La qualité du sommeil des patients en soins intensifs est mauvaise, avec une fragmentation du sommeil, une diminution de la phase de sommeil paradoxal et une redistribution des temps de sommeil durant la période diurne. Si le bruit semble une cause évidente, il ne rendrait compte que de 20% des perturbations du sommeil dans ce contexte (Freedman et al. 1999; Gabor et al. 2003). La ventilation mécanique apparaît comme une autre source d'altération de la qualité et de la quantité de sommeil chez les patients en soins intensifs (Meza et al. 1998; Cooper et al. 2000; Parthasarathy et Tobin, 2004;). Le sommeil est en effet affecté par l'asynchronisme fréquent entre le patient et le ventilateur (Parthasarathy and Tobin, 2002; Cabello et al. 2007). La meilleure adéquation de la machine avec une réponse rapide du ventilateur aux demandes du patient, obtenue à l'aide de la modalité ventilatoire NAVA (Neurally Adjusted Ventilatory Assist) est, à cet égard, importante. Dans cette étude, quatorze patients ont été ventilés successivement et dans un ordre aléatoire par le mode NAVA ou un mode classique en ventilation pression de support (PS), et leur sommeil évalué par polysomnographie. La proportion de sommeil paradoxal par rapport à la durée totale de sommeil est différente selon la modalité ventilatoire : la médiane de pourcentage de sommeil paradoxal (sommeil REM) est de 4,5% (3-11%) en mode PS contre 16,5% (13-29%) au cours d'une ventilation par NAVA (p=0,001). L'indice de fragmentation est plus faible en mode NAVA avec 16 ± 9 éveils ou microéveils par heure contre 40 ± 20 au cours d'une ventilation PS (p=0,001). Selon le mode ventilatoire, il y a de grandes différences dans les efforts inefficaces (24 événements par heure de sommeil en PS, et 0 durant les phases de ventilation en NAVA) ainsi que dans le nombre d'apnées centrales (10,5 événements par heure vs 0 respectivement en PS et en NAVA). Durant les périodes d'enregistrement des données, la ventilation minute était similaire entre les deux modes, témoignant d'une qualité équivalente de ventilation globale. En conclusion, comparativement au PS, le mode NAVA améliore la qualité du sommeil des malades de soins intensifs sevrés de la sédation, en augmentant la durée de la phase paradoxale du sommeil et en diminuant la fragmentation de leur sommeil.

Lilija Žemaitienė. Pacientų, kuriems taikoma trečiojo lygio neuroreabilitacija, mitybos būklės pokyčių ir su jais susijusių veiksnių vertinimas, magistro baigiamasis darbas/mokslinė vadovė doc. dr. O. Riklikienė; Lietuvos sveikatos mokslų universitetas, Medicinos akademija, Slaugos fakultetas, Slaugos ir rūpybos katedra; konsultantė doc. dr. G. Damulevičienė; Lietuvos sveikatos mokslų universitetas, Medicinos akademija, Geriatrijos klinika. ‒Kaunas, 2014‒85 p. / Lilija Žemaitienė. Third level neurorehabilitation patiens nutritional status changes and related factors assesment / supervisor Ph. d. O. Riklikienė ; Lithuanian University of Health Sciences; Faculty of Nursing, Department or Nursing and Care; consultant Ph. d. G. Damulevičienė; Lithuanian University of Health Sciences, Clinic Geriatric, Kaunas, 2014, – s. 85.

The subject of this thesis is to develop a temporal neuro-fuzzy system for fore- casting the future behavior of a multivariate time series data. The system has two components combined by means of a system interface. First, a rule extraction method is designed which is named Fuzzy MAR (Multivari- ate Auto-regression). The method produces the temporal relationships between each of the variables and past values of all variables in the multivariate time series system in the form of fuzzy rules. These rules may constitute the rule-base in a fuzzy expert system. Second, a temporal neuro-fuzzy system which is named ANFIS unfolded in - time is designed in order to make the use of fuzzy rules, to provide an environment that keeps temporal relationships between the variables and to forecast the future behavior of data. The rule base of ANFIS unfolded in time contains temporal TSK(Takagi-Sugeno-Kang) fuzzy rules. In the training phase, Back-propagation learning algorithm is used. The system takes the multivariate data and the num- ber of lags needed which are the output of Fuzzy MAR in order to describe a variable and predicts the future behavior. Computer simulations are performed by using synthetic and real multivariate data and a benchmark problem (Gas Furnace Data) used in comparing neuro- fuzzy systems. The tests are performed in order to show how the system efficiently model and forecast the multivariate temporal data. Experimental results show that the proposed model achieves online learning and prediction on temporal data. The results are compared by other neuro-fuzzy systems, specifically ANFIS.

In autonomous navigation of mobile robots the dynamic environment is a source of problems. Because it is not possible to model all the possible conditions, the key point in the robot control is to design a system that is adaptable to different conditions and robust in dynamic environments. This study presents a reactive control system for a Khepera robot with the ability to navigate in a dynamic environment for reaching goal objects. The main motivation of this research is to design a robot control, which is robust to sensor errors and sudden changes and adaptable to different environments and conditions. Behavior based approach is used with taking the advantage of fuzzy reasoning in design. Experiments are made on Webots, which is a simulation environment for Khepera robot.

In agent based systems, especially in autonomous mobile robots, modelling the environment and its changes is a source of problems. It is not always possible to effectively model the uncertainity and the dynamic changes in complex, real-world domains. Control systems must be robust to changes and must be able to handle these uncertainties to overcome this problem. In this study, a reactive behaviour based agent control system is modelled and implemented. The control system is tested in a navigation task using an environment, which has randomly placed obstacles and a goal position to simulate an environment similar to an autonomous robot&rsquo / s indoor environment. Then the control system was extended to control an agent in a multi-agent environment. The main motivation of this study is to design a control system which is robust to errors and easy to modify. Behaviour based approach with the advantages of fuzzy reasoning systems is used in the system.

Thesis--Copenhagen. / Summary in Danish. Includes bibliographical references (p. 127-130).

This thesis outlines the dynamic system analysis of a 3D Ultrasonic neuro- navigation system for use in motion capture studies. The work entails the development and implementation of methods for achieving the same. The objective of the project is to come up with an accurate dynamic 3D ultrasonic neuro-navigation system which can deliver up to sub mm accuracy within the operating workspace for use in image guided neuro surgery. The major focus of the work is to come up with a second order Kalman filter which can take out the outliers occurring in a static system in real time, thereby making the system more robust and accurate. Once the filter achieves the requisites, it can be integrated into the current motion tracking software which allows for the real time tracking of transmitters, hence the points of interest.

INTRODUCTION: Cancers of the gastrointestinal tract are the second most prevalent malignancy with 289,610 new cases last year and the second most common cause of cancer-related death with 150,000 deaths last year in the United States. Prognosis for patients with these malignancies is poor and worsens significantly once the cancer has metastasized to the brain. We evaluated the outcome of patients following Stereotactic Radiosurgery (SRS) for brain metastases (BM) in individuals with GI cancers to identify safety and effectivity of treatment and we assessed prognostic factors that affect tumor control and survival. OBJECTIVES: By the conclusion of this session, participants should be able to: 1) Identify an effective treatment for brain metastases from GI cancers in terms of increasing survival; 2) Identify which treatment provides the best local and distant control of CNS disease; 3) Discuss the effects of different prognostic factors on local control and survival. METHODS: This is a retrospective analysis of 58 brain metastases from 18 consecutive patients who underwent SRS treatment at BIDMC between 2006 and 2013. 11/18 patients underwent prior microsurgical resection for their metastases and 3/18 patients had undergone Whole Brain Radiation Therapy (WBRT). Overall Survival (OS), Local Control (LC), Distal control (DC), and prognostic factors such as age, number of brain metastases (BM), Karnofsky Performance Status (KPS), Recursive Partition Analysis (RPA) and Disease Specific Graded Prognostic Assessment (Ds-GPA) class were evaluated. RESULTS: The median overall survival (mOS) for the entire cohort was 14 months after the diagnosis of BM. The mOS for patients receiving only SRS, Surgical Resection + SRS, and WBXRT + SRS were 8 months, 18 months, and 13 months respectively. The difference in overall survival between treatment groups was not found to be statistically significant. Increasing number of BM was a factor shown to negatively influence survival. Local control was achieved in 55% of lesions after SRS, and in 75% of lesions that were surgically resected followed by SRS boost to the resection cavity. The difference in local control between SRS alone vs. Surgery + SRS was found to be statistically significant (p = 0.013). CONCLUSION: With a higher overall survival and significantly better local control rates, Surgery followed by SRS boost to the resection cavity should be considered as the treatment of choice in this specific subgroup of cancer patients as this study shows that they benefit from this more aggressive treatment option.

Complex network models of functional connectivity have emerged as a paradigm shift in brain mapping over the past decade. Despite significant attention within the neuroimaging and cognitive neuroscience communities, these approaches have hitherto not been extensively explored in neurosurgery. The aim of this thesis is to investigate how the field of connectomics can contribute to understanding the effects of focal brain lesions and to functional brain mapping in neurosurgery. This datasets for this thesis include a clinical population with focal brain tumours and a cohort focused on healthy adolescent brain development. Multiple network analyses of increasing complexity are performed based upon resting state functional MRI. In patients with focal brain tumours, the full complement of resting state networks were apparent, while also suggesting putative patterns of network plasticity. Connectome analysis was able to identify potential signatures of node robustness and connections at risk that could be used to individually plan surgery. Focal lesions induced the formation of new hubs while down regulating previously established hubs. Overall these data are consistent with a dynamic rather than a static response to the presence of focal lesions. Adolescent brain development demonstrated discrete dynamics with distinct gender specific and age-gender interactions. Network architecture also became more robust, particularly to random removal of nodes and edges. Overall these data provide evidence for the early vulnerability rather than enhanced plasticity of brain networks. In summary, this thesis presents a combined analysis of pathological and healthy development datasets focused on understanding the functional effects of focal brain lesions at a network level. The coda serves as an introduction to a forthcoming study, known as Connectomics and Electrical Stimulation for Augmenting Resection (CAESAR), which is an evolution of the results and methods herein.

Submitted by Santos Davilene (davilenes@ufba.br) on 2013-01-25T11:15:23Z No. of bitstreams: 1 TESE_Methanias Rodrigues Júnior.pdf: 1771083 bytes, checksum: a086d4543ad576bc8ac845022acd6eb5 (MD5) / Made available in DSpace on 2013-01-25T11:15:23Z (GMT). No. of bitstreams: 1 TESE_Methanias Rodrigues Júnior.pdf: 1771083 bytes, checksum: a086d4543ad576bc8ac845022acd6eb5 (MD5) / Hodiernamente, o processo de desenvolvimento de software pode contar com a utilização de diversas ferramentas de apoio. Os sistemas de controle de versão, as listas de discussão entre as pessoas envolvidas no projeto e os sistemas de rastreamento de erros são usados freqüentemente para ajudar a controlar o andamento de projetos de software, produzindo repositórios de dados históricos. Nos últimos anos, pesquisadores vêm realizando análises lingüísticas nas listas de discussão de projetos de software para compreender as complexidades e especificidades do seu desenvolvimento. Uma abordagem inovadora para isso é usar a Teoria da Neuro-Lingüística. A Neuro-Lingüística postula que indivíduos, em contextos específicos, utilizam um sistema representacional preferencial (SRP) para cognição. Isto significa que apesar de diferentes recursos e canais cognitivos serem usados pelos desenvolvedores para entender o software, existem sistemas representacionais preferidos pelos mesmos. Nesta tese, apresentamos uma ferramenta de análise psicométrica baseada na Neuro-Lingüística (NEUROMINER) para classificar os Sistemas Representacionais Preferidos (SRP) de desenvolvedores de software. A avaliação experimental da abordagem foi realizada em três experimentos que visaram testar a classificação do SRP: (1) Um estudo realizado nas listas de discussão dos projetos do servidor Apache e do PostgreSQL; (2) Uma pesquisa de campo com engenheiros de software para estabelecer quais os tipos de sistemas representacionais são os preferidos pelos mesmos; e (3) Um experimento controlado feito na indústria para avaliação da efetividade da ferramenta neste tipo de ambiente. Os resultados indicaram que a nossa abordagem pode ser usada para classificar engenheiros de software com relação às suas preferências de representação para cognição. Esta classificação pode nortear a alocação de desenvolvedores em tarefas específicas e, possivelmente, melhorar a comunicação em organizações de desenvolvimento de software. / Salvador