Estudo da precocidade diagnóstica dos melanomas cutâneos primários em Porto Alegre por análise de imagem computadorizada

Fundamentos: A literatura tem demonstrado que a detecção precoce e a remoção cirúrgica em fases iniciais reduz a mortalidade do melanoma e que, em conseqüência, a identificação do melanoma em fases curáveis deve ser encorajada. Objetivos: O interesse principal do estudo foi conhecer se os melanomas cutâneos, no meio, estão sendo diagnosticados em fases iniciais, através de método reprodutível e armazenável. Metodologia: Foi realizado um estudo transversal com os casos de melanomas cutâneos primários, analisados nos laboratórios de patologia de Porto Alegre, de 1° de janeiro de 1994 a 30 de junho de 1995, a fim de avaliar se os diagnósticos foram realizados em estágios precoces. Os casos foram revisados por três dermatopatologistas, que classificaram quanto ao tipo histológico e quanto ao nível de invasão de Clark. Foi realizado um consenso com pelo menos duas concordâncias. A espessura de Breslow foi considerada fator prognóstico determinante e foi medida através de um sistema de análise de imagem computadorizada, por dois membros da equipe. Resultados: Do total de 279 casos que preencheram os critérios de inclusão, 2,15% eram intraepiteliais. Dos melanomas invasivos, 52% tinham espessura ≤ 1,5 mm. Quando agrupado por sexo e procedência, as mulheres de Porto Alegre, capital do estado do Rio Grande do Sul, tiveram a mais alta taxa de diagnóstico precoce (75% ≤ 1,5 mm). O tronco foi o sítio predominante no homem e freqüente na mulher. O melanoma de espalhamento superficial foi o tipo histológico mais freqüente (80,9%), seguido pelo nodular (10,1%). Para definir os determinantes do diagnóstico precoce, foram realizados cruzamentos simples, dos melanomas intraepiteliais somados aos de espessura <0,76 mm, com o sexo, a idade, a procedência, a situação previdenciária, a região anatômica e o tipo histológico. A análise de variáveis múltiplas demonstrou que apenas o sexo (feminino), o sítio anatômico (outras regiões exceto membros inferiores) e a procedência (Porto Alegre) mostraram-se variáveis independentes para determinar um diagnóstico precoce. A idade ≥ 40 anos apresentou significância próxima ao limite. O tipo histológico foi excluído do modelo, uma vez que gerou instabilidade estatística. Conclusão: Embora o número de casos fosse pequeno, o diagnóstico do melanoma ainda é tardio (52% com até 1,5 mm de espessura). Entretanto, existe um subgrupo de diagnóstico precoce que são mulheres, sobretudo de Porto Alegre, possivelmente por estarem mais atentas e informadas sobre os riscos do melanoma. As mudanças no estilo de vida, nas últimas décadas, provavelmente são responsáveis pela maior incidência no tronco e pela alta freqüência de melanoma de espalhamento superficial encontrada. A análise da espessura tumoral por projeção em tela de computador mostrou-se um recurso auxiliar vantajoso.

Dynamic hedging in Markov regimes

This dissertation proposes a bivariate markov switching dynamic conditional correlation model for estimating the optimal hedge ratio between spot and futures contracts. It considers the cointegration between series and allows to capture the leverage efect in return equation. The model is applied using daily data of future and spot prices of Bovespa Index and R$/US$ exchange rate. The results in terms of variance reduction and utility show that the bivariate markov switching model outperforms the strategies based ordinary least squares and error correction models.

Exploratory semiparametric analysis of two-dimensional diffusions in finance

We examine bivariate extensions of Aït-Sahalia’s approach to the estimation of univariate diffusions. Our message is that extending his idea to a bivariate setting is not straightforward. In higher dimensions, as opposed to the univariate case, the elements of the Itô and Fokker-Planck representations do not coincide; and, even imposing sensible assumptions on the marginal drifts and volatilities is not sufficient to obtain direct generalisations. We develop exploratory estimation and testing procedures, by parametrizing the drifts of both component processes and setting restrictions on the terms of either the Itô or the Fokker-Planck covariance matrices. This may lead to highly nonlinear ordinary differential equations, where the definition of boundary conditions is crucial. For the methods developed, the Fokker-Planck representation seems more tractable than the Itô’s. Questions for further research include the design of regularity conditions on the time series dependence in the data, the kernels actually used and the bandwidths, to obtain asymptotic properties for the estimators proposed. A particular case seems promising: “causal bivariate models” in which only one of the diffusions contributes to the volatility of the other. Hedging strategies which estimate separately the univariate diffusions at stake may thus be improved.

On the welfare costs of business-cycle fluctuations and economic-growth variation in the 20th century and beyond

The main objective of this paper is to propose a novel setup that allows estimating separately the welfare costs of the uncertainty stemming from business-cycle uctuations and from economic-growth variation, when the two types of shocks associated with them (respectively,transitory and permanent shocks) hit consumption simultaneously. Separating these welfare costs requires dealing with degenerate bivariate distributions. Levis Continuity Theorem and the Disintegration Theorem allow us to adequately de ne the one-dimensional limiting marginal distributions. Under Normality, we show that the parameters of the original marginal distributions are not afected, providing the means for calculating separately the welfare costs of business-cycle uctuations and of economic-growth variation. Our empirical results show that, if we consider only transitory shocks, the welfare cost of business cycles is much smaller than previously thought. Indeed, we found it to be negative - -0:03% of per-capita consumption! On the other hand, we found that the welfare cost of economic-growth variation is relatively large. Our estimate for reasonable preference-parameter values shows that it is 0:71% of consumption US$ 208:98 per person, per year.

Wrong-way risk in stock swaps : measuring counterparty credit risk and CVA

Uma forma interessante para uma companhia que pretende assumir uma posição comprada em suas próprias ações ou lançar futuramente um programa de recompra de ações, mas sem precisar dispor de caixa ou ter que contratar um empréstimo, ou então se protegendo de uma eventual alta no preço das ações, é através da contratação de um swap de ações. Neste swap, a companhia fica ativa na variação de sua própria ação enquanto paga uma taxa de juros pré ou pós-fixada. Contudo, este tipo de swap apresenta risco wrong-way, ou seja, existe uma dependência positiva entre a ação subjacente do swap e a probabilidade de default da companhia, o que precisa ser considerado por um banco ao precificar este tipo de swap. Neste trabalho propomos um modelo para incorporar a dependência entre probabilidades de default e a exposição à contraparte no cálculo do CVA para este tipo de swap. Utilizamos um processo de Cox para modelar o instante de ocorrência de default, dado que a intensidade estocástica de default segue um modelo do tipo CIR, e assumindo que o fator aleatório presente na ação subjacente e que o fator aleatório presente na intensidade de default são dados conjuntamente por uma distribuição normal padrão bivariada. Analisamos o impacto no CVA da incorporação do riscowrong-way para este tipo de swap com diferentes contrapartes, e para diferentes prazos de vencimento e níveis de correlação.

Studies in non-Gaussian analysis

This thesis presents general methods in non-Gaussian analysis in infinite dimensional spaces. As main applications we study Poisson and compound Poisson spaces. Given a probability measure μ on a co-nuclear space, we develop an abstract theory based on the generalized Appell systems which are bi-orthogonal. We study its properties as well as the generated Gelfand triples. As an example we consider the important case of Poisson measures. The product and Wick calculus are developed on this context. We provide formulas for the change of the generalized Appell system under a transformation of the measure. The L² structure for the Poisson measure, compound Poisson and Gamma measures are elaborated. We exhibit the chaos decomposition using the Fock isomorphism. We obtain the representation of the creation, annihilation operators. We construct two types of differential geometry on the configuration space over a differentiable manifold. These two geometries are related through the Dirichlet forms for Poisson measures as well as for its perturbations. Finally, we construct the internal geometry on the compound configurations space. In particular, the intrinsic gradient, the divergence and the Laplace-Beltrami operator. As a result, we may define the Dirichlet forms which are associated to a diffusion process. Consequently, we obtain the representation of the Lie algebra of vector fields with compact support. All these results extends directly for the marked Poisson spaces.

Os estilos de liderança nas organizações não governamentais da região metropolitana de Belém

This study aimed to analyze the leadership style adopted by managers of nongovernmental organizations in the metropolitan region of Belem on the theory of Hersey and Blanchard. This theory is called situational leadership ranks E1, E2, E3, E4 and the styles of leadership and maturity in parallel classes M1, M2, M3 and M4. This study examined the relationship of leadership styles with the maturity of work, identified the relationship of leadership styles as related to psychological maturity and job maturity and psychological maturity. The main objectives were to analyze and relate leadership styles with the maturity of the leaders and understand the phenomenon of leadership from the self-perception of those who lead the organizations studied. To achieve the objectives we used a questionnaire already validated the theory of situational leadership and applied in 320 non-governmental organizations in the metropolitan region of Belem The methodology was quantitative, descriptive and exploratory. The analysis was by descriptive statistics and inferential statistics for univariate and bivariate form, applying the chi-square, the V Crammer and Spearman correlation. The data analysis shows safety, attested to the frequencies, and average margin of error and after application of the tests it was found that a relationship between the leadership style of work with the maturity and psychological maturity. The managers of nongovernmental organizations practicing various styles of leadership and focus on the quadrant of high maturity. It was diagnosed when the manager uses only one style of leadership was the predominance of E3 "share or support", which represents 24% of the sample. As uses two styles of leadership is the predominance of E3 and E2, which represents 76%. So the managers of nongovernmental organizations in the metropolitan region of Belem, practicing a style of leadership support, sharing ideas for decision making using a democratic style

Treinamento e desenvolvimento de pessoas e a nova gestão pública : o caso do projeto Formação de tecnólogos em gestão pública do governo do Rio Grande do Norte

This thesis aims to identify how civil servants perceive changes made inthe carrying out of their work after their taking part in the Course forTechnicians in Public Management of the Government of Rio Grande do NorteState. As for the methodological procedures, an exploratory-descriptivequantitative research has been carried out through structured questionnaires appliedto 118 civil servants from the first groups of the Course for Technicians, thusshowing a margin of error of 4.18% to 95% of confidence, according to theprocedures of finite sampling. The table processing and analysis rested uponthe Statistical Package for the Social Sciences SPSS and was carried outthrough univariate, bivariate and multivariate techniques with emphasis on thetechnique called Factor Analysis. It was possible to identify that the level ofsatisfaction of the students was high and there was a clear perception by themthat the course assisted to changes in their work. Through Factor Analysis itwas verified that the factors that may be related to changes in the work of thecivil servants are "Contribution to Society", "Efficiency andEfficacy in the Work Environment", "Applicability of Contents"and "Capacitating for Leadership". The conclusion of the studyindicates that the factors obtained are directly related to the basis of thenew public management by means of guidance toward efficiency and efficacy in aperspective of leadership, the contents of the course being thus made into newattitudes toward work which end up yielding better results for society

Influência de fatores biopsicossociais sobre a mortalidade de idosos no município de Santa Cruz/RN: um estudo prospectivo

The aging process if characterizes for a complex events network, from multidimensional nature, that encloses biological, social, psychic and functional aspects. The alteration of one or more aspects can speed up the aging process, anticipating limitations and until the death in the aged. For an adjusted confrontation of this question is necessary an interdisciplinary vision, in which the some areas of the knowledge can interact and with this to intervenes of the best possible form. Then, information derived from studies of aspects related to incidence, morbidity-mortality and transition patterns, involved in the health-illness process can more accurately identify risk groups thereby establishing links between social factors, illness, incapacity and death. Thus, this study aimed to identify, by a multidimensional vision, the risk factors of mortality in a coorth of elderly in a city in the interior of the state of Rio Grande do Norte (RN), Brazil. A prospective study carried out in Santa Cruz RN, where 310 elderly were randomly selected to form a baseline. The follow-up was 53 months. The predictive variables were divided into sociodemographic, physical health, neuropsychiatric and functional capacity. The statistical analysis carried out by bivariate analysis, survival analysis, followed by binary logistic regression and Cox regression, in the multivariate analysis, considering significant levels p < 0.05 and confidence interval (CI) of 95%. A total of 60 (19.3%) elderly died during the follow-up, where cardiovascular disease was the main cause. The survival was approximately 24.8 months. The study of general survival showed, at 12, 24, 36, and 48 months of observation, a survival rate of 97%, 54%, 31%, and 5% respectively, with a statistical difference in survival only observed for the variables of cognitive function and Basic Activities of Daily Living. In the logistic regression analysis, the risk factors identified were cognitive deficits (OR = 8.74), poor perception of health (OR = 3.89) and dependence for Basic Activities of Daily Living (OR = 3.96). In the Cox analysis, as well as dependence for Basic Activities of Daily Living (HR = 3.17), cognitive deficit (HR = 4.30) and stroke (CVA) (HR = 3.49) continued as independent risk factors for death. The risk factors found in the study can be interpreted as the primary predictors for death among elderly members of the community. Therefore, improvements in health conditions, with actions towards sustaining an autonomous life with special attention for elderly with cognitive impairment, could mean additional healthy quality of life, resulting in the reduction of premature mortality in this population

Prevalência e fatores associados da síndrome de Osgood-Schlatter em uma amostra populacional de adolescentes brasileiros

Osgood-Schlatter (O-S) syndrome, a pathology of the musculoskeletal system, exhibits high incidence in adolescence, a phase of accelerated bone growth. Detection of physiopathological mechanisms that may cause disorders and dysfunctions in bone growth must be taken into account when planning physical activities, in order to promote normal physiological growth patterns. The aim of this epidemiological investigation was to identify and analyze the relationships between sociodemographic, anthropometric and clinical aspects and O-S. A cross-sectional design was used, with a representative sample of 956 subjects: 474 (49.6%) males and 482 (50.4%) females. Age range varied between 12 and 15 years (mean = 13.7±1.04). We used a battery of tests, previously applied in a pilot study, which met the aims of the investigation. Descriptive statistics (frequency, mean and standard deviation) were used and the odds ratio was calculated from bivariate and multivariate logistic regression (p<0.05). A prevalence of 9.8% was found (n = 94 cases): 11% males and 8.3% females. Hierarchized multivariate analysis showed a significant association between regular physical activities (OR= 1.94; CI 95%, 1.22-3.10) and shortening of the rectus femoris muscle (OR= 7.15; CI 95%, 2.86-17.86). The results may serve as a basis for therapeutic and prophylactic measures, in addition to increasing our knowledge of this syndrome in Brazilian adolescents. This investigation used a multidisciplinary approach, involving elements of anatomy, nutrition, physical education and physical therapy to elucidate the object under study related to Osgood-Schlatter syndrome

Estado nutricional antropométrico, perfil lipídico e consumo alimentar como fatores de risco para doença cardiovascular em adolescentes

The dyslipidemia and excess weight in adolescents, when combined, suggest a progression of risk factors for cardiovascular disease (CVD). Besides these, the dietary habits and lifestyle have also been considered unsuitable impacting the development of chronic diseases. The study objectives were: (1) estimate the prevalence of lipid profile and correlate with body mass index (BMI), waist circumference (WC) and waist / height ratio (WHR) in adolescents, considering the maturation sexual, (2) know the sources of variance in the diet and the number of days needed to estimate the usual diet of adolescents and (3) describe the dietary patterns and lifestyle of adolescents, family history of CVD and age correlates them with the patterns of risk for CVD, adjusted for sexual maturation. A cross-sectional study was performed with 432 adolescents, aged 10-19 years from public schools of the Natal city, Brazil. The dyslipidemias were evaluated considering the lipid profile, the index of I Castelli (TC / HDL) and II (LDL / HDL) and non-HDL cholesterol. Anthropometric indicators were BMI, WC and WHR. The intake of energy, nutrients including fiber, fatty acids and cholesterol was estimated from two 24-hour recalls (24HR). The variables of lipid profile, anthropometric and clinical data were used in the models of Pearson correlation and linear regression, considering the sexual maturation. The variance ratio of the diet was calculated from the component-person variance, determined by analysis of variance (ANOVA). The definition of the number of days to estimate the usual intake of each nutrient was obtained by taking the hypothetical correlation (r) ≥ 0.9, between nutrient intake and the true observed. We used the principal component analysis as a method of extracting factors that 129 accounted for the dependent variables and known cardiovascular risk obtained from the lipid profile, the index for Castelli I and II, non-HDL cholesterol, BMI, and WC the WHR. Dietary patterns and lifestyle were obtained from the independent variables, based on nutrients consumed and physical activity weekly. In the study of principal component analysis (PCA) was investigated associations between the patterns of cardiovascular risk factors in dietary patterns and lifestyle, age and positive family history of CVD, through bivariate and multiple logistic regression adjusted for sexual maturation. The low HDL-C dyslipidemia was most prevalent (50.5%) for adolescents. Significant correlations were observed between hypercholesterolemia and positive family history of CVD (r = 0.19, p <0.01) and hypertriglyceridemia with BMI (r = 0.30, p <0.01), with the CC (r = 0.32, p <0.01) and WHR (r = 0.33, p <0.01). The linear model constructed with sexual maturation, age and BMI explained about 1 to 10.4% of the variation in the lipid profile. The sources of variance between individuals were greater for all nutrients in both sexes. The reasons for variances were  1 for all nutrients were higher in females. The results suggest that to assess the diet of adolescents with greater precision, 2 days would be enough to R24h consumption of energy, carbohydrates, fiber, saturated and monounsaturated fatty acids. In contrast, 3 days would be recommended for protein, lipid, polyunsaturated fatty acids and cholesterol. Two cardiovascular risk factors as have been extracted in the ACP, referring to the dependent variables: the standard lipid profile (HDL-C and non-HDL cholesterol) and "standard anthropometric index (BMI, WC, WHR) with a power explaining 75% of the variance of the original data. The factors are representative of two independent variables led to dietary patterns, "pattern 130 western diet" and "pattern protein diet", and one on the lifestyle, "pattern energy balance". Together, these patterns provide an explanation power of 67%. Made adjustment for sexual maturation in males remained significant variables: the associations between puberty and be pattern anthropometric indicator (OR = 3.32, CI 1.34 to 8.17%), and between family history of CVD and the pattern lipid profile (OR = 2.62, CI 1.20 to 5.72%). In females adolescents, associations were identified between age after the first stage of puberty with anthropometric pattern (OR = 3.59, CI 1.58 to 8.17%) and lipid profile (OR = 0.33, CI 0.15 to 0.75%). Conclusions: The low HDL-C was the most prevalent dyslipidemia independent of sex and nutritional status of adolescents. Hypercholesterolemia was influenced by family history of CVD and sexual maturation, in turn, hypertriglyceridemia was closely associated with anthropometric indicators. The variance between the diets was greater for all nutrients. This fact reflected in a variance ratio less than 1 and consequently in a lower number of days requerid to estimate the usual diet of adolescents considering gender. The two dietary patterns were extracted and the pattern considered unhealthy lifestyle as healthy. The associations were found between the patterns of CVD risk with age and family history of CVD in the studied adolescents

Análise da variabilidade genética aditiva de características de crescimento na raça Nelore

Foram utilizados dados de cinqüenta e um rebanhos participantes do Programa de Melhoramento Genético da Raça Nelore (PMGRN), distribuídos nos estados de Goiás (GO), Mato Grosso do Sul (MS), Mato Grosso (MT), Minas Gerais (MG), São Paulo (SP), Maranhão (MA) e Bahia (BA). Foram obtidas estimativas de parâmetros genéticos para os pesos padronizados aos 120 (P120), 455 (P455) e 550 (P550) dias de idade. Análises unicaráter e bicaráter foram realizadas por modelo animal usando o aplicativo MTDFREML. Para P120 foi utilizado um modelo que incluiu como efeitos fixos, grupo de contemporâneos e classe de idade da vaca ao parto, e como aleatórios, os efeitos genéticos direto, materno e de ambiente permanente da vaca. Para P455 e P550, o modelo utilizado incluiu os mesmos efeitos fixos e o efeito genético direto do animal. ANas análises unicaráter, as estimativas de herdabilidade direta foram 0,29, 0,51 e 0,47 para P120, P455 e P550, respectivamente. Nas análises bicaráter, observaram-se coeficientes de herdabilidade direta de 0,50 e 0,58 para P120, 0,50 e 0,53 para P455 e 0,44 e 0,49 para P550. As correlações genéticas estimadas entre P120 e P455, P120 e P550 e P455 e P550, foram 0,92, 0,93 e 0,96, respectivamente. As estimativas de herdabilidade obtidas para P455 e as correlações genéticas deste peso com P120 e P550 sugerem que a avaliação genética pode ser feita aos 15 meses de idade em substituição aos 18 meses.

Estimation of genetic parameters for partial egg production periods by means of random regression models

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

O conhecimento e as atitudes das famílias de pacientes em tratamento em tuberculose na atenção primária à saúde

This study thus sought to examine knowledge about TB and attitudes of patients families in disease treatment in Primary Health Care in Natal- RN. To this end, a cross-sectional study was undertaken through a questionnaire with families of patients diagnosed with TB and follow up by APS from Natal. The study subjects were recruited from a non-probabilistic way, by convenience, contemplating a sample of 50 families. Among the criteria considered for inclusion of subjects, older than 18 years were considered, as well as residing with the TB patient and in Natal and availability to participate in the research. Data collection was performed by own researcher and an assistant, through a questionnaire with families of patients diagnosed with TB following the double independent digitalization of data. In the analytical phase, was initially conducted an exploratory phase and univariate data, with description of the position measurements (mean, median, mode) and dispersion (confidence interval and standard deviation). In bivariate analysis, it was conducted an intersection of dependent variables of knowledge e and changes of attitude dichotomous, with each of the independent variables, using contingency tables and calculating the chi-square test and, when appropriate, the Fisher exact test. In 2x2 tables, calculated the odds ratio (OR) with confidence intervals of 95% (95% CI). From the selected sample, 43 (86%) subjects were female, average age and median respectively of 46.64 and 46.50 years, 25 (50%) had elementary school. The knowledge expressed by family members about TB was considered satisfactory. However, the lack of interest of the family (54%) in seeking information about tuberculosis; the wrong way of reply in relation to the organism causing the disease (64%); the water content (62%) and contaminated food (54% ) as a means of spreading TB was a weakness identified in the investigation. Regarding the time of transmission, 90% of respondents indicated not know or answered wrong. From investigated independent variables, only two were associated with lack of knowledge of TB, and they did not have religion (OR: 0.146, 95% CI: 0.027 to 0.800) and income below 1, 7 minimum wages (OR: 0.155, 95% CI: 0.029 to 0.813). Thus they seem to exercise a protective effect on this outcome. As for the changes in attitude, most of the found variables had no association with statistical significance, except no internet access (OR: 0.212, 95% CI: 0,048-0, 935). Most attitudes were positive in relation to TB patient. Results have demonstrated weaknesses in TB care, which has taken on a more individual and welfare character. Data not only express health outcomes produced by health services, but also the political and social situation of the families that are affected by TB

Models for the analysis of growth curves for rearing tinamous (Rhynchotus rufescens) in captivity

Growth curves models provide a visual assessment of growth as a function of time, and prediction body weight at a specific age. This study aimed at estimating tinamous growth curve using different models, and at verifying their goodness of fit. A total number 11,639 weight records from 411 birds, being 6,671 from females and 3,095 from males, was analyzed. The highest estimates of a parameter were obtained using Brody (BD), von Bertalanffy (VB), Gompertz (GP,) and Logistic function (LG). Adult females were 5.7% heavier than males. The highest estimates of b parameter were obtained in the LG, GP, BID, and VB models. The estimated k parameter values in decreasing order were obtained in LG, GP, VB, and BID models. The correlation between the parameters a and k showed heavier birds are less precocious than the lighter. The estimates of intercept, linear regression coefficient, quadratic regression coefficient, and differences between quadratic coefficient of functions and estimated ties of quadratic-quadratic-quadratic segmented polynomials (QQQSP) were: 31.1732 +/- 2.41339; 3.07898 +/- 0.13287; 0.02689 +/- 0.00152; -0.05566 +/- 0.00193; 0.02349 +/- 0.00107, and 57 and 145 days, respectively. The estimated predicted mean error values (PME) of VB, GP, BID, LG, and QQQSP models were, respectively, 0.8353; 0.01715; -0.6939; -2.2453; and -0.7544%. The coefficient of determination (RI) and least square error values (MS) showed similar results. In conclusion, the VB and the QQQSP models adequately described tinamous growth. The best model to describe tinamous growth was the Gompertz model, because it presented the highest R-2 values, easiness of convergence, lower PME, and the easiness of parameter biological interpretation.