Update on the non-prewhitening model observer in computed tomography for the assessment of the adaptive statistical and model-based iterative reconstruction algorithms.

The state of the art to describe image quality in medical imaging is to assess the performance of an observer conducting a task of clinical interest. This can be done by using a model observer leading to a figure of merit such as the signal-to-noise ratio (SNR). Using the non-prewhitening (NPW) model observer, we objectively characterised the evolution of its figure of merit in various acquisition conditions. The NPW model observer usually requires the use of the modulation transfer function (MTF) as well as noise power spectra. However, although the computation of the MTF poses no problem when dealing with the traditional filtered back-projection (FBP) algorithm, this is not the case when using iterative reconstruction (IR) algorithms, such as adaptive statistical iterative reconstruction (ASIR) or model-based iterative reconstruction (MBIR). Given that the target transfer function (TTF) had already shown it could accurately express the system resolution even with non-linear algorithms, we decided to tune the NPW model observer, replacing the standard MTF by the TTF. It was estimated using a custom-made phantom containing cylindrical inserts surrounded by water. The contrast differences between the inserts and water were plotted for each acquisition condition. Then, mathematical transformations were performed leading to the TTF. As expected, the first results showed a dependency of the image contrast and noise levels on the TTF for both ASIR and MBIR. Moreover, FBP also proved to be dependent of the contrast and noise when using the lung kernel. Those results were then introduced in the NPW model observer. We observed an enhancement of SNR every time we switched from FBP to ASIR to MBIR. IR algorithms greatly improve image quality, especially in low-dose conditions. Based on our results, the use of MBIR could lead to further dose reduction in several clinical applications.

On the path integral formulation and the evaluation of quantum statistical averages

Four problems of physical interest have been solved in this thesis using the path integral formalism. Using the trigonometric expansion method of Burton and de Borde (1955), we found the kernel for two interacting one dimensional oscillators• The result is the same as one would obtain using a normal coordinate transformation, We next introduced the method of Papadopolous (1969), which is a systematic perturbation type method specifically geared to finding the partition function Z, or equivalently, the Helmholtz free energy F, of a system of interacting oscillators. We applied this method to the next three problems considered• First, by summing the perturbation expansion, we found F for a system of N interacting Einstein oscillators^ The result obtained is the same as the usual result obtained by Shukla and Muller (1972) • Next, we found F to 0(Xi)f where A is the usual Tan Hove ordering parameter* The results obtained are the same as those of Shukla and Oowley (1971), who have used a diagrammatic procedure, and did the necessary sums in Fourier space* We performed the work in temperature space• Finally, slightly modifying the method of Papadopolous, we found the finite temperature expressions for the Debyecaller factor in Bravais lattices, to 0(AZ) and u(/K/ j,where K is the scattering vector* The high temperature limit of the expressions obtained here, are in complete agreement with the classical results of Maradudin and Flinn (1963) .

Système de listes de vérification interactives du niveau de conformité des maquettes avec les recommandations des fabricants de plateformes mobiles

L'ensemble de mon travail a été réalisé grâce a l'utilisation de logiciel libre.

Development of a Real-time Formative Feedback Student Response System

This paper is focusing IT-supported real-time formative feedback in a classroom context. The development of a Student and Teacher Response System (STRS) is described. Since there are a number of obstacles for effective interaction in large classes, IT can be used to support the teachers aim to find out if students understand the lecture and accordingly adjust the content and design of the lecture. The system can be used for formative assessment before, during, and after a lecture. It is also possible for students to initiate interaction during lectures by posing questions anonymously. The main contributions of the paper are a) the description of the interactive real-time system and b) the development process behind it.

Discrimination of media moments and media intervals: sticker-based watch-and-comment annotation

In this paper we discuss the problem of how to discriminate moments of interest on videos or live broadcast shows. The primary contribution is a system which allows users to personalize their programs with previously created media stickers-pieces of content that may be temporarily attached to the original video. We present the system's architecture and implementation, which offer users operators to transparently annotate videos while watching them. We offered a soccer fan the opportunity to add stickers to the video while watching a live match: the user reported both enjoying and being comfortable using the stickers during the match-relevant results even though the experience was not fully representative.

Analyzing smooth flowcharts : teaching structured programming in a computer-based education environment /

Vita.

The brief encounter review : an investigation in graphic computer-based medical record reporting systems /

Bibliography: p. 85.

ROBOCAR : educating the layman in computer science /

Originally presented as the author's thesis (M.A.), University of Illinois at Urbana-Champaign.

Mipomersen, an apolipoprotein B synthesis inhibitor, for lowering of LDL cholesterol concentrations in patients with homozygous familial hypercholesterolaemia: a randomised, double-blind, placebo-controlled trial

Background Homozygous familial hypercholesterolaemia is a rare genetic disorder in which both LDL-receptor alleles are defective, resulting in very high concentrations of LDL cholesterol in plasma and premature coronary artery disease. This study investigated whether an antisense inhibitor of apolipoprotein B synthesis, mipomersen, is effective and safe as an adjunctive agent to lower LDL cholesterol concentrations in patients with this disease. Methods This randomised, double-blind, placebo-controlled, phase 3 study was undertaken in nine lipid clinics in seven countries. Patients aged 12 years and older with clinical diagnosis or genetic confirmation of homozygous familial hypercholesterolaemia, who were already receiving the maximum tolerated dose of a lipid-lowering drug, were randomly assigned to mipomersen 200 mg subcutaneously every week or placebo for 26 weeks. Randomisation was computer generated and stratified by weight (<50 kg vs >= 50 kg) in a centralised blocked randomisation, implemented with a computerised interactive voice response system. All clinical, medical, and pharmacy personnel, and patients were masked to treatment allocation. The primary endpoint was percentage change in LDL cholesterol concentration from baseline. Analysis was by intention to treat. This trial is registered with ClinicalTrials.gov, number NCT00607373. Findings 34 patients were assigned to mipomersen and 17 to placebo; data for all patients were analysed. 45 patients completed the 26-week treatment period (28 mipomersen, 17 placebo). Mean concentrations of LDL cholesterol at baseline were 11.4 mmol/L (SD 3.6) in the mipomersen group and 10.4 mmol/L (3.7) in the placebo group. The mean percentage change in LDL cholesterol concentration was significantly greater with mipomersen (-24.7%, 95% CI 31.6 to 17.7) than with placebo (-3.3%, 12.1 to 5.5; p=0.0003). The most common adverse events were injection-site reactions (26 [76%] patients in mipomersen group vs four [24%] in placebo group). Four (12%) patients in the mipomersen group but none in the placebo group had increases in concentrations of alanine aminotransferase of three times or more the upper limit of normal. Interpretation Inhibition of apolipoprotein B synthesis by mipomersen represents a novel, effective therapy to reduce LDL cholesterol concentrations in patients with homozygous familial hypercholesterolaemia who are already receiving lipid-lowering drugs, including high-dose statins.

Cilengitide combined with standard treatment for patients with newly diagnosed glioblastoma with methylated MGMT promoter (CENTRIC EORTC 26071-22072 study): a multicentre, randomised, open-label, phase 3 trial.

BACKGROUND: Cilengitide is a selective αvβ3 and αvβ5 integrin inhibitor. Data from phase 2 trials suggest that it has antitumour activity as a single agent in recurrent glioblastoma and in combination with standard temozolomide chemoradiotherapy in newly diagnosed glioblastoma (particularly in tumours with methylated MGMT promoter). We aimed to assess cilengitide combined with temozolomide chemoradiotherapy in patients with newly diagnosed glioblastoma with methylated MGMT promoter. METHODS: In this multicentre, open-label, phase 3 study, we investigated the efficacy of cilengitide in patients from 146 study sites in 25 countries. Eligible patients (newly diagnosed, histologically proven supratentorial glioblastoma, methylated MGMT promoter, and age ≥18 years) were stratified for prognostic Radiation Therapy Oncology Group recursive partitioning analysis class and geographic region and centrally randomised in a 1:1 ratio with interactive voice response system to receive temozolomide chemoradiotherapy with cilengitide 2000 mg intravenously twice weekly (cilengitide group) or temozolomide chemoradiotherapy alone (control group). Patients and investigators were unmasked to treatment allocation. Maintenance temozolomide was given for up to six cycles, and cilengitide was given for up to 18 months or until disease progression or unacceptable toxic effects. The primary endpoint was overall survival. We analysed survival outcomes by intention to treat. This study is registered with ClinicalTrials.gov, number NCT00689221. FINDINGS: Overall, 3471 patients were screened. Of these patients, 3060 had tumour MGMT status tested; 926 patients had a methylated MGMT promoter, and 545 were randomly assigned to the cilengitide (n=272) or control groups (n=273) between Oct 31, 2008, and May 12, 2011. Median overall survival was 26·3 months (95% CI 23·8-28·8) in the cilengitide group and 26·3 months (23·9-34·7) in the control group (hazard ratio 1·02, 95% CI 0·81-1·29, p=0·86). None of the predefined clinical subgroups showed a benefit from cilengitide. We noted no overall additional toxic effects with cilengitide treatment. The most commonly reported adverse events of grade 3 or worse in the safety population were lymphopenia (31 [12%] in the cilengitide group vs 26 [10%] in the control group), thrombocytopenia (28 [11%] vs 46 [18%]), neutropenia (19 [7%] vs 24 [9%]), leucopenia (18 [7%] vs 20 [8%]), and convulsion (14 [5%] vs 15 [6%]). INTERPRETATION: The addition of cilengitide to temozolomide chemoradiotherapy did not improve outcomes; cilengitide will not be further developed as an anticancer drug. Nevertheless, integrins remain a potential treatment target for glioblastoma. FUNDING: Merck KGaA, Darmstadt, Germany.

Effect of interleukin-6 receptor inhibition with tocilizumab in patients with rheumatoid arthritis (OPTION study): a double-blind, placebo-controlled, randomised trial.

BACKGROUND: Interleukin 6 is involved in the pathogenesis of rheumatoid arthritis via its broad effects on immune and inflammatory responses. Our aim was to assess the therapeutic effects of blocking interleukin 6 by inhibition of the interleukin-6 receptor with tocilizumab in patients with rheumatoid arthritis. METHODS: In this double-blind, randomised, placebo-controlled, parallel group phase III study, 623 patients with moderate to severe active rheumatoid arthritis were randomly assigned with an interactive voice response system, stratified by site with a randomisation list provided by the study sponsor, to receive tocilizumab 8 mg/kg (n=205), tocilizumab 4 mg/kg (214), or placebo (204) intravenously every 4 weeks, with methotrexate at stable pre-study doses (10-25 mg/week). Rescue therapy with tocilizumab 8 mg/kg was offered at week 16 to patients with less than 20% improvement in both swollen and tender joint counts. The primary endpoint was the proportion of patients with 20% improvement in signs and symptoms of rheumatoid arthritis according to American College of Rheumatology criteria (ACR20 response) at week 24. Analyses were by intention to treat. This trial is registered with ClinicalTrials.gov, number NCT00106548. FINDINGS: The intention-to-treat analysis population consisted of 622 patients: one patient in the 4 mg/kg group did not receive study treatment and was thus excluded. At 24 weeks, ACR20 responses were seen in more patients receiving tocilizumab than in those receiving placebo (120 [59%] patients in the 8 mg/kg group, 102 [48%] in the 4 mg/kg group, 54 [26%] in the placebo group; odds ratio 4.0 [95% CI 2.6-6.1], p<0.0001 for 8 mg/kg vs placebo; and 2.6 [1.7-3.9], p<0.0001 for 4 mg/kg vs placebo). More people receiving tocilizumab than those receiving placebo had at least one adverse event (143 [69%] in the 8 mg/kg group; 151 [71%] in the 4 mg/kg group; 129 [63%] in the placebo group). The most common serious adverse events were serious infections or infestations, reported by six patients in the 8 mg/kg group, three in the 4 mg/kg group, and two in the placebo group. INTERPRETATION: Tocilizumab could be an effective therapeutic approach in patients with moderate to severe active rheumatoid arthritis. FUNDING: F Hoffmann-La Roche, Chugai Pharmaceutical.

Fraud detection in the banking sector : a multi-agent approach

Fraud is an increasing phenomenon as shown in many surveys carried out by leading international consulting companies in the last years. Despite the evolution of electronic payments and hacking techniques there is still a strong human component in fraud schemes. Conflict of interest in particular is the main contributing factor to the success of internal fraud. In such cases anomaly detection tools are not always the best instruments, since the fraud schemes are based on faking documents in a context dominated by lack of controls, and the perpetrators are those ones who should control possible irregularities. In the banking sector audit team experts can count only on their experience, whistle blowing and the reports sent by their inspectors. The Fraud Interactive Decision Expert System (FIDES), which is the core of this research, is a multi-agent system built to support auditors in evaluating suspicious behaviours and to speed up the evaluation process in order to detect or prevent fraud schemes. The system combines Think-map, Delphi method and Attack trees and it has been built around audit team experts and their needs. The output of FIDES is an attack tree, a tree-based diagram to ”systematically categorize the different ways in which a system can be attacked”. Once the attack tree is built, auditors can choose the path they perceive as more suitable and decide whether or not to start the investigation. The system is meant for use in the future to retrieve old cases in order to match them with new ones and find similarities. The retrieving features of the system will be useful to simplify the risk management phase, since similar countermeasures adopted for past cases might be useful for present ones. Even though FIDES has been built with the banking sector in mind, it can be applied in all those organisations, like insurance companies or public organizations, where anti-fraud activity is based on a central anti-fraud unit and a reporting system.

Yleislääkärin vastaanottotapahtuma - näkökulmia laatuun

Tutkimuksen tavoitteena oli tutkia yleislääkärin vastaanottotapahtuman laadun eri ulottuvuuksia, erityisesti lääkärin ja potilaan arvioita vastaanottotapahtuman laadusta, sekä verrata näitä arvioita keskenään. Lisäksi tarkoituksena oli tutkia palkkausjärjestelmän yhteyttä laatuun sekä löytää sopivia välineitä yleislääkärin vastaanottotapahtuman laadun arviointiin. Tutkimuksessa käytettiin triangulaatiota sekä materiaalien, tutkijoiden että menetelmien osalta. Materiaali koostui kyselylomakkeista (2191 vastaanottotapahtumaa, 2167 lääkärin lomaketta ja 1777 potilaan lomaketta), potilasasiakirjoista (n=175) ja vastaanottotapahtumien videoinneista (n=20). Analyysissä käytettiin sekä kvantitatiivisia että kvalitatiivisia menetelmiä. Laatu koostuu tässä tutkimuksessa tieteellisteknisestä/ammatillisesta osaamisesta, vuorovaikutustaidoista ja taloudellisesta laadusta. Kaikki osatekijät olivat kyselylomaketutkimuksen perusteella varsin hyviä, ja potilaat arvioivat laadun kaikki osatekijät paremmiksi kuin lääkärit. Potilaiden selviytyminen ja voimaantuminen vastaanottotapahtuman jälkeen oli parempaa, mikäli he pitivät vuorovaikutuksen laatua hyvänä ja lääkäriä omalääkärinään. Kyselylomaketutkimus antoi laadusta kuitenkin positiivisemman kuvan kuin tutkijoiden potilasasiakirjojen ja videointien avulla tekemät arviot. Potilasasiakirjat oli laadittu puutteellisesti ja potilasasiakirjajärjestelmät vaikuttivat postilaisasiakirjojen laatuun. Tutkijoiden arvioimana lääkäreiden vuorovaikutustaidot olivat keskimäärin tyydyttävät. Lääkärin virkaehtosopimus ei näyttänyt vaikuttavan potilaan kokemaan laatuun, mutta väestövastuulääkärit kokivat sekä oman työnsä ammatillisen laadun että vuorovaikutustaitonsa paremmaksi kuin muut lääkärit. Väestövastuuterveyskeskuksissa myös hoidon jatkuvuus ja potilaan valinnanvapaus näyttivät toteutuvan muita terveyskeskuksia paremmin. Yleislääkärin työn laadun arviointiin tarvitaan useita menetelmiä. Potilasasiakirjajärjestelmien tulisi olla helppokäyttöisiä, interaktiivisia ja tietoa automaattisesti kerääviä, jotta niistä saataisiin luotettavaa tietoa laadun arvioimiseksi. Lääkärin työn itsearviointia on edelleen tutkittava ja kehitettävä.

La migration de retour de la population italienne immigrée au Canada et en Belgique

Thèse numérisée par la Division de la gestion de documents et des archives de l'Université de Montréal

A multimedia environment for supporting the teaching of robotics systems

This paper aims at describing an educational system for teaching and learning robotic systems. Multimedia resources were used to construct a virtual laboratory where users are able to use functionalities of a virtual robotic arm, by moving and clicking the mouse without caring about the detailed internal robot operation. Moreover through the multimedia system the user can interact with a real robot arm. The engineering students are the target public of the developed system. With its contents and interactive capabilities, it has been used as a support to the traditional face-to-face classes on the subject of robotics.. In the paper it is first introduced the metaphor of Virtual Laboratory used in the system. Next, it is described the Graphical and Multimedia Environment approach: an interactive graphic user interface with a 3D environment for simulation. Design and implementation issues of the real-time interactive multimedia learning system, which supports the W3C SMIL standard for presenting the real-time multimedia teaching material, are described. Finally, some preliminary conclusions and possible future works from this research are presented.