The most prominent causes of loss of vision in individuals over 50 years include age-related macular degeneration(AMD),glaucoma,and diabetic retinopathy(DR).While it is important to screen for these diseases effective...The most prominent causes of loss of vision in individuals over 50 years include age-related macular degeneration(AMD),glaucoma,and diabetic retinopathy(DR).While it is important to screen for these diseases effectively,current eye care is not properly doing so for much of the population,resulting in unfortunate visual disability and high costs for patients.Innovative functional testing can be unified with other screening methods for a more robust and safer screening and prediction of disease.The goal in the creation of functional testing modalities is to develop highly sensitive screening tests that are easy to use,accessible to all users,and inexpensive.The tests herein are deployed on an iPad with easily understood and intuitive instructions for rapid,streamlined,and automatic administration.These testing modalities could become highly sensitive screenings for early detection of potentially blinding diseases.The applications from our collaborators at AMA Optics include a cone photostress recovery test for detection of AMD and diabetic macular edema(DME),brightness balance perception for optic nerve dysfunction and especially glaucoma,color vision testing which is a broad screening tool,and visual acuity test.Machine learning with the combined structural and functional data will optimize identification of disease and prediction of outcomes.Here,we review and assess various tests of visual function that are easily administered on a tablet for screening in primary care.These user-friendly and simple screening tests allow patients to be identified in the early stages of disease for referral to specialists,proper assessment and treatment.展开更多
Background Many patients have symptoms suggestive of coronary artery disease (CAD) and are often eval- uated with the use of diagnostic testing, although there are limited data from randomized trials to guide care.
BACKGROUND Timely identification and monitoring of lung disease progression are key components of effective management in patients with cystic fibrosis(CF).Pulmonary function tests(PFTs)and high-resolution computed to...BACKGROUND Timely identification and monitoring of lung disease progression are key components of effective management in patients with cystic fibrosis(CF).Pulmonary function tests(PFTs)and high-resolution computed tomography(HRCT)scans are commonly used to assess disease progression in these patients.Determining which modality provides the most sensitive and reliable assessment is crucial for establishing effective disease monitoring guidelines,particularly in India,where national guidelines are lacking.AIM To assess the progression of lung disease in patients with CF using a combination of HRCT and PFTs.METHODS A total of 32 patients with CF were prospectively enrolled from the outpatient clinic and followed longitudinally.Clinical and physiological parameters,including age,spirometric indices,and HRCT based Bhalla scores,were evaluated at baseline and after one-year followup.Paired comparisons between baseline and follow-up HRCT scores,as well as baseline and follow-up PFT parameters,were performed using a two-tailed paired t-test to assess statistically significant changes over the follow-up period.Pearson correlation coefficient(r)was used to evaluate the relationship between HRCT scores and spirometric parameters at each individual time point(baseline and follow-up).A P value0.05).CONCLUSION Despite significant radiological progression of structural lung damage detected by HRCT,pulmonary function parameters remained relatively stable.These findings suggest that PFTs may be less sensitive in detecting progressive structural deterioration in CF,underscoring the value of HRCT as a sensitive tool for disease monitoring and early detection of worsening lung disease.展开更多
Functional testing is key to fulfill quality control in laptop manufacturing and is of great economic value.However,due to the unavailability of practical data,mathematical model and systematic perspective,it has bare...Functional testing is key to fulfill quality control in laptop manufacturing and is of great economic value.However,due to the unavailability of practical data,mathematical model and systematic perspective,it has barely been touched from the academic community to date.For the first time,this work provides technical understanding of the key principles of functional testing,mathematically models the general framework,elucidates existing testing strategy under the proposed framework and model,and finally proposes a specified optimization strategy which outperforms existing strategies.This work lays the model foundation for the further optimization of functional testing,and can be regarded as a good example of how a systematic approach can solve practical industrial challenges.展开更多
This work is devoted to the study of initial boundary value problem for k-component system of semilinear wave equations with several fundamental boundary conditions(namely,the Dirichlet,Neumann,and Robin boundary cond...This work is devoted to the study of initial boundary value problem for k-component system of semilinear wave equations with several fundamental boundary conditions(namely,the Dirichlet,Neumann,and Robin boundary conditions).Blow-up results and lifespan estimates of solutions to the problem with two different types of weak damping terms and power nonlinearities in the sub-critical and critical cases on exterior domain are obtained.The test function technique is performed in the proofs.It is worth observing that our results in Theorem 1.1 in this article contain the results in[6]as a special case whenθ=0.To the best of our knowledge,the results in Theorems 1.1-1.2 are new.展开更多
Objective Scoliosis is a prevalent spinal deformity that severely impacts the physical and psychological well being of adolescents and often requires surgical correction.This study aimed to investigate the risk factor...Objective Scoliosis is a prevalent spinal deformity that severely impacts the physical and psychological well being of adolescents and often requires surgical correction.This study aimed to investigate the risk factors for postoperative pulmonary complications(PPCs)following posterior spinal fusion in adolescent scoliosis,with a specific focus on evaluating the predictive value of preoperative forced vital capacity(FVC)and etiological classification.Methods This retrospective cohort study enrolled adolescents who underwent posterior spinal fusion for scoliosis correction at Peking Union Medical College Hospital between January 2018 and December 2022.The baseline demographic,clinical,and perioperative variables were collected.The primary endpoint was the occurrence of PPCs prior to hospital discharge.Univariate and multivariable binary logistic regression analyses were conducted to identify independent risk factors.Results A total of 1,234 patients were included,of whom 29(2.35%)developed PPCs and 1,205 did not.Univariate analysis revealed that 12 variables,including non-idiopathic scoliosis,a larger main thoracic curve,a decreased FVC%predicted,and increased perioperative blood transfusions,were significantly associated with PPCs(P<0.05).Multivariable logistic regression model showed that non-idiopathic scoliosis emerged as the sole independent risk factor for PPCs[adjusted odds ratio(OR)=5.478,95%confidence interval:2.017-19.148,P=0.002].Preoperative FVC%predicted(adjusted OR=0.993,P=0.497)and main thoracic curve(adjusted OR=1.002,P=0.736)did not demonstrate independent predictive value.Conclusions Non-idiopathic scoliosis,rather than preoperative pulmonary function or curve severity,is an independent risk factor for PPCs following posterior spinal fusion in adolescents.During perioperative respiratory risk assessment,particular emphasis should be placed on the etiological classification of these patients.展开更多
BACKGROUND Hepatitis A virus(HAV)infection remains a significant cause of acute viral hepatitis globally,and the endemicity pattern is intermediate in Mexico.Although most cases follow a benign and self-limited course...BACKGROUND Hepatitis A virus(HAV)infection remains a significant cause of acute viral hepatitis globally,and the endemicity pattern is intermediate in Mexico.Although most cases follow a benign and self-limited course,less than 5%of patients with HAV infection progress to acute liver failure,which carries mortality rates of 13%-33%depending on access to liver transplantation(LT).The identification of clinical and biochemical predictors of adverse outcomes is crucial to improve early risk stratification,optimize patient management,and guide timely referral to transplant centers.AIM To assess the utility of clinical and biochemical variables and prognostic scores in predicting mortality and the need for LT in patients with acute HAV infection.METHODS We conducted a retrospective case series of all patients hospitalized at Medica Sur Clinic between 2018 and 2024 who were positive for immunoglobulin M antibodies for HAV.Clinical and laboratory data were collected from patients’electronic medical records.Continuous variables were summarized as the means±SD or median and interquartile range and compared using Student’s t-test or the Mann-Whitney U test,as appropriate.Categorical variables were expressed as frequencies and percentages and compared using the χ2 test or Fisher’s exact test.RESULTS A total of 69 patients with HAV infection(mean age,38±11 years;65%male)were included.14%of patients had a history of hepatic steatosis,10%had type 2 diabetes,and 45%were smokers.Acute liver injury was observed in 47 patients(68%),acute liver failure was detected in five patients(7.2%),and mortality or LT occurred in three patients(4.3%;two deaths and one transplant).Patients who died or required orthotopic LT were older,and they had higher heart and respiratory rates at admission.These patients additionally exhibited greater liver dysfunction,including higher bilirubin and transaminase levels,prolonged coagulation times,lower sodium and albumin levels,and worse albumin-bilirubin scores.Severity scores[model for end-stage liver disease(MELD),MELD with sodium,MELD version 3.0]were significantly higher in patients with complications than in those without complications.CONCLUSION Advanced age,elevated severity,and higher albumin-bilirubin scores emerged as predictors of adverse outcomes in patients with HAV infection,and consideration of these factors could guide the need for more intensive monitoring strategies.These findings highlight the importance of incorporating prognostic scoring systems into routine clinical evaluation to improve outcomes in high-risk patients.展开更多
BACKGROUND Hepatitis B Virus(HBV)remains a global public health challenge,affecting over 296 million people,many of whom are asymptomatic.Incidentally diagnosed carriers provide a critical window for early interventio...BACKGROUND Hepatitis B Virus(HBV)remains a global public health challenge,affecting over 296 million people,many of whom are asymptomatic.Incidentally diagnosed carriers provide a critical window for early intervention and prevention.Understanding their hematological profile and viral burden can help inform risk assessment and clinical management.AIM To evaluate hematological parameters and HBV viral load in incidentally detected asymptomatic hepatitis B surface antigen positive patients during routine health screenings.METHODS A cross-sectional observational study was conducted from June 2024 to March 2025 at Dr.D.Y.Patil Medical College,Hospital and Research Centre a tertiary care hospital in Pune,Maharashtra,India,involving 100 hepatitis B surface antigen-positive patients and 20 healthy controls.Hematological and liver function parameters were assessed,and quantitative HBV DNA analysis was performed using real-time polymerase chain reaction.Statistical analysis was conducted using GraphPad Prism v8.0.RESULTS Marked variations were detected in hemoglobin levels(P2000 IU/mL was found in 17 patients,and<2000 IU/mL in 24 patients.Viral load positively correlated with conjugated bilirubin,serum glutamic-oxaloacetic transaminase,serum glutamic-pyruvic transaminase,and alkaline phosphatase,and negatively with albumin and the albumin-globulin ratio.CONCLUSION Incidentally detected HBV infections present an opportunity for early disease detection.Hematological and viral markers can guide clinical decisions.Routine screening and contact tracing are essential strategies to control HBV transmission and progression.展开更多
Pulmonary function test(PFT)is a vital noninvasive method for evaluating respiratory system function and is widely used in the diagnosis,surgical risk assessment,and prognostic prediction of chronic airway diseases an...Pulmonary function test(PFT)is a vital noninvasive method for evaluating respiratory system function and is widely used in the diagnosis,surgical risk assessment,and prognostic prediction of chronic airway diseases and interstitial lung diseases.In 2021,the American Thoracic Society and the European Respiratory Society updated their pulmonary function interpretation guidelines,choosing to adopt z-scores instead of percentage of predicted forced expiratory volume in 1 second(FEV1),thereby significantly improving sensitivity and prognostic evaluation.However,conventional PFT relies on patient cooperation and is limited in its ability to effectively capture the heterogeneity of localized lesions.In recent years,the use of multimodal medical imaging in pulmonary function prediction has progressed rapidly.When combined with radiomics and deep learning techniques,these imaging methods enable more accurate and quantitative functional assessments.This review introduces that pulmonary function assessment should integrate multimodal imaging features with clinical functional indicators.This approach establishes cross-scale linkages between morphology and function and provides new perspectives for the early screening of high-risk individuals with accelerated pulmonary aging,evaluating the effectiveness of interventions,and enabling personalized intervention strategies.We review the classification systems and clinical value of PFT,discuss the advances and limitations of multimodal imaging in predicting lung function,and explore future directions in standardized data acquisition and multicenter validation to promote precise pulmonary function assessment and clinical application.展开更多
Excessive dynamic airway collapse(EDAC)is characterized by weakness in the posterior membranous wall of the airway,which results in more than 50%narrowing of the central airway lumen during expiration.EDAC differs fro...Excessive dynamic airway collapse(EDAC)is characterized by weakness in the posterior membranous wall of the airway,which results in more than 50%narrowing of the central airway lumen during expiration.EDAC differs from tracheobronchomalacia,which involves the weakening of the cartilage rather than the membranous wall.EDAC poses a diagnostic challenge due to overlapping symptoms with chronic obstructive pulmonary disease and asthma,including dyspnea,cough,and wheezing.The diagnosis of EDAC relies on dynamic airway imaging techniques,including bronchoscopy,dynamic computed tomography,dynamic magnetic resonance imaging,and endobronchial ultrasound,to assess airway collapse during expiration.Pulmonary function testing helps in ruling out obstructive lung disease.Treatment includes medical management of underlying comorbidities,pulmonary rehabilitation,and,in severe cases,bronchoscopyguided stenting of the airway or tracheobronchoplasty.This mini-review discusses pathophysiology,diagnostic challenges,and evolving treatment strategies for EDAC,highlighting the need for increased clinical awareness and targeted therapies.展开更多
The diagnosis of Chronic Pancreatitis (CP) is based on the detection of abnormal structure or function of the diseased pancreas. The pancreatic function tests more accurately determine the presence of CP than tests ...The diagnosis of Chronic Pancreatitis (CP) is based on the detection of abnormal structure or function of the diseased pancreas. The pancreatic function tests more accurately determine the presence of CP than tests of structure, especially for early stage disease. The function tests can be divided into two categories: non- invasive and invasive. The invasive "tube" tests can reliably detect mild, early CP, but are only available at a few referral centers and tend to be poorly tolerated by patients. The non-invasive tests are easy to obtain, but tend to perform poorly in patients with early, mild disease. Therefore, no one test is useful in all clinical situations, and a detailed understanding of the rational, pathophysiologic basis, strengths, and limitations of various tests is needed. This review highlights the role of various pancreatic function tests in the diagnosis of CP including fecal fat analysis, fecal elastase, fecal chymotrypsin, serum trypsin, the secretin stimulation test, the cholecystokinin (CCK) stimulation test, the combined secretin-CCK stimulation test, the intraductal and endoscopic secretin stimulation tests, and the functional magnetic resonance imaging of the pancreas after secretin stimulation.展开更多
Hormone-stimulated pancreatic function tests (PFTs) are considered the gold standard for measuring pancreatic exocrine function. PFTs involve the administration of intravenous secretin or cholecystokinin, followed by ...Hormone-stimulated pancreatic function tests (PFTs) are considered the gold standard for measuring pancreatic exocrine function. PFTs involve the administration of intravenous secretin or cholecystokinin, followed by collection and analysis of pancreatic secretions. Because exocrine function may decline in the earliest phase of pancreatic fibrosis, PFTs are considered accurate for diagnosing chronic pancreatitis. Unfortunately, these potentially valuable tests are infrequently performed except at specialized centers, because they are time consuming and complicated. To overcome these limitations, endoscopic PFT methods have been developed which include aspiration of pancreatic secretions through the suction channel of the endoscope. The secretin endoscopic pancreatic function test (ePFT) involves collection of duodenal aspirates at 15, 30, 45 and 60 min after secretin stimulation. A bicarbonate concentration greater than 80 mmol/L in any of the samples is considered a normal result. The secretin ePFT has demonstrated good sensitivity and specificity compared with various reference standards, including the "Dreiling tube" secretin PFT, endoscopic ultrasound, and surgical histology. Furthermore, a standard autoanalyzer can be used for bicarbonate analysis, which allows the secretin ePFT to be performed at any hospital. The secretin ePFT may complement imaging tests like endoscopic ultrasound (EUS) in the diagnosis of early chronic pancreatitis.This paper will review the literature validating the use of ePFT in the diagnosis of exocrine insufficiency and chronic pancreatitis. Newer developments will also be discussed, including the feasibility of combined EUS/ ePFT, the use of cholecystokinin alone or in combination with secretin, and the discovery of new protein and lipid pancreatic juice biomarkers which may complement traditional fluid analysis.展开更多
This review focuses on current aspects of the novel technology of combined impedance manometry for esophageal motility testing. It presents methodological features, summarizes current results and discusses implication...This review focuses on current aspects of the novel technology of combined impedance manometry for esophageal motility testing. It presents methodological features, summarizes current results and discusses implications for further research. The combined technique assesses simultaneously bolus transport and associated peristalsis, thus allowing detailed analysis of the relationships between bolus transit and esophageal motility. Recent studies demonstrate that combined impedance manometry provides important additional information about esophageal motility as compared to conventional manometry: (1) monitoring of bolus transport patterns, (2) calculation of bolus transit parameters, (3) evaluation of bolus clearance, (4) monitoring of swallow associated events such as air movement and reflux, and (5) investigation of the relationships between bolus transit and LES relaxation. Studies with healthy subjects have identified several useful parameters for comprehensive assessment of eosphageal function. These parameters were found to be pathological in patients with classical achalasia, mild GERD, and ineffective esophageal motility. The technology of combined impedance manometry provides an important new tool for esophageal function testing, advancing both clinical and basic research. However, several important issues remain to be standardized to make the technique suitable for widely clinical use.展开更多
Sperm function testing, once commonly performed for the infertile couple before employing assisted reproductive technology (ART), has fallen out of favour in many reproductive medicine centers throughout the world. ...Sperm function testing, once commonly performed for the infertile couple before employing assisted reproductive technology (ART), has fallen out of favour in many reproductive medicine centers throughout the world. Indeed, the most recent addition of the 'World Health Organisation (WHO) Laboratory Manual for the Examination and Processing of Hu- man Semen' now groups many of these procedures into a section termed Research Procedures. In large part, this reflects the current clinical practice of bypassing the in-depth evaluation of the male partner, while assuming that if a spermatozoon can be found for intracytoplasmic sperm injection (ICSI), it must be a healthy cell capable of achieving fertilization. Never- theless, sperm function testing can provide valuable clinical insights into defects causing male infertility. Admittedly, in some cases, functional sperm deficiencies can be overcome using an ART. In other cases, couples will be empowered by the knowledge of the cause of their infertility, and for some couples, perhaps even the likelihood of ICSI success (relative to the spermatozoa). The knowledge allows them to make truly informed reproductive decisions, including (perhaps) the de- cision to seek donor insemination, to adopt or to remain childless. Knowledge of the cause of their infertility may provide closure for couples and a sense of confidence regarding their choice of reproductive treatment.展开更多
BACKGROUND Dopaminergic neurons are lost in Parkinson’s disease(PD),a degenerative neurological condition.While the effects of PD on motor functions are well understood,its impact on respiratory function is less clea...BACKGROUND Dopaminergic neurons are lost in Parkinson’s disease(PD),a degenerative neurological condition.While the effects of PD on motor functions are well understood,its impact on respiratory function is less clear.In PD patients with suspicious pulmonary symptoms,the presence and degree of impairment in lung function often cannot be optimally assessed through pulmonary function tests(PFTs)due to the patients'neurological symptoms.AIM To examine the relationship between diaphragmatic thickness as determined by ultrasonography(US)and conventional PFTs in PD patients.Additionally,we evaluated the potential use of diaphragmatic thickness as an alternative measure for assessing respiratory function in PD patients who are unable to perform PFTs.METHODS A total of 43 PD patients who presented to the clinics between June 15,2021,and June 30,2022,were included.Patients with coronavirus disease 2019 infection history,conditions affecting diaphragmatic motility,recent thoracic or abdominal surgery,or imaging showing restrictive masses were excluded.Demographic data,disease duration,Hoehn-Yahr stage,and medication use were recorded.PFTs were used to evaluate forced vital capacity,forced expiratory volume in the first second,and other parameters,while US was used to measure diaphragmatic thickness.Breathlessness was assessed using the modified medical research council dyspnea scale.RESULTS Significant correlations were found between peak expiratory flow(PEF)and diaphragm fraction(P=0.019),as well as between PEF percentage and diaphragmatic thickness during expiration(P=0.023).In early-stage PD,diaphragmatic thickness during inspiration correlated with oxygen saturation(P=0.048).In advanced-stage PD,PEF and PEF%were significantly correlated with diaphragm thickness during expiration[r=0.405,P=0.049(for PEF);r=0.463,P=0.023(for PEF%)]and diaphragm fraction[r=-0.476,P=0.019(for PEF);r=-0.617,P=0.001(for PEF%)].CONCLUSION Present study assessed the relationship between PFTs and diaphragmatic thickness in PD patients.Diaphragmatic thickness measured by US was found to correlate with certain PFT parameters,suggesting it could be used as an alternative measure for assessing respiratory function in Parkinson’s patients who have difficulty performing PFTs.展开更多
The main purpose of this paper is to investigate the singularities of solutions to the single Tricomi equation with derivative term and combined memory term.In addition,the blow-up of the solution to the weakly couple...The main purpose of this paper is to investigate the singularities of solutions to the single Tricomi equation with derivative term and combined memory term.In addition,the blow-up of the solution to the weakly coupled system with memory term is also considered,where one is a power nonlinear term and the other is a derivative nonlinear term.Upper bound lifespan estimates of solution are obtained in the sub-critical by utilizing the test function method and iteration technique.The innovation of this paper focuses on the lifespan estimates of the solutions,which extends the well-known Strauss and Glassey conjectures.展开更多
Tests of preoperative visual function and prediction of postoperative E chart visual acuity(ECVA) using laser interferometric visual acuity(LIVA) and electroretinogram(ERG) were performed in 16 cases(19 eyes) of catar...Tests of preoperative visual function and prediction of postoperative E chart visual acuity(ECVA) using laser interferometric visual acuity(LIVA) and electroretinogram(ERG) were performed in 16 cases(19 eyes) of cataract. The results showed that the coincident rate between preoperative LIVA and postoperative ECVA was 63.2%, and there was a parallel correlation between preoperative amplitude of photopic ERG b-wave and postoperative ECVA in 79.0% of the eyes. Comparing these two methods, the test of LIVA ...展开更多
Virtual reality is nowadays used to facilitate motor recovery in stroke patients. Most virtual reality studies have involved chronic stroke patients; however, brain plasticity remains good in acute and subacute patien...Virtual reality is nowadays used to facilitate motor recovery in stroke patients. Most virtual reality studies have involved chronic stroke patients; however, brain plasticity remains good in acute and subacute patients. Most virtual reality systems are only applicable to the proximal upper limbs (arms) because of the limitations of their capture systems. Nevertheless, the functional recovery of an affected hand is most difficult in the case of hemiparesis rehabilitation after a stroke. The recently developed Leap Motion controller can track the fine movements of both hands and fingers. Therefore, the present study explored the effects of a Leap Motion-based virtual reality system on subacute stroke. Twenty-six subacute stroke patients were assigned to an experimental group that received virtual reality training along with conventional occupational rehabilitation, and a control group that only received conventional rehabilitation. The Wolf motor func- tion test (WMFT) was used to assess the motor function of the affected upper limb; functional magnetic resonance imaging was used to measure the cortical activation. After four weeks of treatment, the motor functions of the affected upper limbs were significantly improved in all the patients, with the improvement in the experimental group being significantly better than in the control group. The action perfor- mance time in the WMFT significantly decreased in the experimental group. Furthermore, the activation intensity and the laterality index of the contralateral primary sensorimotor cortex increased in both the experimental and control groups. These results confirmed that Leap Motion-based virtual reality training was a promising and feasible supplementary rehabilitation intervention, could facilitate the recovery of motor functions in subacute stroke patients. The study has been registered in the Chinese Clinical Trial Registry (registration number: ChiCTR-OCH- 12002238).展开更多
In this paper, the new organization for unit testing embedding pair-wise mode is proposed with the core thought focused on the cooperation of programmer and tester by “cross-testing”. The typical content of unit tes...In this paper, the new organization for unit testing embedding pair-wise mode is proposed with the core thought focused on the cooperation of programmer and tester by “cross-testing”. The typical content of unit testing for the new organizing mode should have three aspects, including self-checking, cross-testing and independent-testing. For cross-testing, executing “pair-wise” mode, mainly tackles data testing, function testing and state testing, which function testing must be done by details and state testing must be considered for completeness. With the specializing of independent-testing, it should be taken as more rigid testing without arbitrariness. Consequently, strategy and measure are addressed for data testing focusing on boundary testing and function/state testing. And organizing method of procedure and key points of tackling unit testing are investigated for the new organizing mode. In order to assess the validity of our study and approach, a series of actual examples are demonstrated for GUI software. The result indicates that the execution of unit testing for the new organizing mode is effective and applicable.展开更多
Subjective visual vertical(SVV)and subjective visual horizontal(SVH)tests can be used to evaluate the perception of verticality and horizontality,respectively,and can aid the diagnosis of otolith dysfunction in clinic...Subjective visual vertical(SVV)and subjective visual horizontal(SVH)tests can be used to evaluate the perception of verticality and horizontality,respectively,and can aid the diagnosis of otolith dysfunction in clinical practice.In this study,SVV and SVH screen version tests are implemented using virtual reality(VR)equipment;the proposed test method promotes a more immersive feeling for the subject while using a simple equipment configuration and possessing excellent mobility.To verify the performance of the proposed VR-based SVV and SVH tests,a reliable comparison was made between the traditional screen-based SVV and SVH tests and the proposed method,based on 30 healthy subjects.The average results of our experimental tests on the VR-based binocular SVV and SVH equipment were−0.15◦±1.74 and 0.60◦±1.18,respectively.The proposed VR-based method satisfies the normal tolerance for horizontal or vertical lines,i.e.,a±3◦error,as defined in previous studies,and it can be used to replace existing test methods.展开更多
基金supported in part by a Challenge Grant from Research to Prevent Blindness,NY.
摘要The most prominent causes of loss of vision in individuals over 50 years include age-related macular degeneration(AMD),glaucoma,and diabetic retinopathy(DR).While it is important to screen for these diseases effectively,current eye care is not properly doing so for much of the population,resulting in unfortunate visual disability and high costs for patients.Innovative functional testing can be unified with other screening methods for a more robust and safer screening and prediction of disease.The goal in the creation of functional testing modalities is to develop highly sensitive screening tests that are easy to use,accessible to all users,and inexpensive.The tests herein are deployed on an iPad with easily understood and intuitive instructions for rapid,streamlined,and automatic administration.These testing modalities could become highly sensitive screenings for early detection of potentially blinding diseases.The applications from our collaborators at AMA Optics include a cone photostress recovery test for detection of AMD and diabetic macular edema(DME),brightness balance perception for optic nerve dysfunction and especially glaucoma,color vision testing which is a broad screening tool,and visual acuity test.Machine learning with the combined structural and functional data will optimize identification of disease and prediction of outcomes.Here,we review and assess various tests of visual function that are easily administered on a tablet for screening in primary care.These user-friendly and simple screening tests allow patients to be identified in the early stages of disease for referral to specialists,proper assessment and treatment.
基金Funded by the National Heart,Lung,and Blood InstitutePROMISE Clinical Trials.gov number,NCT01174550
摘要Background Many patients have symptoms suggestive of coronary artery disease (CAD) and are often eval- uated with the use of diagnostic testing, although there are limited data from randomized trials to guide care.
摘要BACKGROUND Timely identification and monitoring of lung disease progression are key components of effective management in patients with cystic fibrosis(CF).Pulmonary function tests(PFTs)and high-resolution computed tomography(HRCT)scans are commonly used to assess disease progression in these patients.Determining which modality provides the most sensitive and reliable assessment is crucial for establishing effective disease monitoring guidelines,particularly in India,where national guidelines are lacking.AIM To assess the progression of lung disease in patients with CF using a combination of HRCT and PFTs.METHODS A total of 32 patients with CF were prospectively enrolled from the outpatient clinic and followed longitudinally.Clinical and physiological parameters,including age,spirometric indices,and HRCT based Bhalla scores,were evaluated at baseline and after one-year followup.Paired comparisons between baseline and follow-up HRCT scores,as well as baseline and follow-up PFT parameters,were performed using a two-tailed paired t-test to assess statistically significant changes over the follow-up period.Pearson correlation coefficient(r)was used to evaluate the relationship between HRCT scores and spirometric parameters at each individual time point(baseline and follow-up).A P value0.05).CONCLUSION Despite significant radiological progression of structural lung damage detected by HRCT,pulmonary function parameters remained relatively stable.These findings suggest that PFTs may be less sensitive in detecting progressive structural deterioration in CF,underscoring the value of HRCT as a sensitive tool for disease monitoring and early detection of worsening lung disease.
基金supported by the Key Research and Development Program of Anhui under Grant No.202104a05020064。
摘要Functional testing is key to fulfill quality control in laptop manufacturing and is of great economic value.However,due to the unavailability of practical data,mathematical model and systematic perspective,it has barely been touched from the academic community to date.For the first time,this work provides technical understanding of the key principles of functional testing,mathematically models the general framework,elucidates existing testing strategy under the proposed framework and model,and finally proposes a specified optimization strategy which outperforms existing strategies.This work lays the model foundation for the further optimization of functional testing,and can be regarded as a good example of how a systematic approach can solve practical industrial challenges.
基金Supported by Fundamental Research Program of Shanxi Province(20210302123045,20210302123182)National Natural Science Foundation of China(11601446)。
摘要This work is devoted to the study of initial boundary value problem for k-component system of semilinear wave equations with several fundamental boundary conditions(namely,the Dirichlet,Neumann,and Robin boundary conditions).Blow-up results and lifespan estimates of solutions to the problem with two different types of weak damping terms and power nonlinearities in the sub-critical and critical cases on exterior domain are obtained.The test function technique is performed in the proofs.It is worth observing that our results in Theorem 1.1 in this article contain the results in[6]as a special case whenθ=0.To the best of our knowledge,the results in Theorems 1.1-1.2 are new.
摘要Objective Scoliosis is a prevalent spinal deformity that severely impacts the physical and psychological well being of adolescents and often requires surgical correction.This study aimed to investigate the risk factors for postoperative pulmonary complications(PPCs)following posterior spinal fusion in adolescent scoliosis,with a specific focus on evaluating the predictive value of preoperative forced vital capacity(FVC)and etiological classification.Methods This retrospective cohort study enrolled adolescents who underwent posterior spinal fusion for scoliosis correction at Peking Union Medical College Hospital between January 2018 and December 2022.The baseline demographic,clinical,and perioperative variables were collected.The primary endpoint was the occurrence of PPCs prior to hospital discharge.Univariate and multivariable binary logistic regression analyses were conducted to identify independent risk factors.Results A total of 1,234 patients were included,of whom 29(2.35%)developed PPCs and 1,205 did not.Univariate analysis revealed that 12 variables,including non-idiopathic scoliosis,a larger main thoracic curve,a decreased FVC%predicted,and increased perioperative blood transfusions,were significantly associated with PPCs(P<0.05).Multivariable logistic regression model showed that non-idiopathic scoliosis emerged as the sole independent risk factor for PPCs[adjusted odds ratio(OR)=5.478,95%confidence interval:2.017-19.148,P=0.002].Preoperative FVC%predicted(adjusted OR=0.993,P=0.497)and main thoracic curve(adjusted OR=1.002,P=0.736)did not demonstrate independent predictive value.Conclusions Non-idiopathic scoliosis,rather than preoperative pulmonary function or curve severity,is an independent risk factor for PPCs following posterior spinal fusion in adolescents.During perioperative respiratory risk assessment,particular emphasis should be placed on the etiological classification of these patients.
摘要BACKGROUND Hepatitis A virus(HAV)infection remains a significant cause of acute viral hepatitis globally,and the endemicity pattern is intermediate in Mexico.Although most cases follow a benign and self-limited course,less than 5%of patients with HAV infection progress to acute liver failure,which carries mortality rates of 13%-33%depending on access to liver transplantation(LT).The identification of clinical and biochemical predictors of adverse outcomes is crucial to improve early risk stratification,optimize patient management,and guide timely referral to transplant centers.AIM To assess the utility of clinical and biochemical variables and prognostic scores in predicting mortality and the need for LT in patients with acute HAV infection.METHODS We conducted a retrospective case series of all patients hospitalized at Medica Sur Clinic between 2018 and 2024 who were positive for immunoglobulin M antibodies for HAV.Clinical and laboratory data were collected from patients’electronic medical records.Continuous variables were summarized as the means±SD or median and interquartile range and compared using Student’s t-test or the Mann-Whitney U test,as appropriate.Categorical variables were expressed as frequencies and percentages and compared using the χ2 test or Fisher’s exact test.RESULTS A total of 69 patients with HAV infection(mean age,38±11 years;65%male)were included.14%of patients had a history of hepatic steatosis,10%had type 2 diabetes,and 45%were smokers.Acute liver injury was observed in 47 patients(68%),acute liver failure was detected in five patients(7.2%),and mortality or LT occurred in three patients(4.3%;two deaths and one transplant).Patients who died or required orthotopic LT were older,and they had higher heart and respiratory rates at admission.These patients additionally exhibited greater liver dysfunction,including higher bilirubin and transaminase levels,prolonged coagulation times,lower sodium and albumin levels,and worse albumin-bilirubin scores.Severity scores[model for end-stage liver disease(MELD),MELD with sodium,MELD version 3.0]were significantly higher in patients with complications than in those without complications.CONCLUSION Advanced age,elevated severity,and higher albumin-bilirubin scores emerged as predictors of adverse outcomes in patients with HAV infection,and consideration of these factors could guide the need for more intensive monitoring strategies.These findings highlight the importance of incorporating prognostic scoring systems into routine clinical evaluation to improve outcomes in high-risk patients.
摘要BACKGROUND Hepatitis B Virus(HBV)remains a global public health challenge,affecting over 296 million people,many of whom are asymptomatic.Incidentally diagnosed carriers provide a critical window for early intervention and prevention.Understanding their hematological profile and viral burden can help inform risk assessment and clinical management.AIM To evaluate hematological parameters and HBV viral load in incidentally detected asymptomatic hepatitis B surface antigen positive patients during routine health screenings.METHODS A cross-sectional observational study was conducted from June 2024 to March 2025 at Dr.D.Y.Patil Medical College,Hospital and Research Centre a tertiary care hospital in Pune,Maharashtra,India,involving 100 hepatitis B surface antigen-positive patients and 20 healthy controls.Hematological and liver function parameters were assessed,and quantitative HBV DNA analysis was performed using real-time polymerase chain reaction.Statistical analysis was conducted using GraphPad Prism v8.0.RESULTS Marked variations were detected in hemoglobin levels(P2000 IU/mL was found in 17 patients,and<2000 IU/mL in 24 patients.Viral load positively correlated with conjugated bilirubin,serum glutamic-oxaloacetic transaminase,serum glutamic-pyruvic transaminase,and alkaline phosphatase,and negatively with albumin and the albumin-globulin ratio.CONCLUSION Incidentally detected HBV infections present an opportunity for early disease detection.Hematological and viral markers can guide clinical decisions.Routine screening and contact tracing are essential strategies to control HBV transmission and progression.
基金supported by Top Talent of Changzhou’s“The 14th Five-Year Plan”High-Level Health Talents Training Project(Grant No.:2022CZBJ037,2024CZBJ008)Key Laboratory of Changzhou High-tech Research Project(Grant No.:CM20193010)+4 种基金Changzhou Science and Technology Program(Grant No.:CJ20220228)Postgraduate Research&Practice Innovation Program of Jiangsu Province(Grant No.:SJCX25_1794,SJCX25_1795)Changzhou Clinical Medical Center(Nuclear Medicine)(Grant No.:CZZX202204)Major Project of Changzhou Health Commission(Grant No.:ZD202405)Social Development Project of Changzhou Science and Technology Bureau(Grant No.:CE20235057).
摘要Pulmonary function test(PFT)is a vital noninvasive method for evaluating respiratory system function and is widely used in the diagnosis,surgical risk assessment,and prognostic prediction of chronic airway diseases and interstitial lung diseases.In 2021,the American Thoracic Society and the European Respiratory Society updated their pulmonary function interpretation guidelines,choosing to adopt z-scores instead of percentage of predicted forced expiratory volume in 1 second(FEV1),thereby significantly improving sensitivity and prognostic evaluation.However,conventional PFT relies on patient cooperation and is limited in its ability to effectively capture the heterogeneity of localized lesions.In recent years,the use of multimodal medical imaging in pulmonary function prediction has progressed rapidly.When combined with radiomics and deep learning techniques,these imaging methods enable more accurate and quantitative functional assessments.This review introduces that pulmonary function assessment should integrate multimodal imaging features with clinical functional indicators.This approach establishes cross-scale linkages between morphology and function and provides new perspectives for the early screening of high-risk individuals with accelerated pulmonary aging,evaluating the effectiveness of interventions,and enabling personalized intervention strategies.We review the classification systems and clinical value of PFT,discuss the advances and limitations of multimodal imaging in predicting lung function,and explore future directions in standardized data acquisition and multicenter validation to promote precise pulmonary function assessment and clinical application.
摘要Excessive dynamic airway collapse(EDAC)is characterized by weakness in the posterior membranous wall of the airway,which results in more than 50%narrowing of the central airway lumen during expiration.EDAC differs from tracheobronchomalacia,which involves the weakening of the cartilage rather than the membranous wall.EDAC poses a diagnostic challenge due to overlapping symptoms with chronic obstructive pulmonary disease and asthma,including dyspnea,cough,and wheezing.The diagnosis of EDAC relies on dynamic airway imaging techniques,including bronchoscopy,dynamic computed tomography,dynamic magnetic resonance imaging,and endobronchial ultrasound,to assess airway collapse during expiration.Pulmonary function testing helps in ruling out obstructive lung disease.Treatment includes medical management of underlying comorbidities,pulmonary rehabilitation,and,in severe cases,bronchoscopyguided stenting of the airway or tracheobronchoplasty.This mini-review discusses pathophysiology,diagnostic challenges,and evolving treatment strategies for EDAC,highlighting the need for increased clinical awareness and targeted therapies.
摘要The diagnosis of Chronic Pancreatitis (CP) is based on the detection of abnormal structure or function of the diseased pancreas. The pancreatic function tests more accurately determine the presence of CP than tests of structure, especially for early stage disease. The function tests can be divided into two categories: non- invasive and invasive. The invasive "tube" tests can reliably detect mild, early CP, but are only available at a few referral centers and tend to be poorly tolerated by patients. The non-invasive tests are easy to obtain, but tend to perform poorly in patients with early, mild disease. Therefore, no one test is useful in all clinical situations, and a detailed understanding of the rational, pathophysiologic basis, strengths, and limitations of various tests is needed. This review highlights the role of various pancreatic function tests in the diagnosis of CP including fecal fat analysis, fecal elastase, fecal chymotrypsin, serum trypsin, the secretin stimulation test, the cholecystokinin (CCK) stimulation test, the combined secretin-CCK stimulation test, the intraductal and endoscopic secretin stimulation tests, and the functional magnetic resonance imaging of the pancreas after secretin stimulation.
摘要Hormone-stimulated pancreatic function tests (PFTs) are considered the gold standard for measuring pancreatic exocrine function. PFTs involve the administration of intravenous secretin or cholecystokinin, followed by collection and analysis of pancreatic secretions. Because exocrine function may decline in the earliest phase of pancreatic fibrosis, PFTs are considered accurate for diagnosing chronic pancreatitis. Unfortunately, these potentially valuable tests are infrequently performed except at specialized centers, because they are time consuming and complicated. To overcome these limitations, endoscopic PFT methods have been developed which include aspiration of pancreatic secretions through the suction channel of the endoscope. The secretin endoscopic pancreatic function test (ePFT) involves collection of duodenal aspirates at 15, 30, 45 and 60 min after secretin stimulation. A bicarbonate concentration greater than 80 mmol/L in any of the samples is considered a normal result. The secretin ePFT has demonstrated good sensitivity and specificity compared with various reference standards, including the "Dreiling tube" secretin PFT, endoscopic ultrasound, and surgical histology. Furthermore, a standard autoanalyzer can be used for bicarbonate analysis, which allows the secretin ePFT to be performed at any hospital. The secretin ePFT may complement imaging tests like endoscopic ultrasound (EUS) in the diagnosis of early chronic pancreatitis.This paper will review the literature validating the use of ePFT in the diagnosis of exocrine insufficiency and chronic pancreatitis. Newer developments will also be discussed, including the feasibility of combined EUS/ ePFT, the use of cholecystokinin alone or in combination with secretin, and the discovery of new protein and lipid pancreatic juice biomarkers which may complement traditional fluid analysis.
摘要This review focuses on current aspects of the novel technology of combined impedance manometry for esophageal motility testing. It presents methodological features, summarizes current results and discusses implications for further research. The combined technique assesses simultaneously bolus transport and associated peristalsis, thus allowing detailed analysis of the relationships between bolus transit and esophageal motility. Recent studies demonstrate that combined impedance manometry provides important additional information about esophageal motility as compared to conventional manometry: (1) monitoring of bolus transport patterns, (2) calculation of bolus transit parameters, (3) evaluation of bolus clearance, (4) monitoring of swallow associated events such as air movement and reflux, and (5) investigation of the relationships between bolus transit and LES relaxation. Studies with healthy subjects have identified several useful parameters for comprehensive assessment of eosphageal function. These parameters were found to be pathological in patients with classical achalasia, mild GERD, and ineffective esophageal motility. The technology of combined impedance manometry provides an important new tool for esophageal function testing, advancing both clinical and basic research. However, several important issues remain to be standardized to make the technique suitable for widely clinical use.
摘要Sperm function testing, once commonly performed for the infertile couple before employing assisted reproductive technology (ART), has fallen out of favour in many reproductive medicine centers throughout the world. Indeed, the most recent addition of the 'World Health Organisation (WHO) Laboratory Manual for the Examination and Processing of Hu- man Semen' now groups many of these procedures into a section termed Research Procedures. In large part, this reflects the current clinical practice of bypassing the in-depth evaluation of the male partner, while assuming that if a spermatozoon can be found for intracytoplasmic sperm injection (ICSI), it must be a healthy cell capable of achieving fertilization. Never- theless, sperm function testing can provide valuable clinical insights into defects causing male infertility. Admittedly, in some cases, functional sperm deficiencies can be overcome using an ART. In other cases, couples will be empowered by the knowledge of the cause of their infertility, and for some couples, perhaps even the likelihood of ICSI success (relative to the spermatozoa). The knowledge allows them to make truly informed reproductive decisions, including (perhaps) the de- cision to seek donor insemination, to adopt or to remain childless. Knowledge of the cause of their infertility may provide closure for couples and a sense of confidence regarding their choice of reproductive treatment.
摘要BACKGROUND Dopaminergic neurons are lost in Parkinson’s disease(PD),a degenerative neurological condition.While the effects of PD on motor functions are well understood,its impact on respiratory function is less clear.In PD patients with suspicious pulmonary symptoms,the presence and degree of impairment in lung function often cannot be optimally assessed through pulmonary function tests(PFTs)due to the patients'neurological symptoms.AIM To examine the relationship between diaphragmatic thickness as determined by ultrasonography(US)and conventional PFTs in PD patients.Additionally,we evaluated the potential use of diaphragmatic thickness as an alternative measure for assessing respiratory function in PD patients who are unable to perform PFTs.METHODS A total of 43 PD patients who presented to the clinics between June 15,2021,and June 30,2022,were included.Patients with coronavirus disease 2019 infection history,conditions affecting diaphragmatic motility,recent thoracic or abdominal surgery,or imaging showing restrictive masses were excluded.Demographic data,disease duration,Hoehn-Yahr stage,and medication use were recorded.PFTs were used to evaluate forced vital capacity,forced expiratory volume in the first second,and other parameters,while US was used to measure diaphragmatic thickness.Breathlessness was assessed using the modified medical research council dyspnea scale.RESULTS Significant correlations were found between peak expiratory flow(PEF)and diaphragm fraction(P=0.019),as well as between PEF percentage and diaphragmatic thickness during expiration(P=0.023).In early-stage PD,diaphragmatic thickness during inspiration correlated with oxygen saturation(P=0.048).In advanced-stage PD,PEF and PEF%were significantly correlated with diaphragm thickness during expiration[r=0.405,P=0.049(for PEF);r=0.463,P=0.023(for PEF%)]and diaphragm fraction[r=-0.476,P=0.019(for PEF);r=-0.617,P=0.001(for PEF%)].CONCLUSION Present study assessed the relationship between PFTs and diaphragmatic thickness in PD patients.Diaphragmatic thickness measured by US was found to correlate with certain PFT parameters,suggesting it could be used as an alternative measure for assessing respiratory function in Parkinson’s patients who have difficulty performing PFTs.
基金Supported by National Natural Science Foundation of China Under Grant(12401647)Supported by Fundamental Research Program of Shanxi Province(202203021212336)+2 种基金Taiyuan Institute of Technology Scientific Research Initial Funding(2023KJ057,2024KJ007,2024LJ005)Supported by Scientific and Technologial Innovation Programs of Higher Education Institutions in Shanxi(2024L358)Youth Program of Taiyuan University(24TYQN10)。
摘要The main purpose of this paper is to investigate the singularities of solutions to the single Tricomi equation with derivative term and combined memory term.In addition,the blow-up of the solution to the weakly coupled system with memory term is also considered,where one is a power nonlinear term and the other is a derivative nonlinear term.Upper bound lifespan estimates of solution are obtained in the sub-critical by utilizing the test function method and iteration technique.The innovation of this paper focuses on the lifespan estimates of the solutions,which extends the well-known Strauss and Glassey conjectures.
摘要Tests of preoperative visual function and prediction of postoperative E chart visual acuity(ECVA) using laser interferometric visual acuity(LIVA) and electroretinogram(ERG) were performed in 16 cases(19 eyes) of cataract. The results showed that the coincident rate between preoperative LIVA and postoperative ECVA was 63.2%, and there was a parallel correlation between preoperative amplitude of photopic ERG b-wave and postoperative ECVA in 79.0% of the eyes. Comparing these two methods, the test of LIVA ...
基金supported by the Sub-Project under National "Twelfth Five-Year" Plan for Science&Technology Support Project in China,No.2011BAI08B11the Research Project of China Rehabilitation Research Center,No.2014-3
摘要Virtual reality is nowadays used to facilitate motor recovery in stroke patients. Most virtual reality studies have involved chronic stroke patients; however, brain plasticity remains good in acute and subacute patients. Most virtual reality systems are only applicable to the proximal upper limbs (arms) because of the limitations of their capture systems. Nevertheless, the functional recovery of an affected hand is most difficult in the case of hemiparesis rehabilitation after a stroke. The recently developed Leap Motion controller can track the fine movements of both hands and fingers. Therefore, the present study explored the effects of a Leap Motion-based virtual reality system on subacute stroke. Twenty-six subacute stroke patients were assigned to an experimental group that received virtual reality training along with conventional occupational rehabilitation, and a control group that only received conventional rehabilitation. The Wolf motor func- tion test (WMFT) was used to assess the motor function of the affected upper limb; functional magnetic resonance imaging was used to measure the cortical activation. After four weeks of treatment, the motor functions of the affected upper limbs were significantly improved in all the patients, with the improvement in the experimental group being significantly better than in the control group. The action perfor- mance time in the WMFT significantly decreased in the experimental group. Furthermore, the activation intensity and the laterality index of the contralateral primary sensorimotor cortex increased in both the experimental and control groups. These results confirmed that Leap Motion-based virtual reality training was a promising and feasible supplementary rehabilitation intervention, could facilitate the recovery of motor functions in subacute stroke patients. The study has been registered in the Chinese Clinical Trial Registry (registration number: ChiCTR-OCH- 12002238).
摘要In this paper, the new organization for unit testing embedding pair-wise mode is proposed with the core thought focused on the cooperation of programmer and tester by “cross-testing”. The typical content of unit testing for the new organizing mode should have three aspects, including self-checking, cross-testing and independent-testing. For cross-testing, executing “pair-wise” mode, mainly tackles data testing, function testing and state testing, which function testing must be done by details and state testing must be considered for completeness. With the specializing of independent-testing, it should be taken as more rigid testing without arbitrariness. Consequently, strategy and measure are addressed for data testing focusing on boundary testing and function/state testing. And organizing method of procedure and key points of tackling unit testing are investigated for the new organizing mode. In order to assess the validity of our study and approach, a series of actual examples are demonstrated for GUI software. The result indicates that the execution of unit testing for the new organizing mode is effective and applicable.
基金supported by the Soonchunhyang University Research Fund and 2018 Ulsan University Hospital Research Grant(UUH-2018-12)(Grantee:JYP,http://gffzz951d03ea78ca4279h5kcnkw9n00up6nbo.ffgz.tsg.suse.edu.cn).The authors are grateful for their supports.
摘要Subjective visual vertical(SVV)and subjective visual horizontal(SVH)tests can be used to evaluate the perception of verticality and horizontality,respectively,and can aid the diagnosis of otolith dysfunction in clinical practice.In this study,SVV and SVH screen version tests are implemented using virtual reality(VR)equipment;the proposed test method promotes a more immersive feeling for the subject while using a simple equipment configuration and possessing excellent mobility.To verify the performance of the proposed VR-based SVV and SVH tests,a reliable comparison was made between the traditional screen-based SVV and SVH tests and the proposed method,based on 30 healthy subjects.The average results of our experimental tests on the VR-based binocular SVV and SVH equipment were−0.15◦±1.74 and 0.60◦±1.18,respectively.The proposed VR-based method satisfies the normal tolerance for horizontal or vertical lines,i.e.,a±3◦error,as defined in previous studies,and it can be used to replace existing test methods.