Determining the Biomechanical Behavior of the Liver Using Medical Image Analysis and Evolutionary Computation

Modeling the liver deformation forms the basis for the development of new clinical applications that improve the diagnosis, planning and guidance in liver surgery. However, the patient-specific modeling of this organ and its validation are still a challenge in Biomechanics. The reason is the difficulty to measure the mechanical response of the in vivo liver tissue. The current approach consist of performing minimally invasive or open surgery aimed at estimating the elastic constant of the proposed biomechanical models. This dissertation presents how the use of medical image analysis and evolutionary computation allows the characterization of the biomechanical behavior of the liver, avoiding the use of these minimally invasive techniques. In particular, the use of similarity coefficients commonly used in medical image analysis has permitted, on one hand, to estimate the patient-specific biomechanical model of the liver avoiding the invasive measurement of its mechanical response. On the other hand, these coefficients have also permitted to validate the proposed biomechanical models. Jaccard coefficient and Hausdorff distance have been used to validate the models proposed to simulate the behavior of ex vivo lamb livers, calculating the error between the volume of the experimentally deformed samples of the livers and the volume from biomechanical simulations of these deformations. These coefficients has provided information, such as the shape of the samples and the error distribution along their volume. For this reason, both coefficients have also been used to formulate a novel function, the Geometric Similarity Function (GSF). This function has permitted to establish a methodology to estimate the elastic constants of the models proposed for the human liver using evolutionary computation. Several optimization strategies, using GSF as cost function, have been developed aimed at estimating the patient-specific elastic constants of the biomechanical models proposed for the human liver. Finally, this methodology has been used to define and validate a biomechanical model proposed for an in vitro human liver.Martínez Martínez, F. (2014). Determining the Biomechanical Behavior of the Liver Using Medical Image Analysis and Evolutionary Computation [Tesis doctoral no publicada]. Universitat Politècnica de València. https://doi.org/10.4995/Thesis/10251/39337TESI

Patterns of injury and violence in Yaoundé Cameroon: an analysis of hospital data.

BackgroundInjuries are quickly becoming a leading cause of death globally, disproportionately affecting sub-Saharan Africa, where reports on the epidemiology of injuries are extremely limited. Reports on the patterns and frequency of injuries are available from Cameroon are also scarce. This study explores the patterns of trauma seen at the emergency ward of the busiest trauma center in Cameroon's capital city.Materials and methodsAdministrative records from January 1, 2007, through December 31, 2007, were retrospectively reviewed; information on age, gender, mechanism of injury, and outcome was abstracted for all trauma patients presenting to the emergency ward. Univariate analysis was performed to assess patterns of injuries in terms of mechanism, date, age, and gender. Bivariate analysis was used to explore potential relationships between demographic variables and mechanism of injury.ResultsA total of 6,234 injured people were seen at the Central Hospital of Yaoundé's emergency ward during the year 2007. Males comprised 71% of those injured, and the mean age of injured patients was 29 years (SD = 14.9). Nearly 60% of the injuries were due to road traffic accidents, 46% of which involved a pedestrian. Intentional injuries were the second most common mechanism of injury (22.5%), 55% of which involved unarmed assault. Patients injured in falls were more likely to be admitted to the hospital (p < 0.001), whereas patients suffering intentional injuries and bites were less likely to be hospitalized (p < 0.001). Males were significantly more likely to be admitted than females (p < 0.001)DiscussionPatterns in terms of age, gender, and mechanism of injury are similar to reports from other countries from the same geographic region, but the magnitude of cases reported is high for a single institution in an African city the size of Yaoundé. As the burden of disease is predicted to increase dramatically in sub-Saharan Africa, immediate efforts in prevention and treatment in Cameroon are strongly warranted