Development of Clinical Decision Support Systems based on Mathematical Models of Physiological Systems

In the last years of research, I focused my studies on different physiological problems. Together with my supervisors, I developed/improved different mathematical models in order to create valid tools useful for a better understanding of important clinical issues. The aim of all this work is to develop tools for learning and understanding cardiac and cerebrovascular physiology as well as pathology, generating research questions and developing clinical decision support systems useful for intensive care unit patients. I. ICP-model Designed for Medical Education We developed a comprehensive cerebral blood flow and intracranial pressure model to simulate and study the complex interactions in cerebrovascular dynamics caused by multiple simultaneous alterations, including normal and abnormal functional states of auto-regulation of the brain. Individual published equations (derived from prior animal and human studies) were implemented into a comprehensive simulation program. Included in the normal physiological modelling was: intracranial pressure, cerebral blood flow, blood pressure, and carbon dioxide (CO2) partial pressure. We also added external and pathological perturbations, such as head up position and intracranial haemorrhage. The model performed clinically realistically given inputs of published traumatized patients, and cases encountered by clinicians. The pulsatile nature of the output graphics was easy for clinicians to interpret. The manoeuvres simulated include changes of basic physiological inputs (e.g. blood pressure, central venous pressure, CO2 tension, head up position, and respiratory effects on vascular pressures) as well as pathological inputs (e.g. acute intracranial bleeding, and obstruction of cerebrospinal outflow). Based on the results, we believe the model would be useful to teach complex relationships of brain haemodynamics and study clinical research questions such as the optimal head-up position, the effects of intracranial haemorrhage on cerebral haemodynamics, as well as the best CO2 concentration to reach the optimal compromise between intracranial pressure and perfusion. We believe this model would be useful for both beginners and advanced learners. It could be used by practicing clinicians to model individual patients (entering the effects of needed clinical manipulations, and then running the model to test for optimal combinations of therapeutic manoeuvres). II. A Heterogeneous Cerebrovascular Mathematical Model Cerebrovascular pathologies are extremely complex, due to the multitude of factors acting simultaneously on cerebral haemodynamics. In this work, the mathematical model of cerebral haemodynamics and intracranial pressure dynamics, described in the point I, is extended to account for heterogeneity in cerebral blood flow. The model includes the Circle of Willis, six regional districts independently regulated by autoregulation and CO2 reactivity, distal cortical anastomoses, venous circulation, the cerebrospinal fluid circulation, and the intracranial pressure-volume relationship. Results agree with data in the literature and highlight the existence of a monotonic relationship between transient hyperemic response and the autoregulation gain. During unilateral internal carotid artery stenosis, local blood flow regulation is progressively lost in the ipsilateral territory with the presence of a steal phenomenon, while the anterior communicating artery plays the major role to redistribute the available blood flow. Conversely, distal collateral circulation plays a major role during unilateral occlusion of the middle cerebral artery. In conclusion, the model is able to reproduce several different pathological conditions characterized by heterogeneity in cerebrovascular haemodynamics and can not only explain generalized results in terms of physiological mechanisms involved, but also, by individualizing parameters, may represent a valuable tool to help with difficult clinical decisions. III. Effect of Cushing Response on Systemic Arterial Pressure. During cerebral hypoxic conditions, the sympathetic system causes an increase in arterial pressure (Cushing response), creating a link between the cerebral and the systemic circulation. This work investigates the complex relationships among cerebrovascular dynamics, intracranial pressure, Cushing response, and short-term systemic regulation, during plateau waves, by means of an original mathematical model. The model incorporates the pulsating heart, the pulmonary circulation and the systemic circulation, with an accurate description of the cerebral circulation and the intracranial pressure dynamics (same model as in the first paragraph). Various regulatory mechanisms are included: cerebral autoregulation, local blood flow control by oxygen (O2) and/or CO2 changes, sympathetic and vagal regulation of cardiovascular parameters by several reflex mechanisms (chemoreceptors, lung-stretch receptors, baroreceptors). The Cushing response has been described assuming a dramatic increase in sympathetic activity to vessels during a fall in brain O2 delivery. With this assumption, the model is able to simulate the cardiovascular effects experimentally observed when intracranial pressure is artificially elevated and maintained at constant level (arterial pressure increase and bradicardia). According to the model, these effects arise from the interaction between the Cushing response and the baroreflex response (secondary to arterial pressure increase). Then, patients with severe head injury have been simulated by reducing intracranial compliance and cerebrospinal fluid reabsorption. With these changes, oscillations with plateau waves developed. In these conditions, model results indicate that the Cushing response may have both positive effects, reducing the duration of the plateau phase via an increase in cerebral perfusion pressure, and negative effects, increasing the intracranial pressure plateau level, with a risk of greater compression of the cerebral vessels. This model may be of value to assist clinicians in finding the balance between clinical benefits of the Cushing response and its shortcomings. IV. Comprehensive Cardiopulmonary Simulation Model for the Analysis of Hypercapnic Respiratory Failure We developed a new comprehensive cardiopulmonary model that takes into account the mutual interactions between the cardiovascular and the respiratory systems along with their short-term regulatory mechanisms. The model includes the heart, systemic and pulmonary circulations, lung mechanics, gas exchange and transport equations, and cardio-ventilatory control. Results show good agreement with published patient data in case of normoxic and hyperoxic hypercapnia simulations. In particular, simulations predict a moderate increase in mean systemic arterial pressure and heart rate, with almost no change in cardiac output, paralleled by a relevant increase in minute ventilation, tidal volume and respiratory rate. The model can represent a valid tool for clinical practice and medical research, providing an alternative way to experience-based clinical decisions. In conclusion, models are not only capable of summarizing current knowledge, but also identifying missing knowledge. In the former case they can serve as training aids for teaching the operation of complex systems, especially if the model can be used to demonstrate the outcome of experiments. In the latter case they generate experiments to be performed to gather the missing data.

Measurement of top quark pairs production cross-section in the semi-leptonic channel with the ATLAS experiment

This thesis is about three major aspects of the identification of top quarks. First comes the understanding of their production mechanism, their decay channels and how to translate theoretical formulae into programs that can simulate such physical processes using Monte Carlo techniques. In particular, the author has been involved in the introduction of the POWHEG generator in the framework of the ATLAS experiment. POWHEG is now fully used as the benchmark program for the simulation of ttbar pairs production and decay, along with MC@NLO and AcerMC: this will be shown in chapter one. The second chapter illustrates the ATLAS detectors and its sub-units, such as calorimeters and muon chambers. It is very important to evaluate their efficiency in order to fully understand what happens during the passage of radiation through the detector and to use this knowledge in the calculation of final quantities such as the ttbar production cross section. The last part of this thesis concerns the evaluation of this quantity deploying the so-called "golden channel" of ttbar decays, yielding one energetic charged lepton, four particle jets and a relevant quantity of missing transverse energy due to the neutrino. The most important systematic errors arising from the various part of the calculation are studied in detail. Jet energy scale, trigger efficiency, Monte Carlo models, reconstruction algorithms and luminosity measurement are examples of what can contribute to the uncertainty about the cross-section.

Suche nach einem leichten Higgs-Boson im Kanal WH ev e bb in pp-Kollisionen bei s=1.96 TeV am DO-Detektor des Tevatron

Eine wichtige Komponente des Standardmodells der Teilchenphysik bildet der Higgs-Mechanismus, der benötigt wird um den vom Standardmodell beschriebenen Teilchen Masse zu verleihen. Dieser Mechanismus beinhaltet jedoch ein weiteres schweres Elementarteilchen das bislang noch nich beobachtet werden konnte. Die Suche nach diesem Teilchen ist eines Hauptziele der derzeitigen Forschung an Teilchenbeschleunigern. Diese Arbeit untersucht die vom D0-Detektor am Tevatron des Fermi National Accelerator Laboratory (FNAL) aufgezeichneten Daten von ppbar-Kollisionen bei einer Schwerpunktsenergie von sqrt{s}=1.96 TeV, um im Kanal WH -> enu bb nach einem leichten Higgs-Boson zu suchen. Darüber hinaus wird der Produktionswirkungsquerschnitt der Wbb-Produktion ermittelt. Für die Analyse stand eine integrierte Luminosität von L=255pb^{-1} zur Verfügung. Zur Selektion dieser Prozesse, werden Ereignisse ausgewählt, die Elektronen und fehlenden Transversalimpuls enthalten, sowie mindestens zwei Jets, die sich als b-Jets identifizieren lassen. Um eine effiziente Selektion zu erhalten, wurden Schnitte auf verschiedene Kenngrößen entwickelt, getestet und optimiert. Aus den selektierten Ereignissen wird der Wbb-Wirkungsquerschnitt ermittelt, der für Ereignisse angegeben wird, in denen die b-Quarks p_T>8 GeV und |eta|<3 erfüllen. Der unter Berücksichtigung des Verzweigungsverhältnisses BR(W->enu)=0.108 errechnete Wert ist sigma(Wbb)=21.8 pb (+15.5; -20.0 pb(sys+stat)). Wegen der geringen Signifikanz der Messung von etwa 1.2sigma wurden die Ereigniszahlen auch zur Berechnung einer oberen Grenze auf den Wirkungsquerschnitt verwendet, die sich bei einem Konfidenzniveau von 95% zu sigma^95(Wbb)=60.9pb ergibt. Ebenso wurden Grenzen auf den WH-Produktionswirkungsquerschnitt ermittelt. Dafür wurde die statistische Methode von Feldman und Cousins angewandt, nachdem sie nach den Vorschlägen von Conrad et al. erweitert worden war, um systematische Unsicherheiten zu berücksichtigen. Für ein Standardmodell Higgs-Boson der Masse 115 GeV kann eine obere Grenze auf den Produktionswirkungsquerschnitt von sigma^{95} (WH)=12.2pb angegeben werden. Für höhere Massen bis 135 GeV werden ähnliche Grenzen ermittelt.

Measurement of the differential cross section of tt pairs in pp collision at sqrt(s) = 7TeV with the ATLAS detector at the LHC

In this thesis three measurements of top-antitop differential cross section at an energy in the center of mass of 7 TeV will be shown, as a function of the transverse momentum, the mass and the rapidity of the top-antitop system. The analysis has been carried over a data sample of about 5/fb recorded with the ATLAS detector. The events have been selected with a cut based approach in the "one lepton plus jets" channel, where the lepton can be either an electron or a muon. The most relevant backgrounds (multi-jet QCD and W+jets) have been extracted using data driven methods; the others (Z+ jets, diboson and single top) have been simulated with Monte Carlo techniques. The final, background-subtracted, distributions have been corrected, using unfolding methods, for the detector and selection effects. At the end, the results have been compared with the theoretical predictions. The measurements are dominated by the systematic uncertainties and show no relevant deviation from the Standard Model predictions.

Resolved stellar populations in milky way and andromeda's new satellites

This thesis concerns the study of the variable stars and resolved stellar populations in four recently discovered dSphs, namely, Hercules and Ursa Major I (UMa I), which are UFD satellites of the MW; Andromeda XIX (And XIX) and Andromeda XXI (And XXI), which are satellites of M31. The main aim is to obtain detailed informations on the properties (age, metallicity, distance, and Oosterhoff type) of the stellar populations in these galaxies, to compare them with those of other satellites around the MW and M31, both ''classical'' dSphs and UFDs. The observables used to achieve these goals are the pulsating variables, especially the RR Lyrae stars, and the color magnitude diagram (CMD) of the resolved stellar populations. In particular, for UMa I, we combined B, V time-series observations from four different ground-based telescopes (Cassini, TLS, TT1 and Subaru) and for Hercules, we used archival data acquired with the Advanced Camera for Surveys (ACS) on board the HST. We used, instead B and V times-series photometry obtained with the Large Binocular Telescope (LBT) for And XIX and And XXI .

Measurements of ttbar Differential Cross Section at the ATLAS Experiment in pp Collisions at sqrt(s)=7TeV and sqrt(s)=8TeV

This PhD thesis presents two measurements of differential production cross section of top and anti-top pairs tt ̅ decaying in a lepton+jets final state. The normalize cross section is measured as a function of the top transverse momentum and the tt ̅ mass, transverse momentum and rapidity using the full 2011 proton-proton (pp) ATLAS data taking at a center of mass energy of √s=7 TeV and corresponding to an integrated luminosity of L=4.6 〖fb〗^(-1). The cross section is also measured at the particle level as a function of the hadronic top transverse momentum for highly energetic events using the full 2012 data taking at √s=8 TeV and with L=20 〖fb〗^(-1). The measured spectra are fully corrected for detector efficiency and resolution effects and are compared to several theoretical predictions showing a quite good agreement, depending on different spectra.

Factorization and non-local 1/m b corrections in the decay B X s gamma

In this thesis, a systematic analysis of the bar B to X_sgamma photon spectrum in the endpoint region is presented. The endpoint region refers to a kinematic configuration of the final state, in which the photon has a large energy m_b-2E_gamma = O(Lambda_QCD), while the jet has a large energy but small invariant mass. Using methods of soft-collinear effective theory and heavy-quark effective theory, it is shown that the spectrum can be factorized into hard, jet, and soft functions, each encoding the dynamics at a certain scale. The relevant scales in the endpoint region are the heavy-quark mass m_b, the hadronic energy scale Lambda_QCD and an intermediate scale sqrt{Lambda_QCD m_b} associated with the invariant mass of the jet. It is found that the factorization formula contains two different types of contributions, distinguishable by the space-time structure of the underlying diagrams. On the one hand, there are the direct photon contributions which correspond to diagrams with the photon emitted directly from the weak vertex. The resolved photon contributions on the other hand arise at O(1/m_b) whenever the photon couples to light partons. In this work, these contributions will be explicitly defined in terms of convolutions of jet functions with subleading shape functions. While the direct photon contributions can be expressed in terms of a local operator product expansion, when the photon spectrum is integrated over a range larger than the endpoint region, the resolved photon contributions always remain non-local. Thus, they are responsible for a non-perturbative uncertainty on the partonic predictions. In this thesis, the effect of these uncertainties is estimated in two different phenomenological contexts. First, the hadronic uncertainties in the bar B to X_sgamma branching fraction, defined with a cut E_gamma > 1.6 GeV are discussed. It is found, that the resolved photon contributions give rise to an irreducible theory uncertainty of approximately 5 %. As a second application of the formalism, the influence of the long-distance effects on the direct CP asymmetry will be considered. It will be shown that these effects are dominant in the Standard Model and that a range of -0.6 < A_CP^SM < 2.8 % is possible for the asymmetry, if resolved photon contributions are taken into account.

Efficient calculation of gluon amplitudes with n legs and an implementation of parton showers using the dipole formalism

The conventional way to calculate hard scattering processes in perturbation theory using Feynman diagrams is not efficient enough to calculate all necessary processes - for example for the Large Hadron Collider - to a sufficient precision. Two alternatives to order-by-order calculations are studied in this thesis.rnrnIn the first part we compare the numerical implementations of four different recursive methods for the efficient computation of Born gluon amplitudes: Berends-Giele recurrence relations and recursive calculations with scalar diagrams, with maximal helicity violating vertices and with shifted momenta. From the four methods considered, the Berends-Giele method performs best, if the number of external partons is eight or bigger. However, for less than eight external partons, the recursion relation with shifted momenta offers the best performance. When investigating the numerical stability and accuracy, we found that all methods give satisfactory results.rnrnIn the second part of this thesis we present an implementation of a parton shower algorithm based on the dipole formalism. The formalism treats initial- and final-state partons on the same footing. The shower algorithm can be used for hadron colliders and electron-positron colliders. Also massive partons in the final state were included in the shower algorithm. Finally, we studied numerical results for an electron-positron collider, the Tevatron and the Large Hadron Collider.

Tracking, b-tagging and measurement of the b-jet production cross section with the ATLAS detector

The Standard Model of elementary particle physics was developed to describe the fundamental particles which constitute matter and the interactions between them. The Large Hadron Collider (LHC) at CERN in Geneva was built to solve some of the remaining open questions in the Standard Model and to explore physics beyond it, by colliding two proton beams at world-record centre-of-mass energies. The ATLAS experiment is designed to reconstruct particles and their decay products originating from these collisions. The precise reconstruction of particle trajectories plays an important role in the identification of particle jets which originate from bottom quarks (b-tagging). This thesis describes the step-wise commissioning of the ATLAS track reconstruction and b-tagging software and one of the first measurements of the b-jet production cross section in pp collisions at sqrt(s)=7 TeV with the ATLAS detector. The performance of the track reconstruction software was studied in great detail, first using data from cosmic ray showers and then collisions at sqrt(s)=900 GeV and 7 TeV. The good understanding of the track reconstruction software allowed a very early deployment of the b-tagging algorithms. First studies of these algorithms and the measurement of the b-tagging efficiency in the data are presented. They agree well with predictions from Monte Carlo simulations. The b-jet production cross section was measured with the 2010 dataset recorded by the ATLAS detector, employing muons in jets to estimate the fraction of b-jets. The measurement is in good agreement with the Standard Model predictions.

Measurement of the inclusive jet cross section in proton-proton collisions at root out s = 7 TeV with the ATLAS detector

The dominant process in hard proton-proton collisions is the production of hadronic jets.rnThese sprays of particles are produced by colored partons, which are struck out of their confinement within the proton.rnPrevious measurements of inclusive jet cross sections have provided valuable information for the determination of parton density functions and allow for stringent tests of perturbative QCD at the highest accessible energies.rnrnThis thesis will present a measurement of inclusive jet cross sections in proton-proton collisions using the ATLAS detector at the LHC at a center-of-mass energy of 7 TeV.rnJets are identified using the anti-kt algorithm and jet radii of R=0.6 and R=0.4.rnThey are calibrated using a dedicated pT and eta dependent jet calibration scheme.rnThe cross sections are measured for 40 GeV < pT <= 1 TeV and |y| < 2.8 in four bins of absolute rapidity, using data recorded in 2010 corresponding to an integrated luminosity of 3 pb^-1.rnThe data is fully corrected for detector effects and compared to theoretical predictions calculated at next-to-leading order including non-perturbative effects.rnThe theoretical predictions are found to agree with data within the experimental and theoretic uncertainties.rnrnThe ratio of cross sections for R=0.4 and R=0.6 is measured, exploiting the significant correlations of the systematic uncertainties, and is compared to recently developed theoretical predictions.rnThe underlying event can be characterized by the amount of transverse momentum per unit rapidity and azimuth, called rhoue.rnUsing analytical approaches to the calculation of non-perturbative corrections to jets, rhoue at the LHC is estimated using the ratio measurement.rnA feasibility study of a combined measurement of rhoue and the average strong coupling in the non-perturbative regime alpha_0 is presented and proposals for future jet measurements at the LHC are made.

Supersymmetry searches in the single lepton final state with the ATLAS detector

This thesis presents an analysis for the search of Supersymmetry with the ATLAS detector at the LHC. The final state with one lepton, several coloured particles and large missing transverse energy was chosen. Particular emphasis was placed on the optimization of the requirements for lepton identification. This optimization showed to be particularly useful when combining with multi-lepton selections. The systematic error associated with the higher order QCD diagrams in Monte Carlo production is given particular focus. Methods to verify and correct the energy measurement of hadronic showers are developed. Methods for the identification and removal of mismeasurements caused by the detector are found in the single muon and four jet environment are applied. A new detector simulation system is shown to provide good prospects for future fast Monte Carlo production. The analysis was performed for $35pb^{-1}$ and no significant deviation from the Standard Model is seen. Exclusion limits subchannel for minimal Supergravity. Previous limits set by Tevatron and LEP are extended.

Modelling, diagnostics and experimental analysis of plasma assisted processes for material treatment

This work presents results from experimental investigations of several different atmospheric pressure plasmas applications, such as Metal Inert Gas (MIG) welding and Plasma Arc Cutting (PAC) and Welding (PAW) sources, as well as Inductively Coupled Plasma (ICP) torches. The main diagnostic tool that has been used is High Speed Imaging (HSI), often assisted by Schlieren imaging to analyse non-visible phenomena. Furthermore, starting from thermo-fluid-dynamic models developed by the University of Bologna group, such plasma processes have been studied also with new advanced models, focusing for instance on the interaction between a melting metal wire and a plasma, or considering non-equilibrium phenomena for diagnostics of plasma arcs. Additionally, the experimental diagnostic tools that have been developed for industrial thermal plasmas have been used also for the characterization of innovative low temperature atmospheric pressure non equilibrium plasmas, such as dielectric barrier discharges (DBD) and Plasma Jets. These sources are controlled by few kV voltage pulses with pulse rise time of few nanoseconds to avoid the formation of a plasma arc, with interesting applications in surface functionalization of thermosensitive materials. In order to investigate also bio-medical applications of thermal plasma, a self-developed quenching device has been connected to an ICP torch. Such device has allowed inactivation of several kinds of bacteria spread on petri dishes, by keeping the substrate temperature lower than 40 degrees, which is a strict requirement in order to allow the treatment of living tissues.

Supersymmetry searches in dilepton final states with the ATLAS experiment

One of the main goals of the ATLAS experiment at the Large Hadron Collider (LHC) at CERN in Geneva is the search for new physics beyond the Standard Model. In 2011, proton-proton collisions were performed at the LHC at a center of mass energy of 7 TeV and an integrated luminosity of 4.7 fb^{-1} was recorded. This dataset can be tested for one of the most promising theories beyond limits achieved thus far: supersymmetry. Final states in supersymmetry events at the LHC contain highly energetic jets and sizeable missing transverse energy. The additional requirement of events with highly energetic leptons simplifies the control of the backgrounds. This work presents results of a search for supersymmetry in the inclusive dilepton channel. Special emphasis is put on the search within the Gauge-Mediated Symmetry Breaking (GMSB) scenario in which the supersymmetry breaking is mediated via gauge fields. Statistically independent Control Regionsrnfor the dominant Standard Model backgrounds as well as Signal Regions for a discovery of a possible supersymmetry signal are defined and optimized. A simultaneous fit of the background normalizations in the Control Regions via the profile likelihood method allows for a precise prediction of the backgrounds in the Signal Regions and thus increases the sensitivity to several supersymmetry models. Systematic uncertainties on the background prediction are constrained via the jet multiplicity distribution in the Control Regions driven by data. The observed data are consistent with the Standard Model expectation. New limits within the GMSB and the minimal Supergravity (mSUGRA) scenario as well as for several simplified supersymmetry models are set or extended.

Measurement of the top quark mass in multijet events with the CMS experiment at LHC

La massa del quark top è qui misurata per mezzo dei dati raccolti dall’esperimento CMS in collisioni protone-protone ad LHC, con energia nel centro di massa pari ad 8 TeV. Il campione di dati raccolto corrisponde ad una luminosità integrata pari a 18.2 /fb. La misura è effettuata su eventi con un numero di jet almeno pari a 6, di cui almeno due b-taggati (ovvero identificati come prodotto dell’adronizzazione di due quark bottom). Il valore di massa trovato è di (173.95 +- 0.43 (stat)) GeV/c2, in accordo con la media mondiale. The top quark mass is here measured by using the data that have been collected with the CMS experiment in proton-proton collisions at the LHC, at a center-of-mass energy of 8 TeV. The dataset which was used, corresponds to an integrated luminosiy of 18.2 /fb. The mass measurement is carried out by using events characterized by six or more jets, two of which identified as being originated by the hadronization of bottom quarks. The result of the measurement of the top quark mass performed here is: (173.95 +- 0.43 (stat)) GeV/c2, in accordance with the recently published world average.

Stacked searches for high-energy neutrinos from blazars with IceCube

In the year 2013, the detection of a diffuse astrophysical neutrino flux with the IceCube neutrino telescope – constructed at the geographic South Pole – was announced by the IceCube collaboration. However, the origin of these neutrinos is still unknown as no sources have been identified to this day. Promising neutrino source candidates are blazars, which are a subclass of active galactic nuclei with radio jets pointing towards the Earth. In this thesis, the neutrino flux from blazars is tested with a maximum likelihood stacking approach, analyzing the combined emission from uniform groups of objects. The stacking enhances the sensitivity w.r.t. the still unsuccessful single source searches. The analysis utilizes four years of IceCube data including one year from the completed detector. As all results presented in this work are compatible with background, upper limits on the neutrino flux are given. It is shown that, under certain conditions, some hadronic blazar models can be challenged or even rejected. Moreover, the sensitivity of this analysis – and any other future IceCube point source search – was enhanced by the development of a new angular reconstruction method. It is based on a detailed simulation of the photon propagation in the Antarctic ice. The median resolution for muon tracks, induced by high-energy neutrinos, is improved for all neutrino energies above IceCube’s lower threshold at 0.1TeV. By reprocessing the detector data and simulation from the year 2010, it is shown that the new method improves IceCube’s discovery potential by 20% to 30% depending on the declination.