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Les macro-amputations sont des traumatismes gravissimes et représentent l'une des rares urgences extrêmes en chirurgie de la main et du membre supérieur. Leur rareté actuelle, surtout dans nos pays développés, rend leur prise en charge relativement peu connue des équipes chirurgicales et anesthésiques. Pourtant, le plan d'action à mettre en place lors d'une macro-réimplantation, les éléments décisifs du management pré- et postopératoire, ainsi que les étapes clés de la chirurgie en elle-même, doivent être parfaitement connus, puisqu'ils conditionnent la réussite d'une réimplantation majeure, tant d'un point de vue de la survie du membre que du résultat fonctionnel futur. Après un bref rappel historique, la revue de littérature proposée ici nous permet de refaire un point sur ces blessures redoutables, et de proposer un algorithme de prise en charge permettant de guider l'équipe médicale dans la gestion de ces patients complexes. Macro-amputations are extremely serious traumas and represent one of the rare extreme emergencies in hand and upper limb surgery. Their rarity, especially in our developed countries, makes their treatment relatively unknown by surgical and anesthetic teams. However, the action plan to use during a macro-reimplantation, the decisive elements of pre- and post-operative management, and the key stages of the surgery, must be perfectly known, because they determine the success of a major reimplantation, for the limb survival and the future functional result. After a brief historical overview, the literature review proposed here provides an opportunity for an update on these formidable injuries and propose a treatment algorithm to guide the medical team in the management of these complex patients. [ABSTRACT FROM AUTHOR]

Objective: To estimate prevalence and incidence rates over time in children and youth with attention deficit/hyperactivity disorder from the validation of population-based administrative data algorithms using family physicians' electronic medical records as a reference standard. Methods: A retrospective cohort study was conducted in Ontario, Canada to identify attention deficit/hyperactivity disorder among children and youth aged 1–24 years in health administrative data derived from case-finding algorithms using family physicians' electronic medical records. Multiple administrative data algorithms identifying attention deficit/hyperactivity disorder cases were developed and tested from physician-diagnosis of attention deficit/hyperactivity disorder in the electronic medical record to determine their diagnostic accuracy. We calculated algorithm performance using sensitivity, specificity, and predictive values. The most optimal algorithm was used to estimate prevalence and incidence rates of attention deficit/hyperactivity disorder from 2014 to 2021 in Ontario. Results: The optimal performing algorithm was "2 physician visits for attention deficit/hyperactivity disorder in 1 year or 1 attention deficit/hyperactivity disorder-specific prescription" with sensitivity: 83.2% (95% confidence interval [CI], 81.8% to 84.5%), specificity: 98.6% (95% CI, 98.5% to 98.7%), positive predictive value: 78.6% (95% CI, 77.1% to 80.0%) and negative predictive value: 98.9% (95% CI, 98.8% to 99.0%). From 2014, prevalence rates for attention deficit/hyperactivity disorder increased from 5.29 to 7.48 per 100 population in 2021 (N = 281,785). Males had higher prevalence rates (7.49 to 9.59 per 100 population, 1.3-fold increase) than females (2.96–5.26 per 100 population, 1.8-fold increase) from 2014 to 2021. Incidence rates increased from 2014 (0.53 per 100 population) until 2018, decreased in 2020 then rose steeply in 2021 (0.89 per 100 population, N = 34,013). Males also had higher incidence rates than females from 2014 to 2020 with females surpassing males in 2021 (0.70–0.81 per 100 male population,1.2-fold increase versus 0.36–0.97 per 100 female population, 2.7-fold increase). Conclusions: Attention deficit/hyperactivity disorder is increasing in prevalence. We developed an administrative data algorithm that can reliably identify children and youth with attention deficit/hyperactivity disorder with good diagnostic accuracy. [ABSTRACT FROM AUTHOR]

Copyright of Romanian Journal of Intellectual Property Law / Revista Română de Dreptul Proprietăţii Intelectuale is the property of Universul Juridic Publishing House and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

La sécurité des données reste l'un des domaines de recherche exploités par les chercheurs aujourd'hui, notamment en raison de l'émergence d'Internet, qui génère chaque jour de grandes masses de données. Actuellement, pour garantir la confidentialité des données, plusieurs systèmes cryptographiques basés sur le calcul matriciel utilisent le chiffrement bigraphique (matrices carrées d'ordre 2) avec l'alphabet normal modulo 26, c’est le cas pour chiffrement de Hill. Cependant, cette méthode de cryptage n'est pas sûre et fiable à cause de la linéarité de sa combinaison. L'objectif de cet article est de proposer un système de cryptage hybride utilisant une matrice carré de grande taille, afin de garantir une meilleure confidentialité des données, ce nouveau système ajouté à la vitesse de cryptage symétrique avec le calcul matriciel, la force de cryptage asymétrique proposée par RSA (Riverst, Shamir, and Adleman). Les résultats obtenus et la complexité de la nouvelle méthode montrent la fiabilité et la robustesse du système hybride proposé.

Plusieurs secteurs de la vie humaine sont aujourd’hui pris en charge et règlementés par des algorithmes, c’est-à-dire par des règles opératoires dont l'application permet de résoudre un problème existentiel de manière automatique. Or, ces algorithmes peuvent être sources des discriminations a priori et des failles d’appréciation. D’où la tâche philosophique de penser une éthique algorithmique qui tient compte non seulement de la « démocratisation » de la création et du contrôle du langage de programmation, mais aussi de la centralité du bien de l’humain et de l’environnement. De même, il convient de penser aux perspectives d’encadrement juridique de ces algorithmes dont l’activité bouleverse, à l’instar de toutes les technologies numériques, les fonctions traditionnelles des organes d’édiction de la règle du droit tout en transformations les liens sociaux que régi le droit.

Cet article vise à faire le point sur la notion d’expression et notamment sur l’élément matériel qui la caractérise a minima. Après avoir examiné la relation entre matière et forme et entre image et schématisme, nous prendrons en considération la substance visuelle telle qu’elle est mise à disposition dans les bases de données qui permettent non seulement l’analyse des collections d’images, notamment artistiques, mais aussi la production de nouvelles œuvres via des plateformes de génération d’images telles que Midjourney et Stable Diffusion.

Copyright of Épidémiologie et Santé Animale is the property of Association pour l'Etude de l'Epidemiologie des Maladies Animales (AEEMA) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Canadian Journal of Hospital Pharmacy / Journal Canadien de la Pharmacie Hospitalière is the property of Canadian Society of Hospital Pharmacists and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Pensamiento Jurídico is the property of Universidad Nacional de Colombia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Actualités Pharmaceutiques is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Les carcinomes cutanés se localisent plus fréquemment sur la face, dont environ 1/3 sur le nez. La reconstruction des pertes de substance nasale doit répondre à trois objectifs : carcinologique, fonctionnel et esthétique. Le but de cet article est de réaliser un arbre décisionnel simple qui oriente le choix de la reconstruction selon deux critères : localisation et taille de la perte de substance. Nous avons effectué une analyse rétrospective dans le service de chirurgie plastique du CHU d'Angers de 2013 à 2019, incluant 229 patients adressés pour exérèse de tumeurs cutanées nasales nécessitant un geste de reconstruction. Nous avons étudié le type de reconstruction, la taille de la perte de substance et la localisation par rapport aux sous unités esthétiques. Sur les 229 patients inclus, la localisation la plus fréquente de la perte de substance était la pointe du nez (32 %) : 44 % des patients étaient reconstruits par greffe de peau totale ou composée, 56 % par lambeau dont 48 % par lambeau local et 4 % par une association des deux techniques. Les exérèses limitées, centrales de la pointe étaient reconstruites majoritairement par greffe de peau, le lambeau de Rybka et le lambeau bilobé étaient choisis pour les reconstructions latérales de la pointe. Les reconstructions plus importantes de la pointe étaient effectuées par lambeau de Rieger ou lambeau frontal. Le dorsum était volontiers reconstruit par lambeau local : glabellaire à la partie haute, Rieger à la partie basse. La face latérale est adaptée aux lambeaux en îlot. L'aile du nez nécessite une armature : le greffon chondro-cutané était le choix le plus judicieux pour les pertes de substances limitées tandis que le lambeau frontal armé ou le lambeau de Schmid-Meyer prenaient le devant pour les pertes de substances plus importantes. La reconstruction nasale est complexe et doit s'adapter à chaque patient. Cet article basé sur notre expérience nous a permis d'obtenir un arbre décisionnel simple et original basé sur deux critères : la taille et la localisation de la perte de substance. The Face is the most frequent localization for cutaneous carcinoma. The nose accounts for about 30% of these tumors. Nose tissue loss repair has to pursue 3 types of objectives: carcinologic, aesthetic and functional. The aim of this article is to identify a decision tree to guide the choice of surgical reconstruction technique based on localization and size of the defect. We performed a retrospective analysis in Angers' CHU from 2013 to 2019 including 229 patients referred for cutaneous tumors excision in need of reconstruction. We analyzed the type of reconstruction, size of the tissue loss and localization of the defect in terms of nose aesthetic subunits. Among the 229 patients included, the most frequent localization was nose tip (32%). 44% of patients were reconstructed with skin grafts or composite graft, 56% with flaps (48% local flaps and 4% association of both methods). Limited central resections of nose tip were reconstructed with skingraft. The Rybka flap and bilobed flap were the preferred choice for lateral reconstruction of nose tip. Largest tip defects were reconstructed using Rieger flap or forehead flap. The dorsum was often reconstructed with local flap: glabellar on the upper part, Rieger on the lower part. Lateral side was perfectly reconstructed with island flap. Nose wings needed framework: composite graft was the judicious choice in case of limited tissue loss whereas forehead flap with framework or Schmid-Meyer flap were chosen for larger defects. Our past experience in nasal reconstruction has provided us with an original decision tree to guide surgeons in choosing the right reconstruction technique according to the size and localization of the defect. [ABSTRACT FROM AUTHOR]

De multiples approches thérapeutiques de la stabilisation et réanimation de la lèvre inférieure paralysée ont été proposées, parfois combinées mais les auteurs restent peu précis. Nous proposons à travers nos cas et la littérature un algorithme. Soixante-six patients ont été revus rétrospectivement. L'évaluation clinique statique et dynamique a été effectuée par étude de dossiers, photographies et enregistrements vidéographiques. Les différents moyens thérapeutiques utilisés ont été : (a) la toxine botulique dans le depressor labii inferioris (DLI) controlatéral (n = 66), la myectomie du DLI controlatéral (n = 1) ; (b) une bandelette de fascia lata (n = 16) soit connectée à une myoplastie d'allongement du temporal (MAT) (n = 10), soit réalisant une suspension passive par un seul vecteur (n = 4), soit réalisant une suspension passive par 2 vecteurs (n = 2) ; (c) un transfert du ventre postérieur du muscle digastrique (n = 4). Quand les muscles élévateurs sont sains, la toxine botulique (± myectomie) est proposée si la lèvre inférieure n'est pas inversée. Dans le cas contraire, une suspension par transfert du digastrique ou une suspension passive à deux vecteurs est à prévoir. Si les muscles releveurs ne sont plus fonctionnels, il faut envisager une MAT avec une suspension passive à un vecteur et si la lèvre est inversée, un transfert du muscle digastrique avec une bandelette de fascia lata ou une MAT associé à deux bandelettes de fascia lata. Cette proposition d'algorithme permet de raffiner le traitement de la stabilisation et de la réanimation de la lèvre inférieure. Several techniques for the stabilization and the reanimation of the paralyzed lower lip have been proposed, sometimes combined but the authors are rather vague. Thanks to our cases and a literature review, we suggest an algorithm. Sixty-six patients haven been reviewed. The static and dynamic clinical evaluation have been done thanks to the study of the medical files, photographs and videos samples. The different techniques we have used were: (a) botulinum toxin in the contralateral depressor labii inferioris (DLI) (n = 66), contralateral DLI myectomy (n = 1); (b) a strip of fascia lata (n = 16) either combined with a lengthening temporalis myoplasty (MAT) (n = 10) or only realizing a passive suspension thanks to one vector (n = 4), or a passive suspension with two strips (n = 2); (c) digastric muscle transfer (n = 4). When the elevator muscles are sounds, botulin toxin (± myectomy) is proposed if the lower lip is not inverted. Otherwise, a suspension thanks to a digastric muscle transfer or a passive suspension with a horizontal and a vertical strips are recommended. If the elevator muscles are no more operational, a MAT with a passive suspension with one vector is considerated and if the lower lip is inverted, a digastric muscle transfer with a fascia lata strip or a MAT with two strips is proposed. This algorithm submission allows to refine the treatment of the stabilization and the reanimation of the lower lip. [ABSTRACT FROM AUTHOR]

Based on a review of the state of the art and a qualitative research conducted with youtubers, this article highlights the fact that YouTubes' algorithm recommendation for videos promotes extreme content conspiracy theories and fake news in particular. In addition to the fact that the algorithm objectively gives preference to such content, it also guides youtubers' practices towards a pursuit of success by radicalising what they post. This perverse effect is associated with guerrilla warfare between communities that share antagonistic points of view, encouraging polarisation of opinions. [ABSTRACT FROM AUTHOR]

This study evaluated six segmentation methods (clustering, flood-fill, graph-cut, colour-thresholding, watershed, and Otsu's-thresholding) for segmentation accuracy and classification accuracy in discriminating Fusarium infected corn grains using RGB colour images. The segmentation accuracy was calculated using Jaccard similarity index and Dice coefficient in comparison with the gold standard (manual segmentation method). Flood-fill and graph-cut methods showed the highest segmentation accuracy of 77% and 87% for Jaccard and Dice evaluation metrics, respectively. Pre-trained convolution neural network (CNN) and support vector machine (SVM) were used to evaluate the effect of segmentation methods on classification accuracy using segmented images and extracted features from the segmented images, respectively. The SVM based two-class model to discriminate healthy and Fusarium infected corn grains yielded the classification accuracy of 84%, 79%, 78%, 74%, 69% and 65% for graphcut, watershed, clustering, flood-fill, colour-thresholding, and Otsu's-thresholding, respectively. In pretrained CNN model, the classification accuracies were 93%, 88%, 87%, 84%, 61% and 59% for flood-fill, graph-cut, colourthresholding, clustering, watershed, and Otsu'sthresholding, respectively. Jaccard and Dice evaluation metrics showed the highest correlation with the pretrained CNN classification accuracies with R2 values of 0.9693 and 0.9727, respectively. The correlation with SVM classification accuracies were R2-0.505 for Jaccard and R2-0.5151 for Dice evaluation metrics. [ABSTRACT FROM AUTHOR]

Les mutations de KRAS font partie des altérations génomiques les plus fréquentes des cancers pulmonaires non à petites cellules non épidermoïdes (CPNPC), en particulier des adénocarcinomes. Dans l'extrême majorité des cas, ces mutations sont mutuellement exclusives d'altérations génomiques sensibles aux thérapies ciblées présentes sur EGFR , ALK , ROS 1 , BRAF et NTRK. Très récemment, des essais cliniques prometteurs utilisant des molécules ciblant la mutation KRAS G 1 2C permettent d'envisager à court terme une nouvelle thérapeutique des CPNPC. Parallèlement, d'autres travaux ont montré que ces cancers présentaient une résistance primaire à l'immunothérapie en cas de mutations concomitantes sur KRAS , STK 11 et KEAP 1. L'évaluation du statut de KRAS est donc devenue incontournable dans les CPNPC de stade avancé ou métastatique afin de définir la meilleure stratégie thérapeutique. Ceci va modifier les algorithmes de la prise en charge des CPNPC dans les laboratoires et conditionne ainsi une nouvelle organisation des pathologistes thoraciques afin de proposer une offre de soins optimale à ces patients. KRAS mutations are among the most frequent genomic alterations identified in non-squamous non-small cell lung carcinoma (NS-NSCLC), notably in lung adenocarcinoma. In most of the cases, these mutations are mutually exclusive of the different genomic alteration currently known to be sensitive to targeted therapies, notably present in EGFR , ALK , BRAF , ROS 1 or NTRK. Recently, different promising clinical trials targeting KRAS G 1 2C mutated NSCLC open new hopes for a better treatment of these tumors. In parallel, other studies have shown that NSCLC harboring co-mutations on KRAS , STK 11 and KEAP 1 demonstrated immunotherapy primary resistance. So, the assessment of KRAS status in late stage NS-NSCLC has become essential in order to set up an optimal therapeutic strategy in lung cancer patients. This has induced new algorithms for NSCLC sample management in the pathology laboratories and conditioned a new organization for the thoracic pathologists for an optimal health taking care of these patients. [ABSTRACT FROM AUTHOR]

Situant son propos dans l’espace théorique de « l’énonciation éditoriale » et du « numérique comme écriture », l’auteur interroge les paradigmes de la pensée linguistique et statistique qui président à la constitution des algorithmes de recherche dédiés à l’analyse des données textuelles ; il invite à questionner les épistémies qui conduisent à leur conception avant d’envisager les résultats qu’ils produisent ; il s’interroge sur les bienfaits d’outils d’aide à l’édition critique des textes dans le cadre d’un programme de recherche en Intelligence artificielle sur la critique littéraire (Cattleya) et revient sur les bienfaits de l’activité médiévale de lettrure (lecture-écriture) pour l’édition scientifique des textes littéraires. Avec Joanna Pomian, il s’enquiert des acquis conceptuels, théoriques et méthodologiques de Cattleya. En toile de fond, quarante années de recherche et une interrogation sur les conditions politiques et intellectuelles de la recherche actuelle : et si on faisait confiance aux jeunes chercheurs en songeant à des « humanités » non plus « numériques » mais bien « intellectuelles » ?

Le phénomène de quantification de soi et les pratiques d’automesures numériques sont à la source d’une gigantesque production de données collectées par des objets connectés. En s’appuyant sur des plateformes numériques dédiées au sport, l’objectif de cet article est de montrer comment le traitement algorithmique des données permet une prise en charge énonciative et opère des transformations automatisées de contenus pour créer ou modifier l’écriture et la représentation de soi. Il s’agit également de rendre compte d’une stratégie éditoriale qui mobilise la performance sportive des utilisateurs pour générer une augmentation de trafic par le biais du partage des contenus, et répondre aux logiques marchandes.

Conjuguer IA et médecine c'est parler de médecine du futur mais davantage encore d'amélioration de la qualité des soins. À ses champs d'applications: médecine prédictive, de précision, aide à la décision, prévention, chirurgie assistée par ordinateur, accompagnement robotisé des personnes âgées. répondent des préoccupations liées: la possibilité de conserver un contact humain pour le patient, l'explicabilité de l'algorithme, la collecte des données de santé, l'amélioration du système de soins. Les applications de l'IA permettant déjà d'améliorer la qualité des soins. Son déploiement au cœur de la médecine du futur est en évolution constante. Pour être acceptables et légitimes, les décisions de tout algorithme doivent pouvoir être comprises et donc expliquées. Seule une bonne compréhension des diagnostics et thérapies proposés par l'application de l'IA pourra en effet permettre aux médecins de discuter avec leurs patients et de leur exposer les alternatives possibles. Dans le cas inverse, le médecin risque d'écarter l'utilisation des algorithmes car il ne pourra pas justifier les décisions ce qui posera des problèmes en terme notamment de recherche de responsabilité. Combining AI and medicine means talking about the medicine of the future, but even more about improving the quality of care. Its fields of application: predictive medicine, precision medicine, decision support, prevention, computer-assisted surgery, robotic support for the elderly, etc. are all related concerns: the possibility of maintaining human contact with the patient, the explicability of the algorithm - the collection of health data - and the improvement of the health care system. AI applications are already improving the quality of care. Its deployment at the heart of the medicine of the future is in constant evolution. To be acceptable and legitimate, the decisions of any algorithm must be understood and therefore explained. Only a good understanding of the diagnoses and therapies proposed by the AI application will allow doctors to discuss with their patients and to explain the possible alternatives. In the opposite case, the doctor risks to dismiss the use of algorithms because he will not be able to justify the decisions which will pose problems in terms of liability research in particular. [ABSTRACT FROM AUTHOR]

The study investigated antibiotic utilization after the implementation of a procalcitonin (PCT)- guided antibiotic algorithm in the burn intensive care unit (BICU) to minimize antibiotic exposure appropriately. An algorithm established the ordering of an initial procalcitonin level, an additional level following 48 hours post- admission, and upon suspicion of sepsis. The primary endpoint was the percent of days on antibiotics in the BICU. Secondary endpoints were the percent of patients reinitiated on antibiotics, length of BICU and hospital stay, and 30-day mortality. Desirability of Outcome Ranking (DOOR) and Response Adjusted for Duration of Antibiotic Risk (RADAR) methodology aided in antibiotic usage evaluation. The retrospective and prospective phases involved five and seven patients in the final analysis, respectively. The median percent of days on antibiotics in the BICU was 33.3% versus 14.3% in the retrospective and prospective phases, respectively (p=0.222). Secondary outcomes evaluated were percent of patients reinitiated on antibiotics at 80.0% versus 28.6% (p=0.242), the median length of BICU stay at 38 days versus 31 days (p=0.465), the median duration of hospital stay at 39 days versus 37 days (p=0.624) and 30-day mortality of one versus zero cases (p=0.417) in the retrospective and prospective group, respectively. The probability of better DOOR with a PCT-guided antibiotic algorithm versus the control group was 95.7% (95% CI, 81.4-99.5%). The benefit of a PCT-guided antibiotic algorithm implementation cannot be determined based on the small sample size producing a lack of internal validity. Future studies warrant utilizing DOOR/RADAR to evaluate antibiotic stewardship strategies in the burn patient population. [ABSTRACT FROM AUTHOR]

Copyright of ERA Forum is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Les applications e-santé grand public sont très nombreuses et leurs indications sont de plus en plus orientées vers des pathologies lourdes. Certaines ont pour objectifs la détection précoce d'événements, l'aide au diagnostic ou l'identification des risques de complication. La qualité des données qui permettent la construction des algorithmes d'intelligence artificielle est souvent insuffisante, ce qui a pour conséquence que l'information du patient, y compris par l'intermédiaire d'un professionnel de santé, ne soit pas toujours optimale. There are a large number of e-health applications for the general public and their indications are increasingly oriented towards serious pathologies. Some of them aim at early detection of events, diagnostic assistance or identification of complication risks. The quality of the data used to build the artificial intelligence algorithms is often insufficient, which means that the information provided to the patient, including through a health professional, is not always optimal. [ABSTRACT FROM AUTHOR]

L'intelligence artificielle est une notion hautement polysémique. Pour réaliser un raisonnement complexe dans la vie réelle, et s'adapter à des connaissances et des situations nouvelles, deux grandes approches sont développées en informatique : les réseaux de neurones basés sur le modèle connexionniste (deep learning) pour l'apprentissage, et les méthodes symboliques et logiques capables de travailler à un niveau abstrait de description et de raisonnement. Les algorithmes d'intelligence artificielle reproduisant les processus de déduction, induction et abduction ont des applications en radiothérapie. Combinés à la radiomique, les réseaux de neurones ont obtenu de bons résultats en classification d'images, traitement du langage naturel, phénotypage à partir des dossiers patients, adaptation des traitements. Les approches logiques ont produit des ontologies formelles, des algorithmes déterministes pour la décision et des méthodes de vérification de cohérence des systèmes complexes. Une intelligence artificielle hybride conjuguant apprentissage et logique est nécessaire pour réaliser des tâches complexes allant au delà de l'intelligence artificielle qui réalise des tâches restreintes et spécialisées. Combinée à des modèles formalisant les connaissances physicobiologiques, l'intelligence artificielle est au cœur de nouveaux outils comme les jumeaux numériques (digital twins) nécessaires à la médecine de précision en oncologie. Artificial intelligence is a highly polysemic term. In computer science, with the objective of being able to solve totally new problems in new contexts, artificial intelligence includes connectionism (neural networks) for learning and logics for reasoning. Artificial intelligence algorithms mimic tasks normally requiring human intelligence, like deduction, induction, and abduction. All apply to radiation oncology. Combined with radiomics, neural networks have obtained good results in image classification, natural language processing, phenotyping based on electronic health records, and adaptive radiation therapy. General adversial networks have been tested to generate synthetic data. Logics based systems have been developed for providing formal domain ontologies, supporting clinical decision and checking consistency of the systems. Artificial intelligence must integrate both deep learning and logic approaches to perform complex tasks and go beyond the so-called narrow artificial intelligence that is tailored to perform some highly specialized task. Combined together with mechanistic models, artificial intelligence has the potential to provide new tools such as digital twins for precision oncology. [ABSTRACT FROM AUTHOR]

Background: Eight years ago, a committee of experts from 4 Quebec university psychiatry departments has provided the QAAPAPLE algorithm in order to guide clinicians in their use of long-acting antipsychotics (LAAP) for patients with psychotic disorders.Objective: Update the QAAPAPLE algorithm.Methods: Using a qualitative and selective literature review, the experts have focused on several aspects related to the use of LAAP and the relevance of modifying the algorithm: 1) new data on LAAP (including polypharmacy and co-prescription with clozapine, dose frequency/interval); 2) perception and attitude regarding algorithms and evidence; 3) difficulties in implementing algorithms; 4) polypharmacy involving LAAP and co-prescriptions with clozapine; 5) partner patients perspective on the algorithm.Results: Thirteen meta-analysis were published and completed observational studies (including those on national registries), confirming the LAAP benefits. Literature adds specifications about using some drug associations as well as dose frequency and interval. Therefore, scientific advances have been considered to modify the algorithm.Conclusion: Interacting with Quebec psychiatrists, we have examined changes in prescription and literature to better understand the use of algorithm. The committee has updated the QAAPAPLE algorithm to guide clinicians in using LAAP along the path of patients with psychosis as early as the first episode and through different clinical settings (including treatment resistance) in order to have a more flexible and user-friendly treatment. [ABSTRACT FROM AUTHOR]

Copyright of Annales Françaises de Médecine d'Urgence is the property of John Libbey Eurotext Ltd. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objectives: Restricted capacity for viral load (VL) testing is a major obstacle for antiretroviral therapy (ART) programmes in high-burden regions. Algorithms for targeted VL testing could help allocate laboratory resources rationally. We validated the performance of the Viral Load Testing Criteria (VLTC), an algorithm with satisfactory performance in derivation (sensitivity 91%, specificity 43%).Methods: HIV-positive adults who had been receiving first-line ART for ≥12 months at three Ethiopian public ART clinics were included. Healthcare providers collected data on variables of the VLTC: current CD4 count, mid-upper arm circumference (MUAC) and self-reported treatment interruption. VL testing was performed in parallel. Performance of the algorithm for identification of patients with VL ≥ 1000 copies/ml was evaluated.Results: Of 562 patients (female 62%, median ART duration 92 months), 33 (6%) had VL ≥ 1000 copies/ml. Sensitivity for the VLTC was 85% (95% CI, 68-95), specificity 60% (95% CI, 55-64), positive predictive value 12% (95% CI, 10-14) and negative predictive value 98% (95% CI, 97-99). Use of the algorithm would reduce the number of VL tests required by 57%. Misclassification occurred in 5/33 (15%) of subjects with VL ≥ 1000 copies/ml.Conclusion: In validation, the VLTC performed similarly well as derivation. Use of the VLTC may be considered for targeted VL testing for ART monitoring in high-burden regions. [ABSTRACT FROM AUTHOR]

Highlights To quantify the consultations and medical procedures to be planned in a large cohort of HIV-infected patients, we built an algorithm using parameters required for the application of the national guidelines for the management of HIV-infected individuals. This study highlights the large number of consultations and procedures to be carried out during one year of follow-up and emphasizes the benefits of a patient-focused multidisciplinary management within a single facility, especially for aging and/or psychologically or socially deprived patients. Besides the computerization of patients' medical records, physicians involved in the management of HIV-infected individuals must develop algorithms to determine the required procedures according to the patient's profile. Abstract Objectives To quantify within a cohort of HIV-infected individuals the number of medical visits and procedures to be carried out according to comorbidities and risk factors to implement a personalized care pathway. Patients and methods Retrospective study of 915 patients consulting from January 1 to December 31, 2016 at an outpatient unit of multidisciplinary consultations, using an electronic patient record. We built an algorithm using parameters required for the application of the national guidelines for the management of HIV-infected individuals. The frequency of comorbidities was measured according to gender, transmission risk group, and nadir CD4 (< or > 200/mm3). Results Patients were mostly men (median age: 52 years), of whom 16% were aged ≥ 60 years. Viral load was < 40 copies/mL in 93.5% of treated patients and CD4 cell count ≥ 500/mm3 for 73%. Overall, 74.5% of patients had at least one comorbidity. The number of comorbidities was similar in men and women but was significantly higher in patients with a nadir CD4 <200/mm3 and increased with age (irrespective of gender). The minimum number of consultations to be scheduled per year was 8123: 70% for the management of comorbidities with an average of six consultations/year/patient. Overall, 53% of patients should attend a proctology consultation. The minimum number of paramedical procedures to be performed was 5115. Conclusion The implementation of a personalized multidisciplinary management within a single facility seems to be a suitable care model to address the needs of HIV-infected individuals. [ABSTRACT FROM AUTHOR]

Copyright of Review of Science Mathematics & ICT Education is the property of Library & Information Center and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Recent international guidelines recommend rapid initiation and titration of basic treatments of heart failure but do not explain how to achieve this goal. Despite these recommendations, implementation of treatment in daily practice is poor. This may be partly explained by the profile of the patients (frailty, comorbidities), safety considerations and tolerability issues related to kydney function, low blood pressure or heart rate and hyperkalaemia. In this special article, we intended to help the physician, through an algorithmic approach, to quickly and safely introduce guideline-directed medical therapy in the field of heart failure with ejection fraction under 50%. [ABSTRACT FROM AUTHOR]

Copyright of Réseaux (07517971) is the property of Editions La Decouverte and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revue d'Orthopédie Dento-Faciale is the property of Parresia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

„Big Data” is a catchphrase referring to algorithmic procedures to process large amounts of data. It owes its success, and in particular its medial prominence, in part to its opposition to the established paradigm of relational database theory, whose main tenets, will be sketched in a first step. It is by contrasting „Big Data” with this traditional traditional procedure that the crucial contrast regarding the availability of an overwhelming mass of information can be drawn. Proponents of the former approach claim that a change of paradigm is called for because conventional theory is not equipped to handle these unprecedented challenges. The ensuing debate is presented in the second section of this paper. The opposing views can, as it turns out, be traced back to divergent epistemological attitudes. The contribution concludes with a discussion about the questionable move to establish the category „raw data” as an underlying domain for an innovative theory of data processing. [ABSTRACT FROM AUTHOR]

In the study of longitudinal movements in public opinion it is usually the case that data are abundant, but irregular. Both cases (times) and variables are numerous, but it is never the case that all cases are available for any one variable. The dyad ratios algorithm was created to make dimensional analysis possible for this perverse data structure. The central logic of the dyad ratios algorithm is explained. Central focus is on the use of ratios as a starting point, the recursive estimation procedure, validity estimation by iterative procedure and the bootstrapping of standard errors. The ability of the algorithm to estimate a known longitudinal path is tested with artificial data. Then dyad ratios is compared to principal components analysis for a particular real data problem where both are possible. A final section makes a limited comparison between dyad ratios and item response theory. [ABSTRACT FROM AUTHOR]

Résumé Depuis notre précédente actualisation de ces recommandations, de nouvelles données, auparavant pressenties par la clinique, sont aujourd’hui validées par la littérature et font maintenant consensus. Elles nous permettent de mettre à la disposition de tout praticien une prise en charge à la fois simplifiée mais aussi mieux construite et mieux adaptée aux besoins du patient souffrant de dysfonction érectile (DE). Plusieurs points nous paraissent essentiels à la bonne marche de la prise en charge du patient souffrant de DE. Ils ont été développés dans la version longue de nos recommandations, et nous les résumons ici dans un algorithme de prise en charge. Il répond aux différents éléments de la démarche clinique face au patient porteur d’une DE. Comment évaluer les différents paramètres en jeu dans chaque situation, comment déterminer son propre domaine de compétence face à la problématique, savoir prescrire et accompagner sa prescription, assurer le suivi de son patient, comment analyser un échec éventuel, et l’orienter le cas échéant au sein du réseau de soins ? Telles sont les questions auxquelles nous avons répondu et les différentes étapes synthétisées dans cet algorithme. Summary Since the last time these recommendations were updated, new data has been validated by the literature, already suggested by clinical observation, and now reaching consensus. This data offers all practitioners a solution for treatment that is both simple but also better designed and better adapted to patients suffering from Erectile Dysfunction (ED). Several points appear to be crucial for the success of treatment for such patients, and were developed in the full version of our guidelines, and we are summarizing them here as a treatment algorithm. This takes account of all the various components of the clinical approach to a patient suffering from ED; how to assess the different parameters at play in each situation, how to determine one's own field of competence in the face of this problem, knowing what to prescribe and what support to provide alongside the prescription, following up the patient, analysing any potential failings and directing the patient to a care network where appropriate. All these questions find answers in our article, along with a summary of the different stages of the algorithm. [ABSTRACT FROM AUTHOR]

Cet article décrit et évalue la pertinence d’une méthode de conception architecturale : la conception algorithmique par données géospatiales (CADG). Cette méthode est ici proposée comme réponse au problème d’étalement urbain corrélatif au développement immobilier en Amérique du Nord. Les caractéristiques qualitatives, temporelles et organisationnelles de ce développement, telles que décrites par Sanford Kwinter, Daniela Fabricius, Lars Lerup et Rem Koolhaas, permettent de mieux comprendre les causes de l’étalement urbain. L’identification de ces causes ne rend cependant pas plus aisée la mise en place d’interventions architecturales capables de réduire leurs effets. Afin de définir les conditions de telles interventions efficaces, différents outils de conception numérique inhérents à la CADG sont présentés. Deux cas d’étude servent à illustrer leur fonctionnement : Local Code: San Francisco Case Study de Nicholas de Monchaux et À louer : tous les centres commerciaux du boulevard Taschereau par l’auteur de cet article. L’objectif, à travers cette étude, est de faire valoir la pertinence de la CADG pour optimiser l’utilisation de l’espace urbanisé en tenant compte des phénomènes et dynamiques propres au développement de celui-ci.