Municipal distribution of bladder cancer mortality in Spain: Possible role of mining and industry

BACKGROUND Spain shows the highest bladder cancer incidence rates in men among European countries. The most important risk factors are tobacco smoking and occupational exposure to a range of different chemical substances, such as aromatic amines. METHODS This paper describes the municipal distribution of bladder cancer mortality and attempts to "adjust" this spatial pattern for the prevalence of smokers, using the autoregressive spatial model proposed by Besag, York and Molliè, with relative risk of lung cancer mortality as a surrogate. RESULTS It has been possible to compile and ascertain the posterior distribution of relative risk for bladder cancer adjusted for lung cancer mortality, on the basis of a single Bayesian spatial model covering all of Spain's 8077 towns. Maps were plotted depicting smoothed relative risk (RR) estimates, and the distribution of the posterior probability of RR>1 by sex. Towns that registered the highest relative risks for both sexes were mostly located in the Provinces of Cadiz, Seville, Huelva, Barcelona and Almería. The highest-risk area in Barcelona Province corresponded to very specific municipal areas in the Bages district, e.g., Suría, Sallent, Balsareny, Manresa and Cardona. CONCLUSION Mining/industrial pollution and the risk entailed in certain occupational exposures could in part be dictating the pattern of municipal bladder cancer mortality in Spain. Population exposure to arsenic is a matter that calls for attention. It would be of great interest if the relationship between the chemical quality of drinking water and the frequency of bladder cancer could be studied.

Clinical audit of COPD patients requiring hospital admissions in Spain: AUDIPOC study.

BACKGROUNDS AUDIPOC is a nationwide clinical audit that describes the characteristics, interventions and outcomes of patients admitted to Spanish hospitals because of an exacerbation of chronic obstructive pulmonary disease (ECOPD), assessing the compliance of these parameters with current international guidelines. The present study describes hospital resources, hospital factors related to case recruitment variability, patients' characteristics, and adherence to guidelines. METHODOLOGY/PRINCIPAL FINDINGS An organisational database was completed by all participant hospitals recording resources and organisation. Over an 8-week period 11,564 consecutive ECOPD admissions to 129 Spanish hospitals covering 70% of the Spanish population were prospectively identified. At hospital discharge, 5,178 patients (45% of eligible) were finally included, and thus constituted the audited population. Audited patients were reassessed 90 days after admission for survival and readmission rates. A wide variability was observed in relation to most variables, hospital adherence to guidelines, and readmissions and death. Median inpatient mortality was 5% (across-hospital range 0-35%). Among discharged patients, 37% required readmission (0-62%) and 6.5% died (0-35%). The overall mortality rate was 11.6% (0-50%). Hospital size and complexity and aspects related to hospital COPD awareness were significantly associated with case recruitment. Clinical management most often complied with diagnosis and treatment recommendations but rarely (<50%) addressed guidance on healthy life-styles. CONCLUSIONS/SIGNIFICANCE The AUDIPOC study highlights the large across-hospital variability in resources and organization of hospitals, patient characteristics, process of care, and outcomes. The study also identifies resources and organizational characteristics associated with the admission of COPD cases, as well as aspects of daily clinical care amenable to improvement.

Estratègies i errors en la resolució de problemes d'extrems per mètodes elementals

Aquesta investigació s’engloba dins del camp de la resolució de problemes en educació matemàtica i se centra en estudiar de quina manera els alumnes de primer curs de Batxillerat de dos instituts públics de Catalunya resolen alguns problemes d’extrems per mètodes elementals, és a dir, sense utilitzar les tècniques del càlcul diferencial. Tanmateix, s’estudia el punt de partida d’aquests alumnes davant dels problemes de màxims i mínims i es detecten algunes estratègies i diversos errors que cometen a l’hora de resoldre’ls. L’instrument de recollida de dades és un qüestionari individual que combina problemes d’extrems de resposta tancada amb altres problemes de resposta oberta. Es realitza una anàlisi inductiva – deductiva de les dades, la qual permet determinar que una part important dels participants en la recerca confonen les relacions entre l’àrea i el volum d’algunes figures geomètriques. A més, la majoria dels alumnes d’aquesta investigació resolen els problemes d’extrems plantejats fent ús de l’estratègia de conjecturar. Finalment, es detecta que diverses respostes dels participants presenten errors causats per l’ús de teoremes i/o de definicions matemàtiques equivocades. Aquest és el cas d’una aplicació errònia del teorema de Pitàgores, la confusió del perímetre d’un quadrat amb la longitud del seu costat i la determinació incorrecta de l’altura de diversos paral·lelograms.

GNSS signal detection based on first-order absolute statistics

Aquest projecte es centra principalment en el detector no coherent d’un GPS. Per tal de caracteritzar el procés de detecció d’un receptor, es necessita conèixer l’estadística implicada. Pel cas dels detectors no coherents convencionals, l’estadística de segon ordre intervé plenament. Les prestacions que ens dóna l’estadística de segon ordre, plasmada en la ROC, són prou bons tot i que en diferents situacions poden no ser els millors. Aquest projecte intenta reproduir el procés de detecció mitjançant l’estadística de primer ordre com a alternativa a la ja coneguda i implementada estadística de segon ordre. Per tal d’aconseguir-ho, s’usen expressions basades en el Teorema Central del Límit i de les sèries Edgeworth com a bones aproximacions. Finalment, tant l’estadística convencional com l’estadística proposada són comparades, en termes de la ROC, per tal de determinar quin detector no coherent ofereix millor prestacions en cada situació.

Distortion theorems for quasiconformal mappings

L'any 1994, Astala publicà el reconegut teorema de distorió de l'àrea per aplicacions quasiconformes, un resultat innovador que va permetre que n'apareguessin nombrosos més dins d'aquest camp de l'anàlisi durant la darrera dècada. Ens centrem en les conseqüències que té en la distorsió de la mesura de Hausdorff. Seguim la demostració de Lacey, Sawyer i Uriarte-Tuero per la distorsió del contingut de Hausdorff, clarificant-ne alguns punts i canviant l'enfocament per l'acotació de la transformada de Beurling, on prenem les idees d'Astala, Clop, Tolsa, Uriarte-Tuero i Verdera.

Efficacy of prescribed injectable diacetylmorphine in the Andalusian trial: Bayesian analysis of responders and non-responders according to a multi domain outcome index.

BACKGROUND The objective of this research was to evaluate data from a randomized clinical trial that tested injectable diacetylmorphine (DAM) and oral methadone (MMT) for substitution treatment, using a multi-domain dichotomous index, with a Bayesian approach. METHODS Sixty two long-term, socially-excluded heroin injectors, not benefiting from available treatments were randomized to receive either DAM or MMT for 9 months in Granada, Spain. Completers were 44 and data at the end of the study period was obtained for 50. Participants were determined to be responders or non responders using a multi-domain outcome index accounting for their physical and mental health and psychosocial integration, used in a previous trial. Data was analyzed with Bayesian methods, using information from a similar study conducted in The Netherlands to select a priori distributions. On adding the data from the present study to update the a priori information, the distribution of the difference in response rates were obtained and used to build credibility intervals and relevant probability computations. RESULTS In the experimental group (n = 27), the rate of responders to treatment was 70.4% (95% CI 53.287.6), and in the control group (n = 23), it was 34.8% (95% CI 15.354.3). The probability of success in the experimental group using the a posteriori distributions was higher after a proper sensitivity analysis. Almost the whole distribution of the rates difference (the one for diacetylmorphine minus methadone) was located to the right of the zero, indicating the superiority of the experimental treatment. CONCLUSION The present analysis suggests a clinical superiority of injectable diacetylmorphine compared to oral methadone in the treatment of severely affected heroin injectors not benefiting sufficiently from the available treatments. TRIAL REGISTRATION Current Controlled Trials ISRCTN52023186.

Efficacy and safety of acupuncture for the treatment of non-specific acute low back pain: a randomised controlled multicentre trial protocol [ISRCTN65814467]

BACKGROUND Low back pain and its associated incapacitating effects constitute an important healthcare and socioeconomic problem, as well as being one of the main causes of disability among adults of working age. The prevalence of non-specific low back pain is very high among the general population, and 60-70% of adults are believed to have suffered this problem at some time. Nevertheless, few randomised clinical trials have been made of the efficacy and efficiency of acupuncture with respect to acute low back pain. The present study is intended to assess the efficacy of acupuncture for acute low back pain in terms of the improvement reported on the Roland Morris Questionnaire (RMQ) on low back pain incapacity, to estimate the specific and non-specific effects produced by the technique, and to carry out a cost-effectiveness analysis. METHODS/DESIGN Randomised four-branch controlled multicentre prospective study made to compare semi-standardised real acupuncture, sham acupuncture (acupuncture at non-specific points), placebo acupuncture and conventional treatment. The patients are blinded to the real, sham and placebo acupuncture treatments. Patients in the sample present symptoms of non specific acute low back pain, with a case history of 2 weeks or less, and will be selected from working-age patients, whether in paid employment or not, referred by General Practitioners from Primary Healthcare Clinics to the four clinics participating in this study. In order to assess the primary and secondary result measures, the patients will be requested to fill in a questionnaire before the randomisation and again at 3, 12 and 48 weeks after starting the treatment. The primary result measure will be the clinical relevant improvement (CRI) at 3 weeks after randomisation. We define CRI as a reduction of 35% or more in the RMQ results. DISCUSSION This study is intended to obtain further evidence on the effectiveness of acupuncture on acute low back pain and to isolate the specific and non-specific effects of the treatment.

Otimização Não Linear de Mínimos Quadrados

O problema de otimização de mínimos quadrados e apresentado como uma classe importante de problemas de minimização sem restrições. A importância dessa classe de problemas deriva das bem conhecidas aplicações a estimação de parâmetros no contexto das analises de regressão e de resolução de sistemas de equações não lineares. Apresenta-se uma revisão dos métodos de otimização de mínimos quadrados lineares e de algumas técnicas conhecidas de linearização. Faz-se um estudo dos principais métodos de gradiente usados para problemas não lineares gerais: Métodos de Newton e suas modificações incluindo os métodos Quasi-Newton mais usados (DFP e BFGS). Introduzem-se depois métodos específicos de gradiente para problemas de mínimos quadrados: Gauss-Newton e Levenberg-Larquardt. Apresenta-se uma variedade de exemplos selecionados na literatura para testar os diferentes métodos usando rotinas MATLAB. Faz-se uma an alise comparativa dos algoritmos baseados nesses ensaios computacionais que exibem as vantagens e desvantagens dos diferentes métodos.

A primitivação por partes

Expõem-se neste texto os fundamentos do método de primitivação por partes, que se estuda nas disciplinas de Análise Matemática de muitos dos cursos de licenciatura de natureza científica ou técnica. Trata-se de um método simples, embora por vezes surja alguma dificuldade na identificação das situações em que tem de operar-se a sua aplicação. Ilustra-se o método com a doutrina essencial e com uma coletânea de exemplos úteis.

A primitivação pelo método de substutuição

Expõem-se neste texto os fundamentos do método de primitivação por substituição, estudado nas disciplinas de Análise Matemática de muitos dos cursos de licenciatura de natureza científica ou técnica. Trata-se de um método simples, embora gere mais dificuldades junto dos alunos do que o método de primitivação por partes. E, à semelhança do que se fez em trabalho similar sobre este último método de primitivação, ilustra-se o agora apresentado com a doutrina essencial e com uma coletânea de exemplos úteis.

Interferência da fração mineral na estimativa do grau de humificação da matéria orgânica em agregados organominerais por ressonância paramagnética eletrônica

A concentração de radicais livres semiquinona (CRLS), determinada por ressonância paramagnética eletrônica (EPR), é considerada um índice do grau de humificação, sendo uma importante determinação em estudos qualitativos da matéria orgânica do solo. Neste trabalho, avaliou-se a interferência da fração mineral na quantificação da CRLS em agregados organominerais 20-53, 2-20 e < 2 ∝m de Podzólico Vermelho-Amarelo, Podzólico Vermelho-Escuro e Latossolo Roxo. A CRLS foi determinada pela área do sinal, estimada pela aproximação intensidade do sinal (I, em cm), multiplicada pela sua largura de linha ao quadrado (∆H², em Gauss). Os parâmetros espectrais I e ∆H foram obtidos em espectros de EPR com e sem interferência da fração mineral. No Podzólico Vermelho-Amarelo e no Podzólico Vermelho-Escuro, foram detectados dois sinais de radicais livres, um com um valor g 2,004 e largura de linha de 5-6 G, típico de radicais livres semiquinona, outro com um valor g 2,000 e largura de linha de 2-3 G, associado à fração mineral, especificamente ao quartzo (SiO2), como confirmado posteriormente por análise de amostra purificada. Nestes solos, a interferência da fração mineral na obtenção dos parâmetros I e ∆H resultou num erro na estimativa da CRLS de -7 a +488%, comparativamente às quantificações realizadas a partir dos espectros sem interferência da fração mineral. No Latossolo Roxo, os altos teores de Fe3+ não permitiram detectar os sinais dos radicais livres semiquinona por causa da sobreposição dos sinais do metal. A eliminação da interferência da fração mineral demonstrou ser um pré-requisito fundamental no estudo da matéria orgânica por EPR em agregados organominerais, para a qual são sugeridos alguns procedimentos alternativos.

The set of undominated imputations and the core: an axiomatic approach

This paper provides an axiomatic framework to compare the D-core (the set of undominatedimputations) and the core of a cooperative game with transferable utility. Theorem1 states that the D-core is the only solution satisfying projection consistency, reasonableness (from above), (*)-antimonotonicity, and modularity. Theorem 2 characterizes the core replacing (*)-antimonotonicity by antimonotonicity. Moreover, these axioms alsocharacterize the core on the domain of convex games, totally balanced games, balancedgames, and superadditive games

The set of undominated imputations and the core: an axiomatic approach

This paper provides an axiomatic framework to compare the D-core (the set of undominatedimputations) and the core of a cooperative game with transferable utility. Theorem1 states that the D-core is the only solution satisfying projection consistency, reasonableness (from above), (*)-antimonotonicity, and modularity. Theorem 2 characterizes the core replacing (*)-antimonotonicity by antimonotonicity. Moreover, these axioms alsocharacterize the core on the domain of convex games, totally balanced games, balancedgames, and superadditive games

A Lei de Lotka na bibliometria brasileira

Usando os dados reportados em artigos publicados em revistas brasileiras e trabalhos apresentados em congressos nacionais, replicaram-se as aplicações da Lei de Lotka à literatura brasileira em 10 campos diferentes. Utilizou-se o modelo do poder inverso pelos métodos do mínimo quadrado e probabilidade máxima. Das 10 literaturas nacionais analisadas, somente a literatura de medicina, siderurgia, jaca e biblioteconomia ajustaram-se ao modelo do poder inverso generalizado pelo método dos mínimos quadrados. No entanto, só duas literaturas (veterinária e cartas do Arquivo Privado de Getúlio Vargas) não se ajustaram ao modelo quando se usou o método da máxima probabilidade. Para ambas literaturas, tentaram-se modelos diferentes. A literatura de veterinária ajustou-se à distribuição binomial negativa, e as cartas do Arquivo Privado de Getúlio Vargas ajustaram-se melhor à distribuição Gauss-Poisson Inversa Generalizada.

Power variation of some integral fractional processes

We consider the asymptotic behaviour of the realized power variation of processes of the form ¿t0usdBHs, where BH is a fractional Brownian motion with Hurst parameter H E(0,1), and u is a process with finite q-variation, q<1/(1¿H). We establish the stable convergence of the corresponding fluctuations. These results provide new statistical tools to study and detect the long-memory effect and the Hurst parameter.