La différence dans les performances visuo-spatiales des résidents en chirurgie et celles d'un groupe contrôle

Mémoire numérisé par la Direction des bibliothèques de l'Université de Montréal.

The Burden of Burnout: An Assessment of Burnout Among Internal Medicine Residents After the 2011 Duty Hour Changes.

This study sought to determine burnout prevalence and factors associated with burnout in internal medicine residents after introduction of the 2011 ACGME duty hour rules. Burnout was evaluated using an anonymized, abbreviated version of the Maslach Burnout Inventory. Surveys were collected biweekly for 48 weeks during the 2013-2014 academic year. Burnout severity was compared across subgroups and time. A score of 3 or higher signified burnout. Overall, 944 of 3936 (24%) surveys were completed. The mean burnout score across all surveys was 2.8. Categorical residents had higher burnout severity than noncategorical residents (2.9 vs 2.7, P = .005). Postgraduate year 2 residents had the highest burnout severity by year (3.1, P < .001). Residents on inpatient rotations had higher burnout severity than residents on outpatient or consultation rotations (3.1 vs 2.2 vs 2.2, P < .001). Night float rotations had the highest severity (3.8). Burnout remains a significant problem even with recent duty hour modifications.

Ordered magnetic dipoles: controlling anisotropy in nanomodulated continuous ferromagnetic films

In this paper, the research focus is how to entangle magnetic dipoles to control/engineer magnetic properties of different devices at a submicron/nano scale. Here, we report the generation of synthetic arrays of tunable magnetic dipoles in a nanomodulated continuous ferromagnetic film. In-plane magnetic field rotations in modulated Ni 45Fe 55 revealed various rotational symmetries of magnetic anisotropy due to dipolar interaction with a crossover from lower to higher fold as a function of modulation geometry. Additionally, the effect of aspect ratio on symmetry shows a novel phase shift of anisotropy, which could be critical to manipulate the overall magnetic properties of the patterned film. The tendency to form vortex is in fact found to be very small, which highlights that the strong coupling between metastable dipoles is more favorable than vortex formation to minimize energy in this nanomodulated structure. This has further been corroborated by the observation of step hysteresis, magnetic force microscopy images of tunable magnetic dipoles, and quantitative micromagnetic simulations. An analytical expression has been derived to estimate the overall anisotropy accurately for nanomodulated film having low magnetocrystaline anisotropy. Derived mathematical expressions based on magnetic dipolar interaction are found to be in good agreement with our results.

Open-source virtual bronchoscopy for image guided navigation

This thesis describes the development of an open-source system for virtual bronchoscopy used in combination with electromagnetic instrument tracking. The end application is virtual navigation of the lung for biopsy of early stage cancer nodules. The open-source platform 3D Slicer was used for creating freely available algorithms for virtual bronchscopy. Firstly, the development of an open-source semi-automatic algorithm for prediction of solitary pulmonary nodule malignancy is presented. This approach may help the physician decide whether to proceed with biopsy of the nodule. The user-selected nodule is segmented in order to extract radiological characteristics (i.e., size, location, edge smoothness, calcification presence, cavity wall thickness) which are combined with patient information to calculate likelihood of malignancy. The overall accuracy of the algorithm is shown to be high compared to independent experts' assessment of malignancy. The algorithm is also compared with two different predictors, and our approach is shown to provide the best overall prediction accuracy. The development of an airway segmentation algorithm which extracts the airway tree from surrounding structures on chest Computed Tomography (CT) images is then described. This represents the first fundamental step toward the creation of a virtual bronchoscopy system. Clinical and ex-vivo images are used to evaluate performance of the algorithm. Different CT scan parameters are investigated and parameters for successful airway segmentation are optimized. Slice thickness is the most affecting parameter, while variation of reconstruction kernel and radiation dose is shown to be less critical. Airway segmentation is used to create a 3D rendered model of the airway tree for virtual navigation. Finally, the first open-source virtual bronchoscopy system was combined with electromagnetic tracking of the bronchoscope for the development of a GPS-like system for navigating within the lungs. Tools for pre-procedural planning and for helping with navigation are provided. Registration between the lungs of the patient and the virtually reconstructed airway tree is achieved using a landmark-based approach. In an attempt to reduce difficulties with registration errors, we also implemented a landmark-free registration method based on a balanced airway survey. In-vitro and in-vivo testing showed good accuracy for this registration approach. The centreline of the 3D airway model is extracted and used to compensate for possible registration errors. Tools are provided to select a target for biopsy on the patient CT image, and pathways from the trachea towards the selected targets are automatically created. The pathways guide the physician during navigation, while distance to target information is updated in real-time and presented to the user. During navigation, video from the bronchoscope is streamed and presented to the physician next to the 3D rendered image. The electromagnetic tracking is implemented with 5 DOF sensing that does not provide roll rotation information. An intensity-based image registration approach is implemented to rotate the virtual image according to the bronchoscope's rotations. The virtual bronchoscopy system is shown to be easy to use and accurate in replicating the clinical setting, as demonstrated in the pre-clinical environment of a breathing lung method. Animal studies were performed to evaluate the overall system performance.

La différence dans les performances visuo-spatiales des résidents en chirurgie et celles d'un groupe contrôle

Mémoire numérisé par la Direction des bibliothèques de l'Université de Montréal.

Strength of the Iberian intraplate lithosphere: Cenozoic deformations and seismicity

Previous studies about the strength of the lithosphere in the Iberia centre fail to resolve the depth of earthquakes because of the rheological uncertainties. Therefore, new contributions are considered (the crustal structure from a density model) and several parameters (tectonic regime, mantle rheology, strain rate) are checked in this paper to properly examine the role of lithospheric strength in the intraplate seismicity and the Cenozoic evolution. The strength distribution with depth, the integrated strength, the effective elastic thickness and the seismogenic thickness have been calculated by a finite element modelling of the lithosphere across the Central System mountain range and the bordering Duero and Madrid sedimentary basins. Only a dry mantle under strike-slip/extension and a strain rate of 10-15 s-1, or under extension and 10-16 s-1, causes a strong lithosphere. The integrated strength and the elastic thickness are lower in the mountain chain than in the basins. These anisotropies have been maintained since the Cenozoic and determine the mountain uplift and the biharmonic folding of the Iberian lithosphere during the Alpine deformations. The seismogenic thickness bounds the seismic activity in the upper–middle crust, and the decreasing crustal strength from the Duero Basin towards the Madrid Basin is related to a parallel increase in Plio–Quaternary deformations and seismicity. However, elasto–plastic modelling shows that current African–Eurasian convergence is resolved elastically or ductilely, which accounts for the low seismicity recorded in this region.

The Electoral Rise of Populist Radical Right Parties in Europe: Ideological Parameters and Social Motivations

Populist radical right parties have become major political actors in Europe. This paper analyses the path and the different phases that have led them from the fringes of public debate to their present signifi cance, which is based on their capacity to attract electoral support and infl uence the political agendas in their respective countries. Besides, an analysis of the core ideological beliefs of these parties, and of the topics on which their mobilization capacity rests, is provided, as well as of the type of voters that are attracted by them. Finally, the authors discuss the meaning and impact of the growing popularity of the ideas and proposals put forward by the populist radical right parties.

Una planta sin clásicos. La berenjena en la farmacología medieval y renacentista

La berenjena (Solanum melongena L.) es una planta solanácea de múltiples variedades, cuyos ancestros salvajes se sitúan en Indochina y el este de África. Su cultivo fue muy temprano en zonas de China e India. Aun así, no se extendió al Occidente antiguo ni apenas se conoció, de ahí su ausencia en los textos clásicos de botánica y farmacología. Fueron los árabes quienes llevaron el cultivo de la planta por el Norte de África y Al-Andalus, de donde pasó ya a Europa. Los primeros testimonios occidentales de la berenjena aparecen en traducciones latinas de textos árabes, para incorporarse luego a la literatura farmacológica medieval y, más tarde ya, a la del Renacimiento, que empezó a tratar de ella por su posible parecido con una especie de mandrágora. Pese a que se le reconocían algunas virtudes medicinales, siempre se la tuvo bajo sospecha por ser de sabor poco agradable, indigesta y causante de algunas afecciones. Solo los botánicos de finales del Renacimiento describirían la planta y sus variedades con criterios más «científicos» y botánicos, ya sin apenas intereses farmacológicos.

U.S. wildfire governance as social-ecological problem

There are fundamental spatial and temporal disconnects between the specific policies that have been crafted to address our wildfire challenges. The biophysical changes in fuels, wildfire behavior, and climate have created a new set of conditions for which our wildfire governance system is poorly suited to address. To address these challenges, a reorientation of goals is needed to focus on creating an anticipatory wildfire governance system focused on social and ecological resilience. Key characteristics of this system could include the following: (1) not taking historical patterns as givens; (2) identifying future social and ecological thresholds of concern; (3) embracing diversity/heterogeneity as principles in ecological and social responses; and (4) incorporating learning among different scales of actors to create a scaffolded learning system.

Some results on orbifold quotients and related objects

The quotient of a finite-dimensional Euclidean space by a finite linear group inherits different structures from the initial space, e.g. a topology, a metric and a piecewise linear structure. The question when such a quotient is a manifold leads to the study of finite groups generated by reflections and rotations, i.e. by orthogonal transformations whose fixed point subspace has codimension one or two. We classify such groups and thereby complete earlier results by M. A. Mikhaîlova from the 70s and 80s. Moreover, we show that a finite group is generated by reflections and) rotations if and only if the corresponding quotient is a Lipschitz-, or equivalently, a piecewise linear manifold (with boundary). For the proof of this statement we show in addition that each piecewise linear manifold of dimension up to four on which a finite group acts by piecewise linear homeomorphisms admits a compatible smooth structure with respect to which the group acts smoothly. This solves a challenge by Thurston and confirms a conjecture by Kwasik and Lee. In the topological category a counterexample to the above mentioned characterization is given by the binary icosahedral group. We show that this is the only counterexample up to products. In particular, we answer the question by Davis of when the underlying space of an orbifold is a topological manifold. As a corollary of our results we generalize a fixed point theorem by Steinberg on unitary reflection groups to finite groups generated by reflections and rotations. As an application thereof we answer a question by Petrunin on quotients of spheres.

Fusional vergence measurements for eso versus exo deviations: is there a difference?

Purpose: The aims of this study were to compare angle of deviation, fusional vergence measurements and fusion reserve ratio between esophoria and exophoria. Methods: A cross-sectional study was performed in children with best-corrected visual acuity of 0.0 LogMAR in either eye, compensated heterophoria within 10 prism dioptres (PD), full ocular rotations, presence of fusional vergence and stereopsis (60 seconds of arc or better). Fusional amplitudes were compared between angle of deviation (2, 4, 6, 8 and 10 PD) in esophoria and exophoria. The fusion reserve ratio was calculated (to assess the effect of the underlying angle of deviation) as fusional convergence divided by prism alternating cover test measurements. Results: Two-hundred and eleven children (7.65±1.16 years) were recruited to this study. Exophoria was most common for near (n=181; 85.8%) and distance (n=20; 9.5%). Esophoria was present in 22 children for near (10.4%) and in 1 child for distance (0.5%). No significant differences were found between fusional amplitudes and angle of deviation for near (p>0.05). Children with exophoria of 10PD had a slight, but not, significant (p=0.264) increase in fusional convergence from 2PD (19.95±5.09) to 10PD (26.67±5.77). In esophoric children the variation of fusional convergence was smaller from 2P (25.00±0.00) to 10PD (22.50±3.54) and non significant (p=0.185). The fusion reserve ratio was significantly smaller in children with higher deviations (i.e. 10PD) for both esophoria (p=0.003) and exophoria (p>0.001). The fusion reserve ratio ranged between 12.50 (2PD) and 2.25±0.35 (10PD) for esophoria and between 9.98±2.55 (2PD) and 2.67±0.58 (10PD) for exophoria. Conclusions: Angle of deviation is not an efficient measure to predict fusional amplitudes. The fusion reserve ratio appears to be a better measurement to assess the effect of the underlying angle of deviation on fusional convergence. More studies are necessary to understand better the relationship between fusion amplitudes and angle of deviation.

BYGUM – a new tool for BarnYard Grass Understanding and Management

Weed management has become increasingly challenging for cotton growers in Australia in the last decade. Glyphosate, the cornerstone of weed management in the industry, is waning in effectiveness as a result of the evolution of resistance in several species. One of these, awnless barnyard grass, is very common in Australian cotton fields, and is a prime example of the new difficulties facing growers in choosing effective and affordable management strategies. RIM (Ryegrass Integrated Management) is a computer-based decision support tool developed for the south-western Australian grains industry. It is commonly used there as a tool for grower engagement in weed management thinking and strategy development. We used RIM as the basis for a new tool that can fulfil the same types of functions for subtropical Australian cotton-grains farming systems. The new tool, BYGUM, provides growers with a robust means to evaluate five-year rotations including testing the economic value of fallows and fallow weed management, winter and summer cropping, cover crops, tillage, different herbicide options, herbicide resistance management, and more. The new model includes several northernregion- specific enhancements: winter and summer fallows, subtropical crop choices, barnyard grass seed bank, competition, and ecology parameters, and more freedom in weed control applications. We anticipate that BYGUM will become a key tool for teaching and driving the changes that will be needed to maintain sound weed management in cotton in the near future.

Biomechanics of the trunk and lower limbs during gait in individuals with and without chronic low back pain

Combining information on kinetics and kinematics of the trunk during gait is important for both clinical and research purposes, since it can help in better understanding the mechanisms behind changes in movement patterns in chronic low back pain patients. Although three-dimensional gait analysis has been used to evaluate chronic low back pain and healthy individuals, the reliability and measurement error of this procedure have not been fully established. The main purpose of this thesis is to gain a better understanding about the differences in the biomechanics of the trunk and lower limbs during gait, in patients and healthy individuals. To achieve these aims, three studies were developed. The first two, adopted a prospective design and focused on the reliability and measurement error of gait analysis. In these test-retest studies, chronic low back pain and healthy individuals were submitted to a gait assessment protocol, with two distinct evaluation moments, separated by one week. Gait data was collected using a 13-camera opto-electronic system and three force platforms. Data analysis included the computation of time-distance parameters, as well as the peak values for lower limb and trunk joint angles/moments. The third study followed a cross sectional design, where gait in chronic low back pain individuals was compared with matched controls. Step-to-step variability of the thoracic, lumbar and hips was calculated, and step-to-step deviations of these segments from their average pattern (residual rotations) were correlated to each other. The reliability studies in this thesis show that three-dimensional gait analysis is a reliable and consistent procedure for both chronic low back pain and healthy individuals. The results suggest varied reliability indices for multi-segment trunk joint angles, joint moments and time-distance parameters during gait, together with an acceptable level of error (particularly regarding sagittal plane). Our findings also show altered stride-to-stride variability of lumbar and thoracic segments and lower trunk joint moments in patients. These kinematic and kinetic results lend support to the notion that chronic low back pain individuals exhibit a protective movement strategy.

ADVANCED COMPUTATIONAL MODELING OF THE INTERNAL STRUCTURE OF SMART WIND-TURBINE BLADES

Implementation of stable aeroelastic models with the ability to capture the complex features of Multi concept smartblades is a prime step in reducing the uncertainties that come along with blade dynamics. The numerical simulations of fluid structure interaction can thus be used to test a realistic scenarios comprising of full-scale blades at a reasonably low computational cost. A code which was a combination of two advanced numerical models was designed and was run with the help of paralell HPC supercomputer platform. The first model was based on a variation of dimensional reduction technique proposed by Hodges and Yu. This model was the one to record the structural response of heterogenous composite blades. This technique reduces the geometrical complexities of the heterogenous blade section into a stiffness matrix for an equivalent beam. This derived equivalent 1-D strain energy matrix is similar to the actual 3-D strain energy matrix in an asymptotic sense. As this 1-D matrix helps in accurately modeling the blade structure as a 1-D finite element problem, this substantially redues the computational effort and subsequently the computational cost that are required to model the structural dynamics at each step. Second model comprises of implementation of the Blade Element Momentum Theory. In this approach we map all the velocities and the forces with the help of orthogonal matrices that help in capturing the large deformations and the effects of rotations in calculating the aerodynamic forces. This ultimately helps us to take into account the complex flexo torsional deformations. In this thesis we have succesfully tested these computayinal tools developed by MTU’s research team lead by for the aero elastic analysis of wind-turbine blades. The validation in this thesis is majorly based on several experiments done on NREL-5MW blade, as this is widely accepted as a benchmark blade in the wind industry. Along with the use of this innovative model the internal blade structure was also changed to add up to the existing benefits of the already advanced numerical models.

Buckwheat as a Cover Crop in Florida: Mycorrhizal Status, Soil Analysis, and Economic Assessment

This thesis analyses buckwheat as a cover crop in Florida. The study was designed to demonstrate: soil enrichment with nutrients, mycorrhizal arbuscular fungi interactions, growth in different soil types, temperature limitations in Florida, and economic benefits for farmers. Buckwheat was planted at the FIU organic garden (Miami, FL) in early November and harvested in middle December. After incorporation of buckwheat residues, soil analyses indicated the ability of buckwheat to enrich soil with major nutrients, in particular, phosphorus. Symbiosis with arbuscular mycorrhizal fungi increased inorganic phosphorus uptake and plant growth. Regression analysis on aboveground buckwheat biomass weight and soil characteristics showed that high soil pH was the major limiting factor that affected buckwheat growth. Spatial analysis illustrated that buckwheat could be planted in South Florida throughout the year but might not be planted in North and Central Florida in winter. An economic assessment proved buckwheat to be a profitable cover crop.