Single centre experience of the application of self navigated 3D whole heart cardiovascular magnetic resonance for the assessment of cardiac anatomy in congenital heart disease.

BACKGROUND: For free-breathing cardiovascular magnetic resonance (CMR), the self-navigation technique recently emerged, which is expected to deliver high-quality data with a high success rate. The purpose of this study was to test the hypothesis that self-navigated 3D-CMR enables the reliable assessment of cardiovascular anatomy in patients with congenital heart disease (CHD) and to define factors that affect image quality. METHODS: CHD patients ≥2 years-old and referred for CMR for initial assessment or for a follow-up study were included to undergo a free-breathing self-navigated 3D CMR at 1.5T. Performance criteria were: correct description of cardiac segmental anatomy, overall image quality, coronary artery visibility, and reproducibility of great vessels diameter measurements. Factors associated with insufficient image quality were identified using multivariate logistic regression. RESULTS: Self-navigated CMR was performed in 105 patients (55% male, 23 ± 12y). Correct segmental description was achieved in 93% and 96% for observer 1 and 2, respectively. Diagnostic quality was obtained in 90% of examinations, and it increased to 94% if contrast-enhanced. Left anterior descending, circumflex, and right coronary arteries were visualized in 93%, 87% and 98%, respectively. Younger age, higher heart rate, lower ejection fraction, and lack of contrast medium were independently associated with reduced image quality. However, a similar rate of diagnostic image quality was obtained in children and adults. CONCLUSION: In patients with CHD, self-navigated free-breathing CMR provides high-resolution 3D visualization of the heart and great vessels with excellent robustness.

High c-Met expression in stage I-II pancreatic adenocarcinoma: proposal for an immunostaining scoring method and correlation with poor prognosis.

AIMS: c-Met is an emerging biomarker in pancreatic ductal adenocarcinoma (PDAC); there is no consensus regarding the immunostaining scoring method for this marker. We aimed to assess the prognostic value of c-Met overexpression in resected PDAC, and to elaborate a robust and reproducible scoring method for c-Met immunostaining in this setting. METHODS AND RESULTS: c-Met immunostaining was graded according to the validated MetMab score, a classic visual scale combining surface and intensity (SI score), or a simplified score (high c-Met: ≥20% of tumour cells with strong membranous staining), in stage I-II PDAC. A computer-assisted classification method (Aperio software) was developed. Clinicopathological parameters were correlated with disease-free survival (DFS) and overall survival(OS). One hundred and forty-nine patients were analysed retrospectively in a two-step process. Thirty-seven samples (whole slides) were analysed as a pre-run test. Reproducibility values were optimal with the simplified score (kappa = 0.773); high c-Met expression (7/37) was associated with shorter DFS [hazard ratio (HR) 3.456, P = 0.0036] and OS (HR 4.257, P = 0.0004). c-Met expression was concordant on whole slides and tissue microarrays in 87.9% of samples, and quantifiable with a specific computer-assisted algorithm. In the whole cohort (n = 131), patients with c-Met(high) tumours (36/131) had significantly shorter DFS (9.3 versus 20.0 months, HR 2.165, P = 0.0005) and OS (18.2 versus 35.0 months, HR 1.832, P = 0.0098) in univariate and multivariate analysis. CONCLUSIONS: Simplified c-Met expression is an independent prognostic marker in stage I-II PDAC that may help to identify patients with a high risk of tumour relapse and poor survival.

MRI/TRUS fusion software-based targeted biopsy: the new standard of care?

The advent of multiparametric MRI has made it possible to change the way in which prostate biopsy is done, allowing to direct biopsies to suspicious lesions rather than randomly. The subject of this review relates to a computer-assisted strategy, the MRI/US fusion software-based targeted biopsy, and to its performance compared to the other sampling methods. Different devices with different methods to register MR images to live TRUS are currently in use to allow software-based targeted biopsy. Main clinical indications of MRI/US fusion software-based targeted biopsy are re-biopsy in men with persistent suspicious of prostate cancer after first negative standard biopsy and the follow-up of patients under active surveillance. Some studies have compared MRI/US fusion software-based targeted versus standard biopsy. In men at risk with MRI-suspicious lesion, targeted biopsy consistently detects more men with clinically significant disease as compared to standard biopsy; some studies have also shown decreased detection of insignificant disease. Only two studies directly compared MRI/US fusion software-based targeted biopsy with MRI/US fusion visual targeted biopsy, and the diagnostic ability seems to be in favor of the software approach. To date, no study comparing software-based targeted biopsy against in-bore MRI biopsy is available. The new software-based targeted approach seems to have the characteristics to be added in the standard pathway for achieving accurate risk stratification. Once reproducibility and cost-effectiveness will be verified, the actual issue will be to determine whether MRI/TRUS fusion software-based targeted biopsy represents anadd-on test or a replacement to standard TRUS biopsy.

L'informatique: un outil remarquable pour l'enseignement de la médecine interne générale [The informatics: a remarkable tool for teaching general internal medicine].

INTERMED training implies a three week course, integrated in the "primary care module" for medical students in the first master year at the school of medicine in Lausanne. INTERMED uses an innovative teaching method based on repetitive sequences of e-learning-based individual learning followed by collaborative learning activities in teams, named Team-based learning (TBL). The e-learning takes place in a web-based virtual learning environment using a series of interactive multimedia virtual patients. By using INTERMED students go through a complete medical encounter applying clinical reasoning and choosing the diagnostic and therapeutic approach. INTERMED offers an authentic experience in an engaging and safe environment where errors are allowed and without consequences.

Efficient total variation algorithm for fetal MRI reconstruction

Fetal MRI reconstruction aims at finding a high-resolution image given a small set of low-resolution images. It is usually modeled as an inverse problem where the regularization term plays a central role in the reconstruction quality. Literature has considered several regularization terms s.a. Dirichlet/Laplacian energy [1], Total Variation (TV)based energies [2,3] and more recently non-local means [4]. Although TV energies are quite attractive because of their ability in edge preservation, standard explicit steepest gradient techniques have been applied to optimize fetal-based TV energies. The main contribution of this work lies in the introduction of a well-posed TV algorithm from the point of view of convex optimization. Specifically, our proposed TV optimization algorithm for fetal reconstruction is optimal w.r.t. the asymptotic and iterative convergence speeds O(1/n(2)) and O(1/root epsilon), while existing techniques are in O(1/n) and O(1/epsilon). We apply our algorithm to (1) clinical newborn data, considered as ground truth, and (2) clinical fetal acquisitions. Our algorithm compares favorably with the literature in terms of speed and accuracy.

Connectivity and tissue microstructural alterations in right and left temporal lobe epilepsy revealed by diffusion spectrum imaging.

Focal epilepsy is increasingly recognized as the result of an altered brain network, both on the structural and functional levels and the characterization of these widespread brain alterations is crucial for our understanding of the clinical manifestation of seizure and cognitive deficits as well as for the management of candidates to epilepsy surgery. Tractography based on Diffusion Tensor Imaging allows non-invasive mapping of white matter tracts in vivo. Recently, diffusion spectrum imaging (DSI), based on an increased number of diffusion directions and intensities, has improved the sensitivity of tractography, notably with respect to the problem of fiber crossing and recent developments allow acquisition times compatible with clinical application. We used DSI and parcellation of the gray matter in regions of interest to build whole-brain connectivity matrices describing the mutual connections between cortical and subcortical regions in patients with focal epilepsy and healthy controls. In addition, the high angular and radial resolution of DSI allowed us to evaluate also some of the biophysical compartment models, to better understand the cause of the changes in diffusion anisotropy. Global connectivity, hub architecture and regional connectivity patterns were altered in TLE patients and showed different characteristics in RTLE vs LTLE with stronger abnormalities in RTLE. The microstructural analysis suggested that disturbed axonal density contributed more than fiber orientation to the connectivity changes affecting the temporal lobes whereas fiber orientation changes were more involved in extratemporal lobe changes. Our study provides further structural evidence that RTLE and LTLE are not symmetrical entities and DSI-based imaging could help investigate the microstructural correlate of these imaging abnormalities.

Noves funcionalitats per desenvolupar el treball en grup a dins de l'ACME

La plataforma ACME (Avaluació Continuada i Millora de l’Ensenyament) va ser creada l’any 1998 per un grup de professors del departament d’Informàtica i Matemàtica Aplicada. L’ACME es va concebre com una plataforma d’e-learning, és a dir, un sistema que mitjançant l’ús d’Internet afavorís l’aprenentatge, permeten la interactivitat entre l’alumne i el professor. La creació de la plataforma ACME tenia com a objectiu reduir el fracàs dels alumnes en les assignatures de matemàtiques, però degut a l’èxit que va suposar en aquestes, es va decidir incorporar la metodologia de treball ACME a altres disciplines com la programació, les bases de dades, la química, l’economia, etc. de manera que actualment es poden desenvolupar activitats ACME en moltes disciplines. Actualment l’ACME s’utilitza com a complement a les classes presencials, on el professor exposa de manera magistral els conceptes i resol algun exercici a mode d’exemple, per a que després l’alumne, utilitzant la plataforma ACME, intenti resoldre els exercicis proposats pel professor.L’objectiu d’aquest projecte és desenvolupar l’anàlisi, disseny i implementació de les modificacions necessàries a incorporar a la plataforma ACME per tal de millorar el gestor de grups, els exercicis Excel i finalment permetre el treball en grup. El projecte consta de tres parts: millorar les interfícies del professor i de l’alumne, la millora del exercicis Excel i la resolució d’exercicis en grup

Integración de recursos digitales en las tareas de aprendizaje de lenguas: portafolios electrónicos y traducción asistida por ordenador

Las herramientas informáticas abren un amplio campo de posibilidades pedagógicas a las asignaturas de lengua. En el presente artículo se propone un modelo de combinación de recursos digitales (portafolios electrónicos y traducción asistida por ordenador) que refuerzan proyectos docentes del ámbito de las lenguas desde un enfoque pedagógico socioconstructivista. En algunos casos, las actividades se pueden integrar en proyectos reales. Por otra parte, los proyectos relacionados con el uso de estas herramientas pueden tener un enfoque multidisciplinar que implique tanto a los departamentos de las lenguas extranjeras y como a los de las lenguas maternas.

CRM and higher education : developing a monitoring system to improve relationships in e-learning environments

Peer-reviewed

Broadening the CRM domain of application to higher educational (e-learning) environments

In this paper, we reflect about the broadening of the field of application of CRM from the business domain to a wider context of relationships in which the inclusion of non-profit making organizations seems natural. In particular, we focus on analyzing the suitability of adopting CRM processes by universities and higher educational institutions dedicated to e-learning. This is an issue that, in our opinion, has much potential but has received little attention in research so far.

Enriching e-learning metadata through digital library usage analysis

Peer-reviewed

Towards automated specifications of scenarios in enhanced learning technology

Recent standardization efforts in e-learning technology have resulted in a number of specifications, however, the automation process that is considered essential in a learning management system (LMS) is a lessexplored one. As learning technology becomes more widespread and more heterogeneous, there is a growing need to specify processes that cross the boundaries of a single LMS or learning resource repository. This article proposes to obtain a specification orientated to automation that takes on board the heterogeneity of systems and formats and provides a language for specifying complex and generic interactions. Having this goal in mind, a technique based on three steps is suggested. The semantic conformance profiles, the business process management (BPM) diagram, and its translation into the business process execution language (BPEL) seem to be suitable for achieving it.

An ontology to automated learning scenarios? an approach to its knowledge domain

Automation or semi-automation of learning scenariospecifications is one of the least exploredsubjects in the e-learning research area. There isa need for a catalogue of learning scenarios and atechnique to facilitate automated retrieval of stored specifications. This requires constructing anontology with this goal and is justified inthis paper. This ontology must mainlysupport a specification technique for learning scenarios. This ontology should also be useful in the creation and validation of new scenarios as well as in the personalization of learning scenarios or their monitoring. Thus, after justifying the need for this ontology, a first approach of a possible knowledge domain is presented. An example of a concrete learning scenario illustrates some relevant concepts supported by this ontology in order to define the scenario in such a way that it could be easy to automate.

The practical application of e-Portfolio at the Open University of Catalonia : assessment of competence based learning

The paper presents the results of the piloting or pilot test in a virtual classroom. This e-portfolio was carried out in the 2005-2006 academic year, with students of the Doctorate in Information Society, at the Open University of Catalonia. The electronic portfolio is a strategy for competence based assessment. This experience shows the types of e-portfolios, where students show their work without interactions, and apply the competence-based learning theories in an interactive portfolio system. The real process of learning is developed in the competency based system, the portfolio not only is a basic bio document, has become a real space for learning with competence model. The paper brings out new ideas and possibilities: the competence-based learning promotes closer relationships between universities and companies and redesigns the pedagogic act.

Expanding the Customer Relationship Management scope to the non-profit organizations : an analysis focused on the e-university domain

Peer-reviewed