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.

Stand and within-stand factors influencing Golden-winged Warbler use of regenerating stands in the central Appalachian Mountains

The Golden-winged Warbler (Vermivora chrysoptera) is currently being considered for protected status under the U.S. Endangered Species Act. The creation of breeding habitat in the Appalachian Mountains is considered a conservation priority for this songbird, which is dependent on extensively forested landscapes with adequate availability of young forest. We modeled abundance of Golden-winged Warbler males in regenerating harvested forest stands that were 0-17 years postharvest at both mid-Appalachian and northeast Pennsylvania regional scales using stand and within-stand characteristics of 222 regenerating stands, 2010-2011. Variables that were most influential at the mid-Appalachian scale were different than those in the northeast region. Across the mid-Appalachian ecoregion, the proportion of young forest cover, i.e., shrub/scrub cover, within 1 km of regenerating stands best explained abundance of Golden-winged Warblers. Golden-winged Warbler response was best explained by a concave quadratic relationship in which abundance was highest with 5-15% land in young forest cover. We also found evidence that the amount of herbaceous cover, i.e., the amount of grasses and forbs, within a regenerating stand positively influenced abundance of Golden-winged Warblers. In northeastern Pennsylvania, where young forest cover is found in high proportions, the distance to the nearest regenerating stand best explained variation in abundance of Golden-winged Warblers. Abundance of Golden-winged Warblers was <1 male per survey when another regenerating stand was >1500 m away. When modeling within-stand features in the northeast region, many of the models were closely ranked, indicating that multiple variables likely explained Golden-winged Warbler response to within-stand conditions. Based on our findings, we have proposed several management guidelines for land managers interested in creating breeding habitat for Golden-winged Warblers using commercial timber operations. For example, we recommend when managing for Golden-winged Warblers in the central Appalachian Mountains that managers should strive for 15% young forest in a heavily forested landscape (>70% forest cover) and cluster stands within 1-2 km of other young forest habitats.

Visual Object Recognition Using Deformable Models of Vehicles

This workshop paper reports recent developments to a vision system for traffic interpretation which relies extensively on the use of geometrical and scene context. Firstly, a new approach to pose refinement is reported, based on forces derived from prominent image derivatives found close to an initial hypothesis. Secondly, a parameterised vehicle model is reported, able to represent different vehicle classes. This general vehicle model has been fitted to sample data, and subjected to a Principal Component Analysis to create a deformable model of common car types having 6 parameters. We show that the new pose recovery technique is also able to operate on the PCA model, to allow the structure of an initial vehicle hypothesis to be adapted to fit the prevailing context. We report initial experiments with the model, which demonstrate significant improvements to pose recovery.

The potential for the use of agent-based models in ecotoxicology

This chapter introduces ABMs, their construction, and the pros and cons of their use. Although relatively new, agent-basedmodels (ABMs) have great potential for use in ecotoxicological research – their primary advantage being the realistic simulations that can be constructed and particularly their explicit handling of space and time in simulations. Examples are provided of their use in ecotoxicology primarily exemplified by different implementations of the ALMaSS system. These examples presented demonstrate how multiple stressors, landscape structure, details regarding toxicology, animal behavior, and socioeconomic effects can and should be taken into account when constructing simulations for risk assessment. Like ecological systems, in ABMs the behavior at the system level is not simply the mean of the component responses, but the sum of the often nonlinear interactions between components in the system; hence this modeling approach opens the door to implementing and testing much more realistic and holistic ecotoxicological models than are currently used.

The use of colloidal gas aphrons as novel downstream processing for the recovery of astaxanthin from cells of Phaffia rhodozyma

BACKGROUND: There is an increasing interest in obtaining natural products with bioactive properties, using fermentation technology. However, the downstream processing consisting of multiple steps can be complicated, leading to increase in the final cost of the product. Therefore there is a need for integrated, cost-effective and scalable separation processes. RESULTS: The present study investigates the use of colloidal gas aphrons (CGA), which are surfactant-stabilized microbubbles, as a novel method for downstream processing. More particularly, their application for the recovery of astaxanthin from the cells of Phaffia rhodozyma is explored. Research carried out with standard solutions of astaxanthin and CGA generated from the cationic surfactant hexadecyl. trimethyl ammonium bromide (CTAB) showed that up to 90% recovery can be achieved under optimum conditions, i.e., pH 11 with NaOH 0.2 mol L-1. In the case of the cells' suspension from the fermentation broth, three different approaches were investigated: (a) the conventional integrated approach where CGA were applied directly; (b) CGA were applied to the clarified suspension of cells; and finally (c) the in situ approach, where CGA are generated within the clarified suspension of cells. Interestingly, in the case of the whole suspension (approach a) highest recoveries (78%) were achieved under the same conditions found to be optimal for the standard solutions. In addition, up to 97% recovery of total carotenoids could be achieved from the clarified suspension after pretreatment with NaOH. This pretreatment led to maximum cell disruption as well as optimum conditioning for subsequent CGA separation. CONCLUSIONS: These results demonstrate the potential of CGA for the recovery of bioactive components from complex feedstock. (c) 2008 Society of Chemical Industry.

Visual surveillance using deformable models of vehicles

This paper presents recent developments to a vision-based traffic surveillance system which relies extensively on the use of geometrical and scene context. Firstly, a highly parametrised 3-D model is reported, able to adopt the shape of a wide variety of different classes of vehicle (e.g. cars, vans, buses etc.), and its subsequent specialisation to a generic car class which accounts for commonly encountered types of car (including saloon, batchback and estate cars). Sample data collected from video images, by means of an interactive tool, have been subjected to principal component analysis (PCA) to define a deformable model having 6 degrees of freedom. Secondly, a new pose refinement technique using “active” models is described, able to recover both the pose of a rigid object, and the structure of a deformable model; an assessment of its performance is examined in comparison with previously reported “passive” model-based techniques in the context of traffic surveillance. The new method is more stable, and requires fewer iterations, especially when the number of free parameters increases, but shows somewhat poorer convergence. Typical applications for this work include robot surveillance and navigation tasks.

The use of land-sea warming contrast under climate change to improve impact metrics

A favoured method of assimilating information from state-of-the-art climate models into integrated assessment models of climate impacts is to use the transient climate response (TCR) of the climate models as an input, sometimes accompanied by a pattern matching approach to provide spatial information. More recent approaches to the problem use TCR with another independent piece of climate model output: the land-sea surface warming ratio (φ). In this paper we show why the use of φ in addition to TCR has such utility. Multiple linear regressions of surface temperature change onto TCR and φ in 22 climate models from the CMIP3 multi-model database show that the inclusion of φ explains a much greater fraction of the inter-model variance than using TCR alone. The improvement is particularly pronounced in North America and Eurasia in the boreal summer season, and in the Amazon all year round. The use of φ as the second metric is beneficial for three reasons: firstly it is uncorrelated with TCR in state-of-the-art climate models and can therefore be considered as an independent metric; secondly, because of its projected time-invariance, the magnitude of φ is better constrained than TCR in the immediate future; thirdly, the use of two variables is much simpler than approaches such as pattern scaling from climate models. Finally we show how using the latest estimates of φ from climate models with a mean value of 1.6—as opposed to previously reported values of 1.4—can significantly increase the mean time-integrated discounted damage projections in a state-of-the-art integrated assessment model by about 15 %. When compared to damages calculated without the inclusion of the land-sea warming ratio, this figure rises to 65 %, equivalent to almost 200 trillion dollars over 200 years.

Variation in the use of chemotherapy in lung cancer

Factors influencing the use of chemotherapy for the initial (6 months) treatment of lung cancer in South East England were investigated. The variables explored as possibly influencing the use of chemotherapy were sex, age, the year of diagnosis, the type of lung cancer, the stage, the index of multiple deprivation and the cancer network of residence. Chi2 analysis and multivariate logistic regression models were used to examine the effect of each of the variables on the use of chemotherapy. The results showed a highly significant trend in use of chemotherapy over time; the adjusted proportion of patients receiving chemotherapy increasing from 13.6% in 1994 to 29.3% in 2003. However, age, cancer network and type of lung cancer had the strongest influence on the use of chemotherapy. This finding is important when we consider that the NHS Cancer Plan aims at improving inequalities in cancer care in the UK.

Factors influencing the use of antitumoral chemotherapy in the South East of England

Influences on the use of chemotherapy for the treatment of cancer within the South East region of England for patients diagnosed with colorectal, lung, breast and prostate cancer were investigated. The variables investigated as possibly influencing the selection of chemotherapy were the sex of the patients, their age, the year of diagnosis, the cancer site, the cancer stage, the index of multiple deprivation (IMD) and the cancer network of residence. Logistic regression used to adjust the proportion receiving chemotherapy in relation to other variables considered showed significant differences in the proportion of patients receiving chemotherapy between different cancer sites and different networks. There was also a highly significant trend seen in use of chemotherapy over time; the adjusted proportion of patients receiving chemotherapy increasing from 10.6% in 1993 to 24.3% in 2002. Age, stage and cancer site seemed to have the most influence on the use of chemotherapy.

Health surveys and use of maternal and child health care services in three municipalities within the Sao Paulo metropolitan area

Objectives. To describe the changes in the use of maternal and child health care services by residents of three municipalities-Embu, Itapecerica da Serra, and Taboao da Serra-in the Sao Paulo metropolitan area, 12 years after the implementation of the Unified Health System (SUS) in Brazil, and to analyze the potential of population-based health care surveys as sources of data to evaluate these changes. Methods. Two population-based, cross-sectional surveys were carried out in 1990 and 2002 in municipalities located within the Sao Paulo metropolitan area. For children under 1 year of age, the two periods were compared in terms of outpatient services utilization and hospital admission; for the mothers, the periods were compared in terms of prenatal care and deliveries. In both surveys, stratified and multiple-stage conglomerate sampling was employed, with standardization of interview questions. Results. The most important changes observed were regarding the location of services used for prenatal care, deliveries, and hospitalization of children less than 1 year of age. There was a significant increase in the use of services in the surrounding region or hometown, and decrease in the utilization of services in the city of Sao Paulo (in 1990, 80% of deliveries and almost all admissions for children less than 1 year versus 32% and 46%, respectively, in 2002). The use of primary care units and 24-hour walk-in clinics also increased. All these changes reflect care provided by public resources. In the private sector, there was a decrease in direct payments and payments through company-paid health insurance and an increase in payments through self-paid health insurance. Conclusions. The major changes observed in the second survey occurred simultaneous to the changes that resulted from the implementation of the SUS. Population-based health surveys are adequate for analyzing and comparing the utilization of health care services at different times.

Use of a predictive model for food insecurity estimates in Brazil

In 2004 the National Household Survey (Pesquisa Nacional par Amostras de Domicilios - PNAD) estimated the prevalence of food and nutrition insecurity in Brazil. However, PNAD data cannot be disaggregated at the municipal level. The objective of this study was to build a statistical model to predict severe food insecurity for Brazilian municipalities based on the PNAD dataset. Exclusion criteria were: incomplete food security data (19.30%); informants younger than 18 years old (0.07%); collective households (0.05%); households headed by indigenous persons (0.19%). The modeling was carried out in three stages, beginning with the selection of variables related to food insecurity using univariate logistic regression. The variables chosen to construct the municipal estimates were selected from those included in PNAD as well as the 2000 Census. Multivariate logistic regression was then initiated, removing the non-significant variables with odds ratios adjusted by multiple logistic regression. The Wald Test was applied to check the significance of the coefficients in the logistic equation. The final model included the variables: per capita income; years of schooling; race and gender of the household head; urban or rural residence; access to public water supply; presence of children; total number of household inhabitants and state of residence. The adequacy of the model was tested using the Hosmer-Lemeshow test (p=0.561) and ROC curve (area=0.823). Tests indicated that the model has strong predictive power and can be used to determine household food insecurity in Brazilian municipalities, suggesting that similar predictive models may be useful tools in other Latin American countries.

Use of Metals and Anion Species with Chemometrics Tools for Classification of Unprocessed and Processed Coconut Waters

Coconut water is a natural isotonic, nutritive, and low-caloric drink. Preservation process is necessary to increase its shelf life outside the fruit and to improve commercialization. However, the influence of the conservation processes, antioxidant addition, maturation time, and soil where coconut is cultivated on the chemical composition of coconut water has had few arguments and studies. For these reasons, an evaluation of coconut waters (unprocessed and processed) was carried out using Ca, Cu, Fe, K, Mg, Mn, Na, Zn, chloride, sulfate, phosphate, malate, and ascorbate concentrations and chemometric tools. The quantitative determinations were performed by electrothermal atomic absorption spectrometry, inductively coupled plasma optical emission spectrometry, and capillary electrophoresis. The results showed that Ca, K, and Zn concentrations did not present significant alterations between the samples. The ranges of Cu, Fe, Mg, Mn, PO (4) (3-) , and SO (4) (2-) concentrations were as follows: Cu (3.1-120 A mu g L(-1)), Fe (60-330 A mu g L(-1)), Mg (48-123 mg L(-1)), Mn (0.4-4.0 mg L(-1)), PO (4) (3-) (55-212 mg L(-1)), and SO (4) (2-) (19-136 mg L(-1)). The principal component analysis (PCA) and hierarchical cluster analysis (HCA) were applied to differentiate unprocessed and processed samples. Multivariated analysis (PCA and HCA) were compared through one-way analysis of variance with Tukey-Kramer multiple comparisons test, and p values less than 0.05 were considered to be significant.

English as a Second Language and Children’s literature : An empirical study on Swedish elementary school teachers’ methods and attitudes towards the use of children’s literature in the English classroom

Previous research has shown multiple benefits and challenges with the incorporation of children’s literature in the English as a Second language (ESL) classroom. In addition, the use of children’s literature in the lower elementary English classroom is recommended by the Swedish National Agency for Education. Consequently, the current study explores how teachers in Swedish elementary school teach ESL through children’s literature. This empirical study involves English teachers from seven schools in a small municipality in Sweden. The data has been collected through an Internet survey. The study also connects the results to previous international research, comparing Swedish and international research. The results suggest that even though there are many benefits of using children’s literature in the ESL classroom, the respondents seldom use these authentic texts, due to limited time and a narrow supply of literature, among other factors. However, despite these challenges, all of the teachers claim to use children’s literature by reading aloud in the classroom. Based on the results, further research exploring pupils’ thoughts in contrast to teachers would be beneficial. In addition, the majority of the participants expressed that they wanted more information on how to use children’s literature. Therefore, additional research relating to beneficial methods of teaching English through children’s literature, especially in Sweden, is recommended.