Déterminer le lien entre l’hyperglycémie et/ou l’hypoinsulinémie et la dégradation clinique observée avant le diagnostic du Diabète Associé à la Fibrose Kystique.

La Fibrose kystique (FK) est une maladie génétique qui se traduit par une destruction progressive des poumons et éventuellement, à la mort. La principale complication secondaire est le diabète associé à la FK (DAFK). Une dégradation clinique (perte de poids et de la fonction pulmonaire) accélérée est observée avant le diagnostic. L’objectif principal de mon projet de doctorat est de déterminer, par l’intermédiaire du test d’hyperglycémie provoquée par voie orale (HGPO), s’il existe un lien entre l’hyperglycémie et/ou l’hypoinsulinémie et la dégradation clinique observée avant le diagnostic du DAFK. Nous allons ainsi évaluer l’importance des temps intermédiaires de l’HGPO afin de simplifier le diagnostic d’une dysglycémie ainsi que d’établir des nouveaux marqueurs indicateurs de patients à risque d’une détérioration clinique. L’HGPO est la méthode standard utilisée dans la FK pour le diagnostic du DAFK. Nous avons démontré que les valeurs de glycémie obtenues au temps 90-min de l’HGPO seraient suffisantes pour prédire la tolérance au glucose des patients adultes avec la FK, autrement établie à l’aide des valeurs à 2-h de l’HGPO. Nous proposons des glycémies à 90-min de l’HGPO supérieure à 9.3 mmol/L et supérieure à 11.5 mmol/L pour détecter l’intolérance au glucose et le DAFK, respectivement. Une cause importante du DAFK est un défaut de la sécrétion d’insuline. Les femmes atteintes de la FK ont un risque plus élevé de développer le DAFK que les hommes, nous avons donc exploré si leur sécrétion était altérée. Contrairement à notre hypothèse, nous avons observé que les femmes avec la FK avaient une sécrétion d’insuline totale plus élevée que les hommes avec la FK, mais à des niveaux comparables aux femmes en santé. Le groupe de tolérance au glucose récemment proposé et nommé indéterminé (INDET : 60-min HGPO > 11.0 mais 2h-HGPO <7.8mmol/L) est à risque élevé de développer le DAFK. Par contre, les caractéristiques cliniques de ce groupe chez les patients adultes avec la FK n’ont pas été établies. Nous avons observé que le groupe INDET a une fonction pulmonaire réduite et similaire au groupe DAFK de novo et aucun des paramètres glucidiques et insulinémiques expliqueraient cette observation. Dans une population pédiatrique de patients avec la FK, une association a été rapportée entre une glycémie élevée à 60-min de l’HGPO et une fonction pulmonaire diminuée. Dans notre groupe de patients adultes avec la FK, il existe une association négative entre la glycémie à 60-min de l’HGPO et la fonction pulmonaire et une corrélation positive entre l’insulinémie à 60-min de l’HGPO et l’indice de masse corporelle (IMC). De plus, les patients avec une glycémie à 60-min HGPO > 11.0 mmol/L ont une fonction pulmonaire diminuée et une sensibilité à l’insuline basse alors que ceux avec une insulinémie à 60-min HGPO < 43.4 μU/mL ont un IMC ainsi qu’une fonction pulmonaire diminués. En conclusion, nous sommes le premier groupe à démontrer que 1) le test d’HGPO peut être raccourci de 30 min sans compromettre la catégorisation de la tolérance au glucose, 2) les femmes avec la FK démontrent une préservation de leur sécrétion de l’insuline, 3) le groupe INDET présente des anomalies précoces de la fonction pulmonaire comparable au groupe DAFK de novo et 4) la glycémie et l’insuline à la première heure de l’HGPO sont associées aux deux éléments clefs de la dégradation clinique. Il est crucial d’élucider les mécanismes pathophysiologiques importants afin de mieux prévoir la survenue de la dégradation clinique précédant le DAFK.

A Diagnostic and Modeling Study on the Onset of Summer Monsoon over South Asia

This study focuses on the onset of southwest monsoon over Kerala. India Meteorological Department (IMD) has been using a semi-objective method to define monsoon onset. The main objectives of the study are to understand the monsoon onset processes, to simulate monsoon onset in a GCM using as input the atmospheric conditions and Sea Surface Temperature, 10 days earlier to the onset, to develop a method for medium range prediction of the date of onset of southwest monsoon over Kerala and to examine the possibility of objectively defining the date of Monsoon Onset over Kerala (MOK). It gives a broad description of regional monsoon systems and monsoon onsets over Asia and Australia. Asian monsoon includes two separate subsystems, Indain monsoon and East Asian monsoon. It is seen from this study that the duration of the different phases of the onset process are dependent on the period of ISO. Based on the study of the monsoon onset process, modeling studies can be done for better understanding of the ocean-atmosphere interaction especially those associated with the warm pool in the Bay of Bengal and the Arabian Sea.

Antibody Based Diagnostic for Detection Of Vibrios and their Biological Control using Antagonistic Bacteria in Macrobrachium Rosenbergii Larval Rearing Systems

The main objective of the work undertaken here was to develop an appropriate microbial technology to protect the larvae of M.rosenbergii in hatchery from vibriosis. This technology precisely is consisted of a rapid detection system of vibrios and effective antagonistic probiotics for the management of vibrios. The present work was undertaken with the realizations that to stabilize the production process of commercial hatcheries an appropriate, comprehensive and fool proof technology is required primarily for the rapid detection of Vibrio and subsequently for its management. Nine species of Vibrio have been found to be associated with larvae of M. rosenbergii in hatchery. Haemolytic assay of the Vibrio and Aeromonas on prawn blood agar showed that all isolates of V. alginolyticus and Aeromonas sp., from moribund, necrotized larve were haemolytic and the isolates of V.cholerae, V.splendidus II, V.proteolyticus and V.fluvialis from the larvae obtained from apparently healthy larval rearing systems were non-haemolytic. Hydrolytic enzymes such as lipase, chitinase and gelatinase were widespread amongst the Vibrio and Aeromonas isolates. Dominance of V.alginolyticus among the isolates from necrotic larvae and the failure in isolating them from rearing water strongly suggest that they infect larvae and multiply in the larval body and cause mortality in the hatchery. The observation suggested that the isolate V. alginolyticus was a pathogen to the larvae of M.rosenbergii. To sum up, through this work, nine species of Vibrio and genus Aeromonas associated with M.rosenbergii larval rearing systems could be isolated and segregated based on the haemolytic activity and the antibodies (PA bs) for use in diagnosis or epidemiological studies could be produced, based on a virulent culture of V.alginolyticus. This could possibly replace the conventional biochemical tests for identification. As prophylaxis to vibriosis, four isolates of Micrococcus spp. and an isolate of Pseudomonas sp. could be obtained which could possibly be used as antagonistic probiotics in the larval rearing system of M.rosenbergii.

Intraseasonal oscillation of total precipitable water over North Indian Ocean and its application in the diagnostic study of coastal rainfall

TRMM Microwave Imager (TMI) is reported to be a useful sensor to measure the atmospheric and oceanic parameters even in cloudy conditions. Vertically integrated specific humidity, Total Precipitable Water (TPW) retrieved from the water vapour absorption channel (22GHz.) along with 10m wind speed and rain rate derived from TMI is used to investigate the moisture variation over North Indian Ocean. Intraseasonal Oscillations (ISO) of TPW during the summer monsoon seasons 1998, 1999, and 2000 over North Indian Ocean is explored using wavelet analysis. The dominant waves in TPW during the monsoon periods and the differences in ISO over Arabian Sea and Bay of Bengal are investigated. The northward propagation of TPW anomaly and its coherence with the coastal rainfall is also studied. For the diagnostic study of heavy rainfall spells over the west coast, the intrusion of TPW over the North Arabian Sea is seen to be a useful tool.

classification and content based retrieval of digital mammograms and placental sonograms

Image processing has been a challenging and multidisciplinary research area since decades with continuing improvements in its various branches especially Medical Imaging. The healthcare industry was very much benefited with the advances in Image Processing techniques for the efficient management of large volumes of clinical data. The popularity and growth of Image Processing field attracts researchers from many disciplines including Computer Science and Medical Science due to its applicability to the real world. In the meantime, Computer Science is becoming an important driving force for the further development of Medical Sciences. The objective of this study is to make use of the basic concepts in Medical Image Processing and develop methods and tools for clinicians’ assistance. This work is motivated from clinical applications of digital mammograms and placental sonograms, and uses real medical images for proposing a method intended to assist radiologists in the diagnostic process. The study consists of two domains of Pattern recognition, Classification and Content Based Retrieval. Mammogram images of breast cancer patients and placental images are used for this study. Cancer is a disaster to human race. The accuracy in characterizing images using simplified user friendly Computer Aided Diagnosis techniques helps radiologists in detecting cancers at an early stage. Breast cancer which accounts for the major cause of cancer death in women can be fully cured if detected at an early stage. Studies relating to placental characteristics and abnormalities are important in foetal monitoring. The diagnostic variability in sonographic examination of placenta can be overlooked by detailed placental texture analysis by focusing on placental grading. The work aims on early breast cancer detection and placental maturity analysis. This dissertation is a stepping stone in combing various application domains of healthcare and technology.

Relativistische vier und zwei Spinor Finite Elemente Berechnungen zweiatomiger Moleküle

Der Vielelektronen Aspekt wird in einteilchenartigen Formulierungen berücksichtigt, entweder in Hartree-Fock Näherung oder unter dem Einschluß der Elektron-Elektron Korrelationen durch die Dichtefunktional Theorie. Da die Physik elektronischer Systeme (Atome, Moleküle, Cluster, Kondensierte Materie, Plasmen) relativistisch ist, habe ich von Anfang an die relativistische 4 Spinor Dirac Theorie eingesetzt, in jüngster Zeit aber, und das wird der hauptfortschritt in den relativistischen Beschreibung durch meine Promotionsarbeit werden, eine ebenfalls voll relativistische, auf dem sogenannten Minimax Prinzip beruhende 2-Spinor Theorie umgesetzt. Im folgenden ist eine kurze Beschreibung meiner Dissertation: Ein wesentlicher Effizienzgewinn in der relativistischen 4-Spinor Dirac Rechnungen konnte durch neuartige singuläre Koordinatentransformationen erreicht werden, so daß sich auch noch für das superschwere Th2 179+ hächste Lösungsgenauigkeiten mit moderatem Computer Aufwand ergaben, und zu zwei weiteren interessanten Veröffentlichungen führten (Publikationsliste). Trotz der damit bereits ermöglichten sehr viel effizienteren relativistischen Berechnung von Molekülen und Clustern blieben diese Rechnungen Größenordnungen aufwendiger als entsprechende nicht-relativistische. Diese behandeln das tatsächliche (relativitische) Verhalten elektronischer Systeme nur näherungsweise richtig, um so besser jedoch, je leichter die beteiligten Atome sind (kleine Kernladungszahl Z). Deshalb habe ich nach einem neuen Formalismus gesucht, der dem möglichst gut Rechnung trägt und trotzdem die Physik richtig relativistisch beschreibt. Dies gelingt durch ein 2-Spinor basierendes Minimax Prinzip: Systeme mit leichten Atomen sind voll relativistisch nunmehr nahezu ähnlich effizient beschrieben wie nicht-relativistisch, was natürlich große Hoffnungen für genaue (d.h. relativistische) Berechnungen weckt. Es ergab sich eine erste grundlegende Veröffentlichung (Publikationsliste). Die Genauigkeit in stark relativistischen Systemen wie Th2 179+ ist ähnlich oder leicht besser als in 4-Spinor Dirac-Formulierung. Die Vorteile der neuen Formulierung gehen aber entscheidend weiter: A. Die neue Minimax Formulierung der Dirac-Gl. ist frei von spuriosen Zuständen und hat keine positronischen Kontaminationen. B. Der Aufwand ist weit reduziert, da nur ein 1/3 der Matrix Elemente gegenüber 4-Spinor noch zu berechnen ist, und alle Matrixdimensionen Faktor 2 kleiner sind. C. Numerisch verhält sich die neue Formulierung ähnlilch gut wie die nichtrelativistische Schrödinger Gleichung (Obwohl es eine exakte Formulierung und keine Näherung der Dirac-Gl. ist), und hat damit bessere Konvergenzeigenschaften als 4-Spinor. Insbesondere die Fehlerwichtung (singulärer und glatter Anteil) ist in 2-Spinor anders, und diese zeigt die guten Extrapolationseigenschaften wie bei der nichtrelativistischen Schrödinger Gleichung. Die Ausweitung des Anwendungsbereichs von (relativistischen) 2-Spinor ist bereits in FEM Dirac-Fock-Slater, mit zwei Beispielen CO und N2, erfolgreich gemacht. Weitere Erweiterungen sind nahezu möglich. Siehe Minmax LCAO Nährung.

Accuracy of outcome anticipation, but not gaze behavior, differs against left- and right-handed penalties in team-handball goalkeeping

Low perceptual familiarity with relatively rarer left-handed as opposed to more common right-handed individuals may result in athletes' poorer ability to anticipate the former's action intentions. Part of such left-right asymmetry in visual anticipation could be due to an inefficient gaze strategy during confrontation with left-handed individuals. To exemplify, observers may not mirror their gaze when viewing left- vs. right-handed actions but preferentially fixate on an opponent's right body side, irrespective of an opponent's handedness, owing to the predominant exposure to right-handed actions. So far empirical verification of such assumption, however, is lacking. Here we report on an experiment where team-handball goalkeepers' and non-goalkeepers' gaze behavior was recorded while they predicted throw direction of left- and right-handed 7-m penalties shown as videos on a computer monitor. As expected, goalkeepers were considerably more accurate than non-goalkeepers and prediction was better against right- than left-handed penalties. However, there was no indication of differences in gaze measures (i.e., number of fixations, overall and final fixation duration, time-course of horizontal or vertical fixation deviation) as a function of skill group or the penalty-takers' handedness. Findings suggest that inferior anticipation of left-handed compared to right-handed individuals' action intentions may not be associated with misalignment in gaze behavior. Rather, albeit looking similarly, accuracy differences could be due to observers' differential ability of picking up and interpreting the visual information provided by left- vs. right-handed movements.

Diagnostic value of the Dominic Interactive Assessment with children exposed to intimate partner violence

Resumen tomado de la publicaci??n

A system to evaluate the accuracy of a visual mosaicking methodology

When underwater vehicles navigate close to the ocean floor, computer vision techniques can be applied to obtain motion estimates. A complete system to create visual mosaics of the seabed is described in this paper. Unfortunately, the accuracy of the constructed mosaic is difficult to evaluate. The use of a laboratory setup to obtain an accurate error measurement is proposed. The system consists on a robot arm carrying a downward looking camera. A pattern formed by a white background and a matrix of black dots uniformly distributed along the surveyed scene is used to find the exact image registration parameters. When the robot executes a trajectory (simulating the motion of a submersible), an image sequence is acquired by the camera. The estimated motion computed from the encoders of the robot is refined by detecting, to subpixel accuracy, the black dots of the image sequence, and computing the 2D projective transform which relates two consecutive images. The pattern is then substituted by a poster of the sea floor and the trajectory is executed again, acquiring the image sequence used to test the accuracy of the mosaicking system

Planar homography: accuracy analysis and applications

Projective homography sits at the heart of many problems in image registration. In addition to many methods for estimating the homography parameters (R.I. Hartley and A. Zisserman, 2000), analytical expressions to assess the accuracy of the transformation parameters have been proposed (A. Criminisi et al., 1999). We show that these expressions provide less accurate bounds than those based on the earlier results of Weng et al. (1989). The discrepancy becomes more critical in applications involving the integration of frame-to-frame homographies and their uncertainties, as in the reconstruction of terrain mosaics and the camera trajectory from flyover imagery. We demonstrate these issues through selected examples

A Novel Breast Tissue Density Classification Methodology

It has been shown that the accuracy of mammographic abnormality detection methods is strongly dependent on the breast tissue characteristics, where a dense breast drastically reduces detection sensitivity. In addition, breast tissue density is widely accepted to be an important risk indicator for the development of breast cancer. Here, we describe the development of an automatic breast tissue classification methodology, which can be summarized in a number of distinct steps: 1) the segmentation of the breast area into fatty versus dense mammographic tissue; 2) the extraction of morphological and texture features from the segmented breast areas; and 3) the use of a Bayesian combination of a number of classifiers. The evaluation, based on a large number of cases from two different mammographic data sets, shows a strong correlation ( and 0.67 for the two data sets) between automatic and expert-based Breast Imaging Reporting and Data System mammographic density assessment

Accuracy estimation of a new omnidirectional 3D vision sensor

We present a computer vision system that associates omnidirectional vision with structured light with the aim of obtaining depth information for a 360 degrees field of view. The approach proposed in this article combines an omnidirectional camera with a panoramic laser projector. The article shows how the sensor is modelled and its accuracy is proved by means of experimental results. The proposed sensor provides useful information for robot navigation applications, pipe inspection, 3D scene modelling etc

Diagnóstico de apendicitis aguda en la edad pedíatrica en la Fundación Cardio Infantil : utilidad de la ultrasonografía

Los niños que presentan dolor abdominal agudo representan una de las principales demandas de atención en los servicios de Urgencias Pediátricas, convirtiéndose en un reto para quien realiza la valoración inicial la decisión de que paciente amerita realizar estudios adicionales, para descartar una patología quirúrgica. Considerando que la apendicitis es la primera emergencia quirúrgica en niños, y que sus complicaciones son un problema frecuente, es imprescindible que el clínico conozca cual es la utilidad y beneficio que le brindan las herramientas diagnósticas disponibles para realizar un diagnóstico más certero. Objetivo: Describir el manejo de los pacientes menores de 18 años con sospecha de apendicitis en la FCI y determinar la sensibilidad y especificidad de la ecografía en esta población. Métodos: Estudio de Prueba Diagnóstica. Revisión expedita de los niños valorados en la FCI con sospecha clínica de apendicitis aguda durante un periodo de 4 meses. Se tomaron datos de hallazgos ecográficos para apendicitis (positivos, negativos o indeterminados) y del desenlace de tener o no apendicitis. Posteriormente se realizó una inferencia mediante una tabla de contingencia, teniendo en cuenta intervalos de confianza para determinar la sensibilidad, especificidad, VPP, VPN y exactitud de la prueba basados en el diagnóstico final. Resultados: En 52% de pacientes que consultaron por dolor abdominal se sospecho patología quirúrgica, grupo en el que se utilizó la ecografía abdominal como herramienta diagnóstica para descartar apendicitis encontrando: sensibilidad: 63%(IC 95%, 48.6-75.5), especificidad: 82,7%(IC 95%, 76- 87.8) y exactitud: 78,2%(IC 95%, 72-83,4). La prevalencia de la enfermedad fue 22,8%, con probabilidad postprueba positiva de 88.3%(IC 95%, 82,1-92.6). Conclusiones: Los resultados de este estudio evidencian un menor rendimiento de la ecografía como prueba diagnóstica para apendicitis en pediatría en nuestro medio comparado al descrito en la literatura. Dicha discordancia probablemente se encuentra determinada por los sesgos propios de un estudio histórico como este, en el que básicamente la falta de uniformidad en el registro de datos en la historia clínica por los observadores (clínicos y radiólogos), así como las limitaciones para determinar el seguimiento de todos los pacientes que no fueron operados, pueden alterar la capacidad operativa real de la prueba. De ahí la importancia de realizar a futuro un estudio concurrente.

Utilidad de la electromiografía de esfínter anal en el diagnóstico diferencial de la atrofia multisistémica: una revisión de la literatura

La atrofia multisistémica (AMS) es una enfermedad degenerativa caracterizada por disautonomías y síntomas extrapiramidales. El diagnóstico diferencial con otros parkinsonismos es difícil, por lo cual se requiere una ayuda paraclínica para soportar el diagnóstico clínico. La degeneración del núcleo de Onuf, exclusiva en esta enfermedad, podría sugerir que la presencia de denervación en el esfínter anal podría ser tomada en cuenta como criterio diagnóstico de AMS. Se realizó una revisión sistemática con el fin de determinar la utilidad de la electromiografía de esfínter anal (EMG-EA) en el diagnóstico diferencial de AMS contra otros parkinsonismos. Se incluyeron 17 estudios que analizaron los resultados de EMG-EA en pacientes con AMS. De éstos, 11 de estudios fueron analíticos y compararon pacientes con AMS y otros parkinsonismos. Los 6 estudios restantes fueron descriptivos. La duración de los potenciales de unidad motora (PUM) es significativamente mayor en pacientes con AMS comparados con otros parkinsonismos, y utilizando un punto de corte > 13 ms muestra características operativas que hacen a este parámetro potencialmente útil. Solo un estudio encontró diferencias significativas en el porcentaje de PUM polifásicos, el cual tuvo una sensibilidad y especificidad clínicamente útil cuando el punto de corte es mayor a 60%. El resto de los estudios no reportan diferencias estadísticamente significativas entre parkinsonismos. La literatura disponible apunta a la potencial utilidad de la EMG-EA en el diagnóstico diferencial de la AMS de otros parkinsonismos; sin embargo es necesario conducir más estudios para solventar las limitaciones metodológicas existentes.