Análise funcional do ventrículo esquerdo em angio-TC coronária

Doutoramento em Engenharia InformáticaCoronary CT angiography is widely used in clinical practice for the assessment of coronary artery disease. Several studies have shown that the same exam can also be used to assess left ventricle (LV) function. LV function is usually evaluated using just the data from end-systolic and end-diastolic phases even though coronary CT angiography (CTA) provides data concerning multiple cardiac phases, along the cardiac cycle. This unused wealth of data, mostly due to its complexity and the lack of proper tools, has still to be explored in order to assess if further insight is possible regarding regional LV functional analysis. Furthermore, different parameters can be computed to characterize LV function and while some are well known by clinicians others still need to be evaluated concerning their value in clinical scenarios. The work presented in this thesis covers two steps towards extended use of CTA data: LV segmentation and functional analysis. A new semi-automatic segmentation method is presented to obtain LV data for all cardiac phases available in a CTA exam and a 3D editing tool was designed to allow users to fine tune the segmentations. Regarding segmentation evaluation, a methodology is proposed in order to help choose the similarity metrics to be used to compare segmentations. This methodology allows the detection of redundant measures that can be discarded. The evaluation was performed with the help of three experienced radiographers yielding low intraand inter-observer variability. In order to allow exploring the segmented data, several parameters characterizing global and regional LV function are computed for the available cardiac phases. The data thus obtained is shown using a set of visualizations allowing synchronized visual exploration. The main purpose is to provide means for clinicians to explore the data and gather insight over their meaning, as well as their correlation with each other and with diagnosis outcomes. Finally, an interactive method is proposed to help clinicians assess myocardial perfusion by providing automatic assignment of lesions, detected by clinicians, to a myocardial segment. This new approach has obtained positive feedback from clinicians and is not only an improvement over their current assessment method but also an important first step towards systematic validation of automatic myocardial perfusion assessment measures.A angiografia coronária por TC (angio-TC) é prática clínica corrente para a avaliação de doença coronária. Alguns estudos mostram que é também possível utilizar o exame de angio-TC para avaliar a função do ventrículo esquerdo (VE). A função ventricular esquerda (FVE) é normalmente avaliada considerando as fases de fim de sístole e de fim de diástole, apesar de a angio-TC proporcionar dados relativos a diferentes fases distribuídas ao longo do ciclo cardíaco. Estes dados não considerados, devido à sua complexidade e à falta de ferramentas apropriadas para o efeito, têm ainda de ser explorados para que se perceba se possibilitam uma melhor compreensão da FVE. Para além disso, podem ser calculados diferentes parâmetros para caracterizar a FVE e, enquanto alguns são bem conhecidos dos médicos, outros requerem ainda uma avaliação do seu valor clínico. No âmbito de uma utilização alargada dos dados proporcionados pelos angio- TC, este trabalho apresenta contributos ao nível da segmentação do VE e da sua análise funcional. É proposto um método semi-automático para a segmentação do VE de forma a obter dados para as diferentes fases cardíacas presentes no exame de angio- TC. Foi também desenvolvida uma ferramenta de edição 3D que permite aos utilizadores a correcção das segmentações assim obtidas. Para a avaliação do método de segmentação apresentado foi proposta uma metodologia que permite a detecção de medidas de similaridade redundantes, a usar no âmbito da avaliação para comparação entre segmentações, para que tais medidas redundantes possam ser descartadas. A avaliação foi executada com a colaboração de três técnicos de radiologia experientes, tendo-se verificado uma baixa variabilidade intra- e inter-observador. De forma a permitir explorar os dados segmentados, foram calculados vários parâmetros para caracterização global e regional da FVE, para as diversas fases cardíacas disponíveis. Os resultados assim obtidos são apresentados usando um conjunto de visualizações que permitem uma exploração visual sincronizada dos mesmos. O principal objectivo é proporcionar ao médico a exploração dos resultados obtidos para os diferentes parâmetros, de modo a que este tenha uma compreensão acrescida sobre o seu significado clínico, assim como sobre a correlação existente entre diferentes parâmetros e entre estes e o diagnóstico. Finalmente, foi proposto um método interactivo para ajudar os médicos durante a avaliação da perfusão do miocárdio, que atribui automaticamente as lesões detectadas pelo médico ao respectivo segmento do miocárdio. Este novo método obteve uma boa receptividade e constitui não só uma melhoria em relação ao método tradicional mas é também um primeiro passo para a validação sistemática de medidas automáticas da perfusão do miocárdio

To Whom Belong the Streets?

Avec en toile de fond les différentes formes de contestations qui se produisirent à Damas au printemps et à l’été 1878, cet article étudie la façon dont les femmes, les groupes de jeunes, les auteurs et placardeurs d’affiches de l’opposition au pouvoir, les membres des élites locales et les autorités ont produit des formes particulières de lieux et d’espaces publics dans la ville. En élaborant la production de l’espace à un moment de transition entre l’« Ancien Régime » et le paradigme de la modernité, cet article apporte une contribution à l’histoire sociale de Damas et l’historicisation du concept d’espace public.In the perspective of different forms of spatial contestations in spring and summer 1878, this article investigates how protests produced the particular public places and public spaces of the urban society. It pays a particular attention to women, fighting youths, authors and posters of oppositional placards, members of local elites, and the authorities. By elaborating the production of space at the transition from an urban “ancien régime” to the paradigm of modernity, it contributes to the social history of Damascus and to the historicization of the concept of public space.في سياق الأشكال المختلفة للاحتجاجات التي حدثت في دمشق في ربيع وصيف عام ١٨٧٨، تتناول هذه المقالة دراسة الطريقة التي قام بها النساء ومجموعات الشباب والذين ألفوا وألصقوا إعلانات المعارضة وعناصر النخب المحلية والسلطات، لإنتاج أشكال خاصة من الأماكن والفضاءات العامة في المدينة. وبتشكيل إنتاج الفضاء العام في الفترة الانتقالية ما بين «النظام العمراني القديم» ونموذج الحداثة، تجلب هذه المقالة مساهمة في تاريخ دمشق الاجتماعي وفي تاريخ مفهوم الفضاء العام

Power in the Land

In 1542 William Ramsden bought his wife’s family home at Longley and so began a long association between the Ramsdens and Huddersfield which lasted until Sir John Frecheville Ramsden sold his greatly increased Huddersfield estate to the Corporation in 1920. This collection of essays is published to commemorate the centenary of that event. Seven local historians examine different aspects of the Ramsden family’s relationship with the town and its inhabitants, especially in the nineteenth century.  The book incorporates new research and gives fresh insights into the events which led to Huddersfield becoming ‘the town that bought itself’ a century ago

The coming of the Arabic-speaking people to the United States

Thesis (Ph.D.)--Boston University.Eminent historians and writers have frequently referred to the important role American missionaries played in acquainting Arabic-speaking people of the Near East with the United States, which subsequently led to their emigration to America. Studies of available letters, reports, and biographies reveal the founding of educational, clinical, and press publications in Syria during the early nineteenth century. These occurred simultaneously with important changes that began to take place within the Near Eastern area. Forerunners, like Pliny Fisk and Levi Parsons in 1819, were followed by prominent American men and women who worked among the people in peace and in times of civil disturbances. The presence of these strangers from a distant country, who made available their services in humane endeavors without political opportunism, enhanced greatly American prestige in the Near East. The few emigrants in the United States between 1849 and 1860 came through this association with Americans. Monseigneur Flavianus Efoury, Superior General of St. John's Convent in Khonchara, Lebanon, sought American Catholic aid to restore the monastery destroyed by civil wars. Antonio Bishallany, also of Mount Lebanon, studied here, hoping to acquire a wider background in Protestant missionary education. One exception to the missionary story during this period is that of Hadji Ali or Hi Jolly. He led a Levantine group to the United States in 1856 when this country introduced the camel caravan into the Arizona territory. There is evidence that there were earlier arrivals of Moors from North Africa who came with the Spaniards. Father Elias al-Mawsili, of Mosul, Iraq, reached Mexico and South America in 1668. Some Rabbis from Asia Minor were in Newport, Rhode Island, in the middle eighteenth century. Algerians may have brought horses here for the Continental army during the American Revolution. By 1856 statistics reveal about 272 Near Easterners in the United States, including North Africans. But these classifications are not certain. However, widespread emigration to the United States occurred only after the American Civil War. [TRUNCATED

Architecture for a New Age: Imperial Ottoman Mosques in Eighteenth-Century Istanbul

The eighteenth century saw the Ottoman capital Istanbul undergo some of its most significant physical changes. Restored as the seat of government in 1703 after the court had spent fifty years in Edirne, the city became the site of lavish architectural patronage intended to reinscribe the sultans' presence. This campaign culminated in the years 1740-1800 with two distinct but related developments: the revival of the imperial mosque as a building type, and the creation of a new architectural style--the so-called Ottoman Baroque--informed by Western models. Though these shifts have typically been viewed within a well-established decline paradigm branding the material decadent and derivative, this study demonstrates that the eighteenth-century mosques were powerful symbols of sultanic authority designed to reassert and redefine the empire's standing on a changing world stage.History of Art and Architectur

La Croisière du Vanadis : sur les traces d'Edith Wharton

A trace is both a material imprint and a trail or series of imprints, marking the passage of a being or an object in transit; it can therefore be understood as the material evidence of a path that has been pursued. In the particular context of this research, the term trace refers first and foremost to the record of a sea voyage. This unpublished journal, kept by Edith Wharton, gives an account of the various stages of the Mediterranean cruise she made in the yacht, the Vanadis, in the spring of 1888.This long book is of particular interest, insofar as it, not only gives a fascinating account of the response of a young nineteenth-century cultivated American to the different cultures discovered in the course of a voyage leading her from North Africa to the Greek Islands and the shores of the Adriatic, but also provides valuable insight into the early responses of an artist in the making.The term “trace” therefore refers to both these aspects: first the voyage itself, the places visited, their physical features and historical significance; secondly the traces left by the visitor who embarked on this adventure at a turning point in her life. The sentiment that the future artist is poised at the crossroads of her existence, leads the researcher – in an attempt to leave as few stones as possible unturned – on a trail leading back to her past and forward to her future. This investigation would not be complete without a survey of travel literature, as the particular genre Edith Wharton has chosen as her means of expression. All these traces unite to form a series of “signs” (in the Saussurian sense of the word), which the researcher endeavours to interpret in the hopes of understanding what is “signified” on a deeper level.Une trace est une suite d’empreintes, laissées par le passage d’un être ou d’un objet – c’est donc avant tout l’indice d’un chemin parcouru. C’est à ce déplacement dans le temps et dans l’espace qu’invitent mes travaux de recherche dont l’objectif est de suivre Edith Wharton « à la trace ». La trace, c’est d’abord, pour ce qu’elle nous apprend sur le voyageur et son rapport au monde, cette croisière en Méditerranée qu’elle entreprend en 1888 à bord du Vanadis. C’est également l’empreinte qui subsiste de cette expérience du voyage : un manuscrit dactylographié qui retrace le périple et rend compte du rapport particulier d’Edith Wharton à l’écriture.La trace – ce qu’on suit (« suivre à la trace ») – renvoie donc à une double activité : d’une part au voyage lui-même, d’autre part, à l’exploration de toutes les pistes que j’ai cru bon d’ouvrir à partir du document originel : sur la vie et l’œuvre d’Edith Wharton, sur son environnement socio-culturel et sur le genre de la littérature de voyage – toute une série d’empreintes, donc de signes conduisant à de nombreux signifiés. La question demeure toujours, en dernier ressort, de savoir si les signifiés que croit avoir découvert le chercheur sont bien ceux de l’écrivain

Friedrich Rosen

Diplomat, Orientalist, and German foreign minister: Friedrich Rosen (1856-1935) was an Orient expert par excellence in the age of German imperialism. His story is told here for the first time. Following his rise to the centres of international politics and Orientalist scholarship, this study argues that power and knowledge sustained, challenged and subverted each other