Variation Of Diameter Research Articles

Comparing Ultrasound and MRI Evaluations of the Hamstring Tendon for Predicting Autograft Size in Anterior Cruciate Ligament Reconstruction.

Adequate graft size and length are crucial factors in anterior cruciate ligament (ACL) reconstruction. Accurate identification of patients who may be at risk for an insufficient length or size of the hamstring tendon (HT) can aid surgeons in preoperative planning. To evaluate whether magnetic resonance imaging (MRI) or ultrasound could more accurately predict the size of the semitendinosus tendon (ST) and gracilis tendon (GT) and to investigate the correlation between anthropometry, graft size, and imaging measurements to find a predictive formula. Cross-sectional study; Level of evidence, 3. Included in the study were 36 patients who underwent ACL reconstruction with HT autograft at our institution between July 2021 and May 2022. Anthropometric data and MRI and ultrasound measurements were collected preoperatively. The length and diameter of the HT were recorded intraoperatively. Correlations between anthropometry, graft size, and imaging measurements were analyzed. Linear regression analysis was performed to construct a prediction formula. The intraoperative graft diameters of the ST and GT were weakly to moderately associated with their cross-sectional areas as measured by MRI and ultrasound. MRI and ultrasound interpreted 11.9% to 15.7% and 18.4% to 41.7% of the variation in the graft diameter of the HT, with an accuracy of 50.0% to 55.6% and 69.4% to 86.1%, respectively. The intraoperative lengths of the ST and GT were both associated with patient height and tendon lengths as measured by ultrasound. Additionally, intraoperative GT length was associated with patient weight. Four formulas combining relevant anthropometric parameters and imaging measurements were calculated from multilinear regression analysis, explaining up to 46.3% of the variance in the size of HT. Ultrasound and MRI alone showed limited ability to predict the graft diameter of the ST and GT, while ultrasound could more accurately predict the graft size than MRI. Among the different anthropometric variables, height was the most influential in predicting tendon length.

Effect of pre-straining direction on the microstructure, mechanical properties and microstructural response of AA2099-T83 Al-Li alloy

Understanding the microstructural evolution and anisotropic behavior of Al-Li alloys after pre-deformation in different directions is crucial for optimizing their forming performance. This study investigates the microstructural evolution in AA2099 Al-Li alloy rolled sheets after pre-deformation in the extrusion direction (ED) and transverse direction (TD), and the resulting changes in mechanical properties during subsequent tensile deformation. A crystal plasticity finite element model (CPFEM) was established to quantitatively analyze the link between pre-deformation direction and the microstructural response during the hardening stages of tensile deformation. The results showed that the differences in mechanical properties due to pre-deformation direction are mainly attributed to the variations in volume fraction and diameter of the T1 precipitates. The contributions of T1 phase to yield strength are estimated to be 239 MPa (ED) and 223 MPa (TD), respectively. An increase in T1 (Al2CuLi) phase volume fraction and a decrease in phase diameter lead to higher average von Mises stress and average maximum principal strain values during the hardening stages.

Biological studies of the activity of Manuka honey against Carbapenem-resistant Enterobacterales (CRE) bacteria.

To evaluate the potency of Manuka honey UMF +15 against Carbapenem-resistant Enterobacterales (CRE). Bacterial resistance is a worldwide problem that is increasing year by year, especially Carbapenem resistance. Alternatives to antibiotics are needed to both reduce costs, and to reduce the spread of antibiotic resistance, with the ultimate goal of saving lives. The efficacy of Manuka honey UMF +15 was tested by 2 methods; Well diffusion assay and minimum bactericidal concentration (MBC) against twenty Carbapenem-resistant isolates which collected from Makkah city hospitals during three months of study from 1st of September 2023 up to 1st of December 2023. The growth of all isolates of Carbapenem-resistant Enterobacterales (CRE) was severely inhibited by low concentrations of Manuka honey, affecting 25% of isolates at 15% and 75% of isolates at 18% of Manuka honey. In addition, using the honey at different concentrations in a well diffusion assay resulted, as expected, in a variable zone diameter, ranging from large zones(14mm) to small zones (2mm) according to the concentration of the honey. This study shows the remarkable antibacterial activity of Manuka honey and suggests that this natural remedy might be used in the future as an alternative treatment option against Carbapenem-resistant Enterobacterales (CRE); however, further clinical trials should be performed to corroborate our initial findings.

Phylogenetic Effect on Tree Radial Growth Depends on Drought and Tree Sizes

AbstractTree radial growth is one of the most direct measures of tree performance and is also sensitive to climate. Growth performance is the consequence of the interplay between ecological and evolutionary processes. However, the effect of the evolutionary relatedness among species (i.e., phylogeny) on tree radial growth, especially under stressful conditions, remains largely unknown. Furthermore, there is still no ecological evidence for the influence of phylogeny on tree growth across different tree attributes (i.e., tree diameter variation and tree canopy height) and topographic habitat types. We used Blomberg's K to quantify the tree growth phylogenetic signal (TGPS) using two long‐term dendrometer data sets: one a continuous census of 225 tree species at 3‐month intervals in a tropical forest in southwest China from 2009 to 2017; the other, 12 tree species measured at 6‐month intervals in a temperate forest in Washington State, USA from 2013 to 2019. We found that TGPS values were higher in the temperate forest than in the tropical forest. Precipitation, tree diameter, canopy strata, and habitat types all influenced TGPS values. TGPS values were significantly (p < 0.05) and negatively related to precipitation in Xishuangbanna, and the three of four tree diameter classes in the temperate forest, respectively. Stressful growing conditions arose from either based on low precipitation or among large‐diameter trees competing with each other in the upper canopy led to phylogenetic conservatism in trees' radial growth performance. We conclude that phylogeny is pivotal to understanding the growth response differences among species and their responses to climate variability.

Cyclic loading experiments and numerical analysis of laterally loaded piles constructed in marine soil

This study aims to thoroughly analyze the lateral loads that impact tubular steel piles, which are extensively employed in the construction of coastal structures. The ASTM D 3966 standard was followed for conducting field tests on test piles installed at the Mersin International Port. The “time-displacement” and “load-displacement” curves were obtained from the cyclic loading test of the laterally loaded piles at the construction site. The finite elements models of the tests conducted on the construction site with the same parameters was built to perform numerical analysis. At the end of the analysis, it was determined that the numerical model's results were highly consistent with those obtained from the field test. After verifying the field experiments with numerical models, a parametric study was conducted. Parametric studies were conducted to compare the lateral displacements of tubular steel piles with variations in pile diameter, wall thickness, and load application height effect. The relationship between pile head displacements and these parameters appears to be almost linear. It is noteworthy that a change of approximately 10 percent in these parameters shows a correlation with changes of up to 3 percent in deformations.

Controllable variable beam diameter ion source based on the Einzel lens

With the development of modern optical systems, high-power laser systems, ultraviolet lithography systems, etc., the requirements for the precision and processing efficiency of optical components continue to increase. Although sub-nanometer precision can be achieved with current ion beam figuring, the introduction of additional removal layers greatly limits its machining efficiency due to the inability of the machine dynamics to satisfy the velocity and acceleration requirements mathematically. Therefore, an efficient figuring technology of controllable variable beam diameter ion beam based on the Einzel lens has been proposed. The simulation results show that the ion beam diameter can be effectively controlled by adjusting the voltage of the Einzel lens. The experimental results show that the ion source can control the ion beam diameter by voltage, and then change the size of the ion beam, and obtain a very small removal function. The FWHM is reduced from 12.1 mm to 10.1 mm, and the peak removal rate is increased by 1.7 times, which significantly improves the removal efficiency and figuring ability. Therefore, this work aims to improve the accuracy of ion beam figuring of high-power laser optical components and address the problem of reduced efficiency caused by additional removal layers in the existing figuring process.

Multi-factor quality assessment of digital speckle pattern for speckle projection profilometry

Abstract The digital speckle pattern (DSP) is an essential component in the speckle projection profilometry (SPP) task, its quality directly affects the results of three-dimensional (3D) shape reconstruction. However, the SPP field lacks specialized numerical metrics for evaluating speckle quality. To address this issue, this study introduces a multi-factor metric (MFM) for comprehensive DSP assessment. Through comparing the metric, optimal parameter ranges for DSP design and the advisable matching subset size can be determined for SPP algorithm. A global indicator named valid feature distribution (VFD) based on scale-invariant feature transform (SIFT) and Delaunay triangulation, is defined to analyze the overall information distribution in DSPs. In addition, MFM incorporates a local metric called mean subset intensity gradient (MSIG), which aids in selecting the suitable radius for different DSPs to balance the accuracy and efficiency. The quality assessment targets the speckle scene images, allowing for the reverse adjustment of the most suitable DSP according to different scenes. The performance of DSPs can be evaluated based on the accuracy and completeness of 3D reconstruction results. By conducting simulation experiments on the 3ds Max platform, the recommended parameter range for DSP can be inferred, including speckle density ratio, speckle diameter, and random variation rate. Appropriate subset sizes for different scenes are also investigated. Furthermore, the MFM is verified on a real binocular speckle device, demonstrating that the measurement standard deviation of a complex workpiece can be reduced to 0.078 mm using the recommended DSP.

Unloading Technology and Application Research of Variable Diameter Drilling in Dynamic Pressure Roadway

Theoretical analysis and numerical simulation are used to study the influence of different parameters of variable diameter borehole pressure relief technology on the surrounding rock and support. A strain-softening model was established to analyze the intrinsic connection between the parameters of variable diameter boreholes and the evolution of surrounding rock stress, deformation law, and support strength. The results show that: (1) With the increase in shallow borehole diameter, it is easy to cause anchor de-anchoring phenomenon. (2) After the deep borehole diameter is more than 250 mm, it transfers the peak of the shallow vertical stress to the deep surrounding rock (about 16 m away from the coal wall). (3) If the position of the variable borehole aperture is set between the anchorage zone and the stress peak of the roadway, the stress transfer effect is better, and the influence and effective binding force on the surrounding rock is smaller. (4) When the spacing is 1.0 m~2.0 m, the vertical stress starts to transfer to the deep surrounding rock, the deformation of the surrounding rock is smaller, and the reduction in the effective binding force of the anchors is smaller. The result can provide a reference for similar production conditions.

Stand spatial structural diversity: Developing and validating a novel index

Numerous studies related to the diversity-productivity relationships have mainly focused on the effects of species diversity, function diversity, and nonspatial structural diversity (e.g., variations of diameter), but have overlooked the significant roles of spatial structural diversity. Therefore, the motivation of the present study was to develop a comprehensive index of stand spatial structural diversity (H′) by integrating the strengths of the Shannon-Wiener index and the quaternion joint probability distribution of commonly used neighborhood-based parameters, namely the uniform angle index (W), mingling index (M), diameter dominance index (U) and crowdedness index (C). The application abilities of the index were tested using ten 100 m ×100 m sample plots that were distributed in three different climate zones [4 plots in Greater Khingan Mountains (GKM), 2 plots in Lesser Khingan Mountains (LKM), 4 plots in Changbai Mountains (CBM)] in Heilongjiang Province, northeast China. Meanwhile, the potential driving factors on stand spatial structural diversity were also detected using stepwise regression and hierarchical partitioning techniques based on 3000 simulated stands. The results indicated that the average values of H′ at GKM, LKM, and CBM were 0.8436, 0.8079, and 0.8098, suggesting that the stand spatial structural diversities of the forests in GKM were notably higher than those in LKM and CBM. The characteristics of M, C, and W emerged as the three most influential factors driving stand spatial structural diversity. This study contributes significantly not only by providing an effective index for measuring stand spatial structural diversity, but also by streamlining the complex decision processes associated with optimizing stand spatial structure.

Model Test Study on the Bearing Mechanism of Inclined Variable Cross-Section Piles Using Transparent Soil

In view of the influence of the inclination and variable section on the pile stability and bearing capacity, this paper introduces particle image velocimetry (PIV) technology, and designs a transparent soil visualization model test. The experimental results show that, when the pile has a variable cross-section and inclination angle, the friction resistance on both sides of the pile increases. The vertical-load-carrying capacity of the 2% and 4% inclined piles with a variable cross-section is greater than that of the piles with inclinations greater than 8%. For model piles with the degrees of inclination of 2% and 4%, the variable-section inclined piles with diameters of 17 mm and 15 mm show significantly less settlement than the equal-section inclined piles. For the model pile with an inclination of 8%, the settlement of the inclined piles with a variable cross-section diameter of 17 mm is slightly smaller than that of the equal cross-section inclined piles. The change in variable cross-section and inclination angle has a large effect on the soil displacement around the pile, and the conclusions of this paper can provide guidance for the engineering application of variable cross-section piles.

Variable Area Jet Impingement for Enhanced Junction Temperature Control of High-Power Electronics

Abstract Convective heat transfer by jet impingement cooling offers a suitable solution for high heat flux applications. Compared to techniques that rely on bulk conduction in series with convection, direct liquid impingement reduces the thermal resistance between power device hot spots and the coolant. Although capable of highly efficient cooling, static impingement devices must be designed for the worst-case cooling requirements for a transient power profile. This can result in wasted hydraulic performance. Aircraft, highway vehicles, and heavy machinery fall into this category where a substantial factor of safety is required. This work proposes a method for improving power electronics reliability by limiting temperature fluctuations at reduced coolant pressure requirements during transient power cycling using a variable area jet. Single phase jet impingement cooling is implemented in an active control scheme using a variable diameter iris mechanism as the primary nozzle architecture. In addition to pressure drop and temperature control, the active nozzle structure introduces the ability to create pulsating jet flows to further enhance the heat transfer compared to fixed-geometry nozzles. The key underlying fluid mechanics characteristic of pulsating flows is the effect of disrupting the thermal boundary layer on the electrical device surface. By introducing a variable diameter jet, eddy formation can be fine-tuned for optimal boundary layer disruption. Using the definition of the Strouhal number, vortex shedding created by the non-steady jet flows is directly correlated with the resulting Nusselt number as a function of the iris kinematics. An experimental apparatus for jet impingement thermal-fluid testing is used to evaluate the Nusselt number versus Strouhal number for a parametric study of variable diameter iris configurations. The apparatus utilizes a voice coil actuator to achieve sine and square waveforms, to vary the amplitude of actuation, and to vary the mean of actuation. Finally, power cycling with a single emulated hot spot is performed to estimate the reliability increase as a result of maintaining constant junction temperatures with the active jet impingement scheme.

Development of an Esophageal Sleeve With Variable Stiffness and Internal Diameter for Endoscopic Surgery

Abstract In natural orifice transluminal endoscopic surgery (NOTES), the flexible endoscopic surgical robot utilizes a continuum configuration to navigate narrow, multicurvature esophageal pathways. However, the tool channel's dimensional limitations and the restricted internal layout make it challenging to reduce the outside diameter and highly efficient variable stiffness function significantly. As a result, safe insertion into the esophagus and precise operation remains hugely challenging. In this paper, an esophageal sleeve with variable stiffness and internal diameter is developed for endoscopic procedures. The proposed esophageal sleeve adopts specially designed spiral elastic deployable parts that allow for variations in internal diameter. Furthermore, the elastic deployable parts are designed with serrated protrusion structures that can realize rapid transition between rigidity and flexibility under negative pressure. Fundamental experimental results showed that the outer diameter of the proposed esophageal sleeve can expand from 17 mm to 20 mm, providing inner access up to 13 mm for endoscopic instruments. The serrated protrusion structure allows the esophageal sleeve to rapidly transition from a flexible to a rigid state, resulting in a stiffness gain of approximately 5. Phantom experiments validated the effectiveness and usability of the proposed esophageal sleeve in assisting endoscope insertion, demonstrating its potential clinical value in endoscopic procedures. The significance of this study is the development of a device that can better assist endoscopic procedures.

Investigation of oil palm fiber reinforced polylactic acid composite extruded filament quality

This study examines the quality of Polylactic Acid (PLA) filament reinforced with Oil Palm Fiber (OPF) for additive manufacturing applications. The research aims to create a composite filament that leverages the advantages of PLA, a biodegradable polymer, and OPF, a natural fiber from the oil palm tree, to enhance mechanical strength, dimensional stability, and printability. The methodology involves crushing the PLA filament and OPF to the desired size using a crusher machine, blending them in different ratios (e.g., 90:10 and 80:20 PLA to OPF), and using a hot-pressing process to bond the components. The resulting pelletized composites are then extruded into filaments using an extruder machine. The quality of the produced filament is assessed based on diameter consistency, surface smoothness, and printability, considering compatibility with 3D printers. The study reveals that composition ratios and processing parameters impact filament quality, leading to challenges such as diameter variations, rapid hardening, breakage, and extruder die clogs. Future recommendations were suggested to optimize compositions, refine processing, explore advanced extrusion, and investigate fiber distribution and bonding for improved filament properties. This research offers valuable insights for creating high-quality OPF-reinforced PLA filaments for additive manufacturing, advancing understanding of filament quality factors, and proposing ways to enhance composite filament performance across applications.

Cylindrical TGR as early radiological predictor of RLT progression in GEPNETs: a proof of concept

This study aims to assess the predictive capability of cylindrical Tumor Growth Rate (cTGR) in the prediction of early progression of well-differentiated gastro-entero-pancreatic tumours after Radio Ligand Therapy (RLT), compared to the conventional TGR. Fifty-eight patients were included and three CT scans per patient were collected at baseline, during RLT, and follow-up. RLT response, evaluated at follow-up according to RECIST 1.1, was calculated as a percentage variation of lesion diameters over time (continuous values) and as four different RECIST classes. TGR between baseline and interim CT was computed using both conventional (approximating lesion volume to a sphere) and cylindrical (called cTGR, approximating lesion volume to an elliptical cylinder) formulations. Receiver Operating Characteristic (ROC) curves were employed for Progressive Disease class prediction, revealing that cTGR outperformed conventional TGR (area under the ROC equal to 1.00 and 0.92, respectively). Multivariate analysis confirmed the superiority of cTGR in predicting continuous RLT response, with a higher coefficient for cTGR (1.56) compared to the conventional one (1.45). This study serves as a proof of concept, paving the way for future clinical trials to incorporate cTGR as a valuable tool for assessing RLT response.

Measurement and theoretical analysis of effective thermal conductivity of lanthanum pentanickel powder beds for hydrogen storage in different particle sizes and bed porosities

Particle diameter and bed porosity change due to the expansion and contraction of metal hydride particles during hydrogen absorption and desorption, which leads to variations in the effective thermal conductivity of metal hydride beds. Therefore, the effective thermal conductivity of the metal hydride beds under different bed porosities and particle diameters must be measured for the design of metal hydride-based hydrogen storage tanks. In this study, the effective thermal conductivities of four kinds of lanthanum pentanickel (LaNi5) powder beds with different bed porosities and particle diameters were measured in various gas atmospheres with gas pressure varying from 0.1 to 4.0 MPa. The volume mean diameters of the four kinds of LaNi5 powders equal 335.2, 196.4, 147.7, and 23.7 μm, respectively. Subsequently, the effects of bed porosity and particle diameter on the effective thermal conductivities were analyzed through the modified Zehner–Schlünder–Damköhler model considering the Smoluchowski effect. Experimental results show that particle diameter and bed porosity influence markedly the effective thermal conductivity of lanthanum pentanickel (LaNi5) powder beds. However, the findings of theoretical analysis based on the modified Zehner–Schlünder–Damköhler model reveal the considerably weaker effect of particle diameter on the effective thermal conductivity under identical bed porosity compared with the measurement results. Such a finding was observed because the variation in particle diameter inevitably changed bed porosity during the effective thermal conductivity measurement, which also affected the effective thermal conductivity of the beds. In addition, decreasing bed porosity and increasing particle diameter can remarkably improve the heat transport via the gas–solid mixture pathway, which improved the effective thermal conductivity of the beds and thus explained the experimental results.

Predicting and Measuring Fluid Responsiveness by Hemodynamic Indices versus Transthoracic Echocardiography in Clinically Shocked Patients

Abstract Background In the last decades dynamic measures had evolved as a better solution to predict fluid responsiveness in clinically shocked patients, out of multiple dynamic parameters we chose transthoracic echocardiographic based measurements of variations of aortic blood flow and inferior vena caval diameter. Aim of the Work to assess accuracy of transthoracic echo measured variation in aortic blood flow and inferior vena caval diameter with limited bolus crystalloid infusion in predicting fluid responsiveness in patients with clinical shock. Patients and Methods This study included 51 selected Patients with acute circulatory failure secondary to clinical shock admitted to ICU. All patients had undergone basic transthoracic echocardiographic (TTE) assessment of aortic blood flow (using left ventricular outflow tract velocity time integral as a surrogate) and inferior vena caval diameter changes with respiratory cycle, these measures were obtained at time of diagnosis of shock and repeated after infusion of 300 ml crystalloid fluid bolus (over fifteen minutes). Results Our results had revealed significant difference between responders and non-responders regarding aortic flow variation after fifteen minutes. Conclusion Based on the results obtained in this study, it was proved that transthoracic echocardiography can be used as an accurate method to predict fluid responsiveness in shocked patient with fluid challenge.

Development of a new environmentally friendly and efficient centrifugal variable diameter metering device.

The design of the maize metering device involves centrifugal variable diameter pneumatic and cleaning mechanisms, aiming to enhance the performance and power efficiency of pneumatic maize metering devices. Leveraging the impact of changes in centrifugal diameter and the guidance and positioning of airflow, we optimize the hole insert, seeding plate, seed limit board, and integrated front shell. This optimization facilitates the adjustment of both the quantity and posture of seed filling. As a result, seeds can form a uniform flow within the annular cavity, reducing the wind pressure necessary for regular operation and decreasing power consumption. A quadratic regression orthogonal rotation combination experiment is conducted using a self-made experiment bench, considering ground speed, wind pressure, and seeding rate as the experiment factors. Furthermore, a comparative experiment involving a novel centrifugal variable-diameter type metering device. The results indicate optimal seeding performance when the ground speed is 13.2 km/h, the wind pressure is 1.2 kPa, and the feeding rate is 25 seeds/s. Under these conditions, the quality of feed index reaches 95.20%, the multi-index is 3.87%, and the miss index is 0.93%. Findings reveal that the developed seed metering device achieved a quality of feed index exceeding 93.00% across varying speeds of 12~18 km/h, aligning with the production requirements. Moreover, the actual power consumption of Type B and C is about 85.00% and 98.00% lower than Type A, standing at only 32.90 W at 18 km/h. The COP of Type C is about 86 times and 12 times that of Type A and B, respectively, meeting the demands for efficient production of maize seed metering devices. In comparison to traditional design and structural parameter optimization methods for maize seed metering device, this study is helpful to the sustainable development of maize industry and reduce environmental pollution.

The photothermal coupling of TiN@Au core-shell nanorods applied to near-infrared photothermal therapy

Thermal plasmonic nanoparticles offer a novel and significant approach for photothermal therapy in the medical field, which is photothermal therapy of cancer. This study introduces a type of core-shell nanorods with internal coupling of titanium nitride (TiN) and gold (Au) nanomaterials. The photothermal properties of these nanorods in the near infrared (NIR) band were investigated using COMSOL Multiphysics software and the finite element method. Results indicate that TiN@Au and Au@TiN core-shell nanorods exhibit superior photothermal properties in the NIR band compared to pure TiN nanorods of similar volume. Furthermore, core-shell nanorods with polarization angles of 0° and 45° demonstrate enhanced optical absorption properties in the near infrared range. Furthermore, the study on the tunability of localized surface plasmon resonance with variations in core diameter, shell thickness, and combined changes of core diameter and shell thickness for core-shell nanorods of equal volume suggests that TiN@Au core-shell nanorods with a 10 nm Au shell offer increased optical absorption efficiency and photothermal conversion capability. Ultimately, the TiN and Au core-shell nanorods proposed in this research offer valuable insights for the structural design and heat transfer control of nanoparticle heat generators to enhance fluid temperature, as well as provide practical guidance for the preparation of core-shell nanoparticles.

Association Between Myopia and Pupil Diameter in Preschoolers: Evidence from a Machine Learning Approach Based on a Real-World Large-Scale Dataset.

Previous studies have explored the connections between various ocular biological parameters with myopia. Our previous study also found that pupil data can predict the myopic progression during the interventions for myopia. However, studies exploring the association between pupil diameter and myopia in preschoolers with myopia were lacking. Hence this study was aimed to investigate the association between pupil diameter and myopia in preschoolers with myopia based on a real-world, large-scale dataset. Data containing 650,671 preschoolers were collected from a total of 1943 kindergartens in Shenzhen, China. Refraction and pupil parameters were collected. After data filtering, the occurrence of myopia and its association with age, gender, pupil diameter, and other variables, were analyzed. Random forest (RF) and eXtreme gradient boosting (XGBoost) were selected from seven machine learning algorithms to build the model. The mean decrease accuracy (MDA), mean decrease Gini (MDG), and gain feature importance (GFI) techniques were employed to quantify the importance of pupil diameter and other features. After the assessments, 51,325 valid records with complete pupil data were included, and 3468 (6.76%) were identified as myopia based on the calculated cycloplegic refraction. Preschoolers with myopia presented reduced pupil diameter and greater variation (5.00 ± 0.99mm) compared to non-myopic preschoolers (6.22 ± 0.67mm). A nonlinear relationship was found according to the scatterplots between pupil diameter and refraction (R2 = 0.14). Especially preschoolers with myopia had reduced pupil diameter compared to emmetropic preschoolers, but hyperope did not experience additional pupil enlargement. After adjusting for other covariates, this relationship is still consistent (P < 0.001). XGBoost and RF algorithms presented the highest performance and validated the importance of pupil diameter in myopia. Based on a real-world large-scale dataset, the current study illuminated that preschoolers with myopia had a reduced pupil diameter compared to emmetropic preschoolers with a nonlinear pattern. Machine learning algorithms visualized and validated the pivotal role of pupil diameter in myopia. chictr.org Identifier: ChiCTR2200057391.

A clinical ultrasound algorithm to identify uterine sarcoma and smooth muscle tumors of uncertain malignant potential in patients with myometrial lesions: the MYometrial Lesion UltrasouNd And mRi study

BackgroundDifferential diagnosis between benign uterine smooth muscle tumors and malignant counterpart is challenging. We evaluated the accuracy of a clinical and ultrasound based algorithm in predicting mesenchimal uterine malignancies (MUMs), including smooth muscle tumors of uncertain malignant potential (STUMPs). MethodsWe report the twelve-months follow-up of an observational, prospective, single-centre study that included women with at least one myometrial lesion ≥3 cm on ultrasound examination. These patients were classified according to a three-class diagnostic algorithm, using symptoms and ultrasound features. “White” patients underwent annual telephone follow-up for 2 years, “Green” patients underwent a clinical and ultrasound follow-up at 6, 12 and 24 months and “Orange” patients underwent surgery. We further developed a risk class system to stratify the malignancy risk. Findings2,268 women were included andtarget lesion was classified as benign in 2,158 (95.1%), as other malignancies in 58 (2.6%) an as mesenchymal uterine malignancies in 52 (2.3%) patients. At multivariable analysis, age (OR 1.05 (95% CI 1.03-1.07), tumor diameter >8 cm (OR 5.92 (95% CI 2.87-12.24), irregular margins (OR 2.34 (95% CI 1.09-4.98), color score=4 (OR 2.73 (95% CI 1.28-5.82), were identified as independent risk factors for malignancies, whereas acoustic shadow resulted in an independent protective factor (OR 0.39 (95% CI 0.19-0.82). The model, which included age as a continuous variable and lesion diameter as a dichotomized variable (cut-off 81 mm), provided the best AUC (0.87 (95% CI 0.82-0.91)). A risk class system was developed, and patients were classified as low-risk (predictive model value <0.39%: 0/606 malignancies, risk 0%), intermediate risk (predictive model value 0.40%-2.2%: 9/1,093 malignancies, risk 0.8%), high risk (predictive model value ≥2.3%: 43/566 malignancies, risk 7.6%). ConclusionThe preoperative three-class diagnostic algorithm and risk class system can stratify women according to risk of malignancy. Our findings, if confirmed in a multicentre study, will permit differentiation between benign and MUMs allowing a personalized clinical approach. FundingNothing to declare.