[Mobile child psychiatric team in French Guiana: Analyzing Amerindian teenager issues]. / Équipe mobile de pédopsychiatrie en territoire guyanais : questionnement de l'adolescent amérindien.

INTRODUCTION: Since their French naturalization in 1969, Amerindians of French Guiana have been facing a full and fast reorganization of their way of life. Teenagers, at the forefront of this cultural transition, are challenging French school institutions, as well as cultural society and care system organizations in Amazonian French remote villages. Rates of autolytic behaviors such as toxic substance abuse or suicide attempts, but mostly completed suicides, are alarming among this adolescent population. To improve care delivery to those teenagers, a mobile child psychiatric team was implemented in 2013. METHODS: We describe this device, its activities and the problematics encountered. RESULTS: This team's purpose is to lead a psychiatric evaluation of teenagers in order to determine a possible psychiatric diagnosis and elaborate a care plan. Although the results are mostly encouraging, this device seems to show some limitations: lack of time dedicated to these interventions, lack of psychiatric care available for follow-up in these villages, tremendous numbers of social distress situations implicated in psychological issues. Moreover, it appears that cultural aspects must be considered in the analysis of the Amerindian adolescent population's issues and the determination of providing care. CONCLUSION: Implementation of actions based on more educational and social levels might be a solution.

Compressed sampling and dictionary learning framework for wavelength-division-multiplexing-based distributed fiber sensing.

We propose a compressed sampling and dictionary learning framework for fiber-optic sensing using wavelength-tunable lasers. A redundant dictionary is generated from a model for the reflected sensor signal. Imperfect prior knowledge is considered in terms of uncertain local and global parameters. To estimate a sparse representation and the dictionary parameters, we present an alternating minimization algorithm that is equipped with a preprocessing routine to handle dictionary coherence. The support of the obtained sparse signal indicates the reflection delays, which can be used to measure impairments along the sensing fiber. The performance is evaluated by simulations and experimental data for a fiber sensor system with common core architecture.

Modeling photon transport in turbid media for measuring colloidal concentration in drops using the time-shift technique.

Colloidal drops-suspensions, dispersions, emulsions-are widespread in the process industry but are difficult to characterize by size, velocity, and concentration of particulate matter in the drop. The present study investigates the use of the time-shift (TS) technique for such measurements. Numerically, a model based on ray tracing is developed, incorporating interactions with randomly placed monodispersed scattering centers within the spherical drop. The model creates a random walk propagation trajectory, known from radiative transfer problems. The model approximates Mie scattering from each internal particle with a Gaussian distribution. Experiments are performed using a conventional TS instrument, first with water as a reference and for validation, and then with different concentrations of a milk/water emulsion. Comparison of the modeled and received signals exhibits very good agreement, confirming the possibility of measuring the colloidal concentration in drops using the TS technique.

Emergency Response Person Localization and Vital Sign Estimation Using a Semi-Autonomous Robot Mounted SFCW Radar.

The large number and scale of natural and man-made disasters have led to an urgent demand for technologies that enhance the safety and efficiency of search and rescue teams. Semi-autonomous rescue robots are beneficial, especially when searching inaccessible terrains, or dangerous environments, such as collapsed infrastructures. For search and rescue missions in degraded visual conditions or non-line of sight scenarios, radar-based approaches may contribute to acquire valuable, and otherwise unavailable information. This article presents a complete signal processing chain for radar-based multi-person detection, 2D-MUSIC localization and breathing frequency estimation. The proposed method shows promising results on a challenging emergency response dataset that we collected using a semi-autonomous robot equipped with a commercially available through-wall radar system. The dataset is composed of 62 scenarios of various difficulty levels with up to five persons captured in different postures, angles and ranges including wooden and stone obstacles that block the radar line of sight. Ground truth data for reference locations, respiration, electrocardiogram, and acceleration signals are included.

Doppler Radar for the Extraction of Biomechanical Parameters in Gait Analysis.

The applicability of Doppler radar for gait analysis is investigated by quantitatively comparing the measured biomechanical parameters to those obtained using motion capturing and ground reaction forces. Nineteen individuals walked on a treadmill at two different speeds, where a radar system was positioned in front of or behind the subject. The right knee angle was confined by an adjustable orthosis in five different degrees. Eleven gait parameters are extracted from radar micro-Doppler signatures. Here, new methods for obtaining the velocities of individual lower limb joints are proposed. Further, a new method to extract individual leg flight times from radar data is introduced. Based on radar data, five spatiotemporal parameters related to rhythm and pace could reliably be extracted. Further, for most of the considered conditions, three kinematic parameters could accurately be measured. The radar-based stance and flight time measurements rely on the correct detection of the time instant of maximal knee velocity during the gait cycle. This time instant is reliably detected when the radar has a back view, but is underestimated when the radar is positioned in front of the subject. The results validate the applicability of Doppler radar to accurately measure a variety of medically relevant gait parameters. Radar has the potential to unobtrusively diagnose changes in gait, e.g., to design training in prevention and rehabilitation. As contact-less and privacy-preserving sensor, radar presents a viable technology to supplement existing gait analysis tools for long-term in-home examinations.

Evaluation of margins in pelvic lymph nodes and prostate radiotherapy and the impact of bladder and rectum on prostate position.

PURPOSE: The aims of this study were: determination of the CTV to PTV margins for prostate and pelvic lymph nodes. Investigation of the impact of registration modality (pelvic bones or prostate) on the CTV to PTV margins of pelvic lymph nodes. Investigation of the variations of bladder and rectum over the treatment course. Investigation of the impact of bladder and rectum variations on prostate position. PATIENTS AND METHODS: This study included 15 patients treated for prostate adenocarcinoma. Daily kilo voltage images and weekly CBCT scans were performed to assess prostate displacements and common and external iliac vessels motion. These data was used to calculate the CTV to PTV margins using Van Herk equation in the setting of a daily bone registration. We also compared the CTV to PTV margins of pelvic lymph nodes according to registration method; based on pelvic bone or prostate. We delineated bladder and rectum on all CBCT scans to assess their variations over treatment course at 4 anatomic levels [1.5cm above pubic bone (PB), superior edge, mid- and inferior edge of PB]. RESULTS: Using Van Herk equation, the prostate CTV to PTV margins (bone registration) were 8.03mm, 5.42mm and 8.73mm in AP, ML and SI direction with more than 97% of prostate displacements were less than 5mm. The CTV to PTV margins ranged from 3.12mm to 3.25mm for external iliac vessels and from 3.12mm to 4.18mm for common iliac vessels. Compared to registration based on prostate alignment, bone registration resulted in an important reduction of the CTV to PTV margins up to 54.3% for external iliac vessels and up to 39.6% for common iliac vessels. There was no significant variation of the mean bladder volume over the treatment course. There was a significant variation of the mean rectal volume before and after the third week of treatment. After the third week, the mean rectal volume seemed to be stable. The uni- and multivariate analysis identified the anterior wall of rectum as independent factor acting on prostate motion in AP direction at 2 levels (superior edge of, mid PB). The right rectal wall influenced the prostate motion in ML direction at inferior edge of PB. The bladder volume tends toward significance as factor acting on prostate motion in AP direction. CONCLUSIONS: We recommend CTV to PTV margins of 8mm, 6mm and 9mm in AP, ML and SI directions for prostate. And, we suggest 4mm and 5mm for external and common iliac vessels respectively. We also prefer registration based on bony landmarks to minimize bowel irradiation. More CBCT scans should be performed during the first 3weeks and especially the first week to check rectum volume.

[Hydatid cyst of the kidney in children: a retrospective study of 10 cases]. / Le kyste hydatique du rein chez l'enfant: étude rétrospective de dix cas.

INTRODUCTION: The hydatid cyst disease of the kidney is rare in children, it ranks third among the liver and the lung. MATERIAL: We report a series of 10 pediatric case of hydatid cyst of the kidney, managed in the department of surgery pediatric of Rabat, between 1990 and 2008. RESULTS: The median age was 9 years (4-15 years). The clinical presentation was pain (7 cases) and/or abdominal mass (6 cases). Diagnostic accuracy has been improved since the wide use of ultrasonography in eight cases. In all cases, the resection of the prominent dome was usually sufficient. CONCLUSION: In the light of these 10 observations, the ultrasonography may be sufficient and the surgical conservative treatment is still necessary.

[Urethral diverticulum with stone complicating epispadias repair]. / Réparation d'un épispadias compliquée d'un diverticule de l'urètre avec calcul.

Diverticula of the male urethra are rare clinical entities. Congenital and acquired have similar modes of presentation. No case of urethral diverticulum, containing stone, complicating epispadias repair have been reported. We report the case of 8-year-old boy with an urethral diverticulum, containing stone, complicating epispadias repair. Diverticulectomy with removal of the stone by urethroplasty was performed. Through this observation and review of the literature, authors describe pathological and management finding of urethral diverticula.

[Cystic adenomatoid malformations of the lung: a retrospective study of 12 cases]. / Malformations adénomatoïdes kystiques du poumon : étude rétrospective de 12 observations.

The authors present a retrospective study of 12 cases of cystic adenomatoid lung malformations in clinical surgery unit "A" at the Rabat Children's hospital, between 1999 to 2006. Two pregnancies with lung malformation were identified. All of the patients were symptomatic. The treatment was surgical in all cases (lobectomy: 11 cases; pneumonectomy: one case). The evolution was good after an average of three years. In the light of these 12 malformations, the authors try and demonstrate the value of early diagnosis in order to surgically treat the anomaly in optimum conditions. Moreover, the authors insist on the exeresis not only of the malformation, but of the entire lobe involved in anomaly to guarantee a recurrence-free result.

Toward Unobtrusive In-Home Gait Analysis Based on Radar Micro-Doppler Signatures.

OBJECTIVE: In this paper, we demonstrate the applicability of radar for gait classification with application to home security, medical diagnosis, rehabilitation, and assisted living. Aiming at identifying changes in gait patterns based on radar micro-Doppler signatures, this paper is concerned with solving the intra motion category classification problem of gait recognition. METHODS: New gait classification approaches utilizing physical features, subspace features, and sum-of-harmonics modeling are presented and their performances are evaluated using experimental K-band radar data of four test subjects. Five different gait classes are considered for each person, including normal, pathological, and assisted walks. RESULTS: The proposed approaches are shown to outperform existing methods for radar-based gait recognition, which utilize physical features from the cadence-velocity data representation domain as in this paper. The analyzed gait classes are correctly identified with an average accuracy of 93.8%, where a classification rate of 98.5% is achieved for a single gait class. When applied to new data of another individual, a classification accuracy on the order of 80% can be expected. CONCLUSION: Radar micro-Doppler signatures and their Fourier transforms are well suited to capture changes in gait. Five different walking styles are recognized with high accuracy. SIGNIFICANCE: Radar-based sensing of gait is an emerging technology with multi-faceted applications in security and health care industries. We show that radar, as a contact-less sensing technology, can supplement existing gait diagnostic tools with respect to long-term monitoring and reproducibility of the examinations.

A Bayesian Approach to Policy Recognition and State Representation Learning.

Learning from demonstration (LfD) is the process of building behavioral models of a task from demonstrations provided by an expert. These models can be used, e.g., for system control by generalizing the expert demonstrations to previously unencountered situations. Most LfD methods, however, make strong assumptions about the expert behavior, e.g., they assume the existence of a deterministic optimal ground truth policy or require direct monitoring of the expert's controls, which limits their practical use as part of a general system identification framework. In this work, we consider the LfD problem in a more general setting where we allow for arbitrary stochastic expert policies, without reasoning about the optimality of the demonstrations. Following a Bayesian methodology, we model the full posterior distribution of possible expert controllers that explain the provided demonstration data. Moreover, we show that our methodology can be applied in a nonparametric context to infer the complexity of the state representation used by the expert, and to learn task-appropriate partitionings of the system state space.

Robust Nonlinear Causality Analysis of Nonstationary Multivariate Physiological Time Series.

GOAL: An important research area in biomedical signal processing is that of quantifying the relationship between simultaneously observed time series and to reveal interactions between the signals. Since biomedical signals are potentially nonstationary and the measurements may contain outliers and artifacts, we introduce a robust time-varying generalized partial directed coherence (rTV-gPDC) function. METHODS: The proposed method, which is based on a robust estimator of the time-varying autoregressive (TVAR) parameters, is capable of revealing directed interactions between signals. By definition, the rTV-gPDC only displays the linear relationships between the signals. We therefore suggest to approximate the residuals of the TVAR process, which potentially carry information about the nonlinear causality by a piece-wise linear time-varying moving-average model. RESULTS: The performance of the proposed method is assessed via extensive simulations. To illustrate the method's applicability to real-world problems, it is applied to a neurophysiological study that involves intracranial pressure, arterial blood pressure, and brain tissue oxygenation level (PtiO2) measurements. CONCLUSION AND SIGNIFICANCE: The rTV-gPDC reveals causal patterns that are in accordance with expected cardiosudoral meachanisms and potentially provides new insights regarding traumatic brain injuries. The rTV-gPDC is not restricted to the above problem but can be useful in revealing interactions in a broad range of applications.

Measuring Blood Glucose Concentrations in Photometric Glucometers Requiring Very Small Sample Volumes.

Glucometers present an important self-monitoring tool for diabetes patients and, therefore, must exhibit high accuracy as well as good usability features. Based on an invasive photometric measurement principle that drastically reduces the volume of the blood sample needed from the patient, we present a framework that is capable of dealing with small blood samples, while maintaining the required accuracy. The framework consists of two major parts: 1) image segmentation; and 2) convergence detection. Step 1 is based on iterative mode-seeking methods to estimate the intensity value of the region of interest. We present several variations of these methods and give theoretical proofs of their convergence. Our approach is able to deal with changes in the number and position of clusters without any prior knowledge. Furthermore, we propose a method based on sparse approximation to decrease the computational load, while maintaining accuracy. Step 2 is achieved by employing temporal tracking and prediction, herewith decreasing the measurement time, and, thus, improving usability. Our framework is tested on several real datasets with different characteristics. We show that we are able to estimate the underlying glucose concentration from much smaller blood samples than is currently state of the art with sufficient accuracy according to the most recent ISO standards and reduce measurement time significantly compared to state-of-the-art methods.

Computationally efficient algorithm for photoplethysmography-based atrial fibrillation detection using smartphones.

Atrial fibrillation (AF) is one of the major causes of stroke, heart failure, sudden death, and cardiovascular morbidity and the most common type of arrhythmia. Its diagnosis and the initiation of treatment, however, currently requires electrocardiogram (ECG)-based heart rhythm monitoring. The photoplethysmogram (PPG) offers an alternative method, which is convenient in terms of its recording and allows for self-monitoring, thus relieving clinical staff and enabling early AF diagnosis. We introduce a PPG-based AF detection algorithm using smartphones that has a low computational cost and low memory requirements. In particular, we propose a modified PPG signal acquisition, explore new statistical discriminating features and propose simple classification equations by using sequential forward selection (SFS) and support vector machines (SVM). The algorithm is applied to clinical data and evaluated in terms of receiver operating characteristic (ROC) curve and statistical measures. The combination of Shannon entropy and the median of the peak rise height achieves perfect detection of AF on the recorded data, highlighting the potential of PPG for reliable AF detection.

[Currarino's triad: anorectal malformation, sacral anomaly and presacral mass]. / Le syndrome de Currarino: malformation anorectale, anomalie sacrée et tumeur pré-sacrée. A propos d'un cas.

We report the case of a 3 year old boy with a combination of anorectal malformation, sacral agenesia and anterior meningocele (Currarino's triad) and provide a review of the literature of this rare syndrome.

[Peritoneal hydatidosis in children. Report of a historical case]. / L'hydatidose péritonéale chez l'enfant. A propos d'un cas historique.

Peritoneal hydatidosis is a rare localisation of hydatic disease, most often secondary to a hydatic cyst of the liver. Its primitive form is considered due to a haematogenous diffusion through arterial vessels. We report a historical case of peritoneal hydatidosis concomitant to a hepatic localisation, in a 13-year-old girl. Diagnosis was performed by ultrasounds and CT scan, and a strong positive serology. Surgical cure has been completed by pharmacologic treatment with the aim of avoiding a relapse. A brief reminder of the therapeutic management of the disease is provided.

[Laryngeal dyspnea caused by cervical hydatidosis: apropos of a case]. / Dyspnée laryngée révélatrice d'une localisation cervicale d'hydatidose: à propos d'un cas.

Hydatid cysts rarely present as a cervical tumor. We report a case of hydatid cyst of the neck in a child with multiple hydatid cysts in the liver, which was revealed by laryngeal dyspnea. Symptoms occurred in a six year-old country dweller, who presented with progressive laryngeal dyspnea. The chest radiographs showed extrinsic tracheal compression. A cervical ultrasonography showed a liquid filled mass evocative of hydatid cyst type 1. Explorative cervicotomy confirmed the diagnosis. The treatment was conservative after destruction of the parasite using a hypertonic saline solution. The immediate result was the disappearance of the laryngeal dyspnea.

[Pheochromocytoma in children. Two case reports]. / Le phéochromocytome de l'enfant. A propos de deux cas.

Severe sustained hypertension occurs in only 0.1% of the pediatric population and only about 2% of these patients will have an underlying endocrine cause. Pheochromocytoma as a catecholamine secreting tumour causing severe hypertension is exceedingly rare in children. A high index of suspicion and an awareness of the clinical spectrum are therefore necessary to make the diagnosis. We report two cases of pheochromocytoma occurring in two a 12 year-old boys who's presented with sustained hypertension, headache, sweating, and visual blurring. Measurement of 24 hour urinary catecholamines showed a marked increase and localization of adrenal unilateral pheochromocytoma was determined by ultrasonography and computed tomography. The approaches to the adrenal gland were transverse transperitoneal and the excision of the tumors was followed of return to the normal of tensional numbers.

Regional analysis of functions and demographics of health information managers.

Based on the findings of this study, HIM professionals' tasks or functions tend to vary across regions and in relation to levels of experience. As experience increased for RRAs, the task performed by them tended to be more management related. All other HIM professionals performed tasks that were more related to data collection than management. The most frequent title for the RRA (Director/manager/chief of medical records or HIM) was also more related to management activities while the title for the ART (Coder) was directly related to data collection. The majority of all HIM professionals work in acute care with approximately 3-8 percent working in long term care, ambulatory care, mental health care, and other healthcare settings such as software companies or health departments. The two most important predictors of salary across all regions were years of experience and educational level. When experience and education were controlled for, there was a slight salary advantage for males in the Midwest and West regions.

A quantitative computerized recording method in clinical education: a pilot project.

This paper describes an approach to a quantitative computerized method for recording the clinical education experiences of physical therapy students. While the project was conducted in the field of physical therapy, it provides a model that can be adapted to other allied health fields. The objectives, methodology, outcome and future prospects of the project are discussed.