Cost-effectiveness of an exercise intervention program in perimenopausal women: the Fitness League Against MENopause COst (FLAMENCO) randomized controlled trial.

BACKGROUND The high prevalence of women that do not reach the recommended level of physical activity is worrisome. A sedentary lifestyle has negative consequences on health status and increases health care costs. The main objective of this project is to assess the cost-effectiveness of a primary care-based exercise intervention in perimenopausal women. METHODS/DESIGN The present study is a Randomized Controlled Trial. A total of 150 eligible women will be recruited and randomly assigned to either a 16-week exercise intervention (3 sessions/week), or to usual care (control) group. The primary outcome measure is the incremental cost-effectiveness ratio. The secondary outcome measures are: i) socio-demographic and clinical information; ii) body composition; iii) dietary patterns; iv) glycaemic and lipid profile; v) physical fitness; vi) physical activity and sedentary behaviour; vii) sleep quality; viii) quality of life, mental health and positive health; ix) menopause symptoms. All outcomes will be assessed at baseline and post intervention. The data will be analysed on an intention-to-treat basis and per protocol. In addition, we will conduct a cost effectiveness analysis from a health system perspective. DISCUSSION The intervention designed is feasible and if it proves to be clinically and cost effective, it can be easily transferred to other similar contexts. Consequently, the findings of this project might help the Health Systems to identify strategies for primary prevention and health promotion as well as to reduce health care requirements and costs. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT02358109 . Date of registration: 05/02/2015.

An Analysis of black-box optimization problems in reinsurance: evolutionary-based approaches

Black-box optimization problems (BBOP) are de ned as those optimization problems in which the objective function does not have an algebraic expression, but it is the output of a system (usually a computer program). This paper is focussed on BBOPs that arise in the eld of insurance, and more speci cally in reinsurance problems. In this area, the complexity of the models and assumptions considered to de ne the reinsurance rules and conditions produces hard black-box optimization problems, that must be solved in order to obtain the optimal output of the reinsurance. The application of traditional optimization approaches is not possible in BBOP, so new computational paradigms must be applied to solve these problems. In this paper we show the performance of two evolutionary-based techniques (Evolutionary Programming and Particle Swarm Optimization). We provide an analysis in three BBOP in reinsurance, where the evolutionary-based approaches exhibit an excellent behaviour, nding the optimal solution within a fraction of the computational cost used by inspection or enumeration methods.

Analysis and evaluation of techniques for the extraction of classes in the ontology learning process

This paper analyzes and evaluates, in the context of Ontology learning, some techniques to identify and extract candidate terms to classes of a taxonomy. Besides, this work points out some inconsistencies that may be occurring in the preprocessing of text corpus, and proposes techniques to obtain good terms candidate to classes of a taxonomy.

Iowa's Adult Literacy Program Benchmark Analysis Report, 2002

The purpose of this document is to present Iowa’s Adult Literacy Benchmark Analysis Report: Program Year 2002. The report is designed to provide a supplemental analysis of the information presented in Tables 5-19 (pp. 16-37) referenced in the publication titled Iowa's Adult Basic Education Program Annual Benchmark Report: Program Year 2002. The original data source for Tables 1-7 is from Iowa’s National Reporting System (NRS) report Tables 4B and 5 and the publication titled Iowa’s Community College Basic Literacy Skills Credential Program: Program Year 2002. (See Appendix B of Iowa’s Adult Basic Education Program Annual Benchmark Report: Program Year 2002, [pp. 54-55] and Iowa’s Community College Basic Literacy Skills Credential Program Annual Report: Program Year 2002 Tables 1-2 [pp. 6-7]).

Integrated Analysis of High-Resolution Gene Expression and Copy Number Profiling Identified Biallelic Deletion of CDKN2A/2B Tumor Suppressor Locus As the Most Frequent and Unique Genomic Abnormality in Diffuse Large B-Cell Lymphoma (DLBCL) with Strong Prognostic Value in Both GCB and ABC Subtypes and Not Overcome by a Dose-Intensive Immunochemotherapy Regimen Plus Rituximab. Results of a Prospective GELA Clinical Trial Program

Background and aim of the study: Genomic gains and losses play a crucial role in the development and progression of DLBCL and are closely related to gene expression profiles (GEP), including the germinal center B-cell like (GCB) and activated B-cell like (ABC) cell of origin (COO) molecular signatures. To identify new oncogenes or tumor suppressor genes (TSG) involved in DLBCL pathogenesis and to determine their prognostic values, an integrated analysis of high-resolution gene expression and copy number profiling was performed. Patients and methods: Two hundred and eight adult patients with de novo CD20+ DLBCL enrolled in the prospective multicentric randomized LNH-03 GELA trials (LNH03-1B, -2B, -3B, 39B, -5B, -6B, -7B) with available frozen tumour samples, centralized reviewing and adequate DNA/RNA quality were selected. 116 patients were treated by Rituximab(R)-CHOP/R-miniCHOP and 92 patients were treated by the high dose (R)-ACVBP regimen dedicated to patients younger than 60 years (y) in frontline. Tumour samples were simultaneously analysed by high resolution comparative genomic hybridization (CGH, Agilent, 144K) and gene expression arrays (Affymetrix, U133+2). Minimal common regions (MCR), as defined by segments that affect the same chromosomal region in different cases, were delineated. Gene expression and MCR data sets were merged using Gene expression and dosage integrator algorithm (GEDI, Lenz et al. PNAS 2008) to identify new potential driver genes. Results: A total of 1363 recurrent (defined by a penetrance > 5%) MCRs within the DLBCL data set, ranging in size from 386 bp, affecting a single gene, to more than 24 Mb were identified by CGH. Of these MCRs, 756 (55%) showed a significant association with gene expression: 396 (59%) gains, 354 (52%) single-copy deletions, and 6 (67%) homozygous deletions. By this integrated approach, in addition to previously reported genes (CDKN2A/2B, PTEN, DLEU2, TNFAIP3, B2M, CD58, TNFRSF14, FOXP1, REL...), several genes targeted by gene copy abnormalities with a dosage effect and potential physiopathological impact were identified, including genes with TSG activity involved in cell cycle (HACE1, CDKN2C) immune response (CD68, CD177, CD70, TNFSF9, IRAK2), DNA integrity (XRCC2, BRCA1, NCOR1, NF1, FHIT) or oncogenic functions (CD79b, PTPRT, MALT1, AUTS2, MCL1, PTTG1...) with distinct distribution according to COO signature. The CDKN2A/2B tumor suppressor locus (9p21) was deleted homozygously in 27% of cases and hemizygously in 9% of cases. Biallelic loss was observed in 49% of ABC DLBCL and in 10% of GCB DLBCL. This deletion was strongly correlated to age and associated to a limited number of additional genetic abnormalities including trisomy 3, 18 and short gains/losses of Chr. 1, 2, 19 regions (FDR < 0.01), allowing to identify genes that may have synergistic effects with CDKN2A/2B inactivation. With a median follow-up of 42.9 months, only CDKN2A/2B biallelic deletion strongly correlates (FDR p.value < 0.01) to a poor outcome in the entire cohort (4y PFS = 44% [32-61] respectively vs. 74% [66-82] for patients in germline configuration; 4y OS = 53% [39-72] vs 83% [76-90]). In a Cox proportional hazard prediction of the PFS, CDKN2A/2B deletion remains predictive (HR = 1.9 [1.1-3.2], p = 0.02) when combined with IPI (HR = 2.4 [1.4-4.1], p = 0.001) and GCB status (HR = 1.3 [0.8-2.3], p = 0.31). This difference remains predictive in the subgroup of patients treated by R-CHOP (4y PFS = 43% [29-63] vs. 66% [55-78], p=0.02), in patients treated by R-ACVBP (4y PFS = 49% [28-84] vs. 83% [74-92], p=0.003), and in GCB (4y PFS = 50% [27-93] vs. 81% [73-90], p=0.02), or ABC/unclassified (5y PFS = 42% [28-61] vs. 67% [55-82] p = 0.009) molecular subtypes (Figure 1). Conclusion: We report for the first time an integrated genetic analysis of a large cohort of DLBCL patients included in a prospective multicentric clinical trial program allowing identifying new potential driver genes with pathogenic impact. However CDKN2A/2B deletion constitutes the strongest and unique prognostic factor of chemoresistance to R-CHOP, regardless the COO signature, which is not overcome by a more intensified immunochemotherapy. Patients displaying this frequent genomic abnormality warrant new and dedicated therapeutic approaches.

Tension-band wiring of olecranon fractures - Biomechanical analysis of different fixation techniques

Tension-band wiring is a recognised standard treatment for fixation of olecranon fractures. The classical operation technique is well known and widespread among the orthopaedic surgeons. Nevertheless complications like K-wire migration or skin perforation and difficult technical as well as anatomical prerequisites require better-adapted operation fixation methods. In older female patients a cut through of the Kirschner wires with concomitant secondary displacement was observed. We intent to develop a new, better adapted operation technique for olecranon fractures in the old patients, in order to decrease complications and follow-up procedures. In this study we compare two different K-wire positions: 10 models of the classical AO tension-banding to 10 models with adapted K-wire insertion. In this group the K-wire passes from the tip of the olecranon to the posterior cortical of the distal fragment of the ulna. We tested maximal failure load, maximal opening angle as well as maximal work to achieve maximal force. In either technique we were able to determine different variables: a maximal failure load of more than 600N (p = 0.94) for both fixation methods and a maximal opening angle for both techniques of about 10° (p = 0.86). To achieve the maximal force our modified technique required a slightly increased work (p = 0.16). In this study no statistical significant differences between the two fixation techniques was shown. This leads to the conclusion that the modified version is comparable to the classical operation technique considering the stability, but due to the adaption of the angle in the modified procedure, less lesions of neurovascular structures on the volar side can be expected. To support our findings cadaver studies are needed for further investigations.

Topics, techniques and applications in urban and regional science in the nineties: a bibliometric analysis

The current state of regional and urban science has been much discussed and a number of studies have speculated on possible future trends in the development of the discipline. However, there has been little empirical analysis of current publication patterns in regional and urban journals. This paper studies the kinds of topics, techniques and data used in articles published in nine top international journals during the 1990s with the aim of identifying current trends in this research field

Diagnostic techniques applied in geostatistics for agricultural data analysis

The structural modeling of spatial dependence, using a geostatistical approach, is an indispensable tool to determine parameters that define this structure, applied on interpolation of values at unsampled points by kriging techniques. However, the estimation of parameters can be greatly affected by the presence of atypical observations in sampled data. The purpose of this study was to use diagnostic techniques in Gaussian spatial linear models in geostatistics to evaluate the sensitivity of maximum likelihood and restrict maximum likelihood estimators to small perturbations in these data. For this purpose, studies with simulated and experimental data were conducted. Results with simulated data showed that the diagnostic techniques were efficient to identify the perturbation in data. The results with real data indicated that atypical values among the sampled data may have a strong influence on thematic maps, thus changing the spatial dependence structure. The application of diagnostic techniques should be part of any geostatistical analysis, to ensure a better quality of the information from thematic maps.

BIO-INSPIRED COMPUTATIONAL TECHNIQUES APPLIED TO THE CLUSTERING AND VISUALIZATION OF SPATIO-TEMPORAL GEOSPATIAL DATA

The coverage and volume of geo-referenced datasets are extensive and incessantly¦growing. The systematic capture of geo-referenced information generates large volumes¦of spatio-temporal data to be analyzed. Clustering and visualization play a key¦role in the exploratory data analysis and the extraction of knowledge embedded in¦these data. However, new challenges in visualization and clustering are posed when¦dealing with the special characteristics of this data. For instance, its complex structures,¦large quantity of samples, variables involved in a temporal context, high dimensionality¦and large variability in cluster shapes.¦The central aim of my thesis is to propose new algorithms and methodologies for¦clustering and visualization, in order to assist the knowledge extraction from spatiotemporal¦geo-referenced data, thus improving making decision processes.¦I present two original algorithms, one for clustering: the Fuzzy Growing Hierarchical¦Self-Organizing Networks (FGHSON), and the second for exploratory visual data analysis:¦the Tree-structured Self-organizing Maps Component Planes. In addition, I present¦methodologies that combined with FGHSON and the Tree-structured SOM Component¦Planes allow the integration of space and time seamlessly and simultaneously in¦order to extract knowledge embedded in a temporal context.¦The originality of the FGHSON lies in its capability to reflect the underlying structure¦of a dataset in a hierarchical fuzzy way. A hierarchical fuzzy representation of¦clusters is crucial when data include complex structures with large variability of cluster¦shapes, variances, densities and number of clusters. The most important characteristics¦of the FGHSON include: (1) It does not require an a-priori setup of the number¦of clusters. (2) The algorithm executes several self-organizing processes in parallel.¦Hence, when dealing with large datasets the processes can be distributed reducing the¦computational cost. (3) Only three parameters are necessary to set up the algorithm.¦In the case of the Tree-structured SOM Component Planes, the novelty of this algorithm¦lies in its ability to create a structure that allows the visual exploratory data analysis¦of large high-dimensional datasets. This algorithm creates a hierarchical structure¦of Self-Organizing Map Component Planes, arranging similar variables' projections in¦the same branches of the tree. Hence, similarities on variables' behavior can be easily¦detected (e.g. local correlations, maximal and minimal values and outliers).¦Both FGHSON and the Tree-structured SOM Component Planes were applied in¦several agroecological problems proving to be very efficient in the exploratory analysis¦and clustering of spatio-temporal datasets.¦In this thesis I also tested three soft competitive learning algorithms. Two of them¦well-known non supervised soft competitive algorithms, namely the Self-Organizing¦Maps (SOMs) and the Growing Hierarchical Self-Organizing Maps (GHSOMs); and the¦third was our original contribution, the FGHSON. Although the algorithms presented¦here have been used in several areas, to my knowledge there is not any work applying¦and comparing the performance of those techniques when dealing with spatiotemporal¦geospatial data, as it is presented in this thesis.¦I propose original methodologies to explore spatio-temporal geo-referenced datasets¦through time. Our approach uses time windows to capture temporal similarities and¦variations by using the FGHSON clustering algorithm. The developed methodologies¦are used in two case studies. In the first, the objective was to find similar agroecozones¦through time and in the second one it was to find similar environmental patterns¦shifted in time.¦Several results presented in this thesis have led to new contributions to agroecological¦knowledge, for instance, in sugar cane, and blackberry production.¦Finally, in the framework of this thesis we developed several software tools: (1)¦a Matlab toolbox that implements the FGHSON algorithm, and (2) a program called¦BIS (Bio-inspired Identification of Similar agroecozones) an interactive graphical user¦interface tool which integrates the FGHSON algorithm with Google Earth in order to¦show zones with similar agroecological characteristics.

Topics, techniques and applications in urban and regional science in the nineties: a bibliometric analysis

The current state of regional and urban science has been much discussed and a number of studies have speculated on possible future trends in the development of the discipline. However, there has been little empirical analysis of current publication patterns in regional and urban journals. This paper studies the kinds of topics, techniques and data used in articles published in nine top international journals during the 1990s with the aim of identifying current trends in this research field

Role of hepatitis C virus genotype 3 in liver fibrosis progression : a systematic review and meta-analysis ; et, Impact of nurse vaccination program on hepatitis B immunity in a Swiss HIV clinic

Rôle du génotype 3 du virus de l'hépatite C dans la progression de la fibrose hépatique, une revue systématique avec méta-analyse. On estime à 170 millions le nombre de personnes atteintes d'hépatite C chronique dans le monde. La principale conséquence de cette maladie est la fibrose du foie, qui évolue plus ou moins rapidement, pour aboutir au développement d'une cirrhose et/ou d'un hépatocarcinome. Certains des facteurs accélérateurs de la fibrose, comme l'âge avancé au moment de l'infection, le sexe masculin, la consommation d'alcool, sont bien connus. On a longtemps considéré que les six différents génotypes viraux n'influençaient pas la progression de la fibrose. Des études récentes ont cependant suggéré que certains génotypes, en particulier ie génotype 3, pouvaient entraîner une fibrose plus rapide. Le but de ce travail de thèse était de déterminer à l'aide d'une méta-analyse le rôle du génotype viral dans la progression de la fibrose dans l'infection chronique au virus de l'hépatite C. Les études ont été sélectionnées dans la littérature médicale à partir d'une série de mots-clés. Le degré de fibrose a été estimé par biopsie, en utilisant le score Metavir. Deux types d'études ont décrits de manière différente la durée d'infection. Les premières ont calculé la progression de la fibrose depuis le moment estimée de l'infection (« études avec une biopsie »), les secondes ont exprimés cette durée comme étant l'intervalle entre deux biopsies (« études avec deux biopsies »). L'analyse a permis d'identifier 8 études avec une biopsie pour un collectif total de 3182 patients ainsi que 8 études avec deux biopsies pour un collectif de 896 patients. Dans une méta-analyse de type « random effect », le rapport de cote pour l'association du génotype 3 avec une fibrose accélérée est de 1.52 (95% IC 1.12-2.07, p=0.007) pour les études à une biopsie. Pour les études à deux biopsies, le rapport de cote pour cette association est de 1.37 (95% IC 0.87-2.17, P=0.17). Cette étude montre que les patients avec une hépatite C chronique due au génotype 3 ont une progression de fibrose plus rapide que ceux qui sont infectés par les autres génotypes. Alors que la méta-analyse des études avec une biopsie est clairement significative, celle des études avec deux biopsies est au-dessous du seuil de significativité. Les études à deux biopsies peuvent être limitées par plusieurs facteurs, comprenant un « biais d'indication » (seuls les patients évoluant rapidement vers la cirrhose ont plus de risque d'avoir une deuxième biopsie), une durée d'observation très courte (5 années comparée à 13 années pour les études à 2 biopsies), et un nombre de patient limité (896 pour le études à 2 biopsies comparé à 3182 pour les études à 1 biopsie). Impact d'un programme de vaccination sur l'immunité contre l'hépatite Β dans une clinique suisse du VIH Le virus de l'hépatite Β cause une infection aigûe dont la symptomatologie varie d'une présentation subclinique à une progression fulminante. Dans une minorité de cas, l'infection aigiie est suivie d'une infection chronique pouvant évoluer vers une cirrhose hépatique et/ou un hépatocarcinome. La prévalence de l'hépatite Β aiguë et chronique chez les personnes vivant avec le virus d'immunodéficience humaine (VIH) est supérieure à celle de la population générale. Par ailleurs la co-infection avec le virus du VIH entraine une progression plus rapide de l'hépatite B. Dès lors, l'immunité pour le virus de l'hépatite Β représente un facteur primordial de prévention dans la population infectée par le virus de l'HIV. Bien que l'administration d'un vaccin contre l'hépatite Β soit particulièrement recommandée chez tous les individus infectés par le VIH, la couverture vaccinale dans cette population est souvent insuffisante. Le but de cette étude était de déterminer l'état d'immunisation contre le virus de l'hépatite Β dans la population infectée par le VIH de la cohorte Suisse HIV et d'analyser l'efficacité d'un programme de vaccination administré par le personnel soignant. L'immunité avant et après intervention dans notre centre a été comparée aux autres centres de la cohorte HIV en Suisse. L'immunité pour le centre d'intervention a passé de 32% avant intervention à 76% après intervention alors que pour les autres centres, l'immunité n'a progressé que de 33% à 39% dans le même laps de temps (n=2712, P=0.001). Cette étude montre qu'un contrôle systématique de l'immunité par du personnel soignant augmente de manière significative l'immunité pour le vaccin de l'hépatite Β dans la population HIV.

X-Ray systems: radiation protection program in basic research applications

Although the radiation doses involved in basic research radiology are relatively small, the increasing number of radiological procedures makes risks becoming increasingly high. Quality control techniques in radiological practice have to ensure an adequate system of protection for people exposed to radiation. These techniques belong to a quality assurance program for X-ray machines and are designed to correct problems related to equipment and radiological practices, to obtain radiological images of high quality and to reduce the unnecessary exposures.

The Use of Remote Sensing Techniques Compared to Traditional Archaeological Phase II Testing Methods: A Cost-Benefit Analysis, HR-524, 1986

Remote sensing was utilized in the Phase II Cultural Resources Investigation for this project in lieu of extensive excavations. The purpose of the present report is to compare the costs and benefits of the use of remote sensing to the hypothetical use of traditional excavation methods for this project. Estimates for this hypothetical situation are based on the project archaeologist's considerable past experience in conducting similar investigations. Only that part of the Phase II investigation involving field investigations is addressed in this report. Costs for literature review, laboratory analysis, report preparation, etc., are not included. The project manager proposed the use of this technique for the fol lowing logistic, safety and budgetary reasons.

The Application of 3D Reconstruction Techniques in the Analysis of Ancient Tarraco’s Urban Topography

The widespread implementation of GIS-based 3D topographical models has been a great aid in the development and testing of archaeological hypotheses. In this paper, a topographical reconstruction of the ancient city of Tarraco, the Roman capital of the Tarraconensis province, is presented. This model is based on topographical data obtained through archaeological excavations, old photographic documentation, georeferenced archive maps depicting the pre-modern city topography, modern detailed topographical maps and differential GPS measurements. The addition of the Roman urban architectural features to the model offers the possibility to test hypotheses concerning the ideological background manifested in the city shape. This is accomplished mainly through the use of 3D views from the main city accesses. These techniques ultimately demonstrate the ‘theatre-shaped’ layout of the city (to quote Vitrubius) as well as its southwest oriented architecture, whose monumental character was conceived to present a striking aspect to visitors, particularly those arriving from the sea.