm, it’s CN system resolution is 5 nm.So this aspheric grinding system ensures profile accuracy of the machined part. The resolution of this interferometer is 5 nm. Finally, lots of ultra-precision grinding experiments are carried out on this grinding system. Some optical aspheric parts, with profiles accuracy of 0.3 μm, surface roughness less than 0.01 μm, are obtained.

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 ℃.

Survivorship, attained diameter, height and volume of three Paulownia species after 9 years in the southern Appalachians, USA

Little is known of the tree and stand dynamics of varied species of planted Paulownia left unmanaged until harvest in the southeastern United States.We sought to remedy this lack of information needed by land managers to make informed decisions by investigating diff erences in survivorship,attained diameter breast height(DBH),diameter at ground level,total height,tree volume and standlevel volume yields of planted P.elongata,P.fortunei,and P.tomentosa in the cool-moist environment of the southern Appalachian Mountains.After 9 years,combined-species survivorship was only 27.3%.Low survivorship was likely related to several inclement weather events.P.fortunei was signifi cantly smaller in DBH and total height.Three combined-species stem(bole)volume models were developed as functions of(1)DBH squared,(2)the product DBH squared and total height,and(3)the product diameter ground line squared and total height.Mean total volume production of unmanaged stands was greatest for P.elongata and P.fortunei 4 years after planting;by the 9th year,total volume of P.elongata was greater than the other two species.Results of our study provide managers information on productivity of three species of Paulownia that can be used for estimating plantation yields.

Modelling joint distribution of tree diameter and height using Frank and Plackett copulas

Bivariate distribution models are veritable tools for improving forest stand volume estimations.Their accuracy depends on the method of construction.To-date,most bivariate distributions in forestry have been constructed either with normal or Plackett copulas.In this study,the accuracy of the Frank copula for constructing bivariate distributions was assessed.The effectiveness of Frank and Plackett copulas were evaluated on seven distribution models using data from temperate and tropical forests.The bivariate distributions include:Burr III,Burr XII,Logit-Logistic,Log-Logistic,generalized Weibull,Weibull and Kumaraswamy.Maximum likelihood was used to fit the models to the joint distribution of diameter and height data of Pinus pinaster(184 plots),Pinus radiata(96 plots),Eucalyptus camaldulensis(85 plots)and Gmelina arborea(60 plots).Models were evaluated based on negative log-likelihood(-ΛΛ).The result show that Frank-based models were more suitable in describing the joint distribution of diameter and height than most of their Plackett-based counterparts.The bivariate Burr III distributions had the overall best performance.The Frank copula is therefore recommended for the construction of more useful bivariate distributions in forestry.

Longitudinal height-diameter curves for Norway spruce, Scots pine and silver birch in Norway based on shape constraint additive regression models

Background： Generalized height-diameter curves based on a re-parameterized version of the Korf function for Norway spruce （Piceo abies （L.） Karst.）, Scots pine （Pinus sylvestris L.） and silver birch （Betula pendula Roth） in Norwa are presented. The Norwegian National Forest Inventory （NFI） is used as data base for estimating the model parameters. The derived models are developed to enable spatially explicit and site sensitive tree height imputatio in forest inventories as well as future tree height predictions in growth and yield scenario simulations. Methods： Generalized additive mixed models （gamm） are employed to detect and quantify potentially non-linear effects of predictor variables. In doing so the quadratic mean diameter serves as longitudinal covariate since stand ag as measured in the NFI, shows only a weak correlation with a stands developmental status in Norwegian forests. Additionally the models can be locally calibrated by predicting random effects if measured height-diameter pairs are available. Based on the model selection of non-constraint models, shape constraint additive models （scare） were fit tc incorporate expert knowledge and intrinsic relationships by enforcing certain effect patterns like monotonicity. Results： Model comparisons demonstrate that the shape constraints lead to only marginal differences in statistical characteristics but ensure reasonable model predictions. Under constant constraints the developed models predict increasing tree heights with decreasing altitude, increasing soil depth and increasing competition pressure of a tree. / two-dimensional spatially structured effect of UTM-coordinates accounts for the potential effects of large scale spatial correlated covariates, which were not at our disposal. The main result of modelling the spatially structured effect is lower tree height prediction for coastal sites and with increasing latitude. The quadratic mean diameter affects both the level and the slope of the height-diameter curve and both effects are positive. Conclusions： In this investigation it is assumed that model effects in additive modelling of height-diameter curves which are unfeasible and too wiggly from an expert point of view are a result of quantitatively or qualitatively limited data bases. However, this problem can be regarded not to be specific to our investigation but more general since growth and yield data that are balanced over the whole data range with respect to all combinations of predictor variables are exceptional cases. Hence, scare may provide methodological improvements in several applications by combining the flexibility of additive models with expert knowledge.

Fabrication and Property of SiC Ceramic with Large Thickness/Diameter Ratios

Silicon carbide ceramics with different thicknesses/diameter ratios were prepared by using ultra-fine silicon carbide powder with the sintering additives of 1.0 wt% boron and 1.5 wt% carbon. The influence of thickness/diameter ratio on the microstructure and density of SiC ceramics was investigated in detail. The experimental results show that the addition of boron and carbon sintering aids can promote the densification process of SiC ceramic, leading to the low sintering temperature and improve mechanical properties. At 1950 ℃, SiC ceramic with a density of 99% exhibits Young's modulus, hardness, and flexural strength of 476 MPa, 28.3 GPa, and 334 MPa, respectively. It is found that long holding time has a positive effect on the uniformity of the microstructure and density distribution of SiC ceramics with large thickness/diameter ratios. Additionally, the sintering additive of boron can solid-solve into SiC, and then facilitate the phase transformation of SiC to form 6H-SiC and 4H-SiC composite ceramics.

Height-Diameter Relationship of Some Forest Species Exploited for Wood in the Natural Tropical Forest of the Congo Basin

To enrich knowledge on the growth dynamics of commercial forest species in the Congo Basin, a study was conducted in Cameroon, within a community forest in savannah forest transition zone (Zone 1) and within FMU 10 052 in dense semi-deciduous humid forest (Zone 2). It aimed to obtain, in 8 species, the height (H) of the tree from its diameter (D) more accessible: Entandophragma cylindricum (Meliacea), Eribroma oblongum, Sterculia rhinopetala et Triplochiton scleroxylon (Malvaceae);Erythrophleum suaveolens et Piptadeniastrum africanum (Fabaceae), Milicia excelsa (Moraceae) et Terminalia superba (Combretaceae). The destructive method was used. After felling and flushing out a tree, the dendrometric parameters were measured and/or calculated. In Zone 1, 6 species including T. scleroxylon were calibrated using 30 trees of each. In Zone 2, 45 trees of E. cylindricum, 99 of E. suaveolens and 82 of T. scleroxylon constituted the sample. At the 5% threshold (95% confidence interval), the height-diameter relationship is a linear model. In all species, the height of a tree is predicted by measuring its diameter through linear regression. In Zone 1 regression equation is: H(m) = 28.13 + 19.09 * D(m) for T. scleroxylon;H(m) = 12.35 + 30.38 * D(m) for S. rhinopetala;H(m) = 23.09 + 26.42 * D(m) for E. oblongum;H(m) = 14.86 + 20.92 * D(m) for P. africanum;H(m) = 14.98 + 24.78 * D(m) for T. superba and H(m) = 1.55 + 32.37 * D(m) for M. excelsa. In Zone 2, the relationship is: H(m) = 27.40 + 14.21 * D(m) for T. scleroxylon;H(m) = 7.79 + 20.18 * D(m) for E. cylindricum and H(m) = 20.08 + 9.74 * D(m) for E. suaveolens (probability associated with F < 0.0001). The influence of site parameters (biotic and abiotic) on the height-diameter relationship should be more studied in multilayers forests specifically in the Congo Basin.

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.