A Blind Spot in the Reframing of a Universe of Possibles: Towards a Suitable Model for Decision-Making Theory and A.I.

Bayesian inference model is an optimal processing of incomplete information that, more than other models, better captures the way in which any decision-maker learns and updates his degree of rational beliefs about possible states of nature, in order to make a better judgment while taking new evidence into account. Such a scientific model proposed for the general theory of decision-making, like all others in general, whether in statistics, economics, operations research, A.I., data science or applied mathematics, regardless of whether they are time-dependent, have in common a theoretical basis that is axiomatized by relying on related concepts of a universe of possibles, especially the so-called universe (or the world), the state of nature (or the state of the world), when formulated explicitly. The issue of where to stand as an observer or a decision-maker to reframe such a universe of possibles together with a partition structure of knowledge (i.e. semantic formalisms), including a copy of itself as it was initially while generalizing it, is not addressed. Memory being the substratum, whether human or artificial, wherein everything stands, to date, even the theoretical possibility of such an operation of self-inclusion is prohibited by pure mathematics. We make this blind spot come to light through a counter-example (namely Archimedes’ Eureka experiment) and explore novel theoretical foundations, fitting better with a quantum form than with fuzzy modeling, to deal with more than a reference universe of possibles. This could open up a new path of investigation for the general theory of decision-making, as well as for Artificial Intelligence, often considered as the science of the imitation of human abilities, while being also the science of knowledge representation and the science of concept formation and reasoning.

Investigation of Carbonation of Concrete Based on Crushed Sand and Admixtures

Carbonation is a natural aging process that occurs in all types of concrete. One of its primary implications is the acceleration of steel corrosion caused by the phenomena of depassivation. The goal of this research is to investigate the carbonation of quarry sand-based concrete. The concrete is made of 100% crushed sand 0/6.3, gravel 8/15, and 15/25 from the Arab Contractor quarry in Nomayos, Cameroon, with CEM II B-P 42.5 R from CIMENCAM (Cimenteries du Cameroun). The study employed two admixtures: one with a dual superplasticizing and reducing action (Sikamen) and another with a water-repellent effect (Sika liquid). Carbonation was performed on concrete samples at the following dates: 0, 7, 14, 28, 56, 90, 180 days, one year, and six months. Carbonated concrete (CC) and non-carbonated concrete (NCC) samples are compared in terms of their physical attributes and mineralogical characteristics. The results of this investigation reveal that after more than a year and six months of carbonation, porosity decreases and permeability increases. Despite the high fineness modulus of quarry sand, the compressive strength of quarry sand-based concrete is satisfactory. Carbonation depth is relatively high on some dates, exceeding the minimal cover value for concrete reinforcement. Sikament additive increases concrete compactness and durability while decreasing permeability. Sika water repellant mixes with the lime in cement to generate complimentary crystallizations that block the mortar’s capillaries, making it watertight.

Advancements in the application of natural extracts for atopic dermatitis treatment

Atopic dermatitis,a common chronic inflammatory skin disease,has an unclear etiology and may involve multiple factors such as genetic predisposition,immune abnormalities,and impaired skin barrier function.Currently,there is no specific medication available for the complete cure of atopic dermatitis.The current treatment approaches mainly focus on symptom relief and control rather than curative treatment.Some commonly used medications for atopic dermatitis,such as topical corticosteroids and immunosuppressants,may have certain adverse reactions and side effects.This review summarizes the research progress on natural extracts in the treatment of atopic dermatitis,aiming to provide a foundation for the development of safe and side-effectfree medications.

Psychological quality of life and employability skills among newly registered first-year students: Opportunities for further university development

In accord with new European university reforms initiated by the Bologna Process, our objective was to evaluate influences on the relationship between psychological quality of life (QoL) and the acquisition of academic employability skills (AES) among first-year students at the University in Luxembourg. At the beginning (2 months in) and the end (9 months) of the academic year, 973 newly registered students participated in this study involving two cross-university surveys. Students who redoubled or who had studied at other universities were excluded. Data were collected with an online questionnaire comprising the psychological Whoqol-bref subscale, AES scale, and questions about other related factors. The AES score decreased from 74.2 to 65.6. At both time points, the psychological Whoqol-bref was positively correlated with environmental and social relations QoL and perceived general health. Multiple regression models including interaction terms showed that a higher psychological QoL was associated with better general health (difference satisfied-dissatisfied 9.44), AES (slope 0.099), social relationships QoL (0.321), and environmental QoL (0.298). No interaction with time effects was significant, which indicates that the effects remain stable with time. If the university could maintain the QoL indicators at appropriate levels or manage decreases as they occur, it would have implications for health promotion and the creation of new student support systems. The SQA- LES project provides valuable information for universities aiming to develop a European Higher Educational Area.

Transperineal laser ablation of the prostate as a treatment for benign prostatic hyperplasia and prostate cancer: The results of a Delphi consensus project

Objective: To evaluate transperineal laser ablation (TPLA) with Echolaser® (Echolaser® TPLA, Elesta S.p.A., Calenzano, Italy) as a treatment for benign prostatic hyperplasia (BPH) and prostate cancer (PCa) using the Delphi consensus method.Methods: Italian and international experts on BPH and PCa participated in a collaborative consensus project. During two rounds, they expressed their opinions on Echolaser® TPLA for the treatment of BPH and PCa answering online questionnaires on indications, methodology, and potential complications of this technology. Level of agreement or disagreement to reach consensus was set at 75%. If the consensus was not achieved, questions were modified after each round. A final round was performed during an online meeting, in which results were discussed and finalized.Results: Thirty-two out of forty invited experts participated and consensus was reached on all topics. Agreement was achieved on recommending Echolaser® TPLA as a treatment of BPH in patients with ample range of prostate volume, from <40 mL (80%) to >80 mL (80%), comorbidities (100%), antiplatelet or anticoagulant treatment (96%), indwelling catheter (77%), and strong will of preserving ejaculatory function (100%). Majority of respondents agreed that Echolaser® TPLA is a potential option for the treatment of localized PCa (78%) and recommended it for low-risk PCa (90%). During the final round, experts concluded that it can be used for intermediate-risk PCa and it should be proposed as an effective alternative to radical prostatectomy for patients with strong will of avoiding urinary incontinence and sexual dysfunction. Almost all participants agreed that the transperineal approach of this organ-sparing technique is safer than transrectal and transurethral approaches typical of other techniques (97% of agreement among experts). Pre-procedural assessment, technical aspects, post-procedural catheterization, pharmacological therapy, and expected outcomes were discussed, leading to statements and recommendations.Conclusion: Echolaser® TPLA is a safe and effective procedure that treats BPH and localized PCa with satisfactory functional and sexual outcomes.

3D Vector Reconstruction of the Muscles of the Ventral Region of the Neck from Anatomical Sections of Korean Visible Human at the Paris Descartes Anatomy Laboratory

Objective: To carry out a 3D vector reconstruction of the muscles of the ventral region of the neck from anatomical sections of the “Korean Visible Human” for educational purposes. Materials and Methods: The anatomical subject was a 33-year-old Korean man who died of leukemia. He was 164 cm tall and weighed 55 kgs. The anatomical sections were made in 2010 after an MRI and a CT scan. A special saw (cryomacrotome) made it possible to make cuts 0.2 mm thick on the frozen body, i.e. 5960 cuts. Sections numbered 1500 to 2000 (or 500 cuts covering the neck) were used for our study. A segmentation by manual contouring of each anatomical element of the anterior neck region was done using Winsurf version 3.5 software on a laptop PC running Windows 7 equipped with an 8 gigabyte RAM. Results: We modeled the sternocleidomastoid muscles, the supra-hyoid muscles, the infra-hyoid muscles and the muscle structures of the anterior neck region, the aero-digestive axis of the anterior neck region and the vasculo-nervous axis of the neck. This model is easily manipulated using the Acrobat 3Dpdf interface. Each item accessible in a menu can be displayed, hidden or made transparent, and 3D labels are available as well as educational menus for learning anatomy. This vector model has been integrated into the Diva3d virtual dissection table, a new educational tool used by universities and medical schools to learn anatomy. This model was also uploaded to the Sketchfab? website and 3D printed using an ENDER? pro 3 printer. Conclusion: This original work constitutes a remarkable educational tool for the anatomical study of the anterior neck region and can also be used as a 3D atlas for simulation purposes for training in therapeutic gestures.

Plus Energy Buildings:A Numerical Case Study

The feasibility of Plus Energy Building for a sample relevant case is investigated.After a literature review aimed to identify key aspects of this type of buildings,a preliminary evaluation of the thermal performance of a building constructed using conventional material is presented together with a parametric analysis of the impact of typical influential parameters.Solar domestic hot water(SDHW)and photovoltaic systems(PV)are considered in the study.Numerical simulations indicate that for the examined sample case(Beirut in Lebanon)the total annual energy need of conventional building is 87.1 kWh/y.m^(2).About 49%of energy savings can be achieved by improving the building envelope and installing energy efficient technologies.Moreover,about 90%of energy savings in domestic hot water production can be achieved by installing a SDHW system composed of two solar collectors connected in series.Finally,the addition of a grid connected PV array system can significantly mitigate the energy needs of the building leading to an annual excess of energy.

Evidence of voriconazole pharmacokinetic variability in children and adolescents with haematological disease: proposal for therapeutic drug monitoring optimisation

Objective:Voriconazole(VCZ)is a triazole antifungal agent widely used in immunocompromised patients with suspected or proven invasive fungal infections.The achievement of therapeutic range(1-5 mg/L)is essential to maximize VCZ efficacy,as its pharmacokinetics is characterized by a wide inter-and intra-individual variability.This study aims to quantify the variability of VCZ trough concentrations in children and adolescents with haematological diseases and optimize therapeutic drug monitoring in clinical practice.Methods:We analysed the monitoring concentrations of all children(<18 years old)treated with VCZ in the Haematology Department of Robert DebréHospital between January 2014 and December 2016.Demographic,clinical data,and VCZ dosing and monitoring concentrations measured by high-performance liquid chromatography with ultraviolet detection(HPLC-UV)were analysed.Non-parametric tests were performed using SPSS IBM 24.0.Results:380 trough VCZ concentrations at steady-state(Ctrough,ss)were available in 79 children:45.6%had first Ctrough,ss in the therapeutic range at first monitoring,46.8%had Ctrough,ss below 1 mg/L and 7.6%had Ctrough,ss over 5 mg/L.Forty-one patients were treated with recommended doses but only 53%of them reached the therapeutic range.There was no impact of age,sex,biological parameters,or indication of VCZ on Ctrough,ss values.The number of Ctrough,ss in the therapeutic range increases with the number of monitoring per patient following dosage adaptations.Conclusion:The wide inter-and intra-individual variability of VCZ trough concentrations at recommended doses confirm the need to standardize VCZ monitoring and identify factors to be considered to prospectively adapt treatment for each patient.

Long-Term Persistent Absolute Insulin Secretion Deficiency in Diabetes Induced by Immune Checkpoint Inhibitors

Immune checkpoint inhibitors are today an immense hope in the management of cancers. However, since their widespread use, many cases of insulin-requiring diabetes appearing suddenly, as fulminant diabetes have been reported. Here, we describe 4 cases that occurred at different times after the beginning of immune checkpoint inhibitor therapy with Nivolumab alone or associated with Ipilimumab. There are 3 cases of newly diagnosed diabetes and 1 case of known type 2 diabetes formerly quite well balanced with Metformin. The clinical and biological characteristics of these patients are quite similar. They were all insulin-requiring at the discovery of diabetes and remained so throughout their follow-up. This type of diabetes which looks like type 1 diabetes seems rather to be a new entity.

面向边缘智能的两阶段对抗知识迁移方法

对抗样本的出现,对深度学习的鲁棒性提出了挑战.随着边缘智能的兴起,如何在计算资源有限的边缘设备上部署鲁棒的精简深度学习模型,是一个有待解决的问题.由于精简模型无法通过常规的对抗训练获得良好的鲁棒性,提出两阶段对抗知识迁移的方法,先将对抗知识从数据向模型迁移,然后将复杂模型获得的对抗知识向精简模型迁移.对抗知识以对抗样本的数据形式蕴含,或以模型决策边界的形式蕴含.具体而言,利用云平台上的GPU集群对复杂模型进行对抗训练,实现对抗知识从数据向模型迁移;利用改进的蒸馏技术将对抗知识进一步从复杂模型向精简模型的迁移,最后提升边缘设备上精简模型的鲁棒性.在MNIST,CIFAR-10和CIFAR-100这3个数据集上进行验证,实验结果表明:提出的这种两阶段对抗知识迁移方法可以有效地提升精简模型的性能和鲁棒性,同时加快训练过程的收敛性.

生殖器流行性卡波西氏肉瘤71例临床分析

目的 :分析生殖器流行性卡波西氏肉瘤 (Kaposi sSarcoma简称KS)的发病情况、临床特征及治疗方法。资料和方法 :1986年 6月至 1996年 12月 ,巴黎第十二大学医学院HenriMondor医院肿瘤放疗科共收治 64 5例爱滋病KS病人 ,其中 71例有阴茎及阴囊病变。单发于阴茎或阴囊有 12例 ,其余 5 9例均合并有其它部位的皮肤侵犯。中位年龄 3 7岁 ,9例有排尿困难 ,13例有水肿或 /和疼痛。均采用放射治疗 ,选用低能 ( 4 5KV)X线 ,大野照射10Gy/4次·周 ,根据病变反应 ,休息 15天 ,缩野再予 5～ 10Gy。结果 :所有病人均获客观上的缓解和器官功能的恢复。在 71例共 189个病变部位中 ,完全反应率 2 8% ,部分反应率 66% ,6%无反应。所有病人均获随访 ,平均随访期 7 5个月。结论 :发生于生殖器的流行性KS少见。放疗对本病可取得满意结果 ;

Transjugular intrahepatic portosystemic shunt as bridge-to-surgery in refractory gastric antral vascular ectasia

Gastric antral vascular ectasia(GAVE) may cause gastrointestinal bleeding(GIB). The treatment of GAVE relies on endoscopic approaches such as electrocoagulation(argon plasma coagulation, laser therapy, heater probe therapy, radiofrequency ablation), cryotherapy, and band ligation. In refractory cases, antrectomy may be considered. In the event of an associated cirrhosis and portal hypertension, it has been suggested that antrectomy could be an option, provided the mortality risk isn't considered too great. We report the case of a 67-year-old cirrhotic patient who presented with GAVE related GIB, unresponsive to multiple endoscopic treatments. The patient had a good liver function(model for end-stage disease 10). After a multidisciplinary meeting, a transjugular intrahepatic portosystemic shunt(TIPS) procedure was performed, in order to treat the cirrhosis associated ascites. The outcome was successful. An antrectomy was then performed, with no recurrence of GIB and no transfusion need during three months of follow up. In this case, the TIPS procedure achieved a complete ascites regression, allowing a safer surgical treatment of the GAVE-related GIB.

Role of endoscopic ultrasound in the screening and follow-up of high-risk individuals for familial pancreatic cancer

Managing familial pancreatic cancer(FPC)is challenging for gastroenterologists,surgeons and oncologists.High-risk individuals(HRI)for pancreatic cancer(PC)(FPC or with germline mutations)are a heterogeneous group of subjects with a theoretical lifetime cumulative risk of PC over 5%.Screening is mainly based on annual magnetic resonance imaging(MRI)and endoscopic ultrasound(EUS).The goal of screening is to identify early-stage operable cancers or high-risk precancerous lesions(pancreatic intraepithelial neoplasia or intraductal papillary mucinous neoplasms with high-grade dysplasia).In the literature,target lesions are identified in 2%-5%of HRI who undergo screening.EUS appears to provide better identification of small solid lesions(0%-46%of HRI)and chronicpancreatitis-like parenchymal changes(14%-77%of HRI),while MRI is probably the best modality to identify small cystic lesions(13%-49%of HRI).There are no specific studies in HRI on the use of contrast-enhanced harmonic EUS.EUS can also be used to obtain tissue samples.Nevertheless,there is still limited evidence on the accuracy of imaging procedures used for screening or agreement on which patients to treat.The cost-effectiveness of screening is also unclear.Certain new EUS-related techniques,such as searching for DNA abnormalities or protein markers in pancreatic fluid,appear to be promising.

Obesity leads to higher risk of sperm DNA damage in infertile patients

There has been a growing interest over the past few years in the impact of male nutrition on fertility. Infertility has been linked to male overweight or obesity, and conventional semen parameter values seem to be altered in case of high body mass index （BMI）. A few studies assessing the impact of BMI on sperm DNA integrity have been published, but they did not lead to a strong consensus. Our objective was to explore further the relationship between sperm DNA integrity and BMI, through a 3-year multicentre study. Three hundred and thirty male partners in subfertile couples were included. Using the terminal uridine nick-end labelling （TUNEL） assay, we observed an increased rate of sDerm DNA damage in obese men （odds ratio （95% confidence interval）： 2.5 （1.2-5.1））.

New trends in colorectal surgery: Single port and natural orifice techniques

Single-incision laparoscopic surgery (SILS) and natural orifice transluminal endoscopic surgery (NOTES) have rapidly gained pace worldwide, potentially replacing conventional laparoscopic surgery (CLS) as the preferred colorectal surgery technique. Currently available data mainly consist of retrospective series analyzed in four meta-analyses. Despite conflicting results and lack of an objective comparison, SILS appears to offer cosmetic advantages over CLS. However, due to conflicting results and marked heterogeneity, present data fail to show significant differences in terms of operative time, postoperative morbidity profiles, port-site complications rates, oncological appropriateness, duration of hospitalization or cost when comparing SILS with conventional laparoscopy for colorectal procedures. The application of &#x0201c;pure&#x0201d; NOTES in humans remains limited to case reports because of unresolved issues concerning the ideal access site, distant organ reach, spatial orientation and viscera closure. Alternatively, minilaparoscopy-assisted natural orifice surgery techniques are being developed. The transanal &#x0201c;down-to-up&#x0201d; total mesorectum excision has been derived for transanal endoscopic microsurgery (TEM) and represents the most encouraging NOTES-derived technique. Preliminary experiences demonstrate good oncological and functional short-term outcomes. Large-scale randomized controlled trials are now mandatory to confirm the long-term SILS results and validate transanal TEM for the application of NOTES in humans.

NOD2/CARD15 gene mutations in North Algerian patients with inflammatory bowel disease

AIM: To analyse allelic frequency of NOD2 gene variantsand to assess their correlation with inflammatory bowel disease(IBD) in Algeria.METHODS: We studied 132 unrelated patients diagnosed with IBD, 86 with Crohn's disease(CD) and 46 with ulcerative colitis(UC). Data was prospectively collected between January 2011 and December 2013. The demographic and clinical characteristics were recorded for all the patients. A group of 114 healthy unrelated individuals were selected as controls. All groups studied originated from different regions of North Algeria and confirmed the Algerian origin of their parents and grandparents. Informed and written consent was obtained from each of the participants. All individuals were genotyped for the three CDassociated NOD2 variants(p.Arg702 Trp, p.Gly908 Arg and p.Leu1007 fsins C mutations) using the polymerase chain reaction-restriction fragment length polymorphism method. Allele and genotype frequencies in patients and control subjects were compared by χ2 test and Fisher's exact test where appropriate. Odds ratios(OR) and 95% confidence intervals(95%CI) were also estimated. Association analyses were performed to study the influence of these variants on IBD and on clinical phenotypes.RESULTS: The p.Arg702 Trp mutation showed the highest frequency in CD patients(8%) compared to UC patients(2%)(P = 0.09, OR = 3.67, 95%CI: 0.48-4.87) and controls(5%)(P = 0.4, OR = 1.47, 95%CI: 0.65-3.31). In CD patients allelic frequencies of p.Gly908 Arg and p.Leu1007 fsins C variants compared to HC were 3% vs 2%(P = 0.5, OR = 1.67, 95%CI: 0.44-6.34); 2% vs 1%(P = 0.4 OR = 2.69 95%CI: 0.48-14.87 respectively). In UC patients, allelic frequencies of p.Gly908 Arg and p.Leu1007 fsins C variants compared to HC were 1% vs 2%(P = 1, OR = 1.62, 95%CI: 0.17-4.74) and 2% vs 1%(P = 0.32, OR = 0.39, 95%CI: 0.05-2.87). The total frequency of the mutated NOD2 chromosomes was higher in CD(13%), than in HC(8%) and UC(5%). In addition, NOD2 variants were linked to a particular clinical sub-phenotype in CD in this Algerian cohort. As expected, the three NOD2 variants showed a significant association with CD but did not reach statistical significance, despite the fact that the allele frequency of NOD2 variants was in the range found in most of the European populations. This might be due to the non-exposure of the NOD2 carriers to environmental factors, required for the expression of the disease.CONCLUSION: Further analyses are necessary to study genetic and environmental factors in IBD in the Algerian population, using larger patient groups.

The influence of physiobiomechanical parameters,technical aspects of shooting,and psychophysiological factors on biathlon performance:A review

The biathlon, an Olympic sporting discipline that combines cross-country skiing with rifle marksmanship, entails considerable physiological demands, as well as fine motor control while shooting after intense exercise and under mental pressure. Although much of our knowledge about cross-country skiing is probably also applicable to the biathlon, carrying the rifle and shooting under stress make this discipline somewhat unique. The present review summarizes and examines the scientific literature related to biathlon performance, with a focus on physiological and biomechanical factors and shooting technique, as well as psychophysiological aspects of shooting performance. We conclude with suggestions for future research designed to extend our knowledge about the biathlon, which is presently quite limited.2018 Published by Elsevier B.V. on behalf of Shanghai University of Sport. This is an open access article under the CC BY-NC-ND license. （http：//creativecommons.org/licenses/by-nc-nd/4.0/）.

Toward Energy-Efficient and Trustworthy eHealth Monitoring System

The rapid technological convergence between Internet of Things （loT）, Wireless Body Area Networks （WBANs） and cloud computing has made e-healthcare emerge as a promising application domain, which has significant potential to improve the quality of medical care. In particular, patient-centric health monitoring plays a vital role in e-healthcare service, involving a set of important operations ranging from medical data collection and aggregation, data transmission and segregation, to data analytics. This survey paper firstly presents an architectural framework to describe the entire monitoring life cycle and highlight the essential service components. More detailed discussions are then devoted to {／em data collection} at patient side, which we argue that it serves as fundamental basis in achieving robust, efficient, and secure health monitoring. Subsequently, a profound discussion of the security threats targeting eHealth monitoring systems is presented, and the major limitations of the existing solutions are analyzed and extensively discussed. Finally, a set of design challenges is identified in order to achieve high quality and secure patient-centric monitoring schemes, along with some potential solutions.

Designer substrates and devices for mechanobiology study

Both biological and engineering approaches have contributed significantly to the recent advance in the field of mechanobiology.Collaborating with biologists,bio-engineers and materials scientists have employed the techniques stemming from the conventional semiconductor industry to rebuild cellular milieus that mimic critical aspects of in vivo conditions and elicit cell/tissue responses in vitro.Such reductionist approaches have help to unveil important mechanosensing mechanism in both cellular and tissue level,including stem cell differentiation and proliferation,tissue expansion,wound healing,and cancer metastasis.In this mini-review,we discuss various microfabrication methods that have been applied to generate specific properties and functions of designer substrates/devices,which disclose cell-microenvironment interactions and the underlying biological mechanisms.In brief,we emphasize on the studies of cell/tissue mechanical responses to substrate adhesiveness,stiffness,topography,and shear flow.Moreover,we comment on the new concepts of measurement and paradigms for investigations of biological mechanotransductions that are yet to emerge due to on-going interdisciplinary efforts in the fields of mechanobiology and microengineering.