Standard Classification System Research Articles

A ureteral stricture disease score and classification system: correlation with upper urinary tract reconstructive surgery complexity.

BackgroundTo develop an original and standardized ureteral stricture disease (USD) score and classification system for quantifying ureter stricture characteristics, assessing complexity of the minimally invasive upper urinary tract reconstructive (UUTR) surgical procedure, formulating preoperative plans, and offering objective comparisons of surgical techniques between different institutions and surgeons.MethodsWe retrospectively reviewed a test set of 64 patients and a validation set of 170 patients who underwent minimally invasive UUTR surgery from January 2018 to January 2021. Three factors were selected to be included in the USD score and classification system: (I) stricture etiology (E, 1–2 points); (II) stricture segment (S, 0–3 points); and (III) length of stricture (L, 1–5 points). The UUTR surgery involves low-complex surgeries (cystoscopy with ureteral dilation and stent placement, ureteropyeloplasty, end to end repair, ureteral reimplantation) and high-complex surgeries (onlay repair (buccal mucosae, lingual mucosae, appendix mucosae), Boari flap repair and ileal ureter replacement). Estimated blood loss and operative time were used as surrogate indicators of surgical complexity.ResultsThe interrater reliability of the USD score and classification system was 0.908. A linear relationship between the USD score and estimated blood loss was observed (rs =0.676, P<0.001). The USD score was also correlated with operative time (rs =0.638, P<0.001). A significant difference in USD scores was found between the high and low complexity surgery groups (4 vs. 7, P<0.001). Variability of UUTR surgery is based on USD classification system, but with regularity to conform to.ConclusionsThe USD score and classification system is a concise, easily applicable, and validated scale to delineate the clinically significant features of ureter stricture that correlate with the complexity of the UUTR surgical procedure. The use of this score and classification system can facilitate preoperative plan and comparison of USD treatments in clinical practice and urological literature. Research with large sample is needed to further examine and modify the use of the system.

Применение показателей вариабельности сердечного ритма для оценки адаптационных процессов и уровня стресса у гастроэнтерологических больных (использование современных технологий PRECISE-диагностики)

Изучению вариабельности сердечного ритма (ВСР) посвящено множество научных работ. В статье приведен обзор публикаций по данной теме, где изложены современные представления о ВСР, по показателям которой можно оценить состояние механизмов регуляции физиологических функций организма человека, рассмотрены классические методы анализа и возможности клинического применения. Сердечный ритм является индикатором отклонений в вегетативном гомеостазе, причем изменение сердечного ритма — наиболее ранний прогностический признак возникновения многих заболеваний. В клинической практике анализ ВСР находит все более широкое применение при гастроэнтерологической патологии (гастроэзофагеальная рефлюксная болезнь, язвенная болезнь, синдром раздраженного кишечника), взаимодействии звеньев вегетативной нервной системы при различной гастроэнтерологической патологии. В ГУ «Институт гастроэнтерологии НАМН Украины» пациентов с разнообразной патологией пищеварительной системы обследуют при помощи современной PRECISE-диагностики для определения адаптационных и вегетативных нарушений с последующим лечением, используя технологии виртуальной реальности. С помощью PRECISE-диагностики анализируют уровень стресса и определяют возможный риск возникновения осложнений у гастроэнтерологических больных. Проводится анализ ВСР с использованием облачной технологии автоматизированной интерпретации электрокардиограммы с анализом более 700 параметров на основе Миннесотского кода с анализом каждого миллиметра сигнала.

Standardized Classification of Lumbar Spine Degeneration on Magnetic Resonance Imaging Reduces Intra- and Inter-subspecialty Variability

Background and PurposeTo determine the efficacy of standardized definitions of degenerative change in reducing variability in interpretation of lumbar spine magnetic resonance imaging within and between groups of subspecialty-trained neuroradiologists (NR) and musculoskeletal radiologists (MSK). Materials and MethodsSix radiologists, three from both NR and MSK groups were trained on a standardized classification system of degenerative change. After an 11-month washout period, they independently re-interpreted fifty exams at the L4-L5 and L5-S1 levels. Responses were converted to a six-point ordinal scale for the assessment of neural foraminal stenosis and spinal canal stenosis (SCS), three-point scale for lateral recess stenosis, and four-point scale for facet osteoarthritis (FO). Intra-subspecialty and inter-subspecialty analysis was performed using the weighted Cohen's kappa with a binary matrix of all reader pairs. ResultsInter-subspecialty agreement improved from k=0.527 (moderate) to k=0.602 (substantial) for neural foraminal stenosis, from k=0.540 (moderate) to k=0.652 (substantial) for SCS, from k=0.0818 (slight) to k=0.337 (fair) for lateral recess stenosis, and from k=0.176 (slight) to k=0.495 (moderate) for FO. The NR group demonstrated improved intra-subspecialty agreement for the assessment of SCS, from k=0.368 (fair) to k=0.638 (substantial). The MSK group demonstrated improved intra-subspecialty agreement for the assessment of FO, from k=0.134 (slight) to k=0.413 (moderate). Intra-subspecialty agreement was similar for other parameters before and after training. ConclusionsAs result of the standardized definitions training, the NR and MSK groups each improved in one of the four parameters, while inter-subspecialty variability improved in all four parameters. These definitions may be useful in clinical practice across radiology subspecialties.

Clinician's commentary: Atypia in urinary tract cytology specimens.

At the 18th International Congress of Cytology in Paris in 2013, the "Paris Group" created standardized reporting system/criteria for urine cytopathology. This reporting system provided evidence-based criteria for all the urine cytopathologic diagnosis in aims to avoid atypia being used a "waste basket." The addition of standard classification system greatly helps minimizing atypia diagnosis; however, clinicians, specifically, urologist, are still left without a clear set of guidelines for how to approach atypia. Prospective collaborate work with cytopathologists and urologist can help solve the dreaded atypia cytology pathological report and provide a framework and guidelines on management, providing better care to our patients.

Incidence of Stillbirth in Relation to Period of Delivery, Socioeconomic Status and Period of Gestation in a Rural Tertiary Care Hospital-MGIMS, Sewagram Within Study Period of Three Years (2013-2016).

Stillbirth remains one of the most common adverse outcomes of pregnancy, yet is among the least studied. Occurrence of stillbirth is a tragic event faced by mother as well as obstetrician. It has implications on couple, their family and the health care providers. It reflects a failure or lapse in implementation of maternal and child health care programs. Worldwide 3.2 million stillbirth occur in world, 20-66 per 1000 total births in India in different states. Stillbirth in India is largely underreported. Stillbirths contribute to more than half of perinatal death. More than 2/3rd Stillbirth take place during pregnancy and remaining during course of labour. Registration of all live births and stillbirths, together with evaluation of cause of stillbirths are important initial steps for developing countries. A standard classification system would be important to document aetiology of stillbirth in developing countries. All cases who delivered a stillborn baby in the hospital were studied in details. The records were maintained date-wise. Initially, the basic demographic information was taken giving special attention to age, education, occupation, socioeconomic status, rural or urban residence etc. The two controls of live births were also asked the same details and the data were entered in Microsoft word excel sheet and analyzed by Chi-square test. Incidence of stillbirth in MGIMS Sewagram which is Tertiary care centre placed in rural area was 30.57%. Incidence in relation to place (rural) 62.42%, more in antepartum 94.9% (149/157), in low socioeconomic status 48%. It was found more in 30-32 weeks of period of gestation as in this period most of medical disorders of pregnancy precipitate. The online version of this article (10.1007/s13224-021-01453-6) contains supplementary material, which is available to authorized users.

Noninvasive Angiographic Results of Clipped or Coiled Intracranial Aneurysms: An Inter- and Intraobserver Reliability Study.

Noninvasive angiography is commonly used to assess the outcome of surgical or endovascular treatment of intracranial aneurysms in clinical series or randomized trials. We sought to assess whether a standardized 3-grade classification system could be reliably used to compare the CTA and MRA results of both treatments. An electronic portfolio composed of CTAs of 30 clipped and MRAs of 30 coiled aneurysms was independently evaluated by 24 raters of diverse experience and training backgrounds. Twenty raters performed a second evaluation 1 month later. Raters were asked which angiographic grade and management decision (retreatment; close or long-term follow-up) would be most appropriate for each case. Agreement was analyzed using the Krippendorff α (αK) statistic, and the relationship between angiographic grade and clinical management choice, using the Fisher exact and Cramer V tests. Interrater agreement was substantial (αK = 0.63; 95% CI, 0.55-0.70); results were slightly better for MRA results of coiling (αK = 0.69; 95% CI, 0.56-0.76) than for CTA results of clipping (αK = 0.58; 95% CI, 0.44-0.69). Intrarater agreement was substantial to almost perfect. Interrater agreement regarding clinical management was moderate for both clipped (αK = 0.49; 95% CI, 0.32-0.61) and coiled subgroups (αK = 0.47; 95% CI, 0.34-0.54). The choice of clinical management was strongly associated with the size of the residuum (mean Cramer V = 0.77 [SD, 0.14]), but complete occlusions (grade 1) were followed more closely after coiling than after clipping (P = .01). A standardized 3-grade scale was found to be a reliable and clinically meaningful tool to compare the results of clipping and coiling of aneurysms using CTA or MRA.

Relatively Low Rate of Heterotopic Ossification Following Primary Total Knee Arthroplasty: A Systematic Review and Meta-analysis.

Background:Heterotopic ossification (HO) is abnormal growth of ectopic bone and negatively affects the outcomes after total knee arthroplasty (TKA). This systematic review and meta-analysis were performed to characterize the prevalence and severity of HO after primary TKA.Methods:A systematic review of the literature was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Patient demographics, publication year, and HO prevalence after a primary TKA were recorded. A meta-analysis was performed to determine the overall prevalence of HO formation, and a subanalysis compared the studies published in different timeframes to determine whether a temporal effect exists for HO prevalence.Results:Two thousand nine hundred eighty-eight patients underwent primary TKA across the included studies. Fourteen percent of patients (9% to 20%; I2: 93.68%) developed HO postoperatively during a mean follow-up of 40.1 months (11 to 108 months). HO rates seemed to decrease in studies published in more recent years, with a pooled HO prevalence of 5% (0% to 13%; I2: 92.26%) among studies published in the past 15 years compared with 18% (12% to 25%; I2: 92.49%) among studies published before then.Conclusion:Although studies reported a relatively low overall rate of HO after a primary TKA, the absence of a single, standardized classification system precludes the comparisons of HO severity between studies. Overall, HO prevalence seems to have decreased over time, likely reflecting the changes in perioperative medication protocols.

Classification of Seasonal Hyperacute Panuveitis (SHAPU)

ABSTRACT Introduction Classification are essential part of scientific methodology and has important role in medical reporting system. Even after having 46 years long history, Seasonal Hyperacute Panuveitis (SHAPU), the blinding diseases reported mainly from Nepal lacks a standard classification system. Thus, we aim to contribute in the ophthalmic nosology by purposing a classification system for SHAPU. Methodology The classification is suggested on the background of prolonged experience of this entity by the group of investigators who have dedicated years of research on this topic. Conclusion We are optimistic that the proposed classification system will help in effective planning and evaluation of this ocular emergency condition and deliver the appropriate and reliable information for timely management and prevention of complications.

Acute and Chronic Placental Abnormalities in a Multicenter Cohort of Newborn Infants with Hypoxic–Ischemic Encephalopathy

To examine the frequency of placental abnormalities in a multicenter cohort of newborn infants with hypoxic-ischemic encephalopathy (HIE) and to determine the association between acuity of placental abnormalities and clinical characteristics of HIE. Infants born at ≥36weeks of gestation (n=500) with moderate or severe HIE were enrolled in the High-dose Erythropoietin for Asphyxia and Encephalopathy Trial. A placental pathologist blinded to clinical information reviewed clinical pathology reports to determine the presence of acute and chronic placental abnormalities using a standard classification system. Complete placental pathologic examination was available for 321 of 500 (64%) trial participants. Placental abnormalities were identified in 273 of 321 (85%) and were more common in infants ≥40weeks of gestation (93% vs 81%, P=.01). A combination of acute and chronic placental abnormalities (43%) was more common than either acute (20%) or chronic (21%) abnormalities alone. Acute abnormalities included meconium staining of the placenta (41%) and histologic chorioamnionitis (39%). Chronic abnormalities included maternal vascular malperfusion (25%), villitis of unknown etiology (8%), and fetal vascular malperfusion (6%). Infants with chronic placental abnormalities exhibited a greater mean base deficit at birth (-15.9 vs -14.3, P=.049) than those without such abnormalities. Patients with HIE and acute placental lesions had older mean gestational ages (39.1 vs 38.0, P<.001) and greater rates of clinically diagnosed chorioamnionitis (25% vs 2%, P<.001) than those without acute abnormalities. Combined acute and chronic placental abnormalities were common in this cohort of infants with HIE, underscoring the complex causal pathways of HIE. ClinicalTrials.gov: NCT02811263.

Architecture design and demand analysis on application layer of standard system for ubiquitous power Internet of Things

The ubiquitous power Internet of Things (UPIoT) is an intelligent service system with comprehensive state perception, efficient processing, and flexible application of information. It focuses on each link of the power system and makes full use of the mobile internet, artificial intelligence, and other advanced information and communication technologies in order to realize the inter-human interaction of all things in all links of the power system. This article systematically presents to the national and international organizations and agencies in charge of UPIoT layer standardization the status quo of the research on the Internet of Things (IoT)-related industry standards system. It briefly describes the generic standard classification methods, layered architecture, conceptual model, and system tables in the UPIoT application layer. Based on the principles of inheritance, innovation, and practicability, this study divides the application layer into customer service, power grid operation, integrated energy, and enterprise operation, emerging business and analyzes the standard requirements of these five fields. This study also proposes a standard plan. Finally, it summarizes the research report and provides suggestions for a follow-up work.

A retrospective analysis of pleural effusion specimens based on the newly proposed International System for Reporting Serous Fluid Cytopathology.

Recently, the International System for Reporting Serous Fluid Cytopathology (TIS) has been established, with an aim to standardize reporting and guide clinical decision making. The cytological and clinicopathological data of pleural effusions were retrieved from the pathology database and electronic medical records. All specimens were evaluated and reclassified in accordance with the TIS recommendations. Finally, the risk of malignancy (ROM) and performance parameters were measured. A total of 2454 pleural effusion specimens were included, among which 30 (1.2%), 1670 (68.1%), 151 (6.2%), 54 (2.2%) and 549 (22.4%) patients were classified into non-diagnostic (ND), negative for malignancy (NFM), atypia of undetermined significance (AUS), suspicious for malignancy (SFM) and malignancy (MAL) groups, respectively. The most commonly diagnosed malignancies were lung cancer (48.4%), ovary cancer (10.2%), breast cancer (7.5%), and 21.3% unknown primary site (UPS). Among the 36 UPS patients, the most common site of origin was lung (36.1%), followed by ovary (13.9%) and breast (11.1%) via immunocytochemistry of cell block. The calculated ROM values were 26.7%, 12%, 62.3%, 77.8% and 100% for ND, NFM, AUS, SFM and MAL groups, respectively. When considering MAL as the only positive group, the diagnostic accuracy, sensitivity, specificity, positive and negative predictive values were determined to be 95.2%, 81.9%, 100%, 100% and 93.6%, respectively. The newly proposed TIS is an easy-to-master, user-friendly, and standardized classification system, especially when applying on pleural effusions. An adequate serous sample, application of immunocytochemistry, review of cytomorphological data and past medical history could enhance the accuracy of cytological diagnosis.

English

BACKGROUND A standard and comprehensive classification system is needed to maintain appropriate Caesarean section (CS) rates like Robson Ten Group Classification System. The present study was conducted to analyse Caesarean section rate and its distribution according to Robson’s classification. METHODS A descriptive study was conducted in the Department of Obstetrics and Gynaecology, Deen Dayal Upadhyay Hospital, Hari Nagar, New Delhi, from August 2018 to May 2019 on pregnant women of more than 28 weeks of gestation admitted for delivery. RESULTS Out of 8099 deliveries, 2924 required Caesarean section. The overall Caesarean section rate was 36.11 %, 1616 (55.27 %) were primary Caesarean section and 1308 (44.73 %) were repeat Caesarean section. Preterm delivery by Caesarean section was in 7.49 %. Majority of Caesarean section were in 37- 40 weeks of gestation (79.42 %). Out of 2924 cases 90.62 %, 8.21 % and 1.17 % were cephalic presentation, breech and other presentations respectively. 32 Caesarean section cases were twin pregnancy, 20.83 % was induced whereas 23.91 % was in spontaneous labour. Previous Caesarean section (44.74 %) was the commonest cause followed by foetal distress (16.82 %). Commonest cause for repeat Caesarean section was foetal distress (25.76 %). Major contributor to overall Caesarean section rate was Robson’s group 5 (38.72 %) followed by group 2 and group 1 i.e 21.64 % and 11.79 % respectively. Least contributor was group 8 (1.09 %). CONCLUSIONS Robson’s classification can help to identify broad categories of women to be targeted to decrease Caesarean section rates. Caesarean section rate can be reduced by decreasing primary Caesarean section, offering trial of labour (TOLAC), strict induction protocols implementation and precise interpretation of foetal heart rate tracings. KEYWORDS Caesarean Section, Robson’s Classification, Malpresentation

Open fetal myelomeningocele repair at a university hospital: surgery and pregnancy outcomes.

Myelomeningocele (MMC) is an open neural tube defect that causes great morbidity. Prenatal open repair is the standard treatment; however, there are many complications related to the procedure. This study reports preliminary findings of open in utero repair of MMC in a public tertiary hospital in Brazil and describes factors that could be associated with increased surgical morbidity. Thirty-nine patients underwent open in utero repair of MMC from October 2015 to August 2019. The Clavien-Dindo classification of surgical complications and a classification system with the preterm definitions of the World Health Organization were used, respectively, for maternal and fetal complications. A total of 28 mothers (71.8%) and 31 fetuses (79.5%) experienced at least one minor to major complication. Three mothers (7.7%) had a severe grade 4 complication. Fetal complications grades 3 to 5 occurred in 13 fetuses (33.3%). Gestational age at surgery and at birth were 24.88 ± 1.16weeks and 33.23 ± 3.68weeks, respectively. Preterm delivery occurred in 30 patients (76.9%), membrane rupture in 18 patients (46.2%) and chorioamnionitis in 13 patients (33.3%). Open fetal surgery for MMC was performed at a Brazilian public tertiary care center, resulting in three grade 4 maternal complications. Relevant fetal complications were also present. The use of a standard classification system for complications renders studies more comparable and data more useful for counseling patients. Adjustments of perioperative procedures and long-term follow-up are needed to determine the real benefit of open in utero repair of MMC at our hospital.

Angiographic prostatic arterial anatomy in a Turkish population with benign prostatic hyperplasia

Background/aim Prostatic artery embolization (PAE) is a minimally invasive effective method in the treatment of benign prostatic hyperplasia (BPH). The procedure is technically challenging, as pelvic vascular anatomy is highly prone to variations and the identification of the prostatic artery (PA) is the most time-consuming step, which can lead to increased procedure times. The aim of this study was to categorize the anatomic variations in the prostatic supply in patients with BPH treated with PAE.Materials and methods The digital subtraction angiography findings of 68 PAE procedures were reviewed retrospectively and the age, PA origin, number, and procedure of the patients were recorded. The origin of the PA was classified into 5 subtypes using the de Assis/Carnavale classification. The incidence of each anatomic type was calculated. Results In the 68 PAE procedures, 119 pelvic sides were analyzed and a total of 119 PAs were classified. The most common origin was type 1 (n = 43, 36.1%), with the PA originating from the anterior division of the internal iliac artery (IIA), from a common trunk with the superior vesical artery. This was followed by type 4 (n = 34, 28.6%), with the PA originating from the internal pudendal artery; type 3 (n = 22, 18.5%), with the PA originating from the obturator artery; and type 2 (n = 13, 10.9%), with the PA originating from the anterior division of the IIA. Conclusion Anatomic variations are common in the IIA and PA, showing racial and individual differences. Following a standard classification system to identify the origin of the PA is crucial and being aware of the most common types in each population will make PAE a faster and safer procedure.

Popliteal entrapment syndrome-The case for a new classification.

To assess the ability of the current classification system for popliteal entrapment syndrome to accurately capture all patients, and if not, to design an all-inclusive new classification. Retrospective review of all interventions performed for popliteal entrapment syndrome between 1994 and 2013 at our institution was performed. Preoperative imaging and intraoperative findings were used to establish the compressive morphology of popliteal entrapment syndrome. Patients were categorized, when possible, into six types of the current classification system (Rich classification, modified by Levien) and into seven types of a new classification. Sixty-seven limbs of 49 patients were operated on for unilateral (31) or bilateral (18) popliteal entrapment syndrome. The current classification system captured the anatomy of only 43 (64%) of 67 limbs with popliteal entrapment syndrome. Compressive morphologies without a defined class included aberrant insertion of the lateral head of gastrocnemius muscle, muscle slip originating from the lateral head of gastrocnemius or hamstrings, hypertrophied hamstring muscle, abnormal fibrous bands, perivascular connective tissue, and prominent lateral femoral condyle. The new classification captured 100% of the limbs with popliteal entrapment syndrome. Current classification of popliteal entrapment syndrome is inadequate as more than one-third of the cases reviewed fell outside of the standard classification system. Consideration of a more inclusive new anatomic classification system is warranted.

Measuring industry employment, 1990–2018: a look at the auxiliary-unit concept

The North American Industry Classification System (NAICS) replaced the Standard Industrial Classification (SIC) system in 1997. Since the change, some analysts have expressed concerns about the elimination in NAICS of the concept of auxiliary units, which are now classified with other worksites that perform similar functions. This article examines how employment trends by broad industry groups would have differed over the past few decades if the auxiliary-unit concept had been used to estimate employment in those units as it was in the SIC system.

Heterotopic Ossification Negatively Influences Range of Motion After Revision Total Knee Arthroplasty

BackgroundThe incidence of heterotopic ossification (HO) after total knee arthroplasty (TKA) varies and is of unclear clinical significance. This study aimed to identify the incidence of HO in patients undergoing revision TKA for either stiffness or aseptic loosening/instability and determine if the presence of HO is associated with inferior absolute range of motion (ROM) and ROM gains. MethodsEighty-seven patients were prospectively enrolled and separated into 2 cohorts to evaluate ROM after revision TKA (2017-2019). Group 1 (N = 40) patients were revised for stiffness, while group 2 (N = 47) patients were revised for either aseptic loosening or instability. Goniometer-measured ROM values were obtained preoperatively and at 6 weeks, 6 months, and 1 year postoperatively. Statistical analysis included a Fisher’s exact test to assess for an association between preoperative HO and final ROM at 1 year after revision TKA. ResultsHO was identified on preoperative radiographs in 17 patients (20%). There was a significantly higher rate of preoperative HO in patients revised for stiffness compared to patients revised for instability or loosening (30% vs 11%; P = .03). Five cases of HO qualitatively identified as most clinically severe were associated with lower ROM at each time point compared to the remainder of HO cases in this study cohort (P < .02). ConclusionThe presence of HO is greater in patients undergoing revision TKA for stiffness. Additionally, HO severity appears to have a major effect on preoperative and postoperative ROM trajectory. This information should help guide patient expectations and highlight the need for a comprehensive, standardized classification system for HO.

Flower color classification and correlation between color space values with pigments in potted multiflora chrysanthemum

Flower color, which varies widely in potted multiflora chrysanthemum, is an extremely important character for classification. A quantitative definition of the flower color of potted multiflora chrysanthemums and the establishment of a standard color classification system may help us to evaluate the germplasm resources effectively. In this study, 273 potted multiflora chrysanthemum advanced lines were selected as materials. First, color classification results were compared between two methods: one is a combination of CIELAB and Munsell color systems, and the other one applying Q clustering analysis based on the CIELAB color system. We then divided the 273 lines into six color groups. The composition and content of anthocyanins and carotenoids in the different color advanced lines were identified by HPLC-MS. Two derivatives of cyanidin, cyanidin-3-O-(6″-O-malonyl-glucoside) and cyanidin-3-O-(3″,6″-O-dimalonyl-β-glucopyanoside), were identified in the pink, purple, orange-brown, and red lines. The carotenoids, primarily consisting of violanthin, z-violanthin, 9′z-lutein 5,6-epoxide, lutein, α-carotene, β-carotene, and 9z-β-carotene, were identified in all chrysanthemum advanced lines. Additionally, a*, represents the green-red component with green in the negative direction and red in the positive direction, was strongly positively correlated with cyanidin-3-O-(6″-O-malonyl-glucoside) (r = 0.884, P < 0.01), cyanidin-3-O-(3″, 6″-O-dimalonyl-β-glucopyanoside) (r = 0.864, P < 0.01) and total anthocyanins (r = 0.896, P < 0.01) by linear regression analysis and Pearson correlation coefficients. Meanwhile, b*, represents the blue–yellow component with blue in the negative direction and yellow in the positive direction, was strongly positively correlated with lutein (r = 0.804, P < 0.01) and total carotenoids (r = 0.881, P＜0.01) in potted multiflora chrysanthemum. Then, linear equations were obtained according to the significant correlations between a* and anthocyanins and b* and carotenoids. These results were helpful for rapidly and accurately estimating the content of anthocyanins/carotenoids.

049 Does the Clasification of Peyronie's Disease with Doppler US Affect Surgical Intervention Pursued by the Patient?

Peyronie’s disease (PyD) is a benign disorder with a broad spectrum of presentations, disease severity and management that we do not fully understand yet. There is also no standard classification system for it. Our institution utilizes a unique classification system using Color Doppler Duplex Ultrasound (CDDU) to evaluation and grade patients with Peyronie’s disease.

Development of an Ontological Cost Estimating Knowledge Framework for EPC Projects

This research standardizes a knowledge structure for estimation in the construction field by creating a method to enhance cost management efficiency of construction projects while meeting the need for reusability of accumulated construction information. The construction knowledge structure was developed to execute the project cost estimation with an ontological concept. The knowledge framework was defined and relevant examples were addressed to explain the structure. The detailed estimation process and methodology for using standard unit price information was also developed to strengthen cost information interoperability by utilizing standard classification systems, such as MasterFormat, UniFormat, UniClass, and ISO 12006. This concept may be proposed as a method of connecting construction information based on a standard cost classification system in order to improve estimation efficiency by increasing the connectivity of cost information. Ontology can be a powerful tool when used in conjunction with interoperability to manage the massive volume of construction information for cost management. This methodology can expand to integrated management in cost and time to derive additional classes for work breakdown structure (WBS). Thus, ontology may improve the efficiency of cost estimation and systematization by reusing construction information. As a further step, the interoperability method will enhance overall construction project management.