Competing risks to breast cancer mortality in Catalonia

Background: Breast cancer mortality has experienced important changes over the last century. Breast cancer occurs in the presence of other competing risks which can influence breast cancer incidence and mortality trends. The aim of the present work is: 1) to assess the impact of breast cancer deaths among mortality from all causes in Catalonia (Spain), by age and birth cohort and 2) to estimate the risk of death from other causes than breast cancer, one of the inputs needed to model breast cancer mortality reduction due to screening or therapeutic interventions. Methods: The multi-decrement life table methodology was used. First, all-cause mortality probabilities were obtained by age and cohort. Then mortality probability for breast cancer was subtracted from the all-cause mortality probabilities to obtain cohort life tables for causes other than breast cancer. These life tables, on one hand, provide an estimate of the risk of dying from competing risks, and on the other hand, permit to assess the impact of breast cancer deaths on all-cause mortality using the ratio of the probability of death for causes other than breast cancer by the all-cause probability of death. Results: There was an increasing impact of breast cancer on mortality in the first part of the 20th century, with a peak for cohorts born in 1945–54 in the 40–49 age groups (for which approximately 24% of mortality was due to breast cancer). Even though for cohorts born after 1955 there was only information for women under 50, it is also important to note that the impact of breast cancer on all-cause mortality decreased for those cohorts. Conclusion: We have quantified the effect of removing breast cancer mortality in different age groups and birth cohorts. Our results are consistent with US findings. We also have obtained an estimate of the risk of dying from competing-causes mortality, which will be used in the assessment of the effect of mammography screening on breast cancer mortality in Catalonia.

Dissemination of periodic mammography and patterns of use, by birth cohort, in Catalonia (Spain)

Background: In Catalonia (Spain) breast cancer mortality has declined since the beginning of the 1990s. The dissemination of early detection by mammography and the introduction of adjuvant treatments are among the possible causes of this decrease, and both were almost coincident in time. Thus, understanding how these procedures were incorporated into use in the general population and in women diagnosed with breast cancer is very important for assessing their contribution to the reduction in breast cancer mortality. In this work we have modeled the dissemination of periodic mammography and described repeat mammography behavior in Catalonia from 1975 to 2006. Methods: Cross-sectional data from three Catalan Health Surveys for the calendar years 1994, 2002 and 2006 was used. The dissemination of mammography by birth cohort was modeled using a mixed effects model and repeat mammography behavior was described by age and survey year. Results: For women born from 1938 to 1952, mammography clearly had a period effect, meaning that they started to have periodic mammograms at the same calendar years but at different ages. The age at which approximately 50% of the women were receiving periodic mammograms went from 57.8 years of age for women born in 1938–1942 to 37.3 years of age for women born in 1963–1967. Women in all age groups experienced an increase in periodic mammography use over time, although women in the 50–69 age group have experienced the highest increase. Currently, the target population of the Catalan Breast Cancer Screening Program, 50–69 years of age, is the group that self-reports the highest utilization of periodic mammograms, followed by the 40–49 age group. A higher proportion of women of all age groups have annual mammograms rather than biennial or irregular ones. Conclusion: Mammography in Catalonia became more widely implemented during the 1990s. We estimated when cohorts initiated periodic mammograms and how frequently women are receiving them. These two pieces of information will be entered into a cost-effectiveness model of early detection in Catalonia.

Efectos del diseño de la tienda virtual en el comportamiento de compra: tipificación del consumidor online

Cuando una empresa se decide a realizar una iniciativa comercial en Internet, al igual que en el mundo físico, es necesario definir un diseño adecuado del sitio web que se ajuste a su idea de negocio y a su público objetivo. El presente trabajo trata de analizar como influye el diseño del establecimiento virtual en el desarrollo de la gestión comercial, incidiendo en los siguientes aspectos: diseño gráfico, usabilidad y accesibilidad. A partir de este análisis, se estudian los distintos grupos de consumidores con comportamientos homogéneos y se posicionan en función de sus actitudes. El análisis también permite definir la calidad del servicio prestado por este tipo de establecimientos, así como las principales dimensiones en que se despliega. En las conclusiones se citan aspectos en los que el gestor de una tienda online debe incidir para mejorar la calidad de su servicio.

Tipologías de viveros de empresas: tradicionales y especializados

A través del presente estudio empírico se detecta que existen dos tipos de viveros de empresas. Los viveros tradicionales se centran en la promoción de nuevas empresas que desde un buen inicio tengan unas ciertas garantías de éxito. En estos viveros conviven empresas que representan a una amplia gama de sectores empresariales. Los principales requisitos de entrada (obligatorios) son un plan de viabilidad económica y técnica, además de que la empresa sea de reciente creación. Los viveros especializados son aquellos que priman iniciativas empresariales relacionadas con un sector concreto: frecuentemente las empresas relacionadas con las nuevas tecnologías de la información y comunicación (TIC).

¿Muestran el mismo perfil competitivo las PYMES y las grandes empresas industriales españolas?

El objetivo de este trabajo es analizar, mediante la técnica multicriterio, cómo ha evolucionado la competitividad de los sectores de la industria manufacturera española en el período 1991-2001. El análisis se realiza diferenciando entre PYMES y grandes empresas y no se focaliza en la competitividad-precio, sino que adopta un enfoque más amplio en el que se incorporan aspectos estructurales. Los resultados permiten afirmar, en primer lugar, que en la década de estudio no se han producido cambios de gran envergadura en los perfiles competitivos de los sectores industriales españoles. En segundo lugar, que los perfiles competitivos difieren según hablemos de PYMES o grandes empresas. Y en tercer lugar, que uno de los factores que siguen siendo más determinantes de la posición competitiva de los sectores industriales es la innovación.

El derecho penal ante el fenómeno sectario

El fenómeno de las sectas destructivas pone de manifiesto los riesgos de un abusivo recurso a la vía punitiva, por lo que el Derecho penal debe hacer frente a diversas dificultades para adentrarse en el terreno de las actividades que puedan desarrollarse en el seno de estas agrupaciones. Así, tras analizar la relevancia jurídico penal de las actividades de las sectas destructivas, aludiendo tanto a las conductas relativas a menores de edad e incapaces, como a las conductas delictivas contra adultos, se propone la forma de superar las dificultades para una adecuada identificación y persecución de los responsables.

Estimation of age- and stage-specific Catalan breast cancer survival functions using US and Catalan survival data

Background: During the last part of the 1990s the chance of surviving breast cancer increased. Changes in survival functions reflect a mixture of effects. Both, the introduction of adjuvant treatments and early screening with mammography played a role in the decline in mortality. Evaluating the contribution of these interventions using mathematical models requires survival functions before and after their introduction. Furthermore, required survival functions may be different by age groups and are related to disease stage at diagnosis. Sometimes detailed information is not available, as was the case for the region of Catalonia (Spain). Then one may derive the functions using information from other geographical areas. This work presents the methodology used to estimate age- and stage-specific Catalan breast cancer survival functions from scarce Catalan survival data by adapting the age- and stage-specific US functions. Methods: Cubic splines were used to smooth data and obtain continuous hazard rate functions. After, we fitted a Poisson model to derive hazard ratios. The model included time as a covariate. Then the hazard ratios were applied to US survival functions detailed by age and stage to obtain Catalan estimations. Results: We started estimating the hazard ratios for Catalonia versus the USA before and after the introduction of screening. The hazard ratios were then multiplied by the age- and stage-specific breast cancer hazard rates from the USA to obtain the Catalan hazard rates. We also compared breast cancer survival in Catalonia and the USA in two time periods, before cancer control interventions (USA 1975–79, Catalonia 1980–89) and after (USA and Catalonia 1990–2001). Survival in Catalonia in the 1980–89 period was worse than in the USA during 1975–79, but the differences disappeared in 1990–2001. Conclusion: Our results suggest that access to better treatments and quality of care contributed to large improvements in survival in Catalonia. On the other hand, we obtained detailed breast cancer survival functions that will be used for modeling the effect of screening and adjuvant treatments in Catalonia.

Effectiveness of early detection on breast cancer mortality reduction in Catalonia (Spain)

Background: At present, it is complicated to use screening trials to determine the optimal age intervals and periodicities of breast cancer early detection. Mathematical models are an alternative that has been widely used. The aim of this study was to estimate the effect of different breast cancer early detection strategies in Catalonia (Spain), in terms of breast cancer mortality reduction (MR) and years of life gained (YLG), using the stochastic models developed by Lee and Zelen (LZ). Methods: We used the LZ model to estimate the cumulative probability of death for a cohort exposed to different screening strategies after T years of follow-up. We also obtained the cumulative probability of death for a cohort with no screening. These probabilities were used to estimate the possible breast cancer MR and YLG by age, period and cohort of birth. The inputs of the model were: incidence of, mortality from and survival after breast cancer, mortality from other causes, distribution of breast cancer stages at diagnosis and sensitivity of mammography. The outputs were relative breast cancer MR and YLG. Results: Relative breast cancer MR varied from 20% for biennial exams in the 50 to 69 age interval to 30% for annual exams in the 40 to 74 age interval. When strategies differ in periodicity but not in the age interval of exams, biennial screening achieved almost 80% of the annual screening MR. In contrast to MR, the effect on YLG of extending screening from 69 to 74 years of age was smaller than the effect of extending the screening from 50 to 45 or 40 years. Conclusion: In this study we have obtained a measure of the effect of breast cancer screening in terms of mortality and years of life gained. The Lee and Zelen mathematical models have been very useful for assessing the impact of different modalities of early detection on MR and YLG in Catalonia (Spain).

Reduction of oxidative cellular damage by overexpression of the thioredoxin TRX2 gene improves yield and quality of wine yeast dry active biomass

Background: Wine Saccharomyces cerevisiae strains, adapted to anaerobic must fermentations, suffer oxidative stress when they are grown under aerobic conditions for biomass propagation in the industrial process of active dry yeast production. Oxidative metabolism of sugars favors high biomass yields but also causes increased oxidation damage of cell components. The overexpression of the TRX2 gene, coding for a thioredoxin, enhances oxidative stress resistance in a wine yeast strain model. The thioredoxin and also the glutathione/glutaredoxin system constitute the most important defense against oxidation. Trx2p is also involved in the regulation of Yap1p-driven transcriptional response against some reactive oxygen species. Results: Laboratory scale simulations of the industrial active dry biomass production process demonstrate that TRX2 overexpression increases the wine yeast final biomass yield and also its fermentative capacity both after the batch and fed-batch phases. Microvinifications carried out with the modified strain show a fast start phenotype derived from its enhanced fermentative capacity and also increased content of beneficial aroma compounds. The modified strain displays an increased transcriptional response of Yap1p regulated genes and other oxidative stress related genes. Activities of antioxidant enzymes like Sod1p, Sod2p and catalase are also enhanced. Consequently, diminished oxidation of lipids and proteins is observed in the modified strain, which can explain the improved performance of the thioredoxin overexpressing strain. Conclusions: We report several beneficial effects of overexpressing the thioredoxin gene TRX2 in a wine yeast strain. We show that this strain presents an enhanced redox defense. Increased yield of biomass production process in TRX2 overexpressing strain can be of special interest for several industrial applications.

Reliability of the density functional approximation to describe the charge transfer and electrostatic complexes involved in the modeling of organic conducting polymers

Both the intermolecular interaction energies and the geometries for M ̄ thiophene, M ̄ pyrrole, M n+ ̄ thiophene, and M n+ ̄ pyrrole ͑with M = Li, Na, K, Ca, and Mg; and M n+ = Li+ , Na+ , K+ , Ca2+, and Mg2+͒ have been estimated using four commonly used density functional theory ͑DFT͒ methods: B3LYP, B3PW91, PBE, and MPW1PW91. Results have been compared to those provided by HF, MP2, and MP4 conventional ab initio methods. The PBE and MPW1PW91 are the only DFT methods able to provide a reasonable description of the M ̄ complexes. Regarding M n+ ̄ ␲ complexes, the four DFT methods have been proven to be adequate in the prediction of these electrostatically stabilized systems, even though they tend to overestimate the interaction energies.

El merchandising en el establecimiento virtual: una aproximación al diseño y la usabilidad

En este artículo se explican las claves que debe poseer una tienda virtual en Internet para realizar una óptima estrategia de merchandising. Para ello, se analizan las principales características que tiene un establecimiento virtual, que le diferencia de una tienda real. A la hora de realizar una iniciativa comercial en Internet, al igual que en el mundo físico, es necesario definir un diseño adecuado del sitio web que se ajuste a nuestra idea de negocio y a nuestro público objetivo. Por tanto, en el presente trabajo, se analiza como influye el diseño del establecimiento virtual en el desarrollo de la gestión comercial, incidiendo en los siguientes aspectos: diseño gráfico, usabilidad y accesibilidad.

Instrumentos promocionales en el marketing público: una aplicación empírica

El presente trabajo trata de determinar que elementos son valorados por el sector privado a nivel global de cara a dar soporte a una determinada acción de promoción por parte de una entidad pública. Este estudio ha sido complementado con un análisis sectorial detallado para caracterizar los sectores que definen el tejido económico y comprobar si cada uno de ellos requiere un trato individualizado. En el desarrollo del estudio se ha aplicado análisis univariante y bivariante, y contraste χ 2, llevado a cabo sobre una muestra representativa de las empresas seleccionadas sectorialmente y que se hallan ubicadas en la zona de influencia de la población de Mollerusa de la provincia de Lleida. El origen de nuestro trabajo se encuentra en un proyecto de investigación que realizó nuestro Departamento en convenio con el Patronat de Fires de Mollerussa (Patronato de Ferias de Mollerusa).

L'impacte econòmic de la Universitat de Lleida

La tendència descentralitzadora que ha caracteritzat els darrers anys la política universitària ha tingut, sens dubte, un impacte important sobre l’economia de les regions en les quals s’ha ubicat una universitat de nova creació. Els estudis de l’impacte econòmic de la universitat sobre el territori són un instrument important per justificar i incentivar la descentralització geogràfica de l’ensenyament superior. Sobretot en èpoques en què les rigideses pressupostàries exigeixen racionalitzar al màxim els nivells de despesa pública. Aquest estudi aplica la metodologia input-output per quantificar l’impacte que les activitats de la Universitat de Lleida han tingut sobre l’economia del territori. En concret, s’avaluen els impactes de la despesa de la mateixa Universitat, del professorat, de la resta del personal i dels estudiants. L’objectiu principal és arribar a conclusions sobre com un impuls exogen al territori genera producció, renda i ocupació en la mateixa regió.

Cuestiones sobre el contrato de servicios diseñado en el Marco Común de Referencia

La reciente publicación del draft del Common Frame of Reference invita a reflexionar sobre la figura del contrato de servicios, tal como ha sido desarrollada por el Study Group on a European Civil Code, y respecto de la que encontramos verdaderas innovaciones en comparación con la teoría tradicional que aún mantienen nuestra doctrina y jurisprudencia. El objeto del trabajo es exponer algunas de las soluciones que propone el derecho contractual europeo, e incidir en la posibilidad y conveniencia de su aplicación en nuestro país, con vistas a la oportuna elaboración de la tan esperada regulación civil sobre el contrato de servicios.

Els límits a la facultat d’interpretació de les clàusules testamentàries per part del marmessor universal

Aquest comentari analitza la sentència del Tribunal Superior de Justícia de Catalunya de 29 de desembre de 2008, que crea jurisprudència. A la sentència el Tribunal Superior determina el caràcter revisable i revocable, per part dels tribunals de justícia, de la interpretació que realitza el marmessor universal de les clàusules testamentàries.