Tesis sobre el tema "Prédiction précise"
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Ben, Soussia Amal. "Analyse prédictive des données d’apprentissage, en situation d’enseignement à distance". Electronic Thesis or Diss., Université de Lorraine, 2022. http://www.theses.fr/2022LORR0216.
Texto completoOver the past few decades, the adoption of e-learning has evolved rapidly and its use has been pushedeven further with the COVID-19 pandemic. The objective of this learning mode is to guarantee thecontinuity of the learning process. However, the online learning is facing several challenges, and themost widespread is the high failure rates among learners. This issue is due to many reasons such asthe heterogeneity of the learners and the diversity of their learning behaviors, their total autonomy, thelack and/or the inefficiency of the pedagogical provided follow-up. . .. Therefore, teachers need a systembased on analytical and intelligent methods allowing them an accurate and early prediction of at-risk offailure learners. This solution is commonly adopted in the state of the art. However, the work carried outdoes not respond to some particularities of the learning process (the continuity and evolution of learning,the diversity of learners and their total autonomy) and to some teachers expectations such as the alertgeneration.This thesis belongs to the field of learning analytics and uses the numeric traces of online learnersto design a predictive system (Early Warning Systems (EWS)) dedicated to teachers in online establish-ments. The objective of this EWS is to identify learners at risk as soon as possible in order to alertteachers about them. In order to achieve this objective, we have dealt with several sub-problems whichhave allowed us to elaborate four scientific contributions.We start by proposing an in-depth methodology based on the Machine Learning (ML) steps and thatallows the identification of four learning indicators among : performance, engagement, reactivity andregularity. This methodology also highlights the importance of temporal data for improving predictionperformance. In addition, this methodology allowed to define the model with the best ability to identifyat-risk learners.The 2nd contribution consists in proposing a temporal evaluation of the EWS using temporal metricswhich measure the precocity of the predictions and the stability of the system. From these two metrics,we study the trade-offs that exist between ML precision metrics and temporal metrics.Online learners are characterized by the diversity of their learning behaviors. Thus, an EWS shouldrespond to this diversity by ensuring an equitable functioning with the different learners profiles. Wepropose an evaluation methodology based on the identification of learner profiles and that uses a widespectrum of temporal and precision metrics.By using an EWS, teachers expect an alert generation. For this reason, we design an algorithm which,based on the results of the prediction, the temporal metrics and the notion of alert rules, proposes anautomatic method for alert generation. This algorithm targets mainly at-risk learners.The context of this thesis is the French National Center for Distance Education (CNED). In parti-cular, we use the numeric traces of k-12 learners enrolled during the 2017-2018 and 2018-2019 schoolyears
Wang, Zeya. "Robotisation de la fabrication additive par procédé arc-fil : Identification et amélioration de la commande". Electronic Thesis or Diss., Université de Lorraine, 2022. http://www.theses.fr/2022LORR0068.
Texto completoAdditive manufacturing of metallic parts has gained significant popularity in recent years as an important technological solution for the production of complex parts. Among the different processes of metal additive manufacturing, the wire-arc additive manufacturing (WAAM) using CMT (Cold metal transfer) welding is taken for our study because of its high deposition rate, low cost of equipment and little loss of material (low spatter) during manufacturing. In the literature review, it can be noted that one of the most important problems that prevent the industrial application of the WAAM is the poor geometric accuracy of the manufactured parts due to the instability of the process and the lack of reliable control system to deal with irregularities during deposition. The focus of this work is to improve the stability and geometric performance of the process. In this work, an experimental system is implemented to robotize the process and to monitor the geometry of the deposited parts. The process is modeled by artificial neural networks and a control system is developed to regulate the geometry of the deposit and to reduce manufacturing errors. Furthermore, an improvement strategy is applied in order to reduce the geometric instabilities at the ends of the bead; an in-situ monitoring method is also developed to detect the internal defects of deposited parts
Bendifallah, Sofiane. "Prédiction et modélisation du risque dans le cancer de l'endomètre de stade précoce". Thesis, Paris 6, 2016. http://www.theses.fr/2016PA066319.
Texto completoWith the abundance of new options in diagnostic and treatment modalities, a shift in the medical decision process for endometrial cancer has been observed. The emergence of individualized medicine and the increasing complexity of available medical data have lead to the development of prediction models. In endometrial cancer, those clinical models (algorithms, nomograms, and risk scoring systems) have been reported, for stratifying and subgrouping patients, with various unanswered questions regarding such things as the optimal surgical staging for lymph node metastasis as well as the assessment of recurrence and survival outcomes. Through this manuscript we developed the question of the risk stratification for recurrence at the population level and the probability of lymph node involvement estimation at an individual level in early stage endometrial cancer. This double approach was adopted with the aim to illustrate the interest of these tools in clinical practice. At the population level, we proposed: i) a comparison of the main international clinicopathological classifications ii) a new clinicopathological classification based on a pathological predictor iii) two risk stratification systems for recurrence and lymph node metastasis. At the individual level we developed: i) a reproducible methodology for external validation of predictive models, ii) a specific clinic pathological nomogram for lymph node metastasis. In the future, the emerging field of molecular or biochemical markers research may substantially improve the predictive approach for preventive and curative strategies in endometrial cancer
Portier, Eric. "Lien entre environnement de dépôt et diagenèse précoce : importance dans la prédiction des qualités réservoir". Thesis, Université Paris-Saclay (ComUE), 2018. http://www.theses.fr/2018SACLS548.
Texto completoReservoir quality distribution in subsurface, within an aquifer, storage or a hydrocarbon bearing reservoir, is largely variable and hence, difficult to predict. This study focuses on the early diagenetic processes, which are considered as key in the next steps of the diagenesis of deeply buried reservoir. Based on the examples of sandstones deposited in glacial setting during Ordovician of a gas field in Algeria and tidal sandstones from a Permian formation in Australia, the objective is to show the role and control exerted by the depositional environment on early diagenesis, and especially the major role of sediment reworking to predict reservoir quality distribution. The studied reworking processes are responsible of clay incorporation into sand deposits, as clay coats around detrital gains or as pore linings. The nature of clay is then determinant in the diagenetic processes, as these coatings may enhance chemical compaction if illitic in nature, or reversely, may inhibit cementation and help preserving reservoir quality if they are made of ferrous chlorite. These reworkings are associated to fluid overpressure within the sediment in glacial settings, whilst they are associated to the permanent reworking of sands by tidal currents, enabling the agglomeration of clay flocs to detrital grains with biofilm elements acting as natural glue
Thériault, Sébastien. "Prédiction précoce du risque de diabète gestationnel : développement de modèles combinant facteurs cliniques et marqueurs biochimiques". Thesis, Université Laval, 2014. http://www.theses.ulaval.ca/2014/30778/30778.pdf.
Texto completoThis project aims to develop an early risk-prediction tool for gestational diabetes (GDM). This is a case-control study from a prospective cohort including 7929 pregnant women recruited between 2005 and 2010 in the Quebec City metropolitan area. External validation of four predictive models proposed in the literature allowed the identification of clinical variables (including past history of GDM, body mass index and family history of diabetes) performing particularly well for the prediction of GDM requiring insulin therapy. An original model combining some of these clinical variables with three readily available biochemical markers (HbA1c, SHBG and hsCRP measured between 14 and 17 weeks of gestation) yielded area under the ROC curve of 0.90 and sensitivity of 72% at a false-positive rate of 10%. This project allowed the identification of predictive factors for GDM available early in pregnancy, which could improve the management of high risk women.
Dubos, François. "Outils prédictifs pour la distinction précoce des méningites bactériennes et virales de l'enfant". Paris 6, 2010. http://www.theses.fr/2010PA066165.
Texto completoMessou, Kouassi Eugène. "Traitement antirétroviral de l'adulte infecté par le virus de l'immunodéficience humaine en Côte d'Ivoire : modification précoce et prédiction de l'échec". Bordeaux 2, 2008. http://www.theses.fr/2008BOR21584.
Texto completoIn sub-Saharan Africa, 2 milliion adults have already started antiretroviral treatment (ART). However, the number of patients needing urgent treatment or likely to need it in the future is estimated to be 3 times and 10 times higher, respectively. Clinical research must back up this historical challenge, identify the issues that ART in resource-limited settings specifically raises, and help innovate. Over the past 10 years, several pilot initiatives and then many large programs of access to care and treatment have brought about data on the early phase of ART in sub-Saharan Africa, ie the time just before ART initiation and the first year on ART. During this early phase : the rate of loss to follow-up is still too high, but the rate of treatment failure in patients who remain in care is low ; the spectrum of early morbidity on ART is similar to that off ART, though with IRIS being a specific additional issue to deal with during the first months of treatment ; and treatment regimen modification is mainly related to toxicity, though tuberculosis and pregnancy also frequently lead to nevirapine and efavirenz discontinuation. From the end of the first year of ART, virological failure emerges as a challenging issue in settings where plasma viral load cannot be measured. The CD4 count and the body mass index evolution at 6 months and 12 months are not predictive enough to become surrogates for virological outcomes. However, they are strongly associated with early viral load suppression, and further studies should assess whether they might become useful tools for helping decide when to switch to second-line regimen over a longer period of time
Girond, Florian. "Mise en place d’un système d’information géographique pour la détection précoce et la prédiction des épidémies de paludisme à Madagascar". Thesis, La Réunion, 2017. http://www.theses.fr/2017LARE0012/document.
Texto completoWe describe a Malaria Early Warning System (MEWS) using various epidemic thresholds and a forecasting component with the support of recent technologies to improve the performance of a sentinel MEWS. Malaria-related data from sentinel sites collected by Short Message Service are automatically stored in a database hosted on a server at Institut Pasteur de Madagascar. Concomitantly our system routinely and automatically acquires site specific satellite weather data related to changes in malaria prevalence such as temperature, rainfall and Normalized Difference Vegetation Index (NDVI). A Malaria Control Intervention data base has also been. This system has already demonstrated its ability to detect a malaria outbreak in southeastern part of Madagascar in 2014. In a second time, we conducted a study to assess the relationship between the effectiveness of mass campaign of long-lasting insecticidal nets (LLIN) over time and malaria outbreaks identified in Madagascar from 2009 to 2015 through the Sentinel surveillance system. This study showed that the difference between efficacy and effectiveness may result in gaps in service coverage during the subsequent years contributing to malaria rebound well before the replacement of the LLINs and highlights the need of continuous distribution mechanism of LLINs.This work aims to maximize the usefulness of a sentinel surveillance system to predict and detect epidemics in limited-resource environments, to guide any changes in the orientation of malaria control programs and to provide practical examples and suggestions for use in other systems or settings
Brunet, Sophie. "Incidence, facteurs prédictifs et physiopathologie du S. I. R. S. Sévère en postopératoire précoce de chirurgie cardiaque". Montpellier 1, 1996. http://www.theses.fr/1996MON11035.
Texto completoMatte-Landry, Alexandra. "Le retard de langage précoce : difficultés développementales concomitantes et à l'âge scolaire selon sa persistance". Doctoral thesis, Université Laval, 2018. http://hdl.handle.net/20.500.11794/30032.
Texto completoThe present thesis focuses on children with early language delay (LD) at 18 months of age from a populationbased longitudinal study. It focuses on their co-occurring and school-age developmental difficulties according to LD persistence. First, a retrodictive approach was used to document motor development, sleep and psychosocial development in late-talkers to identify whether specific difficulties and/or their accumulation predict expressive LD persistence over and above initial language levels. Results showed that children with persistent LD accumulated developmental difficulties at 18 months of age whereas those with transient LD only had more oppositional behaviors than children with persistent LD and controls. These developmental difficulties seem to have a contribution to the development of expressive language but they do not predict LD persistence over and above the nature and the severity of early LD. The only unique predictor of persistence at 5 years of age was 18-month receptive vocabulary. Second, school-age language, academic and psychosocial outcomes of children with early LD were investigated according to LD persistence. We wanted to test empirically the hypothesis that children with transient LD had residual difficulties at school-age. Results showed that children with persistent LD accumulated language, academic and psychosocial difficulties up to Grade 6. Children with transient LD however had some psychosocial difficulties in the early school years. Thus, the hypothesis of an illusory recovery in children with transient LD was empirically supported only for psychosocial development. In sum, the results of this thesis showed that children with persistent LD have more co-occurring and schoolage developmental difficulties than those with typical language development. Difficulties were more severe or affected more developmental domains in children with persistent LD in comparison with children with transient LD. Moreover, early co-occurring developmental difficulties could help predict LD persistence at age 5. These results may suggest that children with persistent and transient LD belong to two distinct developmental trajectories underpinned by distinct developmental and etiological mechanisms. The implications of these results for the advancement of scientific knowledge and clinical practice are discussed in the conclusion.
Lhortolary, Julien. "Modèle prédictif de transistor HEMT pour la simulation précise de l'intermodulation à très bas niveau de puissance et aux hautes fréquences : évaluation des performances en linéarité de différentes filières technologiques pHEMT AsGa". Limoges, 2007. https://aurore.unilim.fr/theses/nxfile/default/92041af0-26f1-4756-82ed-f1eaa3b70dad/blobholder:0/2007LIMO4007.pdf.
Texto completoToday, confident design of highly linear high-frequency MMICs is of primary concern in modern telecommunication systems. Unfortunately, at high frequencies and low output power, accurate prediction of intermodulation distortions fails with most of the available HEMT models due to nonlinearity extractions based on CW S-parameter measurements at DC bias points or low RF frequency measurements. In this manuscript, we propose a suitable HEMT model, extracted from pulsed I/V and pulsed S-parameter measurements over a wide frequency range, which allows accurate intermodulation distortions prediction at both high frequencies range and for low output power. Careful IM3 generation analysis has been undertaken. Complex interaction phenomenon involving each transistor’s intrinsic non-linear elements have been demonstrated and the role of the capacitance Cgd have been shown to be of primary concern. Finally, a comparison study of 6 different pHEMT GaAs foundry process based on 10GHz 2-tons load pull measurements is presented. This study have point out 2 foundry process (PPH15 and PP15-20) suitable for highly linear high frequency MMIC design
Daugrois, Camille. "Lymphomes anaplasiques à grandes cellules ALK positifs : signature pronostique des rechutes précoces". Thesis, Toulouse 3, 2015. http://www.theses.fr/2015TOU30281.
Texto completoAnaplastic large cell lymphomas (ALCL) peripheral belong to T cell lymphomas and may be associated with translocations involving the ALK gene (ALK+). These lymphoma are rare, of high grade and often affect young subjects. Current treatments allow obtaining a complete remission for over 80% of patients. However nearly 30% of patients whose treatment is stratified according to current clinical prognostic factors, will relapse in the year following the end of treatment. It is therefore essential to decipher predictive factors of relapse at diagnosis in order to improve therapeutic management. The aim of my project was on one hand, to identify molecular factors of the tumor or its microenvironment, associated with relapse or lack of relapse and secondly, to establish a predictive gene expression signature at diagnosis that could be used in clinical routine. We performed transcriptome analysis of samples obtained at diagnosis in a cohort of 48 patients with ALK+ ALCL and sufficient follow up (26 from patients who early relapsed, 22 patients who did not relapse). We have identified 47 differentially expressed genes between the two groups. This signature shows in particular, from the group of patients who did not relapse, an enrichment of genes encoding proteins involved in the regulation of the extracellular matrix. This signature has been then validated by high-throughput quantitative PCR (Fluidigm). Classification algorithms such as Random Forests and PLS-DA helped select the eight most discriminating genes in terms of predictive power. Based on their expression level, three genes with the strongest predictive power were identified by logistic regression. For diagnostic testing in routine practice, these three genes were validated by standard qPCR. A score and a threshold for distinguishing patients who will relapse from patients who will not were established from the expression of these three genes. This dichotomous classification gives a prediction failure rate of only 16% on this first cohort. This prediction score was then validated in an independent cohort of 18 patients, with a failure rate of 22%. This study demonstrates the value of predictive signatures derived from high-throughput data to guide treatment strategy
Jeancolas, Laetitia. "Détection précoce de la maladie de Parkinson par l'analyse de la voix et corrélations avec la neuroimagerie". Electronic Thesis or Diss., Université Paris-Saclay (ComUE), 2019. http://www.theses.fr/2019SACLL019.
Texto completoVocal impairments, known as hypokinetic dysarthria, are one of the first symptoms to appear in Parkinson's Disease (PD). A large number of articles exist on PD detection through voice analysis, but few have focused on the early stages of the disease. Furthermore, to our knowledge, no study had been published on remote PD detection via speech transmitted through the telephone channel. The aim of this PhD work was to study vocal changes in PD at early and preclinical stages, and develop automatic detection and monitoring models. The long-term purpose is to build a cheap early diagnosis and monitoring tool, that doctors could use at their office, and even more interestingly, that could be used remotely with any telephone. The first step was to build a large voice database with more than 200 French speakers, including early PD patients, healthy controls and idiopathic Rapid eye movement sleep Behavior Disorder (iRBD) subjects, who can be considered at PD preclinical stage. All these subjects performed different vocal tasks and were recorded with a professional microphone and with the internal microphone of a computer. Moreover, they called once a month an interactive voice server, with their own phone. We studied the effect of microphone quality, speech tasks, gender, and classification analysis methodologies. We analyzed the vocal recordings with three different analysis methods, covering different time scale analyses. We started with cepstral coefficients and Gaussian Mixture Models (GMM). Then we adapted x-vectors methodology (which never had been used in PD detection) and finally we extracted global features classified with Support Vector Machine (SVM). We detected vocal impairments at PD early and preclinical stages in articulation, prosody, speech flow and rhythmic abilities. With the professional microphone recordings, we obtained an accuracy (Acc) of 89% for male early PD detection, just using 6min of reading, free speech, fast and slow syllable repetitions. As for women, we reached Acc = 70% with 1min of free speech. With the telephone recordings, we achieved Acc = 75% for men, with 5min of rapid syllable repetitions, and 67% for women, with 5min of free speech. These results are an important first step towards early PD telediagnosis. We also studied correlations with neuroimaging, and we were able to linearly predict DatScan and Magnetic Resonance Imaging (MRI) neuromelanin sensitive data, from a set of vocal features, in a significant way. This latter result is promising regarding the possible future use of voice for early PD monitoring
Michaud, Dumont Frédérique. "L'autorégulation émotionnelle chez les enfants en contexte d'adversité : association avec le fonctionnement scolaire à la première année". Master's thesis, Université Laval, 2019. http://hdl.handle.net/20.500.11794/34579.
Texto completoThe three objectives of this study were to describe the differences in emotional self-regulation skills among children in an adversity context group versus a group of children in a low-risk context, examine association between inhibitory control, capacity of emotions identification and prefrontal hemodynamic activation with school functioning and explore potential significant association between underlying skills of emotion regulation. A meeting in the summer before the school year was held and the children (n = 48) performed a face emotion identification task and a Stroop task during the use of Near-infrared spectroscopy. Following the beginning of the first school year, school functioning was evaluated with the Social Skills Improvement System by telephone interview with parents and teachers. The results show a comparable performance of the two groups of children in the psychophysical tasks presented, but a significant difference in the hemodynamic activation of the right Brodmann's area (BA8R) during the performance of Stroop's task. The activation of the Brodmann 9 right area (BA9R) during Stroop's task presents an association with the school functioning of the children. Finally, the results reveal the implication of BA8 and BA9 during performance in tasks requiring processing of emotional stimuli and inhibitory control. This study contributed to a better understanding of the impact of adversity on the development of emotional self-regulation skills, the role of these skills on school functioning and contribute to support empirical knowledge of emotional self-regulation. This knowledge aims to support the implementation of effective preventive measures for successful transition to school in the first year.
Al, Saleh Mohammed. "SPADAR : Situation-aware and proactive analytics for dynamic adaptation in real time". Electronic Thesis or Diss., université Paris-Saclay, 2022. http://www.theses.fr/2022UPASG060.
Texto completoAlthough radiation level is a serious concern that requires continuous monitoring, many existing systems are designed to perform this task. Radiation Early Warning System (REWS) is one of these systems which monitors the gamma radiation level in the air. Such a system requires high manual intervention, depends totally on experts' analysis, and has some shortcomings that can be risky sometimes. In this thesis, the RIMI (Refining Incoming Monitored Incidents) approach will be introduced, which aims to improve this system while becoming more autonomous while keeping the final decision to the experts. A new method is presented which will help in changing this system to become more intelligent while learning from past incidents of each specific system
Arnaud, Mado. "Interventions précoces en autisme : trajectoires développementales, prédicteurs de la progression et vécu parental". Thesis, Toulouse 2, 2019. http://www.theses.fr/2019TOU20011.
Texto completoBackground: Autism spectrum disorder is characterized by a large heterogeneity at both the level of its etiology and in the developmental course of its core features. In this context, it is worth stressing the need for developing early interventions and evaluate their effects as well as questioning the role of the family.Study 1: This study aims to examine the effect of context on social attention in young children with ASD. Children with ASD look less at the face especially in contexts that are less socially engaging. The present Social attention task may be used as a predictive factor of a child’s progression.Study 2: The objective of this study is to characterize the developmental trajectories of young children who received Early Start Denver model intervention, and to identify factors that may influence their progression. Children show significant improvements in their level of comprehension and expression. Initial level of comprehension is a predictor of children's progress in the field of expressive communication. The social attention task is a predictor of the initial level of social skills.Study 3: In the third study the parental experiences of Parent Mediated Intervention via a telehealth program is explored. Interviews conducted after the program ended indicate that Telehealth may be relevant to the dissemination of Parent Mediated Interventions but caution is also needed as these interventions should not replace early intervention.Conclusion: Heterogeneity in ASD is present from early childhood and is expressed through significant differences in developmental patterns. This heterogeneity is also reflected in the children's response to an intervention. The search for predictive factors and the active ingredients of the intervention is necessary to offer the most individualized support possible. Finally, the support of parents is essential to improve their quality of life, foster their educational practices and to promote paths continuity
Seners, Pierre. "Recanalisation artérielle précoce après thrombolyse intraveineuse d’un accident ischémique cérébral avec occlusion artérielle proximale : incidence, prédiction et physiopathologie Indicidence and predictors of early recanalization following IV thrombolysis. A systematic review and meta-analysis Post-thrombolysis recanalization in stroke referrals for thrombectomy: Incidence, predictors and prediction scores Relationships between brain perfusion and early recanalization after intravenous thrombolysis for acute stroke with large vessel occlusion Better collaterals are independently associated with post-thrombolysis recanalization before thrombectomy Thrombus length predicts lack of post-thrombolysis early recanalization in minor stroke with large vessel occlusion Early recanalization in tenecteplase vs. alteplase-treated drip-and-ship patients referred for thrombectomy". Thesis, Sorbonne Paris Cité, 2018. http://www.theses.fr/2018USPCB222.
Texto completoIn acute stroke patients with large-vessel occlusion (LVO), the goal of intravenous thrombolysis (IVT) is to achieve early recanalization. Whether all patients with LVO need to undergo intravenous thrombolysis (IVT) before mechanical thrombectomy (MT) – i.e. bridging therapy, which is standard-of-care since 2015 – is debated as: i) thrombolysis may be harmful in patients unlikely to recanalize following IVT; and, ii) conversely, transfer for MT may be unnecessary in patients highly likely to recanalize. It is therefore timely and important to investigate the mechanisms and predictors of post-IVT recanalization, since the findings could have major clinical implications, such as the development of more efficient intravenous therapies, as well as moving towards personalized medicine, involving the selection of individual patients for best therapy, i.e., IVT alone, bridging, or MT alone. In the present thesis, we studied the incidence and predictors of post-IVT early recanalization in a large French multicentric cohort of acute stroke with LVO (n=1107), where all patients were treated with IVT and referred for MT between 2015 and 2017. Recanalization was evaluated on first intracranial angiogram or non-invasive vascular imaging within the first 3h following IVT start. The incidence of early recanalization following IVT was substantial in the overall cohort, occurring in ~1 in 5 patients. Thrombus site and length, time elapsed between IVT start and recanalization assessment, and quality of the leptomeningeal collateral flow or severity of hypoperfusion, were all independently associated with early recanalization occurrence. These findings are novel and important, and shed new light on the mechanisms underlying post-IVT recanalization. A six-point score derived from the three former variables afforded >90% specificity for no-recanalization, but did not reliably predict occurrence of early recanalization. This score should prove of value for patient selection into trials, testing e.g. bridging therapy vs. MT alone, but may not be used to support decisions to withhold referral for MT. In the subgroup of LVO patients with minor neurological symptoms (NIHSS score <6), in whom the optimal treatment is unknown, we found that thrombus length was a powerful independent predictor of no-recanalization, and that the optimal cutoff (9mm) had a high sensitivity/specificity ratio for no-recanalization, which may help design randomized trials aiming to test bridging therapy vs. IVT alone in this population. Lastly, unlike the EXTEND-IA TNK randomized trial which found 2-fold higher early recanalization rate before mechanical MT following IVT with tenecteplase as compared to alteplase in patients directly admitted to MT-capable centres, we found similar early recanalization rates with these two thrombolytic agents in patients transferred for MT from a non MT-capable centre (i.e., with longer IVT-to-MT delays than in EXTEND-IA TNK), currently the most frequently encountered clinical situation. Taken together, these data suggest that recanalization may occur earlier with tenecteplase, which if confirmed would have clinical relevance. Towards further clarifying the pathophysiology of post-thrombolysis early recanalization failure and develop more efficient intravenous therapies for acute ischemic stroke, specific studies will need to address two additional potentially important predictors of early recanalization, namely haemostatic biomarkers and thrombus composition
Santucci, Lara. "Évaluation de nouvelles méthodes de prédiction et de dépistage précoce de l’albuminurie chez les patients avec diabète de type 2". Thesis, 2019. http://hdl.handle.net/1866/24507.
Texto completoType 2 diabetes (T2D) is a serious chronic disease and its prevalence keeps increasing all over the world. The most severe and common diabetes complication is nephropathy of which the first symptom is albuminuria. Our first objective is to evaluate if early screening of albuminuria allows for a better patient care of this condition in general practitioner practice. Our second objective is to validate the efficacy of our polygenetic risk score (PRS) on the risk prediction of albuminuria on Canadian cohort composed of hypertensive TD2 patients from groupe de médecine familiale (GMF) and family health team (FHT) in Quebec and in Ontario (CLINPRADIA I). The PRS identified the 30% of T2D patients at high risk of developing albuminuria. Indeed, the albuminuria prevalence of the 30% of subjects at high genetic risk based on the PRS was 2.6 times higher than the remaining patients of CLINPRADIA I. In the same cohort, we established that the introduction of the point of care testing (POCT) improves the practice and the adherence of physicians to the guidelines for the treatment of albuminuria. The values of albuminuria and the number of patients with albuminuria decreased significantly after the introduction of the POCT. We can conclude from our results that the use of our PRS enables the early identification of the patients at high risk of albuminuria while the POCT enables the early detection of patients with albuminuria who benefited from an early intervention.
Saint-Pierre, Chantal. "Élaboration et vérification d'un modèle prédictif de l'adaptation aux rôles associés de mère et de travailleuse à statut précaire". Thèse, 2002. http://hdl.handle.net/1866/14395.
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