Classification of Ataxic Gait.

Gait disorders accompany a number of neurological and musculoskeletal disorders that significantly reduce the quality of life. Motion sensors enable high-quality modelling of gait stereotypes. However, they produce large volumes of data, the evaluation of which is a challenge. In this publication, we compare different data reduction methods and classification of reduced data for use in clinical practice. The best accuracy achieved between a group of healthy individuals and patients with ataxic gait extracted from the records of 43 participants (23 ataxic, 20 healthy), forming 418 segments of straight gait pattern, is 98% by random forest classifier preprocessed by t-distributed stochastic neighbour embedding.

Deep Learning for Accelerometric Data Assessment and Ataxic Gait Monitoring.

Ataxic gait monitoring and assessment of neurological disorders belong to important multidisciplinary areas that are supported by digital signal processing methods and machine learning tools. This paper presents the possibility of using accelerometric data to optimise deep learning convolutional neural network systems to distinguish between ataxic and normal gait. The experimental dataset includes 860 signal segments of 16 ataxic patients and 19 individuals from the control set with the mean age of 38.6 and 39.6 years, respectively. The proposed methodology is based upon the analysis of frequency components of accelerometric signals simultaneously recorded at specific body positions with a sampling frequency of 60 Hz. The deep learning system uses all of the frequency components in a range of 〈0,30 〉 Hz. Our classification results are compared with those obtained by standard methods, which include the support vector machine, Bayesian methods, and the two-layer neural network with features estimated as the relative power in selected frequency bands. Our results show that the appropriate selection of sensor positions can increase the accuracy from 81.2% for the foot position to 91.7% for the spine position. Combining the input data and the deep learning methodology with five layers increased the accuracy to 95.8%. Our methodology suggests that artificial intelligence methods and deep learning are efficient methods in the assessment of motion disorders and they have a wide range of further applications.

Traits and evolution of wing venation pattern in paraneopteran insects.

Two different patterns of wing venation are currently supposed to be present in each of the three orders of Paraneoptera. This is unlikely compared with the situation in other insects where only one pattern exists per order. We propose for all Paraneoptera a new and unique interpretation of wing venation pattern, assuming that the convex cubitus anterior gets fused with the common stem of median and radial veins at or very near to wing base, after separation from concave cubitus posterior, and re-emerges more distally from R + M stem. Thereafter, the vein between concave cubitus posterior and CuA is a specialized crossvein called "cua-cup," proximally concave and distally convex. We show that despite some variations, that is, cua-cup can vary from absent to hypertrophic; CuA can re-emerge together with M or not, or even completely disappear, this new interpretation explains all situations among all fossil and recent paraneopteran lineages. We propose that the characters "CuA fused in a common stem with R and M"and "presence of specialized crossvein cua-cup" are venation apomorphies that support the monophyly of the Paraneoptera. In the light of these characters, we reinterpret several Palaeozoic and early Mesozoic fossils that were ascribed to Paraneoptera, and confirm the attribution of several to this superorder as well as possible attribution of Zygopsocidae (Zygopsocus permianus Tillyard, 1935) as oldest Psocodea. We discuss the situation in extinct Hypoperlida and Miomoptera, suggesting that both orders could well be polyphyletic, with taxa related to Archaeorthoptera, Paraneoptera, or even Holometabola. The Carboniferous Protoprosbolidae is resurrected and retransferred into the Paraneoptera. The genus Lithoscytina is restored. The miomopteran Eodelopterum priscum Schmidt, 1962 is newly revised and considered as a fern pinnule. In addition, the new paraneopteran Bruayaphis oudardi gen. nov. et sp. nov. is described fromthe Upper Carboniferous of France (see Supporting Information).

Endovascular treatment combined with stratified surgery is effective in the management of venous thoracic outlet syndrome complications: a long term ultrasound follow-up study in patients with thrombotic events due to venous thoracic outlet syndrome.

Thoracic outlet syndrome (TOS) is caused by compression of peripheral nerves and vascular structures along their course through the upper thoracic aperture to the axilla. The aim of our study was to analyze long-term outcomes of different treatments stratified by symptom severity. We performed a retrospective analysis of a cohort of 73 consecutive patients treated at our institution presenting with TOS-associated venous thrombotic events. Treatment strategies and immediate outcome analysis were completed by long-term follow-up with duplex ultrasound controls 6-12 months after the initial clinical event. Conservative therapy was started in mildly symptomatic patients (n = 32), of which 12 required endovascular procedures because of treatment failure. Endovascular treatment was attempted in all highly symptomatic patients and in those with conservative treatment failure (n = 53), of which 12 required acute surgical intervention. Elective surgical treatment was indicated in 30 other patients because of persistent symptoms. Surgery was associated with a significantly lower rate of the ultrasound-detected signs of persisting vascular compression. However, the rate of persisting clinical symptoms was comparable to those treated only by endovascular or conservative therapy. Our data demonstrate that initial endovascular treatment proposed as first line therapy to highly symptomatic subjects and in those with conservative treatment failure improves the symptoms in 77% of patients avoiding the need of acute surgery. Acute and elective surgical decompression leads to lower rates of vascular compression signs without significant amelioration of persisting clinical symptoms as compared to endovascular or conservative therapy.

Regulation of direct supplemental payments for services covered by the public health insurance in a comparative perspective.

In modem societies, people are strongly urged to get the best health care for themselves and their families. Although controlled costs of the health care system may be an important goal for society as a whole, the individual patient is seldom satisfied with being an object of health care rationing. When, due to financial constraints, the health services covered by the public programs become rationed and their quality is perceived as decreasing, patients tend to contract with the providers directly. From the societal viewpoint, supplemental payments for improved care play a negative role when they lead to competition for limited resources in public programs and therefore decrease access for the non-paying patient. They, however, play a positive role when they create new resources and when they thus do not affect the access for the poor negatively, or even improve it by increasing overall health services supply.