Efficacy of Preoperative Chemotherapy in Treatment of Children With Wilms’ Tumor: A Meta-Analysis

Context: To assess the efficacy of preoperative chemotherapy in Wilms’ tumor patients and explore its true value for specific subgroups. Objectives: In the presence of these controversies, a meta-analysis that examines the efficacy of preoperative chemotherapy in Wilms’ tumor patients and specific subgroups is needed to clarify these issues. The objective of this meta-analysis is to assess the efficacy of preoperative chemotherapy in Wilms’ tumor patients and explore its true value for specific subgroups. Data Sources: Computer-based systematic search with “preoperative chemotherapy”, “Neoadjuvant Therapy” and “Wilms’ tumor” as search terms till January 2013 was performed. Study Selection: No language restrictions were applied. Searches were limited to randomized clinical trials (RCTs) or retrospective studies in human participants under 18 years. A manual examination of references in selected articles was also performed. Data Extraction: Relative Risk (RR) and their 95% Confidence Interval (CI) for Tumor Shrinkage (TS), total Tumor Resection (TR), Event-Free Survival (EFS) and details of subgroup analysis were extracted. Meta-analysis was carried out with the help of the software STATA 11.0. Finally, four original Randomized Clinical Trials (RCTs) and 28 retrospective studies with 2375 patients were included. Results: For preoperative chemotherapy vs. up-front surgery (PC vs. SU) group, the pooled RR was 9.109 for TS (95% CI: 5.109 - 16.241; P < 0.001), 1.291 for TR (95% CI: 1.124 - 1.483; P < 0.001) and 1.101 for EFS (95% CI: 0.980 - 1.238; P = 0.106). For subgroup short course vs. long course (SC vs. LC), the pooled RR was 1.097 for TS (95% CI: 0.784 - 1.563; P = 0.587), 1.197 for TR (95% CI: 0.960 - 1.493; P = 0.110) and 1.006 for EFS (95% CI: 0.910 - 1.250; P = 0.430). Conclusions: Short course preoperative chemotherapy is as effective as long course and preoperative chemotherapy only benefits Wilms’ tumor patients in tumor shrinkage and resection but not event-free survival.

Learning data-driven models of non-verbal behaviors for building rapport using an intelligent virtual agent

There is a growing societal need to address the increasing prevalence of behavioral health issues, such as obesity, alcohol or drug use, and general lack of treatment adherence for a variety of health problems. The statistics, worldwide and in the USA, are daunting. Excessive alcohol use is the third leading preventable cause of death in the United States (with 79,000 deaths annually), and is responsible for a wide range of health and social problems. On the positive side though, these behavioral health issues (and associated possible diseases) can often be prevented with relatively simple lifestyle changes, such as losing weight with a diet and/or physical exercise, or learning how to reduce alcohol consumption. Medicine has therefore started to move toward finding ways of preventively promoting wellness, rather than solely treating already established illness.^ Evidence-based patient-centered Brief Motivational Interviewing (BMI) interventions have been found particularly effective in helping people find intrinsic motivation to change problem behaviors after short counseling sessions, and to maintain healthy lifestyles over the long-term. Lack of locally available personnel well-trained in BMI, however, often limits access to successful interventions for people in need. To fill this accessibility gap, Computer-Based Interventions (CBIs) have started to emerge. Success of the CBIs, however, critically relies on insuring engagement and retention of CBI users so that they remain motivated to use these systems and come back to use them over the long term as necessary.^ Because of their text-only interfaces, current CBIs can therefore only express limited empathy and rapport, which are the most important factors of health interventions. Fortunately, in the last decade, computer science research has progressed in the design of simulated human characters with anthropomorphic communicative abilities. Virtual characters interact using humans’ innate communication modalities, such as facial expressions, body language, speech, and natural language understanding. By advancing research in Artificial Intelligence (AI), we can improve the ability of artificial agents to help us solve CBI problems.^ To facilitate successful communication and social interaction between artificial agents and human partners, it is essential that aspects of human social behavior, especially empathy and rapport, be considered when designing human-computer interfaces. Hence, the goal of the present dissertation is to provide a computational model of rapport to enhance an artificial agent’s social behavior, and to provide an experimental tool for the psychological theories shaping the model. Parts of this thesis were already published in [LYL+12, AYL12, AL13, ALYR13, LAYR13, YALR13, ALY14].^

Analys av NIR hårdvaruuppsättning samt metod för fotografering av individer i fordon

Abstract Purpose – To study the possibility of using a NIR hardware solution to photograph individuals in a private vehicle as well as an analysis of its images. Method – A study of existing theories around the NIR-method’s performance in selected conditions and individual tests were performed to examine if the literature statements were valid for this study. Two empirical tests have been carried out, the first was carried out at Kapsch test track and the other outside the test track in a single stationary test. An interview which formed the basis for the assessment on the quality of empirical data with a focus on computer-based detection of the number of individuals in the vehicle. Findings – The results have demonstrated the potential of the NIR method’s performance in a fully automated detection system for the number of individuals inside the vehicle. Empirical data indicates that the method can depict individuals inside vehicles of sufficiently high quality, but it is greatly affected by reflections, weather and light conditions. Implications – Result supports the assumption that the NIR method using an external light source can be used to image the interior through a varying number of weather and lightning conditions. The study originated until the results suggested that a NIR-based hardware setup can create images with high enough quality for the human eye to be able to detect the number of individuals inside the vehicle.If the overall performance into account, it suggests that the main problem with the use of the hardware set is to maintain the quality of the whole sample and that the crucial variables for the method’s performance is the influence of light and reflection conditions. Limitations – The major limitations have been that we limited ourselves to a subjective analysis of the selection and assessment on the image features for computer-based detection of the number of individuals in the vehicle. We were limited to two tests, one in tough conditions where only the driver was in the vehicle and the second stationary test, where the focus was on the number of people in vehicles and light sources impact on the result.

Relación entre atrofia cortical difusa y desempeño cognitivo : estudio en población mayor de 60 años en un hospital universitario en la ciudad de Bogotá

El presente trabajo tuvo como objetivo evaluar la existencia de la relación entre la atrofia cortical difusa objetivada por neuroimagenes cerebrales y desempeños cognitivos determinados mediante la aplicación de pruebas neuropsicológicas que evalúan memoria de trabajo, razonamiento simbólico verbal y memoria anterógrada declarativa. Participaron 114 sujetos reclutados en el Hospital Universitario Mayor Méderi de la ciudad de Bogotá mediante muestreo de conveniencia. Los resultados arrojaron diferencias significativas entre los dos grupos (pacientes con diagnóstico de atrofia cortical difusa y pacientes con neuroimagenes interpretadas como dentro de los límites normales) en todas las pruebas neuropsicológicas aplicadas. Respecto a las variables demográficas se pudo observar que el grado de escolaridad contribuye como factor neuroprotector de un posible deterioro cognitivo. Tales hallazgos son importantes para determinar protocoles tempranos de detección de posible instalación de enfermedades neurodegenerativas primarias.

The nature of communication structures of university students in an international web-based computer-supported collaborative learning (CSCL) course

Communication, the flow of ideas and information between individuals in a social context, is the heart of educational experience. Constructivism and constructivist theories form the foundation for the collaborative learning processes of creating and sharing meaning in online educational contexts. The Learning and Collaboration in Technology-enhanced Contexts (LeCoTec) course comprised of 66 participants drawn from four European universities (Oulu, Turku, Ghent and Ramon Llull). These participants were split into 15 groups with the express aim of learning about computer-supported collaborative learning (CSCL). The Community of Inquiry model (social, cognitive and teaching presences) provided the content and tools for learning and researching the collaborative interactions in this environment. The sampled comments from the collaborative phase were collected and analyzed at chain-level and group-level, with the aim of identifying the various message types that sustained high learning outcomes. Furthermore, the Social Network Analysis helped to view the density of whole group interactions, as well as the popular and active members within the highly collaborating groups. It was observed that long chains occur in groups having high quality outcomes. These chains were also characterized by Social, Interactivity, Administrative and Content comment-types. In addition, high outcomes were realized from the high interactive cases and high-density groups. In low interactive groups, commenting patterned around the one or two central group members. In conclusion, future online environments should support high-order learning and develop greater metacognition and self-regulation. Moreover, such an environment, with a wide variety of problem solving tools, would enhance interactivity.

Legal LEGO: Model based computer assisted teaching in evidence courses

This paper describes the development of a new approach to the use of ICT for the teaching of courses in the interpretation and evaluation of evidence. It is based on ideas developed for the teaching of science to school children, in particular the importance of models and qualitative reasoning skills. In the first part, we make an analysis of the basis of current research into “evidence scholarship” and the demands such a system would have to meet. In the second part, we introduce the details of such a system that we developed initially to assist police in the interpretation of evidence.

An esthetics rehabilitation with computer-aided design/ computer-aided manufacturing technology

This paper describes a case of a rehabilitation involving Computer Aided Design/Computer Aided Manufacturing (CAD-CAM) system in implant supported and dental supported prostheses using zirconia as framework. The CAD-CAM technology has developed considerably over last few years, becoming a reality in dental practice. Among the widely used systems are the systems based on zirconia which demonstrate important physical and mechanical properties of high strength, adequate fracture toughness, biocompatibility and esthetics, and are indicated for unitary prosthetic restorations and posterior and anterior framework. All the modeling was performed by using CAD-CAM system and prostheses were cemented using resin cement best suited for each situation. The rehabilitation of the maxillary arch using zirconia framework demonstrated satisfactory esthetic and functional results after a 12-month control and revealed no biological and technical complications. This article shows the important of use technology CAD/CAM in the manufacture of dental prosthesis and implant-supported.

Computer game-based and traditional learning method: a comparison regarding students’ knowledge retention

Abstract Background Educational computer games are examples of computer-assisted learning objects, representing an educational strategy of growing interest. Given the changes in the digital world over the last decades, students of the current generation expect technology to be used in advancing their learning requiring a need to change traditional passive learning methodologies to an active multisensory experimental learning methodology. The objective of this study was to compare a computer game-based learning method with a traditional learning method, regarding learning gains and knowledge retention, as means of teaching head and neck Anatomy and Physiology to Speech-Language and Hearing pathology undergraduate students. Methods Students were randomized to participate to one of the learning methods and the data analyst was blinded to which method of learning the students had received. Students’ prior knowledge (i.e. before undergoing the learning method), short-term knowledge retention and long-term knowledge retention (i.e. six months after undergoing the learning method) were assessed with a multiple choice questionnaire. Students’ performance was compared considering the three moments of assessment for both for the mean total score and for separated mean scores for Anatomy questions and for Physiology questions. Results Students that received the game-based method performed better in the pos-test assessment only when considering the Anatomy questions section. Students that received the traditional lecture performed better in both post-test and long-term post-test when considering the Anatomy and Physiology questions. Conclusions The game-based learning method is comparable to the traditional learning method in general and in short-term gains, while the traditional lecture still seems to be more effective to improve students’ short and long-term knowledge retention.

Computer-assisted, fluoroscopy-based ventral spondylodesis of thoracolumbar fractures

OBJECTIVE: To design and evaluate a novel computer-assisted, fluoroscopy-based planning and navigation system for minimally invasive ventral spondylodesis of thoracolumbar fractures. MATERIALS AND METHODS: Instruments and an image intensifier are tracked with the SurgiGATE navigation system (Praxim-Medivision). Two fluoroscopic images, one acquired from anterior-posterior (AP) direction and the other from lateral-medial (LM) direction, are used for the complete procedure of planning and navigation. Both of them are calibrated with a custom-made software to recover their projection geometry and to co-register them to a common patient reference coordinate system, which is established by attaching an opto-electronically trackable dynamic reference base (DRB) on the operated vertebra. A bi-planar landmark reconstruction method is used to acquire deep-seated anatomical landmarks such that an intraoperative planning of graft bed can be interactively done. Finally, surgical actions such as the placement of the stabilization devices and the formation of the graft bed using a custom-made chisel are visualized to the surgeon by superimposing virtual instrument representations onto the acquired images. The distance between the instrument tip and each wall of the planned graft bed are calculated on the fly and presented to the surgeon so that the surgeon could formalize the graft bed exactly according to his/her plan. RESULTS: Laboratory studies on phantom and on 27 plastic vertebras demonstrate the high precision of the proposed navigation system. Compared with CT-based measurement, a mean error of 1.0 mm with a standard deviation of 0.1 mm was found. CONCLUSIONS: The proposed computer assisted, fluoroscopy-based planning and navigation system promises to increase the accuracy and reliability of minimally invasive ventral spondylodesis of thoracolumbar fractures.

Computer Vision-Based Carbohydrate Estimation for Type 1 Diabetic Patients Using Smartphones

Background: Individuals with type 1 diabetes (T1D) have to count the carbohydrates (CHOs) of their meal to estimate the prandial insulin dose needed to compensate for the meal’s effect on blood glucose levels. CHO counting is very challenging but also crucial, since an error of 20 grams can substantially impair postprandial control. Method: The GoCARB system is a smartphone application designed to support T1D patients with CHO counting of nonpacked foods. In a typical scenario, the user places a reference card next to the dish and acquires 2 images with his/her smartphone. From these images, the plate is detected and the different food items on the plate are automatically segmented and recognized, while their 3D shape is reconstructed. Finally, the food volumes are calculated and the CHO content is estimated by combining the previous results and using the USDA nutritional database. Results: To evaluate the proposed system, a set of 24 multi-food dishes was used. For each dish, 3 pairs of images were taken and for each pair, the system was applied 4 times. The mean absolute percentage error in CHO estimation was 10 ± 12%, which led to a mean absolute error of 6 ± 8 CHO grams for normal-sized dishes. Conclusion: The laboratory experiments demonstrated the feasibility of the GoCARB prototype system since the error was below the initial goal of 20 grams. However, further improvements and evaluation are needed prior launching a system able to meet the inter- and intracultural eating habits.

A Survey on FPGA-Based Sensor Systems: Towards Intelligent and Reconfigurable Low-Power Sensors for Computer Vision, Control and Signal Processing

The current trend in the evolution of sensor systems seeks ways to provide more accuracy and resolution, while at the same time decreasing the size and power consumption. The use of Field Programmable Gate Arrays (FPGAs) provides specific reprogrammable hardware technology that can be properly exploited to obtain a reconfigurable sensor system. This adaptation capability enables the implementation of complex applications using the partial reconfigurability at a very low-power consumption. For highly demanding tasks FPGAs have been favored due to the high efficiency provided by their architectural flexibility (parallelism, on-chip memory, etc.), reconfigurability and superb performance in the development of algorithms. FPGAs have improved the performance of sensor systems and have triggered a clear increase in their use in new fields of application. A new generation of smarter, reconfigurable and lower power consumption sensors is being developed in Spain based on FPGAs. In this paper, a review of these developments is presented, describing as well the FPGA technologies employed by the different research groups and providing an overview of future research within this field.

The impact of computer display height and desk design on 3D posture during information technology work by young adults

Computer display height and desk design to allow forearm support are two critical design features of workstations for information technology tasks. However there is currently no 3D description of head and neck posture with different computer display heights and no direct comparison to paper based information technology tasks. There is also inconsistent evidence on the effect of forearm support on posture and no evidence on whether these features interact. This study compared the 3D head, neck and upper limb postures of 18 male and 18 female young adults whilst working with different display and desk design conditions. There was no substantial interaction between display height and desk design. Lower display heights increased head and neck flexion with more spinal asymmetry when working with paper. The curved desk, designed to provide forearm support, increased scapula elevation/protraction and shoulder flexion/abduction.

A practical system for hands-off computer interaction based on electromyogram (EMG)/eye gaze tracking (EGT)

Effective interaction with personal computers is a basic requirement for many of the functions that are performed in our daily lives. With the rapid emergence of the Internet and the World Wide Web, computers have become one of the premier means of communication in our society. Unfortunately, these advances have not become equally accessible to physically handicapped individuals. In reality, a significant number of individuals with severe motor disabilities, due to a variety of causes such as Spinal Cord Injury (SCI), Amyothrophic Lateral Sclerosis (ALS), etc., may not be able to utilize the computer mouse as a vital input device for computer interaction. The purpose of this research was to further develop and improve an existing alternative input device for computer cursor control to be used by individuals with severe motor disabilities. This thesis describes the development and the underlying principle for a practical hands-off human-computer interface based on Electromyogram (EMG) signals and Eye Gaze Tracking (EGT) technology compatible with the Microsoft Windows operating system (OS). Results of the software developed in this thesis show a significant improvement in the performance and usability of the EMG/EGT cursor control HCI.

Creating Partnerships: Computer Training with Assistive Technology for Senior Adults

Currently, at the SC Commission for the Blind, there is no opportunity for computer training for adults in the Older Blind Program. The Older Blind Program has to look for outside partners to make this service viable again. This project proposes that the OB Program partner with regional senior and recreation centers to establish a community-based training program that is both effective and is of minimal cost to the agency and to the partnering centers.

Interdisciplinary project-based learning: technology for improving student cognition

The article studies a way of enhancing student cognition by using interdisciplinary project-based learning (IPBL) in a higher education institution. IPBL is a creative pedagogic approach allowing students of one area of specialisation to develop projects for students with different academic profiles. The application of this approach in the Ural State University of Economics resulted in a computer-assisted learning system (CALS) designed by IT students. The CALS was used in an analytical chemistry course with students majoring in Commodities Management and Expertise (‘expert’ students). To test how effective the technology was, the control and experimental groups were formed. In the control group, learning was done with traditional methods. In the experimental group, it was reinforced by IPBL. A statistical analysis of the results, with an application of Pearson χ 2 test, showed that the cognitive levels in both IT and ‘expert’ experimental groups improved as compared with the control groups. The findings demonstrated that IPBL can significantly enhance learning. It can be implemented in any institution of higher or secondary education that promotes learning, including the CALS development and its use for solving problems in different subject areas.