Total disc replacement surgery for symptomatic degenerative lumbar disc disease: a systematic review of the literature

The objective of this study is to evaluate the effectiveness and safety of total disc replacement surgery compared with spinal fusion in patients with symptomatic lumbar disc degeneration. Low back pain (LBP), a major health problem in Western countries, can be caused by a variety of pathologies, one of which is degenerative disc disease (DDD). When conservative treatment fails, surgery might be considered. For a long time, lumbar fusion has been the “gold standard” of surgical treatment for DDD. Total disc replacement (TDR) has increased in popularity as an alternative for lumbar fusion. A comprehensive systematic literature search was performed up to October 2008. Two reviewers independently checked all retrieved titles and abstracts, and relevant full text articles for inclusion. Two reviewers independently assessed the risk of bias of included studies and extracted relevant data and outcomes. Three randomized controlled trials and 16 prospective cohort studies were identified. In all three trials, the total disc replacement was compared with lumbar fusion techniques. The Charité trial (designed as a non-inferiority trail) was considered to have a low risk of bias for the 2-year follow up, but a high risk of bias for the 5-year follow up. The Charité artificial disc was non-inferior to the BAK® Interbody Fusion System on a composite outcome of “clinical success” (57.1 vs. 46.5%, for the 2-year follow up; 57.8 vs. 51.2% for the 5-year follow up). There were no statistically significant differences in mean pain and physical function scores. The Prodisc artificial disc (also designed as a non-inferiority trail) was found to be statistically significant more effective when compared with the lumbar circumferential fusion on the composite outcome of “clinical success” (53.4 vs. 40.8%), but the risk of bias of this study was high. Moreover, there were no statistically significant differences in mean pain and physical function scores. The Flexicore trial, with a high risk of bias, found no clinical relevant differences on pain and physical function when compared with circumferential spinal fusion at 2-year follow up. Because these are preliminary results, in addition to the high risk of bias, no conclusions can be drawn based on this study. In general, these results suggest that no clinical relevant differences between the total disc replacement and fusion techniques. The overall success rates in both treatment groups were small. Complications related to the surgical approach ranged from 2.1 to 18.7%, prosthesis related complications from 2.0 to 39.3%, treatment related complications from 1.9 to 62.0% and general complications from 1.0 to 14.0%. Reoperation at the index level was reported in 1.0 to 28.6% of the patients. In the three trials published, overall complication rates ranged from 7.3 to 29.1% in the TDR group and from 6.3 to 50.2% in the fusion group. The overall reoperation rate at index-level ranged from 3.7 to 11.4% in the TDR group and from 5.4 to 26.1% in the fusion group. In conclusion, there is low quality evidence that the Charité is non-inferior to the BAK cage at the 2-year follow up on the primary outcome measures. For the 5-year follow up, the same conclusion is supported only by very low quality evidence. For the ProDisc, there is very low quality evidence for contradictory results on the primary outcome measures when compared with anterior lumbar circumferential fusion. High quality randomized controlled trials with relevant control group and long-term follow-up is needed to evaluate the effectiveness and safety of TDR

Similarity-based virtual screening using 2D fingerprints

This paper summarises recent work at the University of Sheffield on virtual screening methods that use 2D fingerprint measures of structural similarity. A detailed comparison of a large number of similarity coefficients demonstrates that the well-known Tanimoto coefficient remains the method of choice for the computation of fingerprint-based similarity, despite possessing some inherent biases related to the sizes of the molecules that are being sought. Group fusion involves combining the results of similarity searches based on multiple reference structures and a single similarity measure. We demonstrate the effectiveness of this approach to screening, and also describe an approximate form of group fusion, turbo similarity searching, that can be used when just a single reference structure is available

Enhancing the effectiveness of ligand-based virtual screening using data fusion

Data fusion is being increasingly used to combine the outputs of different types of sensor. This paper reviews the application of the approach to ligand-based virtual screening, where the sensors to be combined are functions that score molecules in a database on their likelihood of exhibiting some required biological activity. Much of the literature to date involves the combination of multiple similarity searches, although there is also increasing interest in the combination of multiple machine learning techniques. Both approaches are reviewed here, focusing on the extent to which fusion can improve the effectiveness of searching when compared with a single screening mechanism, and on the reasons that have been suggested for the observed performance enhancement

Grouping of coefficients for the calculation of inter-molecular similarity and dissimilarity using 2D fragment bit-strings

This paper compares 22 different similarity coefficients when they are used for searching databases of 2D fragment bit-strings. Experiments with the National Cancer Institute's AIDS and IDAlert databases show that the coefficients fall into several well-marked clusters, in which the members of a cluster will produce comparable rankings of a set of molecules. These clusters provide a basis for selecting combinations of coefficients for use in data fusion experiments. The results of these experiments provide a simple way of increasing the effectiveness of fragment-based similarity searching systems

Grouping of coefficients for the calculation of inter-molecular similarity and dissimilarity using 2D fragment bit-strings

This paper compares 22 different similarity coefficients when they are used for searching databases of 2D fragment bit-strings. Experiments with the National Cancer Institute's AIDS and IDAlert databases show that the coefficients fall into several well-marked clusters, in which the members of a cluster will produce comparable rankings of a set of molecules. These clusters provide a basis for selecting combinations of coefficients for use in data fusion experiments. The results of these experiments provide a simple way of increasing the effectiveness of fragment-based similarity searching systems

Combination of molecular similarity measures using data fusion

Many different measures of structural similarity have been suggested for matching chemical structures, each such measure focusing upon some particular type of molecular characteristic. The multi-faceted nature of biological activity suggests that an appropriate similarity measure should encompass many different types of characteristic, and this article discusses the use of data fusion methods to combine the results of searches based on multiple similarity measures. Experiments with several different types of dataset and activity suggest that data fusion provides a simple, but effective, approach to the combination of individual similarity measures. The best results were generally obtained with a fusion rule that sums the rank positions achieved by each molecule in searches using individual measures

Measuring the integrated effectiveness of regional development : directions for regional government

Purpose: The purpose of the study is to identify the proper economic tools to evaluate the effectiveness and efficiency of a regional development policy. Design/Methodology/Approach: The proposed methodology consists of three stages. At the first stage, the indicators are analyzed, allowing pointing the level of particular development dimensions in the self government strategy. At the second stage, indicators characterizing the efficiency of Opolskie Regional Operating Programme (OROP) and Development Strategy of Opole Voivodeship are examined. The third final stage is the analysis of the integrated effectiveness of regional development policy. The research methodology is based on the use of the following methods: desk research, the method of grouping statistical data, and the method of effectiveness analysis. Findings: The proposed methodology let us to find the need of redefining the tool enabling the measure of the degree of imbalance as the result of leading the regional development policy, as well as the uneven development potentials. Practical Implications: The authors purpose a new approach to the regional development policy by defining the complementary tools for regional self government evaluation. Originality/Value: The authors propose the new approach to the regional development policy programming, especially by redefining regional needs included into regional strategies.peer-reviewe

Effectiveness of Surgery for Lumbar Spinal Stenosis : A Systematic Review and Meta-Analysis

Peer reviewedPublisher PD

High-level feature detection from video in TRECVid: a 5-year retrospective of achievements

Successful and effective content-based access to digital video requires fast, accurate and scalable methods to determine the video content automatically. A variety of contemporary approaches to this rely on text taken from speech within the video, or on matching one video frame against others using low-level characteristics like colour, texture, or shapes, or on determining and matching objects appearing within the video. Possibly the most important technique, however, is one which determines the presence or absence of a high-level or semantic feature, within a video clip or shot. By utilizing dozens, hundreds or even thousands of such semantic features we can support many kinds of content-based video navigation. Critically however, this depends on being able to determine whether each feature is or is not present in a video clip. The last 5 years have seen much progress in the development of techniques to determine the presence of semantic features within video. This progress can be tracked in the annual TRECVid benchmarking activity where dozens of research groups measure the effectiveness of their techniques on common data and using an open, metrics-based approach. In this chapter we summarise the work done on the TRECVid high-level feature task, showing the progress made year-on-year. This provides a fairly comprehensive statement on where the state-of-the-art is regarding this important task, not just for one research group or for one approach, but across the spectrum. We then use this past and on-going work as a basis for highlighting the trends that are emerging in this area, and the questions which remain to be addressed before we can achieve large-scale, fast and reliable high-level feature detection on video

Affect Recognition in Ads with Application to Computational Advertising

Advertisements (ads) often include strongly emotional content to leave a lasting impression on the viewer. This work (i) compiles an affective ad dataset capable of evoking coherent emotions across users, as determined from the affective opinions of five experts and 14 annotators; (ii) explores the efficacy of convolutional neural network (CNN) features for encoding emotions, and observes that CNN features outperform low-level audio-visual emotion descriptors upon extensive experimentation; and (iii) demonstrates how enhanced affect prediction facilitates computational advertising, and leads to better viewing experience while watching an online video stream embedded with ads based on a study involving 17 users. We model ad emotions based on subjective human opinions as well as objective multimodal features, and show how effectively modeling ad emotions can positively impact a real-life application.Comment: Accepted at the ACM International Conference on Multimedia (ACM MM) 201