A review of the trunk surface metrics used as Scoliosis and other deformities evaluation indices

Background

Although scoliosis is characterized by lateral deviation of the spine, a 3D deformation actually is responsible for geometric and morphologic changes in the trunk and rib cage. In a vast related medical literature, one can find quite a few scoliosis evaluation indices, which are based on back surface data and are generally measured along three planes. Regardless the large number of such indices, the literature is lacking a coherent presentation of the underlying metrics, the involved anatomic surface landmarks, the definition of planes and the definition of the related body axes. In addition, the long list of proposed scoliotic indices is rarely presented in cross-reference to each other. This creates a possibility of misunderstandings and sometimes irrational or even wrong use of these indices by the medical society.

Materials and methods

It is hoped that the current work contributes in clearing up the issue and gives rise to innovative ideas on how to assess the surface metrics in scoliosis. In particular, this paper presents a thorough study on the scoliosis evaluation indices, proposed by the medical society.

Results

More specifically, the referred indices are classified, according to the type of asymmetry they measure, according to the plane they refer to, according to the importance, and relevance or the level of scientific consensus they enjoy.

Conclusions

Surface metrics have very little correlation to Cobb angle measurements. Indices measured on different planes do not correlate to each other. Different indices exhibit quite diverging characteristics in terms of observer-induced errors, accuracy, sensitivity and specificity. Complicated positioning of the patient and ambiguous anatomical landmarks are the major error sources, which cause observer variations. Principles that should be followed when an index is proposed are presented.     

A method for analysis of back shape in scoliosis

The shape of the back is an important factor in the clinical assessment of various spinal disorders, in particular scoliosis. A method of analysis of back surface shape is described which was designed to present most of the numerical parameters needed to assess the progress of the disease as it affects body shape. Measurements of back surface shape and manually marked anatomical landmarks were taken from a television/computer surface measurement system in which a plane of light was scanned over the back and from moiré topographs. The anatomical landmarks were used to define reference planes from which successive analyses were matched. Asymmetry in the transverse plane was illustrated by horizontal cross-sections and skin surface angles. The lateral deformity was shown by an estimate of the line of the vertebral bodies beneath the skin, derived by adding an extra lateral displacement to the palpated positions of the spinous processes, proportional to the rotation of the skin in the transverse plane. This model was used to estimate vertebral end-plate angles and Cobb angles. Lateral sections showed kyphosis and lordosis. Correlations of Lateral Asymmetry from the surface shape analysis with Cobb angle from X-ray measurements in three groups of patients (totalling 119 subjects) were in the range r = 0.77 to r = 0.94, p less than 0.0001. The analysis has reduced follow-up X-ray examinations at the Nuffield Orthopaedic Centre because it indicates quantitatively and with complete safety both lateral asymmetry and deformity in the transverse plane.     

An experimental evaluation of diversity indices as environmental discriminators

Seven diversity indices were calculated for each of fifty-eight microcosm communities. All fifty-eight communities were initiated from equal density inoculations of fourteen algal species. Each microcosm developed in one of six controlled experimental environments; the environments differing only in their temporal patterns of disturbance. Five linear discriminating techniques were used to evaluate the diversity index most useful for discriminating between these environments. The Shannon-Wiener index was best according to two of the discriminating methodologies and second best using the other techniques. Evenness was best when the Shannon-Wiener index was second best and vice versa.     

Plan evaluation indices: A journey of evolution

AimA systemic review and analysis of evolution journey of indices, such as conformity index (CI), homogeneity index (HI) and gradient index (GI), described in the literature.BackgroundModern radiotherapy techniques like VMAT, SRS and SBRT produce highly conformal plans and provide better critical structure and normal tissue sparing. These treatment techniques can generate a number of competitive plans for the same patients with different dose distributions. Therefore, indices like CI, HI and GI serve as complementary tools in addition to visual slice by slice isodose verification while plan evaluation. Reliability and accuracy of these indices have been tested in the past and found shortcomings and benefits when compared to one another.Material and methodsPotentially relevant studies published after 1993 were identified through a pubmed and web of science search using words “conformity index”, “Homogeneity index”, “Gradient index”,” Stereotactic radiosurgery”,” stereotactic Body radiotherapy” “complexity metrics” and “plan evaluation index”. Combinations of words “plan evaluation index conformity index” were also searched as were bibliographies of downloaded papers.Results and conclusionsMathematical definitions of plan evaluation indices modified with time. CI definitions presented by various authors tested at their own and could not be generalized. Those mathematical definitions of CI which take into account OAR sparing grant more confidence in plan evaluation. Gradient index emerged as a significant plan evaluation index in addition to CI whereas homogeneity index losing its credibility. Biological index base plan evaluation is becoming popular and may replace or alter the role of dosimetrical indices.     

Modeling wetland plant metrics to improve the performance of vegetation-based indices of biological integrity

The objective of this study was to determine if the accuracy and precision of wetland plant indices of biological integrity (IBIs) could be improved through the use of modeling techniques. To do this, we developed a modeled vegetation IBI (MVIBI) based on metrics previously used to develop vegetation indices of biological integrity (VIBIs) for Ohio wetlands (e.g. % invasive grass, % sensitive species, shrub richness). We selected 82 emergent, forested, and shrub-dominated reference sites distributed across the State of Ohio and built Random Forest models to predict plant metric scores at reference wetlands from naturally occurring environmental features related to climate, hydrology, geology, soils, and landscape position. The models explained between 14 and 52% of the variance in the scores of 21 metrics indicating that variation in wetland plant assemblages was significantly associated with naturally occurring environmental gradients. We used principal component analysis to identify ten groups of statistically independent metrics and selected one metric from each group that discriminated most strongly between reference and most degraded sites based on t-scores. Two axes did not contain discriminating metrics so we used eight metrics in the MVIBI. Analysis of variance of reference site MVIBI scores indicated that we could use one distribution of reference site scores to assess multiple wetland types, thus eliminating the need to separately designate wetland types. We used the MVIBI to assess 170 test sites and compared the accuracy, precision, responsiveness, and sensitivity of the MVIBI to those of the original VIBIs. The MVIBI was up to twice as accurate and precise as the original VIBIs, indicating that modeling can be used to improve the performance of vegetation-based IBIs. The use of model-based IBIs for wetland plants should reduce assessment errors associated with natural variation in plant metrics and should increase confidence in wetland assessments.     

A microscope slide test for the evaluation of insect repellents as used with Culicoides impunctatus

An account is given of a field test suitable for evaluating insect repellents. Our test insect was Culicoides impunctatus. The test is based on the avoidance of a test substance placed within a circular chamber. It appears to be reliable and reproducible. The different components of oil of Myrica gale have been investigated and a hierarchy of activity is revealed, limonene and terpenine-4-ol being at the extremes of the range of activity.     

Detecting coevolution without phylogenetic trees? Tree-ignorant metrics of coevolution perform as well as tree-aware metrics

Background  

Identifying coevolving positions in protein sequences has myriad applications, ranging from understanding and predicting the structure of single molecules to generating proteome-wide predictions of interactions. Algorithms for detecting coevolving positions can be classified into two categories: tree-aware, which incorporate knowledge of phylogeny, and tree-ignorant, which do not. Tree-ignorant methods are frequently orders of magnitude faster, but are widely held to be insufficiently accurate because of a confounding of shared ancestry with coevolution. We conjectured that by using a null distribution that appropriately controls for the shared-ancestry signal, tree-ignorant methods would exhibit equivalent statistical power to tree-aware methods. Using a novel t-test transformation of coevolution metrics, we systematically compared four tree-aware and five tree-ignorant coevolution algorithms, applying them to myoglobin and myosin. We further considered the influence of sequence recoding using reduced-state amino acid alphabets, a common tactic employed in coevolutionary analyses to improve both statistical and computational performance.     

Influence of sampling effort on metrics of fish-based indices for the assessment of estuarine ecological quality

Multimetric fish-based indices have been increasingly gaining importance in Europe, as the Water Framework Directive (WFD) requires fish fauna, and particularly its composition and abundance, to be taken into account in the assessment of the ecological quality of continental surface waters, including transitional waters. These indices are composed of several metrics, mostly related with structural and functional characteristics of fish communities, such as species richness, the role of nursery areas, or trophic web structure. Therefore, ecological quality assessments should ensure that these structural and functional characteristics of fish communities were covered by the sampling methods used. In the present work, the influence of sampling effort on several metrics of the Estuarine Fish Assessment Index (EFAI) was studied. Pseudo-random samples were generated from data of four Portuguese estuaries and bootstrap cycles were performed, in order to obtain metrics’ means and standard deviations per number of hauls analysed. The number of hauls necessary for the means to level off differed with the metrics considered. Generally, for metrics on percentages (percentage of marine migrants, percentage of estuarine residents and percentage of piscivores) the curve levelled off with less than 20 hauls, both for the estuary as a whole and for different estuarine salinity zones. On the other hand, metrics on species richness required much larger samples. In order to decrease to −5% the current estimated bias of metrics, the WFD sampling costs would have to be more than 3 times higher than they currently are. The findings in the present study are of great importance for an effective assessment of estuarine ecological quality and particularly in the context of the WFD, as the metrics studied are common to other Member State indices.     

生态城市指标体系与评价方法

生态城市是依据生态学原理提出的一类社会-经济-自然协调发展的城市。目前生态城市理论研究主要应用在城市的规划、设计和管理上。生态城市建设的评价是衡量生态城市规划、建设、管理成效的主要依据。在对生态城市理论和内涵详细分析的基础上,采用专家咨询的定性和定量信息构建了扬州生态城市评价指标体系,该指标体系包括了城市复合生态系统中社会、经济、自然3个子系统,反映生态城市的内涵和衡量生态城市各子系统的状态、动态和实力。为对各级指标进行综合,提出了全排列多边形图示指标评价方法,评价生态城市在各个规划时段的建设成效。评价结果表明,扬州生态城市的综合发展能力市在2005规划年将达到0.44,在2010规划年将达到0.64,在2020规划年将达到0.85。评价方法简单直观,代数计算结果考虑了各级指标临界值对综合指标的放大和紧缩效应,反映了整体大于或者小于部分之和的系统整合原理。     

Critical controls in the evaluation of cAMP-dependent protein kinase activity ratios as indices of hormonal action

Measurement of the cAMP-dependent protein kinase "activity ratio" was introduced by Corbin et al. (Corbin, J.D., Soderling, T.R., and Park, C.R. (1973) J. Biol. Chem. 248, 1813-1821) and has been used by a large number of investigators as an index of the activation of this enzyme in the intact cell. This communication reports that with the typical conditions used the dissociation of the protein kinase is not blocked throughout the extraction. This is demonstrated, with glucagon-stimulated rat liver as the example tissue, by the addition of exogenous protein kinase. These data call into question the meaning of results reported using this experimental approach.     

Manual therapy as a conservative treatment for adolescent idiopathic scoliosis: a systematic review

Background

Studies on adolescent idiopathic scoliosis have well documented the differences between natural history of male and female patients. There are also differences in responses to nonoperative treatment, but the results of operative treatment in male patients compared with females have not been widely reported. Only few studies had compared the outcomes of operative treatment between male and female patients with different results.

Methods

We retrospectively reviewed the outcome of 150 (112 girls and 38 boys) consecutive patients with diagnosis of adolescent idiopathic scoliosis who were managed surgically between May 1996 and September 2005. Next, male radiographic parameters were compared with female ones pre- and postoperatively. Then, a subgroup of 38 matched girls was compared regarding the age, curve type, curve magnitude, and the instrumentation we used.

Results

In comparing male patients with unmatched girls, the boys had greater mean age (17.3 ± 2.3 vs. 16.3 ± 2.9; p = 0.049), greater primary curve (71.4 ± 21.3° vs. 62.7 ± 17.5°; p = 0.013), less flexibility (30.1 ± 13.5% vs. 40.3 ± 17.8%; p = 0.01), and less correction percentage (51.3 ± 12.9% vs. 58.8 ± 16.5%; p = 0/013). The loss of correction was comparable between the two groups. In the matched comparison, the flexibility in boys was less than girls (30.1 ± 13.5% vs. 38.1 ± 17.5%; p = 0.027). Also, the boys had a smaller correction percentage compared to the girls, but this finding was not statistically significant.

Conclusion

There was similar distribution curve pattern between male and female patients with AIS. Males had more rigid primary curves compared to females but a similar degree of postoperative scoliosis correction. Male AIS patients were older at the time of surgery. These preoperative gender differences, however; did not compromise the radiological outcomes of surgical treatment and the results were comparable between the genders.     

应用微根管法测定细根指标方法评述

树木细根(直径<2mm)在森林生态系统能量流动和物质循环中起着重要的作用。原有的细根生产周转研究中常采用的土钻法、内生长法、挖掘法、根室法和土柱法等,均不能直接观察到细根的动态变化。微根管法是一种非破坏性、可定点直接观察和研究植物根系的方法,为研究细根的生长、衰老、死亡、分解和再生长的过程提供了有效的工具,尤其适用于细根周转、寿命和分解等方面的研究。但该技术不能直接测定单位面积的细根生物量、细根化学组成及细根周转对土壤碳和养分循环的影响,需要与土钻法结合。本文就运用微根管法对细根生物量、生产、周转和寿命等指标的研究方法进行了评述。     

Quantitative evaluation of the lengths of homobifunctional protein cross-linking reagents used as molecular rulers

Homobifunctional chemical cross-linking reagents are important tools for functional and structural characterization of proteins. Accurate measures of the lengths of these molecules currently are not available, despite their widespread use. Stochastic dynamics calculations now provide quantitative measures of the lengths, and length dispersions, of 32 widely used molecular rulers. Significant differences from published data have been found.     

A critical review and a new proposal of karyotype asymmetry indices

In literature seven different methods of evaluating karyotype asymmetry – the TF%, the As K%, Stebbins' classification, the Rec and the Syi, the A₁ and the A₂, the DI, and the A – are used for the elucidation of phylogenetic relationships and taxonomic treatments within a particular group or taxon. The investigation of these seven methods reveals that the intervals used by Stebbins to separate the different types of karyotype asymmetry are very broad and only one quantitative parameter, the A₂ index, correctly describes the variation in chromosome length in a complement. A new asymmetry index (AI) is proposed to measure karyotype asymmetry and a new parameter, the CV_CI, is offered, that precisely assesses the relative variation in centromere position in a complement. The AI index, the CV_CI and the CV_CL (=A₂ × 100) have the potential to display even minor karyotypic variations. Thus, these three indices together increase the precision of results in comparison with other existing methods. All this has important consequences as regards the interpretation of the results of karyological studies.