Ischemic heart disease and primary care: identifying gender-related differences. An observational study

Background: Gender-related differences are seen in multiple aspects of both health and illness. Ischemic heart disease (IHD) is a pathology in which diagnostic, treatment and prognostic differences are seen between sexes, especially in the acute phase and in the hospital setting. The objective of the present study is to analyze whether there are differences between men and women when examining associated cardiovascular risk factors and secondary pharmacological prevention in the primary care setting. Methods: Retrospective descriptive observational study from January to December of 2006, including 1907 patients diagnosed with ischemic heart disease in the city of Lleida, Spain. The clinical data were obtained from computerized medical records and pharmaceutical records of medications dispensed in pharmacies with official prescriptions. Data was analyzed using bivariate descriptive statistical analysis as well as logistic regression. Results: There were no gender-related differences in screening percentages for arterial hypertension, diabetes, obesity, dyslipemia, and smoking. A greater percentage of women were hypertensive, obese and diabetic compared to men. However, men showed a tendency to achieve control targets more easily than women, with no statistically significant differences. In both sexes cardiovascular risk factors control was inadequate, between 10 and 50%. For secondary pharmaceutical prevention, the percentages of prescriptions were greater in men for anticoagulants, beta-blockers, lipid-lowering agents and angiotensin-converting enzyme inhibitors/angiotensin II receptor blockers, with age group variations up to 10%. When adjusting by age and specific diagnoses, differences were maintained for anticoagulants and lipid-lowering agents. Conclusion: Screening of cardiovascular risk factors was similar in men and women with IHD. Although a greater percentage of women were hypertensive, diabetic or obese, their management of risk factors tended to be worse than men. Overall, a poor control of cardiovascular risk factors was noted. Taken as a whole, more men were prescribed secondary prevention drugs, with differences varying by age group and IHD diagnosis.

Genetic alterations in head and neck squamous cell carcinomas

The genetic alterations observed in head and neck cancer are mainly due to oncogene activation (gain of function mutations) and tumor suppressor gene inactivation (loss of function mutations), leading to deregulation of cell proliferation and death. These genetic alterations include gene amplification and overexpression of oncogenes such as myc, erbB-2, EGFR and cyclinD1 and mutations, deletions and hypermethylation leading to p16 and TP53 tumor suppressor gene inactivation. In addition, loss of heterozygosity in several chromosomal regions is frequently observed, suggesting that other tumor suppressor genes not yet identified could be involved in the tumorigenic process of head and neck cancers. The exact temporal sequence of the genetic alterations during head and neck squamous cell carcinoma (HNSCC) development and progression has not yet been defined and their diagnostic or prognostic significance is controversial. Advances in the understanding of the molecular basis of head and neck cancer should help in the identification of new markers that could be used for the diagnosis, prognosis and treatment of the disease.

MMP-1/PAR-1 signal transduction axis and its prognostic impact in esophageal squamous cell carcinoma

The matrix metalloprotease-1 (MMP-1)/protease-activated receptor-1 (PAR-1) signal transduction axis plays an important role in tumorigenesis. To explore the expression and prognostic value of MMP-1 and PAR-1 in esophageal squamous cell carcinoma (ESCC), we evaluated the expression of two proteins in resected specimens from 85 patients with ESCC by immunohistochemistry. Sixty-two (72.9%) and 58 (68.2%) tumors were MMP-1- and PAR-1-positive, respectively, while no significant staining was observed in normal esophageal squamous epithelium. MMP-1 and PAR-1 overexpression was significantly associated with tumor node metastasis (TNM) stage and regional lymph node involvement. Patients with MMP-1- and PAR-1-positive tumors, respectively, had poorer disease-free survival (DFS) than those with negative ESCC (P = 0.002 and 0.003, respectively). Univariate analysis showed a significant relationship between TNM stage [hazard ratio (HR) = 2.836, 95% confidence interval (CI) = 1.866-4.308], regional lymph node involvement (HR = 2.955, 95%CI = 1.713-5.068), MMP-1 expression (HR = 2.669, 95%CI = 1.229-6.127), and PAR-1 expression (HR = 1.762, 95%CI = 1.156-2.883) and DFS. Multivariate analysis including the above four parameters identified TNM stage (HR = 2.035, 95%CI = 1.167-3.681), MMP-1 expression (HR = 2.109, 95%CI = 1.293-3.279), and PAR-1 expression (HR = 1.967, 95%CI = 1.256-2.881) as independent and significant prognostic factors for DFS. Our data suggest for the first time that MMP-1 and PAR-1 were both overexpressed in ESCC and are novel predictors of poor patient prognosis after curative resection. The MMP-1/PAR-1 signal transduction axis might be a new therapeutic target for future therapies tailored against ESCC.

Properties and algorithms of the (n, k)-star graphs

The (n, k)-star interconnection network was proposed in 1995 as an attractive alternative to the n-star topology in parallel computation. The (n, k )-star has significant advantages over the n-star which itself was proposed as an attractive alternative to the popular hypercube. The major advantage of the (n, k )-star network is its scalability, which makes it more flexible than the n-star as an interconnection network. In this thesis, we will focus on finding graph theoretical properties of the (n, k )-star as well as developing parallel algorithms that run on this network. The basic topological properties of the (n, k )-star are first studied. These are useful since they can be used to develop efficient algorithms on this network. We then study the (n, k )-star network from algorithmic point of view. Specifically, we will investigate both fundamental and application algorithms for basic communication, prefix computation, and sorting, etc. A literature review of the state-of-the-art in relation to the (n, k )-star network as well as some open problems in this area are also provided.

Properties and algorithms of the (n, k)-arrangement graphs

The (n, k)-arrangement interconnection topology was first introduced in 1992. The (n, k )-arrangement graph is a class of generalized star graphs. Compared with the well known n-star, the (n, k )-arrangement graph is more flexible in degree and diameter. However, there are few algorithms designed for the (n, k)-arrangement graph up to present. In this thesis, we will focus on finding graph theoretical properties of the (n, k)- arrangement graph and developing parallel algorithms that run on this network. The topological properties of the arrangement graph are first studied. They include the cyclic properties. We then study the problems of communication: broadcasting and routing. Embedding problems are also studied later on. These are very useful to develop efficient algorithms on this network. We then study the (n, k )-arrangement network from the algorithmic point of view. Specifically, we will investigate both fundamental and application algorithms such as prefix sums computation, sorting, merging and basic geometry computation: finding convex hull on the (n, k )-arrangement graph. A literature review of the state-of-the-art in relation to the (n, k)-arrangement network is also provided, as well as some open problems in this area.

Properties and algorithms of the hyper-star graph and its related graphs

The hyper-star interconnection network was proposed in 2002 to overcome the drawbacks of the hypercube and its variations concerning the network cost, which is defined by the product of the degree and the diameter. Some properties of the graph such as connectivity, symmetry properties, embedding properties have been studied by other researchers, routing and broadcasting algorithms have also been designed. This thesis studies the hyper-star graph from both the topological and algorithmic point of view. For the topological properties, we try to establish relationships between hyper-star graphs with other known graphs. We also give a formal equation for the surface area of the graph. Another topological property we are interested in is the Hamiltonicity problem of this graph. For the algorithms, we design an all-port broadcasting algorithm and a single-port neighbourhood broadcasting algorithm for the regular form of the hyper-star graphs. These algorithms are both optimal time-wise. Furthermore, we prove that the folded hyper-star, a variation of the hyper-star, to be maixmally fault-tolerant.

Comparison of classification ability of hyperball algorithms to neural network and k-nearest neighbour algorithms

The main focus of this thesis is to evaluate and compare Hyperbalilearning algorithm (HBL) to other learning algorithms. In this work HBL is compared to feed forward artificial neural networks using back propagation learning, K-nearest neighbor and 103 algorithms. In order to evaluate the similarity of these algorithms, we carried out three experiments using nine benchmark data sets from UCI machine learning repository. The first experiment compares HBL to other algorithms when sample size of dataset is changing. The second experiment compares HBL to other algorithms when dimensionality of data changes. The last experiment compares HBL to other algorithms according to the level of agreement to data target values. Our observations in general showed, considering classification accuracy as a measure, HBL is performing as good as most ANn variants. Additionally, we also deduced that HBL.:s classification accuracy outperforms 103's and K-nearest neighbour's for the selected data sets.

Paraphilic Coercive Disorder : Behavioral Markers and Validity of Diagnostic Criteria

Le présent projet doctoral vise à considérer les lacunes dans la documentation scientifique sur le Trouble Paraphilique Coercitif (TPC) en mettant l’accent sur la validité des critères diagnostiques proposés pour inclusion dans le DSM-5 et les marqueurs comportementaux. À ce fait, les données archivées d’individus ayant sexuellement agressé des femmes adultes ont été étudiées. La thèse est constituée de trois articles empiriques. Le premier article présente des résultats clés découlant des analyses, élaborés dans les articles subséquents. Le second (N = 47) évalue les fréquences observées du TPC, la validité et l’impact du recours au nombre minimal de victimes comme critère diagnostique, ainsi que les indices prédisant la récidive sexuelle. Le troisième article (N = 52) compare les groupes diagnostiques sur une série de comportements délictuels, tels que les gestes sexuels et les comportements violents, dans le but d’identifier les marqueurs comportementaux associés avec la propension au viol qui pourraient assister dans le processus diagnostique. Dans le même ordre d’idées, nous avons créé des typologies de violeurs à partir des gestes sexuels commis, d’un côté, et des comportements violents, de l’autre côté. Conséquemment, les caractéristiques des typologies ainsi obtenues et leur association avec le TPC furent examinées. Dans l’ensemble, nos résultats ne soutiennent pas le recours au nombre de victimes. Nos données suggèrent que, globalement, les violeurs avec le TPC utilisent un niveau de gestes sexuels plus envahissant et un niveau de violence moindre que les violeurs n’ayant pas ce diagnostic, et que l’exhibitionnisme et l’attouchement pourraient servir de marqueurs comportementaux pour le TPC. En outre, les violeurs avec le TPC sont caractérisés davantage par demande indécente, exhibitionnisme, attouchement, masturbation, tentative de pénétration et pénétration digitale que par pénétration vaginale et sodomie. De plus, ces derniers font moins recours à l’utilisation d’armes, semblent ne pas frapper/donner des coups à la victime et sont caractérisés par la manipulation plutôt que par le recours aux menaces de mort, force excessive et utilisation d’armes. En somme, nos données soulignent la nécessité de s’appuyer sur une combinaison de méthodes d’évaluation afin d’améliorer la validité diagnostique et discriminante du TPC.

Exact error estimates and optimal randomized algorithms for integration

Exact error estimates for evaluating multi-dimensional integrals are considered. An estimate is called exact if the rates of convergence for the low- and upper-bound estimate coincide. The algorithm with such an exact rate is called optimal. Such an algorithm has an unimprovable rate of convergence. The problem of existing exact estimates and optimal algorithms is discussed for some functional spaces that define the regularity of the integrand. Important for practical computations data classes are considered: classes of functions with bounded derivatives and Holder type conditions. The aim of the paper is to analyze the performance of two optimal classes of algorithms: deterministic and randomized for computing multidimensional integrals. It is also shown how the smoothness of the integrand can be exploited to construct better randomized algorithms.

Evaluation of two cloud parametrization schemes using ARM and Cloudnet observations

Ground-based remote-sensing observations from Atmospheric Radiation Measurement (ARM) and Cloud-Net sites are used to evaluate the clouds predicted by a weather forecasting and climate model. By evaluating the cloud predictions using separate measures for the errors in frequency of occurrence, amount when present, and timing, we provide a detailed assessment of the model performance, which is relevant to weather and climate time-scales. Importantly, this methodology will be of great use when attempting to develop a cloud parametrization scheme, as it provides a clearer picture of the current deficiencies in the predicted clouds. Using the Met Office Unified Model, it is shown that when cloud fractions produced by a diagnostic and a prognostic cloud scheme are compared, the prognostic cloud scheme shows improvements to the biases in frequency of occurrence of low, medium and high cloud and to the frequency distributions of cloud amount when cloud is present. The mean cloud profiles are generally improved, although it is shown that in some cases the diagnostic scheme produced misleadingly good mean profiles as a result of compensating errors in frequency of occurrence and amount when present. Some biases remain when using the prognostic scheme, notably the underprediction of mean ice cloud fraction due to the amount when present being too low, and the overprediction of mean liquid cloud fraction due to the frequency of occurrence being too high.

Searching for molecular markers in head and neck squamous cell carcinomas (HNSCC) by statistical and bioinformatic analysis of larynx-derived SAGE libraries

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Stage, Grade and Behavior of Bladder Urothelial Carcinoma Defined by the MicroRNA Expression Profile

Purpose: We identified miRNA expression profiles in urothelial carcinoma that are associated with grade, stage, and recurrence-free and disease specific survival. Materials and Methods: The expression of 14 miRNAs was evaluated by quantitative reverse transcriptase-polymerase chain reaction in surgical specimens from 30 patients with low grade, noninvasive (pTa) and 30 with high grade, invasive (pT2-3) urothelial carcinoma. Controls were normal bladder tissue from 5 patients who underwent surgical treatment for benign prostatic hyperplasia. Endogenous controls were RNU-43 and RNU-48. miRNA profiles were compared and Kaplan-Meier curves were constructed to analyze disease-free and disease specific survival. Results: miR-100 was under expressed in 100% of low grade pTa specimens (p <0.001) and miR-10a was over expressed in 73.3% (p <0.001). miR-21 and miR-205 were over expressed in high grade pT2-3 disease (p = 0.02 and <0.001, respectively). The other miRNAs were present at levels similar to those of normal bladder tissue or under expressed in each tumor group. miR-21 over expression (greater than 1.08) was related to shorter disease-free survival in patients with low grade pTa urothelial carcinoma. Higher miR-10a levels (greater than 2.30) were associated with shorter disease-free and disease specific survival in patients with high grade pT2-3 urothelial carcinoma. Conclusions: Four miRNAs were differentially expressed in the 2 urothelial carcinoma groups. miR-100 and miR-10a showed under expression and over expression, respectively, in low grade pTa tumors. miR-21 and miR-205 were over expressed in pT2-3 disease. In addition, miR-10a and miR-21 over expression was associated with shorter disease-free and disease specific survival. miRNAs could be incorporated into the urothelial carcinoma molecular pathway. These miRNAs could also serve as new diagnostic or prognostic markers and new target drugs.

Expression of human protein S100A7 (psoriasin), preparation of antibody and application to human larynx squamous cell carcinoma

Background Up-regulation of S100A7 (Psoriasin), a small calcium-binding protein, is associated with the development of several types of carcinomas, but its function and possibility to serve as a diagnostic or prognostic marker have not been fully defined. In order to prepare antibodies to the protein for immunohistochemical studies we produced the recombinant S100A7 protein in E. coli. mRNA extracted from human tracheal tumor tissue which was amplified by RT-PCR to provide the region coding for the S100A7 gene. The amplified fragment was cloned in the vector pCR2.1-TOPO and sub-cloned in the expression vector pAE. The protein rS100A7 (His-tag) was expressed in E. coli BL21::DE3, purified by affinity chromatography on an Ni-NTA column, recovered in the 2.0 to 3.5 mg/mL range in culture medium, and used to produce a rabbit polyclonal antibody anti-rS100A7 protein. The profile of this polyclonal antibody was evaluated in a tissue microarray. Results The rS100A7 (His-tag) protein was homogeneous by SDS-PAGE and mass spectrometry and was used to produce an anti-recombinant S100A7 (His-tag) rabbit serum (polyclonal antibody anti-rS100A7). The molecular weight of rS100A7 (His-tag) protein determined by linear MALDI-TOF-MS was 12,655.91 Da. The theoretical mass calculated for the nonapeptide attached to the amino terminus is 12,653.26 Da (delta 2.65 Da). Immunostaining with the polyclonal anti-rS100A7 protein generated showed reactivity with little or no background staining in head and neck squamous cell carcinoma cells, detecting S100A7 both in nucleus and cytoplasm. Lower levels of S100A7 were detected in non-neoplastic tissue. Conclusions The polyclonal anti-rS100A7 antibody generated here yielded a good signal-to-noise contrast and should be useful for immunohistochemical detection of S100A7 protein. Its potential use for other epithelial lesions besides human larynx squamous cell carcinoma and non-neoplastic larynx should be explored in future.

Application of evolutionary algorithms and the boundary element method in the optimization of noise barrier profiles

[EN]This Ph.D. thesis presents a general, robust methodology that may cover any type of 2D acoustic optimization problem. A procedure involving the coupling of Boundary Elements (BE) and Evolutionary Algorithms is proposed for systematic geometric modifications of road barriers that lead to designs with ever-increasing screening performance. Numerical simulations involving single- and multi-objective optimizations of noise barriers of varied nature are included in this document. results disclosed justify the implementation of this methodology by leading to optimal solutions of previously defined topologies that, in general, greatly outperform the acoustic efficiency of classical, widely used barrier designs normally erected near roads.

UWB radar sensor networks: Detection algorithms design and experimental analysis

In the last years radar sensor networks for localization and tracking in indoor environment have generated more and more interest, especially for anti-intrusion security systems. These networks often use Ultra Wide Band (UWB) technology, which consists in sending very short (few nanoseconds) impulse signals. This approach guarantees high resolution and accuracy and also other advantages such as low price, low power consumption and narrow-band interference (jamming) robustness. In this thesis the overall data processing (done in MATLAB environment) is discussed, starting from experimental measures from sensor devices, ending with the 2D visualization of targets movements over time and focusing mainly on detection and localization algorithms. Moreover, two different scenarios and both single and multiple target tracking are analyzed.