Managing marginal capital requirements in solvency II: Analysis of a real insurance portfolio

This thesis provides a complete analysis of the Standard Capital Requirements given by Solvency II for a real insurance portfolio. We analyze the investment portfolio of BPI Vida e Pens��es, an insurance company affiliated with a Portuguese bank BPI, both at security, sub-portfolio and asset class levels. By using the Standard Formula from EIOPA, Total SCR amounts to 239M���. This value is mostly explained by Market and Default Risk whereas the former is driven by Spread and Concentration Risks. Following the methodology of Leblanc (2011), we examine the Marginal Contribution of an asset to the SCR which allows for the evaluation of the risks of each security given its characteristics and interactions in the portfolio. The top contributors to the SCR are Corporate Bonds and Term Deposits. By exploring further the composition of the portfolio, our results show that slight changes in allocation of Term and Cash Deposits have severe impacts on the total Concentration and Default Risks, respectively. Also, diversification effects are very relevant by representing savings of 122M���. Finally, Solvency II represents an opportunity for the portfolio optimization. By constructing efficient frontiers, we find that as the target expected return increases, a shift from Term Deposits/ Commercial Papers to Eurozone/Peripheral and finally Equities occurs.

Sustainable urban planning: parameters to the operational process

In modern society, energy consumption and respect for the environment have become essential aspects of urban planning. The rising demand for alternative sources of energy, coupled with the decline in the construction sector and material usage, gives the idea that the thinking on modern cities, where attention is given to reduced energy consumption, savings, waste recycling and respect for the surrounding environment, is being put into practice. If we examine development of the city over recent centuries, by means of the theories of the most famous and influential urban planners, it is possible to identify the major problems caused by this type of planning. For this reason, in recent urban planning the use of systems of indicators that evaluate and certify land environmentally and energetically guides the master plan toward a more efficient city model. In addition the indicators are targeted on key factors determined by the commissioner or the opportunities the territory itself provides. Due the complexity of the environmental mechanics, the process of design and urban planning has become a challenging issue. The introduction of the indicators system has made it possible to register the life of the process, with a spiral route that allows the design itself to be refined. The aim of this study, built around the creation of a system of urban sustainability indicators that will evaluate highly eco-friendly cities, is to develop a certification system for cities or portions of them. The system will be upgradeable and objective, will employ real data and will be concerned with energy production and consumption.

Overstock and stock-out in Volkswagen Autoeuropa

The following work is a case study of overstock and stock-out problems at Volkswagen Autoeuropa (VWAE). It introduces the supply chain of Autoeuropa and specializes then on failures connected to inventory problems. Having a successful supply chain is important in a world where products become more and more similar as it can give to companies an edge over their competitors. The case shows three practices that VWAE uses to prevent and to overcome stock problems. Information was gathered by doing interviews with different managers, by analyzing the company���s key processes and by literature research related to the topics of supply chain management and flexibility in the supply chain. Three practices were further investigated: the use of alternative parts, support of the supplier and a rating system of suppliers. In the question section of this work the importance of flexibility and Supplier Relationship Management (SRM) when connected to supply chain management are explained. The described different practices are numerically analyzed and it is concluded that each practice brings both cost savings and the possibility of achieving target numbers to the company, showing the company���s flexibility to react to supply chain disturbances. Because of confidentiality reasons, persons in the case are fictionalized and numbers are wherever possible equalized to 100 in order to display true proportions.

Avalia����o econ��mica em transplanta����o renal : abordagem estrat��gica do processo de doa����o e an��lise de custo-utilidade do programa de transplanta����o renal versus hemodi��lise

SUM��RIO - O desafio atual da Sa��de P��blica �� assegurar a sustentabilidade financeira do sistema de sa��de. Em ambiente de recursos escassos, as an��lises econ��micas aplicadas �� presta����o dos cuidados de sa��de s��o um contributo para a tomada de decis��o que visa a maximiza����o do bem-estar social sujeita a restri����o or��amental. Portugal �� um pa��s com 10,6 milh��es de habitantes (2011) com uma incid��ncia e preval��ncia elevadas de doen��a renal cr��nica estadio 5 (DRC5), respetivamente, 234 doentes por milh��o de habitantes (pmh) e 1.600 doentes/pmh. O crescimento de doen��as associadas ��s causas de DRC, nomeadamente, diabetes Mellitus e hipertens��o arterial, antecipam uma tend��ncia para o aumento do n��mero de doentes. Em 2011, dos 17.553 doentes em tratamento substitutivo renal, 59% encontrava-se em programa de hemodi��lise (Hd) em centros de di��lise extra-hospitalares, 37% viviam com um enxerto renal funcionante e 4% estavam em di��lise peritoneal (SPN, 2011). A lista ativa para transplante (Tx) renal registava 2.500 doentes (SPN 2009). O Tx renal �� a melhor modalidade terap��utica pela melhoria da sobrevida, qualidade de vida e rela����o custo-efetividade, mas a elegibilidade para Tx e a oferta de ��rg��os condicionam esta op����o. Esta investiga����o desenvolveu-se em duas vertentes: i) determinar o r��cio custo-utilidade incremental do Tx renal comparado com a Hd; ii) avaliar a capacidade m��xima de dadores de cad��ver em Portugal, as caracter��sticas e as causas de morte dos dadores potenciais a n��vel nacional, por hospital e por Gabinete Coordenador de Colheita e Transplanta����o (GCCT), e analisar o desempenho da rede de colheita de ��rg��os para Tx. Realizou-se um estudo observacional/n��o interventivo, prospetivo e anal��tico que incidiu sobre uma coorte de doentes em Hd que foi submetida a Tx renal. O tempo de seguimento m��nimo foi de um ano e m��ximo de tr��s anos. No in��cio do estudo, colheram-se dados sociodemogr��ficos e cl��nicos em 386 doentes em Hd, eleg��veis para Tx renal. A qualidade de vida relacionada com a sa��de (QVRS) foi avaliada nos doentes em Hd (tempo 0) e nos transplantados, aos tr��s, seis, 12 meses, e depois, anualmente. Inclu��ram-se os doentes que por fal��ncia do enxerto renal transitaram para Hd. Na sua medi����o, utilizou-se um instrumento baseado em prefer��ncias da popula����o, o EuroQol-5D, que permite o posterior c��lculo dos QALY. Num grupo de 82 doentes, a QVRS em Hd foi avaliada em dois tempos de resposta o que permitiu a an��lise da sua evolu����o. Realizou-se uma an��lise custo-utilidade do Tx renal comparado com a Hd na perspetiva da sociedade. Identificaram-se os custos diretos, m��dicos e n��o m��dicos, e as altera����es de produtividade em Hd e Tx renal. Inclu��ram-se os custos da colheita de ��rg��os, sele����o dos candidatos a Tx renal e follow-up dos dadores vivos. Cada doente transplantado foi utilizado como controle de si pr��prio em di��lise. Avaliou-se o custo m��dio anual em programa de Hd cr��nica relativo ao ano anterior �� Tx renal. Os custos do Tx foram avaliados prospetivamente. Considerou-se como horizonte temporal o ciclo de vida nas duas modalidades. Usaram-se taxas de atualiza����o de 0%, 3% e 5% na atualiza����o dos custos e QALY e efetuaram-se an��lises de sensibilidade one way. Entre 2008 e 2010, 65 doentes foram submetidos a Tx renal. Registaram-se, prospetivamente, os resultados em sa��de inclu��ndo os internamentos e os efeitos adversos da imunossupress��o, e o consumo dos recursos em sa��de. Utilizaram-se modelos de medidas repetidas na avalia����o da evolu����o da QVRS e modelos de regress��o m��ltipla na an��lise da associa����o da QVRS e dos custos do transplante com as caracter��sticas basais dos doentes e os eventos cl��nicos. Comparativamente �� Hd, observou-se melhoria da utilidade ao 3�� m��s de Tx e a qualidade de vida aferida pela escala EQ-VAS melhorou em todos os tempos de observa����o ap��s o Tx renal. O custo m��dio da Hd foi de 32.567,57���, considerado uniforme ao longo do tempo. O custo m��dio do Tx renal foi de 60.210,09��� no 1�� ano e 12.956,77��� nos anos seguintes. O r��cio custo-utilidade do Tx renal vs Hd cr��nica foi de 2.004,75���/QALY. A partir de uma sobreviv��ncia do enxerto de dois anos e cinco meses, o Tx associou-se a poupan��a dos custos. Utilizaram-se os dados nacionais dos Grupos de Diagn��stico Homog��neos e realizou-se um estudo retrospectivo que abrangeu as mortes ocorridas em 34 hospitais com colheita de ��rg��os, em 2006. Considerou-se como dador potencial o indiv��duo com idade entre 1-70 anos cuja morte ocorrera a n��vel hospitalar, e que apresentasse crit��rios de adequa����o �� doa����o de rim. Analisou-se a associa����o dos dadores potenciais com caracter��sticas populacionais e hospitalares. O desempenho das organiza����es de colheita de ��rg��os foi avaliado pela taxa de convers��o (r��cio entre os dadores potenciais e efetivos) e pelo n��mero de dadores potenciais por milh��o de habitantes a n��vel nacional, regional e por Gabinete Coordenador de Colheita e Transplanta����o (GCCT). Identificaram-se 3.838 dadores potenciais dos quais 608 apresentaram c��digos da Classifica����o Internacional de Doen��as, 9.�� Revis��o, Modifica����es Cl��nicas (CID- 9-MC) que, com maior frequ��ncia, evoluem para a morte cerebral. O modelo logit para dados agrupados identificou a idade, o r��cio da lota����o em Unidades de Cuidados Intensivos e lota����o de agudos, exist��ncia de GCCT e de Unidade de Transplanta����o, e mortalidade por acidente de trabalho como fatores preditivos da convers��o dum dador potencial em efetivo e atrav��s das estimativas do modelo logit quantificou-se a probabilidade dessa convers��o. A doa����o de ��rg��os deve ser assumida como uma prioridade e as autoridades em sa��de devem assegurar o financiamento dos hospitais com programas de doa����o, evitando o desperd��cio de ��rg��os para transplanta����o, enquanto um bem p��blico e escasso. A colheita de ��rg��os deve ser considerada uma op����o estrat��gica da atividade hospitalar orientada para a organiza����o e planeamento de servi��os que maximizem a convers��o de dadores potenciais em efetivos incluindo esse crit��rio como medida de qualidade e efetividade do desempenho hospitalar. Os resultados deste estudo demonstram que: 1) o Tx renal proporciona ganhos em sa��de, aumento da sobrevida e qualidade de vida, e poupan��a de custos; 2) em Portugal, a taxa m��xima de efic��cia da convers��o dos dadores cadav��ricos em dadores potenciais est�� longe de ser atingida. O investimento na rede de colheita de ��rg��os para Tx �� essencial para assegurar a sustentabilidade financeira e promover a qualidade, efici��ncia e equidade dos cuidados em sa��de prestados na DRC5.

Cost of drugs manufactured by the University Hospital - role of the Central Pharmacy

The hospital pharmacy in large and advanced institutions has evolved from a simple storage and distribution unit into a highly specialized manipulation and dispensation center, responsible for the handling of hundreds of clinical requests, many of them unique and not obtainable from commercial companies. It was therefore quite natural that in many environments, a manufacturing service was gradually established, to cater to both conventional and extraordinary demands of the medical staff. That was the case of Hospital das Clinicas, where multiple categories of drugs are routinely produced inside the pharmacy. However, cost-containment imperatives dictate that such activities be reassessed in the light of their efficiency and essentiality. METHODS: In a prospective study, the output of the Manufacturing Service of the Central Pharmacy during a 12-month period was documented and classified into three types. Group I comprised drugs similar to commercially distributed products, Group II included exclusive formulations for routine consumption, and Group III dealt with special demands related to clinical investigations. RESULTS: Findings for the three categories indicated that these groups represented 34.4%, 45.3%, and 20.3% of total manufacture orders, respectively. Costs of production were assessed and compared with market prices for Group 1 preparations, indicating savings of 63.5%. When applied to the other groups, for which direct equivalent in market value did not exist, these results would suggest total yearly savings of over 5 100 000 US dollars. Even considering that these calculations leave out many components of cost, notably those concerning marketing and distribution, it might still be concluded that at least part of the savings achieved were real. CONCLUSIONS: The observed savings, allied with the convenience and reliability with which the Central Pharmacy performed its obligations, support the contention that internal manufacture of pharmaceutical formulations was a cost-effective alternative in the described setting.

Optimization of wastewater quality in the Sines refinery

In order to address and resolve the wastewater contamination problem of the Sines refinery with the main objective of optimizing the quality of this stream and reducing the costs charged to the refinery, a dynamic mass balance was developed nd implemented for ammonia and polar oil and grease (O&G) contamination in the wastewater circuit. The inadequate routing of sour gas from the sour water stripping unit and the kerosene caustic washing unit, were identified respectively as the major source of ammonia and polar substances present in the industrial wastewater effluent. For the O&G content, a predictive model was developed for the kerosene caustic washing unit, following the Projection to Latent Structures (PLS) approach. Comparison between analytical data for ammonia and polar O&G concentrations in refinery wastewater originating from the Dissolved Air Flotation (DAF) effluent and the model predictions of the dynamic mass balance calculations are in a very good agreement and highlights the dominant impact of the identified streams for the wastewater contamination levels. The ammonia contamination problem was solved by rerouting the sour gas through an existing clogged line with ammonia salts due to a non-insulated line section, while for the O&G a dynamic mass balance was implemented as an online tool, which allows for prevision of possible contamination situations and taking the required preventive actions, and can also serve as a basis for establishing relationships between the O&G contamination in the refinery wastewater with the properties of the refined crude oils and the process operating conditions. The PLS model developed could be of great asset in both optimizing the existing and designing new refinery wastewater treatment units or reuse schemes. In order to find a possible treatment solution for the spent caustic problem, an on-site pilot plant experiments for NaOH recovery from the refinery kerosene caustic washing unit effluent using an alkaline-resistant nanofiltration (NF) polymeric membrane were performed in order to evaluate its applicability for treating these highly alkaline and contaminated streams. For a constant operating pressure and temperature and adequate operating conditions, 99.9% of oil and grease rejection and 97.7% of chemical oxygen demand (COD) rejection were observed. No noticeable membrane fouling or flux decrease were registered until a volume concentration factor of 3. These results allow for NF permeate reuse instead of fresh caustic and for significant reduction of the wastewater contamination, which can result in savings of 1.5 M��� per year at the current prices for the largest Portuguese oil refinery. The capital investments needed for implementation of the required NF membrane system are less than 10% of those associated with the traditional wet air oxidation solution of the spent caustic problem. The operating costs are very similar, but can be less than half if reusing the NF concentrate in refinery pH control applications. The payback period was estimated to be 1.1 years. Overall, the pilot plant experimental results obtained and the process economic evaluation data indicate a very competitive solution through the proposed NF treatment process, which represents a highly promising alternative to conventional and existing spent caustic treatment units.

Polyhydroxyalkanoates production by photosynthetic mixed cultures

Polyhydroxyalkanoates (PHAs) are natural biologically synthesized polymers that have been the subject of much interest in the last decades due to their biodegradability. Thus far, its microbial production is associated with high operational costs, which increases PHA prices and limits its marketability. To address this situation, this thesis��� work proposes the utilization of photosynthetic mixed cultures (PMC) as a new PHA production system that may lead to a reduction in operational costs. In fact, the operational strategies developed in this work led to the selection of PHA accumulating PMCs that, unlike the traditional mixed microbial cultures, do not require aeration, thus permitting savings in this significant operational cost. In particular, the first PHA accumulating PMC tested in this work was selected under non-aerated illuminated conditions in a feast and famine regime, being obtained a consortium of bacteria and algae, where photosynthetic bacteria accumulated PHA during the feast phase and consumed it for growth during the famine phase, using the oxygen produced by algae. In this symbiotic system, a maximum PHA content of 20% cell dry weight (cdw) was reached, proving for the first time, the capacity of a PMC to accumulate PHA. During adaptation to dark/light alternating conditions, the culture decreased its algae content but maintained its viability, achieving a PHA content of 30% cdw. Also, the PMC was found to be able to utilize different volatile fatty acids for PHA production, accumulating up to 20% cdw of a PHA co-polymer composed of 3-hydroxybutyrate (3HB) and 3-hydroxyvalerate (HV) monomers. Finally, a new selective approach for the enrichment of PMCs in PHA accumulating bacteria was tested. Instead of imposing a feast and famine regime, a permanent feast regime was used, thus selecting a PMC that was capable of simultaneously growing and accumulating PHA, being attained a maximum PHA content of 60% cdw, the highest value reported for a PMC thus far. The results presented in this thesis prospect the utilization of cheap, VFA-rich fermented wastes as substrates for PHA production, which combined with this new photosynthetic technology opens up the possibility for direct sunlight illumination, leading to a more cost-effective and environmentally sustainable PHA production process.

Relat��rio de est��gio na AXA Portugal

The present report has the goal of enunciating and exposing some of the main judicial subjects that were developed during the period of internship, coming forth in the form of answers to questions properly reformulated as not to injure the confidentiality of data available while in the process of making said report, they deal with different branches of the law, although with a special focus on the field of Insurance Law. It being an academic piece, it was of the utmost importance to focus more sharply on a specific theme, in casu, medical-civil responsibility, causing the interest in this matter due to the curricular internship and a case law research on the subject. The last chapter of this paper focuses mainly on the problematic of seizure by insurance intermediary���s commissions, credits from occupational accidents and illnesses and Retirement and Education Savings Plans (PPR/Es), this being one problematic with which I dealt directly in the early stages of the internship.

Sistema de seguran��a interna : a unifica����o do sistema em Portugal

A acelera����o do ritmo de mudan��a verificado nas sociedades atuais, tem sido impulsionado pela globaliza����o, fen��meno decorrente da evolu����o das tecnologias da informa����o, das telecomunica����es, das comunica����es e transportes e do desaparecimento de fronteiras. Viver na ���aldeia global��� ou �� escala global como o previu Marshall McLuhan (1964) no livro Understanding Media, �� hoje uma realidade inquestion��vel. As consequ��ncias desta transforma����o foram m��ltiplas quer do ponto de vista dos benef��cios, quer do ponto de vista dos problemas gerados. No plano da seguran��a, face ao multiculturalismo envolvido e ao aumento crescente do crime transfronteiri��o, tornou-se essencial a partilha de informa����o a n��vel internacional tendo em vista o seu combate n��o s�� olhando a situa����o dos cidad��os como a defesa dos princ��pios democr��ticos. Real��a-se que os progressos tecnol��gicos e as facilidades que criam aos seus utilizadores, neste caso os criminosos, fazem com que as a����es por estes praticadas sejam cada vez mais meticulosas, imprevis��veis, sofisticadas e complexas o que imp��e uma resposta correspondente e adequada. Por essa raz��o, as pol��ticas de seguran��a existentes mostraram-se insuficientes e esgotadas requerendo novas respostas capazes de produzir os efeitos desej��veis para uma efetiva preven����o da criminalidade. Pelas dimens��es que tem vindo a tomar, a criminalidade tornou-se uma preocupa����o que ultrapassou o dom��nio da seguran��a interna de cada pa��s para ser encarada a n��vel internacional ou mesmo mundial. Para o efeito urge concertar processos e procedimentos securit��rios agregando vontades que convirjam e defendam a unifica����o dos sistemas dos pa��ses a n��vel mundial. A verificar-se tal intento, da�� resultariam significativas melhorias da seguran��a a todos os n��veis (nacional, internacional e mundial). Al��m disso tamb��m resultariam ganhos em termos de tempo, redu����o de custos, impacto na qualidade dos servi��os prestados, na gest��o das pessoas e na efici��ncia das organiza����es. Real��a-se que a democracia ao promover a dignidade do homem densificando os seus direitos, liberdades e garantias, criou indiretamente condi����es para que fosse gerada instabilidade e o desenvolvimento de comportamentos criminosos. Importa, portanto, face �� situa����o existente e �� previs��vel complexidade do crime no futuro, estudar profundamente a nova realidade neste dom��nio, para tomar as medidas preventivas tendentes a reporem a estabilidade e a promoverem a paz social. Foi neste contexto que a presente investiga����o, desenvolvida no ��mbito acad��mico, mas tamb��m suportado na realidade profissional, pretendeu refletir sobre o estado da seguran��a global e dar o seu contributo nesta mat��ria.

Otimiza����o de esquemas terap��uticos do carcinoma da pr��stata envolvendo braquiterapia de baixa taxa de dose e radioterapia externa : abordagens f��sica e radiobiol��gica

RESUMO: Este trabalho teve como objetivo a determina����o de esquemas de tratamento alternativos para o carcinoma da pr��stata com radioterapia externa (EBRT) e braquiterapia de baixa taxa de dose (LDRBT) com implantes permanentes de Iodo-125, biologicamente equivalentes aos convencionalmente usados na pr��tica cl��nica, com recurso a modelos te��ricos e a m��todos de Monte Carlo (MC). Os conceitos de dose biol��gica efetiva (BED) e de dose uniforme equivalente (EUD) foram utilizados, com o modelo linear-quadr��tico (LQ), para a determina����o de regimes de tratamento equivalentes. Numa primeira abordagem, utilizou-se a BED para determinar: 1) esquemas hipofracionados de EBRT mantendo as complica����es retais tardias de regimes convencionais com doses totais de 75,6 Gy, 77,4 Gy, 79,2 Gy e 81,0 Gy; e 2) a rela����o entre as doses totais de EBRT e LDRBT de modo a manter a BED do regime convencional de 45 Gy de EBRT e 110 Gy de LDRBT. Numa segunda abordagem, recorreu-se ao c��digo de MC MCNPX para a simula����o de distribui����es de dose de EBRT e LDRBT em dois fantomas de voxel segmentados a partir das imagens de tomografia computorizada de pacientes com carcinoma da pr��stata. Os resultados das simula����es de EBRT e LDRBT foram somados e determinada uma EUD total de forma a obterem-se: 1) esquemas equivalentes ao tratamento convencional de 25 fra����es de 1,8 Gy de EBRT em combina����o com 110 Gy de LDRBT; e 2) esquemas equivalentes a EUD na pr��stata de 67 Gy, 72 Gy, 80 Gy, 90 Gy, 100 Gy e 110 Gy. Em todos os resultados nota-se um ganho terap��utico te��rico na utiliza����o de esquemas hipofracionados de EBRT. Para uma BED no reto equivalente ao esquema convencional, tem-se um aumento de 2% na BED da pr��stata com menos 5 fra����es. Este incremento d��-se de forma cada vez mais vis��vel �� medida que se reduz o n��mero de fra����es, sendo da ordem dos 10-11% com menos 20 fra����es e dos 35-45% com menos 40 fra����es. Considerando os resultados das simula����es de EBRT, obteve-se uma EUD m��dia de 107 Gy para a pr��stata e de 42 Gy para o reto, com o esquema convencional de 110 Gy de LDRBT, seguidos de 25 fra����es de 1,8 Gy de EBRT. Em termos de probabilidade de controlo tumoral (igual EUD), �� equivalente a este tratamento a administra����o de EBRT em 66 fra����es de 1,8 Gy, 56 de 2 Gy, 40 de 2,5 Gy, 31 de 3 Gy, 20 de 4 Gy ou 13 de 5 Gy. Relativamente �� administra����o de 66 fra����es de 1,8 Gy, a EUD generalizada no reto reduz em 6% com o recurso a fra����es de 2,5 Gy e em 10% com fra����es de 4 Gy. Determinou-se uma BED total de 162 Gy para a administra����o de 25 fra����es de 1,8 Gy de EBRT em combina����o com 110 Gy de LDRBT. Variando-se a dose total de LDRBT (TDLDRBT) em fun����o da dose total de EBRT (TDEBRT), de modo a garantir uma BED de 162 Gy, obteve-se a seguinte rela����o:.......... Os resultados das simula����es mostram que a EUD no reto diminui com o aumento da dose total de LDRBT para dose por fra����o de EBRT (dEBRT) inferiores a 2, Gy e aumenta para dEBRT a partir dos 3 Gy. Para quantidades de TDLDRBT mais baixas (<50 Gy), o reto beneficia de fra����es maiores de EBRT. �� medida que se aumenta a TDLDRBT, a EUD generalizada no reto torna-se menos dependente da dEBRT. Este trabalho mostra que �� poss��vel a utiliza����o de diferentes regimes de tratamento para o carcinoma da pr��stata com radioterapia que possibilitem um ganho terap��utico, quer seja administrando uma maior dose biol��gica com efeitos tardios constantes, quer mantendo a dose no tumor e diminuindo a toxicidade retal. A utiliza����o com precau����o de esquemas hipofracionados de EBRT, para al��m do benef��cio terap��utico, pode trazer vantagens ao n��vel da conveni��ncia para o paciente e economia de custos. Os resultados das simula����es deste estudo e convers��o para doses de efeito biol��gico para o tratamento do carcinoma da pr��stata apresentam linhas de orienta����o te��rica de interesse para novos ensaios cl��nicos. --------------------------------------------------ABSTRACT: The purpose of this work was to determine alternative radiotherapy regimens for the treatment of prostate cancer using external beam radiotherapy (EBRT) and low dose-rate brachytherapy (LDRBT) with Iodine-125 permanent implants which are biologically equivalent to conventional clinical treatments, by the use of theoretical models and Monte Carlo techniques. The concepts of biological effective dose (BED) and equivalent uniform dose (EUD), together with the linear-quadratic model (LQ), were used for determining equivalent treatment regimens. In a first approach, the BED concept was used to determine: 1) hypofractionated schemes of EBRT maintaining late rectal complications as with the conventional regimens with total doses of 75.6 Gy, 77.4 Gy, 79.2 Gy and 81.0 Gy; and 2) the relationship between total doses of EBRT and LDRBT in order to keep the BED of the conventional treatment of 45 Gy of EBRT and 110 Gy of LDRBT. In a second approach, the MC code MCNPX was used for simulating dose distributions of EBRT and LDRBT in two voxel phantoms segmented from the computed tomography of patients with prostate cancer. The results of the simulations of EBRT and LDRBT were added up and given an overall EUD in order to obtain: 1) equivalent to conventional treatment regimens of 25 fraction of 1.8 Gy of EBRT in combination with 110Gy of LDRBT; and 2) equivalent schemes of EUD of 67 Gy, 72 Gy, 80 Gy, 90 Gy, 100 Gy, and 110Gy to the prostate. In all the results it is noted a therapeutic gain using hypofractionated EBRT schemes. For a rectal BED equivalent to the conventional regimen, an increment of 2% in the prostate BED was achieved with less 5 fractions. This increase is visibly higher as the number of fractions decrease, amounting 10-11% with less 20 fractions and 35-45% with less 20 fractions. Considering the results of the EBRT simulations an average EUD of 107 Gy was achieved for the prostate and of 42 Gy for the rectum with the conventional scheme of 110 Gy of LDRBT followed by 25 fractions of 1.8 Gy of EBRT. In terms of tumor control probability (same EUD) it is equivalent to this treatment, for example, delivering the EBRT in 66 fractions of 1.8 Gy, 56 fractions of 2 Gy, 40 fractions of 2.5 Gy, 31 fractions of 3 Gy, 20 fractions of 4 Gy or 13 fractions of 5 Gy. Regarding the use of 66 fractions of 1.8 Gy, the rectum EUD is reduced to 6% with 2.5 Gy per fraction and to 10% with 4 Gy. A total BED of 162 Gy was achieved for the delivery of 25 fractions of 1.8 Gy of EBRT in combination with 110 Gy of LDRBT. By varying the total dose of LDRBT (TDLDRBT) with the total dose of EBRT (TDEBRT) so as to ensure a BED of 162 Gy, the following relationship was obtained: ....... The simulation results show that the rectum EUD decreases with the increase of the TDLDRBT, for EBRT dose per fracion (dEBRT) less than 2.5 Gy and increases for dEBRT above 3 Gy. For lower amounts of TDLDRBT (< 50Gy), the rectum benefits of larger EBRT fractions. As the TDLDRBT increases, the rectum gEUD becomes less dependent on the dEBRT. The use of different regimens which enable a therapeutic gain, whether deivering a higher dose with the same late biological effects or maintaining the dose to the tumor and reducing rectal toxicity is possible. The use with precaution of hypofractionated regimens, in addition to the therapeutic benefit, can bring advantages in terms of convenience for the patient and cost savings. The simulation results of this study together with the biological dose conversion for the treatment of prostate cancer serve as guidelines of interest for new clinical trials.

Improving Millennium Bank's personal finance manager

Double Degree

Should my company use Bitcoin?

This work project analyses the possibility for a company to trade their goods and services for bitcoins, by joining the Bitcoin network. It analyses the technological and business requirements to join the Bitcoin Network by looking at Bitcoin���s potential to act as a mean of exchange for trade, unit of account and store of value. The analysis points to the motives, benefits and risks for investors to use the Bitcoin as a traditional currency and recommends on strategies for addressing those risks and maximizing benefits. Other than companies this report, to a lesser extent, will also analyse the Bitcoin from an investor���s point of view, this is, should an investor buy bitcoins for trade and make savings on a regular and everyday basis? A major finding in this work project is that companies could start using the Bitcoin system as a legit form of payment since the benefits of using this technology outweigh the costs and risks, given the right approach. This form of payment will contribute for the upgrade of a company���s business��� image, attract a new pool of consumers and businesses that already trade in bitcoins and pressure existing financial institutions and electronic payment vendors to upgrade their service levels.

Non emergency patients transport - a mixed integer linear programming

This work presents a model and a heuristic to solve the non-emergency patients transport (NEPT) service issues given the new rules recently established in Portugal. The model follows the same principle of the Team Orienteering Problem by selecting the patients to be included in the routes attending the maximum reduction in costs when compared with individual transportation. This model establishes the best sets of patients to be transported together. The model was implemented in AMPL and a compact formulation was solved using NEOS Server. A heuristic procedure based on iteratively solving problems with one vehicle was presented, and this heuristic provides good results in terms of accuracy and computation time.

Earthwork optimization system for sustainable highway construction

In highway construction, earthworks refer to the tasks of excavation, transportation, spreading and compaction of geomaterial (e.g. soil, rockfill and soil-rockfill mixture). Whereas relying heavily on machinery and repetitive processes, these tasks are highly susceptible to optimization. In this context Artificial Intelligent techniques, such as Data Mining and modern optimization can be applied for earthworks. A survey of these applications shows that they focus on the optimization of specific objectives and/or construction phases being possible to identify the capabilities and limitations of the analyzed techniques. Thus, according to the pinpointed drawbacks of these techniques, this paper describes a novel intelligent earthwork optimization system, capable of integrating DM, modern optimization and GIS technologies in order to optimize the earthwork processes throughout all phases of design and construction work. This integration system allows significant savings in time, cost and gas emissions contributing for a more sustainable construction.

Melhoria da efici��ncia energ��tica em edif��cios dos anos 70: implementa����o de solu����es sustent��veis low-tech e low-cost

Disserta����o de mestrado em Constru����o e Reabilita����o Sustent��veis