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  • About
  • The Global ETD Search service is a free service for researchers to find electronic theses and dissertations. This service is provided by the Networked Digital Library of Theses and Dissertations.
    Our metadata is collected from universities around the world. If you manage a university/consortium/country archive and want to be added, details can be found on the NDLTD website.
271

Réseaux ad hoc véhiculaires : vers une dissémination de données efficace, coopérative et fiable / Vehicular ad hoc networks : towards efficient, collaborativeand reliable data dissemination

Haddadou, Nadia 16 June 2014 (has links)
Les réseaux ad hoc véhiculaires (VANETs) permettent le partage de différents types de données entre les véhicules, de manière collaborative. Dans cette thèse, nous nous sommes tout particulièrement intéressés aux applications de sûreté et de sécurité routière, dédiées à l'échange des informations sur l'état de l'environnement routier. Les contraintes de ces applications en termes de qualité de services sont des plus rigoureuses, car l'acheminent de leurs données doit être exhaustif et ne souffrir d'aucun retard pour assurer une information utile et en temps opportun au profit de tous les usagers concernés. Cet acheminement doit faire face aux difficultés induites par la dispersion et la forte mobilité des véhicules, l'absence ou l'insuffisance d'infrastructure, la densité variable du réseau, la surcharge en informations à envoyer et l'étendue des zones géographiques à couvrir. En effet, la problématique de diffusion des données dans les VANETs s'avère non-triviale et de nombreux verrous scientifiques doivent être levés pour permettre un support efficace, collaboratif et fiable pour les applications de sûreté et de sécurité routière.Plus précisément, nous aborderons la problématique de la dissémination collaborative en se posant trois questions : “comment disséminer les données ? À quel moment le faire ? Mais aussi quoi disséminer et comment inciter à le faire ? ” Nous avons apporté des réponses à travers les trois contributions de cette thèse. La première consiste à proposer une stratégie de dissémination efficace, qui soit adaptée à l'importance de l'information échangée et à sa durée de vie, permettant ainsi d'éviter un processus de diffusion intensif. Celui-ci est inapproprié dans ce cas de figure, car il génère de la congestion et beaucoup de redondance. Une étude de performances par simulation est réalisée, laquelle montre une diminution de 90% du taux de messages redondants par rapport au cas de la diffusion par inondation. Afin d'améliorer plus encore les performances du processus de diffusion des messages de sûreté, nous proposons, dans un second temps, un ordonnanceur pour l'accès au canal de communication qui a pour objectif de réduire le nombre de collisions dues aux synchronisations afférentes à l'utilisation du multi-canal dans le standard IEEE 802.11p/1609.4 et donc élever le taux de réception des données. Nous basons notre proposition sur la théorie de l'arrêt optimal, qui décide du moment opportun pour l'envoi d'une information en conciliant occupation du canal, efficacité de l'envoi et délai d'ajournement toléré par une information. Dans notre cas, la théorie de l'arrêt optimal est formulée par un processus de décision Markovien (MDP). Nous montrons ainsi par simulation une amélioration substantielle du taux de réception (de 25%) et une diminution importante des pertes (de 47%).Après s'être intéressé à l'aspect quantitatif des performances du réseau, nous nous intéresserons ensuite à l'amélioration de la fiabilité du processus de diffusion. Cette fiabilité est obtenue grâce à l'incitation des véhicules à la coopération et à l'exclusion des véhicules malicieux de celui-ci. Ceci est réalisé au travers de la proposition d'un modèle de confiance, inspiré des jeux de signaux. Le modèle crée une situation d'équilibre, tel que les différentes parties le composant ne soient pas tentées de le contourner, ainsi découle une auto-sélection des véhicules, laquelle est rapide et peu coûteuse. À notre connaissance, notre modèle est le seul à s'attaquer aux effets néfastes des deux types de véhicules, malicieux et égoïstes, en même temps. Comme précédemment, nous évaluons les performances de notre solution au travers d'une modélisation par une chaîne de Markov et divers jeux de simulation. Ceci a permis de montrer que 100% des véhicules malicieux sont exclus, avec le maintien d'un taux de coopération élevé dans le réseau, soit une amélioration de 42% / Vehicular Ad Hoc Networks (VANETs) allow sharing different kinds of data between vehicles in a collaborative way. In this thesis, we are particularly interested in road safety applications, designed for the exchange of information on road traffic and conditions. This kind of applications have strict Quality of Service (QoS) requirements, as data must be routed thoroughly and without any delays so for assuring the timely delivery of useful information to the drivers. In this context, data routing must face several issues raised by the high mobility and dispersion of vehicles, inadequate or completely lacking infrastructure, a variable network density, network saturation due to the large of information to deliver, and the size of the geographical areas to cover. Indeed, the problem of data dissemination in VANETs is non-trivial, and several research challenges must be solved in order to provide an efficient, collaborative, and reliable support for road safety applications. Specifically, we will address the problem of collaborative data dissemination through the following three questions: “How to perform data dissemination?”, “When should we do it?”, and “What must be disseminated?” We have provided answers to these questions through the three contributions of this thesis. Our first contribution is an efficient dissemination strategy, specifically tailored to the importance of the exchanged information as well as its lifespan, which is able to avoid the intensive dissemination process that generates network congestion and data redundancy. We confirm our statements and validate the performance of our solution by modeling it using a discrete-time Markov chain, which demonstrates the number of necessary retransmissions for all concerned vehicles to receive information. Moreover, we performed extensive simulations that show a reduction of up to 90% of redundant messages with respect to message flooding dissemination strategies. Next, in order to further improve the road safety message dissemination process, we propose a communications channel access scheduler, which aims at reducing the number of collisions caused by IEEE 802.11p/1609.4 multi-channel synchronizations, and thus improving the data reception rate. We base our solution on the optimal stopping theory, which chooses the right moment to send information by balancing the channel occupancy rate, the data delivery efficiency, and the maximum deferment delay tolerated by the information. To this end, we formulate the optimal stopping theory through a Markov decision process (MDP). We show through simulation-based evaluations an improvement of the reception rate of up to 25% and a reduction of up to 47% of message losses. Finally, after being interested in the quantitative aspect of network performance, we centered our efforts on improving the reliability of the dissemination process, which is obtained by motivating vehicles to cooperate and evicting malicious vehicles from the process. To this end, we propose a trust model inspired on signaling games, which are a type of dynamic Bayesian games. Through the use of our model, equilibrium is achieved, thus resulting in a fast and low-cost vehicle self-selection process. We define the parameters of our trust model through a discrete-time Markov chain model. To the best of our knowledge, our solution is the only existing solution that tackles the negative effects introduced by the presence of both malicious and selfish vehicles in a VANET. We evaluated the performance of our solution by modeling it using a Markov chain, and a set of simulations. Our results show that up to 100% of malicious vehicles are evicted while keeping a high cooperation rate, thus achieving an improvement of 42% when compared to other similar solutions
272

Identification et caractérisation moléculaire et fonctionnelle des cellules tissulaires de l’immunité innée chez les patients atteints de maladies inflammatoires intestinales

Chapuy, Laurence 01 1900 (has links)
Les maladies inflammatoires intestinales (MII), maladie de Crohn (MC) et colite ulcéreuse (CU), représentent un problème de santé publique majeur en raison de leur prévalence, de leur chronicité et de l’absence de traitement curatif disponible. La physiopathologie de ces maladies implique des facteurs de prédisposition génétique, des facteurs environnementaux et une réponse anormale du système immunitaire. De par leur position à l’interface entre les facteurs environnementaux, les cellules épithéliales et les cellules de l’immunité adaptative, les cellules de l’immunité innée (phagocytes monocucléés (MNPs) et granulocytes) sont des acteurs importants dans l’initiation et le maintien de l’inflammation intestinale. Largement étudiés chez la souris, leur investigation chez l’humain restait parcellaire, souvent contradictoire dans le colon et rarement étudiée dans le ganglion mésentérique (MLN). Nous avons caractérisé par des méthodes de cytométrie de flux multi-couleurs, de cytométrie de masse (CyTOF) et de séquencage de l’ARN (total et à l’échelon de la cellule unique), les MNPs de la muqueuse colique et des ganglions mésentériques chez les patients atteints de MC et de CU. Nous avons également évalué la fonction des MNPs et des basophiles sur les réponses mémoires T CD4+ autologues tissulaires. Notre travail a mis en évidence des similitudes et des différences entre la MC et la CU, dans la distribution des MNPs et le profil de la réponse mémoire T CD4+ dans le colon et le ganglion. La sous-population de MNPs HLADR+SIRPα+CD14+CD64+CD163- qualifiée de monocytes inflammatoires, et non les macrophages HLADR+SIRPα+CD14+CD64+CD163+, s’accumule dans la muqueuse inflammatoire des patients atteints de MC et de CU, et promeut les réponses mémoires de type Th17 et Th17/Th1 d’une manière dépendante de l’IL-1β. La fréquence de cette population corrèle avec le score de sévérité endoscopique en MC. Cependant, la distribution des MNPs ganglionnaires diffère entre la MC et la CU. Nous montrons que, dans les ganglions des patients atteints de CU, les MNPs HLADR+SIRPα+CD14+CD64+ sont enrichis en cellules CD163+, qui incluent principalement des cellules ‘monocyte-like’ HLA-DRdim en plus de macrophages HLA-DRhi. Parmi les cellules dendritiques (DCs) HLADR+SIRPα+CD14-CD64-, les DCs plasmocytoides prédominent dans les deux MII, avec une fréquence supérieure en MC qu’en CU. Par ailleurs, l’IL-1β dans la MC et l’IL-12 dans la CU favorisent un profil pathogénique dans les lymphocytes T CD4+ (IFN-γ, TNF-α, GM-CSF, IL-6) de la muqueuse colique. Par sérendipité, nous avons aussi mis en évidence que l’IL-12 et les monocytes inflammatoires tissulaires induisent la production d’IL-8 par les lymphocytes T CD4+ mémoires de la muqueuse intestinale et des MLNs dans la CU mais pas dans la MC. Au cours de cette étude, nous avons également observé l’accumulation de basophiles, mais pas de mastocytes, dans la muqueuse colique et le MLN en MC et en CU, et montré qu’ils favorisaient également les réponses Th17 et Th17/Th1 et non Th1 dans les lymphocytes T CD4+ mémoires exprimant CCR7. En conclusion, la caractérisation des MNPs de la muqueuse intestinale et des MLNs dans les maladies inflammatoires intestinales (MII) permet de mieux appréhender la physiopathologie de la maladie, dans l’espoir d’optimiser la stratification des MII et de permettre ainsi une prise en charge thérapeutique personnalisée. / Crohn's disease (CD) and ulcerative colitis (UC), two common forms of inflammatory bowel disease (IBD), represent a major public health problem because of their prevalence, chronicity and lack of available curative treatment. The pathophysiology of these diseases involves predisposing genetic factors, environmental triggers, and a dysfunctional immune response. Innate immune cells, including mononuclear phagocytes (MNPs) and granulocytes, are important players in the initiation and maintenance of intestinal inflammation due to their position at the interface between the external environment, epithelium and adaptive immune cells. Although widely studied in mice, their investigation in humans remains fragmentary, often with contradictory findings reported in the colon, and they are rarely studied in the mesenteric lymph nodes (MLNs). MNPs from the colon and MLNs of patients with CD and UC were characterized by multi-color flow cytometry, mass cytometry (CyTOF) and RNA sequencing (bulk and single cell). The function of MNPs and basophils on autologous memory CD4+ T cell responses was also assessed. The results presented here highlight similarities and differences in the distribution of MNPs between CD and UC, and the profile of memory CD4+ T cell response in colon and MLNs. HLADR+SIRPα+CD14+CD64+CD163- MNPs, defined as inflammatory monocytes, but not HLADR+SIRPα+CD14+CD64+CD163+ macrophages, accumulated in the inflammatory mucosa of CD and UC patients, and promoted Th17 and Th17/Th1 memory responses in an IL-1β dependent manner. The frequency of this subpopulation correlated with endoscopic severity in CD. In contrast, the distribution of these two MNP populations in the MLNs differs between CD and UC. HLADR+SIRPα+CD14+CD64+ MNPs were enriched in CD163+ cells that predominantly included HLA-DRdim monocytes-like cells over HLA-DRhi macrophages in UC patients only. Among HLADR+SIRPα+CD14-CD64- dendritic cells (DCs), plasmocytoid DCs predominated in both UC and CD, with higher frequency in CD versus UC. IL-1β in CD and IL-12 in UC favor a pathogenic CD4+ T cell profile (IFN-γ, TNF-α, GM-CSF, IL-6 expression/production) in the colonic mucosa. It was also demonstrated that IL-12 and inflammatory tissue monocytes induced IL-8 production by memory CD4+ T cells in intestinal mucosa and MLNs of UC but not CD. In this study, it was also observed that basophils and not mast cells accumulated, in the colonic mucosa and MLNs of CD and UC patients, and favored Th17 and Th17/Th1, but not Th1, responses in CCR7+ memory CD4+ T cells. In conclusion, characterization of MNPs in the intestinal mucosa and MLNs of IBD patients contributes to a better understanding of IBD pathophysiology and opens avenues to optimize patient stratification, and thus, personalized treatment of IBD patients.
273

Rôle de CD47 dans l’induction de la tolérance in vivo

Gautier-Éthier, Patrick 08 1900 (has links)
La tolérance orale permet la modulation de la réponse immunitaire à l’égard des antigènes exogènes présents dans la lumière intestinale. Essentiels à l’établissement d’une relation symbiotique entre le système immunitaire et la flore intestinale, l’induction et le maintien de la tolérance orale reposent sur différents mécanismes immunologiques. Parmi eux, l’induction de cellules T régulatrices par les cellules dendritiques et de mécanismes apoptotiques. Or, la glycoprotéine membranaire CD47 est impliquée, en périphérie, dans ces mécanismes. Cependant, le rôle de CD47 dans la tolérance orale n’est pas connu. À l’aide d’un modèle murin déficient en CD47, nous avons démontré principalement, que l’absence de CD47 est associée à une diminution de 50 % de la proportion de cellules dendrites myéloïdes CD11b+CD103- retrouvées dans les ganglions mésentériques. Suite au transfert adoptif de cellules T antigènes spécifiques dans nos différents modèles expérimentaux, on a, aussi, observé une diminution de 45 % de leur niveau d’activation dans les ganglions mésentériques. Malgré les effets observés, le CD47 n’est pas impliqué dans l’induction d’une réaction de tolérance orale secondaire à l’administration intragastrique de fortes doses d’ovalbumine. Cependant, nous avons démontré que CD47 est impliquée au niveau de la migration des cellules dendritiques de la peau et de certaines sous-populations retrouvées dans les ganglions mésentériques. / Oral tolerance allows the modulation of the immune response against exogenous antigens present in the intestinal lumen. Essential to establish a symbiotic relationship between the immune system and intestinal flora, the induction and maintenance of oral tolerance rests on different immunological mechanisms. Among them, induction of regulatory T cells by dendritic cells and apoptotic mechanisms. However, the membrane glycoprotein CD47 is involved in the periphery of these mechanisms. However, the role of CD47 in oral tolerance is unknown. With a mouse model deficient in CD47, we showed mainly that the absence of CD47 is associated with a decrease of 50% in the proportion of myeloid dendritic cells CD11b+ CD103- found in the mesenteric lymph nodes. Following the adoptive transfer of antigen specific T cells in our experimental models, we also observed a decrease of 45% of their level of activation in mesenteric lymph nodes. Despite the observed effects, CD47 is not involved in the induction of oral tolerance response secondary to intragastric administration of high doses of ovalbumin. However, we have shown that CD47 is involved in the migration of dendritic cells of the skin and some sub-populations found in mesenteric lymph nodes.
274

The M2X Economy – Concepts for Business Interactions, Transactions and Collaborations Among Autonomous Smart Devices

Leiding, Benjamin 11 December 2019 (has links)
No description available.
275

Uticaj dubine invazije oralnog planocelularnog karcinoma na pojavu metastaza u limfnim čvorovima vrata / The effect of depth of tumor invasion on neck lymph node metastasis in patients with oral squamous cell carcinoma

Mijatov Ivana 22 November 2019 (has links)
<p>Oralni karcinom je po učestalosti &scaron;esta najče&scaron;ća maligna bolest u svetu čija incidenca varira u različitim geografskim područjima. Predstavlja 5% svih novootkrivenih malignih tumora godi&scaron;nje i čini 14% svih malignih tumora glave i vrata. Pod oralnim karcinom podrazumevamo planocelularni karcinom obzirom na činjenicu da on čini preko 90% malignih tumora oralne lokalizacije, dok se u manjem procentu javljaju drugi tumori (maligni tumori malih pljuvačnih žlezda, limfomi, mezenhimni tumori). Oralni karcinom podrazumeva karcinome koji se javljaju u sledećim anatomskim regijama: sluznici prednje 2/3 jezika, poda usta, obraza, gingivi gornje i donje vilice, retromolarnom trouglu, kao i sluznici mekog i tvrdog nepca. Najče&scaron;ća lokalizacija oralnog planocelularnog karcinoma je sluznica pokretnog dela jezika i poda usta. Oralni karcinom se če&scaron;će javlja kod mu&scaron;karaca (odnos mu&scaron;karci:žene je 3:1) verovatno zbog većeg procenta rizičnog pona&scaron;anja kod mu&scaron;karaca. Najče&scaron;će se javlja u &scaron;estoj i sedmoj deceniji života (medijana je 62 godine) iako se poslednjih godina sve če&scaron;će javlja kod mlađih od 45 godina. Faktori rizika za oboljevanje su dobro poznati. Na prvom mestu se izdvaja pu&scaron;enje duvana (značajna je dužina pu&scaron;enja, da li pacijent pu&scaron;i lulu ili cigaretu, da li žvaće duvan, kao i dužina trajanja apstinencije). Smatra se da je smrtnost kod oralnog karcinoma direktno povezana sa brojem popu&scaron;enih cigareta na dan. Preko 75% pacijenata sa oralnim karcinomom anamnestički daje podatak o prekomernoj upotrebi alkohola. Postoji sinergističko dejstvo alkohola i cigareta, dugotrajna ekspozicija ovim faktorima rizika dovodi do pojave &ldquo;polja kancerizacije&ldquo;, pojave genetske nestabilnosti i razvoja tumora. Kod oralnog planocelulranog karcinoma primećene su hromozomske abnormalnosti koje su rezultat o&scaron;tećenja DNK i uključuju promene genetskog materijala na hromozomima.Jedna od najče&scaron;ćih genetskih abnormalnosti kod oralnog planocelularnog karcinoma je mutacija r53 gena koji se nalazi na kratkom kraku hromozoma 17 i predstavlja tumor supresor gen. Planocelularni karcinom nije te&scaron;ko dijagnostikovati kada postane simptomatski. Pacijent se žali na bol, krvavljenje, otalgiju, otežano gutanje, smanjenje pokretljivosti jezika. Neretko je prvi simptom metastatski uvećan limfni čvor na vratu jer bolesnici ne primećuju ili ignori&scaron;u oralnu patologiju. Dijagnoza oralnog karcinoma se postavlja na osnovu detaljno uzete anamneze, kliničkog pregleda i patohistolo&scaron;ke verifikacije. Oralni planocelularni karcinom se javlja u tri klinike forme: egzofitična, endofitična i infiltrativna. Zlatni standard za dijagnozu oralnog karcinoma je biopsija i patohistolo&scaron;ka verifikacija, pri čemu se može primeniti &bdquo;punch&ldquo; biopsija, inciziona biopsija ili eksciziona biopsija kod manjih promena. TNM &bdquo;staging&ldquo; sistem AJCC (American Joint Committee on Cancer) se danas standardno koristi za klinički &bdquo;staging&ldquo; oralnog karcinoma i bazira se na podacima dobijenim kliničkim pregledom i &bdquo;imaging&ldquo; metodama. Sam &bdquo;staging&ldquo; je bitan kako zbog komunikacije među lekarima koji učestvuju u lečenju bolesnika tako i zbog standardizacije prognoze. T stadijum označava veličinu primarnog tumora, N stadijum označava regionalnu nodalnu zahvaćenost dok M stadijum prikazuje prisustvo udaljenih metastaza. Terapija patohistolo&scaron;ki dokazanog oralnog karcinoma zahteva multidisciplinarni pristup. Osnova terapije oralnog planocelularnog karcinoma je hirur&scaron;ko lečenje koje podrazumeva ablativno i rekonstruktivno hirur&scaron;ko lečenje. Osnovni princip ablativne hirurgije kod oralnog karcinoma je resekcija primarnog tumora sa najmanje 1cm negativnim hirur&scaron;kim marginama. Pored ablacije tumora hirur&scaron;ko lečenje podrazumeva i uklanjanje regionalnih limfnih čvorova vrata. Cilj disekcije vrata je da se kod klinički evidentnih metastaza iste uklone (terapijska disekcija) ili da se uklone okultne metastaze koje su klinički neevidentne (elektivna disekcija). Oralni planocelularni karcinom spada u tumore sa visokom stopom smrtnosti, većom nego &scaron;to je kod limfoma, laringealnog karcinoma, karcinoma testisa i endokrinih karcinoma. Stopa petogodi&scaron;njeg preživljavanja je direktno povezana sa veličinom tumora, prisustvom metastaza u regionalnim limfnim čvorovima i prisutvom udaljenih metastaza. Prosečno trogodi&scaron;nje preživljavanje bolesnika sa oralnim karcinomom je 52% dok je prosečno petogodi&scaron;nje preživljavanje oko 39% i ove stope se nisu mnogo menjale tokom godina bez obzira na nova saznanja i nove pristupe lečenju oralnog planocelulanog karcinoma. Ciljevi istraživanja su da se utvrdi da li postoji korelacija debljine OPK izmerene kompjuterizovanom tomografijom i svetlosnim mikroskopom, da li dubina invazije OPK i volume tumora mogu biti prediktivni faktor za razvoj regionalnih cervikalnih metastaza kod oralnog planocelularnog karcinoma. Istraživanje je uključilo 65 konsekutivnih bolesnika oba pola lečenih od oralnog karcinoma na Klinici za maksilofacijalnu hirurgiju Kliničkog centra Vojvodine. Dijagnoza oralnog karcinoma je postavljena na osnovu anamneze, kliničkog pregleda i biopsije. U sklopu TNM &bdquo;staging&ldquo;-a bolesnika načinjen je pregled glave i vrata i grudnog ko&scaron;a kompjuterizovanom tomografijom (CT) na osnovu kog smo dobili podatak o dimenzijama tumora. Na osnovu kliničkog nalaza i analize CT nalaza planiralo se operativno lečenje u skladu sa bolesnikovim TNM statusom. Postoperatativni patohisto&scaron;ki preparati je pregledan od strane istog patologa. Parametri koji će su određivani su sledeći: 1. Veličina tumora (2 dimenzije) izmerene na osnovu CT pregleda izražene u cm 2. Debljina tumora izmerena na osnovu CT pregleda izražena u cm 3. Veličina tumora (2 dijametra) na makroskopskom preparatu izražena u cm 4. Debljina tumora na mikroskopskom preparatu izmerena svetlosnim mikroskopom izražena u cm 5. Dubina invazije tumora na mikroskopskom preparatu izmerena svetlosnim mikroskopom izražena u mm 6. Volumen tumora koji se izračunavao prema formuli: VT=&pi;/6 x maksimalni dijametar tumora A x minimalni dijametar tumora B x dubina invazije tumora i izražava se u cm&sup3; 7. Broj metastatski izmenjenih limfnih čvorova u disekatu vrata 8. Ukupan broj patohistolo&scaron;ki ispitanih limfnih čvorova u disekatu vrata Nakon prikupljanja planiranog materijala urađena je statistička obrada podataka. Statistička analiza podataka je uključila metode deskriptivne statistike (srednja vrednost, standardna devijacija, učestalost), kao i standardne parametrijske i neparametrijske testove za komparacije dve grupe (Studentov T test, Mann&ndash;Whitney U test, hikvadrat test). U fazi statističke analize međusobnih uticaja i povezanosti prikupljenih podataka kori&scaron;ćen je Pearsonov test korelacije. Sva testiranja sprovedena su na nivou statističke značajnosti p&lt;0,05. REZULTATI: Istraživanje je obuhvatilo 65 bolesnika, od kojih je 82% bilo mu&scaron;kog pola prosečne starosti 59 godina. 83% bolesnika su se izja&scaron;njavali kao pu&scaron;ači, dok je 69% bolesnika navelo da redovno koristi alkohol. Svim pacijentima je tokom hirur&scaron;kog lečenja OPK rađena disekcija vrata i to najče&scaron;čće selektivna disekcija vrata (91%). Kod 30 bolesnika je utvrđeno postojanje cervikalnih regionalnih metastaza na operativnom preparatu te su bolesnici podeljeni u dve grupe: sa prisustvom i bez prisustva metastaza u limfnim čvorovima vrata. Utvrđeno je da se ove dve grupe statistički značajno razlikuju u dubini invazije tumora i volumenu tumora. Utvrđeno je takođe da postoji statistički značajna korelacija između debljine tumora izmerene CT pregledom i debljine tumora izmerene svetlosnim mikroskopom. Dokazano je da dubina invazije tumora veća od 7mm i zapremina tumora veća od 4cm&sup3; predstavljaju prediktivni faktor za pojavu regionalnih cervikalnih metastaza. ZAKLjUČAK: Na osnovu istraživanja izvedeni su zaključci koji ukazuju na to da postoji statistički značajna korelacija između debljine tumora OPK izmerene CTpregledom i svetlosnim mikroskopom te se debljina tumora izmerena CT pregledom može koristiti za planiranje operativnog zahvata prilikom lečenja OPK. Dubina invazije tumora veća od 7mm i volumen tumora veći od 4 cm&sup3; predstavljaju prediktivni faktor za pojavu nodalnih cervikalnih metastaza te su značajni za određivanje stadijuma bolesti.</p> / <p>Oral cancer is the sixth most common malignant disease in the world which incidence varies based on geographic area. It represents 5% of all newly discovered malignant tumors annually and constitutes 14 % of all malignant tumors of head and neck. Squamous cell carcinoma is considered to be a type of oral cancer because more than 90 % of malignant tumors that occur in oral cavity are squamous cell carcinomas while other tumors (malignant tumor of minor salivary gland, lymphoma, sarcoma) rarely occur. Oral cancer is the cancer found in the following anatomic regions: mucosa of front two-thirds of the tongue, the floor of the mouth, cheeks, upper and lower gingiva, retromolar trigone as well as&nbsp; mucosa of soft and hard palates. Oral squamous cell carcinoma is most commonly localized in mucous membrane of the movable part of the tongue and floor of the mouth. Men are more affected than women (male to female ratio is 3:1) probably because of men&rsquo;s riskier behavior. It is most commonly diagnosed in the sixth and seventh decade of life (the median is 62 years old) although it has been diagnosed in patents younger than 45 in recent years. Risk factors of oral squamous cell carcinoma are well known. The major factor is tobacco smoking (the period of smoking is significant, it is also important to consider whether a patient smokes a pipe or cigarette, whether he/she chews tobacco as well as the period of abstinence). The mortality rate is believed to be directly related to the number of cigarettes smoked a day. An excessive use of alcohol has been reported in over 75% of patients with oral cancer. There is a synergistic effect of alcohol and cigarette consumption and long-term exposure to these risk factors results in &lsquo;field of cancerization&rsquo;, genetic instability and tumor development. Chromosome abnormalities, which are caused by DNA damage and include the change in genetic material of chromosomes, have been reported in patients with oral squamous cell carcinoma. One of the most common genetic abnormalities in patients with oral squamous cell carcinoma is a mutation of р53 gene which is located on a short arm of chromosome 17 and represents a tumor suppressor gene. Oral squamous cell carcinoma is not difficult to diagnose when it becomes symptomatic. The patient complains of pain, bleeding, otalgia, swallowing difficulties, decreased tongue mobility. The first symptom is rarely metastatic lymph node on the neck because patients either do not notice or ignore oral pathology. The oral cancer is diagnosed based on the detailed anamnesis, physical examination and pathohistological verification. The oral squamous cell carcinoma occurs in three clinical forms: exophytic, endophytic and infiltrative form. The gold standard for diagnosis of oral cancer is biopsy and pathohistological verification. However, in case of smaller changes, punch biopsy, incisional and excisional biopsies can also be applied. ТNМ staging system of AJCC (American Joint Committee on Cancer) is nowadays used for clinical staging of oral cancer and it is based on the data acquired by clinical examination and imaging methods. Not only is the staging itself important for communication between the doctors involved in treatment, but it is also important for standardization of prognosis. Т describes the size of primary tumor, N describes regional nodal spread and М describes distant metastasis. The treatment of histopathologically proven oral cancer requires multidisciplinary approach. The main treatment of oral squamous cell carcinoma is surgical treatment which involves ablative and reconstructive surgical treatment. The basic principle of ablative surgery for oral cancer is the resection of primary tumor with at least 1 cm negative surgical margins. Apart from tumor ablation surgical treatment also involves removal of regional lymph nodes on the neck. The aim of neck dissection is to remove clinically evident metastasis (therapeutic dissection) or to remove occult metastasis that are not clinically evident (elective dissection). The oral squamous cell carcinoma is the cancer with high mortality rate. The mortality rate is higher than the mortality rate for lymphoma, laryngeal cancer, testicular cancer and endocrine cancer. The five-year survival rate is directly related to the size of the tumor, presence of metastasis in regional lymph nodes and distant metastasis. The average three-year survival rate of the patients with oral cancer is 52% and the average five-year survival rate is 39%. These rates have not changed a lot over the years regardless of new knowledge and approaches in treatment of oral squamous cell carcinoma. The aims of the study are to determine whether there is a correlation between the depth of invasion of oral squamous cell carcinoma determined by computed tomography and light microscope and whether the invasion depth of OSCC and tumor volume can be predictive factors of development of regional cervical metastases in case of oral squamous cell carcinoma. The study covered 65 consecutive patients of both sexes who received treatment for oral cancer at the Clinic for Maxillofacial Surgery of the Clinical Center of Vojvodina. The diagnosis of oral cancer was established based on the anamnesis, physical examination and biopsies. The TNM &lsquo;staging&rsquo; of the cancer involved the examination of the patient&rsquo;s head and thorax by computed tomography (CT) which enabled us to obtain reliable data about the tumor size. After obtaining clinical findings and CT results, the patients&rsquo; treatment was planned based on their TNM status. A postoperative histopathological examination was performed by the same pathologist and the following parameters were determined: 1. Tumor size (2 dimensions) measured by CT and expressed in cm 2. Tumor thickness measured by CT and expressed in cm 3. Tumor size (2 diameters) on microscopic device and expressed in cm 4. Tumor thickness on microscopic device measured by light microscope and expressed in cm 5. Depth of tumor invasion on microscopic device measured by light microscope and expressed in cm 6. Tumor volume calculated based on the following formula: VT=&pi;/6 x maximum tumor diameter А x minimum tumor diameter B x depth of tumor invasion and expressed in cm&sup3; 7. The number of metastatic lymph nodes in the neck dissection 8. Total number of pathohistologically tested lymph nodes in the neck dissection. Upon collecting the planned material, statistical analysis of all data was carried out. The statistical analysis included the methods of descriptive statistics (mean value, standard deviation, frequency) and standard parametric and nonparametric tests for comparison of two groups (Student&rsquo;s T test, Whitney U test, chi-square test). The Pearson&rsquo;s Test of Correlation was used in the phase of statistical analysis of interaction effects and correlation of obtained data. All tests were performed at the level of statistical significance of p&lt;0.05. RESULTS: The study covered 65 patients, out of which 82% were male patients aged 59. 83% of patients said they smoked and 69% of patients stated that they consumed alcohol regularly. A neck dissection was performed in all patients during surgical treatment of OSCC and it was selective neck dissection (91%). Cervical regional metastasis was found in 30 patients so they were divided into two groups: the group of patients who had metastasis in the lymph nodes and the group of patients with no metastasis in lymph nodes of the neck. It was determined that there was a statistically significant difference in depth of invasion and tumor volume between these two groups. The statistically significant difference was also determined between the thickness of tumor measured by CT and thickness of tumor measured by light microscope. Moreover, the depth of invasion of tumor greater than 7mm and volume of tumor greater than 4cm&sup3; were proven to represent a predictive factor of development of regional cervical metastasis. The study results show that there is a statistically significant correlation between the thickness of OSCC tumor measured by CT and the thickness measured by light microscope, so the thickness of tumor measured by CT can be used for planning the surgery during the treatment of OSCC. The depth of tumor invasion greater than 7 mm and tumor volume greater than 4 cm&sup3; represent a predictive factor of development of cervical metastasis, which means that they are significant for determining the stage of disease.</p>
276

Topological control of 3,4-connected frameworks based on the Cu2-paddle-wheel node: tbo or pto, and why?

Müller, Philipp, Grünker, Ronny, Bon, Volodymyr, Pfeffermann, Martin, Senkovska, Irena, Weiss, Manfred S., Feng, Xinliang, Kaskel, Stefan 06 April 2017 (has links)
Two trigonal tritopic ligands with different conformational degree of freedom: conformationally labile H3tcbpa (tris((4-carboxyl)phenylduryl)amine) and conformationally obstructed H3hmbqa (4,4′,4′′-(4,4,8,8,12,12-hexamethyl-8,12-dihydro-4H-benzo[9,1]quino-lizino[3,4,5,6,7-defg]acridine-2,6,10-triyl)tribenzoic acid) are assembled with square-planar paddle-wheel nodes with the aim of selective engineering of the frameworks with tbo and pto underlying net topologies. In the case of H3tcbpa, both topological types were obtained forming non-interpenetrated MOFs namely DUT-63 (tbo) and DUT-64 (pto). Whereas synthesis of DUT-63 proceeds under typical conditions, formation of DUT-64 requires an additional topology directing reagent (topological modifier). Solvothermal treatment of the conformationally hindered H3hmbqa ligand with the Cu-salt results exclusively in DUT-77 material, based on the single pto net. The possibility to insert the salen based metallated pillar ligand into networks with pto topology post-synthetically results in DUT-78 and DUT-79 materials (both ith-d) and opens new horizons for post-synthetic insertion of catalytically active metals within the above-mentioned topological type of frameworks.
277

Měření vzdáleností mezi stanicemi v IP sítích / Distance measurement between nodes in IP networks

Šimák, Jan January 2010 (has links)
This thesis deals with delay prediction issue between nodes on the Internet. Accurate delay prediction helps with choosing of the nearest internet neighbor and contributes to effective usage of network sources. Unnecessary network load is decreased due to algorithms of delay prediction (no need for many latency measuring). The thesis focuses theoretically on the three main algorithms using coordinate systems - GNP, Vivaldi, Lighthouses. Last one is at the same time the main subject of the thesis too. Algorithm Lighthouses is explored in detail theoretically and in practise too. In order to verify the accurate of delay prediction of Lighthouses algorithm the simulation application was developed. The application is able to compute node coordinates of synthetic network using Lighthouses algorithm. Description of simulation application and evaluation of simalution results are part of practice part of this thesis.
278

Eine prospektive Studie zur operativen Therapie des Beinlymphödems / Microsurgical therapy of lymphedema of the leg – a prospective study

Weiß, Sophia Magdalena 14 January 2020 (has links)
No description available.
279

Architecture logicielle et matérielle d'un système de détection des émotions utilisant les signaux physiologiques. Application à la mnémothérapie musicale / Hardware and software architecture of an emotions detection system using physiological signals. Application to the musical mnemotherapy

Koné, Chaka 01 June 2018 (has links)
Ce travail de thèse s’inscrit dans le domaine de l’informatique affective et plus précisément de l’intelligence artificielle et de l’exploration d’architecture. L’objectif de ce travail est de concevoir un système complet de détection des émotions en utilisant des signaux physiologiques. Ce travail se place donc à l’intersection de l’informatique pour la définition d’algorithme de détection des émotions et de l’électronique pour l’élaboration d’une méthodologie d’exploration d’architecture et pour la conception de nœuds de capteurs. Dans un premier temps, des algorithmes de détection multimodale et instantanée des émotions ont été définis. Deux algorithmes de classification KNN puis SVM, ont été implémentés et ont permis d’obtenir un taux de reconnaissance des émotions supérieurs à 80%. Afin de concevoir un tel système alimenté sur pile, un modèle analytique d’estimation de la consommation à haut niveau d’abstraction a été proposé et validé sur une plateforme réelle. Afin de tenir compte des contraintes utilisateurs, un outil de conception et de simulation d’architecture d’objets connectés pour la santé a été développé, permettant ainsi d’évaluer les performances des systèmes avant leur conception. Une architecture logicielle/matérielle pour la collecte et le traitement des données satisfaisant les contraintes applicatives et utilisateurs a ainsi été proposée. Doté de cette architecture, des expérimentations ont été menées pour la Mnémothérapie musicale. EMOTICA est un système complet de détection des émotions utilisant des signaux physiologiques satisfaisant les contraintes d’architecture, d’application et de l’utilisateur. / This thesis work is part of the field of affective computing and more specifically artificial intelligence and architectural exploration. The goal of this work is to design a complete system of emotions detection using physiological signals. This work is therefore situated at the intersection of computer science for the definition of algorithm of detection of emotions and electronics for the development of an architecture exploration methodology for the design of sensor nodes. At first, algorithms for multimodal and instantaneous detection of emotions were defined. Two algorithms of classification KNN then SVM, were implemented and made it possible to obtain a recognition rate of the emotions higher than 80%. To design such a battery-powered system, an analytical model for estimating the power consumption at high level of abstraction has been proposed and validated on a real platform. To consider user constraints, a connected object architecture design and simulation tool for health has been developed, allowing the performance of systems to be evaluated prior to their design. Then, we used this tool to propose a hardware/software architecture for the collection and the processing of the data satisfying the architectural and applicative constraints. With this architecture, experiments have been conducted for musical Mnemotherapy. EMOTICA is a complete system for emotions detection using physiological signals satisfying the constraints of architecture, application and user.
280

Workflowanalyse Neck Dissection - monozentrische Betrachtung des chirurgischen Vorgehens im Interoperateur-Vergleich

Krempel, Annika 11 August 2015 (has links)
Die Kopf-Hals-Region ist eine der anatomisch kompliziertesten Regionen und enthält et- wa 300 Lymphknoten, die innerhalb eines komplexen Lymphgefäßsystems miteinander in Verbindung stehen. Die meisten Plattenepithelkarzinome der oberen Luft- und Speise- wege sind potentiell heilbar, aber sie metastasieren früh in die regionalen zervikalen Lymphknoten. Der Status dieser Lymphknoten ist der signifikanteste prognostische Faktor in der Therapie der Kopf-Hals-Tumoren. Die Neck Dissection, englisch für „Halsausräu- mung“, wird auch im deutschsprachigen Raum so genannt und ist der Standard der chir- urgischen Behandlung. Die vorliegende monozentrische Studie untersucht erstmals mittels Workflowanalyse ei- ne Serie von Neck dissections (ND) im Interoperateur-Vergleich und zielt auf die quali- tätsrelevante Erfassung der Operationssystematik ab. Von Januar bis Dezember 2011 wurden an einer onkologisch ausgerichteten HNO-Univer- sitätsklinik 42 selektive NDs (SND) und modifiziert radikale NDs (MRND) bei 5 unter- schiedlichen Operateuren mit der Workflowaufnahmesoftware s.w.an-Editor systemati- siert kodiert und vergleichend ausgewertet. Die Operateure variierten in ihrer Operationserfahrung mit Neck dissections zwischen 1- 17 Jahren und führten im Untersuchungszeitraum 19-76 NDs durch. Die Gesamtpräpara- tionszeit (15min. (2-48)) korrelierte negativ mit der Anzahl der jährlich durchgeführten NDs (p<.033). Bei der Dauer der Entfernung der einzelnen Lymphknotenpakete (33min. (10-81)) ergab sich eine negative Korrelation mit der jeweiligen Erfahrung des Opera- teurs (p<.001). 63 Als bevorzugte Reihenfolge der entfernten Level zeigte sich die Chronologie: 3-2A-(2B)- 5-4-(1). Diese variierte trotz „Schule des Hauses“ signifikant. Bei SNDs ergab sich eine Korrelation (p<.038) zwischen Erfahrung und Befolgung dieser Reihenfolge. Die Summe der entfernten Lymphknoten im histopathologischen Präparat gesamt (17 (0- 29)) sowie pro Level (3,8 (0-11)) zeigte keinen signifikanten Unterschied in Abhängigkeit von Erfahrung, Anzahl der 2011 durchgeführten NDs, befolgter Chronologie und Dauer der Operation. Trotz signifikanter Unterschiede bei den Operateuren im operativen Vorgehen fanden sich keine signifikanten Unterschiede in Gesamtsumme der entnommenen Lymphknoten- zahl. Die Workflowanalyse hilft, die Operationssystematik zu erfassen und damit bei wechselnden Operateuren einen Standard zu definieren.:1.1. KOPF-HALS-TUMOREN 1.2. ÄTIOLOGIE UND RISIKOFAKTOREN 1.3. EPIDEMIOLOGIE 1.4. KLINIK 1.5. DIAGNOSTIK 1.6. HISTORISCHER ÜBERBLICK 1.6.1. ANFÄNGE DER CHIRURGIE 1.6.2. ENTWICKLUNG DER STRAHLENTHERAPIE 1.6.3. RADIKALE NECK DISSECTION 1.6.4. FUNKTIONELLE ODER MODIFIZIERT RADIKALE NECK DISSECTION 1.6.5. SELEKTIVE NECK DISSECTION 1.6.6. NOMENKLATUR DER LYMPHKNOTEN-LEVEL 1.6.7. NOMENKLATUR DER NECK DISSECTION 1.7. THERAPIE 1.7.1. STRAHLENTHERAPIE 1.7.2. NECK DISSECTION 1.7.3. CHEMOTHERAPIE 1.8. AKTUELLEENTWICKLUNGEN 1.8.1. ENTWICKLUNGEN IN DER DIAGNOSTIK 1.8.2. ENTWICKLUNGEN DES CHIRURGISCHEN VORGEHENS 1.9. KOMPLIKATIONEN 1.10. PROGNOSE 2. AUFGABENSTELLUNG 3. MATERIAL UND METHODEN 3.1. PATIENTEN 3.2. DATENERHEBUNG 3.3. EIN- UND AUSSCHLUSSKRITERIEN DER ERHOBENEN DATEN 3.4. STATISTISCHE METHODEN II 4. ERGEBNISSE 4.1. GESAMTKOLLEKTIV 4.1.1. PATIENTENGUT 4.1.2. EINTEILUNG DER OPERATION IN PHASEN 4.1.3. EINTEILUNG DER DATEN NACH KOMPLEXITÄT DER OPERATION 4.2. OPERATEURE IM VERGLEICH 4.2.1. ERFAHRUNG UND ROUTINE DER OPERATEURE 4.2.2. GESAMTDAUER DER OPERATION 4.2.3. ANZAHL DER DURCHGEFÜHRTEN ARBEITSSCHRITTE 4.2.4. KORRELATION ZWISCHEN ERFAHRUNG SOWIE ROUTINE DER OPERATEURE UND DAUER DER OPERATION 4.3. LYMPHKNOTEN IM FOKUS 4.3.1. CHRONOLOGIE DER LYMPHKNOTENENTNAHME 4.3.2. HISTOPATHOLOGIE 5. DISKUSSION 5.1. GESAMTKOLLEKTIV 5.1.1. PATIENTENGUT 5.1.2. EINTEILUNG DER OPERATION IN PHASEN 5.1.3. EINTEILUNG DER DATEN NACH KOMPLEXITÄT DER OPERATION 5.2. OPERATEURE IM VERGLEICH 5.2.1. ERFAHRUNG UND ROUTINE DER OPERATEURE 5.2.2. GESAMTDAUER DER OPERATION 5.2.3. ANZAHL DER DURCHGEFÜHRTEN ARBEITSSCHRITTE 5.2.4. KORRELATION ZWISCHEN ERFAHRUNG SOWIE ROUTINE DER OPERATEURE UND DAUER DER OPERATION 5.3. LYMPHKNOTEN IM FOKUS 5.3.1. CHRONOLOGIE DER LYMPHKNOTENENTNAHME 5.3.2. HISTOPATHOLOGIE 5.4. SCHLUSSFOLGERUNG 6. BIBLIOGRAFIE

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