Une nouvelle méthode pour estimer la torsion géométrique en scoliose idiopathique de l’adolescent

La scoliose idiopathique de l’adolescent (SIA) est une déformation tridimensionnelle (3D) de la colonne vertébrale. Pour la plupart des patients atteints de SIA, aucun traitement chirurgical n’est nécessaire. Lorsque la déformation devient sévère, un traitement chirurgical visant à réduire la déformation est recommandé. Pour déterminer la sévérité de la SIA, l’imagerie la plus utilisée est une radiographie postéroantérieure (PA) ou antéro-postérieure (AP) du rachis. Plusieurs indices sont disponibles à partir de cette modalité d’imagerie afin de quantifier la déformation de la SIA, dont l’angle de Cobb. La conduite thérapeutique est généralement basée sur cet indice. Cependant, les indices disponibles à cette modalité d’imagerie sont de nature bidimensionnelle (2D). Celles-ci ne décrivent donc pas entièrement la déformation dans la SIA dû à sa nature tridimensionnelle (3D). Conséquemment, les classifications basées sur les indices 2D souffrent des mêmes limitations. Dans le but décrire la SIA en 3D, la torsion géométrique a été étudiée et proposée par Poncet et al. Celle-ci mesure la tendance d’une courbe tridimensionnelle à changer de direction. Cependant, la méthode proposée est susceptible aux erreurs de reconstructions 3D et elle est calculée localement au niveau vertébral. L’objectif de cette étude est d’évaluer une nouvelle méthode d’estimation de la torsion géométrique par l’approximation de longueurs d’arcs locaux et par paramétrisation de courbes dans la SIA. Une première étude visera à étudier la sensibilité de la nouvelle méthode présentée face aux erreurs de reconstructions 3D du rachis. Par la suite, deux études cliniques vont présenter la iv torsion géométrique comme indice global et viseront à démontrer l’existence de sous-groupes non-identifiés dans les classifications actuelles et que ceux-ci ont une pertinence clinique. La première étude a évalué la robustesse de la nouvelle méthode d’estimation de la torsion géométrique chez un groupe de patient atteint de la SIA. Elle a démontré que la nouvelle technique est robuste face aux erreurs de reconstructions 3D du rachis. La deuxième étude a évalué la torsion géométrique utilisant cette nouvelle méthode dans une cohorte de patient avec des déformations de type Lenke 1. Elle a démontré qu’il existe deux sous-groupes, une avec des valeurs de torsion élevées et l’autre avec des valeurs basses. Ces deux sous-groupes possèdent des différences statistiquement significatives, notamment au niveau du rachis lombaire avec le groupe de torsion élevée ayant des valeurs d’orientation des plans de déformation maximales (PMC) en thoraco-lombaire (TLL) plus élevées. La dernière étude a évalué les résultats chirurgicaux de patients ayant une déformation Lenke 1 sous-classifiées selon les valeurs de torsion préalablement. Cette étude a pu démontrer des différences au niveau du PMC au niveau thoraco-lombaire avec des valeurs plus élevées en postopératoire chez les patients ayant une haute torsion. Ces études présentent une nouvelle méthode d’estimation de la torsion géométrique et présentent cet indice quantitativement. Elles ont démontré l’existence de sous-groupes 3D basés sur cet indice ayant une pertinence clinique dans la SIA, qui n’étaient pas identifiés auparavant. Ce projet contribue dans la tendance actuelle vers le développement d’indices 3D et de classifications 3D pour la scoliose idiopathique de l’adolescent.

Russian army justifies its reforms. OSW Commentary No. 109, 2013-06-25

The Armed Forces of the Russian Federation have been more active than usual since mid- -February this year, holding a number of previously unannounced military exercises aimed at testing combat readiness. They have also maintained, for many months, a Russian warship task force in the Mediterranean in connection with the civil war in Syria. Those activities stand out of the usual training routine of the Russian army. They have no precedent in Russia’s recent history in terms of the size of the forces involved, the measures employed, the territorial span, the number of exercises, or the scheduling and mode of carrying out the drills. The last combat-readiness tests on this scale were carried out by the Soviet army in the 1980s. The intensity of the Russian Navy’s activities in the Mediterranean and the military means engaged are comparable, in due proportion, with the activities of the Soviet fleet during the Vietnam war. The Russian leadership, including president Vladimir Putin, has been directly following the recent activities of the Russian Armed Forces and their evolution.

Flashlight Europe N°7–09 July 2015. Greece After the Referendum: Three Possible Scenarios for the Euro Area

About ten days ago Alexis Tsipras, the Greek prime minister, announced that there was going to be a referendum, and thus terminated the negotiations on a new rescue package unilaterally. Since then the euro area has been plunged into a wholly unprecedented political crisis. Whether or not Greece can re-main in the monetary union is more uncertain than ever, and decisions that can give a new twist to the political and financial situation are being made almost every day. The Greek banks have been closed for over a week. The economic data are deteriorating rapidly. And yet a solution is nowhere to be seen. The No vote in the Greek referendum has not exactly improved the chances of reaching an agree-ment. For the time being the positions seem to have become uncompromising. At the summit of the heads of state and government on 7 July the Greek government was given five days and a “final deadline” in order to come up with viable proposals for reform. Thus the next few days are of crucial im-portance. At the weekend the heads of state and government of all 28 EU member states are going to meet in order to decide the future of Greece. This flashlight europe provides an overview of the events of the last few days, outlines possible scenarios for what may happen in the near future, and identifies factors which may exert an influence in the short term. We are not trying to give an exact forecast or to formulate action recommendations. But we are trying to shed some light on a confusing situation by identifying important patterns and some of the salient factors.

Cautious and rotational – US military engagement on NATO’s eastern flank. OSW Commentary NUMBER 216 | 05.07.2016

The Russian annexation of Crimea in 2014 put a stop to the gradual scaling down of US military engagement in Europe, a policy that the United States had pursued since the end of the Cold War. The Russian-Ukrainian conflict became a watershed for the US perceptions of European security as Washington started to see the threat of a conflict between Russia and a NATO member as more probable. The United States decided that – despite the mounting challenges in the Pacific region and its involvement in conflicts in the Middle East – it had to invest more in European security. The US has stepped up the intensity of joint drills with the allies and the activities of its forces in Europe. However, its support for the allies has been subject to various limitations and should be treated as a political signal to Moscow, rather than an element in a broader strategy. The future of the policy of strengthening the eastern flank will depend on the outcome of the US presidential elections in November and on developments in the bilateral relations between Washington and Moscow.

Eleven little pictures.

Mode of access: Internet.

Arts revealed, and universal guide : containing many rare and invaluable recipes and directions for the use of families, from the best authorities.

Includes sections on household hints, etiquette, needlework, home remedies, medicinal plants, diseases in children, first aid, and cake baking. Sample recipes: Common twist or cough candy, Crullers, Rich bride cake.

The works of Charles Dickens,

Title-pages in red and black.

Encyclopædia of agriculture by the most eminent authorities.

I. Aberdeen-Angus cattle to drains.--II. Drills to joint-ill.--III. Kainit to Zelkova.--IV. Calendar of operations. Tables of manures, feeding stuffs, weights and measures and other matters. Statutes and statutory orders relating to agriculture. Coloured plates of animal anatomy, and an index to this and the preceding three volumes.

Works of Charles Dickens.

Illustrations by G. Cattermole, H.K. Browne, F. Walker, George Cruikshank, Marcus Stone, John Leech, D. Maclise, Frank Stone, J. Tenniel, C. Stanfield and S. Eytinge, Jr.

Deep hole drilling ...

Introduction.--Principles of deep hold drilling, by L.G. French and C.L. Goodrich.--Deep hold drilling in gun construction, by J.M.B. Scheele.--Construction of deep hole drills, by F.B. Kleinhans, O. Eckelt, and E.W. Norton.

Wide-awakes hand book : Manual of drill, portraits of candidates, and instructions for forming political clubs and companies /

Poll sheets, 9 blank pages at end.

Aanteekeningen betreffende eene reis door de Molukken in de maanden September en October 1855.

Includes tables.

Horse-hoeing husbandry; or, an essay on the principles of vegetation and tillage : designed to introduce a new method of culture, whereby the produce of land will be increased, and the usual expence lessened : together with accurate descriptions and cuts of the instruments employed in it /

Goldsmiths'-Kress no. 08603.

The theory and practice of the drill husbandry : founded upon philosophical principles, and confirmed by experience /

"Illustrated with exact drawings of all the respective parts, and a perspective view of each machine compleat, on nine copper plates, whereby every farmer will be enabled to make his own drill machines."

[Works. Illustrated library edition]

[1] American notes for general circulation, and Pictures from Italy.--[2] Barnaby Rudge.--[3] Barnaby Rudge and Hard times.--[4-5] Bleak house.--[6] A child's history of England.--[7] Christmas books.--[8] Christmas stories from "Household words" and "All the year round".--[9-10] The personal history of David Copperfield.--[11-12] Dombey and son.--[13] The mystery of Edwin Drood, and other stories.--[14] Great expectations.--[15-16] Little Dorrit.--[17-18] The life and adventures of Martin Chuzzlewit.--[19-20] The life and adventures of Nicholas Nickleby.--[21] The old curiosity shop.--[22] The old curiosity shop and Reprinted pieces.--[23] The adventures of Oliver Twist.--[24-25] Our mutual friend.--[26-27] The posthumous papers of the Pickwick Club.--[28] Sketches by Boz.--[29] A tale of two cities.--[30] The uncommercial traveller.