Personalised and Precision Medicine in Cancer Clinical Trials: Panacea for Progress or Pandora's Box?

Cancer clinical trials have been one of the key foundations for significant advances in oncology. However, there is a clear recognition within the academic, care delivery and pharmaceutical/biotech communities that our current model of clinical trial discovery and development is no longer fit for purpose. Delivering transformative cancer care should increasingly be our mantra, rather than maintaining the status quo of, at best, the often miniscule incremental benefits that are observed with many current clinical trials. As we enter the era of precision medicine for personalised cancer care (precision and personalised medicine), it is important that we capture and utilise our greater understanding of the biology of disease to drive innovative approaches in clinical trial design and implementation that can lead to a step change in cancer care delivery. A number of advances have been practice changing (e.g. imatinib mesylate in chronic myeloid leukaemia, Herceptin in erb-B2-positive breast cancer), and increasingly we are seeing the promise of a number of newer approaches, particularly in diseases like lung cancer and melanoma. Targeting immune checkpoints has recently yielded some highly promising results. New algorithms that maximise the effectiveness of clinical trials, through for example a multi-stage, multi-arm type design are increasingly gaining traction. However, our enthusiasm for the undoubted advances that have been achieved are being tempered by a realisation that these new approaches may have significant cost implications. This article will address these competing issues, mainly from a European perspective, highlight the problems and challenges to healthcare systems and suggest potential solutions that will ensure that the cost/value rubicon is addressed in a way that allows stakeholders to work together to deliver optimal cost-effective cancer care, the benefits of which can be transferred directly to our patients.

On the Ontological Quality and Logical Quality of Conceptual-Modeling Grammars: The Need for a Dual Perspective

A core activity in information systems development involves building a conceptual model of the domain that an information system is intended to support. Such models are created using a conceptual-modeling (CM) grammar. Just as high-quality conceptual models facilitate high-quality systems development, high-quality CM grammars facilitate high-quality conceptual modeling. This paper provides a new perspective on ways to improve the quality of the semantics of CM grammars. For many years, the leading approach to this topic has relied on ontological theory. We show, however, that the ontological approach captures only half the story. It needs to be coupled with a logical approach. We explain how the ontological quality and logical quality of CM grammars interrelate. Furthermore, we outline three contributions that a logical approach can make to evaluating the quality of CM grammars: a means of seeing some familiar conceptual-modeling problems in simpler ways; the illumination of new problems; and the ability to prove the benefit of modifying existing CM grammars in particular ways. We demonstrate these benefits in the context of the Entity-Relationship grammar. More generally, our paper opens up a new area of research with many opportunities for future research and practice.

Evidence for the reliability and validity, but not the practical utility of the two-factor Consideration of Future Consequences Scale-14

Researchers have proposed 1-factor, 2-factor, and bifactor solutions to the 12-item Consideration of Future Consequences Scale (CFCS-12). In order to overcome some measurement problems and to create a robust and conceptually useful two-factor scale the CFCS-12 was recently modified to include two new items and to become the CFCS-14. Using a University sample, we tested four competing models for the CFCS-14: (a) a 12-item unidimensional model, (b) a model fitted for two uncorrelated factors (CFC-Immediate and CFC-Future), (c) a model fitted for two correlated factors (CFC-I and CFC-F), and (d) a bifactor model. Results suggested that the addition of the two new items has strengthened the viability of a two factor solution of the CFCS-14. Results of linear regression models suggest that the CFC-F factor is redundant. Further studies using alcohol and mental health indicators are required to test this redundancy.

Limited range coverage problems

Tal como o título indica, esta tese estuda problemas de cobertura com alcance limitado. Dado um conjunto de antenas (ou qualquer outro dispositivo sem fios capaz de receber ou transmitir sinais), o objectivo deste trabalho é calcular o alcance mínimo das antenas de modo a que estas cubram completamente um caminho entre dois pontos numa região. Um caminho que apresente estas características é um itinerário seguro. A definição de cobertura é variável e depende da aplicação a que se destina. No caso de situações críticas como o controlo de fogos ou cenários militares, a definição de cobertura recorre à utilização de mais do que uma antena para aumentar a eficácia deste tipo de vigilância. No entanto, o alcance das antenas deverá ser minimizado de modo a manter a vigilância activa o maior tempo possível. Consequentemente, esta tese está centrada na resolução deste problema de optimização e na obtenção de uma solução particular para cada caso. Embora este problema de optimização tenha sido investigado como um problema de cobertura, é possível estabelecer um paralelismo entre problemas de cobertura e problemas de iluminação e vigilância, que são habitualmente designados como problemas da Galeria de Arte. Para converter um problema de cobertura num de iluminação basta considerar um conjunto de luzes em vez de um conjunto de antenas e submetê-lo a restrições idênticas. O principal tema do conjunto de problemas da Galeria de Arte abordado nesta tese é a 1-boa iluminação. Diz-se que um objecto está 1-bem iluminado por um conjunto de luzes se o invólucro convexo destas contém o objecto, tornando assim este conceito num tipo de iluminação de qualidade. O objectivo desta parte do trabalho é então minimizar o alcance das luzes de modo a manter uma iluminação de qualidade. São também apresentadas duas variantes da 1-boa iluminação: a iluminação ortogonal e a boa !-iluminação. Esta última tem aplicações em problemas de profundidade e visualização de dados, temas que são frequentemente abordados em estatística. A resolução destes problemas usando o diagrama de Voronoi Envolvente (uma variante do diagrama de Voronoi adaptada a problemas de boa iluminação) é também proposta nesta tese.

Computational methods in the fractional calculus of variations and optimal control

The fractional calculus of variations and fractional optimal control are generalizations of the corresponding classical theories, that allow problem modeling and formulations with arbitrary order derivatives and integrals. Because of the lack of analytic methods to solve such fractional problems, numerical techniques are developed. Here, we mainly investigate the approximation of fractional operators by means of series of integer-order derivatives and generalized finite differences. We give upper bounds for the error of proposed approximations and study their efficiency. Direct and indirect methods in solving fractional variational problems are studied in detail. Furthermore, optimality conditions are discussed for different types of unconstrained and constrained variational problems and for fractional optimal control problems. The introduced numerical methods are employed to solve some illustrative examples.

Challenges in mercury speciation and fractionation in soil and sediment

This investigation focused on the development, test and validation of methodologies for mercury fractionation and speciation in soil and sediment. After an exhaustive review of the literature, several methods were chosen and tested in well characterised soil and sediment samples. Sequential extraction procedures that divide mercury fractions according to their mobility and potential availability in the environment were investigated. The efficiency of different solvents for fractionation of mercury was evaluated, as well as the adequacy of different analytical instruments for quantification of mercury in the extracts. Kinetic experiments to establish the equilibrium time for mercury release from soil or sediment were also performed. It was found that in the studied areas, only a very small percentage of mercury is present as mobile species and that mobility is associated to higher aluminium and manganese contents, and that high contents of organic matter and sulfur result in mercury tightly bound to the matrix. Sandy soils tend to release mercury faster that clayey soils, and therefore, texture of soil or sediment has a strong influence on the mobility of mercury. It was also understood that analytical techniques for quantification of mercury need to be further developed, with lower quantification limits, particularly for mercury quantification of less concentrated fractions: water-soluble e exchangeable. Although the results provided a better understanding of the distribution of mercury in the sample, the complexity of the procedure limits its applicability and robustness. A proficiency-testing scheme targeting total mercury determination in soil, sediment, fish and human hair was organised in order to evaluate the consistency of results obtained by different laboratories, applying their routine methods to the same test samples. Additionally, single extractions by 1 mol L-1 ammonium acetate solution, 0.1 mol L-1 HCl and 0.1 mol L-1 CaCl2, as well as extraction of the organometallic fraction were proposed for soil; the last was also suggested for sediment and fish. This study was important to update the knowledge on analytical techniques that are being used for mercury quantification, the associated problems and sources of error, and to improve and standardize mercury extraction techniques, as well as to implement effective strategies for quality control in mercury determination. A different, “non chemical-like” method for mercury species identification was developed, optimised and validated, based on the thermo-desorption of the different mercury species. Compared to conventional extraction procedures, this method has advantages: it requires little to no sample treatment; a complete identification of species present is obtained in less than two hours; mercury losses are almost neglectable; can be considered “clean”, as no residues are produced; the worldwide comparison of results obtained is easier and reliable, an important step towards the validation of the method. Therefore, the main deliverables of this PhD thesis are an improved knowledge on analytical procedures for identification and quantification of mercury species in soils and sediments, as well as a better understanding of the factors controlling the behaviour of mercury in these matrices.

Polyhedral study of mixed integer sets arising from inventory problems

“Branch-and-cut” algorithm is one of the most efficient exact approaches to solve mixed integer programs. This algorithm combines the advantages of a pure branch-and-bound approach and cutting planes scheme. Branch-and-cut algorithm computes the linear programming relaxation of the problem at each node of the search tree which is improved by the use of cuts, i.e. by the inclusion of valid inequalities. It should be taken into account that selection of strongest cuts is crucial for their effective use in branch-and-cut algorithm. In this thesis, we focus on the derivation and use of cutting planes to solve general mixed integer problems, and in particular inventory problems combined with other problems such as distribution, supplier selection, vehicle routing, etc. In order to achieve this goal, we first consider substructures (relaxations) of such problems which are obtained by the coherent loss of information. The polyhedral structure of those simpler mixed integer sets is studied to derive strong valid inequalities. Finally those strong inequalities are included in the cutting plane algorithms to solve the general mixed integer problems. We study three mixed integer sets in this dissertation. The first two mixed integer sets arise as a subproblem of the lot-sizing with supplier selection, the network design and the vendor-managed inventory routing problems. These sets are variants of the well-known single node fixed-charge network set where a binary or integer variable is associated with the node. The third set occurs as a subproblem of mixed integer sets where incompatibility between binary variables is considered. We generate families of valid inequalities for those sets, identify classes of facet-defining inequalities, and discuss the separation problems associated with the inequalities. Then cutting plane frameworks are implemented to solve some mixed integer programs. Preliminary computational experiments are presented in this direction.

Regional and urban air quality modelling under a climate change scenario

The better understanding of the interactions between climate change and air quality is an emerging priority for research and policy. Climate change will bring changes in the climate system, which will affect the concentration and dispersion of air pollutants. The main objective of the current study is to assess the impacts of climate change on air quality in 2050 over Portugal and Porto urban area. First, an evaluation and characterization of the air quality over mainland Portugal was performed for the period between 2002 and 2012. The results show that NO2, PM10 and O3 are the critical pollutants in Portugal. Also, the influence of meteorology on O3, NO2 and PM10 levels was investigate in the national main urban areas (Porto and Lisboa) and was verified that O3 has a statistically significant relationship with temperature in most of the components. The results also indicate that emission control strategies are primary regulators for NO2 and PM10 levels. After, understanding the national air quality problems and the influence that meteorology had in the historical air quality levels, the air quality modelling system WRF-CAMx was tested and the required inputs for the simulations were prepared to fulfil the main goal of this work. For the required air quality modelling inputs, an Emission Projections under RCP scenarios (EmiPro-RCP) model was developed to assist the estimation of future emission inventories for GHG and common air pollutants. Also, the current emissions were estimated for Portugal with a higher detailed disaggregation to improve the performance of the air quality simulations. The air quality modelling system WRF/CAMx was tested and evaluated over Portugal and Porto urban area and the results point out that is an adequate tool for the analysis of air quality under climate change. For this purpose, regional simulations of air quality during historical period and future (2045-2050) were conducted with CAMx version 6.0 to evaluate the impacts of simulated future climate and anthropogenic emission projections on air quality over the study area. The climate and the emission projections were produced under the RCP8.5 scenario. The results from the simulations point out, that if the anthropogenic emissions keep the same in 2050, the concentrations of NO2, PM10 and O3 will increase in Portugal. When, besides the climate change effects, is consider the projected anthropogenic emissions the annual mean concentrations of NO2 decrease significantly in Portugal and Porto urban area, and on the contrary the annual mean PM10 concentrations increases in Portugal and decrease in Porto urban area. The O3 results are mainly caused by the reduction of ozone precursors, getting the higher reductions in urban areas and increases in the surrounding areas. All the analysis performed for both simulations for Porto urban area support that, for PM10 and O3, there will be an increase in the occurrence of extreme values, surpassing the annual legislated parameters and having more daily exceedances. This study constitutes an innovative scientific tool to help in future air quality management in order to mitigate future climate change impacts on air quality.

Methods to improve creativity and innovation: the effectiveness of creative problem solving

This chapter focuses on the development of organizational creativity, using the CPS methodology, aiming at demonstrating its effectiveness in using the individual and team divergent thinking improvement in identifying organizational problems. A study was undertaken using problem solving teams in seven companies, in which each individual was submitted to a pre-post test in attitudes towards divergent thinking and asked to express the evaluation of the method. All the information reported in the sessions was recorded. The results indicate a change in attitude favourable to divergent thinking, the provision of a professional, efficient method of organizing knowledge in such a way that can help individuals to find original solutions to problems, and an important way to lead teams to creativity and innovation, according with companies different orientations.

Student’s Engagement in School: Conceptualization and relations with Personal Variables and Academic Performance

This article reviews the literature regarding Student’s Engagement in School (SES), its relationship with personal variables, as well as with academic performance. Although SES’ conceptualization may vary across studies, there is general agreement concerning the multidimensional nature of this construct, encompassing three dimensions – cognitive, affective and behavioural. It is seen as an antecedent of several required outcomes, at academic level, but also as a valorous construct itself, both as mediator and product. More particularly, this concept has been the focus of debate concerning academic success and school dropout. There can also be found a significant number of studies which suggest that personal (self-efficacy, self-concept), as well as contextual (peers, school, family) factors are related with school engagement; additionally, the lack of engagement is linked with low academic performance, behavioural problems and school dropout. Thus, Student’s Engagement in School is perceived as a potentially effective response to the problems affecting schools and their students, and an aspect to be considered in preventing problematic patterns related to scholary contexts.

Achieving human security through UN human rights law: prospects and challenges

This paper explores the prospects and challenges of achieving human security through United Nations (UN) human rights law. The paper does not aim to pronounce definitively on the achievement of human security by way of UN human rights law that is, to assess the achievement of human security per se 'as a future end state'. Rather the focus of the paper is firmly placed on the capacity of UN human rights law to achieve human security. The paper departs from the premise that if human rights define human security, international human rights law and UN human rights law in particular should have something to say about the achievement of human security.

Environmental ethics: philosophy, ecology and other species

Pressure on the environment has increased in step with economic growth and the mass consumption that fueled rising gross domestic product throughout the twentieth century. Both growth and ecological crises have attained a global reach, challenging our established notions of cause and effect, and our framing of problems and solutions. Accordingly, global environmental politics has witnessed major changes and significant "rescaling" in its "locus, agency and scope" (Andonova and Mitchell2010: 257). Both dimensions of global environmental politics - politics and governance, and the ecological problems that are the subject matter of global environmental politics - are being reinterpreted due to increasing complexity, interconnectedness and interdependence. Accordingly, the range of actors and disciplines that infom1 global environmental politics and contribute to framing global environmental problems is widening, in an acknowledgment of inescapable pluralism.

Embracing difference and the deferral of self-government: a critical analysis of the framing and practice of contemporary peace building

This thesis analyses how dominant policy approaches to peacebuilding have moved away from a single and universalised understanding of peace to be achieved through a top-down strategy of democratisation and economic liberalisation, prevalent at the beginning of 1990s. Instead, throughout the 2000s, peacebuilders have increasingly adopted a commitment to cultivating a bottom-up and hybrid peace building process that is context-sensitive and intended to be more respectful of the needs and values of post-war societies. The projects of statebuilding in Kosovo and, to a lesser extent, in Bosnia are examined to illustrate the shift. By capturing this shift, I seek to argue that contemporary practitioners of peace are sharing the sensibility of the theoretical critics of liberalism. These critics have long contended that post-war societies cannot be governed from ‘above’ and have advocated the adoption of a bottom-up approach to peacebuilding. Now, both peace practitioners and their critics share the tendency to embrace difference in peacebuilding operations, but this shift has failed to address meaningfully the problems and concerns of post-conflict societies. The conclusion of this research is that, drawing on the assumption that these societies are not capable of undertaking sovereign acts because of their problematic inter-subjective frames, the discourses of peacebuilding (in policy-making and academic critique) have increasingly legitimised an open-ended role of interference by external agencies, which now operate from ‘below’. Peacebuilding has turned into a long-term process, in which international and local actors engage relationally in the search for ever-more emancipatory hybrid outcomes, but in which self-government and self-determination are constantly deferred. Processes of emphasising difference have thus denied the political autonomy of post-war societies and have continuously questioned the political and human equality of these populations in a hierarchically divided world.

Plurality, policy and the local: can hyperlocals fill the gap?

Over the last 15 years, the acceleration in media consolidation has presented a series of policy challenges around diversity of editorial output. While policy debates on national ownership limits and other regulatory interventions are important, developments at the local level are often marginalised. And yet, the direction of travel—towards more consolidation and more deregulation—has arguably been more debilitating for democracy at the local level, where the vast majority of citizens interact with hospitals, schools, transport systems and local councils. The decline of local media—including, in some towns, the wholesale disappearance of local newspapers—leaves citizens starved of information and local institutions less accountable. This article uses an existing conceptual framework for assessing whether and how journalism makes a real-life contribution to democratic life at the local level. Against this normative framework, it then assesses the contribution of hyperlocal media sites to local democracy. We present findings from the most extensive survey of the hyperlocal sector to date, a collaboration with research partners at Cardiff and Birmingham City Universities and Talk About Local, which analysed online questionnaires from over 180 local online media initiatives. Our research offers a unique insight into the funding, operational problems and sustainability of community media sites, and suggests they have the potential to fulfil a vital democratic and civic role. These data inform our conclusions and recommendations for policy initiatives that would invigorate hyperlocal sites and therefore provide a real alternative for otherwise democratically impoverished local communities.

Convex optimization framework for intermediate deadline assignment in soft and hard real-time distributed systems

It is generally challenging to determine end-to-end delays of applications for maximizing the aggregate system utility subject to timing constraints. Many practical approaches suggest the use of intermediate deadline of tasks in order to control and upper-bound their end-to-end delays. This paper proposes a unified framework for different time-sensitive, global optimization problems, and solves them in a distributed manner using Lagrangian duality. The framework uses global viewpoints to assign intermediate deadlines, taking resource contention among tasks into consideration. For soft real-time tasks, the proposed framework effectively addresses the deadline assignment problem while maximizing the aggregate quality of service. For hard real-time tasks, we show that existing heuristic solutions to the deadline assignment problem can be incorporated into the proposed framework, enriching their mathematical interpretation.