Orientador: Maria Jaqueline Mamprim / Banca: Lucy Mary / Banca: Ribeiro Muniz / Banca: Nilva Maria / Banca: Esteves Mascarenhaz / Resumo: exame radiográfico e a ultra-sonografia foram avaliados como técnicas de imagem no diagnóstico de ruptura do ligamento cruzado cranial (LCCr) em cães. Verificou-se sexo, raça, peso e idade dos animais atendidos no Hospital Veterinário (HV) da Faculdade de Medicina Veterinária e Zootecnia (FMVZ)-UNESP, Botucatu-SP. Num período de 12 meses, 31 cães com suspeita de ruptura do LCCr foram submetidos a exames radiográficos e ultra-sonográficos com objetivo de verificar sinais compatíveis com a lesão. Os casos positivos foram encaminhados para cirurgia, no intuito de confirmar o diagnóstico O e reparar a lesão. Foram verificados por meio de artrotomia 23 casos de ruptura total e dois casos de ruptura parcial do LCCr. Não houve diferença significativa entre machos e fêmeas, bem como entre animais inteiros ou castrados. Os cães sem raça definida foram os mais acometidos, seguidos pelo boxer, pit bull, pastor alemão e rottweiler. O animal mais leve pesava 8,4kg e o mais pesado 71kg, sendo a média igual a 27,9kg. Cães com peso igual ou inferior a 15kg apresentaram uma ocorrência menor da doença quando comparados aos animais com peso acima de 15,1kg. A faixa etária variou entre 12 meses a 13 anos, não sendo verificada variação considerável ao compararmos animais jovens e maduros. O exame radiográfico diagnosticou corretamente a lesão em 84% (21) dos casos, e quatro (16%) animais tiveram resultado falso-negativo. O exame ultra-sonográfico foi capaz de diagnosticar acertadamente 76% dos casos, e fornecer diagnóstico favorável nos 24% restantes, apresentando 100% de resultados positivos. No presente trabalho pudemos concluir que tanto o exame radiográfico quanto a ultra-sonografia são modalidades que podem contribuir de forma positiva no diagnóstico da ruptura do LCCr em cães. / Abstract: Radiographic and ultrasonographic examination was evaluated as image techniques in diagnostic of cranial cruciate ligament (CCL) rupture in dogs. Was determined the sex, breed, body weight and age of the animals taken care in the Hospital Veterinarian (HV) of the Faculdade de Medicina Veterinária e Zootecnia (FMVZ)-UNESP, Botucatu-SP. In a period of 12 months, 31 dogs with supposed CCL rupture were examined radiographic and ultrasonographically with objective to verify compatible signals with the injury. Positive cases had been directed for surgery, in intention to confirm the diagnostic and to repair the injury. Had been verified by artrotomy 23 cases of total rupture and two cases of partial rupture of the CCL. Did not have significant difference between males and females, as well as between intact or neutered animals. Mixed breeds had been affected, followed for boxer, pit bull, german shepherddog and rottweiler. The animal lightest weighed 8,4kg and the heaviest 71kg, mean body weight was 27,9kg. Dogs with equal or inferior weight 15kg had presented a lesser occurrence of the illness when compared with the animals with weight above of 15,1kg. Age varied enters 12 months and 13 years, without considerable variation between mature and young animals. Radiology correctly identified the injury in 84% of the cases, and four (16%) animals had false-negative resulted. In 76% of cases, ultrasonography correctly identified, and to supply to favorable diagnosis in 24% remains, presenting 100% of positive results. In the present study we could conclude that as radiology how ultrasonography are modalities diagnostics that can contribute of positive form in the diagnosis of the rupture of the CCL in dogs. / Mestre

Made available in DSpace on 2014-06-11T19:23:44Z (GMT). No. of bitstreams: 0 Previous issue date: 2006-06-22Bitstream added on 2014-06-13T19:09:54Z : No. of bitstreams: 1 oliveira_rr_me_botfmvz.pdf: 463745 bytes, checksum: e30c44492b4a15ddc8ea111cfcda01cf (MD5) / Universidade Estadual Paulista (UNESP) / exame radiográfico e a ultra-sonografia foram avaliados como técnicas de imagem no diagnóstico de ruptura do ligamento cruzado cranial (LCCr) em cães. Verificou-se sexo, raça, peso e idade dos animais atendidos no Hospital Veterinário (HV) da Faculdade de Medicina Veterinária e Zootecnia (FMVZ)-UNESP, Botucatu-SP. Num período de 12 meses, 31 cães com suspeita de ruptura do LCCr foram submetidos a exames radiográficos e ultra-sonográficos com objetivo de verificar sinais compatíveis com a lesão. Os casos positivos foram encaminhados para cirurgia, no intuito de confirmar o diagnóstico O e reparar a lesão. Foram verificados por meio de artrotomia 23 casos de ruptura total e dois casos de ruptura parcial do LCCr. Não houve diferença significativa entre machos e fêmeas, bem como entre animais inteiros ou castrados. Os cães sem raça definida foram os mais acometidos, seguidos pelo boxer, pit bull, pastor alemão e rottweiler. O animal mais leve pesava 8,4kg e o mais pesado 71kg, sendo a média igual a 27,9kg. Cães com peso igual ou inferior a 15kg apresentaram uma ocorrência menor da doença quando comparados aos animais com peso acima de 15,1kg. A faixa etária variou entre 12 meses a 13 anos, não sendo verificada variação considerável ao compararmos animais jovens e maduros. O exame radiográfico diagnosticou corretamente a lesão em 84% (21) dos casos, e quatro (16%) animais tiveram resultado falso-negativo. O exame ultra-sonográfico foi capaz de diagnosticar acertadamente 76% dos casos, e fornecer diagnóstico favorável nos 24% restantes, apresentando 100% de resultados positivos. No presente trabalho pudemos concluir que tanto o exame radiográfico quanto a ultra-sonografia são modalidades que podem contribuir de forma positiva no diagnóstico da ruptura do LCCr em cães. / Radiographic and ultrasonographic examination was evaluated as image techniques in diagnostic of cranial cruciate ligament (CCL) rupture in dogs. Was determined the sex, breed, body weight and age of the animals taken care in the Hospital Veterinarian (HV) of the Faculdade de Medicina Veterinária e Zootecnia (FMVZ)-UNESP, Botucatu-SP. In a period of 12 months, 31 dogs with supposed CCL rupture were examined radiographic and ultrasonographically with objective to verify compatible signals with the injury. Positive cases had been directed for surgery, in intention to confirm the diagnostic and to repair the injury. Had been verified by artrotomy 23 cases of total rupture and two cases of partial rupture of the CCL. Did not have significant difference between males and females, as well as between intact or neutered animals. Mixed breeds had been affected, followed for boxer, pit bull, german shepherddog and rottweiler. The animal lightest weighed 8,4kg and the heaviest 71kg, mean body weight was 27,9kg. Dogs with equal or inferior weight 15kg had presented a lesser occurrence of the illness when compared with the animals with weight above of 15,1kg. Age varied enters 12 months and 13 years, without considerable variation between mature and young animals. Radiology correctly identified the injury in 84% of the cases, and four (16%) animals had false-negative resulted. In 76% of cases, ultrasonography correctly identified, and to supply to favorable diagnosis in 24% remains, presenting 100% of positive results. In the present study we could conclude that as radiology how ultrasonography are modalities diagnostics that can contribute of positive form in the diagnosis of the rupture of the CCL in dogs.

Des fibres optiques en verres de chalcogénure transmettant dans le moyen infrarouge (MIR) ont été développées par le laboratoire Verres et Céramiques de l’université de Rennes 1. Des travaux ont ensuite montré les potentialités de ces fibres comme outil diagnostic pour la spectroscopie MIR appliquée aux biofluides. Le spectre moyen infrarouge d’un échantillon complexe est le reflet de sa composition moléculaire qui, lorsque celui-ci est un biofluide, peut être assimilé à une image métabolique instantanée d’un individu. Cette technique constitue donc un outil intéressant pour le diagnostic médical. La société Diafir fut crée à la suite du programme ANR émergence FIR-MED pour développer les potentialités de la spectroscopie par fibre optique. L’objectif de l’entreprise est de développer un système composé d’un spectromètre spécifiquement adapté au capteur à fibre optique et d’un algorithme associé pour une réponse diagnostique ne nécessitant pas de connaissance particulière en spectroscopie infrarouge. Dans le cadre de ces travaux de thèse associant l’IRDL et la société Diafir, des projets variés d’applications médicales de la technologie ont été abordés avec pour objectif de développer une méthodologie d’analyse des spectres MIR. Pour cela, il a été nécessaire dans un premier temps de caractériser le signal obtenu à partir des capteurs et d’optimiser et valider des protocoles de mesure applicables aux différents biofluides de manière à réduire au mieux les sources de variabilité d’ordre physique et environnemental. La construction d’un diagnostic médical à partir de spectres infrarouge qui sont des données en grande dimension implique de sélectionner un petit nombre de variables spectrales explicatives. Des méthodes de sélection de variables ont été sélectionnées afin d’éviter l’effet « boite noire » en établissant le lien avec les fonctions biochimiques impactées par les pathologies. Cette approche spectrale infrarouge a notamment permis de mettre en évidence, au cours du développement de pathologies, l’existence de transitions a priori non détectées par les dosages biochimiques classiques. / Chalcogenide glass optical fibres exhibiting unique properties of mid-infrared (MIR) transparency have been developed by the Laboratoire Verres et Céramiques of Rennes 1 University. Our studies investigate the potential of such fibres as a tool for MIR spectroscopy applied to biofluids based diagnostic. The MIR spectrum of complex samples features its molecular composition which, when a biofluid is considered, can be assimilate to an instant metabolic imaging of an individual. The Diafir Company was created following the ANR emergence FIR-MED program to develop the potential of optical fibre biomedical spectroscopy. The company's goal is to develop a system that is composed of the optical fibre sensor, a spectrometer specifically designed to these sensors and an associated algorithm for a diagnostic response without specific knowledge of infrared spectroscopy. As part of this thesis work, linking the IRDL and the Diafir Company, various projects of biomedical applications were driven with the aim of developing a MIR spectra analysis methodology. Accordingly, it was necessary initially to characterize the signal obtained from the sensors and to optimize and validate robust measurement protocols for each biofluid tested with the aim to reduce the physical and environmental sources of variability. The medical diagnosis construction from infrared spectra, that are high dimensional data, involves selecting from the whole spectral data set a small number of explanatory variables. Purposely, particular variables selection algorithms were selected to avoid the effect of "black box" by establishing the link with the biochemical functions affected by the disease. This infrared spectral approach allowed identifying previously unrevealed transitions in the time course of pathologies which were not detected from conventional biochemical markers

[ES] El interés en desarrollar biosensores de alta sensibilidad para identificar y cuantificar una amplia gama de moléculas ha aumentado notablemente durante las últimas décadas en numerosos campos de aplicación. Entre ellos probablemente el más demandado sea el diagnóstico médico, el cual ha sido impulsado por el descubrimiento de nuevos biomarcadores de enfermedades, tales como los miRNAs. No obstante, la mayoría de las técnicas existentes para realizar la detección requieren el uso de marcadores debido a la falta de sensibilidad para detectar analitos en bajas concentraciones. Las estructuras ópticas basadas en campo evanescente, donde la luz es usada para transformar interacciones bioquímicas en variaciones de las señales ópticas, constituyen una interesante alternativa para el desarrollo de este tipo de biosensores sin la necesidad de utilizar marcadores (label-free). Concretamente las estructuras fotónicas integradas en tecnología Silicon On Insulator exhiben alta sensibilidad, bajo límite de detección y alto nivel de multiplexación en aplicaciones de detección, especialmente cuando se utilizan materiales y procesos basados en silicio y compatibles con CMOS. En esta Tesis Doctoral se muestra el desarrollo de un biosensor fotónico integrado label-free para la detección de oligonucleótidos, y más concretamente biomarcadores de cáncer miRNAs. Este biosensor está basado en la combinación de estructuras de band gap fotónico y la inmovilización de sondas de tipo molecular beacon sobre su superficie. La combinación de sendos elementos de transducción y bioreconomiento ha proporcionado una elevada sensibilidad en la detección de oligonucleótidos manteniendo un footprint por debajo de 100 µm2. El uso de este biosensor fotónico ha permitido también estudiar experimentalmente una novedosa técnica de amplificación de detección. Esta técnica explota el cambio conformacional sufrido por la sonda molecular beacon tras la hibridación con su oligonucleótido complementario, permitiendo alejar una partícula/molécula de la superficie del sensor, lo cual podría ser utilizado para amplificar la respuesta de detección del sensor. Finalmente se propone una estrategia de regeneración en línea de los biosensores nanofotónicos desarrollados mediante una estrategia química basada en el uso de formamida. Esta estrategia no solo permite ahorrar tiempo sino que también reduce la variación entre las medidas obtenidas en experimentos diferentes, siendo especialmente útil cuando se testean niveles similares de analito. / [CA] L'interés en desenvolupar biosensors d'alta sensibilitat per a identificar i quantificar una àmplia gamma de molècules ha augmentat notablement durant les últimes dècades en nombrosos camps d'aplicació. Entre ells probablement el més demandat siga el diagnòstic mèdic, el qual ha sigut impulsat pel descobriment de nous biomarcadors de malalties, com ara els miRNAs. No obstant això, la majoria de les tècniques existents per a realitzar la detecció requereixen l'ús de marcadors a causa de la falta de sensibilitat per a detectar anàlits en baixes concentracions. Les estructures òptiques basades en camp evanescent, on la llum és usada per a transformar interaccions bioquímiques en variacions dels senyals òptics, constitueixen una interessant alternativa per al desenvolupament d'aquesta tipus de biosensors sense la necessitat d'utilitzar marcadors (label-free). Concretament les estructures fotòniques integrades en tecnologia Silicon On Insulator exhibeixen alta sensibilitat, baix límit de detecció i alt nivell de multiplexació en aplicacions de detecció, especialment quan s'utilitzen materials i processos basats en silici i compatibles amb CMOS. En aquesta Tesi Doctoral es mostra el desenvolupament d'un biosensor fotònic integrat label-free per a la detecció d'oligonucleòtids, i més concretament biomarcadors de càncer miRNAs. Aquest biosensor està basat en la combinació d'estructures de band gap fotònic i la immobilització de sondes de tipus molecular beacon sobre la seua superfície. La combinació d'ambdós elements de transducció i bioreconeixement ha proporcionat una elevada sensibilitat en la detecció d'oligonucleòtids mantenint un footprint per davall de 100 µm². L'ús d'aquest biosensor fotònic ha permés també estudiar experimentalment una nova tècnica d'amplificació de detecció. Aquesta tècnica explota el canvi conformacional patit per la sonda molecular beacon després de la hibridació amb el seu oligonucleòtid complementari, permetent allunyar una partícula/molècula de la superfície del sensor, la qual cosa podria ser utilitzada per amplificar la resposta de detecció del sensor. Finalment es proposa una estratègia de regeneració en línia dels biosensors nanofotònics desenvolupats mitjançant una estratègia química basada en l'ús de formamida. Aquesta estratègia no sols permet estalviar temps sinó que també redueix la variació entre les mesures obtingudes en experiments diferents, sent especialment útil quan es testen nivells similars d'anàlit. / [EN] The interest in developing highly sensitive biosensors to identify and quantify a wide range of molecules has remarkably been increasing during the last decades in numerous application fields. Among them, medical diagnosis is probably the most demanded, which has been driven by the discovery of new biomarkers of diseases, such as miRNAs. However, most of the existing techniques to perform the detection require the use of labels due to the lack of sensitivity to detect analytes at low concentrations. Evanescent-wave optical structures, where light is used to transduce biochemical interactions into variations of the optical signals, are an interesting alternative for the development of this type of biosensors allowing a label-free detection. Specifically, the planar integrated photonic structures based on Silicon On Insulator technology exhibit an extremely high sensitivity, a low detection limit and a high level of multiplexing in detection applications, especially when using materials and processes based on silicon and being CMOS compatible. This PhD Thesis is focused on the development of label-free integrated photonic biosensors for the detection of oligonucleotides, and more specifically miRNA cancer biomarkers. This biosensor is based on the combination of photonic band gap structures and the immobilization of molecular beacon probes on its surface. The combination of both transduction and biorecognition elements has provided a very high sensitivity towards the detection of target oligonucleotides while keeping a sensor footprint below 100 µm2. The use of this photonic biosensor also allowed the experimental study of a novel detection amplification technique. This technique exploits the conformational change suffered by the molecular beacon probe after hybridization with its complementary oligonucleotide, allowing the displacement of a particle/molecule away from the sensor surface, what might be used for amplifying the sensor's detection response. Finally, an online regeneration strategy for nanophotonic biosensors developed through a chemical strategy based on the use of formamide is proposed. This strategy not only saves time but also reduces the variation between measurements obtained in different experiments, being especially useful when testing similar levels of analyte. / Ruiz Tórtola, Á. (2021). Desarrollo de biosensores nanofotónicos de alta sensibilidad para la detección de biomarcadores microRNA en aplicaciones de diagnóstico médico [Tesis doctoral]. Universitat Politècnica de València. https://doi.org/10.4995/Thesis/10251/172631

Made available in DSpace on 2016-04-26T20:30:08Z (GMT). No. of bitstreams: 1 Analucia Graziano.pdf: 1612461 bytes, checksum: 2ce241b7ad11213fb8d13755502b9632 (MD5) Previous issue date: 2010-05-27 / In line with the idea of rule of law and consequent incompatibility with the irresponsibility of its members, the vast expansion of the area of liability is accompanied by the growing interest of society to find solutions that make effective compensation for damage. It forms new doctrine, concerned with protecting the citizens most vulnerable and helpless. It turns out that the increasing number of complaints begins to disrupt society in general, to increase the financial cost for the professional and the patient because of the increase especially in the application of more sophisticated laboratory tests and refusal to higher-risk procedures, contributing to a consolidation of defensive medicine. The aim of this paper is to provide measures to prevent the questioning of the patient-consumer for the health services used by it. Are brought to bear upon some criteria such as time, sensitivity and specificity of diagnostic method for identification of medical errors. The consent form is also shown as a measure capable of preventing the questions, eliminating or reducing some complications related to relationship conflict or miscommunication between doctor and patient. In the context of public institutions to private, is necessary a detailed analysis of the legal systems adopted. So rich, the issue is not limited to the material aspect, so deals some specific procedural rules, which directly influence the demand indemnification, as the burden of proof. Case law and doctrine and comparative national basis and reap the practical utility of each issue discussed / Em consonância com a idéia de Estado de direito e consequente incompatibilidade com a irresponsabilidade dos seus membros, a grande expansão da área da responsabilidade civil é acompanhada do crescente interesse da sociedade em buscar soluções que tornam efetiva a reparação do dano. Forma-se nova doutrina, preocupada com a proteção aos cidadãos mais frágeis e desamparados. Ocorre que o crescente número de queixas começa perturbar a sociedade em geral, por aumentar o custo financeiro para o profissional e para o paciente em razão especialmente do aumento no pedido de exames complementares mais sofisticados e recusa em procedimentos de maior risco, contribuindo para uma consolidação de uma medicina defensiva. O objetivo do presente trabalho é fornecer medidas capazes de prevenir os questionamentos do paciente-consumidor, relativos aos serviços de saúde utilizados por ele. São trazidos à baila alguns critérios como tempo, sensibilidade e especificidade do método de diagnóstico para a identificação do erro médico. O termo de consentimento esclarecido é também apontado como medida capaz de prevenir os questionamentos, eliminando ou reduzindo algumas causas ligadas a conflitos de relacionamento ou de falha de comunicação entre médico e paciente. No âmbito das instituições públicas a privadas, se faz necessária uma minuciosa análise sobre os regimes jurídicos adotados. De tão rico, o tema não se esgota no aspecto material, por isso pincela algumas particularidades processuais, que diretamente influenciam as demandas indenizatórias, tal como o ônus da prova. O estudo de mecanismos alternativos de recomposição dos acidentes médicos ajuda, também, a compreender melhor que a simples decisão de criar novas hipóteses de responsabilidade objetiva ou adotar um sistema alternativo de solidariedade nacional deve levar em conta a sua viabilidade em termos práticos, e não apenas teórico. Da jurisprudência e doutrina nacional comparada colhe-se o fundamento e a utilidade prática de cada questão discutida

O objetivo desse estudo é o desenvolvimento de um sistema especialista em um ambiente hospitalar para apoiar o diagnóstico médico de pacientes críticos com suspeita de Sepse em unidades de terapia intensiva. Como objetivos específicos, a plataforma desenvolvida emitirá alerta após o processamento em tempo real de todas as informações conforme protocolo de sepse da unidade referente a cada paciente como: exames laboratoriais, monitoramentos, integração com o prontuário eletrônico, indicando assim ao médico quais pacientes necessitam de prioridade naquele momento. Os pacientes serão classificados de acordo as informações processadas acima e identificados no sistema com as cores: vermelho (risco eminente), amarelo (médio risco), verde (baixo risco). Tais informações não devem ser tomadas como únicas, mas como técnica auxiliar e principalmente necessárias para as organizações hospitalares que buscam melhorias de desempenho através de soluções integradas orientadas a eventos. Com base na epidemiologia e um estudo longitudinal, o estudo se ocupa a avaliar o sistema desenvolvido identificando através de gráficos e indicadores as seguintes informações: tempo de tratamento na unidade, tempo de decisão do médico, tempo de iniciação com antibiótico, tempo médio de resultados laboratoriais, altas clínicas e mortalidade. Serão utilizadas no estudo duas amostras de grupo de pacientes adultos maiores de 18 anos em uma unidade de terapia intensiva com suspeita de sepse que chegam à Rede Pública de Saúde, comparando através de um estudo epidemiológico longitudinal, pacientes que passaram pela unidade nos três meses com o sistema implantado e outra amostra com pacientes nos três meses anteriores ao sistema. / The aim of this study is to develop an expert system in a hospital environment to support the medical diagnosis of critically ill patients with suspected sepsis in intensive care units. The specific objectives, the developed platform will issue warning after real-time processing of all information as unit sepsis protocol for each patient as laboratory tests, monitoring, integration with electronic medical records, thus indicating to the physician which patients need priority at that time. Patients will be classified according the information processed above and identified in the system with the colors: red (imminent risk), yellow (medium risk), green (low risk). Such information should not be taken as single, but as a technical assistant and mainly needed for hospital organizations seeking performance improvements through integrated solutions oriented events. Based on the epidemiology and a longitudinal study, the study is concerned to evaluate the system developed by identifying through graphs and indicators the following information: the unit treatment time, doctor\'s decision time, start time antibiotic, average time results laboratory, clinical and high mortality. Will be used to study two largest group of adult patients samples of 18 years in an intensive care unit with suspected sepsis arriving to the Public Health Network, comparing through a longitudinal epidemiological study, patients who had the unit in the three months to the implanted system and another sample of patients in the three months prior to the system.

Qu’il s’agisse de suivre des patients à domicile, ou de prévenir l’isolement ou la vulnérabilité de personnes âgées, les systèmes de suivi et d'assistance électroniques qui émergent offrent des opportunités sans précédents. L’enjeu est considérable, et on assiste à un développement technologique important qui permet désormais aux particuliers ou aux établissements hospitaliers ou médico-sociaux d’assurer le diagnostic, la prévention, le contrôle, voire le traitement de patients à distance (mesures de paramètres physiologiques, administration de médicaments, détection de chutes, etc.). Ce suivi à distance est en particulier devenu possible et performant avec l’avènement des objets connectés. On peut ainsi envisager d’exploiter un réseau de capteurs embarqué sur un patient pour mesurer à distance et en temps réel la température, le rythme cardiaque ou la tension artérielle d’un patient. Les données sont transmises (et/ou stockées) au praticien pour réaliser le diagnostic et définir les traitements. Pour autant la conception optimale (choix des technologies de transmission, de stockage, etc.) ainsi que la problématique de la gestion d’énergie constituent des verrous à leur adoption. Le travail proposé dans cette thèse consiste donc à développer un outil d’aide à la conception de réseaux de capteurs médicaux communicants embarqués sur la personne. Il s’agit en particulier de fournir une information sur la faisabilité au plus tôt dans le cycle de conception, et garantir l’obtention d’un circuit « correcte par construction ». L’accent est porté sur la maîtrise (voire la réduction) de la consommation d’énergie Dans ce sens, une simulation fiable et précise permet de contrôler, dès le début du flot de conception, la consommation en énergie du réseau. Elle assure par la suite une meilleure gestion de l’énergie disponible et éventuellement une autonomie plus importante. L’outil, centré sur l’optimisation de la consommation d’énergie, est implémenté dans un environnement Matlab. Basé sur une modélisation de la consommation en énergie d’un nœud de capteur, il se veut générique aussi bien que précis. Il assure une implémentation simple de nouveaux composants à partir de fiches techniques. Ces composants sont construits sous la forme de blocs réutilisables permettant ainsi à l’utilisateur de créer sa propre librairie. En plus de l’estimation de la consommation, cet outil met en œuvre des algorithmes d’optimisation pour guider l’utilisateur vers une conception qui respecte les contraintes énergétiques et médicales de l’application (choix de composants, choix de source d’énergie, configuration du réseau, etc.). Une application est proposée d’abord au niveau d’un nœud de capteur de température corporelle communiquant par Bluetooth Low Energy. Ce même nœud est ensuite placé au sein d’un réseau de capteurs pour la surveillance de cinq paramètres physiologiques différents. Une validation expérimentale des résultats de simulation est également réalisée. / Whether it is to monitor patients at home, or to prevent the isolation and vulnerability of the elderly, the emerging electronic monitoring and assistance systems offer new opportunities. The technological development we have witnessed allows individuals, hospitals, or medical aid organizations to provide the diagnosis, prevention, control or even treatment of patients outside of conventional clinical settings (measurements of physiological parameters, drug administration, fall detection, etc.).Recent developments in connected objects made efficient remote patient monitoring possible. In other words, we are able to use a network of wearable or implantable sensors to remotely obtain real time measurements of a patient’s vital signs (temperature, heart rate, blood pressure, etc.). Data is transmitted (and / or stored) to medical personnel who are able to perform diagnosis and define treatments accordingly. An optimal design (transmission protocols, data storage, etc.) and energy management are the bottlenecks involved in the implementation of such systems. This work proposes to develop a tool to help in the design of medical sensor networks. It aims to provide information regarding feasibility during the early stages of the design thus ensuring that a "well-constructed" circuit is obtained. The emphasis is on the control (or even reduction) of energy consumption. In this regard, an efficient energy consumption simulation at the beginning of the design flow would enable the user to decide on system parameters. This will ensure an optimal management of the available energy and eventually a longer network lifetime. The proposed tool is centered on the optimization of the energy consumption using Matlab environment. It is built over a model of the energy consumption of wireless sensor nodes. It is intended to be generic and accurate. In fact, it enables fast creation of new component description based on the datasheets. These components are reusable thus producing a growing database. In addition to energy consumption estimation, the tool uses optimization routines to guide the user through an energy aware design (picking energy sources, components, network configuration, etc.) that complies with medical requirements. An application to a single Bluetooth Low Energy body temperature sensor is first proposed. The same sensor is then included in a physiological sensor network. A physical implementation is used in order to compare the results obtained through simulation with practical measurements.

Made available in DSpace on 2016-06-02T20:06:06Z (GMT). No. of bitstreams: 1 4338.pdf: 1335557 bytes, checksum: 8e0bef5711ff8c398be194e335deecec (MD5) Previous issue date: 2012-02-28 / Universidade Federal de Sao Carlos / Classification consists in the discovery of rules of prediction to assist with planning and decision-making, being a continuously indispensable tool and a highly discussed subject in literature. As a special case in classification, we have the process of credit risk rating, within which there is interest in identifying good and bad paying customers through binary classification methods. Therefore, in many application backgrounds, as in financial, several techniques can be utilized, such as discriminating analysis, probit analysis, logistic regression and neural nets. However, the Probabilistic Nets technique, also known as Bayesian Networks, have showed itself as a practical convenient classification method with successful applications in several areas. In this paper, we aim to display the appliance of Probabilistic Nets in the classification scenario, specifically, the technique named K-dependence Bayesian Networks also known as KDB nets, as well as compared its performance with conventional techniques applied within context of the Credit Scoring and Medical diagnosis. Applications of the technique based in real and artificial datasets and its performance assisted by the bagging procedure will be displayed as results. / A classificação consiste na descoberta de regras de previsão para auxílio no planejamento e tomada de decisões, sendo uma ferramenta indispensável e um tema bastante discutido na literatura. Como caso especial de classificação, temos o processo de avaliação de risco de crédito, no qual temos o interesse de identificar clientes bons e maus pagadores através de métodos de classificação binária. Assim, em diversos enredos de aplicação, como nas financeiras, diversas técnicas podem ser utilizadas, tais como análise discriminante, análise probito, regressão logística e redes neurais. Porém, a técnica de Redes Probabilísticas, também conhecida como Redes Bayesianas, tem se mostrado um método prático de classificação e com aplicações bem sucedidas em diversos campos. Neste trabalho, visamos exibir a aplicação das Redes Probabilísticas no contexto de classificação, em específico, a técnica denominada Redes Probabilísticas com K-dependência, também conhecidas como redes KDB, bem como comparar seu desempenho com as técnicas convencionais aplicadas no contexto de Credit Scoring e Diagnose Médica. Exibiremos como resultado aplicações da técnica baseadas em conjuntos de dados reais e artificiais e seu desempenho auxiliado pelo procedimento de bagging.

O objetivo desse estudo é o desenvolvimento de um sistema especialista em um ambiente hospitalar para apoiar o diagnóstico médico de pacientes críticos com suspeita de Sepse em unidades de terapia intensiva. Como objetivos específicos, a plataforma desenvolvida emitirá alerta após o processamento em tempo real de todas as informações conforme protocolo de sepse da unidade referente a cada paciente como: exames laboratoriais, monitoramentos, integração com o prontuário eletrônico, indicando assim ao médico quais pacientes necessitam de prioridade naquele momento. Os pacientes serão classificados de acordo as informações processadas acima e identificados no sistema com as cores: vermelho (risco eminente), amarelo (médio risco), verde (baixo risco). Tais informações não devem ser tomadas como únicas, mas como técnica auxiliar e principalmente necessárias para as organizações hospitalares que buscam melhorias de desempenho através de soluções integradas orientadas a eventos. Com base na epidemiologia e um estudo longitudinal, o estudo se ocupa a avaliar o sistema desenvolvido identificando através de gráficos e indicadores as seguintes informações: tempo de tratamento na unidade, tempo de decisão do médico, tempo de iniciação com antibiótico, tempo médio de resultados laboratoriais, altas clínicas e mortalidade. Serão utilizadas no estudo duas amostras de grupo de pacientes adultos maiores de 18 anos em uma unidade de terapia intensiva com suspeita de sepse que chegam à Rede Pública de Saúde, comparando através de um estudo epidemiológico longitudinal, pacientes que passaram pela unidade nos três meses com o sistema implantado e outra amostra com pacientes nos três meses anteriores ao sistema. / The aim of this study is to develop an expert system in a hospital environment to support the medical diagnosis of critically ill patients with suspected sepsis in intensive care units. The specific objectives, the developed platform will issue warning after real-time processing of all information as unit sepsis protocol for each patient as laboratory tests, monitoring, integration with electronic medical records, thus indicating to the physician which patients need priority at that time. Patients will be classified according the information processed above and identified in the system with the colors: red (imminent risk), yellow (medium risk), green (low risk). Such information should not be taken as single, but as a technical assistant and mainly needed for hospital organizations seeking performance improvements through integrated solutions oriented events. Based on the epidemiology and a longitudinal study, the study is concerned to evaluate the system developed by identifying through graphs and indicators the following information: the unit treatment time, doctor\'s decision time, start time antibiotic, average time results laboratory, clinical and high mortality. Will be used to study two largest group of adult patients samples of 18 years in an intensive care unit with suspected sepsis arriving to the Public Health Network, comparing through a longitudinal epidemiological study, patients who had the unit in the three months to the implanted system and another sample of patients in the three months prior to the system.

Diffuse optical tomography uses near infrared (NIR) light as the probing media to recover the distributions of tissue optical properties. It has a potential to become an adjunct imaging modality for breast and brain imaging, that is capable of providing functional information of the tissue under investigation. As NIR light propagation in the tissue is dominated by scattering, the image reconstruction problem (inverse problem) tends to be non-linear and ill-posed, requiring usage of advanced computational methods to compensate this. Traditional image reconstruction methods in diffuse optical tomography employ l2 –norm based regularization, which is known to remove high frequency noises in the re-constructed images and make them appear smooth. The recovered contrast in the reconstructed image in these type of methods are typically dependent on the iterative nature of the method employed, in which the non-linear iterative technique is known to perform better in comparison to linear techniques. The usage of non-linear iterative techniques in the real-time, especially in dynamical imaging, becomes prohibitive due to the computational complexity associated with them. In the rapid dynamic diffuse optical imaging, assumption of a linear dependency in the solutions between successive frames results in a linear inverse problem. This new frame work along with the l1–norm based regularization can provide better robustness to noise and results in a better contrast recovery compared to conventional l2 –based techniques. Moreover, it is shown that the proposed l1-based technique is computationally efficient compared to its counterpart(l2 –based one). The proposed framework requires a reasonably close estimate of the actual solution for the initial frame and any suboptimal estimate leads to erroneous reconstruction results for the subsequent frames. Modern diffuse optical imaging systems are multi-modal in nature, where diffuse optical imaging is combined with traditional imaging modalities such as MRI, CT, and Ultrasound. A novel approach that can more effectively use the structural information provided by the traditional imaging modalities in these scenarios is introduced, which is based on prior image constrained- l1 minimization scheme. This method has been motivated by the recent progress in the sparse image reconstruction techniques. It is shown that the- l1 based frame work is more effective in terms of localizing the tumor region and recovering the optical property values both in numerical and gelatin phantom cases compared to the traditional methods that use structural information.