TAVI: Simplification Is the Ultimate Sophistication

Since its introduction in 2002, TAVI has evolved dramatically and is now standard of care for intermediate risk patients when the femoral approach can be implemented safely. The development of innovative transcatheter heart valves (THVs) and refinement of technical skills have contributed to the decrease in complication rates associated with TAVI4. Increased experience, smaller sheaths, rigorous pre-procedural planning and improved vascular closing techniques have resulted in markedly lower rates of vascular complications. The next step is the simplification of the procedure, which should contribute to a further decrease in complications, and also reduce procedural time, hospital stay as well as staff workload and costs. Moving to conscious sedation, no predilatation, no temporary pace maker and use of the radial approach as the contralateral approach are all instrumental in achieving this ultimate refinement

An ensemble learning approach for the classification of remote sensing scenes based on covariance pooling of CNN features

International audienceThis paper aims at presenting a novel ensemble learning approach based on the concept of covariance pooling of CNN features issued from a pretrained model. Starting from a supervised classification algorithm, named multilayer stacked covariance pooling (MSCP), which exploits simultaneously second order statistics and deep learning features, we propose an alternative strategy which employs an ensemble learning approach among the stacked convolutional feature maps. The aggregation of multiple learning algorithm decisions, produced by different stacked subsets, permits to obtain a better predictive classification performance. An application for the classification of large scale remote sensing images is next proposed. The experimental results, conducted on two challenging datasets, namely UC Merced and AID datasets, improve the classification accuracy while maintaining a low computation time. This confirms, besides the interest of exploiting second order statistics, the benefit of adopting an ensemble learning approach

Encodage de matrices de covariance par les vecteurs de Fisher log-euclidien : application à la classification supervisée d'images satellitaires

National audienceThis paper introduces a new hybrid architecture based on Fisher vector encoding (VF) of the convolutional layer outputs of a neural network. The originality of this work is based on the exploitation of second-order statistics via the calculation of local covariance matrices. Considering the intrinsic properties of the Riemannian manifold of covariance matrices, we propose to use the log-euclidean metric in order to extend the concept of VF encoding: the log-euclidean Fisher vectors (LE VF). The proposed architecture is then evaluated on different remote sensing databases : the UC Merced Land Use Land Cover database, the AID database, as well as on two Pléiades datasets on maritime pine forests and oyster beds.Cet article présente une nouvelle architecture hybride basée sur l'encodage par vecteurs de Fisher (VF) des sorties des couches convolutives d'un réseau de neurones. L'originalité de ce travail repose sur l'exploitation des statistiques d'ordre deux via le calcul des matrices de covariance locales. Considérant les propriétés intrinsèques à la géométrie Riemannienne propre à l'espace des matrices de covariance, nous proposons d'utiliser la métrique log-euclidienne afin d'étendre le concept des VF pour l'encodage de matrices de covariance : les vecteurs de Fisher log-euclidiens (LE VF). L'architecture proposée est ensuite évaluée sur différentes bases de données de télédétection : la base UC Merced Land Use Land Cover, la base AID, ainsi que sur deux jeux de données Pléiades sur des forêts de pins maritimes et de parcs ostréicoles

The effect of Tecamin Brix-V2 in tomato (Solanum lycopersicum L.) fruit under salt stress

The goal of the present experiment was to evaluate the effect of some biostimulants applications (Tecamin Brix version 2) on the organoleptic quality and production yield parameters of tomato Solanum lycopersicum L. grown under salt stress in the Nador region, Morocco. Climate change is becoming increasingly constraining for plant growth and development, especially in arid and semi-arid areas. These ecosystems are characterized by highly irregular rainfall associated with significant evaporation, which favours the accumulation of salts in the soil. Salt stress is considered in the semi-arid region as a limiting factor affecting crop production and quality. Biostimulants are substances that have the ability to modify plant physiological processes in such a way as to provide potential benefits to growth, development, or stress response. For this purpose, foliar fertilization with Tecamin Brix Version 2 ®, compensates for nutrient deficiency in the roots due to salt stress. The water-soluble fertilizer or a Tecamin brix® Version 2 substance was applied to the foliage to determine the effects on yield and fruit quality parameters of tomato, especially in the Mediterranean region with a high range of salinity

Age- and Sex-Specific Nomographic CT Quantitative Plaque Data From a Large International Cohort.

With growing adoption of coronary computed tomographic angiography (CTA), there is increasing evidence for and interest in the prognostic importance of atherosclerotic plaque volume. Manual tools for plaque segmentation are cumbersome, and their routine implementation in clinical practice is limited. The aim of this study was to develop nomographic quantitative plaque values from a large consecutive multicenter cohort using coronary CTA. Quantitative assessment of total atherosclerotic plaque and plaque subtype volumes was performed in patients undergoing clinically indicated coronary CTA, using an Artificial Intelligence-Enabled Quantitative Coronary Plaque Analysis tool. A total of 11,808 patients were included in the analysis; their mean age was 62.7 ± 12.2 years, and 5,423 (45.9%) were women. The median total plaque volume was 223 mm <sup>3</sup> (IQR: 29-614 mm <sup>3</sup> ) and was significantly higher in male participants (360 mm <sup>3</sup> ; IQR: 78-805 mm <sup>3</sup> ) compared with female participants (108 mm <sup>3</sup> ; IQR: 10-388 mm <sup>3</sup> ) (P < 0.0001). Total plaque increased with age in both male and female patients. Younger patients exhibited a higher prevalence of noncalcified plaque. The distribution of total plaque volume and its components was reported in every decile by age group and sex. The authors developed pragmatic age- and sex-stratified percentile nomograms for atherosclerotic plaque measures using findings from coronary CTA. The impact of age and sex on total plaque and its components should be considered in the risk-benefit analysis when treating patients. Artificial Intelligence-Enabled Quantitative Coronary Plaque Analysis work flows could provide context to better interpret coronary computed tomographic angiographic measures and could be integrated into clinical decision making

Transcatheter heart valve commissural alignment: an updated review

Transcatheter aortic valve replacement (TAVR) indications recently extended to lower surgical risk patients with longer life expectancy. Commissural alignment (CA) is one of the emerging concepts and is becoming one of the cornerstones of the TAVR procedure in a patient with increased longevity. Indeed, CA may improve transcatheter heart valve (THV) hemodynamics, future coronary access, and repeatability. The definition of CA has been recently standardized by the ALIGN-TAVR consortium using a four-tier scale based on CT analysis. Progress has been made during the index TAVR procedure to optimize CA, especially with self-expandable platforms. Indeed, specific delivery catheter orientation, THV rotation, and computed-tomography-derived views have been proposed to achieve a reasonable degree of CA. Recent data demonstrate feasibility, safety, and a significant reduction in coronary overlap using these techniques, especially with self-expandable platforms. This review provides an overview of THV CA including assessment methods, alignment techniques during the index TAVR procedure with different THV platforms, the clinical impact of commissural misalignment, and challenging situations for CA

Marqueurs pronostiques biologiques et morphologiques du TAVI à l’ère de l’évolution des pratiques

Management of aortic stenosis was revolutionized by the advent of transcatheter aortic valve replacement (TAVI). This technique, initially targeting patients at high surgical risk, was extended to lower risk patients regarding to improved outcomes and was accompanied, over the years, by a simplification at each step of the procedure. However, the careful selection of patients upstream of the procedure remains the key to success. Clinical and echographic factors are not sufficient to allow an accurate assessment of their risk profile. Thus, biomarkers and aortic valve calcifications evaluation may improve risk profile stratification. The objective of this thesis was to evaluate the prognostic value of troponin and aortic valve calcium score in patients undergoing TAVI in the era of TAVI simplificationThe first chapter of this thesis confirmed the prognostic value of pre- and post-procedure troponin (myocardial injury) in patients undergoing TAVI and of calcium score with previous generation prosthesis.The second chapter highlighted the impact of predilatation on this post-procedure troponin elevation with a potential prognostic impact.La prise en charge du rétrécissement aortique a connu une véritable révolution avec l’avènement du remplacement valvulaire aortique percutané (TAVI). Cette technique, s’adressant initialement à des patients à haut risque chirurgical, a été étendue à des patients à moindre risque du fait de l’amélioration des résultats et s’est accompagnée, au fil des années, d’une simplification de la procédure. Cependant, la sélection rigoureuse des patients en amont de la procédure reste la clé du succès de cette technique. Les facteurs cliniques et échographiques sont insuffisants pour permettre une évaluation précise du profil de risque. Certains biomarqueurs et les calcifications de la valve aortique, permettraient d’améliorer la stratification du risque. L’objectif de ce travail était d’évaluer la valeur pronostique de la troponine et du score calcique valvulaire dans le TAVI à l’ère de l’évolution des pratiques. Le premier chapitre de cette thèse a permis de confirmer la valeur pronostique de la troponine en pré et post-procédure TAVI et celle du score calcique avec les valves de la précédente génération. Le deuxième chapitre de ce travail a permis de mettre en évidence l’impact de la prédilatation sur l’élévation de troponine post-procédure avec un rôle pronostique potentiel

De la portée des productions discursives de Tariq Ramadan dans le paysage intellectuel musulman belge (contexte, contenu et réception)

1. Introduction En 1994, paraît aux éditions Tawhid Les Musulmans dans la laïcité. Responsabilités et droits des musulmans dans les sociétés occidentales. L’auteur de l’ouvrage, Tariq Ramadan qui se définit comme un « intellectuel engagé » (Zemouri, 2005, p. 126), produit, depuis cette période et ce jusqu’à aujourd’hui, un discours, ainsi que des réflexions intellectuelles et spirituelles, qui ne laissent pas indifférent. En prenant comme référence la date de publication de son premier ouvrag..