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一种高眼压症发展为青光眼的危险预测模型的效果评估

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世界核心医学期刊文摘(眼科学分册) 2006年第2期 33-34页

作者： Medeiros F.A Weinreb R.n Sample P.A. 潘佳鸿 hamilton Glaucoma Center University of California San Diego 9415 Campus PointDr 0946 San Diego CA 92093- 0946United States Dr.

Objectives: To develop and validate a predictive model to estimate the risk of conversion from ocular hypertension to glaucoma. Methods: Predictive models for the 5- year risk of conversion to glaucoma were derived from the results of the Ocular Hypertension Treatment Study (OHTS). The performance of these models was assessed in an independent population of 126 subjects with ocular hypertension from a longitudinal study (Diagnostic Innovations in Glaucoma Study [DIGS]). The performance of the OHTS derived models was assessed in the DIGS cohort according to equality of regression coefficients, discrimination (c-index), and calibration. Results: Thirty-one patients (25% ) developed glaucoma during follow-up. Hazard ratios for DIGS-and OHTS-derived predictive models were similar for age, intraocular pressure, central corneal thickness, vertical cup-disc ratio, and pattern standard deviation but were significantly different for the presence of diabetes mellitus. When applied to the DIGS population, the OHTS-derived predictive models had reasonably good discrimination (c-indexes of 0.68 [full model] and 0.73 [reduced model]) and calibration. Conclusions: The OHTS derived predictive models performed well in assessing the risk of glaucoma development in an independent population of untreated subjects with ocular hypertension. A risk scoring system was developed that allows calculation of the 5- year risk of glaucoma development for an individual patient.

关键词：高眼压症危险度危险系数青光眼数学模型预测模型

应对社会挑战知证决策的先行者:全球证据委员会

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中国循证医学杂志 2023年第10期23卷 1222-1228页

作者：宋旭萍 John nLavis 陈耀龙杨克虎循证社会科学研究中心兰州大学公共卫生学院兰州730000 加拿大麦克马斯特大学卫生研究方法、证据与影响力系卫生论坛汉密尔顿L8S4L6 循证社会科学交叉创新实验室兰州大学兰州730000

决策通常是一个复杂且难以标准化的过程。从抗击新型冠状病毒感染疫情的经验中,决策者们逐渐认识到应对人类面临的诸多社会挑战,如气候变化、优质教育及其他可持续发展目标,都应采用知证决策方法,基于现有的最佳证据进行决策。全球证据... 详细信息

决策通常是一个复杂且难以标准化的过程。从抗击新型冠状病毒感染疫情的经验中,决策者们逐渐认识到应对人类面临的诸多社会挑战,如气候变化、优质教育及其他可持续发展目标,都应采用知证决策方法,基于现有的最佳证据进行决策。全球证据委员会自2021年成立以来,相继在2022年和2023年发布报告。报告利用5种国内证据形式(数据分析、评价、建模、定性见解和行为/实施研究),基于4个决策步骤(理解问题及其原因、选择解决问题的方案、确认实施考量的因素、监测实施和评估效果),面向4类决策者(政策制定者、组织领导者、专业人士和公民)阐述如何基于知证决策科学应对社会挑战。为了进一步传播知证决策的理念和方法,秘书处与25位全球证据委员会委员合作撰写报告,与来自12个国家的国家领导小组开展快速证据支持系统评估,与实施理事会加速实施24条建议。本文系统梳理了全球证据委员会的历史沿革、核心方法和最新动态,旨在为决策者展示知证决策的新视界,并推动科学决策的传播与应用。

关键词：知证决策社会挑战全球证据委员会报告

应用4变量精确平板理论分析FG复合板的自由振动

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应用数学和力学 2011年第7期32卷 866-882页

作者： L·哈吉 H·A·艾特阿特曼 A·杜尼斯 I·米查贝 n·茜安 E·A·A·贝迪亚黄锋(译) 张禄坤(校) 阿贝斯思迪贝尔大学流体材料实验室阿贝斯思迪贝尔22000阿尔及利亚伊本卡尔顿大学土木工程系扎鲁拉BP78提亚雷特14000阿尔及利亚谢里夫哈西巴本布阿利大学科学工程学院阿尔及利亚不详

应用4变量的精确平板理论,对矩形功能梯度材料(FGM)复合板进行自由振动分析.与其它的理论不同,该理论的未知函数数量只有4个,而别的剪变形理论的未知函数为5个.提出的4变量精确平板理论,协调条件有了改变,与经典的薄板理论相比,许多方... 详细信息

应用4变量的精确平板理论,对矩形功能梯度材料(FGM)复合板进行自由振动分析.与其它的理论不同,该理论的未知函数数量只有4个,而别的剪变形理论的未知函数为5个.提出的4变量精确平板理论,协调条件有了改变,与经典的薄板理论相比,许多方面有着惊人的相似,无需引入剪切修正因数——当横向剪应力越过板厚后,为了满足剪应力自由表面条件,出现抛物线状的改变,导致横向剪应力的变化.考虑了两种常见类型的FGM复合板,即,FGM表面层和各向同性夹芯层的复合板,以及各向同性表面层和FGM夹芯层的复合板.通过hamilton原理,得到了FGM复合板的运动方程.得到闭式的navier解,然后求解特征值问题,得到自由振动的基本频率.将该理论得到的结果,与经典理论,一阶的及其它更高阶的理论所得到的结果进行比较,检验了该理论的有效性.研究发现,该理论在求解FGM复合板自由振动性能方面,既精确又简单.

关键词：功能梯度材料(FGMs) 自由振动复合板精确平板理论 navier解

对比1次/d噻吗心安与拉坦前列腺素对夜间眼压的作用

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世界核心医学期刊文摘（眼科学分册） 2005年第3期1卷 33-34页

作者： Liu J.H.K. Kripke D.F. Weinreb R.n. 秦雪娇 hamilton Glaucoma Ctr. Dept. O. La Jolla CA United States Dr

Purpose To compare the nocturnal effects of once-daily timolol and latanopros t on intraocular pressure (IOP) in patients with ocular hypertension or early gl aucomatous changes. Design Prospective, open label, experimental study with cro ssover design. Methods Eighteen patients with ocular hypertension or early glauc omatous changes (aged 41 to 79 years) each received topical treatments with timo lol (0.5%Timoptic XE), latanoprost (0.005%Xalatan), and no IOP lowering medi cation, for at least 4 weeks. Timolol was given once in the morning upon awakeni ng and latanoprost once in the evening at bedtime. At the end of each treatment period, the patient was housed in a sleep laboratory for 24 hours and IOP was me asured every 2 hours using a pneumatonometer. Measurements were taken sitting an d supine during the 16 hour diurnal/wake period and only supine during the 8 h our nocturnal/sleep period. Mean diurnal and nocturnal IOP levels were compared among the treatments with timolol, latanoprost, and no medication. Results In th e diurnal period, the mean IOP under the timolol or the latanoprost treatment wa s significantly less than the mean IOP under no medication in both the sitting a nd the supine positions. There was no statistical difference between the timolol and latanoprost treatments. In the nocturnal period, supine IOP with timolol tr eatment was not different from the supine IOP with no medication but was signifi cantly higher than supine IOP with the latanoprost treatment. Conclusion Althoug h both once daily timolol and latanoprost were effective in lowering IOP during the diurnal period, only latanoprost reduced IOP during the nocturnal period.

关键词：拉坦前列腺素噻吗心安青光眼病气体眼压计仰卧位交叉对照安慰剂无显著性差异

激光扫描偏振仪测量视网膜神经纤维层厚度预测青光眼性视野损害

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世界核心医学期刊文摘（眼科学分册） 2005年第4期1卷 16-17页

作者： Mohammadi K. BowdC. Weinreb R.n. L.M. Zangwill 陈立军 hamilton Glaucoma Center Department of Ophthalmology Univ. of California at San Diego San Diego CA 92093- 0946 United States

Purpose: To assess whether baseline retinal nerve fiber layer (RnFL) measurements obtained with a scanning laser polarimeter, the GDx nerve Fiber Analyzer, (Laser Diagnostic Technologies Inc., San Diego, California) are predictive of development of repeatable glaucomatous visual field damage in glaucoma suspect eyes. Design: Cohort study. Methods: Participants were recruited from the UCSD longitudinal Diagnostic Innovations in Glaucoma Study (DIGS). One eye from each of 160 glaucoma suspects with normal standard automated perimetry (SAP) visual fields at baseline was studied. Study eyes were divided into convert and nonconvert groups based on the development of three consecutive glaucomatous visual fields during follow- up. SLP parameters, IOP, vertical cup disk ratio, stereophotograph assessment as glaucoma or normal, corneal thickness, and visual field indices were included in univariate and multivariate Cox proportional hazards models to determine which SLP RnFL and ocular parameters were predictive of visual field conversion. Results: Sixteen (10% )- eyes developed repeatable visual field damage (converts) and 144 (90% ) did not (nonconverts). Mean (95% CI) follow- up time until visual field conversion for convert eyes was 2.7 (1.7, 3.6) years. Mean total follow- up of nonconvert eyes was 3.8 (3.5, 4.1) years. Four out of thirteen examined baseline SLP parameters and baseline SAP Mean Deviation (MD), SAP Pattern Standard Deviation (PSD), and glaucomatous stereophotograph assessment were significant univariate predictors of visual field conversion. In multivariate models adjusted for age, IOP and CCT, SLP parameters inferior ratio, ellipse modulation, and UCSD linear discriminant function (LDF)were significant predictors of visual field conversion. When SAP PSD and stereophotograph assessment were also included in the multivariate model inferior ratio and UCSD LDF remained independently predictive of visual field loss. Conclusions: Thinner baseline SLP RnFL measu

关键词：视野损害青光眼性可疑青光眼垂直杯盘比偏振仪激光扫描视野检查自动视野计视野缺损立体成像

Progression of Cognitive Deficit in Older People with Mild Cognitive Impairment Treated with Cerebrolysin

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Health 2014年第19期6卷 2581-2591页

作者： Irina S. Boksha Svetlana I. Gavrilova Igor V. Kolykhalov Iana B. Fedorova Iaroslav B. Kalyn natalia D. Selezneva Andrei V. Samorodov Serge n. Miasoedov Elizabeta B. Mukaetova-Ladinska Laboratory of neurochemistry Moscow Russia Department of Alzheimer’s Disease and Related Disorders Moscow Russia Department of Bioengineering and Medical Equipment and Systems Moscow State Technical University Moscow Russia Laboratory of Biostatistics and Evidence Based Medicine Mental Health Research Center of Russian Academy of Medical Sciences Moscow Russia Institute of neurocience Newcastle University Institute for Ageing Newcastle University Campus for Ageing and Vitality Newcastle upon Tyne UK

Objectives: Although people with amnestic mild cognitive impairment (aMCI) benefit from cerebrolysin treatment, some still develop dementia. The aim of the current study was to identify most informative clinical assessment tests to predict the therapy efficacy in aMCI subjects treated with cerebrolysin. Methods: We studied patients with amnestic mild cognitive impairment (aMCI;n = 53) who had regular neurocognitive and clinical psychiatric assessments and were treated with cerebrolysin i.v. infusions 20 × 30 ml twice a year over three years period. Data were analyzed using non-parametric statistics, cluster and linear discriminant analyses. Results: Combined mathematical modeling enabled to predict cognitive decline from aMCI to dementia in the cerebrolysin-treated patients based on their initial neurocognitive assessment scores. We identified a “dementia risk group” with fast cognitive decline (i.e. low efficacy of the treatment). Lower baseline scores in the Mattis Dementia Rating Scale Memory subtest, Mini-Mental State Examination (MMSE), 10 word list immediate recall, and Frontal Assessment Battery tests when accompanied by higher depression score (hamilton Depression Rating Scale) suggest poor prognosis for aMCI patients treated with cerebrolysin. Changes in scores on the MMSE, Boston naming test, Digit span forward, and Wechsler scale subtest “Categorical associations” during the treatment course are more characteristic for patients who convert to dementia than their initial scores. Conclusions: aMCI subjects treated with cerebrolysin with lower baseline cognitive functioning and subclinical depression have poor prognosis in terms of converting to dementia. Changes in the MMSE, Boston naming test, Digit span forward, and Wechsler scale subtest “Categorical associations” scores during the treatment course are more informative to identify patients who will develop dementia than their initial scores.

关键词： Mild Cognitive Impairment Cerebrolysin Dementia Cluster Analysis Linear Discriminant Analysis

高眼压患者角膜中央厚度与视神经纤维层厚度之间的关系

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世界核心医学期刊文摘（眼科学分册） 2005年第7期1卷 35-36页

作者： Henderson P.A. Medeiros F.A. Zangwill L.M. Weinreb R.n. 杨秀梅 hamilton Glaucoma Center University of California San Diego 9500 Gilman Drive San Die- go CA92093- 0946United States

Purpose: To examine the relationship between retinal nerve fiber layer (RnFL) measurements obtained using scanning laser polarimetry with variable corneal compensation and corneal thickness measurements in ocular hypertension (OHT) patients. Design: Observational cross- sectional study. Subjects: The study included 1 eye each from44 OHT patients and48 healthy subjects, all of similar age. All subjects had normal optic discs and normal standard automated perimetry (SAP) visual fields. Ocular hypertension patients had intraocular pressure (IOP) measurements higher than 22 mmHg. Methods: All patients underwent imagingwith the GDx VCC (Laser Diagnostic Technologies, Inc., San Diego, CA) scanning laser polarimeter. We examined the relationship between GDx VCC RnFL measurements and central corneal thickness, a risk factor for development of visual field loss among OHT patients. We also examined the relationship of GDx VCC measurements and age, IOP, SAP pattern standard deviation, and vertical cup- todisc ratio. Main Outcome Measures: Central corneal thickness (CCT) and GDx VCC RnFL thickness parameters. Results: Central corneal thickness measurements in OHT patients were significantly higher than those in healthy subjects (575± 30 μ m vs.555± 32 μ m; P=0.002). Higher GDx VCC parameter nerve fiber indicator (nFI) scores, indicating thinner RnFL, were correlated significantly with thinner CCT measurements in OHT patients (r=- 0.502; P=0.001). Ocular hypertension patients with thinner corneas (n=22; mean CCT,553± 21 μ m)- had significantly higher nFI scores than OHT patients with thicker corneas (n=22; mean CCT,598± 18 μ m) and healthy control subjects (nFI mean± standard deviation, 26.9± 9.5, 20.7± 9.8, and 19.7± 7.0, respectively; P=0.004, analysis of variance). The nFI values were not significantly different between OHT patients with thicker corneas and healthy subjects. In multivariate analysis, only age and CCT measurement were associated significantly with GDx VCC RnFL

关键词：视神经纤维层角膜中央厚度高眼压症自动视野计视野缺损 RnFL 视杯角膜厚度垂直径偏振仪

视野丧失模式与视神经纤维层厚度测量之间的关系

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世界核心医学期刊文摘（眼科学分册） 2006年第6期2卷 5-6页

作者： Hoffmann E.M. Medeiros F.A. Sample P.A. R.n. Weinreb 杨秀梅 hamilton Glaucoma Center Department of OphthalmologyUniversity of CaliforniaSan Diego9500 Gilman DriveSan DiegoCA 92093-0946United States Dr.

PURPOSE: To investigate the association between patterns of visual field (VF) loss and retinal nerve fiber layer (RnFL) thickness measurements. DESIGn: Observational cross-sectional study. METHODS: One hundred twenty-one glaucoma patients and 65 healthy subjects from the Diagnostic Innovations in Glaucoma Study (DIGS) were included. All glaucoma patients had repeatable abnormal VFs and scanning laser polarimetry (SLP) RnFL thickness measurements. RnFL measurements were obtained from 16 equal parapapillary sectors. Patterns of VF loss were classified as arcuate,partial arcuate,nasal step,or paracentral in each VF hemifield. Logistic regression analysis was performed to determine which RnFL sectors were associated with each VF pattern. The ability of SLP to discriminate between eyes with different VF patterns and healthy eyes using receiver operating characteristic (ROC) curve analyses also was investigated. RESULTS: VF patterns in the superior hemifield were significantly associated with RnFL sectors in the temporal inferior hemiretina (P nation between eyes with differentVF patterns and healthy eyes ranged from 0.85 to 0.95. VF patterns in the inferior hemifield were most strongly associated with temporal superior RnFL sectors (P nation between different VF patterns and healthy eyes ranged from 0.73 to 0.98. SLP could discriminate between apparently unaffected VF hemifields in glaucoma eyes and VF hemifields in healthy eyes. COnCLUSIOnS: Parapapillary RnFL thickness was topographically related to patterns of VF loss. SLP can differentiate between apparently unaffected VF hemifields in glaucoma eyes and normal VF hemifields in healthy eyes.

关键词：视神经纤维层厚度测量受试者操作特征曲线 Logistic回归分析青光眼患者 nFL厚度 RnFL 横断面研究半视野健康眼

非酒精性脂肪肝:应用肝脏脂肪成分质子密度的MR成像评价肝脏的脂肪变性

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国际医学放射学杂志 2013年第4期 368-368页

作者： A. Tang J. Tan M. Sun G. hamilton M. Bydder T. Wolfson 张晓丹 Liver Imaging Group Department of Radiology University of California San Diego408 Dickinson St San Diego CA 92103 8226

目的以中心评分的组织病理学证据作为参考标准,评价肝脏脂肪成分质子密度MRI(MRI-PDFF)诊断非酒精性脂肪肝(nALFD)脂肪变性的诊断性能。材料与方法本项经内部审查委员会批准并且符合HIPAA标准的前瞻性、交叉性研究,以77例患有nALFD并行... 详细信息

目的以中心评分的组织病理学证据作为参考标准,评价肝脏脂肪成分质子密度MRI(MRI-PDFF)诊断非酒精性脂肪肝(nALFD)脂肪变性的诊断性能。材料与方法本项经内部审查委员会批准并且符合HIPAA标准的前瞻性、交叉性研究,以77例患有nALFD并行肝脏活检的病人为研究对象。在完成T2*的校正和多频率脂肪模型后,以基于磁场强度的小翻转角快速梯度多回波影像评估MRI-PDFF。根据非酒精性脂肪性肝炎(nASH)临床研究网络病理委员会的统一意见进行组织病理学评分。应用对Spearman相关性、可加性及方差稳定性回归分析探讨多种潜在混杂因素的影响,并应用受试者操作特征(ROC)曲线进行分析。结果肝脏MRI-PDFF越高,组织脂肪变性的程度越高(PnASH诊断、纤维化或磁场强度(P=0.65)所干扰。区别0级与1级或者更高级别(n=72)脂肪变性病人的ROC曲线下面积为0.989(95%CI:0.968～1.000),区别1级或更低级别(n=31)与2级或更高级别脂肪变性病人的ROC曲线下面积为0.825(95%CI:0.734～0.915),区别2级或更低级别(n=58)与3级脂肪变性病人(n=19)的ROC曲线下面积为0.893(95%CI:0.809～0.977)。结论 MRI-PDFF有望成为评价nALFD病人的肝脏脂肪变性程度的一种方法。但仍需大样本研究进一步验证。

关键词：脂肪变性病人肝脏脂肪非酒精性脂肪肝 MR 质子密度