Thèse numérisée par la Direction des bibliothèques de l'Université de Montréal.

Orientador: Donizeti Cesar Honorato / Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Ciências Médicas / Made available in DSpace on 2018-08-23T19:15:40Z (GMT). No. of bitstreams: 1 Leite_JulianaValeria_M.pdf: 641050 bytes, checksum: b62398f140661279efb6ea212dc9afcf (MD5) Previous issue date: 2013 / Resumo: A avaliação do nível de consciência faz parte da rotina da equipe multiprofissional que conduz pacientes em coma. Sinais que possam representar a melhora do nível de consciência destes pacientes são constantemente buscados. Atualmente sabe-se que alguns fatores, como por exemplo, a resposta motora na escala de coma de Glasgow (ECG) e a apresentação do reflexo fotomotor apresentam valor prognóstico, porém nenhum deles é relacionado diretamente ao despertar destes pacientes. O objetivo deste estudo foi o de relacionar a presença do reflexo de piscar à ameaça visual (RPAV), com o despertar de pacientes comatosos e evidenciar o seu valor prognóstico. Para tanto foi feito um estudo retrospectivo com os dados obtidos em prontuários do serviço de arquivos médicos do Hospital das Clínicas da Universidade Estadual de Campinas (HC-UNICAMP) de pacientes internados nas enfermarias de neurologia clinica e neurocirurgia entre os períodos de abril de 2005 a abril de 2010. Foram selecionados 975 prontuários correspondentes ao diagnóstico de traumatismo cranioencefálico e acidente vascular encefálico. Destes, foram selecionados 119 prontuários de pacientes que se enquadraram nos critérios de inclusão representados pela resposta motora menor ou igual a quatro na ECG na admissão hospitalar e a descrição do RPAV durante o período de internação sendo excluídos os pacientes com resposta motora na admissão hospitalar superior a quatro, que não apresentassem a descrição da avaliação do RPAV ou que tivessem patologias neurológicas associadas às mencionadas como fator de seleção para os prontuários. Foram analisados os dados relativos ao sexo, diagnóstico clínico, resposta motora isolada e ao Glasgow total na admissão e alta hospitalar, a apresentação do RPAV durante o período de internação e a evolução clínica do paciente que foi representada pelo despertar, traduzido pela resposta motora seis ou cinco na ECG, evolução ao estado vegetativo persistente e óbito. A análise estatística demonstrou através da análise de regressão logística univariada e multivariada com critério Stepwise de seleção de variáveis uma associação entre a apresentação positiva do RPAV durante o período de internação e o despertar dos pacientes estudados (p<0.001). Todos os 51 pacientes que apresentaram o reflexo despertaram enquanto os pacientes que não apresentaram o reflexo não despertaram, evoluindo ao estado vegetativo persistente (24 pacientes) ou ao óbito (44 pacientes). Os pacientes que apresentaram o reflexo positivo durante o período de internação apresentaram uma maior possibilidade de despertar (11.685.00 vezes maior) dos que não o apresentaram adotando-se o nível de significância para os testes estatísticos de 5%, ou seja, p<0.05. O presente estudo demonstrou que o RPAV apresenta valor prognostico, estando sua apresentação positiva diretamente associada ao despertar destes pacientes / Abstract: The level of consciousness assessment is part of the hospital routine in comatose patients. Signs that may indicate cognitive improvement in these patients are constantly searched. Nowadays it is kwon that some features represent prognostic value, however, none relates directly with awakening in coma patients. The main purpose of this study was to associate the presence of the blinking reflex as a response to a visual threat with awakening in coma patients. We reviewed medical records from University of Campinas Clinical Hospital from patients diagnosed with stroke and traumatic brain injury (TBI) who stayed in the hospital neurological ward from April 2005 to April 2010. We reviewed 975 medical records. 119 patients were included; on admission they presented a score four or less for motor response in Glasgow Coma Scale (GCS) and description RPVA during hospitalization, being excluded patients with diagnoses other than those cited and motor response at admission more than four, which did not present the description of the assessment the blinking reflex or had neurological pathologies associated with those mentioned as selection factor for records. We gathered information from the charts regarding sex, disease, GCS total score, GCS motor score on admission and discharge, the presence or absence of the blinking reflex and level of consciousness on discharge, characterized as awakening, persistent vegetative state or death. Statistical analysis demonstrated through the analysis of univariate and multivariate logistic regression with stepwise selection criterion variables of a direct association between a positive blinking reflex of to visual threat during the period of hospitalization awakening in our cohort (p<0.001) . All the 51 patients with a positive reflex awoke, while patients with a negative reflex don't awakening evolved to persistent vegetative state (24) or death (44). A positive blinking reflex to visual threat during hospitalization increases the chance of awakening by 11.685.00 times when compared with patients with a negative reflex. The blinking reflex as a response to a threat has great prognostic value while its positivity is directly associated with awakening in coma patients / Mestrado / Ciencias Biomedicas / Mestra em Ciências Médicas

Proefschrift Universiteit van Amsterdam. / Met samenvatting in het Nederlands.

We demonstrate the schema and ontology matching tool COMA++. It extends our previous prototype COMA utilizing a composite approach to combine different match algorithms [3]. COMA++ implements significant improvements and offers a comprehensive infrastructure to solve large real-world match problems. It comes with a graphical interface enabling a variety of user interactions. Using a generic data representation, COMA++ uniformly supports schemas and ontologies, e.g. the powerful standard languages W3C XML Schema and OWL. COMA++ includes new approaches for ontology matching, in particular the utilization of shared taxonomies. Furthermore, different match strategies can be applied including various forms of reusing previously determined match results and a so-called fragmentbased match approach which decomposes a large match problem into smaller problems. Finally, COMA++ cannot only be used to solve match problems but also to comparatively evaluate the effectiveness of different match algorithms and strategies.

This chapter presents the generic schema match system, COmbination MAtch (COMA), which provides an extensible library of simple and hybrid match algorithms and supports a powerful framework for combining match results. The user can tailor match strategies by selecting the marchers and their combination for a given match problem. Hybrid matchers can also be configured easily by combining existing matchers using the provided combination strategies. Schema matching is the task of finding semantic correspondences between elements of two schemas. It is needed in many database applications, such as integration of web data sources, data warehouse loading, and XML message mapping. To reduce the amount of user effort as much as possible, automatic approaches combining several match techniques are required. While such match approaches have found considerable interest recently, the problem of how to best combine different match algorithms still requires further work.

Thèse numérisée par la Direction des bibliothèques de l'Université de Montréal.

Measures routinely used to assess the severity and outcome of closed head injury, that is the Glasgow Coma Scale (GCS) and the duration of post-traumatic amnesia (PTA), are of limited use in the case of mild closed head injury (MCHI). The present study investigated the sensitivity of a proposed alternative measure, the Glasgow Coma Scale-Extended (GCS-E), which is a combination of GCS and PTA measures. Twenty subjects who sustai1ed MCHI were assessed with a brief battery of neuropsychological tesrs, six months after the injury. Correlations between the neuropsych1 logical measures and GCS, duration of PTA and the GCS-E were not significant, possibly because of methodological limitations. Although statistical methods do not support the notion that the GCS-E is mere sensitive than currently used measures in detecting the consequem es of MCHI, some support is obtained from qualitative observations. / Psychology / M.A. (Psychology)

Measures routinely used to assess the severity and outcome of closed head injury, that is the Glasgow Coma Scale (GCS) and the duration of post-traumatic amnesia (PTA), are of limited use in the case of mild closed head injury (MCHI). The present study investigated the sensitivity of a proposed alternative measure, the Glasgow Coma Scale-Extended (GCS-E), which is a combination of GCS and PTA measures. Twenty subjects who sustai1ed MCHI were assessed with a brief battery of neuropsychological tesrs, six months after the injury. Correlations between the neuropsych1 logical measures and GCS, duration of PTA and the GCS-E were not significant, possibly because of methodological limitations. Although statistical methods do not support the notion that the GCS-E is mere sensitive than currently used measures in detecting the consequem es of MCHI, some support is obtained from qualitative observations. / Psychology / M.A. (Psychology)

No description available.

The Comet Interceptor is a joint mission by European Space Agency (ESA) and Japan Aerospace Exploration Agency (JAXA) which seeks to perform a flyby over a Long Period Comet using a multi-element spacecraft. The Comet Interceptor comprises three spacecrafts- A, B1 and B2. All three spacecrafts will observe and map the comet at three different points on the coma of the comet, thereby making this mission the first ever multipoint mission dedicated to study a Long Period Comet. Out of the eleven instruments aboard the Comet Interceptor, the work done for this thesis aims to help the team designing the instrument-Optical Periscope Imager forComets (OPIC). The team designing OPIC uses the imaging simulation software Space Imaging Simulator for Proximity Operations (SISPO) to render images of theoretically modelled dust and gas densities of the coma of a comet to obtain prerequisite knowledge of the images which is to be taken by OPIC during its flyby. Using the theoretical model of the coma, a 3D model was created as part of the thesis which shall be later implemented in SISPO. The structure of the coma was made with the help of a sparse volumetric data manipulation tool OpenVDB, which was coded and run in Python. The generated data was imported in Blender to visualise the volumetric data with the help of Blender’s rendering engine-Cycles. To visualise the 3D model with utmost physical realism as the software Blender allows, a study on the scattering properties of the dust and gas model was done. Also, a motion blur was implemented in Blender to simulate the high relative velocity between the instrument and comet. Multiple approaches of varying complexities and time consumption were considered for importing and visualising the volumetric data. The final render images were brightness-matched with reference to images from previous cometary missions. Finally, a qualitative analysis was done by visually comparing the render images to the images from previous missions. With the help of this qualitative analysis, several features and characteristics were identified which were analogous to the real life images, thus establishing the correctness of the renders produced.