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Bradshaw, Kevin J. "Surveillance of dynamic scenes with an active vision system." Thesis, University of Oxford, 1994. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.260139.
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Solmaz, Berkan. "Hardware Implementation Of An Active Feature Tracker For Surveillance Applications." Master's thesis, METU, 2008. http://etd.lib.metu.edu.tr/upload/2/12609718/index.pdf.
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The integration of image sensors and high performance processors into embedded systems enabled the development of intelligent vision systems. In this thesis, we developed an active autonomous system to be used for surveillance applications. The proposed system detects a single moving object in the field of view automatically and tracks it in a wide area by controlling the pan-tilt-zoom features of the camera. The system can also go to an alarm state to warn the user.
The processing unit of the system is a Texas Instruments DM642 Evaluation Module which is a low-cost high performance video &<br>imaging development platform designed to develop and evaluate video based applications.
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Roemeling, Stijn. "Screening for prostate cancer intermediate outcome measures and active surveillance /." [S.l.] : Rotterdam : [The Author] ; Erasmus University [Host], 2007. http://hdl.handle.net/1765/10628.
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Pasqual, Michael C. "Experimental study of non-resolved active polarimetry for space surveillance." Thesis, Massachusetts Institute of Technology, 2016. http://hdl.handle.net/1721.1/105603.
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Thesis: Ph. D., Massachusetts Institute of Technology, Department of Aeronautics and Astronautics, 2016.<br>Cataloged from PDF version of thesis.<br>Includes bibliographical references (pages 119-124).<br>Man-made space debris constitutes a major threat to the future of the space enterprise. The space surveillance community continually seeks more efficient and robust techniques for detecting and characterizing on-orbit debris. This thesis investigates the potential utility of a technique known as active polarimetry, by which a laser radar would illuminate a space object with polarized light and measure the polarization state of the reflected light. A debris fragment's polarimetric signature can help identify its material, shape, and orientation, and, by inference, its mass, origin, and other characteristics. The research takes both an experimental and modeling and simulation approach A bench-top polarimeter ([lambda] = 1064 nm) is used to determine the polarimetric Bidirectional Reflectance Distribution Function (BRDF) of several common spacecraft materials and coatings, including glossy white paint, matte black paint, black Kapton®, silver Teflon®, aluminum, and titanium. Measurements are made in both bistatic (in-plane scans for incident angles of 15°, 30°, 45°, 60°, and 75°) and monostatic (incident angles from 0° to 90°) geometries. The Mueller matrix of each material is then estimated as a function of the illumination and viewing angles. The results reveal notable trends in the materials' geometry-dependent polarimetric properties, particularly diattenuation (D), retardance (R), and depolarization power ([delta]). At specular points, metallic surfaces (i.e., aluminum and titanium) exhibit mirror-like behavior (D = 0, R = 180°, [delta] = 0), while paints and thin films (e.g., Kapton®) are diattenuating (D > 0). All the materials tend to be more depolarizing in the monostatic diffuse regime. Silver Teflon® follows the trends of a metallic surface, with the exception of its distinct retardance at the specular point (R = 115°) and range of retardance values in the bistatic diffuse region (R = 70° to 120°). Since measurements of on-orbit space debris will nominally be non-resolved (in angle), a simulation is also developed (and validated by experiments) to predict the polarimetric signature of non-resolved objects, given the measured polarimetric BRDFs of their constituent materials. The simulation is used to explore object signatures in a variety of engagement scenarios, including monostatic interrogations of stationary and tumbling objects with representative shapes (i.e., panels, spheres, and cylinders), as well as bistatic interrogations of objects with strong specular reflections. The results demonstrate that the signature of a non-resolved object is complex, but can be described as the weighted sum of the geometry-dependent polarimetric behaviors of its facets. In some cases, the signature bears a close resemblance to the behavior of the constituent material, e.g., a white-painted sphere exhibits D = 0, R = 180°, and [delta] = 0.88 in a monostatic geometry, which matches the behavior of glossy white paint in the monostatic diffuse regime. In other cases, the signature is unlike the behavior of any individual facet due to the way the facets' behaviors combine geometrically, e.g., a black-painted sphere exhibits A = 0.67, unlike the behavior of matte black paint at any angle ([delta] < 0.4). It is shown that the effective Mueller matrix of a fast tumbling object is simply the average Mueller matrix of the object over all orientations. The results reveal several opportunities for exploiting the signatures of non-resolved objects, at least in the context of the specific materials and shapes considered in this study. The signature of a stationary or slowly tumbling object can help exclude certain material identities, e.g., a slowly tumbling panel-shaped object with a diattenuation of D > 0.5 (or polarizance P > 0.5) cannot be metallic based on the distribution of possible signatures of metal surfaces. A fast-tumbling panel-shaped object covered in silver Teflon® exhibits the characteristic retardance (R = 115°) of silver Teflon* in a monostatic geometry. The monostatic signature of a fast tumbling object can still be indicative of its shape, e.g., a white-painted sphere exhibits a distinctly high depolarization power ([delta] = 0.88) compared to the low depolarization power ([delta] < 0.12) of a fast tumbling panel-shaped object or cylinder with the same coating. Since a passive system can only estimate an object's polarizance (P), current optical telescopes would not be able to determine and exploit many of these distinguishing features such as retardance and depolarization power. Several operational schemes for interrogating space objects with a ground-based polarimetric laser radar are proposed, including short- and long-duration interrogations and interrogations whose measurements are synchronized with the tumbling period of the object. The utility of polarimetric features is discussed in terms of their ability to discriminate between objects with different materials, shapes, and orientations, as well as to obtain fingerprints that can be used to identify objects in the future and monitor their changes. A look-up table is proposed to determine the number and types of measurements required for estimating different polarimetric properties. The table may be referenced to optimally plan a measurement campaign in the field that maximizes the number of objects measurable in a given period of time. The simulation tools and experimental configuration developed for this research are generally useful for assessing the utility of active polarimetry for other applications.<br>by Michael C. Pasqual.<br>Ph. D.
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Bowman, Andrew. "Active Influenza A Virus Surveillance in Swine at Agricultural Fairs." The Ohio State University, 2013. http://rave.ohiolink.edu/etdc/view?acc_num=osu1371840961.
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Potter, Abbey. "Active disease surveillance in kangaroos utilising the commercial harvesting industry." Thesis, Potter, Abbey (2011) Active disease surveillance in kangaroos utilising the commercial harvesting industry. PhD thesis, Murdoch University, 2011. https://researchrepository.murdoch.edu.au/id/eprint/8471/.
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The aim of this study was to develop a framework for disease surveillance in one of the Australia’s most abundant macropods using the kangaroo harvesting industry. The impetus for this work arose because wildlife species are considered to play a significant role in the introduction, maintenance and spread of a majority of the world’s emerging infectious diseases yet active disease surveillance is rarely undertaken in these free-ranging populations. The framework developed was trialled by collecting samples and testing them for a number of significant emerging infectious diseases, including Salmonella, Coxiella burnetii and Ross River virus (RRV).
Kangaroos have long been suspected of carrying high levels of Salmonella, yet no definitive study has been undertaken to determine the true prevalence of infection in their natural habitat. Faecal samples were collected from 645 western grey kangaroos (Macropus fuliginosus) from ten different geographical locations throughout Western Australia over a period of 18 months and cultured for Salmonella spp. The estimated prevalence in the animals surveyed was approximately 3.6%. Faecal shedding was greatest following increased periods of rainfall in the April to June quarter. The relatively low prevalence of faecal shedding suggests that kangaroos in their natural habitat support the organism but are unlikely to pose any greater risk of zoonotic infection than other domestic livestock species. Whilst kangaroos have not yet been associated with food-borne outbreaks of disease, serotypes known to cause salmonellosis were isolated in this study, such as Salmonella enterica serovar Muenchen, Kiambu and Saintpaul.
Few studies have investigated the role of macropods in the maintenance and transmission of C. burnetii. Paired faecal and serum samples were collected from approximately 1000 western grey kangaroos from across twelve locations throughout Western Australia. An indirect ELISA was used to detect C. burnetii antibodies in serum, whilst quantitative PCR was used to detect C. burnetii DNA in faecal material. The estimated seroprevalence across all sample collection sites was 24.1%, whilst C. burnetii DNA was detected in the faeces of 4.1% of animals surveyed. Seroprevalence was significantly higher following increased periods of rainfall in the 60 days prior to sample collection (p<0.05), with seroprevalence lowest in the October to December quarter. These results suggest that kangaroos are likely reservoirs of the organism in Western Australia, posing a zoonotic threat to industry workers and animal handlers.
Ross River virus is Australia’s most common mosquito-borne disease and the western grey kangaroo is suspected of being a significant vertebrate host in the southwest of Western Australia. A total of 2605 serum samples, collected from across fourteen locations throughout the state, were tested for RRV neutralising antibodies. The seroprevalence varied significantly between geographical regions but was estimated to be 44.0% across all sample collection locations. Despite difficulties associated with age-based selection bias introduced through the kangaroo harvesting industry, surveillance within western grey kangaroo populations appears to provide a means of assessing the background risk of RRV for any given location and may assist in improving the capacity to predict future RRV activity.
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Sommerlade, Eric Chris Wolfgang. "Active visual scene exploration." Thesis, University of Oxford, 2011. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.542975.
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This thesis addresses information theoretic methods for control of one or several active cameras in the context of visual surveillance. This approach has two advantages. Firstly, any system dealing with real inputs must take into account noise in the measurements and the underlying system model. Secondly, the control of cameras in surveillance often has different, potentially conflicting objectives. Information theoretic metrics not only yield a way to assess the uncertainty in the current state estimate, they also provide means to choose the observation parameters that optimally reduce this uncertainty. The latter property allows comparison of sensing actions with respect to different objectives. This allows specification of a preference for objectives, where the generated control will fulfil these desired objectives accordingly. The thesis provides arguments for the utility of information theoretic approaches to control visual surveillance systems, by addressing the following objectives in particular: Firstly, how to choose a zoom setting of a single camera to optimally track a single target with a Kalman filter. Here emphasis is put on an arbitration between loss of track due to noise in the observation process, and information gain due to higher accuracy after successful observation. The resulting method adds a running average of the Kalman filter’s innovation to the observation noise, which not only ameliorates tracking performance in the case of unexpected target motions, but also provides a higher maximum zoom setting. The second major contribution of this thesis is a term that addresses exploration of the supervised area in an information theoretic manner. The reasoning behind this term is to model the appearance of new targets in the supervised environment, and use this as prior uncertainty about the occupancy of areas currently not under observation. Furthermore, this term uses the performance of an object detection method to gauge the information that observations of a single location can yield. Additionally, this thesis shows experimentally that a preference for control objectives can be set using a single scalar value. This linearly combines the objective functions of the two conflicting objectives of detection and exploration, and results in the desired control behaviour. The third contribution is an objective function that addresses classification methods. The thesis shows in detail how the information can be derived that can be gained from the classification of a single target, under consideration of its gaze direction. Quantitative and qualitative validation show the increase in performance when compared to standard methods.
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Ravelomanana, Sahobimaholy. "Gestion de réseaux et de systèmes : surveillance active par une approche MDA." Toulouse 3, 2009. http://www.theses.fr/2009TOU30127.
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La complexité des infrastructures de communication omni présentes, évolutives et supportant de nouvelles applications à fortes contraintes de qualité de service, requiert une gestion active (connaissance de l'état de santé des ressources interdépendantes) masquant l'hétérogénéité des composants sous-jacents. Face à cet accroissement de la complexité des systèmes gérés, les solutions de gestion de réseaux et de services tendent vers l'automatisation de l'exécution de la boucle de contrôle Surveillance/Analyse/Planification/Exécution et un enrichissement de la connaissance de gestion. Etant donné ce cadre, nous avons travaillé sur la mise en œuvre d'une surveillance active (Surveillance/Analyse) fondées sur des standards répondant à l'hétérogénéité et l'interdépendance des systèmes. En se basant sur une approche MDA, nous avons défini une méthodologie de représentation de la connaissance informationnelle de gestion indépendamment des plates-formes supports de cette gestion. Nous y avons couplé le méta-modèle CIM du Distributed Management Task Force et les diagrammes Etats-Transitions d'UML 2. 0 pour permettre la capitalisation d'une base de connaissance unifiée représentant des vues non fonctionnelles d'un système observé. Nous avons également spécifié une architecture générique d'exécution de ces modèles permettant la mise en œuvre de composants fonctionnels de la surveillance active. Cette architecture offre des capacités d'intégration et de détection des changements de comportement des éléments du système observé. Nous avons expérimenté cette approche dans deux contextes applicatifs : un réseau avionique hétérogène et une grille informatique à grande échelle. Les résultats ont montré : (1) les bénéfices d'une capitalisation de la modélisation de la connaissance de gestion à travers un fort taux de réutilisation et la spécification de modèles PIM, (2) la prise en compte automatique des modèles par une plate-forme d'exécution réduisant considérablement le temps de développement (3) la capacité et l'intérêt de l'intégration pour une surveillance globale et ouverte et (4) les bonnes performances de l'exécution du caractère actif de la surveillance<br>The complexity of communications infrastructure requires active management (knowledge of health of interdependent resources) masking the heterogeneity of underlying components. Faced with this increasing complexity of managed systems, the solutions for managing networks and services tend to automate the execution of control loop Monitoring / Analysis / Planning / Execution and enrichment of knowledge management. Given this context, we worked on the implementation of an Active monitoring (Monitoring / Analysis) based on standard response to the heterogeneity and interdependence of systems. Based on an MDA approach, we defined a methodology in order to represent the informational knowledge management regardless of platform supports this management. We have coupled the CIM meta-model of the Distributed Management Task Force and state chart diagram of UML 2. 0 in order to allow the capitalization of a unified knowledge base representing the non-functional views of observed systems. We also specified a generic architecture to support these models including functional components of active monitoring. This architecture offers integration capabilities and detection of changes in the behavior of components of observed system. We tested this approach in two application contexts: a heterogeneous avionics network and a large scale grid computing. The results showed: (1) benefits of capitalization of management knowledge modeling through specification and reuse of PIM models, (2) reduction of development time by taking into account automatically models into an execution platform (3) the ability and interest of integration for global and open monitoring (4) good performance of the implementation of the active monitoring
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Abdelghani, Raid [Verfasser], and Hans [Akademischer Betreuer] Heinzer. "Histologische Tumorcharakteristika und klinischer Verlauf nach radikaler Prostataektomie (RP) von potentiellen Active Surveillance (AS) Kandidaten nach den PRIAS (Prostate cancer Research International : Active Surveillance)-Kriterien / Raid Abdelghani. Betreuer: Hans Heinzer." Hamburg : Staats- und Universitätsbibliothek Hamburg, 2013. http://d-nb.info/1036729826/34.
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Borkowetz, Angelika, Ivan Platzek, Marieta Toma, et al. "Evaluation of Magnetic Resonance Imaging/ Ultrasound-Fusion Biopsy in Patients with Low-Risk Prostate Cancer Under Active Surveillance Undergoing Surveillance Biopsy." Karger, 2018. https://tud.qucosa.de/id/qucosa%3A70640.
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Introduction: Targeted biopsy of tumour-suspicious lesions detected in multiparametric magnetic resonance imaging (mpMRI) plays an increasing role in the active surveillance (AS) of patients with low-risk prostate cancer (PCa). The aim of this study was to compare MRI/ultrasound-fusion biopsy (fusPbx) with systematic biopsy (sysPbx) in patients undergoing biopsy for AS. Methods: Patients undergoing mpMRI and transperineal fusPbx combined with transrectal sysPbx (comPbx) as surveillance biopsy were investigated. The detection of Gleason score upgrading and reclassification according to Prostate Cancer Research International Active Surveillance criteria were evaluated. Results: Eighty-three patients were enrolled. PCa upgrading was detected in 39% by fusPbx and in 37% by sysPbx (p = 1.0). The percentage of patients who were reclassified in fusPbx and sysPbx (p = 0.45) were 64 and 59% respectively. ComPbx detected more frequently tumour upgrading than fusPbx (71 vs. 64%, p = 0.016) and sysPbx (71 vs. 59%, p < 0.001) and more patients had to be reclassified after comPbx than after fusPbx or sysPbx alone. Conclusions: The combination of fusPbx and sysPbx outperforms both modalities alone with regard to the detection of upgrading and reclassification in patients under AS. Because a high missing rate of significant PCa still exists in both biopsy modalities, a combination of fusPbx and sysPbx should be recommended in these patients.
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Nass, Shafique Sani. "Evaluation of Active and Passive Neonatal Tetanus Surveillance Systems in Katsina State, Nigeria." ScholarWorks, 2016. https://scholarworks.waldenu.edu/dissertations/2095.
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The incidence and mortality rates of neonatal tetanus (NNT) remain underreported in Nigeria. This cross-sectional study was guided by the Mosley and Chen's model for the elements of child survival in developing countries. The goals of the study were twofold: (a) to compare the NNT prevalence and the mortality rates from the existing surveillance system and active surveillance of health facility records in 7 selected health facilities from 2010 to 2014 in Katsina state, Nigeria and (b) to assess the associations between selected NNT risk factors, number of maternal tetanus toxoid injections, frequency of antenatal visits, place of delivery, and cord care, and neonatal mortality as the outcome variable. Data from 332 NNT records were extracted through retrospective records review and analyzed using a logistic regression model. The prevalence of NNT and mortality rate were 336 cases and 3.4 deaths per 100,000 population, respectively, while the prevalence of NNT and mortality rate reported through the IDSR system were 111 cases and 1.0 death per 100,000 population, respectively. Only neonates whose mothers had 1 dose of tetanus toxoid vaccine were significantly associated with NNT mortality, (p < 0.05), OR = 4.12, 95% CI [1.04, 16.29]. Frequency of antenatal visits, place of delivery, and cord care were all not significant predictors of NNT mortality. Implications for positive social change include gaining knowledge on associations between NNT risk factors and neonatal mortality, and strengthening the NNT surveillance system with the capacity for early detection of potential risk factors to develop specific public health interventions aimed at improving the outcome of neonatal tetanus.
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Bustillo, Natalie Escobio. "Psychosocial Correlates of Psychological Distress and Arousal in Prostate Cancer Survivors Undergoing Active Surveillance." Scholarly Repository, 2011. http://scholarlyrepository.miami.edu/oa_theses/291.
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Active Surveillance (AS) for the clinical management of prostate cancer (PC) is a treatment option for men with low-risk PC. Screening procedures have led to the overdetection of PCs that would have never caused problems. Active treatment (e.g., surgery or radiation) for these non-aggressive tumors may not be necessary given the slow-growing nature of PC. AS provides a way to monitor the disease and delay treatment-related compromises on quality of life until clinically indicated (e.g., rising PSA level). However, the intensive monitoring in AS may be a stressful experience and lead to greater anxiety, an emotional state that has been associated with undergoing active treatment despite physician recommendation for AS. The current study aimed to identify psychosocial correlates of anxiety in men undergoing AS. Using Mishel’s Reconceptualized Uncertainty in Illness Model as a framework, the proposed study aimed to examine the relationships between perceived stress management skills, PC psychosocial concerns, and anxiety/arousal. Hierarchical multiple regression analyses were conducted on a sample of 71 men undergoing AS, who were on average 65.40 years old (SD=7.85) and ethnically diverse (52% non-Hispanic White; 31% Hispanic; 17% African American). Results indicated that greater PSMS were significantly associated with less IES-R anxiety (β=-.28, p<.04). PSMS were not significantly associated with PC concerns (β=-.02, p>.05), but greater PC concerns were significantly associated with greater IES-R anxiety (β=.61, p<.01) and PSA anxiety (β=.42, p<.01). These associations held after controlling for relevant covariates. The results suggest a possible role for stress management skills as perceived ability to manage stress was related to less anxiety in the AS experience. Future studies should examine the relationship among these factors in longitudinal designs and whether greater stress is associated with unnecessary active treatment in low-risk PC.
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Algohary, Ahmad. "PROSTATE CANCER RISK STRATIFICATION USING RADIOMICS FOR PATIENTS ON ACTIVE SURVEILLANCE: MULTI-INSTITUTIONAL USE CASES." Case Western Reserve University School of Graduate Studies / OhioLINK, 2020. http://rave.ohiolink.edu/etdc/view?acc_num=case1599231033923829.
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Al-Kailani, Zaid [Verfasser], and Michael [Akademischer Betreuer] Stöckle. "Active Surveillance beim Niedrig-Risiko-Prostatakarzinom Ergebnisse nach monozentrischer Patientenbeobachtung / Zaid Al-Kailani ; Betreuer: Michael Stöckle." Saarbrücken : Saarländische Universitäts- und Landesbibliothek, 2018. http://d-nb.info/118605929X/34.
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Girodet, Magali. "Exploration du vécu psychologique et psychosocial chez des patients atteints d’un cancer de la prostate en France : analyses de deux études : VICAN et PRESAgE." Thesis, Lyon, 2019. http://www.theses.fr/2019LYSE1270.
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Le cancer est désormais considéré comme une maladie chronique touchant une population toujours croissante. Une prise en charge et un suivi à long terme, à l’origine d’un bouleversement de la vie des patients et de leur entourage, semblent nécessaires et sont susceptibles d’initier une réorganisation du système de santé. Dans ce travail de thèse interdisciplinaire, nous nous sommes intéressés à l’impact du cancer sur le vécu psychologique et psychosocial des patients en France, en choisissant le modèle du cancer de la prostate. Pour cela, nous avons souhaité combiner deux études. L’une portait sur l’état de santé sexuelle des patients atteints d’un cancer de la prostate via une approche quantitative descriptive basée sur les données représentatives des enquêtes nationales VICAN. L’autre visait à déterminer l’impact du cancer de la prostate sur le couple et sa qualité de vie via une approche compréhensive qualitative complémentaire, focalisée sur une prise en charge en Surveillance Active et basée sur des entretiens semi-directifs de patients et de leurs conjointes. L’analyse des données a permis de montrer une détérioration de la santé sexuelle des patients, selon différents déterminants non nécessairement médicaux, et un endommagement du couple et des relations affectives perçues, avec des stratégies d’ajustements divergentes pour chacun des membres du couple, malgré une prise en charge initialement considérée comme optimale et indemne de conséquences. Une approche pluridisciplinaire pourrait permettre un accompagnement complet des couples pour une amélioration de leurs vécus, de leur bien-être et de leur qualité de vie<br>Cancer is now considered as a chronic disease affecting an ever-increasing population. Long-term care and follow-up, which are responsible of lives disruptions on patients and their relatives, seem necessary and likely to initiate health system reorganization. In this interdisciplinary thesis work, we focused on the impact of cancer on the psychological and psychosocial experiences of patients in France, by choosing the prostate cancer model. To do this, we decided to combine two studies. One aimed on the sexual health status of prostate cancer patients through a descriptive quantitative approach based on data representative of VICAN national surveys. The other one concentrated on the impact of prostate cancer on the couple and its quality of life through a complementary comprehensive qualitative approach, focused on Active Surveillance management and based on semi-directive interviews of patients and their spouses. The data analysis showed deterioration in patients' sexual health associated to several factors, which are not necessarily medical ones, and damages in the couple and perceived affective relationships, with divergent coping strategies for each member of the couple, despite a care management initially considered as optimal and free of consequences. A multidisciplinary approach could help couples to improve their experiences, well-being and quality of life
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Dinh, Kathryn Tindell. "An Exploration of Risk Stratification for Active Surveillance and Androgen Deprivation Therapy Side Effects for Prostate Cancer Utilizing Data From the Surveillance, Epidemiology, and End Results Database." Thesis, Harvard University, 2016. http://nrs.harvard.edu/urn-3:HUL.InstRepos:27007753.
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Part 1: Occult high-risk disease in clinically low-risk prostate cancer patients: Incidence and clinical predictors from SEER data
Objective: First, to determine the incidence of pathologic upgrading and upstaging for contemporary, clinically low-risk patients and identify predictors of having occult, advanced disease to inform selection of patients for active surveillance. We will further consider the differing risk of upgrading at prostatectomy between clinically low-risk patients with ≥50% biopsy cores positive and other prostate cancer patients.
Methods: For the first portion of the study, we identified 10,273 patients in the Surveillance, Epidemiology, and End Results (SEER) database diagnosed with clinically low-risk disease (cT1c/T2a, Prostate specific antigen (PSA)<10ng/mL, Gleason 3+3=6) in 2010-2011 who received a prostatectomy. The primary outcome was the incidence of upgrading to pathologic Gleason score 7-10 or upstaging to pathologic T3-T4/N1 disease. Multivariable logistic regression (MVA) of men with complete biopsy data (n=5,581) identified significant predictors of upgrading or upstaging. As a second analysis, we identified 14,902 patients with prostate cancer of any risk-group diagnosed 2010-2011 with prostatectomy who also had percent positive biopsy cores (PBC) available. Patients were categorized by NCCN clinical risk-groups, separating low-risk patients by percent PBC. We measured incidence of pathologic high-risk disease, defined as pT3a-T4 or Gleason 8-10, and used MVA to consider differing risk of advanced disease in patients with clinical low-risk disease and ≥50% PBC.
Results: Of the first cohort, 44% of patients were upgraded and 9.7% were upstaged at prostatectomy. MVA showed age, PSA, and percent positive cores (all p<0.001), but not race, were associated with occult, more aggressive disease. With these variables dichotomized at the median, age >60 (Adjusted Odds Ratio [AOR] 1.39), PSA>5.0 (AOR 1.28), and >25% positive cores (AOR 1.76) were significantly associated with upgrading (all p<0.001). Similarly, age>60 (AOR 1.42), PSA>5.0 (AOR 1.44), and >25% positive cores (AOR 2.26) were associated with upstaging (all p<0.001). In the second cohort, 9.2% of clinically low-risk and <50%PBC, 18.6% of clinically low-risk and ≥50%PBC, and 27.6% of clinically intermediate-risk patients had occult, high-risk disease at prostatectomy (p<0.001). On MVA, low-risk with ≥50%PBC were more likely than low-risk with <50%PBC to have pathologic high-risk disease (AOR 2.28, 95%CI 1.90-2.73, p<0.001), had similar risk to favorable-intermediate disease overall (AOR 1.09, 0.91-1.31, p=0.33), and had higher risk than favorable-intermediate among men over 60 (AOR 1.28, 1.00-1.64, p=0.04).
Conclusion: Nearly half of clinically low-risk patients harbor Gleason ≥7 or ≥pT3 disease. Percent PBC demonstrates utility for identifying a subset of NCCN low-risk patients who should have further testing before deciding on active surveillance as nearly one in five clinically low-risk prostate cancer patients with ≥50% positive biopsy cores harbored occult pT3a-T4 or Gleason 8-10. This suggests that such patients should not be classified by national guidelines as “low-risk” and these patients should be made aware of this excess risk if considering active surveillance.
Part 2: Association of Androgen Deprivation Therapy with Depression in Localized Prostate Cancer Using SEER-Medicare
Objective: Androgen deprivation therapy (ADT) may contribute to depression, yet several studies have not demonstrated a link. We aimed to determine if receipt of any ADT or longer duration of ADT for prostate cancer is associated with increasing risk of depression.
Methods: We identified 78,552 men over 65 with stage I-III prostate cancer using the Surveillance, Epidemiology, and End Results-Medicare linked database from 1992-2006, excluding patients with psychiatric diagnoses within the prior year. Our primary analysis was the association of pharmacologic ADT with the diagnosis of depression, or receipt of inpatient- or outpatient-psychiatric treatment, using Cox-proportional hazard regression. Drug-data for treatment of depression was not available. Our secondary analysis was association of duration of ADT with each endpoint.
Results: Overall, 43% (33,882) of patients received ADT and had higher 3-year cumulative incidence of depression (7.1% vs. 5.2%), inpatient- (2.8% vs. 1.9%), and outpatient-psychiatric treatment (3.4% vs. 2.5%) than patients without ADT (all p<0.001). Adjusted cox-analyses demonstrated patients with ADT had a 23% increased risk of depression (adjusted hazard ratio [AHR]=1.23,95%CI=[1.15-1.31]), 29% increased risk of inpatient-psychiatric treatment (AHR=1.29,95%CI=[1.17-1.41]), and a non-significant 7% increased risk of outpatient-psychiatric treatment (AHR=1.07,95%CI=[0.97-1.17]) compared to patients without ADT. The risk of depression increased with duration of ADT, from 12% with ≤6, 26% with 7-11, to 37% with ≥12 months (p-trend<0.0001). Similar duration-effect was seen for inpatient- (p-trend<0.0001) and outpatient-psychiatric treatment (p-trend<0.0001).
Conclusion: Pharmacologic ADT increased the risk of depression and inpatient-psychiatric treatment in this large study of elderly men with localized prostate cancer. This risk increased with longer duration of ADT. The possible psychiatric effects of ADT should be recognized by physicians and discussed with patients prior to initiating treatment.
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Perrouin-Verbe, Marie-Aimée. "Valeur pronostique du remodelage de la signalisation calcique dans le cancer de la prostate." Thesis, Brest, 2017. http://www.theses.fr/2017BRES0159.
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Le cancer de prostate (CaP) est le plus fréquent chez l’homme de plus de 50 ans. La généralisation du PSA et du dépistage du CaP a permis son diagnostic à des formes localisées (80% des formes diagnostiquées), accessibles à un traitement curatif. De plus, un certain nombre de ces formes localisées sont indolentes, de très faible risque, éligibles à une surveillance active (SA).Cependant, 15 à 25% des patients vont présenter une récidive 10 ans après un traitement curatif, et environ 30% des patients inclus en SA seraient en fait sous-évalués (cancer significatif). Il est donc nécessaire d’identifier de nouveaux biomarqueurs pronostiques capables de distinguer les tumeurs indolentes des tumeurs à haut risque, et capables d’améliorer la prédiction du risque de récidive après traitement curatif. Objectifs : Evaluer la valeur pronostique potentielle du remodelage de la signalisation calcique dans le cancer de prostate : 1) Evaluer le lien entre remodelage de la signalisation calcique et agressivité tumorale 2) Evaluer l’impact pronostique du remodelage de la signalisation calcique sur la récidive systémique après prostatectomie radicale(PR). 3) Evaluer l’apport du remodelage de la signalisation calcique dans la sélection des patients éligibles à la surveillance active. Méthodologie 1) Evaluation de l’expression (immunohistochimie) de TRPC1, TRPC4, Orai1 et STIM1 à différents stades de progression du CaP, et évaluation de l’impact pronostique de cette expression sur la récidive dans le CaP localisé à partir d’une cohorte de 238 patients. 2) Etude cas-témoin à partir d’une cohorte de 112 patients opérés d’un CaP localisé. Evaluation de l’impact pronostique de l’expression (immunohistochimie) de 10 acteurs de la signalisation calcique (Orai1, Orai2, Orai3, STIM1, STIM2, TRPV5 et V6, TRPC1 et C4, TRPM8) sur la récidive systémique après PR. 3). A partir d’une cohorte de patients ayant été opérés pour des cancers de faible risque, ont été inclus les patients potentiellement éligibles à une SA au moment du diagnostic (n=71). Etude de l’apport de la signalisation calcique dans la sélection des patients éligibles à la SA (marquage immunohistochimie sur biopsies et pièce opératoire : TRPC1 et C4, TRPV5 et V6, Orai1, STIM1) Résultats 1) Dans le Cap localisé, une surexpression de TRPC1 était associée à une prolifération plus faible et une meilleure survie sans récidive (indépendant des marqueurs pronostiques usuels). 2) Une surexpression de TRPC4, TRPV5 et TRPV6 est associée à un plus faible risque de récidive systémique après prostatectomie, et ce indépendamment des 5 facteurs pronostiques usuels. 3) Un marquage plus intense de TRPV6 sur les biopsies prostatiques semble associé à un CaP significatif, éligible à un traitement curatif d’emblée chez les patients présentant un CaP de faible risque. Conclusion : Sur pièce de PR, TRPC1, TRPC4, TRPV5 et TRPV6 possèdent une valeur pronostique indépendante et sont associés à un plus faible risque de récidive après PR. Sur biopsie prostatique, TRPV6 permet de distinguer les CaP indolents des significatifs chez les patients présentant un CaP de faible risque<br>Prostate cancer (PCa) is the most common malignancy in men 50 years and older and the second leading cause of cancerrelated death in men in developed countries. Widespread PSA screening has allowed an increase rate of localised PCa at diagnosis, managed by curative treatment such as radical prostatectomy (RP), or active surveillance (AS) in case of indolent disease. However, 30% of patients experience biochemical relapse during the 10 years following RP. Moreover, 30% of patients in AS are undervalued and present a significant disease. It is therefore necessary to identify new prognostic biomarkers capable of distinguishing indolent from significant tumours, and capable to accurately predict the risk of recurrence after curative treatment. Objectives: To evaluate the potential prognostic value of calcium signalling remodeling in PCa: 1) To assess the impact of calcium signalling remodelling on tumour aggressiveness 2) To assess the prognostic value of calcium signalling remodelling on systemic recurrence after RP. 3) To assess the contribution of calcium signaling remodelling in the selection of patients for active surveillance (AS). Methods 1) Study of the expression (immunohistochemistry) of TRPC1, TRPC4, Orai1 and STIM1 at different stages of PCa, and assessment of the prognostic value of this expression on recurrence in clinically localised PCa (CLC) in a cohort of 238 patients. 2) Case-control study on a cohort of 112 patients who underwent RP for CLC. Evaluation of the prognostic impact of the expression (immunohistochemistry) of 10 actors of calcium signalling (Orai1, Orai2, Orai3, STIM1, STIM2, TRPV5 and V6, TRPC1 and C4, TRPM8) on systemic recurrence after RP. 3) From a cohort of patients who underwent RP for low-risk PCa, were enrolled patients potentially eligible for AS at the time of diagnosis (n = 71). We evaluated the impact of calcium signalling remodelling in patients selection for AS (immunohistochemical staining on biopsies and prostate specimens: TRPC1 and C4, TRPV5 and V6, Orai1, STIM1).Results 1) In CLC, an overexpression of TRPC1 was associated with a decreased proliferation, and with a higher rate of biochemical progression-free survival (independent of usual prognostic markers). 2) Overexpression of TRPC4, TRPV5 and TRPV6 was associated with a lower risk of systemic recurrence after RP, independently of the prognostic factors currently used. 3) More intense staining of TRPV6 on biopsies was associated with a significant PCa, for which a curative treatment is required. Conclusion: On RP specimens, overexpression of TRPC1, TRPC4, TRPV5 and TRPV6 has an independent prognostic value and is associated with a lower risk of recurrence after RP. On prostate biopsies, TRPV6 allows to distinguish indolent from significant disease in patients with low-risk PCa
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Watts, Sam. "The assessment and management of anxiety and depression in prostate cancer patients being managed with active surveillance." Thesis, University of Southampton, 2014. https://eprints.soton.ac.uk/374751/.
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Nelson, Eric D. "Zoom techniques for achieving scale invariant object tracking in real-time active vision systems /." Online version of the thesis, 2006. https://ritdml.rit.edu/dspace/handle/1850/2620.
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Gonzalez, Silvia. "Physical Activity and Sedentary Behaviours Among Colombian Children and Youth: Prevalence, Correlates and International Comparisons." Thesis, Université d'Ottawa / University of Ottawa, 2021. http://hdl.handle.net/10393/42612.
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In the context of epidemiological transitions in Latin American countries evidence is scarce. In Colombia, despite a broad policy framework for healthy lifestyles promotion, surveillance of movement behaviours including physical activity and sedentary behaviours has been limited. Therefore, this thesis aims to: a) Describe indicators of physical activity and sedentary behaviours among Colombian children and adolescents; b) determine the factors associated with meeting physical activity guidelines, engaging in active play, using active transportation and spending excessive recreational screen time among Colombian children and adolescents; and c) draw international comparisons of physical activity and sedentary behaviour indicators. To accomplish this, cross-sectional data from the National Survey of Nutrition in Colombia 2015-2016 and the Global Matrix of Physical Activity in Children and Youth 3.0 were analyzed. This dissertation compiles five research manuscripts prepared and submitted for publication in peer-reviewed scientific journals. Paper one describes physical activity indicators and correlates among Colombian children and found that a low proportion of children and adolescents in Colombia are physically active, with a consistently lower prevalence among females across all age groups. Paper two depicts the national situation of active transportation to school, indicating a non-negligible prevalence of this behaviour and several correlates to guide the design of strategies to promote walking and biking to school in Colombia. Paper three focused on recreational screen time and its correlates and found a high prevalence of excessive recreational screen time that increases with age. Paper four puts Colombian data in global context with nine other countries with a similar human development index participating in the Global Matrix 3.0 initiative. This study compared grades of behavioural and sources of influence indicators and found similarly low performance across countries. In paper five a latent profile analysis approach was used to build active transportation profiles that contribute to understand active commuting to school across 49 countries from the Global Matrix 3.0. This dissertation helps fill gaps in knowledge in Colombia, and middle-income countries more broadly, providing national estimates of physical activity and sedentary behaviours of children aged 3-17 years for the first time in the surveillance history of the country.
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Kou, Tzuyung Doug. "Watchful Waiting Active Surveillance in Prostate Cancer Patients a Population-Based Study Using the SEER-Medicare Linked Database." Cleveland, Ohio : Case Western Reserve University, 2008. http://rave.ohiolink.edu/etdc/view?acc_num=case1207309899.
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Thesis (Ph.D.)--Case Western Reserve University, 2008<br>Title from PDF (viewed on 26 May 2009) Includes abstract Department of Epidemiology and Biostatistics Includes bibliographical references [and appendices] Available online via the OhioLINK ETD Center
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Espino, Carlos. "Active Surveillance and Incidence Rate of Dengue Infection in a Cohort of High Risk Population in Maracay, Venezuela." Scholar Commons, 2009. https://scholarcommons.usf.edu/etd/1626.
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In the absence of an effective vaccine, vector control and surveillance of dengue fever (DF) and dengue hemorrhagic fever (DHF) are the most important strategies currently used to reduce the impact of these diseases in affected population. The objectives of this study were to estimate the incidence of symptomatic and asymptomatic dengue cases, the prevalence of antidengue antibodies, and to evaluate the laboratory and clinical aspects related to an active surveillance of dengue cases. In this study, active surveillance was incorporated as a part of the study design. At total of 3,255 people from four high risk neighborhoods were followed in a two years prospective study whereby the participants' houses were visited three times a week. During these visits, dengue cases were characterized by identifying patients with fever as well as other symptoms that were compatible with dengue disease. In addition, a biannual blood sample was taken for each study participants, to establish the prevalence and six month incidence of dengue infection.
We found a crude incidence density (ID) of 3.24 by 100,000 person/days (p/d) which changed from 5.69 by 100,000 p/d for the first year of the study to 1.45 by 100.000 p/d in the second year. In both years, the months from July through September had the highest ID of 8.81 by 100,000 p/d. Children displayed higher ID when compared to adults, RR: 3.92 (2.38 - 6.48).
The Plaque Reduction Neutralization Test was used to assay for the presence of antidengue antibody in 2,125 study participants (65.3% of total). The prevalence of anti dengue antibodies was found to be 86.6% (1,840 positives). The prevalence of anti DENV-1 was 74%, while 65.2 % of the participants had anti- DENV-1 and anti- DENV-2 simultaneously. The cumulative incidence of anti IgG dengue antibody in the negative participants (283 at the start of the study) was 30% in the first 6 months period, 29.6% in the second 6 months, and 23.8 in the third one.
The difference between the numbers of participants detected in the active surveillance, (270 confirmed and non confirmed dengue cases) with the numbers of people who showed sero-conversion to anti-IgG dengue antibody within a relatively short period of time suggested that there was a high number of asymptomatic dengue infections present in the population. Transmissibility of the virus, the surveillance of dengue, and vaccine implementation in the near future would all be affected by the large number of asymptomatic people in hyperendemic countries.
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Morrison, Eleshia JP. "Psychological Distress and Symptom Burden: Vulnerabilities in Chronic Lymphocytic Leukemia Patients." The Ohio State University, 2013. http://rave.ohiolink.edu/etdc/view?acc_num=osu1366305005.
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LUZZAGO, STEFANO. "REPEATED MRI SCANS DURING ACTIVE SURVEILLANCE FOR PROSTATE CANCER: NATURAL HISTORY OF PROSTATIC LESIONS AND UPGRADING RATES OVER TIME." Doctoral thesis, Università degli Studi di Milano, 2021. http://hdl.handle.net/2434/881234.
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Objectives
To test upgrading rates in patients on Active Surveillance (AS) for prostate cancer (PCa) after serial multiparametric magnetic resonance imaging (mpMRI) scans.
Materials and methods
Retrospective analysis of 558 patients. Five different criteria of mpMRI progression were used: 1) PI-RADS score increase; 2) lesion size increase; 3) EPE score increase; 4) overall mpMRI progression; 5) number of criteria for mpMRI progression (0 vs. 1 vs. 2-3). Moreover, two definitions of PCa upgrading were evaluated:1) ISUP GG≥2 with >10% of pattern 4; 2) ISUP GG≥3. The estimated annual percent changes (EAPC) methodology depicted temporal trends of mpMRI progression criteria. Sensitivity, specificity, positive predictive (PPV) and negative predictive value (NPV) of mpMRI progression criteria were analysed. Multivariable logistic regression models tested PCa upgrading rates.
Results
Lower rates over time of all mpMRI progression criteria were observed. The NPV of serial mpMRIs spans from 90.5 to 93.5% (ISUP GG≥2 with >10% of pattern 4 PCa upgrading) and from 98 to 99% (ISUP GG≥3 PCa upgrading), according to the different mpMRI progression criteria. A PSA-D cut-off of 0.15 ng/ml/ml sub stratified those patients who could skip a prostate biopsy. In multivariable logistic regression models testing PCa upgrading rates, all five mentioned mpMRI progression criteria achieved independent predictor status.
Conclusions:
During AS, approximately 27% of patients experience mpMRI progression at first repeated scan. However, the rates of mpMRI progression decrease over time at subsequent mpMRIs. Patients with stable mpMRI findings and with PSA-D<0.15 ng/ml/ml could safely skip surveillance biopsies. Conversely, patients who experience mpMRI progression should undergo a prostate biopsy.
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Karakas, Samet. "Detecting And Tracking Moving Objects With An Active Camera In Real Time." Master's thesis, METU, 2011. http://etd.lib.metu.edu.tr/upload/12613712/index.pdf.
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Moving object detection techniques can be divided into two categories based on the type of the camera which is either static or active. Methods of static cameras can detect moving objects according to the variable regions on the video frame. However, the same method is not suitable for active cameras. The task of moving object detection for active cameras generally needs more complex algorithms and unique solutions. The aim of this thesis work is real time detection and tracking of moving objects with an active camera. For this purpose, feature based algorithms are implemented due to the computational efficiency of these kinds of algorithms and SURF (Speeded Up Robust Features) is mainly used for these algorithms. An algorithm is developed in C++ environment and OpenCV library is frequently used. The developed algorithm is capable of detecting and tracking moving objects by using a PTZ (Pan-Tilt-Zoom) camera at a frame rate of approximately 5 fps and with a resolution of 640x480.
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Oztarak, Hakan. "An Energy-efficient And Reactive Remote Surveillance Framework Using Wireless Multimedia Sensor Networks." Phd thesis, METU, 2012. http://etd.lib.metu.edu.tr/upload/12614328/index.pdf.
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With the introduction of Wireless Multimedia Sensor Networks, large-scale remote outdoor surveillance applications where the majority of the cameras will be battery-operated are envisioned. These are the applications where the frequency of incidents is too low to employ permanent staffing such as monitoring of land and marine border, critical infrastructures, bridges, water supplies, etc. Given the inexpensive costs of wireless resource constrained camera sensors, the size of these networks will be significantly larger than the traditional multi-camera systems. While large number of cameras may increase the coverage of the network, such a large size along with resource constraints poses new challenges, e.g., localization, classification, tracking or reactive behavior. This dissertation proposes a framework that transforms current multi-camera networks into low-cost and reactive systems which can be used in large-scale remote surveillance applications. Specifically, a remote surveillance system framework with three components is proposed: 1) Localization and tracking of objects<br>2) Classification and identification of objects<br>and 3) Reactive behavior at the base-station. For each component, novel lightweight, storage-efficient and real-time algorithms both at the computation and communication level are designed, implemented and tested under a variety of conditions. The results have indicated the feasibility of this framework working with limited energy but having high object localization/classification accuracies. The results of this research will facilitate the design and development of very large-scale remote border surveillance systems and improve the systems effectiveness in dealing with the intrusions with reduced human involvement and labor costs.
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Chang, Shelley. "Predicting Methicillin-Resistant Staphylococcus Aureus Carriage and Dissemination in a Veterans Affairs Medical Center." Case Western Reserve University School of Graduate Studies / OhioLINK, 2009. http://rave.ohiolink.edu/etdc/view?acc_num=case1238795542.
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Straube, Laurentia. "Import von ESBL und Carbapenemase bildenden Enterobaceriaceae durch Reisende nach Deutschland." Doctoral thesis, Universitätsbibliothek Leipzig, 2017. http://nbn-resolving.de/urn:nbn:de:bsz:15-qucosa-223778.
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303 gesunde, deutsche Freiwillige, die in 53 verschiedene Länder (meist nach Asien, Afrika und Südamerika) reisten, wurden in eine prospektive Kohortenstudie aufgenommen. Stuhlproben und Daten über potenzielle reiseassoziierte Risikofaktoren (wie Reisestil, Essgewohnheiten, Auftreten von Gastroenteritis, Hygienemaßnahmen) wurden vor und nach der Reise mittels Fragebogen gesammelt. Mittels Selektivmedien (CHROMagar™ ESBL/KPC-Platten) wurden eine Untersuchung der Stuhlproben auf extended-spectrum beta-lactamase bildende Enterobacteriaceae (ESBL-PE) und Carbapenemase bildende Enterobacteriaceae (CPE) durchgeführt. Isolate mit bestätigtem ESBL-Phänotyp wurden auf das Vorhandensein von blaCTX-M-, blaTEM-, blaSHV-, blaVIM-, blaNDM-, blaKPC- und blaOXA-48-Genen mit Hilfe von PCR-Amplifikation und -Sequenzierung getestet. Bei den Antibiotikaempfindlichkeitstests wurde mit konventioneller Mikrobouillonverdünnung gearbeitet. Die Auswertung von 205 kompletten Teilnahmen zeigte vor Reiseantritt eine ESBL-PE Prävalenzrate von 6,8% (14/205). Unter den 191 Teilnehmern, die vor der Reise ESBL-negativ getestet wurden, waren nach Reiserückkehr 58 (30,4%) mit ESBL-bildenden Escherichia coli kolonisiert und 5 Reisende (8,6%) waren zusätzlich mit ESBL-produzierenden Klebsiella pneumoniae besiedelt. Carbapenem-resistente Enterobacteriaceae wurden nicht nachgewiesen. Die molekulargenetische ESBL-Typisierung zeigte, dass 52/54 (96,6%) der E. coli und 4/4 (100%) der K. pneumoniae-Stämme, die für die Sequenzierung verfügbar waren, CTX-M-Enzyme produzierten, und zwar überwiegend CTX-M-15 (33/56, 58,9%), und 2/54 (3,7%) der E. coli-Stämme SHV-12-Enzyme bildeten. Die Reisenden nach Indien wiesen die höchste Kolonisationsrate mit ESBL-PE (11/15, 73,3%: p=0.015) auf, gefolgt von Reisenden nach Südostasien (22/46, 47,8%; p=0.038). Die Auswertung der reiseassoziierten Risikofaktoren ergab allein für das Auftreten einer Gastroenteritis eine statistische Signifikanz (p=0.011). Strikte Händehygiene und ausschließliches Konsumieren abgepackter Getränke zeigten keinen protektiven Effekt. Die ESBL-PE-Persistenzrate nach 6 Monaten lag bei 8,6% (3/35). Daraus schlossen wir, dass weltweite Anstrengungen notwendig sind, um die weitere Ausbreitung von ESBL-PE in der Bevölkerung anzugehen. Eine aktive Überwachung und Kontaktisolation ist bei Aufnahme in eine medizinische Einrichtung speziell für Patienten, die innerhalb der letzten 6 Monate nach Indien und Südostasien gereist waren, empfehlenswert.
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Le, Mortellec Antoine. "Proposition d'une architecture de surveillance "active" à base d'agents intelligents pour l'aide à la maintenance de systèmes mobiles - Application au domaine ferroviaire." Phd thesis, Université de Valenciennes et du Hainaut-Cambresis, 2014. http://tel.archives-ouvertes.fr/tel-00947981.
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Ces deux dernières décennies, les systèmes embarqués ont été introduits dans de nombreux domaines d'application (transport, industrie, habitat, médical...). Ces systèmes se sont vu confier des tâches plus importantes pour délivrer de nouveaux services aux utilisateurs avec des délais de mise sur le marché toujours plus courts et à moindre coût. L'intégration rapide de ces systèmes au sein de produits manufacturés est un avantage concurrentiel pour les industriels. Cependant, les pannes associées à ces systèmes et le niveau de complexité croissant des équipements ont rendu les interventions de maintenance bien plus délicates. L'identification des causes de certaines pannes représente actuellement un véritable challenge dans les activités de la maintenance. Elles entrainent une indisponibilité excessive des équipements.Cette thèse propose une architecture générique de surveillance "active" pour l'aide à la maintenance de systèmes mobiles. Cette architecture repose sur des entités de surveillance "intelligentes" capables d'évaluer l'état de santé des équipements surveillés. Notre contribution se situe à la rencontre de différentes communautés de Recherche et s'appuie notamment sur des concepts développés par lacommunauté PHM (Pronostics and Health Management).L'architecture proposée est mise en œuvre et appliquée a la surveillance d'un système réel de transport ferroviaire dans le cadre du projet SURFER (SURveillance active FERroviaire) conduit par Bombardier-Transport.
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Ouzzane, Adil. "Diagnostic du cancer de la prostate par imagerie moderne : place de l’IRM dans la sélection des candidats à une surveillance active et dans la caractérisation des zones tumorales intra-prostatiques." Thesis, Lille 2, 2014. http://www.theses.fr/2014LIL2S054/document.
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L’IRM représente une modalité d’imagerie du cancer de la prostate qui occupe une place de plus en plus importante pour le diagnostic positif. D’autres indications sont en cours de validation pour établir le pronostique, pour guider le traitement et pour assurer le suivi après traitement notamment partiel. La première partie de ce travail a porté sur les études cliniques de l’IRM dans la sélection des candidats à une surveillance active. Les performances de l’IRM particulièrement dans la détection des cancers antérieurs permettront de réduire le risque de sous-estimation initiale des tumeurs et par conséquent le risque de la reclassification au cours des protocoles de surveillance active. La seconde partie de ce travail a porté sur la corrélation entre les anomalies de signal à l’IRM et les zones tumorales et non tumorales intra-prostatiques. La validation d’une technique simple et reproductible de recalage a permis ensuite une corrélation des anomalies de signal enregistrées sur l’IRM et des paramètres histo-pathologiques quantitatifs des pièces opératoires de prostatectomie<br>MRI is an increasingly important imaging modality for prostate cancer diagnosis. Further indications are being validated in prostate cancer to establish the prognostic, to guide treatment and to follow up patients especially after partial treatment. The first part of this work has focused on clinical studies of MRI in patient selection for active surveillance. The performance of MRI particularly in the detection of anterior cancers would reduce the risk of initial underestimation of tumor burden and therefore reduce the risk of reclassification during active surveillance protocols. The second part of this work has focused on the correlation between the signal abnormalities on MRI and intra-prostatic areas. We used a simple and reproducible technique for MRI and histopathology registration and we correlated signal abnormalities recorded on MRI with quantitative histopathological parameters at prostatectomy surgical specimens
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Anisi, David A. "On Cooperative Surveillance, Online Trajectory Planning and Observer Based Control." Doctoral thesis, KTH, Optimeringslära och systemteori, 2009. http://urn.kb.se/resolve?urn=urn:nbn:se:kth:diva-9990.
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The main body of this thesis consists of six appended papers. In the first two, different cooperative surveillance problems are considered. The second two consider different aspects of the trajectory planning problem, while the last two deal with observer design for mobile robotic and Euler-Lagrange systems respectively.In Papers A and B, a combinatorial optimization based framework to cooperative surveillance missions using multiple Unmanned Ground Vehicles (UGVs) is proposed. In particular, Paper A considers the the Minimum Time UGV Surveillance Problem (MTUSP) while Paper B treats the Connectivity Constrained UGV Surveillance Problem (CUSP). The minimum time formulation is the following. Given a set of surveillance UGVs and a polyhedral area, find waypoint-paths for all UGVs such that every point of the area is visible from a point on a waypoint-path and such that the time for executing the search in parallel is minimized. The connectivity constrained formulation extends the MTUSP by additionally requiring the induced information graph to be kept recurrently connected at the time instants when the UGVs perform the surveillance mission. In these two papers, the NP-hardness of both these problems are shown and decomposition techniques are proposed that allow us to find an approximative solution efficiently in an algorithmic manner.Paper C addresses the problem of designing a real time, high performance trajectory planner for an aerial vehicle that uses information about terrain and enemy threats, to fly low and avoid radar exposure on the way to a given target. The high-level framework augments Receding Horizon Control (RHC) with a graph based terminal cost that captures the global characteristics of the environment. An important issue with RHC is to make sure that the greedy, short term optimization does not lead to long term problems, which in our case boils down to two things: not getting into situations where a collision is unavoidable, and making sure that the destination is actually reached. Hence, the main contribution of this paper is to present a trajectory planner with provable safety and task completion properties. Direct methods for trajectory optimization are traditionally based on a priori temporal discretization and collocation methods. In Paper D, the problem of adaptive node distribution is formulated as a constrained optimization problem, which is to be included in the underlying nonlinear mathematical programming problem. The benefits of utilizing the suggested method for online trajectory optimization are illustrated by a missile guidance example.In Paper E, the problem of active observer design for an important class of non-uniformly observable systems, namely mobile robotic systems, is considered. The set of feasible configurations and the set of output flow equivalent states are defined. It is shown that the inter-relation between these two sets may serve as the basis for design of active observers. The proposed observer design methodology is illustrated by considering a unicycle robot model, equipped with a set of range-measuring sensors. Finally, in Paper F, a geometrically intrinsic observer for Euler-Lagrange systems is defined and analyzed. This observer is a generalization of the observer proposed by Aghannan and Rouchon. Their contractivity result is reproduced and complemented by a proof that the region of contraction is infinitely thin. Moreover, assuming a priori bounds on the velocities, convergence of the observer is shown by means of Lyapunov's direct method in the case of configuration manifolds with constant curvature.<br>QC 20100622<br>TAIS, AURES
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Bergeron, Peggy. "Qualité microbiologique des eaux de baignade : des situations subies de pollution littorale à la gestion active des plages : le cas d'Anglet et Biarritz." Bordeaux 1, 2007. http://www.theses.fr/2007BOR13557.
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La population est de plus en plus sensible à la qualité de son cadre de vie et l'évolution réglementaire s'en est fait écho. L'Union Européenne vient ainsi d'adopter une nouvelle directive concernant la gestion des eaux de baignade en milieu naturel (qui sera transposée en droit français en 2008), en vue de : - renforcer les normes sanitaires, - privilégier une gestion globale des plages par des actions concertées et durables - et informer la population avec clareté et réactivité. D'ici à 2015, tous les Etats membres doivent parvenir à un bon état microbiologique de leurs eaux côtières, à la même échéance que l'atteinte du bon état écologique des masses d'eau prescrit par la directive cadre sur l'eau (2000/60/CE). Les collectivités de Biarritz et Anglet (France, 64) ont anticipé ces dates butoirs et sollicité leur délégataire de service public, Lyonnaise des eaux, pour l'élaboration d'outils de surveillance active de leurs eaux de baignade. L'objectif de ce travail de recherche est donc de proposer à ces collectivités un outil d'aide à la décision qui permettra de gérer de manière rationnelle la fermeture et la réouverture des plages, afin d'assurer un niveau élevé de protection des baigneurs. Il s'agit sonc : - d'anticiper les risques de dégradation de la qualité bactériologique des eaux de baignade liés aux différents rejets dans le milieu marin, à l'aide d'un outil de surveillance suivant des seuils d'alerte déterminés. - et de disposer d'une méthode d'analyse bactériologique adaptée, avec un temps de réponse minimal qui donnera une forte précision pour l'aide à la prise de décision.
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Lander, Jonathan, and Emil Johansson. "I väntan på prostatacancer behandling : Copingprocessen för patienter med prostatacancerinnan medicinsk behandling." Thesis, Högskolan i Halmstad, Sektionen för hälsa och samhälle (HOS), 2014. http://urn.kb.se/resolve?urn=urn:nbn:se:hh:diva-26752.
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Varje år diagnostiseras 10 000 män med sjukdomen prostatacancer i Sverige. Att drabbas av sjukdomen prostatacancer är emotionellt ansträngande. Väntetiden vad gäller behandling för patienter med prostatacancer är lång. Detta gör att patienter med prostatacancer lever med sjukdomen prostata-cancer och känslorna kopplade till diagnosen prostatacancer under en lång tid. Syftet med den aktuella studien var att beskriva copingprocessen för patienter med prostatacancer innan medicinsk behandling. Metoden som använts till studien var en litteraturstudie baserad på 15 vetenskapliga artiklar. Resultatet visade att den kognitiva bedömningen av sjukdomen prostatacancer präglades av den information som patienter med prostata-cancer fick. Den kognitiva bedömningen av sjukdomen prostatacancer påverkades också av ålder och tid efter diagnos. Copingresurser som hade betydelse för patienter med prostatacancer var socialt stöd, personlighet och psykisk hälsa. De copingstrategier som användes av patienter med prostatacancer var främst emotionellt fokuserade. Patienter med prostatacancer är under stor emotionell belastning. Information och socialt stöd från vårdpersonal hjälper patienter med prostatacancer att hantera den emotionella belastningen. Ytterligare forskning krävs för att identifiera effektiva copingstrategier i ett tidigt stadium av diagnosen prostatacancer.<br>Every year 10 000 men are diagnosed with prostate cancer in Sweden. Affection of the disease is emotionally strenuous. The wait for treatment among patients diagnosed for prostate cancer is long. This result in patients diagnosed with prostate cancer living with the disease and the emotions associated with the diagnosis of prostate cancer for an extended time. The aim of the current study was to describe the coping process used by patients diagnosed with prostate cancer prior to treatment. The method of the current study was a literature study based on 15 scientific articles. The results indicated that appraisal of prostate cancer was influenced by the information that patients diagnosed with prostate cancer received. Furthermore appraisal of prostate cancer was affected by age and time since diagnosis. Social support, personality and mental health were coping resources that were of significance to patients diagnosed with prostate cancer. Emotion focused coping strategies were primarily used by patients diagnosed with prostate cancer. Patients with prostate cancer are emotionally distressed. Information and social support from healthcare personnel reduces the emotional distress. Further research should investigate what coping strategies are effective in an early stage of prostate cancer diagnosis.
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Slobodan, Stanojević. "Epizootiološki modeli kontrole i mogućnosti primene molekularne dijagnostike u cilju unapređenja aktivnog nadzora enzootske leukoze goveda." Phd thesis, Univerzitet u Novom Sadu, Poljoprivredni fakultet u Novom Sadu, 2016. https://www.cris.uns.ac.rs/record.jsf?recordId=101330&source=NDLTD&language=en.
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Enzootska leukoza goveda je maligna virusna neoplazma retikulohistiocitarnog sistema progresivnog karaktera, koja se karakteriše intenzivnim razmnožavanjem limfocita. Ova bolest govedarstvu nanosi velike materijalne štete dovodeći do visokog nivoa mortaliteta, pojave učestalijih oportunističkih infekcija, smanjenja produktivnosti i reprodukcije na leukoznim farmama. Imajući u vidu, da govedarstvo predstavlja stratešku granu u stočarstvu Srbije i učestvuje u stvaranju znatnog dela nacionalnog dohotka od 1999. godine, preduzimana su sistematska dijagnostička ispitivanja raširenosti ELG na farmama goveda kako u intenzivnoj tako i od 2000. godine i u ekstenzivnoj proizvodnji goveda. Korišćene su savremene metode dijagnostike ELG najpre agargel-imunodifuzioni test (AGID), a potom i indirektna imunoenzimska metoda (ELISA) kao dijagnostički test izbora. Na osnovu dobijenih epizootioloških podataka sprovoñene su mere za suzbijanje i iskorenjivanje EGL nafarmama goveda. U zavisnosti od tehnološkog procesa proizvodnje, kao i od ekonomskih mogućnosti farmi sprovoñeni su različiti modeli kontrole i eradikacije.ELG predstavlja veoma ozbiljan zdravstveni i ekonomski problem za govedarskuproizvodnju posebno za zapate mlečnih goveda, a pošto se i pored sprovoñenja mera za eradikaciju, leukoza još uvek zadržala u nekim našim stadima i zapatima goveda smatrali smo da bi trebalo preispitati dosadašnju strategiju kontrole ELG.Razmatrane su poteškoće u sprovoñenju mera za suzbijanje i iskorenjivanje leukoze goveda kao i potreba za izučavanjem epizootiologije, odnosno kontrole kretanja leukoze u trakozvanim leukoznim zapatima koji predstavljaju potencijalne izvore širenja leukoze. Imajući u vidu navedeno, cilj ovog ispitivanja je bio ustanoviti stepen raširenosti ELG i ispitaju do sada korišćeni programi kontrole i eradikacije oboljenja. Zadaci ovog istraživanja su bili da se ispitaju pogodnosti pojedinih dijagnostičkih metoda u cilju postavljanja rane dijagnoze oboljenja, istražiti incidenciju i prevalenciju bolesti, proceniti značaj pojedinih puteva prenošenja u okviru farmi i u regionu, izvršiti analizu dosadašnjih rezultata borbe i evaluaciju pojedinih modela, predložiti najpogodnije modele kontrole bolesti u cilju potpune eradikacije bolesti, a takoñe razviti i adekvatan model nadzora bolesti kako bi se sprečila njena ponovna pojava i širenje. Rezultati seroloških ispitivanja pokazuju da je otkriveno 10.181 pozitivnih životinja, odnosno 8,1% posto životinja u zapatima goveda na velikim farmama. Epizootiološka situacija na farmama goveda individualnog sektora zahtevala je posebnu pažnju i tu je ispitano 281.369 uzoraka krvi goveda i otkriveno je 567 pozitivnih grla ili 0,4% posto na području 12 opština. Rezultati seroprevalencije predstavljali su ključnu informaciju od značaja za izbor modela kotrole ELG. Odnosno istraživanje efikasnosti pojedinih modela u postizanju rezultata i zadatih ciljeva. Značajnih za izradu komparativne analize korišćenih modela, njihove primene i evaluacije. Epizotiološki modeli su analizirani, izvršena je njihova evaluacija i preporuka za primenu u epizootiološkoj praksi. <br>Enzootic bovine leucosis is viral malignant neoplasm reticulohistiocytic system and has progressive character, which is characterized by intensive multiplication of lymphocytes. This disease is causing a great material damage to cattle farming, leading to high level of mortality, with the emergence of more frequent infections and a reduction in productivity and reproduction in farms in which the leukosis appeared. Having in mind that the cattle farming is a strategic branch of the Serbian livestock and participates in the creation of a significant part of the national income since 1999, systematic diagnostic tests of the prevalence of EBL were undertaken on cattle farms, both in the intensive cattle production and from 2000 extensive production. Modern diagnostics methods of EBL were used, firstly the agargel-immunodiffusion test (AGID), followed by an indirect enzyme immunoassay method (ELISA) as well as a diagnostic test of choice. Based on the obtained epizootic data, the measures for the control and eradication of EBL were carried out on cattle farms. Depending on the technological process of production, as well as the economic farm opportunities, different models of control and eradication were implemented.EBL is a very serious health and economic problem for cattle farming, especially fordairy cattle herds, and despite the implementation of the measures for the eradication of the disease, leucosis is still held in some of our flocks and herds of cattle. Because of that we thought that the current control strategy EBL should be examined.The difficulties in implementing measures to suppress and eradicate bovine leukosis were discuses and the requirement to study the epizootiology , as well as to control the movement of leukosis in so-called leukostic herds, that represent potential source of spreading the leukosis.Taking into account, the purpose of this study was to establish the degree ofprevalence of EBL to examine the programs that were used so far to control and eradicate the diseases. The task of this study was to examine the benefits of specific diagnostic methods in order to establish early diagnosis of the diseases, to see into the incidence and prevalence of the leukosis, to estimate the significance of some routes of transmission within the farm and in the region, and to carry out an analysis of recent results in fighting and evaluation of individual models, to suggest the most appropriate models of disease control in order to complete the eradication of leukosis, but also to develop an adequate model of disease control to prevent its re-emergence and spread. The results of serological tests indicate that 10.181 the positive animals were detected, or 8.1 % percent of the animals in cattle herds in large farms. Epizootiological situation in the cattle farms of individual sectors required special attention and 281.369 blood samples of cattle were examined and the 567 positive cases were discovered, or 0.4 % percent in 12 communities. Results of seroprevalence were a key information for the choice of models to control ELG, or to investigate the efficiency of some models to achieve results and goals, and important for the production of comparative analysis of models that were used, their implementation and evaluation. Epizootic models were analyzed, their evaluation was made and recommendations for their implementation in the epizootic practice.
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Pereira, Abrantes Manuela. "Hétérogénéité des neutrophiles et leurs écosystèmes dans l’immunosurveillance au cours de la tumorigenèse." Electronic Thesis or Diss., Lyon 1, 2023. http://www.theses.fr/2023LYO10147.
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Le neutrophile est la cellule immunitaire la plus représentée dans le sang chez l’Homme, dont la migration au site inflammatoire est rapide. Le rôle du neutrophile a largement été décrit dans des contextes infectieux, auto-immunitaires et allergiques mais reste controversé dans le cancer, notamment dans les mécanismes d’immunosurveillance précoce. Le neutrophile se révèle être une population hétérogène tant phénotypiquement que fonctionnellement. L’origine et la compréhension de l’hétérogénéité des neutrophiles est un sujet émergent et croissant, mais aucune étude à ce jour ne décrit l’évolution de l’hétérogénéité des neutrophiles à différents stades. L’objectif de ma thèse est de caractériser cette hétérogénéité au sein des tissus au cours de la tumorigenèse, à partir de deux modèles d’études. Mon premier projet s’est intéressé au cancer colorectal (CCR) chez l’Homme de par l’accès privilégié à des échantillons de tissus adjacents colorectaux (AT), de tissus prénéoplasiques (polypes, P) et d'adénocarcinomes (ADK), frais, synchrones et pairés à partir de patients subissant des colectomies partielles ou totales. Des quantifications protéomiques démontrent que les neutrophiles représentent la principale augmentation de cellules immunitaires innées au sein de l'ADK. Pour la première fois, les profils transcriptomiques de neutrophiles triés et de leurs partenaires cellulaires par RNA-seq et single cell RNA-seq (scRNA-seq) au cours de la tumorigenèse ont été établis et intégrées pour déchiffrer l'hétérogénéité, l’évolution et les interactions cellulaires clés des neutrophiles, au cours du CCR. Alors que le microenvironnement du P et de l’ADK sont similaires et distinct de l’AT, le transcriptome des neutrophiles de P et d’AT sont corrélés mais différents de ceux de l’ADK. Ces résultats suggèrent une niche pré-inflammatoire dans le P favorable aux modifications des neutrophiles, précédant l'inflammation cancéreuse, favorisant la migration et l’activation des cellules myéloïdes. Les neutrophiles du P présentent des propriétés fonctionnelles (e.g. dégranulation, activation, production de cytokines) tandis que les neutrophiles de l'ADK présentent un état “d’épuisement” associé à un profil plutôt pro-tumoral (i.e. perte de fonctions canoniques et profil pro-tumoral). Le scRNA-seq de neutrophiles triés identifie 8 clusters distincts, dont deux sont spécifiquement enrichis dans l’AT et l’ADK. Le cluster enrichi dans l’AT est associé à des signatures anti-tumorales tandis que le cluster associé à l'ADK démontre des caractéristiques pro-tumorales, basées sur des analyses d’enrichissement de signatures issues de données publiques. Les analyses de trajectoire démontrent un continuum de l’AT, à P et ADK avec 3 trajectoires distinctes, où un cluster unique de neutrophiles exprimant des gènes induits par les interférons et enrichi dans l’ADK se distingue des autres. Le second projet s’est basé sur un modèle murin de carcinogenèse mammaire spontanée MMTV-NeuT pour lequel, à la différence du modèle chez l’Homme, nous avons accès aux différents stades tumoraux mais également au sang et aux organes lymphoïdes primaire (moelle osseuse) et secondaire (rate). Les analyses transcriptomiques de neutrophiles triés révèlent des états phénotypiques et fonctionnels distincts selon l’organe et le stade tumoral analysé. De manière originale, nous avons mis en évidence l’existence de neutrophiles EpCAM+ uniques aux tissus tumoraux et constituant 60 à 90% des neutrophiles totaux au cours de la tumorigenèse. L’expression d’EpCAM n’est pas endogène mais semblerait provenir de fragments membranaires exogènes à la surface du neutrophile, suggérant un mécanisme de trogocytose voire de trogoptose des cellules prénéoplasiques et tumorales. De futures études fonctionnelles permettront d’élucider le mécanisme et le rôle des neutrophiles EpCAM+<br>The neutrophil is the most abundant immune cell in the human blood that migrates rapidly to the inflammatory site. The role of neutrophils has been extensively described in infectious, autoimmune, and allergic contexts, but it remains controversial in cancer, particularly in early immune surveillance mechanisms. Neutrophils are a heterogeneous population, both phenotypically and functionally. The origin and understanding of neutrophil heterogeneity are emerging and increasingly studied, albeit to date, no study has described the evolution of neutrophil heterogeneity at different stages. The aim of my thesis is to characterize this heterogeneity within tissues during tumorigenesis, using two models. My first project focused on colorectal cancer (CRC) in humans, taking advantage of a privileged access to fresh, synchronous, and paired adjacent colorectal tissue samples (AT), preneoplastic tissues (polyps, P), and adenocarcinomas (ADK), from patients undergoing partial or total colectomies. Proteomic quantification demonstrated that neutrophils represent the main increase in the innate immune compartment within ADK. For the first time, transcriptomic profiles of FACS-sorted neutrophils and their cellular partners using RNA-seq and single-cell RNA-seq (scRNA-seq) throughout tumorigenesis were established and integrated to decipher the heterogeneity, evolution, and key cellular interactions of neutrophils in CRC. While the microenvironment of P and ADK were similar and distinct from AT, the transcriptome of P and AT neutrophils were correlated but different from ADK-associated neutrophils. These results suggest a pre-inflammatory niche in P that favors neutrophil modifications, preceding cancer-related inflammation, promoting migration and activation of myeloid cells. P-associated neutrophils exhibited functional properties (e.g. degranulation, activation, cytokine production), while ADK-associated neutrophils showed an "exhausted" state associated with a more pro-tumoral profile (i.e. loss of canonical functions and pro-tumoral profile). scRNA-seq of FACS-sorted neutrophils identified 8 distinct clusters, two of which were specifically enriched in AT and ADK. The AT-enriched cluster was associated with anti-tumoral signatures, while the ADK-enriched cluster demonstrated pro-tumoral characteristics, based on enrichment analyses of publicly available data signatures. Trajectory analyses showed a continuum from AT to P and ADK with three distinct trajectories, where a unique ADK-enriched cluster of neutrophils expressing interferon-stimulated genes stood out from the others. The second project was based on a mouse model of spontaneous mammary carcinogenesis, MMTV-NeuT, for which, unlike the human model, we have access to breast tissues at different stages as well as blood and primary (bone marrow) and secondary (spleen) lymphoid organs. Transcriptomic analysis of FACS-sorted neutrophils revealed distinct phenotypic and functional states depending on the organ and tumor stage. Interestingly, we unveiled the existence of a unique EpCAM+ neutrophil population in tumor tissues, representing 60 to 90% of total neutrophils throughout tumorigenesis. EpCAM expression was not endogenous but seemed to originate from exogenous membrane fragments on the surface of neutrophils, suggesting a mechanism of trogocytosis or even trogoptosis of preneoplastic and tumor cells. Further functional studies will elucidate the mechanism and the role of EpCAM+ neutrophils
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Nyame, Y. A., A. B. Murphy, D. K. Bowen, et al. "Associations Between Serum Vitamin D and Adverse Pathology in Men Undergoing Radical Prostatectomy." AMER SOC CLINICAL ONCOLOGY, 2016. http://hdl.handle.net/10150/614756.
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Purpose Lower serum vitamin D levels have been associated with an increased risk of aggressive prostate cancer. Among men with localized prostate cancer, especially with low-or intermediate-risk disease, vitamin D may serve as an important biomarker of disease aggression. The aim of this study was to assess the relationship between adverse pathology at the time of radical prostatectomy and serum 25-hydroxyvitamin D (25-OH D) levels. Methods This cross-sectional study was carried out from 2009 to 2014, nested within a large epidemiologic study of 1,760 healthy controls and men undergoing prostate cancer screening. In total, 190 men underwent radical prostatectomy in the cohort. Adverse pathology was defined as the presence of primary Gleason 4 or any Gleason 5 disease, or extraprostatic extension. Descriptive and multivariate analyses were performed to assess the relationship between 25-OH D and adverse pathology at the time of prostatectomy. Results Eighty-seven men (45.8%) in this cohort demonstrated adverse pathology at radical prostatectomy. The median age in the cohort was 64.0 years (interquartile range, 59.0 to 67.0). On univariate analysis, men with adverse pathology at radical prostatectomy demonstrated lower median serum 25-OH D (22.7 v 27.0 ng/mL, P = .007) compared with their counterparts. On multivariate analysis, controlling for age, serum prostate specific antigen, and abnormal digital rectal examination, serum 25-OH D less than 30 ng/mL was associated with increased odds of adverse pathology (odds ratio, 2.64; 95% CI, 1.25 to 5.59; P = .01). Conclusion Insufficiency/deficiency of serum 25-OH D is associated with increased odds of adverse pathology in men with localized disease undergoing radical prostatectomy. Serum 25-OH D may serve as a useful biomarker in prostate cancer aggressiveness, which deserves continued study. (C) 2016 by American Society of Clinical Oncology
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Khalifa, Otman. "La protection de la vie privée à l’ère des nouvelles technologies : une protection relative." Thesis, Paris 10, 2019. http://www.theses.fr/2019PA100023.
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Le droit au respect de la vie privée est un droit fondamental. Il est garanti par des textes et la jurisprudence tant nationale que supranationale. Ce caractère fondamental impose aux États de lui accorder une protection appropriée contre tous les risques qui l’entourent, parmi lesquels figurent incontestablement, les nouvelles technologies de l’information et de la communication. Les législateurs français et européen ont adopté des mécanismes juridiques visant à faire face aux risques engendrés par l’usage des nouvelles technologies sur la vie privée. Cependant, l’existence de nombreuses dérogations autorisant le pouvoir public à recourir à des techniques controversées, fragilisent durablement le respect de ce droit fondamental, en réduisant, comme une peau de chagrin, la sphère de la vie privée, ces dernières années. Ainsi des raisons liées à la sécurité et aux intérêts de l’État légitiment des atteintes disproportionnées au droit à la vie privée et ses composantes. Par ailleurs, des activités menées par acteurs majeurs d’internet, sur lesquels les États et les organismes de contrôle n’ont pratiquement pas d’influence majeure, ont conséquences néfastes sur le respect de la vie privée. En fin de compte, les mécanismes de contrôle du respect de la vie privée mis en place, par manque de moyens logistiques et l’absence d’une législation internationale globale, rendent vaine et illusoire, en l’état actuelle, la protection de ce droit fondamental<br>The right to respect private life is a fundamental right, which is fully protected by the provisions of the law and the provisions of the judiciary at the national and international levels. This fundamental nature requires the state to provide effective methods that protect this right against the dangers surrounding it, the most important of which is the threat of modern information and communication technology. The French and European legislators enacted several legislations that would limit the illegal uses of this technology to private life. However, in recent years, justifications for the security and interests of the state have passed legislation authorizing public authorities to use high-tech devices to spy on people's lives and to monitor their private communications without adequate legal safeguards, which has increasingly weakened the scope of privacy protection. Moreover, the dominant Internet companies are now a real threat to the privacy of Internet users. The violations carried out by these companies outweigh the danger of states and legally and realistically exclude the authority of the French and European control bodies. Finally, the actual legal protection mechanisms, in the absence of financial and technical possibilities and the absence of a binding international convention on privacy, would not be able to provide effective legal protection to this fundamental right
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Schwan, Melanie Barbara [Verfasser], Kathleen [Akademischer Betreuer] Herkommer, Kathleen [Gutachter] Herkommer, and Jürgen E. [Gutachter] Gschwend. "Einfluss der Familienanamnese und des Diagnosealters auf das histopathologische Outcome nach Radikaler Prostatektomie von präoperativ für Active Surveillance geeigneten Patienten / Melanie Barbara Schwan ; Gutachter: Kathleen Herkommer, Jürgen E. Gschwend ; Betreuer: Kathleen Herkommer." München : Universitätsbibliothek der TU München, 2017. http://d-nb.info/116577299X/34.
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Jimenez, Zenteno Alejandro Kayum. "Micro-dispositifs pour l'isolement des cellules tumorales circulantes en routine clinique." Thesis, Toulouse 3, 2018. http://www.theses.fr/2018TOU30154.
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Les cellules tumorales circulantes (CTCs) sont la principale voie de dissémination du cancer dans le corps humain au travers de la circulation sanguine. Ces cellules ont la capacité de se détacher de la tumeur primaire, de rejoindre la circulation sanguine et de survivre dans cet environnement. Une sous-population spécifique de ces cellules a la capacité de coloniser de nouveaux tissus et de former des métastases. L'importance de ces cellules rares dans la circulation sanguine a été intensément étudiée au cours des dernières décennies, et il a été constaté que les informations phénotypiques et génomiques qu'elles contiennent pourraient être corrélées avec celles obtenues à partir d'une biopsie tissulaire. De plus, le nombre et l'incidence des CTC chez les patients métastatiques pourraient être utilisés comme indicateurs pronostics. Ainsi, leur isolement à partir d'échantillons sanguins et leur analyse a été proposé en remplacement des biopsies conventionnelles, comme une alternative moins invasive et permettant un échantillonnage plus répété. In fine, la détection et l'analyse des CTC en routine clinique pourraient être utilisées pour le suivi en temps réel des thérapies et de leur efficacité pour améliorer la prise en charge des patients, un pas de plus vers une médecine de précision. Dans ce projet de thèse, nous avons développé de nouveaux micro-dispositifs pour la capture, sous flux, de cellules cancéreuses à partir de sang complet humain. Nous avons exploité les propriétés physiques des CTC, plus grandes et moins déformables que les cellules sanguines normales, pour discriminer ces cellules rares (<1 cellule par mL aux premiers stades de la maladie). Des micro-dispositifs ont été conçus tels des tamis à trois dimensions pour filtrer sélectivement les cellules cancéreuses tout en préservant l'intégrité et la viabilité des cellules. De plus, les dispositifs ont été conçus pour permettre l'accès au matériel biologique isolé et effectuer ainsi une identification des cellules in situ, e.g. par immunocytochimie, mais aussi potentiellement pour servir de plateforme pour une analyse fonctionnelle de ces cellules. Nous avons proposé deux approches totalement compatibles avec la routine clinique. La première consiste en un guide équipé de microdispositifs, conçu pour être introduit directement dans la circulation sanguine au travers d'un cathéter médical et effectuer la capture des cellules cancéreuses in vivo. La deuxième approche vise à réaliser l'isolement des CTCs en utilisant des microdispositifs intégrés à des plateformes ex vivo compatibles avec les consommables médicaux de prélèvement sanguin.[...]<br>Circulating tumor cells (CTCs) are believed to represent the main pathway of cancer dissemination in the human body through the circulatory system. These cells have the ability to detach from the primary tumor, enter into the bloodstream, and survive in this environment. A specific subpopulation of these cells possesses the capacity of colonizing new tissues and forming metastases. The relevance of these rare cells in the bloodstream has been intensively investigated during the last decades, finding that phenotypic and genomic information they carry could be correlated with that of solid biopsies. Moreover, the number and incidence of CTCs in metastatic patients could be used as an indicator for prognosis. Thus, their isolation from blood samples and analysis has been proposed as a surrogate to solid biopsies, having the added value of being a less invasive procedure and allow a more repeated measure. In fine, the routine analysis of CTCs in clinical practice could be used for the real-time monitoring of therapies and the adaptation of treatment in order to improve the outcome of patients, a step forward towards so-called precision medicine. In this PhD project, we have developed novel micro- devices for the capture, in flow conditions, of tumor-derived cells from human whole blood. CTCs being larger and less deformable than normal blood cells, we exploited theses physical traits to discriminate them. Sieve-like micro-devices were engineered to selectively sort out tumor-derived cells having as a priority the preservation of cell integrity and viability. In addition, devices were designed to allow direct access to the isolated biological material and thus perform in situ cell identification, such as immunocytochemistry, but also to potentially serve as a platform for functional analysis. We proposed two approaches compatible with clinical routine. The first approach consists in a customized guiding-strip equipped with integrated microfilters, designed to be introduced directly within the bloodstream through a conventional medical catheter to perform the capture of tumor-derived cells in vivo. The second approach aims to perform CTC isolation ex vivo through the integration of microfilters into a platform compatible with blood collection medical sets. [...]
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Lübbert, Christoph. "Epidemiologie, Klinik, Ausbruchs- und Therapiemanagement von Krankenhausinfektionen durch Carbapenemase bildende Klebsiella pneumoniae und Toxin produzierende Stämme von Clostridium difficile." Doctoral thesis, Universitätsbibliothek Leipzig, 2015. http://nbn-resolving.de/urn:nbn:de:bsz:15-qucosa-163269.
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Die Mehrzahl der jährlich 400.000 bis 600.000 Krankenhausinfektionen in Deutschland wird von Erregern der sog. ESCAPE-Gruppe (Enterococcus faecium, Staphylococcus aureus, Clostridium difficile, Acinetobacter baumannii, Pseudomonas aeruginosa und verschiedene Enterobacteriaceae, u.a. Klebsiella pneumoniae) verursacht. Besondere Sorge bereitet dabei die Ausbreitung von K. pneumoniae-Stämmen mit enzymvermittelter Resistenz gegenüber Carbapenem-Antibiotika (K. pneumoniae-Carbapenemase, KPC) und die Zunahme von C. difficile-Infektionen (CDI) durch hypervirulente Epidemiestämme (z.B. Ribotyp 027).
Die spezifischen Erfahrungen eines prolongierten Ausbruchsgeschehens durch einen KPC-bildenden K. pneumoniae-Stamm (KPC-KP) am Leipziger Universitätsklinikum machen deutlich, dass bei diesem Erregertyp ein hohes Transmissionspotential bei enormer Tenazität (Umweltresistenz) zu berücksichtigen ist, ein Versagen von Standardhygienemaßnahmen in Betracht zu ziehen ist, und Infektionsketten oftmals unklar bleiben. Die Anwendung von Antibiotika ist bei KPC-KP-Infektionen auf einzelne Substanzen (Colistin, Tigecyclin, Gentamicin) beschränkt und vor allem bei immunsupprimierten Patienten (z.B. Lebertransplantierte) mit einem relevanten Risiko des Therapieversagens behaftet. Die Therapie von CDI wird gerade bei Immunsupprimierten durch eine steigende Zahl an Rezidiven erschwert, die teilweise antibiotisch (Vancomycin, Fidaxomicin) nicht beherrschbar sind, so dass alternative Therapieverfahren wie die fäkale Bakterientherapie („Stuhltransplantation“) zur Anwendung kommen. CDI-Rezidive, aber auch eine dauerhafte intestinale Besiedelung mit multiresistenten Enterobakterien wie KPC-KP, scheinen neben wirtsspezifischen Faktoren der Immunantwort durch eine Dysregulation der physiologischen intestinalen Standortflora mit Störung der Kolonisationsresistenz bedingt zu sein. Der Versuch einer Eradikationsbehandlung von Patienten mit persistierender intestinaler Besiedelung durch KPC-KP mittels oraler Applikation der nicht resorbierbaren Antibiotika Colistin und Gentamicin ist mit einem relevanten Risiko der Entstehung von Sekundärresistenzen behaftet.
Die Zulassung neuer, besser wirksamer Antibiotika ist für die nächsten Jahre nicht in Sicht, so dass der Infektionsprävention überragende Bedeutung zukommt. Die Erfahrungen der KPC-Ausbruchsbewältigung am Leipziger Universitätsklinikum zeigen, dass nahezu lückenlose Compliance bei der Händedesinfektion, rigoros praktizierte und kontrollierte Barriere- und Isolationsmaßnahmen, Optimierung des Gebrauchs von Breitspektrum-Antibiotika (sog. „Antibiotic Stewardship“) und systematisches mikrobiologisches Erregerscreening dabei unabdingbar sind.
Nachhaltige Verbesserungen hinsichtlich der globalen Ausbreitung von multiresistenten Krankenhausbakterien werden sich nur durch grundlegende Umgestaltungen in Umwelt, Landwirtschaft, Tierzucht und Gesundheitswesen mit sparsamer und möglichst gezielter Anwendung von Antibiotika erzielen lassen. Um Risikopopulationen hospitalisierter Patienten vor potentiell lebensbedrohlichen Erregertransmissionen effektiv schützen zu können, sind erweiterte Surveillance und konsequent umgesetzte krankenhaushygienische Maßnahmen erforderlich.
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Salazar, Diana Carolina Cortes. "Busca de reações adversas a medicamentos em pacientes internados em Clínica Médica usando rastreadores." Universidade de São Paulo, 2016. http://www.teses.usp.br/teses/disponiveis/6/6135/tde-10012017-095145/.
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Introdução: As reações adversas a medicamentos (RAM) seguem constituindo um problema importante dentro do âmbito hospitalar. Na clínica médica, as reações adversas apresentam-se com alta frequência, pois os pacientes recebem maior número de medicamentos e apresentam maior número de comorbidades. Portanto, são necessárias abordagens que permitam a detecção precoce dos eventos, de maneira que possam ser propostas intervenções que minimizem o dano ao paciente. A busca ativa de rastreadores, sendo estes, resultados alterados de exames laboratoriais, administração de medicamentos específicos e certos acontecimentos, tem se mostrado aplicável e efetiva para o monitoramento das reações adversas a medicamentos. Objetivo: Identificar reações adversas a medicamentos na enfermaria da Clínica Médica de um hospital de nível secundário a partir de rastreadores. Métodos: Desenvolveu-se um estudo de coorte prospectiva na clínica médica do Hospital Universitário da Universidade de São Paulo, sendo utilizada uma lista de 34 rastreadores. Pacientes maiores de 15 anos que permaneceram no mínimo 24 horas na enfermaria foram aleatorizados para compor a amostra. Em cada caso, foram coletadas, de forma cronológica, informações relacionadas aos medicamentos administrados, resultados de exames laboratoriais e a evolução médica. Todos os prontuários foram discutidos por profissionais de saúde, sendo avaliada a causalidade e a gravidade. Realizou-se uma análise univariada comparando pacientes com e sem RAM. Adicionalmente estudou-se o desempenho dos rastreadores usados. Resultados: No período de agosto de 2015 até abril de 2016 foram monitorados 116 pacientes. Identificaram-se reações adversas a medicamentos em 37,9 por cento dos pacientes, sendo achadas 47 suspeitas de RAM em cada 1000 paciente-dia. Pacientes que apresentaram RAMs foram internados mais vezes em leitos classificados como alta-dependência, apresentaram maior duração da internação, maior número de medicamentos usados e menor grau de escolaridade. Em relação ao nível de gravidade, a maioria das suspeitas de RAM (49 eventos, 89,1 por cento ) foram classificadas como moderadas e afetaram o sistema gastrointestinal. Foram identificados 429 rastreadores. Os rastreadores que apresentaram melhor desempenho foram menção da hipotensão, diminuição de plaquetas maior que 50 por cento , administração de glicose hipertônica em 25 ou 50 por cento e suspensão abrupta da medicação. Conclusão: A aplicação prospectiva do método de rastreadores a uma coorte aberta de pacientes da clínica médica permitiu a identificação de suspeitas de reações adversas, a caracterização dos pacientes, as suspeitas, os medicamentos envolvidos e o desempenho dos rastreadores.<br>Introduction: Adverse drug reactions (ADRs) continues to represent a major problem at hospitals. In internal medicine wards, adverse drug reactions present high frequencies, as patients receive more medicines and have higher number of comorbidities. Therefore, approaches are needed that allow early detection of events, so, interventions could be proposed to minimize harm to patients. The active surveillance using triggers, which are, abnormal laboratory values, administration of specific drugs and certain events, has been proven applicable and effective for monitoring adverse drug reactions. Objective: To identify adverse drug reactions in the internal medicine ward of a secondary university hospital using triggers. Methods: a prospective cohort study was developed in the teaching hospital of the University of São Paulo, using a list of 34 sentinel words. Patients aged 15 years or more, who were hospitalized at least 24 hours, were randomized for the sample. For each case, information related to administered drugs, laboratory results and progress notes were collected chronologically. All charts were discussed by health professionals, assessing causality and severity. A univariate analysis was developed comparing patients with and without ADRs. Additionally, the performance of each trigger was studied. Results: In the period from August 2015 to April 2016, 116 patients were monitored. Adverse drug reactions were identified in 37.9 per cent of patients, presenting a rate of 47 suspected ADRs per 1,000 patient-days. Patients who experience ADRs were frequently classified as nursing high dependency, had longer length of stay, lower education level and used larger number of medicines. Regarding to severity, most of the suspected ADRs (49 cases, 89.1 per cent ) was classified as mild and affected the gastrointestinal system. 429 triggers were identified. Triggers with high performances were \"mention of hypotension\", \"platelets decrease greater than 50 per cent ,\" \"administration of dextrose 25 or 50 per cent \" and \"abrupt medication stop\". Conclusion: The prospective surveillance using triggers in an open cohort of internal medicine inpatients allowed the identification of adverse drug reactions and the characterization of patients, drugs involved and triggers.
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Eberst, Guillaume Nicolas. "Seconds cancers après traitement curatif d'un cancer broncho-pulmonaire." Electronic Thesis or Diss., Bourgogne Franche-Comté, 2023. http://www.theses.fr/2023UBFCE029.
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Le premier des objectifs du plan cancer 2014-2019 était de guérir plus de malades en favorisant les diagnostics plus précoces. Cet objectif laisse espérer davantage de diagnostic à des stades précoces accessibles à une résection chirurgicale. A l’heure actuelle, la chirurgie exérèse d’un cancer broncho-pulmonaire non à petites cellules (CBNPC) est le traitement offrant le plus d’espoir de guérison. Ce travail de thèse s’intéresse tout particulièrement au devenir des patients opérés.Malgré une intention curatrice, les patients opérés d’un CBNPC sont à risque de récidive du cancer opéré mais ont également un risque de second cancer, et en particulier de second cancer broncho-pulmonaire primitif (SCBP), supérieur à celui de la population générale, de l’ordre de 20% d’incidence cumulée à 10 ans. Lorsque survient une lésion pulmonaire de même diagnostic histologique que le cancer opéré, le diagnostic différentiel entre récidive du cancer opéré ou SCBP est difficile. Plusieurs définitions existent. En se basant sur l’hypothèse que les récidives sont le témoin d’une agressivité de la maladie cancéreuse, et donc le plus souvent de plus mauvais pronostic que les deuxièmes cancers, nous avons conduit dans un premier temps une revue systématique Cochrane de l’ensemble des définitions utilisées dans la littérature afin d’identifier celle qui offre la meilleure distinction pronostique, sur laquelle se baser pour le diagnostic différentiel entre récidive du cancer opéré et SCBP.Il y a quelques années, l'immunothérapie s'est imposée dans l'arsenal thérapeutique du cancer broncho-pulmonaire. D'abord utilisée en situation métastatique, l'immunothérapie est maintenant testée en situation péri-opératoire dans de nombreux essais. Cependant, en raison de la diversité des combinaisons et des stratégies thérapeutiques, qui n'ont pas toutes été comparées entre elles, une incertitude demeure quant à la meilleure thérapie péri-opératoire pour les patients opérés d'un CBNPC de stade précoce. Nous avons initié une revue systématique d’essais interventionnels avec méta-analyse en réseau selon la méthode Cochrane portant sur l'efficacité de ces traitements péri-opératoires chez les patients atteints de cancer du poumon non à petites cellules.L’étude IFCT-0302 est la seule large étude randomisée de surveillance des opérés d’un CBNPC. Elle a inclus 1775 patients. Son objectif était de comparer la survie globale de deux stratégies de surveillance : par clinique et radiographies thoraciques dans le groupe contrôle, et par clinique, radiographies thoraciques et scanners thoraco-abdominaux dans le groupe expérimental. La qualité de vie décrite par le patient (QdV) est une mesure de trois domaines de la santé perçue : physique, social et émotionnel. La QdV est impactée par une condition médicale ou son traitement. L'évidence suggère que la chirurgie du cancer du poumon a un impact significatif sur la QdV. L’objectif de notre travail a été d’évaluer l’influence du type de surveillance sur la QdV dans la population de l’étude IFCT-0302.Lorsqu’une image pulmonaire anormale est détectée, son diagnostic histologique s’obtient fréquemment par ponction transthoracique guidée par le scanner. La principale complication du geste est le pneumothorax. Les contraintes hospitalières ne permettent pas d’hospitaliser tous les patients après une ponction transthoracique. Nous avons dans ce troisième axe, travaillé à la validation d’un score prédictif de survenue d’un pneumothorax retardé après une ponction-biopsie transpariétale pulmonaire scannoguidée, afin de sélectionner les patients qui doivent être surveillés en hospitalisation conventionnelle. Ce travail a été réalisé sur une cohorte de patients du CHU de Besançon, une partie de la cohorte ayant permis d’élaborer le score, l’autre de le valider. Enfin un travail de validation externe sur une cohorte de patients de l’Hôpital Bichat – Claude Bernard a été réalisé<br>The first objective of the 2014-2019 cancer plan was to cure more patients by promoting earlier diagnosis. This objective gives hope for more diagnosis at early stages accessible to surgical resection. Currently, excisional surgery for non-small cell bronchopulmonary cancer (NSCLC) is the treatment offering the most hope for a cure. This thesis work is particularly interested in the future of operated patients.Despite a curative intention, patients operated on for NSCLC are at risk of recurrence of the operated cancer but also have a higher risk of second cancer, and in particular second primary lung cancer (SPLC), higher than that of the general population. , of the order of 20% cumulative incidence at 10 years.When a lung lesion with the same histological diagnosis as the operated cancer occurs, the differential diagnosis between recurrence of the operated cancer or SPLC is difficult. Several definitions exist. Based on the hypothesis that recurrences indicate an aggressiveness of the cancerous disease, and therefore most often have a worse prognosis than second cancers, we first conducted a Cochrane systematic review of the set of definitions used in the literature in order to identify the one which offers the best prognostic distinction, on which to base the differential diagnosis between recurrence of operated cancer and SCBP.A few years ago, immunotherapy established itself in the therapeutic arsenal for bronchopulmonary cancer. First used in the metastatic situation, immunotherapy is now tested in the perioperative situation in numerous trials. However, due to the diversity of combinations and therapeutic strategies, not all of which have been compared with each other, uncertainty remains regarding the best perioperative therapy for patients undergoing surgery for early-stage NSCLC. We initiated a systematic review of interventional trials with network meta-analysis according to the Cochrane method on the effectiveness of these perioperative treatments in patients with non-small cell lung cancer.The IFCT-0302 study is the only large randomized surveillance study of NSCLC patients. It included 1775 patients. Its objective was to compare the overall survival of two monitoring strategies: by clinic and chest x-rays in the control group, and by clinic, chest x-rays and thoraco-abdominal scans in the experimental group. Patient-described quality of life (HRQoL) is a measure of three domains of perceived health: physical, social, and emotional. QoL is impacted by a medical condition or its treatment. Evidence suggests that lung cancer surgery has a significant impact on QoL. The objective of our work was to evaluate the influence of the type of surveillance on HRQoL in the population of the IFCT-0302 study.When an abnormal lung image is detected, its histological diagnosis is frequently obtained by transthoracic puncture guided by the scanner. The main complication of the procedure is pneumothorax. Hospital constraints do not allow all patients to be hospitalized after a transthoracic puncture. In this third axis, we worked on the validation of a predictive score for the occurrence of delayed pneumothorax after a CT-guided transparietal lung biopsy, in order to select patients who must be monitored in conventional hospitalization. This work was carried out on a cohort of patients from Besançon University Hospital, one part of the cohort having made it possible to develop the score, the other to validate it. Finally, external validation work on a cohort of patients from the Bichat – Claude Bernard Hospital was carried out
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Braga, Stefânia Leirias. "Análise crítica do abastecimento de insumos farmacêuticos importados sob vigilância sanitária." Universidade Federal Fluminense, 2017. https://app.uff.br/riuff/handle/1/5967.
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Previous issue date: 2017<br>Nas últimas décadas a produção nacional de medicamentos a partir de insumos fabricados nacionalmente tem sido estimulada através de vários programas de governo, por entender que os medicamentos são um produto estratégico, tratado em políticas públicas que envolvem a melhoria da saúde da população brasileira. Esse trabalho teve por objetivo, observar se após a adoção do programa de Parceria de Desenvolvimentos Produtivo, entre empresas públicas e privadas, houve alguma mudança na importação dos insumos farmacêuticos ativos: clozapina, cabergolina e lamivudina durante o período de 2010 a 2015. Foram coletados dados dos insumos importados e observados se os mesmos atendiam às normas regulatórias sanitária vigentes, assim como os dados epidemiológicos de doenças tratadas por estes medicamentos e seus hábitos de prescrição médica. Os resultados iniciais revelaram que houve uma diminuição de 50% na quantidade da importação do IFA Cabergolina, a cada ano, a partir do ano de 2013, também foi observado, uma estabilização, sem aumento do quantitativo importado, do IFA Clozapina e em estudos complementares mostrou a diminuição da importação do IFA Lamivudina. A queda no número das importações, não estava relacionada a uma possível diminuição no número de casos das doenças, ou a alguma mudança no hábito de prescrição dos medicamentos contendo os IFA importados. Durante o desenvolvimento do estudo foi observado um aumento das adequações sanitária, e do cumprimento das normas regulatórias a publicações das mesmas pela Anvisa<br>In the last decades, the national production of drugs from nationally manufactured inputs has been stimulated through several government programs, because they understand that medicines are a strategic product, treated in public policies that involve improving the health of the Brazilian population. The objective of this study was to observe whether there was any change in the importation of the active pharmaceutical inputs: clozapine, cabergoline and lamivudine during the period from 2010 to 2015 after the adoption of the Productive Development Partnership program between public and private companies. Data on imported inputs and observed whether they met the current sanitary regulations, as well as epidemiological data on the diseases treated by these medicines and their medical prescription habits. The initial results showed that there was a decrease in the amount of 50% of the import of IFA Cabergoline, every year, from 2013 onwards, a stabilization was also observed, with no increase in the imported quantity, of IFA Clozapine and in studies showed a decrease in the importation of IFA Lamivudine. The decrease in the number of imports was not related to a possible decrease in the number of cases of the diseases, or to some change in the prescription habits of the medicines containing the imported IFAs. During the development of the study it was observed an increase in the sanitary adequacy, and of the compliance with the regulatory norms to the publications of the same ones by Anvisa
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Faoro, Sonia. "Eventi endocrini correlati alla somministrazione di farmaci antitumorali." Doctoral thesis, Università degli studi di Padova, 2016. http://hdl.handle.net/11577/3427253.
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This thesis highlights how the observational study of adverse events (in this case endocrine related) in oncology and, in general, clinical medicine can offer ideas for scientific research.
We focused our attention on the study of secondary endocrine effects of anti-tumor drugs because, as shown by the recent literature, with new targeted therapies, the classic acute toxicities of cytotoxic chemotherapy (vomiting, diarrhea, hair loss etc.) have decreased but less obvious toxicities, which are sometimes more subtle, such as those related to the endocrine system, have emerged.
The unusual event of a rare endocrine disease, such as autoimmune hypophysitis, becoming a relatively common adverse event following a treatment with an anticancer drug (ipilimumab), provides the opportunity to study the rare disease itself.
It is less unusual, however, that the study of a drug-related toxicity in a subset of patients (who respond best to therapy) may suggest a relationship between the target receptor and the adverse event at the molecular level (hypothyroidism-induced sunitinib).
It also seems that the pharmacological treatment (zoledronic acid) of an adverse event (osteoporosis) caused by a class of anticancer agents (aromatase inhibitors) may improve survival outcomes of the malignant disease.
This thesis shows that active surveillance of adverse events can make an important contribution not only to clinical but also to translational research.
It is confirmed, therefore, that pharmacovigilance is an essential activity for the improvement of patient care.<br>In questa tesi si vuole evidenziare come lo studio osservazionale di eventi avversi (nel nostro caso quelli di tipo endocrino) in ambito oncologico e clinico in generale, possa offrire degli spunti per la ricerca scientifica.
Ci siamo orientati verso lo studio di effetti endocrini secondari alla somministrazione di farmaci antumorali perché, come si evince dalla recente letteratura, con le nuove terapie a bersaglio molecolare sono diminuite le classiche tossicità di tipo acuto delle terapie citotossiche (vomito, diarrea, perdita di capelli ecc) ma sono emerse tossicità meno evidenti e per questo qualche volta più subdole come quelle di tipo endocrino.
E’ insolito che una patologia endocrina rara, come l’ipofisite autoimmune, diventi un evento avverso relativamente frequente a seguito di una cura con un farmaco antitumorale (ipilimumab), fornendo, quindi, anche l’occasione per lo studio della patologia rara stessa.
E’ meno insolito, invece, che lo studio di una tossicità farmaco-correlata in un sottogruppo di pazienti (che rispondono meglio alla terapia), possa suggerire una relazione tra il recettore bersaglio e l'evento avverso stesso a livello molecolare (ipotiroidismo indotto da sunitinib).
Ma sembra anche che il trattamento farmacologico (acido zoledronico) di un evento avverso (osteoporosi) causato da una classe di farmaci antitumorali (inibitori dell’aromatasi) possa indurre miglioramenti sugli outcome di sopravvivenza della patologia tumorale.
Dalla presente tesi emerge che la sorveglianza attiva degli eventi avversi può dare un importante contributo non solo alla ricerca clinica ma anche a quella traslazionale.
Si conferma, pertanto, che la farmacovigilanza è un’attività essenziale per il miglioramento della cura del paziente
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Gurrapu, Chaitanya. "Human Action Recognition In Video Data For Surveillance Applications." Thesis, Queensland University of Technology, 2004. https://eprints.qut.edu.au/15878/1/Chaitanya_Gurrapu_Thesis.pdf.
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Detecting human actions using a camera has many possible applications in the security industry. When a human performs an action, his/her body goes through a signature sequence of poses. To detect these pose changes and hence the activities performed, a pattern recogniser needs to be built into the video system. Due to the temporal nature of the patterns, Hidden Markov Models (HMM), used extensively in speech recognition, were investigated. Initially a gesture recognition system was built using novel features. These features were obtained by approximating the contour of the foreground object with a polygon and extracting the polygon's vertices. A Gaussian Mixture Model (GMM) was fit to the vertices obtained from a few frames and the parameters of the GMM itself were used as features for the HMM.
A more practical activity detection system using a more sophisticated foreground segmentation algorithm immune to varying lighting conditions and permanent changes to the foreground was then built. The foreground segmentation algorithm models each of the pixel values using clusters and continually uses incoming pixels to update the cluster parameters. Cast shadows were identified and removed by assuming that shadow regions were less likely to produce strong edges in the image than real objects and that this likelihood further decreases after colour segmentation. Colour segmentation itself was performed by clustering together pixel values in the feature space using a gradient ascent algorithm called mean shift. More robust features in the form of mesh features were also obtained by dividing the bounding box of the binarised object into grid elements and calculating the ratio of foreground to background pixels in each of the grid elements. These features were vector quantized to reduce their dimensionality and the resulting symbols presented as features to the HMM to achieve a recognition rate of 62% for an event involving a person writing on a white board. The recognition rate increased to 80% for the "seen" person sequences, i.e. the sequences of the person used to train the models. With a fixed lighting position, the lack of a shadow removal subsystem improved the detection rate. This is because of the consistent profile of the shadows in both the training and testing sequences due to the fixed lighting positions. Even with a lower recognition rate, the shadow removal subsystem was considered an indispensable part of a practical, generic surveillance system.
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Gurrapu, Chaitanya. "Human Action Recognition In Video Data For Surveillance Applications." Queensland University of Technology, 2004. http://eprints.qut.edu.au/15878/.
Full textAbstract:
Detecting human actions using a camera has many possible applications in the security industry. When a human performs an action, his/her body goes through a signature sequence of poses. To detect these pose changes and hence the activities performed, a pattern recogniser needs to be built into the video system. Due to the temporal nature of the patterns, Hidden Markov Models (HMM), used extensively in speech recognition, were investigated. Initially a gesture recognition system was built using novel features. These features were obtained by approximating the contour of the foreground object with a polygon and extracting the polygon's vertices. A Gaussian Mixture Model (GMM) was fit to the vertices obtained from a few frames and the parameters of the GMM itself were used as features for the HMM. A more practical activity detection system using a more sophisticated foreground segmentation algorithm immune to varying lighting conditions and permanent changes to the foreground was then built. The foreground segmentation algorithm models each of the pixel values using clusters and continually uses incoming pixels to update the cluster parameters. Cast shadows were identified and removed by assuming that shadow regions were less likely to produce strong edges in the image than real objects and that this likelihood further decreases after colour segmentation. Colour segmentation itself was performed by clustering together pixel values in the feature space using a gradient ascent algorithm called mean shift. More robust features in the form of mesh features were also obtained by dividing the bounding box of the binarised object into grid elements and calculating the ratio of foreground to background pixels in each of the grid elements. These features were vector quantized to reduce their dimensionality and the resulting symbols presented as features to the HMM to achieve a recognition rate of 62% for an event involving a person writing on a white board. The recognition rate increased to 80% for the "seen" person sequences, i.e. the sequences of the person used to train the models. With a fixed lighting position, the lack of a shadow removal subsystem improved the detection rate. This is because of the consistent profile of the shadows in both the training and testing sequences due to the fixed lighting positions. Even with a lower recognition rate, the shadow removal subsystem was considered an indispensable part of a practical, generic surveillance system.
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Kumar, B. G. Vijay. "Supervised dictionary learning for action recognition and localization." Thesis, Queen Mary, University of London, 2012. http://qmro.qmul.ac.uk/xmlui/handle/123456789/8780.
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Image sequences with humans and human activities are everywhere. With the amount of produced and distributed data increasing at an unprecedented rate, there has been a lot of interest in building systems that can understand and interpret the visual data, and in particular detect and recognise human actions. Dictionary based approaches learn a dictionary from descriptors extracted from the videos in the first stage and a classifier or a detector in the second stage. The major drawback of such an approach is that the dictionary is learned in an unsupervised manner without considering the task (classification or detection) that follows it. In this work we develop task dependent(supervised) dictionaries for action recognition and localization, i.e., dictionaries that are best suited for the subsequent task. In the first part of the work, we propose a supervised max-margin framework for linear and non-linear Non-Negative Matrix Factorization (NMF). To achieve this, we impose max-margin constraints within the formulation of NMF and simultaneously solve for the classifier and the dictionary. The dictionary (basis matrix) thus obtained maximizes the margin of the classifier in the low dimensional space (in the linear case) or in the high dimensional feature space (in the non-linear case). In the second part the work, we develop methodologies for action localization. We first propose a dictionary weighting approach where we learn local and global weights for the dictionary by considering the localization information of the training sequences. We next extend this approach to learn a task-dependent dictionary for action localization that incorporates the localization information of the training sequences into dictionary learning. The results on publicly available datasets show that the performance of the system is improved by using the supervised information while learning dictionary.
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Sakhraoui, Imane. "Contribution à la surveillance d'un module d'électronique de puissance sous sollicitations actives par mesures thermiques." Thesis, Toulouse, INPT, 2018. http://www.theses.fr/2018INPT0100/document.
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La tendance actuelle est d’intégrer des modules de puissance de plus en plus puissants dans des volumes de plus en plus réduits. Cela pose des problèmes, notamment en termes de fiabilité, car lors de leurs cycles de fonctionnement, les interrupteurs à semi-conducteurs et leur environnement immédiat sont soumis à des contraintes électro-thermiques plus sévères. L’augmentation de la fiabilité des modules de puissance passe par la connaissance précise de la température locale, même si elle ne peut être mesurée en certains points qui seraient pertinents. L’objectif principal de cette thèse est de reconstruire des grandeurs non accessibles à la mesure en utilisant des observateurs de fonctionnelle linéaire, qui permettent d’estimer la température en n’importe quel endroit à l’aide des mesures fournies à partir de capteurs thermiques situés en quelques points précis. L’utilisation de cet observateur permet de réduire la dimension du problème considéré. Dans le contexte multi-physique, nous avons développé des méthodologies et des algorithmes permettant la surveillance du comportement électro-thermique des modules d’électronique de puissance. De façon à obtenir des algorithmes d’observation, qui pourraient être mis en oeuvre sur une cible embarquée en temps réel comme un processeur de signaux numériques, nous avons proposé la conception d’un observateur de fonctionnelle linéaire en temps discret de taille réduite. En conséquence, il est nécessaire d’en réduire la taille par rapport au système initial issu du modèle, afin de limiter la complexité du calcul. L’originalité de ces travaux consiste à proposer des méthodes de conception simples des observateurs de fonctionnelle linéaire d’ordre minimal pour des systèmes complexes de grande taille. Notons que dans le cas d’un module d’électronique de puissance, certaines entrées peuvent être mal connues telles que la puissance thermique extraite par le système de refroidissement, ou celle injectée par les éléments annexes du module comme les pistes ou les fils de bonding. Ainsi, une attention toute particulière a été donnée aux observateurs de fonctionnelle linéaire à entrées inconnues. Un observateur de fonctionnelle linéaire à entrées inconnues permet de s’affranchir de cette méconnaissance en traitant ces entrées comme des perturbations non mesurées. Notons que nous avons choisi de présenter des résultats expérimentaux afin d’indiquer la faisabilité pratique des méthodes présentées<br>The current trend of integrating powerful power modules into increasingly smaller volumes. This volume leads to new problems, especially in terms of reliability : Indeed, during their operating cycles, the semiconductor switches and their surrounding environment become subject to harshful electrothermal stresses. Thus, increase of reliability of power modules induces the precise knowledge of the local temperature, even if it can not be measured at any location. The main objective of this thesis is to estimate a physical variables in a specific non measured location, using linear functional observers allowing to estimate the temperature at any point by means of measurements provided from thermal sensors located at a few precise points. The use of this observer reduce the dimension of the considered problem. In the multi-physics context, methodologies and algorithms have been developed to allow the monitoring of electrothermal behavior power electronics modules. In order to obtain observation algorithms directly, which could be implemented on a real-time embedded target such as a digital signal processor, the application of a linear observer in the discrete time framework is proposed. Consequently, it is necessary to reduce the size compared to the initial system resulting from the model, in order to limit the calculation complexity. The originality of this work consists in proposing simple design methods for minimal order linear functional observers for large complex systems. Special attention has been given to unknown input linear functional observers. Note that in case of a power electronics module, some inputs may be poorly known such as the thermal power extracted by the cooling system, or that injected by the ancillary elements of the module as chips or bonding wire. An unknown input linear functional observer allows to overcome this lack of knowledge by treating these inputs as unknown data. Note that we chose to present experimental results so as to demonstrate the practical feasibility of the proposed methods
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Quénel, Philippe. "La surveillance épidémiologique des épidémies de grippe : validation d'un critère d'alerte épidémique." Paris 11, 1993. http://www.theses.fr/1993PA11T005.
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Marchiori, Chiara. "The role of immune surveillance mechanisms acting to prevent an AOM - induced colorectal carcinogenesis progression." Doctoral thesis, Università degli studi di Padova, 2018. http://hdl.handle.net/11577/3425881.
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Colorectal cancer (CRC) is one of the most frequent cancer worldwide both in men and women. This tumour is the result of a multistep process in which there is a closed connection between the tumour development and immune system is the so-called immune surveillance, a dynamic process that comprises three different steps: elimination, equilibrium and escape. The hypothesis of my PhD project was that CD80 expression on dysplastic epithelial cells is crucial also in successful immune surveillance of sporadic colorectal cancer. The analysis of human colonic surgical specimens demonstrated that CD80 is over-expressed by epithelial cells in colonic pre-neoplastic lesions. Accordingly, also in our azoxymethane (AOM) induced colonic adenocarcinoma model, CD80 is overexpressed by dysplastic epithelial cells supporting a key role of this molecule in the early phases of the carcinogenesis process. Furthermore, the lack of functional CD80 in colonic mucosa accelerated the progression of colonic carcinogenesis. Remarkably, the use of CD80ko/WT bone marrow chimeras in the AOM CRC model further demonstrated the contribute of epithelial CD80 expression to inhibition of dysplasia development. Since AOM-induced carcinogenesis is associated to oxidative stress we hypothesized that CD80 expression is upregulated in intestinal epithelial cells by reactive oxygen species (ROS). Accordingly, our in vitro experiments with intestinal epithelial CT26 and primary intestinal epithelial cells suggested that oxidative stress has a prominent role in CD80 induction. Moreover, the thoughtful investigation of CD80 up regulation induced by ROS revealed that ROS induce CD80 expression via MAPK pathways that activate STAT3 transcription factor in colon epithelial cells. Thus, we showed that CD80 is crucial in the early stages of sporadic colorectal carcinogenesis and free radicals could have a prominent role in both the mechanisms of carcinogenesis and immune surveillance triggering the immune response. Besides, the microbiota signalling has a pivotal role in intestinal colon cancer carcinogenesis. In particular, Toll-like receptors seem to regulate a wide range of biological responses including inflammatory and immune responses during carcinogenesis. In detail, TLR4 signalling has been involved in the regulation of tumour growth, survival and progression connected to inflammation but its role is still controversial in non-inflammatory carcinogenesis. Along with the histological results showing that invasive carcinoma was more frequent in TLR4 deficient mice (TLR4KO) compared to Wild Type (WT) mice both sacrificed after 8 months from the first AOM injection, flow cytometric analysis revealed that MHC expression is impaired in intestinal epithelial cells of AOM-treated TLR4KO. Accordingly, the percentage of CD8+ cytotoxic and CD4+ helper T lymphocytes decreased in AOM-treated TLR4KO proposing a less efficient presentation of the tumoral antigens and the presence of a more effective immune escape mechanism compared to the WT mice. Since microbiota plays a key role to modulate immune cells activities we next compared the gut microbiota of WT and TLR4KO by 16S rDNA sequencing and analysis of faecal SCFA (Short Chain Fatty Acids) by GC-MS. Our results showed that WT and TLR4KO display a comparable composition of the microbiota, thus excluding that the differences observed in AOM-induced CRC development are secondary to microbiota differences, generating anomalous signals to mucosal immune cells. Indeed, in vitro experiments with bone marrow derived DCs confirmed the absolute requirement of TLR4 signalling to generate mature and competent DCs. Concluding, we showed that TLR4 signalling is protective in sporadic colorectal carcinogenesis enhancing the immune response against tumour cells. This result improves the understanding of TLR4-targeted applications, its role in tumor progression and its potential use as immune modulating agent.<br>Il cancro al colon-retto (CRC) è uno dei tumori più frequenti in tutto il mondo sia negli uomini che nelle donne. Questo tumore è il risultato di un processo multistep in cui è presente un stretto legame tra il suo sviluppo e il sistema immunitario, la cosiddetta sorveglianza immunitaria, un processo dinamico che comprende tre diversi passaggi: eliminazione, equilibrio e fuga. Il nostro obbiettivo è stato di dimostrare che l'espressione di CD80 sulle cellule epiteliali displasiche è cruciale nel successo della sorveglianza immunitaria del CRC sporadico. I dati ottenuti dall'analisi dei pazienti dimostrano che il CD80 è sovraespresso dalle cellule epiteliali nelle lesioni pre-neoplastiche ma si riduce quando si è sviluppata una neoplasia Il CD80 è sovraespresso anche nelle prime fasi del processo di carcinogenesi nei topi trattati con AOM. Inoltre, la mancanza del CD80 funzionale nella mucosa accelera la progressione della carcinogenesi nel nostro modello murino e l'uso delle chimere supporta come l'espressione epiteliale di CD80 contribuisca all'inibizione dello sviluppo della displasia. I nostri risultati suggeriscono che l'espressione di CD80 è indotta quindi nelle lesioni preneoplastiche come meccanismo protettivo contro la degenerazione epiteliale indotta da AOM. Utilizzando la linea cellulare epiteliale intestinale CT26 e le cellule epiteliali intestinali primarie da topo, abbiamo accertato che lo stress ossidativo ha un ruolo fondamentale nell'induzione dell’espressione di CD80. Inoltre, i ROS nelle cellule epiteliali del colon inducono l'espressione di CD80 attraverso le vie attivate dalle MAP chinasi, le quali mediano la fosforilazione di STAT3. Abbiamo quindi dimostrato che il CD80 è fondamentale nelle fasi iniziali della carcinogenesi sporadica del CRC e che i ROS hanno un ruolo cruciale sia nei processi di carcinogenesi che di attivazione della sorveglianza immunitaria. Anche il microbiota ha un ruolo chiave nella carcinogenesi del cancro al colon, azione svolta probabilmente attraverso i recettori Toll-like. Nel dettaglio, il TLR4 è coinvolto nella regolazione della crescita, della sopravvivenza e della progressione tumorale connesse all'infiammazione, ma il suo ruolo è ancora controverso nella carcinogenesi non infiammatoria. Ecco che abbiamo messo in luce il ruolo protettivo dei segnali derivati dal recettore TLR4 nel modello di CRC indotto da AOM. Infatti, l’analisi istologica ha dimostrato una maggiore incidenza di carcinoma colico invasivo nei topi TLR4KO rispetto ai topi Wild Type. L'analisi citofluorimetrica ha rivelato che l'espressione del complesso maggiore di istocompatibilità I e II era alterata nei topi TLR4KO e parallelamente, la percentuale di linfociti T helper e citotossici era diminuita significativamente. Questi dati suggeriscono una minore presentazione degli antigeni tumorali da parte delle cellule epiteliali favorendo i meccanismi di fuga da parte delle cellule tumorali nei topi TLR4KO. Inoltre, abbiamo dimostrato nei topi TLR4KO un ridotto livello di cellule dendritiche mature critiche per l'attivazione delle cellule T antitumorali. Poiché il microbiota svolge un ruolo chiave nel modulare le attività delle cellule immunitarie, abbiamo confrontato il microbiota intestinale dei topi WT e TLR4KO mediante il sequenziamento dell'rDNA 16S e abbiamo quantificato gli acidi grassi a corta catena (SCFAs). I nostri risultati hanno mostrato che i due gruppi hanno una composizione comparabile del microbiota, confermando quindi che le differenze osservate non siano secondarie alla composizione del microbiota. Esperimenti in vitro utilizzando cellule dendritiche isolate dal midollo osseo hanno confermato la necessità del segnale proveniente dal TLR4 per ottenere cellule dendritiche mature e competenti. Concludendo, abbiamo dimostrato che il recettore TLR4 svolge un ruolo protettivo nella progressione della carcinogenesi colorettale sporadica, migliorando la risposta immunitaria.