73 research outputs found
Chaponost â 17 avenue Paul-Doumer (lot B)
En 2009, le projet de construction dâun lotissement de huit maisons, appelĂ© « le jardin de lâartisan » dans la parcelle AL 162 au 17 avenue Paul-Doumer, sur le tracĂ© de lâaqueduc du Gier, avait conduit le SRA Ă prescrire un diagnostic archĂ©ologique prĂ©alable. Cette opĂ©ration avait Ă©tĂ© rĂ©alisĂ©e par lâInrap sous la responsabilitĂ© scientifique de Monique Le NĂ©zet-CĂ©lestin, au cours du mois dâavril 2009. Quatre ans aprĂšs, en 2013, suite au dĂ©pĂŽt dâun projet de construction individuelle prĂ©vue dan..
Sainte-Foy-lĂšs-Lyon â Beaunant, pont du siphon de lâYzeron (aqueduc du Gier), piles 8, 9 et 10
LâĂ©tude du bĂąti des piles 8, 9 et 10 du pont du siphon de lâYzeron Ă Beaunant a Ă©tĂ© conduite conjointement aux travaux de restauration de lâĂ©difice engagĂ©s par la municipalitĂ© de Sainte-Foy-lĂšs-Lyon. Ces piles sont situĂ©es dans le premier tiers de la longueur du pont, sur la rive droite de lâYzeron, Ă environ 70 m de la culĂ©e occidentale. Elles ont initialement Ă©tĂ© construites Ă©vidĂ©es sous un arc transversal et bouchĂ©es par la suite. Leurs Ă©lĂ©vations, construites en opus caementicium, se com..
Autonomic Cluster Management System (ACMS): A Demonstration of Autonomic Principles at Work
Cluster computing, whereby a large number of simple processors or nodes are combined together to apparently function as a single powerful computer, has emerged as a research area in its own right. The approach offers a relatively inexpensive means of achieving significant computational capabilities for high-performance computing applications, while simultaneously affording the ability to. increase that capability simply by adding more (inexpensive) processors. However, the task of manually managing and con.guring a cluster quickly becomes impossible as the cluster grows in size. Autonomic computing is a relatively new approach to managing complex systems that can potentially solve many of the problems inherent in cluster management. We describe the development of a prototype Automatic Cluster Management System (ACMS) that exploits autonomic properties in automating cluster management
Machine Learning Models for 6-Month Survival Prediction after Surgical Resection of Glioblastoma
Introduction: The role of surgical resection for the treatment of glioblastoma multiforme is well established. Survival analysis after resective surgery in the literature comprises mostly of traditional statistical models. Machine learning models offer powerful predictive and analytical capability for varied datasets and offer improved generalizability and scalability. We analyzed survival data of patients with glioblastoma with various machine learning algorithms and compared it to binary logistic regression.
Methods: We retrospectively identified cases of glioblastoma treated with surgical resection at our institution from 2012-2018. Feature scaling and one-hot encoding was used to better fit the models to the data and used the formula Xâ = (X â Xmin)/(Xmax â Xmin). Feature selection was performed using chi-squared analysis (features with p
Results: 582 patients fit the inclusion criteria and were used to build these models. 6-month mortality was 43.13%. Accuracy scores (AUC) for models used were 0.670 (logistic regression), 0.704 (Random Forest), 0.585 (Support Vector Machine), 0.560 (NaĂŻve Bayes), 0.650 (XG Boost), 0.585 (Stochastic Gradient Descent Classifier), and 0.740 (Neural Network). 5-fold cross validation was used to ensure generalizability to an independent dataset.
Conclusion: Machine learning methods for prediction of six-month survival for glioblastoma are promising analytical tools that we show can approach or exceed the accuracy of traditional logistic regression, particularly neural networks and the random forest algorithm. Improved prediction of 6-month survival using machine learning offers increased capabilities for patient education, adjuvant chemotherapy or radiation planning, and post-operative counseling, while maintaining increased adaptability and generalizability compared to regression models
Determining the Role of Surgery in Diagnosis and Treatment of Primary CNS Lymphoma
Introduction: Primary central nervous system lymphoma (PCNSL) is a rare entity typically treated with a combination of chemotherapy and radiation. The role of surgery is controversial, and biopsy may be non-definitive or injurious. We review our series of stereotactic and excisional biopsy as well as surgical debulking of PCNSL to quantify overall risk and benefits.
Methods: Patients with biopsy-confirmed intracranial PCNSL were identified from a large singlecenter academic institution between 2012-2018. Preoperative factors and perioperative outcomes were retrospectively reviewed.
Results: A total of 61 cases of PCNSL were identified. Most patients presented with confusion (23.0%), weakness/paralysis (19.7%), and gait disturbance (18.0%). 1.6% were incidentally identified. HIV status was positive in 8.2% of cases. CSF cytology was positive for malignancy in 33.3% of applicable cases. Of all procedures, 44.3% were needle biopsy, 27.9% were open excisional biopsies, and 27.9% were surgical debulking procedures. Prior biopsy had been performed in 9.8%, of which 83.3% (5/6) were positive for PCNSL. Intraoperative frozen pathology failed to illicit a definitive diagnosis in 39.3% of cases despite adequate sampling. Stereotactic biopsies did not demonstrate an increased risk of non-diagnostic frozen pathology compared to open excisional biopsy. Intraoperative complications, 30-day mortality, and long-term survival was not associated with open vs. stereotactic biopsy.
Discussion: Biopsy of PCNSL carries a moderate surgical risk that should not be discounted, particularly in the setting of previously diagnosed PCNSL or with evidence of malignancy in CSF cytology. Early initiation of chemotherapy continues to be the mainstay of long-term response and control
Middle Fossa Extension of Posterior Fossa Meningiomas is Associated with Poorer Clinical Outcomes
Introduction: Progression of posterior fossa meningiomas (PFMs) can lead to extension into the middle cranial fossa. Pre-operative imaging allows for quantification of middle fossa extension (MFE). We aimed to determine the clinical impact of MFE on surgical and clinical outcomes during resection of PFMs.
Methods: Craniotomies for meningiomas performed at a large single center academic institution from January 2012 to December 2018 were identified. Preoperative MRI and CT imaging was reviewed to determine the presence of MFE of posterior fossa meningiomas and correlated to post-operative outcomes.
Results: 65 PFMs were identified and mean follow-up was 28.8 ± 20.1 months. 13/65 PFMs showed MFE preoperatively. Average size of PFMs with MFE (36.1 cm ± 12.1 cm) was similar to PFMs without MFE (33.5 cm ± 9.2 cm, p \u3e 0.05). 9/13 PFMs with MFE were petrous or petroclival, and 4/13 involved the cavernous sinus. Retrosigmoid craniotomy was the most utilized approach for both isolated PFMs (51.9%) and PFMs with MFE (76.9%). Anterior approaches were used in 2/13 PFMs with MFE. Presence of MFE was strongly associated with decreased rates of GTR (RR= 0.1; p \u3c 0.05). MFE wasnât associated with longer LOS or rates of readmission within 30 days of discharge, but was associated with a significantly higher rate of overall mortality at last follow-up (RR=5.3; 95%; p \u3c 0.05).
Conclusion: PFMs with MFE are easily identifiable and are associated with decreased rates of GTR and overall prognosis and may suggest the need for anterior or combined approaches
Deep Supratentorial Extension is Associated with Poor Clinical Outcomes After Glioblastoma Resection
Introduction: Glioblastoma (GBM) often extends to deep supratentorial locations, which limits the extent of maximal safe resection. Deep supratentorial extension (DSE) may be a clinically convenient prognostic indicator following GBM resection.
Methods: 582 GBM resections from 2012-2018 were retrospectively reviewed. DSE was defined as tumoral extension to the basal ganglia, thalamus, corpus callosum, internal capsule, hypothalamus, caudate, or putamen as identified on preoperative imaging.
Results: DSE was identified in 32.9% cases (192), while 52.5% (306) involved only superficial supratentorial locations (frontal, parietal, temporal and occipital lobes). Within the DSE cohort, the most commonly affected anatomical locations were the corpus callosum (18.9%), basal ganglia (10.8%), and thalamus (5.5%). DSE was associated with a significantly higher rate of residual tumor (71.9%vs59.3%, p=.015), larger size (48.3 vs 43.6 mm, p=.007), and lower rate of radiological gross total resection (GTR) (55.6% vs 70.6%, p=.005). DSE was also associated with a worse progression free survival (PFS) (5.55vs8.32 months, p = .009) and overall survival (OS) (9.89vs14.23 months, p=.000). Kaplan-Meier curves showed worse OS with DSE (log rank=.003), and worse OS with involvement of 2+ DSE structures as compared to 1 or none (log rank=.000). DSE had no effect on OS among those achieving GTR (log rank=.626), but without GTR, DSE significantly worsened survival (log rank=.030) on Kaplan-Meier.
Discussion: DSE portended higher rates of residual tumor, lower rates of GTR, and worse PFS and OS, particularly among those not achieving GTR and with involvement of 2+ structures. DSE in GBM is a convenient and reliable negative prognostic factor
Whole blood DNA methylation signatures of diet are associated with cardiovascular disease risk factors and all-cause mortality
Background: DNA methylation patterns associated with habitual diet have not been well studied. Methods: Diet quality was characterized using a Mediterranean-style diet score and the Alternative Healthy Eating Index score. We conducted ethnicity-specific and trans-ethnic epigenome-wide association analyses for diet quality and leukocyte-derived DNA methylation at over 400 000 CpGs (cytosine-guanine dinucleotides) in 5 population-based cohorts including 6662 European ancestry, 2702 African ancestry, and 360 Hispanic ancestry participants. For diet-associated CpGs identified in epigenome-wide analyses, we conducted Mendelian randomization (MR) analysis to examine their relations to cardiovascular disease risk factors and examined their longitudinal associations with all-cause mortality. Results: We identified 30 CpGs associated with either Mediterranean-style diet score or Alternative Healthy Eating Index, or both, in European ancestry participants. Among these CpGs, 12 CpGs were significantly associated with all-cause mortality (Bonferroni correctedP<1.6x10(-3)). Hypermethylation of cg18181703 (SOCS3) was associated with higher scores of both Mediterranean-style diet score and Alternative Healthy Eating Index and lower risk for all-cause mortality (P=5.7x10(-15)). Ten additional diet-associated CpGs were nominally associated with all-cause mortality (P<0.05). MR analysis revealed 8 putatively causal associations for 6 CpGs with 4 cardiovascular disease risk factors (body mass index, triglycerides, high-density lipoprotein cholesterol concentrations, and type 2 diabetes mellitus; Bonferroni corrected MRP<4.5x10(-4)). For example, hypermethylation of cg11250194 (FADS2) was associated with lower triglyceride concentrations (MR,P=1.5x10(-14)).and hypermethylation of cg02079413 (SNORA54;NAP1L4) was associated with body mass index (corrected MR,P=1x10(-6)). Conclusions: Habitual diet quality was associated with differential peripheral leukocyte DNA methylation levels of 30 CpGs, most of which were also associated with multiple health outcomes, in European ancestry individuals. These findings demonstrate that integrative genomic analysis of dietary information may reveal molecular targets for disease prevention and treatment
Genetic analyses of the QT interval and its components in over 250K individuals identifies new loci and pathways affecting ventricular depolarization and repolarization
Genetic analyses of the electrocardiographic QT interval and its components identify additional loci and pathways
The QT interval is an electrocardiographic measure representing the sum of ventricular depolarization and repolarization, estimated by QRS duration and JT interval, respectively. QT interval abnormalities are associated with potentially fatal ventricular arrhythmia. Using genome-wide multi-ancestry analyses (>250,000 individuals) we identify 177, 156 and 121 independent loci for QT, JT and QRS, respectively, including a male-specific X-chromosome locus. Using gene-based rare-variant methods, we identify associations with Mendelian disease genes. Enrichments are observed in established pathways for QT and JT, and previously unreported genes indicated in insulin-receptor signalling and cardiac energy metabolism. In contrast for QRS, connective tissue components and processes for cell growth and extracellular matrix interactions are significantly enriched. We demonstrate polygenic risk score associations with atrial fibrillation, conduction disease and sudden cardiac death. Prioritization of druggable genes highlight potential therapeutic targets for arrhythmia. Together, these results substantially advance our understanding of the genetic architecture of ventricular depolarization and repolarization
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