The use of artificial intelligence algorithms to guide surgical treatment of adolescent idiopathic scoliosis

La scoliose idiopathique de l’adolescent (SIA) est une déformation tri-dimensionelle du rachis. Son traitement comprend l’observation, l’utilisation de corsets pour limiter sa progression ou la chirurgie pour corriger la déformation squelettique et cesser sa progression. Le traitement chirurgical reste controversé au niveau des indications, mais aussi de la chirurgie à entreprendre. Malgré la présence de classifications pour guider le traitement de la SIA, une variabilité dans la stratégie opératoire intra et inter-observateur a été décrite dans la littérature. Cette variabilité s’accentue d’autant plus avec l’évolution des techniques chirurgicales et de l’instrumentation disponible. L’avancement de la technologie et son intégration dans le milieu médical a mené à l’utilisation d’algorithmes d’intelligence artificielle informatiques pour aider la classification et l’évaluation tridimensionnelle de la scoliose. Certains algorithmes ont démontré être efficace pour diminuer la variabilité dans la classification de la scoliose et pour guider le traitement. L’objectif général de cette thèse est de développer une application utilisant des outils d’intelligence artificielle pour intégrer les données d’un nouveau patient et les évidences disponibles dans la littérature pour guider le traitement chirurgical de la SIA. Pour cela une revue de la littérature sur les applications existantes dans l’évaluation de la SIA fut entreprise pour rassembler les éléments qui permettraient la mise en place d’une application efficace et acceptée dans le milieu clinique. Cette revue de la littérature nous a permis de réaliser que l’existence de “black box” dans les applications développées est une limitation pour l’intégration clinique ou la justification basée sur les évidence est essentielle. Dans une première étude nous avons développé un arbre décisionnel de classification de la scoliose idiopathique basé sur la classification de Lenke qui est la plus communément utilisée de nos jours mais a été critiquée pour sa complexité et la variabilité inter et intra-observateur. Cet arbre décisionnel a démontré qu’il permet d’augmenter la précision de classification proportionnellement au temps passé à classifier et ce indépendamment du niveau de connaissance sur la SIA. Dans une deuxième étude, un algorithme de stratégies chirurgicales basé sur des règles extraites de la littérature a été développé pour guider les chirurgiens dans la sélection de l’approche et les niveaux de fusion pour la SIA. Lorsque cet algorithme est appliqué à une large base de donnée de 1556 cas de SIA, il est capable de proposer une stratégie opératoire similaire à celle d’un chirurgien expert dans prêt de 70% des cas. Cette étude a confirmé la possibilité d’extraire des stratégies opératoires valides à l’aide d’un arbre décisionnel utilisant des règles extraites de la littérature. Dans une troisième étude, la classification de 1776 patients avec la SIA à l’aide d’une carte de Kohonen, un type de réseaux de neurone a permis de démontrer qu’il existe des scoliose typiques (scoliose à courbes uniques ou double thoracique) pour lesquelles la variabilité dans le traitement chirurgical varie peu des recommandations par la classification de Lenke tandis que les scolioses a courbes multiples ou tangentielles à deux groupes de courbes typiques étaient celles avec le plus de variation dans la stratégie opératoire. Finalement, une plateforme logicielle a été développée intégrant chacune des études ci-dessus. Cette interface logicielle permet l’entrée de données radiologiques pour un patient scoliotique, classifie la SIA à l’aide de l’arbre décisionnel de classification et suggère une approche chirurgicale basée sur l’arbre décisionnel de stratégies opératoires. Une analyse de la correction post-opératoire obtenue démontre une tendance, bien que non-statistiquement significative, à une meilleure balance chez les patients opérés suivant la stratégie recommandée par la plateforme logicielle que ceux aillant un traitement différent. Les études exposées dans cette thèse soulignent que l’utilisation d’algorithmes d’intelligence artificielle dans la classification et l’élaboration de stratégies opératoires de la SIA peuvent être intégrées dans une plateforme logicielle et pourraient assister les chirurgiens dans leur planification préopératoire.

Preuves empiriques des liens entre des indicateurs de performance processuels et les résultats sensibles aux soins infirmiers

Travail dirigé présenté à la Faculté des sciences infirmières en vue de l’obtention du grade de Maître ès sciences (M.Sc.) en sciences infirmières option administration des services infirmiers

Objective neuropsychological deficits in post-traumatic stress disorder and mild traumatic brain injury: what remains beyond symptom similarity?

This exploratory study intends to characterize the neuropsychological profile in persons with post-traumatic stress disorder (PTSD) and mild traumatic brain injury (mTBI) using objective measures of cognitive performance. A neuropsychological battery of tests for attention, memory and executive functions was administered to four groups: PTSD (n = 25), mTBI (n = 19), subjects with two formal diagnoses: Post-traumatic Stress Disorder and Mild Traumatic Brain Injury (mTBI/PTSD) (n = 6) and controls (n = 25). Confounding variables, such as medical, developmental or neurological antecedents, were controlled and measures of co-morbid conditions, such as depression and anxiety, were considered. The PTSD and mTBI/PTSD groups reported more anxiety and depressive symptoms. They also presented more cognitive deficits than the mTBI group. Since the two PTSD groups differ in severity of PTSD symptoms but not in severity of depression and anxiety symptoms, the PTSD condition could not be considered as the unique factor affecting the results. The findings underline the importance of controlling for confounding medical and psychological co-morbidities in the evaluation and treatment of PTSD populations, especially when a concomitant mTBI is also suspected.

Sustainability of Participatory Projects: Study of Productive Sector under Peoples’ Planning in Chempu Village Panchayat of Kottayam District

The study has wider policy implications as it identifies the possible variables which influence the sustainability of participatory productive sector projects. The method which is developed to study the sustainability of projects under People’s Planning in Chempu Panchayat could be used for studying the same in other panchayats also. Unlike the case of the standard features of sustainability identified, the independent variables vary according to the nature of the project. Hence, this needs to be modified accordingly while applying the method in a dissimilar domain. Selection of a single panchayat for the present study is relevant on the basis of a common package of inputs for decentralised planning which is forwarded by the State Planning Board respectively for the three-tier panchayat system in Kerala. The dynamic filed realities could be brought out in view of a comprehensive planning approach through an in depth study of specific cases.The assessment of the nature and pattern of productive sector projects in the selected Village Panchayat puts the projects under close scrutiny. The analysis has depended largely on secondary sources of information, especially from panchayat level plan documents, and also on the primary information obtained using direct observation and on-site inspection of project sites. An analysis of the nature and pattem of productive sector projects is important as it gives all necessary information regarding follow-up, monitoring/evaluation and even termination of a particular project. It has also revealed the tendencies of including infrastructure and service sector projects under ‘productive’ category, especially for maintaining the stipulated ratio (40:30:30) of grant-in-aid distribution. The study regarding the allocation and expenditure pattern of plan funds is vital in policy level as it reveals the under-noticed allocation and expenditure pattern of plan funds other than grant-in-aid. One major limitation of the study has been the limited availability of secondary data, especially regarding project-wise expenditure and monitoring/evaluation reports of various project committees.

Recruitment And Training Of Managers In The Public Sector Concerns In Kerala

Public undertakings have been assigned a significant role to play in the systematic socio-economic development of India. My interest in the subject was kindled while I was doing my Masters Diploma in Public Administration at the Indian Institute of Public Administration, New Delhi during 1960-61. It was further strengthened by my teaching of the subject in different courses offered by me at the School of Management Studies and in several programmes organised by various voluntary and training organisations like the Institute of Management in Government, Trivandrum, Centre for Management Development, Trivandrum, etc. The several years in which I served as a member of the faculty in the School of Management Studies, University of Cochin,gave me the opportunity to come into close contact with different public sector concerns and their managers at various levels. This rich opportunity gave me a better insight into the problems faced by these concerns. The present study is a result of the interest so developed.

Document Image Segmentation and Compression using Artificial Neural Networks and Evolutionary Methods

The work is intended to study the following important aspects of document image processing and develop new methods. (1) Segmentation ofdocument images using adaptive interval valued neuro-fuzzy method. (2) Improving the segmentation procedure using Simulated Annealing technique. (3) Development of optimized compression algorithms using Genetic Algorithm and parallel Genetic Algorithm (4) Feature extraction of document images (5) Development of IV fuzzy rules. This work also helps for feature extraction and foreground and background identification. The proposed work incorporates Evolutionary and hybrid methods for segmentation and compression of document images. A study of different neural networks used in image processing, the study of developments in the area of fuzzy logic etc is carried out in this work

Unconstrained Handwritten Malayalam Character Recognition using Wavelet Transform and Support vector Machine Classifier

This paper presents the application of wavelet processing in the domain of handwritten character recognition. To attain high recognition rate, robust feature extractors and powerful classifiers that are invariant to degree of variability of human writing are needed. The proposed scheme consists of two stages: a feature extraction stage, which is based on Haar wavelet transform and a classification stage that uses support vector machine classifier. Experimental results show that the proposed method is effective

The Effect of SIFT Features as Content Descriptors in the Context of Automatic Writer Identification in Malayalam Language

The span of writer identification extends to broad domes like digital rights administration, forensic expert decisionmaking systems, and document analysis systems and so on. As the success rate of a writer identification scheme is highly dependent on the features extracted from the documents, the phase of feature extraction and therefore selection is highly significant for writer identification schemes. In this paper, the writer identification in Malayalam language is sought for by utilizing feature extraction technique such as Scale Invariant Features Transform (SIFT).The schemes are tested on a test bed of 280 writers and performance evaluated

Studies on the optical band gap and cluster size of the polyaniline thin films irradiated with swift heavy Si ions

Polyaniline thin films prepared by RF plasma polymerisation were irradiated with 92MeV Si ions for various fluences of 1 1011, 1 1012 and 1 1013 ions/cm2. FTIR and UV–vis–NIR measurements were carried out on the pristine and Si ion irradiated polyaniline thin films for structural evaluation and optical band gap determination. The effect of swift heavy ions on the structural and optical properties of plasma-polymerised aniline thin film is investigated. Their properties are compared with that of the pristine sample. The FTIR spectrum indicates that the structure of the irradiated sample is altered. The optical studies show that the band gap of irradiated thin film has been considerably modified. This has been attributed to the rearrangement in the ring structure and the formation of CRC terminals. This results in extended conjugated structure causing reduction in optical band gap

Ecology And Seasonal Variation Of Microalgal Community In An Oil Refinery Effluent Holding Pond: Monitoring And Assessment

The microalgal community as primary producers has to play a significant role in the biotic and abitoic interactions of any aquatic ecosystem. Whenever a community is exposed to a pollutant, responses can occur because individuals acclimate to pollutant caused changes and selection can occur favouring resistant genotypes within a population and selection among species can result in changes in community structure. The microalgal community of industrial effluent treatment systems are continuously exposed to pollutants and there is little data available on the structure and seasonal variation of microalgal community of industrial effluent holding ponds, especially of a complex effluent like that of refinery. The aim of the present study was to investigate the annual variation in the ecology, biomass, productivity and community structure of the algal community of a refinery effluent holding pond. The results of the study showed the pond to be a eutrophic system with a resistant microalgal community with distinct seasonal variation in species composition

Die Privathochschulen in Ägypten und Deutschland im Vergleich

Die Privatisierung im Hochschulwesen ist eine neue internationale Tendenz, die in der Welt in den letzten 25 Jahren zu umfangreichen wissenschaftlichen Diskussionen zwischen den Experten dieses Gebietes geführt hat. Die private Hochschulbildung erstreckt sich über ein großes Feld der verschiedenen Studiengänge. Ihre Ziele und Aufgaben sowie ihre Bedeutung unterscheiden sich von Staat zu Staat. Ebenso ist die private Hochschulbildung unterschiedlich aufgebaut hinsichtlich ihrer Größe, Finanzierung usw. Die Errichtung einiger privater Hochschulen in Ägypten beeinflusste ebenfalls die wissenschaftliche Diskussion zwischen den Experten bis heute. Um die ägyptische Erfahrung in diesem Gebiet beurteilen zu können, wurde die deutsche Situation vergleichend betrachtet. Das Ziel der Dissertation ist die Beschreibung und Analyse des aktuellen Standes der Entwicklung des privaten Hochschulwesens in Ägypten und in Deutschland, um Ähnlichkeiten und Unterschiede herauszuarbeiten, Nachteile und Vorteile der Entwicklung in beiden Ländern zu bewerten sowie Vorschläge zur Verbesserung der Lage zu machen. Als Untersuchungsmethode wurde die Fallstudie benutzt, dabei wurden jeweils fünf repräsentative Hochschulen ausgewählt. Sie unterschieden sich in den Studienangeboten, der regionalen Lage, der Größe, der Hochschulart, der fachlichen Ausrichtung und dem Gründungsdatum. Das Thema wurde in zwei Teilen behandelt, in einem theoretischen und in einem praktischen Teil. Im theoretischen Teil werden die Geschichte des Hochschulwesens allgemein und seine Entwicklung, Ziele und Aufgaben sowie die gegenwärtige Situation behandelt. In diesem Kontext werden auch die Bedeutung der privaten Hochschulen, ihre Entstehung und Entwicklung, ihre Ziele und Aufgaben, ihre Finanzierung und ihre gesetzliche Lage untersucht; die ausgewählten privaten Hochschulen werden detailliert beschrieben. Der praktische Teil dieser Untersuchung erfolgte vorwiegend in Form von Befragungen an den ausgewählten privaten Hochschulen. Die wichtigsten behandelten Bereiche der Befragungen waren: - Beziehungen zwischen Staat und Hochschule, - Ziel und Aufgaben der Leistungsbewertung, - Finanzierung, - Auswahl der Studienbewerber, - Lehrkörper, - Lehrpläne und -programme. Ergebnisse: Die privaten Hochschulen in Ägypten konnten bis zum heutigen Tag ihre Ziele hinsichtlich der Lehre und der Forschung nicht erreichen. Aufgrund der häufigen Veränderungen bei den staatlichen Rahmenbedingungen wurde die angestrebte Flexibilität nicht erreicht. Zusätzlich leiden die neugegründeten privaten Hochschulen unter der mangelhaften Finanzierung, da sie sich vorwiegend aus Studiengebühren tragen. Deshalb leisten sie keinen Beitrag für die Gesamtfinanzierung des ägyptischen Hochschulsektors. Eine Ausnahme stellt die Französische Universität in Kairo dar. Die deutschen privaten Hochschulen haben ihre Ziele hinsichtlich der Lehre und der Forschung zu einem großen Anteil erreicht. Dies erfolgte vor allem durch eine größere Flexibilität, eine bessere finanzielle Ausstattung sowie zusätzliche unterschiedliche Quellen der Finanzierung. Der Beitrag einiger privater Hochschulen an der Gesamtfinanzierung des deutschen Hochschulwesens ist groß. Generell beruht die Qualität des privaten Hochschulwesens auf der Bildungsphilosophie sowie der allgemeinen Politik des Staates und darauf, wie weit den Anforderungen der Gesellschaft entsprochen wird und ob ein Beitrag zu Entwicklung des Hochschulwesens geleistet wird. Weiterhin ist deren Erfolg von einer ausreichenden Finanzierung abhängig.

State-dependent volume isotope shifts of low-lying states of group-IIa and -IIb elements

Results of relativistic multiconfiguration Dirac-Fock calculations with an extended nucleus are used to analyze the volume isotope shifts of the resonance transitions in the group-IIa and -IIb elements as well as in Yb. This is done together with a review of the isotope shift theory, including a critical evaluation and comparison of the semiempirical calculation of volume isotope shifts commonly used today. Electronic factors F_i, proportional to differences of electronic densities over the nuclear volume, are discussed within various approximations and compared with experimental results.

Notes on PCA, Regularization, Sparsity and Support Vector Machines

We derive a new representation for a function as a linear combination of local correlation kernels at optimal sparse locations and discuss its relation to PCA, regularization, sparsity principles and Support Vector Machines. We first review previous results for the approximation of a function from discrete data (Girosi, 1998) in the context of Vapnik"s feature space and dual representation (Vapnik, 1995). We apply them to show 1) that a standard regularization functional with a stabilizer defined in terms of the correlation function induces a regression function in the span of the feature space of classical Principal Components and 2) that there exist a dual representations of the regression function in terms of a regularization network with a kernel equal to a generalized correlation function. We then describe the main observation of the paper: the dual representation in terms of the correlation function can be sparsified using the Support Vector Machines (Vapnik, 1982) technique and this operation is equivalent to sparsify a large dictionary of basis functions adapted to the task, using a variation of Basis Pursuit De-Noising (Chen, Donoho and Saunders, 1995; see also related work by Donahue and Geiger, 1994; Olshausen and Field, 1995; Lewicki and Sejnowski, 1998). In addition to extending the close relations between regularization, Support Vector Machines and sparsity, our work also illuminates and formalizes the LFA concept of Penev and Atick (1996). We discuss the relation between our results, which are about regression, and the different problem of pattern classification.

Acogimiento en familia extensa: un estudio desde la perspectiva de los acogedores, de los niños y niñas acogidos y de los profesionales que intervienen. = Kinship foster care: a study from the perspective of the caregivers, the children and the child welfare workers

Desde hace aproximadamente dos décadas, en la mayoría de los países occidentales, los acogimientos en familia extensa han entrado a formar parte de los sistemas de protección infantil, siguiendo una evolución creciente en cuanto a número y peso especifico como recurso de acogimiento. Las investigaciones sobre este fenómeno son aún recientes y escasas como también lo son los programas dirigidos a esta población. En el presente artículo presentamos los resultados de un estudio descriptivo sobre los acogimientos en familia extensa en la ciudad de Barcelona, donde se recogen datos de los principales agentes implicados en este fenómeno. Desde la perspectiva de los estudios de la calidad de vida se analizan las percepciones, evaluaciones, y satisfacción expresada, por parte de los acogedores, los niños/as acogidos y los profesionales de los Equipos de Atención a la Infancia y Adolescencia (EAIA) que se encargan del estudio y seguimiento de estos acogimientos. La investigación presenta unos resultados acordes con los estudios que actualmente se realizan en este ámbito y sienta las bases para el despliegue futuro de programas dirigidos a los acogimientos en familia extensa

Kinship foster care: a study from the perspective of the of the caregivers, the children and the child welfare workers

In the last twenty years, in most Western countries, kinship foster care has become an integral part of childcare systems, growing progressively with regard to the numbers of children involved and relative weight as a care resource within the system; indeed, in some countries it is even more common than other placement options, such as non-kinship foster care and residential care. Research on this phenomenon is still recent and scarce, and there are few programmes targeting this population. In this article we present the results of a descriptive study on kinship foster care in the city of Barcelona, including information and data from the different stakeholders involved. From a quality of life research perspective we analyze the perceptions, evaluation and expressed satisfaction of caregivers, children and practitioners from the specialist Child and Adolescent Teams (EAIAs) responsible for the study and follow-up of kinship foster care cases. The research presented results are in line with those of current research in this field, and lays the basis for the future development of kinship foster care programmes