Approches thérapeutiques de la carcinose péritonéale d’origine appendiculaire récidivante

Objectif: Le traitement de la carcinose péritonéale (CP) d’origine appendiculaire récidivante demeure sous-étudié. L’objectif est d’évaluer le traitement à offrir aux patients présentant une récidive de la maladie. Méthodologie: Depuis 2003, les données de tous les patients avec CP d’origine appendiculaire traités dans notre centre ont été recueillies. Le traitement de la maladie primaire consistait en une cytoréduction chirurgicale complète de la CP suivie d’une chimiothérapie hyperthermique intra-péritoneale (CHIP) à l’oxaliplatine. Lors d’une récidive, une deuxième cytoréduction avec une CHIP à la mitomycine C était offerte aux patients rencontrant certains critères de sélection. Résultats: Un total de 58 patients ont subi une cytoréduction complète suivie d’une CHIP avec l’oxaliplatine. Durant la période de suivi, 22 patients démontrèrent une maladie récidivante (39%). Le péritoine était le site de récidive le plus fréquent. Les survies sans maladie étaient statistiquement différentes selon le grade histopathologique et le degré de complétude de la cytoréduction. Parmi ces 22 patients, huit patients ont reçu une deuxième cytoréduction suivie d’une CHIP à la mitomycine C, un patient a subi une cytoréduction complète seule et 13 patients avaient une maladie non résécable. La survie globale moyenne des patients ayant reçu un deuxième traitement fut de 28 mois. Les taux de morbidité et de mortalité suite à une deuxième cytoréduction suivie d’une CHIP furent de 25% et 0%, respectivement. Conclusion: Une cytoréduction suivie d’une CHIP demeure une intervention possible chez les patients qui présentent une maladie récidivante, mais certains critères doivent être appliqués afin de maximiser la survie et minimiser la morbidité et la mortalité de cette approche.

Contributions de la maternité à l'état de santé de femmes vivant avec le VIH

La réalité des femmes vivant avec le VIH (FVVIH) et désireuses d’avoir un enfant soulève un ensemble d’enjeux de santé publique et de promotion de la santé. Les études réalisées jusqu’à maintenant se sont surtout orientées sur les dimensions épidémiologiques et biomédicales de la maternité en contexte de VIH. Peu d’entre elles ont cependant tenu compte des expériences et des besoins du point de vue des FVVIH mais surtout de l’importance et des significations qu’elles accordent à la maternité. Le projet de maternité contribue à leur sens de l’existence et constitue une modalité de transformation du rapport au VIH et d’auto-transcendance. Cette perspective en tant que stratégie de promotion de la santé n’a pas été non plus suffisamment explorée. L’objectif général de cette thèse, à partir d’un cadre théorique fondé sur les approches féministes de la construction sociale de la maternité, des représentations du risque et des stratégies d’adaptation à la maladie, est d’analyser les expériences de maternité chez des FVVIH montréalaises. Au plan méthodologique, cette thèse s’appuie sur l’analyse qualitative secondaire d’entrevues, réalisées auprès de 42 FVVIH d’origine canadienne-française, africaine et haïtienne et recrutées dans des milieux hospitalier et communautaire. Ces entrevues portent sur leurs expériences quotidiennes en relation avec le VIH, leurs enjeux sociaux, leur famille et leurs relations interpersonnelles. Les données ont été analysées et interprétées selon les étapes de la théorie ancrée avec validation inter-juges. Une analyse typologique a aussi été effectuée pour dégager les modèles de maternité présents dans les discours à partir de deux types d’analyses à savoir, la « méthode relationnelle centrée sur la voix » et celle de « la logique d’action ». Trois articles scientifiques, présentant les résultats de l’analyse, ont été soumis. Le premier article décrit les modèles idéologiques de la maternité dans cette population (croissance personnelle ; réalisation sociale ; accomplissement de soi et de complétude) et ses répercussions sur la gestion du VIH (traitements, dévoilement, soins aux enfants). Le second article dégage la manière dont les femmes, selon leur modèle idéologique de la maternité, s’approprient les informations et les conseils provenant des intervenants de la santé et construisent le risque biologique associé à la maternité dans le contexte du VIH. Il cerne aussi les stratégies utilisées pour réaliser leur projet reproductif en conformité ou non avec les injonctions biomédicales. Le troisième article décrit les façons dont le projet de maternité oriente le rapport au VIH, le sens de l’existence et les expériences d’auto-transcendance des femmes (préserver un statut, un rôle et une image sociale ; transformer le rapport à la mort ; faciliter l’acceptation et la transformation du rapport à la maladie ; donner un sens et une direction à l’existence). À partir d’une réflexion sur l’articulation entre les données présentées dans les trois articles, un modèle théorique intégrateur est proposé. Les retombées de cette étude sur la recherche et l’intervention dans une perspective de promotion de la santé sont esquissées. Des pistes de transfert et de partage des connaissances sont aussi proposées.

Fuzzy Topological Games and Related Topics

The main purpose of study is to extend the concept of the topological game G(K, X) and some other kinds of games into fuzzy topological games and to obtain some results regarding them. Owing to the fact that topological games have plenty of applications in covering properties, it made an attempt to explore some inter relations of games and covering properties in fuzzy topological spaces. Even though the main focus is on fuzzy para-meta compact spaces and closure preserving shading families, some brief sketches regarding fuzzy P-spaces and Shading Dimension is also provided. In a topological game players choose some objects related to the topological structure of a space such as points, closed subsets, open covers etc. More over the condition on a play to be winning for a player may also include topological notions such as closure, convergence, etc. It turns out that topological games are related to the Baire property, Baire spaces, Completeness properties, Convergence properties, Separation properties, Covering and Base properties, Continuous images, Suslin sets, Singular spaces etc.

Box Products in Fuzzy Topological Spaces and Related Topics

The topology as the product set with a base chosen as all products of open sets in the individual spaces. This topology is known as box topology. The main objective of this study is to extend the concept of box products to fuzzy box products and to obtain some results regarding them. Owing to the fact that box products have plenty of applications in uniform and covering properties, here made an attempt to explore some inter relations of fuzzy uniform properties and fuzzy covering properties in fuzzy box products. Even though the main focus is on fuzzy box products, some brief sketches regarding hereditarily fuzzy normal spaces and fuzzy nabla product is also provided. The main results obtained include characterization of fuzzy Hausdroffness and fuzzy regularity of box products of fuzzy topological spaces. The investigation of the completeness of fuzzy uniformities in fuzzy box products proved that a fuzzy box product of spaces is fuzzy topologically complete if each co-ordinate space is fuzzy topologically complete. The thesis also prove that the fuzzy box product of a family of fuzzy α-paracompact spaces is fuzzy topologically complete. In Fuzzy box product of hereditarily fuzzy normal spaces, the main result obtained is that if a fuzzy box product of spaces is hereditarily fuzzy normal ,then every countable subset of it is fuzzy closed. It also deals with the notion of fuzzy nabla product of spaces which is a quotient of fuzzy box product. Here the study deals the relation connecting fuzzy box product and fuzzy nabla product

Study on Fuzzy Ordered FuzzyTopological Spaces

In this study we combine the notions of fuzzy order and fuzzy topology of Chang and define fuzzy ordered fuzzy topological space. Its various properties are analysed. Product, quotient, union and intersection of fuzzy orders are introduced. Besides, fuzzy order preserving maps and various fuzzy completeness are investigated. Finally an attempt is made to study the notion of generalized fuzzy ordered fuzzy topological space by considering fuzzy order defined on a fuzzy subset.

“Improved Feature Extraction and Classification Techniques for Multispectral Brain Magnetic Resonance Images”

Magnetic Resonance Imaging (MRI) is a multi sequence medical imaging technique in which stacks of images are acquired with different tissue contrasts. Simultaneous observation and quantitative analysis of normal brain tissues and small abnormalities from these large numbers of different sequences is a great challenge in clinical applications. Multispectral MRI analysis can simplify the job considerably by combining unlimited number of available co-registered sequences in a single suite. However, poor performance of the multispectral system with conventional image classification and segmentation methods makes it inappropriate for clinical analysis. Recent works in multispectral brain MRI analysis attempted to resolve this issue by improved feature extraction approaches, such as transform based methods, fuzzy approaches, algebraic techniques and so forth. Transform based feature extraction methods like Independent Component Analysis (ICA) and its extensions have been effectively used in recent studies to improve the performance of multispectral brain MRI analysis. However, these global transforms were found to be inefficient and inconsistent in identifying less frequently occurred features like small lesions, from large amount of MR data. The present thesis focuses on the improvement in ICA based feature extraction techniques to enhance the performance of multispectral brain MRI analysis. Methods using spectral clustering and wavelet transforms are proposed to resolve the inefficiency of ICA in identifying small abnormalities, and problems due to ICA over-completeness. Effectiveness of the new methods in brain tissue classification and segmentation is confirmed by a detailed quantitative and qualitative analysis with synthetic and clinical, normal and abnormal, data. In comparison to conventional classification techniques, proposed algorithms provide better performance in classification of normal brain tissues and significant small abnormalities.

Translation Invariance in Object Recognition, and Its Relation to Other Visual Transformations

Human object recognition is generally considered to tolerate changes of the stimulus position in the visual field. A number of recent studies, however, have cast doubt on the completeness of translation invariance. In a new series of experiments we tried to investigate whether positional specificity of short-term memory is a general property of visual perception. We tested same/different discrimination of computer graphics models that were displayed at the same or at different locations of the visual field, and found complete translation invariance, regardless of the similarity of the animals and irrespective of direction and size of the displacement (Exp. 1 and 2). Decisions were strongly biased towards same decisions if stimuli appeared at a constant location, while after translation subjects displayed a tendency towards different decisions. Even if the spatial order of animal limbs was randomized ("scrambled animals"), no deteriorating effect of shifts in the field of view could be detected (Exp. 3). However, if the influence of single features was reduced (Exp. 4 and 5) small but significant effects of translation could be obtained. Under conditions that do not reveal an influence of translation, rotation in depth strongly interferes with recognition (Exp. 6). Changes of stimulus size did not reduce performance (Exp. 7). Tolerance to these object transformations seems to rely on different brain mechanisms, with translation and scale invariance being achieved in principle, while rotation invariance is not.

A prediction model for establishing the disability degree in adults with spinal cord injury: results based on WHO-DAS II perspective

Objective: To establish a prediction model of the degree of disability in adults with Spinal CordInjury (SCI ) based on the use of the WHO-DAS II . Methods: The disability degree was correlatedwith three variable groups: clinical, sociodemographic and those related with rehabilitation services.A model of multiple linear regression was built to predict disability. 45 people with sci exhibitingdiverse etiology, neurological level and completeness participated. Patients were older than 18 andthey had more than a six-month post-injury. The WHO-DAS II and the ASIA impairment scale(AIS ) were used. Results: Variables that evidenced a significant relationship with disability were thefollowing: occupational situation, type of affiliation to the public health care system, injury evolutiontime, neurological level, partial preservation zone, ais motor and sensory scores and number ofclinical complications during the last year. Complications significantly associated to disability werejoint pain, urinary infections, intestinal problems and autonomic disreflexia. None of the variablesrelated to rehabilitation services showed significant association with disability. The disability degreeexhibited significant differences in favor of the groups that received the following services: assistivedevices supply and vocational, job or educational counseling. Conclusions: The best predictiondisability model in adults with sci with more than six months post-injury was built with variablesof injury evolution time, AIS sensory score and injury-related unemployment.

Non-commutative symbolic coding

We give a non-commutative generalization of classical symbolic coding in the presence of a synchronizing word. This is done by a scattering theoretical approach. Classically, the existence of a synchronizing word turns out to be equivalent to asymptotic completeness of the corresponding Markov process. A criterion for asymptotic completeness in general is provided by the regularity of an associated extended transition operator. Commutative and non-commutative examples are analysed.

A simple variance formula for population size estimators by conditioning

This note considers the variance estimation for population size estimators based on capture–recapture experiments. Whereas a diversity of estimators of the population size has been suggested, the question of estimating the associated variances is less frequently addressed. This note points out that the technique of conditioning can be applied here successfully which also allows us to identify sources of variation: the variance due to estimation of the model parameters and the binomial variance due to sampling n units from a population of size N. It is applied to estimators typically used in capture–recapture experiments in continuous time including the estimators of Zelterman and Chao and improves upon previously used variance estimators. In addition, knowledge of the variances associated with the estimators by Zelterman and Chao allows the suggestion of a new estimator as the weighted sum of the two. The decomposition of the variance into the two sources allows also a new understanding of how resampling techniques like the Bootstrap could be used appropriately. Finally, the sample size question for capture–recapture experiments is addressed. Since the variance of population size estimators increases with the sample size, it is suggested to use relative measures such as the observed-to-hidden ratio or the completeness of identification proportion for approaching the question of sample size choice.

A simple variance formula for population size estimators by conditioning

This note considers the variance estimation for population size estimators based on capture–recapture experiments. Whereas a diversity of estimators of the population size has been suggested, the question of estimating the associated variances is less frequently addressed. This note points out that the technique of conditioning can be applied here successfully which also allows us to identify sources of variation: the variance due to estimation of the model parameters and the binomial variance due to sampling n units from a population of size N. It is applied to estimators typically used in capture–recapture experiments in continuous time including the estimators of Zelterman and Chao and improves upon previously used variance estimators. In addition, knowledge of the variances associated with the estimators by Zelterman and Chao allows the suggestion of a new estimator as the weighted sum of the two. The decomposition of the variance into the two sources allows also a new understanding of how resampling techniques like the Bootstrap could be used appropriately. Finally, the sample size question for capture–recapture experiments is addressed. Since the variance of population size estimators increases with the sample size, it is suggested to use relative measures such as the observed-to-hidden ratio or the completeness of identification proportion for approaching the question of sample size choice.

Techniques for analysis of proteins by SDS-polyacrylamide gel electrophoresis and Western blotting

The separation of mixtures of proteins by SDS-polyacrylamide gel electrophoresis (SDS-PAGE) is a technique that is widely used—and, indeed, this technique underlies many of the assays and analyses that are described in this book. While SDS-PAGE is routine in many labs, a number of issues require consideration before embarking on it for the first time. We felt, therefore, that in the interest of completeness of this volume, a brief chapter describing the basics of SDS-PAGE would be helpful. Also included in this chapter are protocols for the staining of SDS-PAGE gels to visualize separated proteins, and for the electrotransfer of proteins to a membrane support (Western blotting) to enable immunoblotting, for example. This chapter is intended to complement the chapters in this book that require these techniques to be performed. Therefore, detailed examples of why and when these techniques could be used will not be discussed here.

Integrative workflow-embedded support for process automation and management

This paper presents the on-going research performed in order to integrate process automation and process management support in the context of media production. This has been addressed on the basis of a holistic approach to software engineering applied to media production modelling to ensure design correctness, completeness and effectiveness. The focus of the research and development has been to enhance the metadata management throughout the process in a similar fashion to that achieved in Decision Support Systems (DSS) to facilitate well-grounded business decisions. The paper sets out the aims and objectives and the methodology deployed. The paper describes the solution in some detail and sets out some preliminary conclusions and the planned future work.

A new RBF neural network with boundary value constraints

We present a novel topology of the radial basis function (RBF) neural network, referred to as the boundary value constraints (BVC)-RBF, which is able to automatically satisfy a set of BVC. Unlike most existing neural networks whereby the model is identified via learning from observational data only, the proposed BVC-RBF offers a generic framework by taking into account both the deterministic prior knowledge and the stochastic data in an intelligent manner. Like a conventional RBF, the proposed BVC-RBF has a linear-in-the-parameter structure, such that it is advantageous that many of the existing algorithms for linear-in-the-parameters models are directly applicable. The BVC satisfaction properties of the proposed BVC-RBF are discussed. Finally, numerical examples based on the combined D-optimality-based orthogonal least squares algorithm are utilized to illustrate the performance of the proposed BVC-RBF for completeness.

Generalized neurofuzzy network modeling algorithms using Bezier-Bernstein polynomial functions and additive decomposition

This paper introduces a new neurofuzzy model construction algorithm for nonlinear dynamic systems based upon basis functions that are Bezier-Bernstein polynomial functions. This paper is generalized in that it copes with n-dimensional inputs by utilising an additive decomposition construction to overcome the curse of dimensionality associated with high n. This new construction algorithm also introduces univariate Bezier-Bernstein polynomial functions for the completeness of the generalized procedure. Like the B-spline expansion based neurofuzzy systems, Bezier-Bernstein polynomial function based neurofuzzy networks hold desirable properties such as nonnegativity of the basis functions, unity of support, and interpretability of basis function as fuzzy membership functions, moreover with the additional advantages of structural parsimony and Delaunay input space partition, essentially overcoming the curse of dimensionality associated with conventional fuzzy and RBF networks. This new modeling network is based on additive decomposition approach together with two separate basis function formation approaches for both univariate and bivariate Bezier-Bernstein polynomial functions used in model construction. The overall network weights are then learnt using conventional least squares methods. Numerical examples are included to demonstrate the effectiveness of this new data based modeling approach.