Purpose: In patients with advanced oesophageal carcinoma palliation of dysphagia is important to maintaining a reasonable quality of life. The primary aim of this study was to determine the dysphagia progression-free survival (DPFS) in patients with advanced oesophageal carcinoma treated with palliative radiotherapy (RT). Methods: The medical records of all patients with oesophageal carcinoma presenting to Groote Schuur Hospital, Cape Town between January 2015-December 2016 were reviewed and patients who were not candidates for curative treatment and received palliative RT were selected. For these patients, the dysphagia score (DS) was recorded prior to RT, 6 weeks after RT and at each follow-up visit. The DPFS was calculated as the time from completion of RT to worsening in DS by ≥1 point or until death. Other outcomes measured were objective change in DS and survival post RT. Results: The study population comprised 84 patients. Squamous cell cancer was the primary histological subtype (93%). The median duration of DPFS after RT was 73 days, with approximately two-thirds of patients remaining able to swallow at least liquids and soft diet until death. The difference in median duration of DPFS was not statistically significant in stented versus non-stented patients (54 days vs 83 days; p =0.224). The mean change in DS was 0.45 ± 0.89 points following RT and the post RT survival was significantly shorter in patients with stent insertion (81 days vs 123 days; p=0.042). Conclusion: Palliative RT can be used successfully to prolong DPFS in patients with locally advanced and metastatic squamous cell cancer of the oesophagus.

京都大学 / 0048 / 新制・課程博士 / 博士(医学) / 甲第22311号 / 医博第4552号 / 新制||医||1040(附属図書館) / 京都大学大学院医学研究科医学専攻 / (主査)教授 福原 俊一, 教授 坂井 義治, 教授 妹尾 浩 / 学位規則第4条第1項該当 / Doctor of Medical Science / Kyoto University / DFAM

京都大学 / 0048 / 新制・課程博士 / 博士(医学) / 甲第22353号 / 医博第4594号 / 新制||医||1042(附属図書館) / 京都大学大学院医学研究科医学専攻 / (主査)教授 佐藤 俊哉, 教授 湊谷 謙司, 教授 福原 俊一 / 学位規則第4条第1項該当 / Doctor of Medical Science / Kyoto University / DFAM

The aim of this master's thesis is to explore and elaborate on the Wagnerian conception of "tempo modification" and its overall relevance in the temporal shaping of music in orchestral conducting. The argument is based on a study that aims to revitalise and establish the tempo identification as a conductor's primary area of interest. This phenomenon is studied through performances and recordings of Weber's Der Freischütz Overture. Terminology for different perspectives on temporal shaping is proposed. The historical impact of tempo modification is explored through a comparative audio analysis of three central recordings. The same analytical procedures are then subsequently applied to the author's two recordings, and a cross-comparison is carried out of all five recordings. The thesis further discusses the use of reduction as a method for a conductor's score analysis. Through this multi-layered analysis, the thesis suggests that tempo modification is a stylistically and historically contingent phenomenon, the application of which is indeed dependent on structural elements in the score, but most of all dependent on compositional style and performance practice.

Objetivo: Evaluar el rendimiento del APPS para la predicción de mortalidad a los 28 días en pacientes con diagnóstico de síndrome de distrés respiratorio agudo en una unidad de cuidados intensivos en una clínica privada peruana. Diseño: Cohorte retrospectiva. Se recolectarán los datos de manera retrospectiva de pacientes atendidos desde el 6 de Marzo de 2020 hasta Mayo de 2021, periodo comprendido dentro de la pandemia por SARS-CoV-2 en el Perú.

Adjusting for baseline pre-intervention characteristics between treatment groups, through the use of propensity score matching methods, is an important step that enables researchers to do causal inference with confidence. This is critical, largely, due to the fact that practical treatment allocation scenarios are non-randomized in nature, with various inherent biases that are inevitable, and therefore requiring such experimental manipulations. These propensity score matching methods are the available tools to be used as control mechanisms, for such intrinsic system biases in causal studies, without the benefits of randomization (Lane, To, Kyna , & Robin, 2012). Certain assumptions need to be verifiable or met, before one may embark on a propensity score matching causal effects journey, using the Rubin causal model (Holland, 1986), of which the main ones are conditional independence (unconfoundedness) and common support (positivity). In particular, with this dissertation we are concerned with elaborating the applications of these matching methods, for a ‘strong-ignorability’ case (Rosenbaum & Rubin, 1983), i.e. when both the overlap and unconfoundedness properties are valid. We will take a journey from explaining different experimental designs and how the treatment effect is estimated, closing with a practical example based on two cohorts of enrolled introductory statistics students prior and post-clickers intervention, at a public South African university, and the relevant causal conclusions thereof. Keywords: treatment, conditional independence, propensity score, counterfactual, confounder, common support / Dissertation (MSc)--University of Pretoria, 2020. / Statistics / MSc / Unrestricted

In the era of Internet of Things (IoT) and big data, collecting, processing and analyzing enormous data faces unprecedented challenges even when being stored in preprocessed form. Anomaly detection, statistically viewed as identifying outliers having low probabilities from the modelling of data distribution p(x), becomes more crucial. In this Master thesis, two (supervised and unsupervised) novel deep anomaly detection frameworks are presented which can achieve state-of-art performance on a range of datasets. Capsule net is an advanced artificial neural network, being able to encode intrinsic spatial relationship between parts and a whole. This property allows it to work as both a classifier and a deep autoencoder. Taking this advantage of CapsNet, a new anomaly detection technique named AnoCapsNet is proposed and three normality score functions are designed: prediction-probability-based (PP-based) normality score function, reconstruction-error-based (RE-based) normality score function, and a normality score function that combines prediction-probability-based and reconstruction-error-based together (named as PP+RE-based normality score function) for evaluating the "outlierness" of unseen images. The results on four datasets demonstrate that the PP-based method performs consistently well, while the RE-based approach is relatively sensitive to the similarity between labeled and unlabeled images. The PP+RE-based approach effectively takes advantages of both methods and achieves state-of-the-art results. In many situations, neither the domain of anomalous samples can be fully understood, nor the domain of the normal samples is straightforward. Thus deep generative models are more suitable than supervised methods in such cases. As a variant of variational autoencoder (VAE), beta-VAE is designed for automated discovery of interpretable factorised latent representations from raw image data in a completely unsupervised manner. The t-Distributed Stochastic Neighbor Embedding (t-SNE), an unsupervised non-linear technique primarily used for data exploration and visualizing high-dimensional data, has advantages at creating a single map that reveals local and important global structure at many different scales. Taking advantages of both disentangled representation learning (using beta-VAE as an implementation) and low-dimensional neighbor embedding (using t-SNE as an implementation), another novel anomaly detection approach named AnoDM (stands for Anomaly detection based on unsupervised Disentangled representation learning and Manifold learning) is presented. A new anomaly score function is defined by combining (1) beta-VAE's reconstruction error, and (2) latent representations' distances in the t-SNE space. This is a general framework, thus any disentangled representation learning and low-dimensional embedding techniques can be applied. AnoDM is evaluated on both image and time-series data and achieves better results than models that use just one of the two measures and other existing advanced deep learning methods.

Die Mitralklappeninsuffizienz als zweithäufigstes Klappenvitium der entwickelten Länder ist eine unbehandelt letal verlaufende Krankheit. Die bevorzugte operative Therapie der primären Mitralklappeninsuffizienz besteht in der chirurgischen Mitralklappenrekonstruktion. Die Vorteile gegenüber dem prothetischen Mitralklappenersatz bestehen im Erhalt des Gewebes der Patientenklappe sowie einer geringeren Morbidität und Mortalität im Langzeitverlauf. Gegenstand dieser vorliegenden Dissertation ist die Entwicklung inklusive der internen und externen Validierung eines Scores zur präoperativen Vorhersage des Operationserfolges von Mitralklappenrekonstruktionen anhand der echokardiographisch erhobenen, patientenspezifischen Klappenmorphologie. Der Score besitzt eine hohe Trennschärfe und gute Kalibration mit hoher Vorhersagekraft. Somit stellt der Leipzig MVRS ein hilfreiches Mittel zur präoperativen Therapieplanung für die chirurgische Therapie bei primärer Mitralklappeninsuffizienz dar.

Master thesis touches upon the interesting spheres of risk classification, measurement and management of financial institutions. Modern banks have numerous credit risk measurement models at their disposal. However, agreement about performance of those models is not that unanimous and to some point the models are blamed for breaking out of 2007 financial crisis. In the theoretical part of the thesis we provide survey of risk measurement practices in banks. We investigate the main types of risk of banks in their day-to-day activities. Special focus is paid on the credit risk and on the models and techniques of its measurement; Practical part of thesis then contains construction and accuracy estimation of particular credit-risk-model (Altman Z-score). In it we construct and compute Altman Z-score for sample of firms from two chosen sectors in United Kingdom. Main goals of the work are a) testing accuracy of the model by comparing its outputs to real development, and b) econometric testing of the specification of the model itself.

INTRODUCTION: Spinal deformities, including adult spinal deformities (ASD) and adolescent idiopathic scoliosis (AIS), can cause significant pain and disability. Radiographic parameters are measured in order to establish quantitative relationships among spinal alignment and health related quality of life metrics. Various classification systems including the Scoliosis Research Society (SRS)-Schwab and Global Alignment Proportion (GAP) score have been developed to correlate radiographic parameters with relevant clinical outcomes. While the SRS-Schwab Classification is both a coronal and sagittal categorization that correlates to health related quality of life metrics, the GAP score is a newly developed 13-point scale that focuses on sagittal alignment to predict mechanical failure postoperatively. The study aims to evaluate the utility of the GAP score as a method of evaluating radiographic correction and maintenance over one year. METHODS: This was a retrospective analysis of ASD and AIS patients who underwent operative intervention. Patients were evaluated for GAP score changes from preoperative to postoperative and then to a one year follow up. Of the 285 screened patients, 73 had suitable radiographs for measurements. This included 45 ASD patients, 32 of which had one year follow up radiographs, and 28 AIS patients, of which only 19 had one year follow up radiographs. Measurements were obtained by three independent readers. These included pelvic incidence (PI), pelvic tilt (PT), L1-S1 lumbar lordosis (L1-S1 LL), L4-S1 lumbar lordosis (L4-S1 LL), sacral slope (SS), global tilt (GT), and sagittal vertical axis (SVA). GAP score subcategories were calculated and summed to produce the GAP score. RESULTS: The 73 included patients had an average age of 41.8 ± 24.1, BMI of 26.2 ±6.3, and consisted of 51 females (69.9%). All but one radiographic parameters exhibited an Intra Class Correlation (ICC) of over 0.66. PI had an ICC of 0.59 which was likely due to the incomplete visibility of the femoral heads in few radiographs. Among ASD patients, from pre to postoperative, PI-LL significantly decreased from 18° to 5°, PT significantly decreased from 26° to 19°, L1-S1 LL significantly increased from 37° to 47°, L4-S1 LL significantly increased from 28° to 31°, GT significantly decreased from 37° to 25°, SVA significantly decreased from 120 mm to 64 mm, and total GAP score significantly decreased from 8 to 6. For the 32 patients with long term data, the GAP score changed significantly from 9 to 6 to 7 at one year follow up. Of the 32 patients, 14 patients experienced a worsened score at the one year follow up. Among AIS patients, PI-LL increased from 0° to 3°, PT remained 13°, L1-S1 LL decreased from 56° to 53°, L4-S1 LL significantly decreased from 37° to 31°, GT increased from 14° to 16°, SVA decreased from 25 mm to 28 mm, and total GAP score increased from 3 to 4. For the 19 with long term data, the GAP score changed significantly from 3 to 3 to 2 and 2 patients experienced a worsened score at the one year follow up. DISCUSSION: The patient population showed a slight improvement in GAP score among both ASD and AIS groups. The improvement is more pronounced when evaluating with the SRS-Schwab Classification. The GAP score does not emphasize the same radiographic parameters and therefore does not correlate well with the SRS-Schwab Classification. Many patients also experienced a worsened GAP score by the one year follow up which can be attributed to the adjacent superior or inferior region (PJK), thoracolumbar region (construct failure), or compensation at the pelvis through hip flexion. Additionally, GAP is potentially oversensitive to measurement error and rounding differences. Thus, the utility of the GAP score in evaluating spinal deformity patients is questionable and requires further adjustment and evaluation based on prospective studies.