Relationship between sedimentation sign and morphological grade in symptomatic lumbar spinal stenosis

Introduction Le canal lombaire étroit symptomatique est de plus en plus fréquent. Le traitement dépend des signes cliniques et des résultats radiologiques. Mais actuellement il n'y a pas de consensus concernant la classification radiologique. Le but de notre article est d'étudier la relation entre deux paramètres morphologiques radiologiques récemment décrits sur des examens par IRM. Le premier est le « signe de sédimentation » (Sedimentation Sign) et le second est le grade morphologique de la sténose lombaire (Morphological Grade), tous deux décrit en 2010. Matériel et méthode Nous avons étudié des examens IRM de 137 patients suivit dans notre établissement. De ces 137, 110 étaient issus d'une base de donnée de patients avec une sténose lombaire dont la Symptomatologie était typique. Dans ce groupe, 73 patients avaient été traité chirurgicalement et 37 conservativement, dépendant de la sévérité des symptômes. Un troisième groupe, le groupe contrôle, était formé de 27 patients ne présentant que des douleurs lombaires basses sans sciatalgie. La sévérité de la sténose a été évaluée sur les examens IRM au niveau du disque en utilisant les 4 grades de la classification morphologique, de A à D. La présence d'un signe de sédimentation a été, quand à lui, notée au niveau du pédicule, au-dessus et au-dessous du niveau présentant la sténose maximale, comme décrit dans l'article original. Résultat La présence d'un signe de sédimentation positif a été observée chez 58% des patients présentant un grade morphologique B, 69% chez les patients avec un grade C et 76% des patients avec un grade D. Dans le groupe de patient traité chirurgicalement pour une sténose canalaire, 67% des patients présentaient un signe de sédimentation positif, 35% dans le groupe du traitement conservateur, et 8 % dans le groupe contrôle. En ce qui concerne la classification du grade morphologique, nous avons regroupé les grade C et D. Il y avait 97% de patients avec un grade C et D dans le groupe du traitement chirurgical, 35 % dans le groupe du traitement conservateur et 18% dans le groupe contrôle. Nous avons donc calculé que la présence d'un signe de sédimentation positif chez les patients avec une sténose lombaire symptomatique augmente le risque d'avoir besoin d'une intervention de l'ordre de 3.5 fois (OR=3.5). En utilisant la classification du grade morphologique, nous avons calculé un risque encore plus élevé. Un patient avec une sténose canalaire de grade C ou D a 65 fois plus de risque d'avoir besoin d'une intervention (OR=65). Conclusion : Les résultats montrent une corrélation entre ces deux paramètres morphologiques. Mais la prédiction du besoin d'une intervention n'est pas équivalente. Un tiers des patients dans le groupe du traitement chirurgical n'avaient pas de signe de sédimentation positif. Ce signe apparaît donc comme un moins bon prédicteur pour le choix du traitement comparé à la sévérité de la sténose jugée avec le grade morphologique (OR 3.5 vs 65).

Occurrence of the "applause sign" in patients with amyotrophic lateral sclerosis.

The applause sign was originally described as a quick bedside test to discriminate progressive supranuclear palsy (PSP) (positive applause sign, PAS) from Parkinson's disease (PD) and frontotemporal dementia (FTD) (negative applause sign). However, recent research demonstrated that the test is positive not only in a subset of patients with PD and FTD, but also in other neurodegenerative diseases. We tested 22 patients with amyotrophic lateral sclerosis (ALS) together with 22 healthy sex- and age-matched controls for the occurrence of PAS. Furthermore, we performed neuropsychological testing with the EXIT-25 battery to correlate PAS with neuropsychological deficits, especially frontal lobe dysfunction. Five ALS patients (23%) and none of the controls displayed PAS (p≤0.05). The occurrence of PAS in ALS patients was not correlated with pathologic EXIT-25 scores or subtests for aberrant motor behaviour. We describe for the first time the occurrence of the applause sign in ALS and provide additional evidence that PAS is not specific for Parkinsonian disorders. Although its occurrence has been related to aberrant motor behaviour due to frontal involvement, in our study PAS did not correlate with executive dysfunction as tested by the EXIT-25 test battery, or with subtests of aberrant motor behaviour.

Relationship between sedimentation sign and morphological grade in symptomatic lumbar spinal stenosis.

PURPOSE: We aimed to study the relationship between two morphological parameters recently described on MRI images in relation to lumbar spinal stenosis (LSS): the first is the sedimentation sign (SedS) and the second is the morphological grading of lumbar stenosis. MATERIALS AND METHODS: MRIs from a total of 137 patients were studied. From those, 110 were issued from a prospective database of symptomatic LSS patients, of whom 73 were treated surgically and 37 conservatively based on symptom severity. A third group consisting of 27 subjects complaining of low back pain (LBP) served as control. Severity of stenosis was judged at disc level using the four A to D grade morphological classification. The presence of a SedS was judged at pedicle level, above or below the site of maximal stenosis. RESULTS: A positive SedS was observed in 58, 69 and 76 % of patients demonstrating B, C and D morphology, respectively, but in none with grade A morphology. The SedS was positive in 67 and 35 % of the surgically and conservatively treated patients, respectively, and in 8 % of the LBP group. C and D morphological grades were present in 97 and 35 % of patients in the surgically and conservatively treated group, respectively, and in 18 % of the LBP group. Presence of a positive SedS carried an increased risk of being submitted to surgery in the symptomatic LSS group (OR 3.5). This risk was even higher in the LSS patients demonstrating grade C or D morphology (OR 65). DISCUSSION AND CONCLUSION: One-third of surgically treated LSS patients do not present a SedS. This sign appears to be a lesser predictor of treatment modality in our setting of symptomatic LSS patients compared to the severity of stenosis judged by the morphological grade.

Modelling of North-West Russian market behavior considering technical restrictions of transmission grid

Nowadays the Finnish-Russian electric energy interaction is carried out through the back-to-back DC Vyborg substation and several power plants working synchronously with Finnish power system. Constant amount of energy flows in one direction — from Russia to Finland. But the process of electricity market development in Russian energy system makes the new possibilities of electrical cooperation available. The goal of master's thesis is to analyze the current state and possible evolution trends of North-West Russian system in relation with future possible change in power flow between Russia and Finland. The research is done by modelling the market of North-West Russia and examination of technical grid restrictions. The operational market models of North-West region of Russia for the years 2008 and 2015 were created during the research process. The description of prepared market models together with modelling results and their analysis are shown in the work. The description of power flow study process and results are also presented.

On the development of object functions and restrictions for shapes made with a turret punch press

This study presents the information required to describe the machine and device resources in the turret punch press environment which are needed for the development of the analysing method for automated production. The description of product and device resources and their interconnectedness is the starting point for method comparison the development of expenses, production planning and the performance of optimisation. The manufacturing method cannot be optimized unless the variables and their interdependence are known. Sheet metal parts in particular may then become remarkably complex, and their automatic manufacture may be difficult or, with some automatic equipment, even impossible if not know manufacturing properties. This thesis consists of three main elements, which constitute the triangulation. In the first phase of triangulation, the manufacture occuring on a turret punch press is examined in order to find the factors that affect the efficiency of production. In the second phase of triangulation, the manufacturability of products on turret punch presses is examined through a set of laboratory tests. The third phase oftriangulation involves an examination of five industry parts. The main key findings of this study are: all possible efficiency in high automation level machining cannot be achieved unless the raw materials used in production and the dependencies of the machine and tools are well known. Machine-specific manufacturability factors for turret punch presses were not taken into account in the industrial case samples. On the grounds of the performed tests and industrial case samples, the designer of a sheet metal product can directly influence the machining time, material loss, energy consumption and the number of tools required on a turret punch press by making decisions in the way presented in the hypothesis of thisstudy. The sheet metal parts to be produced can be optimised to bemanufactured on a turret punch press when the material to be used and the kinds of machine and tool options available are known. This provides in-depth knowledge of the machine and tool properties machine and tool-specifically. None of the optimisation starting points described here is a separate entity; instead, they are all connected to each other.

Towards an Integrative Information Society: Studies on Individuality in Speech and Sign

The flow of information within modern information society has increased rapidly over the last decade. The major part of this information flow relies on the individual’s abilities to handle text or speech input. For the majority of us it presents no problems, but there are some individuals who would benefit from other means of conveying information, e.g. signed information flow. During the last decades the new results from various disciplines have all suggested towards the common background and processing for sign and speech and this was one of the key issues that I wanted to investigate further in this thesis. The basis of this thesis is firmly within speech research and that is why I wanted to design analogous test batteries for widely used speech perception tests for signers – to find out whether the results for signers would be the same as in speakers’ perception tests. One of the key findings within biology – and more precisely its effects on speech and communication research – is the mirror neuron system. That finding has enabled us to form new theories about evolution of communication, and it all seems to converge on the hypothesis that all communication has a common core within humans. In this thesis speech and sign are discussed as equal and analogical counterparts of communication and all research methods used in speech are modified for sign. Both speech and sign are thus investigated using similar test batteries. Furthermore, both production and perception of speech and sign are studied separately. An additional framework for studying production is given by gesture research using cry sounds. Results of cry sound research are then compared to results from children acquiring sign language. These results show that individuality manifests itself from very early on in human development. Articulation in adults, both in speech and sign, is studied from two perspectives: normal production and re-learning production when the apparatus has been changed. Normal production is studied both in speech and sign and the effects of changed articulation are studied with regards to speech. Both these studies are done by using carrier sentences. Furthermore, sign production is studied giving the informants possibility for spontaneous speech. The production data from the signing informants is also used as the basis for input in the sign synthesis stimuli used in sign perception test battery. Speech and sign perception were studied using the informants’ answers to questions using forced choice in identification and discrimination tasks. These answers were then compared across language modalities. Three different informant groups participated in the sign perception tests: native signers, sign language interpreters and Finnish adults with no knowledge of any signed language. This gave a chance to investigate which of the characteristics found in the results were due to the language per se and which were due to the changes in modality itself. As the analogous test batteries yielded similar results over different informant groups, some common threads of results could be observed. Starting from very early on in acquiring speech and sign the results were highly individual. However, the results were the same within one individual when the same test was repeated. This individuality of results represented along same patterns across different language modalities and - in some occasions - across language groups. As both modalities yield similar answers to analogous study questions, this has lead us to providing methods for basic input for sign language applications, i.e. signing avatars. This has also given us answers to questions on precision of the animation and intelligibility for the users – what are the parameters that govern intelligibility of synthesised speech or sign and how precise must the animation or synthetic speech be in order for it to be intelligible. The results also give additional support to the well-known fact that intelligibility in fact is not the same as naturalness. In some cases, as shown within the sign perception test battery design, naturalness decreases intelligibility. This also has to be taken into consideration when designing applications. All in all, results from each of the test batteries, be they for signers or speakers, yield strikingly similar patterns, which would indicate yet further support for the common core for all human communication. Thus, we can modify and deepen the phonetic framework models for human communication based on the knowledge obtained from the results of the test batteries within this thesis.

Mental Well-being at Work. A Sign of a Healthy Organisation and a Necessary Precondition for Organisational Development

One of the aims of the study was to clarify the reliability and validity of the Job Diagnostic Survey (JDS) and the Eigenzustand (EZ) method as measures of the objective characteristics of work and short-term mental work load in the Finnish data. The reliability and validity were examined taking into consideration the theoretical backgrounds of the methods and the reliability of the measurements. The methods were used for finding out the preconditions for organisational development based on self-improvement and clarifying the impacts of working environment (organisational functioning and job characteristics) on a worker’s mental state and health. The influences were examined on a general level - regardless of individual personal or specific contextual factors. One aim was also to clarify how cognitions and emotions are intertwined and how they influence a person’s perception of the working environment. The data consisted of 15 blue-collar organisations in the public sector. The organisations were divided in target and comparison groups depending on the research frames. The data was collected by questionnaires by post. The exploratory and confirmatory factor analyses (Lisrel) were used as the main statistical methods in examining the structures of the methods and impacts between the variables. It was shown that it is possible for organisations to develop their working conditions themselves on specific preconditions. The advance of the development processes could be shown by the amount of the development activity as well as by the changes of the mental well-being (ability to act) and sick absenteeism of the personnel. It was found that the JDS and the EZ methods were reliable and valid measures in the Finnish data. It was shown that, in addition to the objective working environment (organisational functioning and job characteristics), also such a personal factor as selfesteem influences a person’s perception of mental work load. However, the influence did not seem to be direct. The importance of job satisfaction as a general indicator of perceived working conditions was emphasised. Emotional and cognitive factors were found to be functionally intertwined constituting a common factor. Organisational functioning and the characteristics of work had connections with a person’s health measured by sick absenteeism.

Automatic traffic sign inventory- and condition analysis

This thesis researches automatic traffic sign inventory and condition analysis using machine vision and pattern recognition methods. Automatic traffic sign inventory and condition analysis can be used to more efficient road maintenance, improving the maintenance processes, and to enable intelligent driving systems. Automatic traffic sign detection and classification has been researched before from the viewpoint of self-driving vehicles, driver assistance systems, and the use of signs in mapping services. Machine vision based inventory of traffic signs consists of detection, classification, localization, and condition analysis of traffic signs. The produced machine vision system performance is estimated with three datasets, from which two of have been been collected for this thesis. Based on the experiments almost all traffic signs can be detected, classified, and located and their condition analysed. In future, the inventory system performance has to be verified in challenging conditions and the system has to be pilot tested.

Portraits de femmes : publication artistique bimensuelle / [texte signé : Émile Henriot]

1912/10 (N48,Catherine de Médicis).

Portraits de femmes : publication artistique bimensuelle / [texte signé : Émile Henriot]

1910/10 (N16,Madame de Lamballe).

Portraits de femmes : publication artistique bimensuelle / [texte signé : Émile Henriot]

1911/09 (N35,Marie-Félicie des Ursins).

Portraits de femmes : publication artistique bimensuelle / [texte signé : Émile Henriot]

1911/04 (N28,La duchesse de Longueville).