Genetic polymorphisms modulate the folate metabolism of Brazilian individuals with Down syndrome

Individuals with Down syndrome (DS) carry three copies of the Cystathionine beta-synthase (C beta S) gene. The increase in the dosage of this gene results in an altered profile of metabolites involved in the folate pathway, including reduced homocysteine (Hcy), methionine, S-adenosylhomocysteine (SAH) and S-adenosylmethionine (SAM). Furthermore, previous studies in individuals with DS have shown that genetic variants in genes involved in the folate pathway influence the concentrations of this metabolism's products. The purpose of this study is to investigate whether polymorphisms in genes involved in folate metabolism affect the plasma concentrations of Hcy and methylmalonic acid (MMA) along with the concentration of serum folate in individuals with DS. Twelve genetic polymorphisms were investigated in 90 individuals with DS (median age 1.29 years, range 0.07-30.35 years; 49 male and 41 female). Genotyping for the polymorphisms was performed either by polymerase chain reaction (PCR) based techniques or by direct sequencing. Plasma concentrations of Hcy and MMA were measured by liquid chromatography-tandem mass spectrometry as previously described, and serum folate was quantified using a competitive immunoassay. Our results indicate that the MTHFR C677T, MTR A2756G, TC2 C776G and BHMT G742A polymorphisms along with MMA concentration are predictors of Hcy concentration. They also show that age and Hcy concentration are predictors of MMA concentration. These findings could help to understand how genetic variation impacts folate metabolism and what metabolic consequences these variants have in individuals with trisomy 21.

Classification of the severity of diabetic neuropathy: a new approach taking uncertainties into account using fuzzy logic

OBJECTIVE: This study proposes a new approach that considers uncertainty in predicting and quantifying the presence and severity of diabetic peripheral neuropathy. METHODS: A rule-based fuzzy expert system was designed by four experts in diabetic neuropathy. The model variables were used to classify neuropathy in diabetic patients, defining it as mild, moderate, or severe. System performance was evaluated by means of the Kappa agreement measure, comparing the results of the model with those generated by the experts in an assessment of 50 patients. Accuracy was evaluated by an ROC curve analysis obtained based on 50 other cases; the results of those clinical assessments were considered to be the gold standard. RESULTS: According to the Kappa analysis, the model was in moderate agreement with expert opinions. The ROC analysis (evaluation of accuracy) determined an area under the curve equal to 0.91, demonstrating very good consistency in classifying patients with diabetic neuropathy. CONCLUSION: The model efficiently classified diabetic patients with different degrees of neuropathy severity. In addition, the model provides a way to quantify diabetic neuropathy severity and allows a more accurate patient condition assessment.

Luminescent Systems for Genomics and Proteomics

The present PhD project was focused on the development of new tools and methods for luminescence-based techniques. In particular, the ultimate goal was to present substantial improvements to the currently available technologies for both research and diagnostic in the fields of biology, proteomics and genomics. Different aspects and problems were investigated, requiring different strategies and approaches. The whole work was thus divided into separate chapters, each based on the study of one specific aspect of luminescence: Chemiluminescence, Fluorescence and Electrochemiluminescence. CHAPTER 1, Chemiluminescence The work on luminol-enhancer solution lead to a new luminol solution formulation with 1 order of magnitude lower detection limit for HRP. This technology was patented with Cyanagen brand and is now sold worldwide for Western Blot and ELISA applications. CHAPTER 2, Fluorescescence The work on dyed-doped silica nanoparticles is marking a new milestone in the development of nanotechnologies for biological applications. While the project is still in progress, preliminary studies on model structures are leading to very promising results. The improved brightness of these nano-sized objects, their simple synthesis and handling, their low toxicity will soon turn them, we strongly believe, into a new generation of fluorescent labels for many applications. CHAPTER 3, Electrochemiluminescence The work on electrochemiluminescence produced interesting results that can potentially turn into great improvements from an analytical point of view. Ru(bpy)3 derivatives were employed both for on-chip microarray (Chapter 3.1) and for microscopic imaging applications (Chapter 3.2). The development of these new techniques is still under investigation, but the obtained results confirm the possibility to achieve the final goal. Furthermore the development of new ECL-active species (Chapter 3.3, 3.4, 3.5) and their use in these applications can significantly improve overall performances, thus helping to spread ECL as powerful analytical tool for routinary techniques. To conclude, the results obtained are of strong value to largely increase the sensitivity of luminescence techniques, thus fulfilling the expectation we had at the beginning of this research work.

Methodological improvement of 3D fluoroscopic analysis for the robust quantification of 3D kinematics of human joints

3D video-fluoroscopy is an accurate but cumbersome technique to estimate natural or prosthetic human joint kinematics. This dissertation proposes innovative methodologies to improve the 3D fluoroscopic analysis reliability and usability. Being based on direct radiographic imaging of the joint, and avoiding soft tissue artefact that limits the accuracy of skin marker based techniques, the fluoroscopic analysis has a potential accuracy of the order of mm/deg or better. It can provide fundamental informations for clinical and methodological applications, but, notwithstanding the number of methodological protocols proposed in the literature, time consuming user interaction is exploited to obtain consistent results. The user-dependency prevented a reliable quantification of the actual accuracy and precision of the methods, and, consequently, slowed down the translation to the clinical practice. The objective of the present work was to speed up this process introducing methodological improvements in the analysis. In the thesis, the fluoroscopic analysis was characterized in depth, in order to evaluate its pros and cons, and to provide reliable solutions to overcome its limitations. To this aim, an analytical approach was followed. The major sources of error were isolated with in-silico preliminary studies as: (a) geometric distortion and calibration errors, (b) 2D images and 3D models resolutions, (c) incorrect contour extraction, (d) bone model symmetries, (e) optimization algorithm limitations, (f) user errors. The effect of each criticality was quantified, and verified with an in-vivo preliminary study on the elbow joint. The dominant source of error was identified in the limited extent of the convergence domain for the local optimization algorithms, which forced the user to manually specify the starting pose for the estimating process. To solve this problem, two different approaches were followed: to increase the optimal pose convergence basin, the local approach used sequential alignments of the 6 degrees of freedom in order of sensitivity, or a geometrical feature-based estimation of the initial conditions for the optimization; the global approach used an unsupervised memetic algorithm to optimally explore the search domain. The performances of the technique were evaluated with a series of in-silico studies and validated in-vitro with a phantom based comparison with a radiostereometric gold-standard. The accuracy of the method is joint-dependent, and for the intact knee joint, the new unsupervised algorithm guaranteed a maximum error lower than 0.5 mm for in-plane translations, 10 mm for out-of-plane translation, and of 3 deg for rotations in a mono-planar setup; and lower than 0.5 mm for translations and 1 deg for rotations in a bi-planar setups. The bi-planar setup is best suited when accurate results are needed, such as for methodological research studies. The mono-planar analysis may be enough for clinical application when the analysis time and cost may be an issue. A further reduction of the user interaction was obtained for prosthetic joints kinematics. A mixed region-growing and level-set segmentation method was proposed and halved the analysis time, delegating the computational burden to the machine. In-silico and in-vivo studies demonstrated that the reliability of the new semiautomatic method was comparable to a user defined manual gold-standard. The improved fluoroscopic analysis was finally applied to a first in-vivo methodological study on the foot kinematics. Preliminary evaluations showed that the presented methodology represents a feasible gold-standard for the validation of skin marker based foot kinematics protocols.

Soil biogenic emissions of nitric oxide from arid and semi-arid ecosystems

The biogenic production of NO in the soil accounts for between 10% and 40% of the global total. A large degree of the uncertainty in the estimation of the biogenic emissions stems from a shortage of measurements in arid regions, which comprise 40% of the earth’s land surface area. This study examined the emission of NO from three ecosystems in southern Africa which cover an aridity gradient from semi-arid savannas in South Africa to the hyper-arid Namib Desert in Namibia. A laboratory method was used to determine the release of NO as a function of the soil moisture and the soil temperature. Various methods were used to up-scale the net potential NO emissions determined in the laboratory to the vegetation patch, landscape or regional level. The importance of landscape, vegetation and climatic characteristics is emphasized. The first study occurred in a semi-arid savanna region in South Africa, where soils were sampled from 4 landscape positions in the Kruger National Park. The maximum NO emission occurred at soil moisture contents of 10%-20% water filled pore space (WFPS). The highest net potential NO emissions came from the low lying landscape positions, which have the largest nitrogen (N) stocks and the largest input of N. Net potential NO fluxes obtained in the laboratory were converted in field fluxes for the period 2003-2005, for the four landscape positions, using soil moisture and temperature data obtained in situ at the Kruger National Park Flux Tower Site. The NO emissions ranged from 1.5-8.5 kg ha-1 a-1. The field fluxes were up-scaled to a regional basis using geographic information system (GIS) based techniques, this indicated that the highest NO emissions occurred from the Midslope positions due to their large geographical extent in the research area. Total emissions ranged from 20x103 kg in 2004 to 34x103 kg in 2003 for the 56000 ha Skukuza land type. The second study occurred in an arid savanna ecosystem in the Kalahari, Botswana. In this study I collected soils from four differing vegetation patch types including: Pan, Annual Grassland, Perennial Grassland and Bush Encroached patches. The maximum net potential NO fluxes ranged from 0.27 ng m-2 s-1 in the Pan patches to 2.95 ng m-2 s-1 in the Perennial Grassland patches. The net potential NO emissions were up-scaled for the year December 2005-November 2006. This was done using 1) the net potential NO emissions determined in the laboratory, 2) the vegetation patch distribution obtained from LANDSAT NDVI measurements 3) estimated soil moisture contents obtained from ENVISAT ASAR measurements and 4) soil surface temperature measurements using MODIS 8 day land surface temperature measurements. This up-scaling procedure gave NO fluxes which ranged from 1.8 g ha-1 month-1 in the winter months (June and July) to 323 g ha-1 month-1 in the summer months (January-March). Differences occurred between the vegetation patches where the highest NO fluxes occurred in the Perennial Grassland patches and the lowest in the Pan patches. Over the course of the year the mean up-scaled NO emission for the studied region was 0.54 kg ha-1 a-1 and accounts for a loss of approximately 7.4% of the estimated N input to the region. The third study occurred in the hyper-arid Namib Desert in Namibia. Soils were sampled from three ecosystems; Dunes, Gravel Plains and the Riparian zone of the Kuiseb River. The net potential NO flux measured in the laboratory was used to estimate the NO flux for the Namib Desert for 2006 using modelled soil moisture and temperature data from the European Centre for Medium Range Weather Forecasts (ECMWF) operational model on a 36km x 35km spatial resolution. The maximum net potential NO production occurred at low soil moisture contents (<10%WFPS) and the optimal temperature was 25°C in the Dune and Riparian ecosystems and 35°C in the Gravel Plain Ecosystems. The maximum net potential NO fluxes ranged from 3.0 ng m-2 s-1 in the Riparian ecosystem to 6.2 ng m-2 s-1 in the Gravel Plains ecosystem. Up-scaling the net potential NO flux gave NO fluxes of up to 0.062 kg ha-1 a-1 in the Dune ecosystem and 0.544 kg h-1 a-1 in the Gravel Plain ecosystem. From these studies it is shown that NO is emitted ubiquitously from terrestrial ecosystems, as such the NO emission potential from deserts and scrublands should be taken into account in the global NO models. The emission of NO is influenced by various factors such as landscape, vegetation and climate. This study looks at the potential emissions from certain arid and semi-arid environments in southern Africa and other parts of the world and discusses some of the important factors controlling the emission of NO from the soil.

I sistemi di raccomandazione in ambito e-learning

I sistemi di raccomandazione per come li conosciamo nascono alla fine del XX secolo, e si sono evoluti fino ai giorni nostri approcciandosi a numerosi campi, tra i quali analizzeremo l’ingegneria del software, la medicina, la gestione delle reti aziendali e infine, come argomento focale della tesi, l’e-Learning. Dopo una rapida panoramica sullo stato dell’arte dei sistemi di raccomandazione al giorno d’oggi, discorrendo velocemente tra metodi puri e metodi ibridi ottenuti come combinazione dei primi, analizzeremo varie applicazioni pratiche per dare un’idea al lettore di quanto possano essere vari i settori di utilizzo di questi software. Tratteremo nello specifico il funzionamento di varie tecniche per la raccomandazione in ambito e-Learning, analizzando tutte le problematiche che distinguono questo settore da tutti gli altri. Nello specifico, dedicheremo un’intera sezione alla descrizione della psicologia dello studente, e su come capire il suo profilo cognitivo aiuti a suggerire al meglio la giusta risorsa da apprendere nel modo più corretto. È doveroso, infine, parlare di privacy: come vedremo nel primo capitolo, i sistemi di raccomandazione utilizzano al massimo dati sensibili degli utenti al fine di fornire un suggerimento il più accurato possibile. Ma come possiamo tutelarli contro intrusioni e quindi contro violazioni della privacy? L’obiettivo di questa tesi è quindi quello di presentare al meglio lo stato attuale dei sistemi di raccomandazione in ambito e-Learning e non solo, in modo da costituire un riferimento chiaro, semplice ma completo per chiunque si volesse affacciare a questo straordinario ed affascinante mondo della raccomandazione on line.  

Terapie sistemiche dell'epatocarcinoma (HCC): dalla preclinica alla clinica

Introduzione Attualmente i principali punti critici del trattamento dell’HCC avanzato sono: 1) la mancanza di predittori di risposta alla terapia con sorafenib, 2) lo sviluppo resistenze al sorafenib, 3) la mancanza di terapie di seconda linea codificate. Scopo della tesi 1) ricerca di predittori clinico-laboratoristici di risposta al sorafenib in pazienti ambulatoriali con HCC; 2) valutazione dell’impatto della sospensione temporanea-definitiva del sorafenib in un modello murino di HCC mediante tecniche ecografiche; 3) valutazione dell’efficacia della capecitabina metronomica come seconda linea dell’HCC non responsivo a sorafenib. Risultati Studio-1: 94 pazienti con HCC trattato con sorafenib: a presenza di metastasi e PVT-neoplastica non sembra inficiare l’efficacia del sorafenib. AFP basale <19 ng/ml è risultata predittrice di maggiore sopravvivenza, mentre lo sviluppo di nausea di una peggiore sopravvivenza. Studio -2: 14 topi con xenografts di HCC: gruppo-1 trattato con placebo, gruppo-2 trattato con sorafenib con interruzione temporanea del farmaco e gruppo-3 trattato con sorafenib con sospensione definitiva del sorafenib. La CEUS targettata per il VEGFR2 ha mostrato al giorno 13 valori maggiori di dTE nel gruppo-3 confermato da un aumento del VEGFR2 al Western-Blot. I tumori del gruppo-2 dopo 2 giorni di ritrattamento, hanno mostrato un aumento dell’elasticità tissutale all’elastonografia. Studio-3:19 pazienti trattati con capecitabina metronomica dopo sorafenib. Il TTP è stato di 5 mesi (95% CI 0-10), la PFS di 3,6 mesi (95% CI 2,8-4,3) ed la OS di 6,3 mesi (95% CI 4-8,6). Conclusioni Lo sviluppo di nausea ed astenia ed AFP basale >19, sono risultati predittivi di una minore risposta al sorafenib. La sospensione temporanea del sorafenib in un modello murino di HCC non impedisce il ripristino della risposta tumorale, mentre una interruzione definitiva tende a stimolare un “effetto rebound” dell’angiogenesi. La capecitabina metronomica dopo sorafenib ha mostrato una discreta attività anti-neoplastica ed una sicurezza accettabile.

Software zur automatischen Tumordiagnose in der funktionalen MRT der weiblichen Brust

In den westlichen Industrieländern ist das Mammakarzinom der häufigste bösartige Tumor der Frau. Sein weltweiter Anteil an allen Krebserkrankungen der Frau beläuft sich auf etwa 21 %. Inzwischen ist jede neunte Frau bedroht, während ihres Lebens an Brustkrebs zu erkranken. Die alterstandardisierte Mortalitätrate liegt derzeit bei knapp 27 %.rnrnDas Mammakarzinom hat eine relative geringe Wachstumsrate. Die Existenz eines diagnostischen Verfahrens, mit dem alle Mammakarzinome unter 10 mm Durchmesser erkannt und entfernt werden, würden den Tod durch Brustkrebs praktisch beseitigen. Denn die 20-Jahres-Überlebungsrate bei Erkrankung durch initiale Karzinome der Größe 5 bis 10 mm liegt mit über 95 % sehr hoch.rnrnMit der Kontrastmittel gestützten Bildgebung durch die MRT steht eine relativ junge Untersuchungsmethode zur Verfügung, die sensitiv genug zur Erkennung von Karzinomen ab einer Größe von 3 mm Durchmesser ist. Die diagnostische Methodik ist jedoch komplex, fehleranfällig, erfordert eine lange Einarbeitungszeit und somit viel Erfahrung des Radiologen.rnrnEine Computer unterstützte Diagnosesoftware kann die Qualität einer solch komplexen Diagnose erhöhen oder zumindest den Prozess beschleunigen. Das Ziel dieser Arbeit ist die Entwicklung einer vollautomatischen Diagnose Software, die als Zweitmeinungssystem eingesetzt werden kann. Meines Wissens existiert eine solche komplette Software bis heute nicht.rnrnDie Software führt eine Kette von verschiedenen Bildverarbeitungsschritten aus, die dem Vorgehen des Radiologen nachgeahmt wurden. Als Ergebnis wird eine selbstständige Diagnose für jede gefundene Läsion erstellt: Zuerst eleminiert eine 3d Bildregistrierung Bewegungsartefakte als Vorverarbeitungsschritt, um die Bildqualität der nachfolgenden Verarbeitungsschritte zu verbessern. Jedes kontrastanreichernde Objekt wird durch eine regelbasierte Segmentierung mit adaptiven Schwellwerten detektiert. Durch die Berechnung kinetischer und morphologischer Merkmale werden die Eigenschaften der Kontrastmittelaufnahme, Form-, Rand- und Textureeigenschaften für jedes Objekt beschrieben. Abschließend werden basierend auf den erhobenen Featurevektor durch zwei trainierte neuronale Netze jedes Objekt in zusätzliche Funde oder in gut- oder bösartige Läsionen klassifiziert.rnrnDie Leistungsfähigkeit der Software wurde auf Bilddaten von 101 weiblichen Patientinnen getested, die 141 histologisch gesicherte Läsionen enthielten. Die Vorhersage der Gesundheit dieser Läsionen ergab eine Sensitivität von 88 % bei einer Spezifität von 72 %. Diese Werte sind den in der Literatur bekannten Vorhersagen von Expertenradiologen ähnlich. Die Vorhersagen enthielten durchschnittlich 2,5 zusätzliche bösartige Funde pro Patientin, die sich als falsch klassifizierte Artefakte herausstellten.rn

Speziation von Plutonium bei der Sorption und Diffusion in Opalinuston

Die vorliegende Arbeit wurde im Rahmen des BMWi-Verbundprojektes Wechselwirkung und Transport von Aktiniden im natürlichen Tongestein unter Berücksichtigung von Huminstoffen und Tonorganika – Wechselwirkung von Neptunium und Plutonium mit natürlichem Tongestein“ durchgeführt. Um die langfristige Sicherheit der nuklearen Endlager beurteilen zu können, muss eine mögliche Migration der radiotoxischen Abfälle in die Umwelt betrachtet werden. Wegen seiner langen Halbwertszeit (24000 a) leistet Pu-239 einen wesentlichen Beitrag zur Radiotoxizität abgebrannter Kernbrennstoffe in einem Endlager. Das redox-sensitive Pu tritt in Lösung unter umweltrelevanten Bedingungen in den Oxidationsstufen +III bis +VI auf und kann nebeneinander in bis zu vier Oxidationsstufen vorliegen. Tonsteinformationen werden als mögliches Wirtsgestein für Endlager hoch-radioaktiver Abfälle betrachtet. Deshalb sind ausführliche Informationen zur Mobilisierung und Immobilisierung des Pu durch/in das Grundwasser aus einem Endlager von besonderer Bedeutung. In dieser Arbeit wurden neue Erkenntnisse über die Wechselwirkung zwischen Pu und dem natürlichen Tongestein Opalinuston (OPA, Mont Terri, Schweiz) mit Hinblick auf die Endlagerung wärmeentwickelnder radioaktiver Abfälle in einem geologischen Tiefenlager gewonnen.rnDer Fokus der Arbeit lag dabei auf der Bestimmung der Speziation von Pu an der Mineraloberfläche nach Sorptions- und Diffusionsprozessen mittels verschiedener synchrotronbasierter Methoden (µ-XRF, µ-XANES/EXAFS, µ-XRD, XANES/EXAFS). rnDie Wechselwirkung zwischen Pu und OPA wurde zunächst in Batch- und Diffusionsexperimenten in Abhängigkeit verschiedener experimenteller Parameter (u.a. pH, Pu-Oxidationsstufe) untersucht. In Sorptionsexperimenten konnte gezeigt werden, dass einige Parameter (z.B. Temperatur, Huminsäure) einen deutlichen Einfluss auf die Sorption von Pu haben.rnDie Speziationsuntersuchungen wurden zum einen an Pulverproben aus Batchexperimenten und zum anderen an OPA-Dünnschliffen bzw. Diffusionsproben in Abhängigkeit verschiedener experimenteller Parameter durchgeführt. Die EXAFS-Messungen an der Pu LIII-Kante der Pulverproben ergaben, dass eine innersphäriche Sorption von Pu(IV) an Tongestein unabhängig von dem Ausgangsoxidationszustand des Plutoniums in Lösung stattgefunden hat. Durch die Kombination der ortsaufgelösten Methoden wurde erstmalig mittels μ-XRF die Verteilung von Pu und anderen in OPA enthaltenen Elementen bestimmt. µ-XANES-Spektren an Pu-Anreicherungen auf OPA-Dünnschliffen und in Diffusionsproben bestätigen, dass das weniger mobile Pu(IV) die dominierende Spezies nach den Sorptions- und Diffusionsprozessen ist. Darüber hinaus wurde zum ersten Mal ein Diffusionsprofil von Pu in OPA mittels µ-XRF gemessen. Die Speziationsuntersuchungen mittels μ-XANES zeigten, dass das eingesetzte Pu(V) entlang seines Diffusionspfades zunehmend zu Pu(IV) reduziert wird. Mit µ-XRD wurde Illit als dominierende Umgebung, in der Pu angereichert wurde, identifiziert und Siderit als eine redoxaktive Phase auftreten kann. Die Ergebnisse dieser Arbeit zeigen, dass die Sicherheit von OPA als Wirtsgestein eines Endlagers hoch-radioaktiver Abfälle positiv zu bewerten ist. rn

Named Entity Extraction: la piattaforma Gate/Annie

In questo lavoro si introducono i concetti di base di Natural Language Processing, soffermandosi su Information Extraction e analizzandone gli ambiti applicativi, le attività principali e la differenza rispetto a Information Retrieval. Successivamente si analizza il processo di Named Entity Recognition, focalizzando l’attenzione sulle principali problematiche di annotazione di testi e sui metodi per la valutazione della qualità dell’estrazione di entità. Infine si fornisce una panoramica della piattaforma software open-source di language processing GATE/ANNIE, descrivendone l’architettura e i suoi componenti principali, con approfondimenti sugli strumenti che GATE offre per l'approccio rule-based a Named Entity Recognition.

Imagery of a moving object: the role of occipital cortex and human MT/V5+

Visual imagery – similar to visual perception – activates feature-specific and category-specific visual areas. This is frequently observed in experiments where the instruction is to imagine stimuli that have been shown immediately before the imagery task. Hence, feature-specific activation could be related to the short-term memory retrieval of previously presented sensory information. Here, we investigated mental imagery of stimuli that subjects had not seen before, eliminating the effects of short-term memory. We recorded brain activation using fMRI while subjects performed a behaviourally controlled guided imagery task in predefined retinotopic coordinates to optimize sensitivity in early visual areas. Whole brain analyses revealed activation in a parieto-frontal network and lateral–occipital cortex. Region of interest (ROI) based analyses showed activation in left hMT/V5+. Granger causality mapping taking left hMT/V5+ as source revealed an imagery-specific directed influence from the left inferior parietal lobule (IPL). Interestingly, we observed a negative BOLD response in V1–3 during imagery, modulated by the retinotopic location of the imagined motion trace. Our results indicate that rule-based motion imagery can activate higher-order visual areas involved in motion perception, with a role for top-down directed influences originating in IPL. Lower-order visual areas (V1, V2 and V3) were down-regulated during this type of imagery, possibly reflecting inhibition to avoid visual input from interfering with the imagery construction. This suggests that the activation in early visual areas observed in previous studies might be related to short- or long-term memory retrieval of specific sensory experiences.

Coupling biomechanics to a cellular level model: An approach to patient-specific image driven multi-scale and multi-physics tumor simulation

Modeling of tumor growth has been performed according to various approaches addressing different biocomplexity levels and spatiotemporal scales. Mathematical treatments range from partial differential equation based diffusion models to rule-based cellular level simulators, aiming at both improving our quantitative understanding of the underlying biological processes and, in the mid- and long term, constructing reliable multi-scale predictive platforms to support patient-individualized treatment planning and optimization. The aim of this paper is to establish a multi-scale and multi-physics approach to tumor modeling taking into account both the cellular and the macroscopic mechanical level. Therefore, an already developed biomodel of clinical tumor growth and response to treatment is self-consistently coupled with a biomechanical model. Results are presented for the free growth case of the imageable component of an initially point-like glioblastoma multiforme tumor. The composite model leads to significant tumor shape corrections that are achieved through the utilization of environmental pressure information and the application of biomechanical principles. Using the ratio of smallest to largest moment of inertia of the tumor material to quantify the effect of our coupled approach, we have found a tumor shape correction of 20\% by coupling biomechanics to the cellular simulator as compared to a cellular simulation without preferred growth directions. We conclude that the integration of the two models provides additional morphological insight into realistic tumor growth behavior. Therefore, it might be used for the development of an advanced oncosimulator focusing on tumor types for which morphology plays an important role in surgical and/or radio-therapeutic treatment planning.

Placement of coiled catheters into the paravertebral space

There are conflicting results with regard to the use of catheter-based techniques for continuous paravertebral block. Local anaesthetic spread within the paravertebral space is limited and the clinical effect is often variable. Discrepancies between needle tip position and final catheter position can also be problematic. The aim of this proof-of-concept study was to assess the reliability of placing a newly developed coiled catheter in human cadavers. Sixty Tuohy needles and coiled catheters were placed under ultrasound guidance, three on each side of the thoracic vertebral column in 10 human cadavers. Computed tomography was used to assess needle tip and catheter tip locations. No catheter was misplaced into the epidural, pleural or prevertebral spaces. The mean (SD) distance between catheter tips and needle tips was 8.2 (4.9) mm. The median (IQR [range]) caudo-cephalad spread of contrast dye injectate through a subset of 20 catheters was 4 (4-5[3-8]) thoracic segments. All catheters were removed without incident. Precise paravertebral catheter placement can be achieved using ultrasound-guided placement of a coiled catheter.

A new system for computer-aided preoperative planning and intraoperative navigation during corrective jaw surgery

A new system for computer-aided corrective surgery of the jaws has been developed and introduced clinically. It combines three-dimensional (3-D) surgical planning with conventional dental occlusion planning. The developed software allows simulating the surgical correction on virtual 3-D models of the facial skeleton generated from computed tomography (CT) scans. Surgery planning and simulation include dynamic cephalometry, semi-automatic mirroring, interactive cutting of bone and segment repositioning. By coupling the software with a tracking system and with the help of a special registration procedure, we are able to acquire dental occlusion plans from plaster model mounts. Upon completion of the surgical plan, the setup is used to manufacture positioning splints for intraoperative guidance. The system provides further intraoperative assistance with the help of a display showing jaw positions and 3-D positioning guides updated in real time during the surgical procedure. The proposed approach offers the advantages of 3-D visualization and tracking technology without sacrificing long-proven cast-based techniques for dental occlusion evaluation. The system has been applied on one patient. Throughout this procedure, we have experienced improved assessment of pathology, increased precision, and augmented control.

Space trajectories optimization using variable-chromosome-length genetic algorithms

The problem of optimal design of a multi-gravity-assist space trajectories, with free number of deep space maneuvers (MGADSM) poses multi-modal cost functions. In the general form of the problem, the number of design variables is solution dependent. To handle global optimization problems where the number of design variables varies from one solution to another, two novel genetic-based techniques are introduced: hidden genes genetic algorithm (HGGA) and dynamic-size multiple population genetic algorithm (DSMPGA). In HGGA, a fixed length for the design variables is assigned for all solutions. Independent variables of each solution are divided into effective and ineffective (hidden) genes. Hidden genes are excluded in cost function evaluations. Full-length solutions undergo standard genetic operations. In DSMPGA, sub-populations of fixed size design spaces are randomly initialized. Standard genetic operations are carried out for a stage of generations. A new population is then created by reproduction from all members based on their relative fitness. The resulting sub-populations have different sizes from their initial sizes. The process repeats, leading to increasing the size of sub-populations of more fit solutions. Both techniques are applied to several MGADSM problems. They have the capability to determine the number of swing-bys, the planets to swing by, launch and arrival dates, and the number of deep space maneuvers as well as their locations, magnitudes, and directions in an optimal sense. The results show that solutions obtained using the developed tools match known solutions for complex case studies. The HGGA is also used to obtain the asteroids sequence and the mission structure in the global trajectory optimization competition (GTOC) problem. As an application of GA optimization to Earth orbits, the problem of visiting a set of ground sites within a constrained time frame is solved. The J2 perturbation and zonal coverage are considered to design repeated Sun-synchronous orbits. Finally, a new set of orbits, the repeated shadow track orbits (RSTO), is introduced. The orbit parameters are optimized such that the shadow of a spacecraft on the Earth visits the same locations periodically every desired number of days.