AN INVESTIGATION ON ROUTINE FOLLOW-UP CARE FOR HEAD AND NECK CANCER

BACKGROUND: Follow-up care aims to provide surveillance with early detection of recurring cancers and to address treatment complications and other health issues in survivorship. It is assumed that follow-up care fulfills these aims, however little evidence supports routine surveillance detecting curable disease early enough to improve survival. Cancer survivors are a diverse patient population, suggesting that a single follow-up regimen may not meet all patients’ follow-up needs. Little is known about what effective follow-up care should include for head and neck cancer patients in a Canadian setting. Identification of subgroups of patients with specific needs and current practices would allow for hypotheses to be generated for enhancing follow-up care. OBJECTIVES: 1a) To describe the follow-up needs and preferences of head and neck cancer patients, 1b) to identify which patient characteristics predict needs and preferences, 1c) to evaluate how needs and preferences change over time, 2a) to describe follow-up care practices by physician visits and imaging tests, and 2b) to identify factors associated to the delivered follow-up care. METHODS: 1) 175 patients who completed treatment between 2012 and 2013 in Kingston and London, Ontario were recruited to participate in a prospective survey study on patients’ needs and preferences in follow-up care. Bivariate and multivariate analyses were employed to describe patient survey responses and to identify patient characteristics that predicted needs and preferences. 2) A retrospective cohort study of 3975 patients on routine follow-up from 2007 to 2015 was carried out using data linkages across registry and administrative databases to describe follow-up practices in Ontario by visits and tests. Multivariate regression analyses assessed factors related to follow-up care. RESULTS: 1) Patients’ needs and preferences were wide-ranging with several characteristics predicting needs and preferences (ORECOG=2.69 and ORAnxiety=1.13). Needs and preferences declined as patients transitioned into their second year of follow-up (p<0.05). 2) Wide variation in practices was found, with marked differences compared to existing consensus guidelines. Multiple factors were associated with follow-up practices (RRTumor site=0.73 and RRLHIN=1.47). CONCLUSIONS: Patient characteristics can be used to personalize care and guidelines are not informing practice. Future research should evaluate individualized approaches to follow-up care.

Graphene-based waveguide resonators for submillimeter-wave applications

Utilization of graphene covered waveguide inserts to form tunable waveguide resonators is theoretically explained and rigorously investigated by means of full-wave numerical electromagnetic simulations. Instead of using graphene-based switching elements, the concept we propose incorporates graphene sheets as parts of a resonator. Electrostatic tuning of the graphene surface conductivity leads to changes in the electromagnetic field boundary conditions at the resonator edges and surfaces, thus producing an effect similar to varying the electrical length of a resonator. The presented outline of the theoretical background serves to give phenomenological insight into the resonator behavior, but it can also be used to develop customized software tools for design and optimization of graphene-based resonators and filters. Due to the linear dependence of the imaginary part of the graphene surface impedance on frequency, the proposed concept was expected to become effective for frequencies above 100 GHz, which is confirmed by the numerical simulations. A frequency range from 100 GHz up to 1100 GHz, where the rectangular waveguides are used, is considered. Simple, all-graphene-based resonators are analyzed first, to assess the achievable tunability and to check the performance throughout the considered frequency range. Graphene–metal combined waveguide resonators are proposed in order to preserve the excellent quality factors typical for the type of waveguide discontinuities used. Dependence of resonator properties on key design parameters is studied in detail. Dependence of resonator properties throughout the frequency range of interest is studied using eight different waveguide sections appropriate for different frequency intervals. Proposed resonators are aimed at applications in the submillimeter-wave spectral region, serving as the compact tunable components for the design of bandpass filters and other devices.

"Ad nostram scientiam referatur": la supervisión administrativa imperial de la aplicación de las leyes durante la dinastía constantiniana

Constantino y sus sucesores, Constancio II, Constante y Juliano, expresaron su particular interés por supervisar la aplicación de determinadas leyes imperiales mediante el uso de la fórmula ad nostram scientiam referatur y de otras similares. Constantino fue el príncipe que la empleó con más frecuencia, especialmente durante el período de 313-324, exceptuando el intervalo de 315-316, cuando la confrontación con Licinio le obligó a renunciar a atender directamente las cuestiones administrativas. La progresiva disminución de la inclusión de estas cláusulas en los textos legales imperiales a partir de la unificación del Imperio en 324 se debe poner en relación con la aparición de los curiosi y luego de los agentes in rebus, como oficiales encargados de vigilar la observancia de las normas vigentes.

Three dimensional Sklyanin algebras and Gröbner bases

We consider Sklyanin algebras $S$ with 3 generators, which are quadratic algebras over a field $\K$ with $3$ generators $x,y,z$ given by $3$ relations $pxy+qyx+rzz=0$, $pyz+qzy+rxx=0$ and $pzx+qxz+ryy=0$, where $p,q,r\in\K$. this class of algebras has enjoyed much attention. In particular, using tools from algebraic geometry, Feigin, Odesskii \cite{odf}, and Artin, Tate and Van Den Bergh, showed that if at least two of the parameters $p$, $q$ and $r$ are non-zero and at least two of three numbers $p^3$, $q^3$ and $r^3$ are distinct, then $S$ is Artin--Schelter regular. More specifically, $S$ is Koszul and has the same Hilbert series as the algebra of commutative polynomials in 3 indeterminates (PHS). It has became commonly accepted that it is impossible to achieve the same objective by purely algebraic and combinatorial means like the Groebner basis technique. The main purpose of this paper is to trace the combinatorial meaning of the properties of Sklyanin algebras, such as Koszulity, PBW, PHS, Calabi-Yau, and to give a new constructive proof of the above facts due to Artin, Tate and Van Den Bergh. Further, we study a wider class of Sklyanin algebras, namely
the situation when all parameters of relations could be different. We call them generalized Sklyanin algebras. We classify up to isomorphism all generalized Sklyanin algebras with the same Hilbert series as commutative polynomials on
3 variables. We show that generalized Sklyanin algebras in general position have a Golod–Shafarevich Hilbert series (with exception of the case of field with two elements).

Neural networks would 'vote' according to Borda's Rule

Can neural networks learn to select an alternative based on a systematic aggregation of convicting individual preferences (i.e. a 'voting rule')? And if so, which voting rule best describes their behavior? We show that a prominent neural network can be trained to respect two fundamental principles of voting theory, the unanimity principle and the Pareto property. Building on this positive result, we train the neural network on profiles of ballots possessing a Condorcet winner, a unique Borda winner, and a unique plurality winner, respectively. We investigate which social outcome the trained neural network chooses, and find that among a number of popular voting rules its behavior mimics most closely the Borda rule. Indeed, the neural network chooses the Borda winner most often, no matter on which voting rule it was trained. Neural networks thus seem to give a surprisingly clear-cut answer to one of the most fundamental and controversial problems in voting theory: the determination of the most salient election method.

Effektiv lagerstyrning med AHP och tvådimensionell artikelklassificering : En fallstudie på Permobil AB, Timrå

Costs related to inventory are usually a significant amount of the company’s total assets. Despite this, companies in general don’t pay a lot of interest in it, even if the benefits from effective inventory are obvious when it comes to less tied up capital, increased customer satisfaction and better working environment. Permobil AB, Timrå is in an intense period when it comes to revenue and growth. The production unit is aiming for an increased output of 30 % in the next two years. To make this possible the company has to improve their way to distribute and handle material,The purpose of the study is to provide useful information and concrete proposals for action, so that the company can build a strategy for an effective and sustainable solution when it comes to inventory management. Alternative methods for making forecasts are suggested, in order to reach a more nuanced perception of different articles, and how they should be managed. Analytic Hierarchy Process (AHP) was used in order to give specially selected persons the chance to decide criteria for how the article should be valued. The criteria they agreed about were annual volume value, lead time, frequency rate and purchase price. The other method that was proposed was a two-dimensional model where annual volume value and frequency was the criteria that specified in which class an article should be placed. Both methods resulted in significant changes in comparison to the current solution. For the spare part inventory different forecast methods were tested and compared with the current solution. It turned out that the current forecast method performed worse than both moving average and exponential smoothing with trend. The small sample of ten random articles is not big enough to reject the current solution, but still the result is a reason enough, for the company to control the quality of the forecasts.

Kvinnors upplevelser av att leva med bröstcanceren litteraturöversikt

Bakgrund: Bröstcancer är den vanligaste cancerformen hos kvinnor och antalet bröstcancerfall ökar. En cancerdiagnos leder till många emotionella förändringar. Som vårdpersonal är det viktigt att ha vetskap och förståelse om patientens subjektiva upplevelser kring sin sjukdom för att kunna ge en god vård. Syfte: Syftet med litteraturstudien är att beskriva kvinnors upplevelser av att leva med bröstcancer. Metod: Databaserna PubMed och Cinahl användes i sökningen av artiklar. Resultaten i artiklarna har analyserats genom en analysmetod för kvalitativa studier och resultatet i litteraturstudien baseras på 14 vetenskapliga artiklar av kvalitativ ansats. Resultat: Kvinnorna upplevde negativa förändringar i deras vardagliga liv relaterat till sjukdomen både fysiskt, psykiskt och socialt. De upplevde en förändrad roll i familjen och som kvinna. Vilken och hur mycket information kvinnorna önskade få om sitt tillstånd varierade. Kvinnorna fick en ny syn på livet och de uppskattade livet mer än de gjorde innan sjukdomen. Slutsats: Kvinnorna upplevde många svårigheter i och med bröstcancersjukdomen och dessa upplevelser är viktiga att ha i beaktande i vårdandet av patienter med bröstcancer.

The Performance Characteristics of a Surface-Modified Cutting Tool

In the past, many papers have been presented which show that the coating of cutting tools often yields decreased wear rates and reduced coefficients of friction. Although different theories are proposed, covering areas such as hardness theory, diffusion barrier theory, thermal barrier theory, and reduced friction theory, most have not dealt with the question of how and why the coating of tool substrates with hard materials such as Titanium Nitride (TiN), Titanium Carbide (TiC) and Aluminium Oxide (Al203) transforms the performance and life of cutting tools. This project discusses the complex interrelationship that encompasses the thermal barrier function and the relatively low sliding friction coefficient of TiN on an undulating tool surface, and presents the result of an investigation into the cutting characteristics and performance of EDMed surface-modified carbide cutting tool inserts. The tool inserts were coated with TiN by the physical vapour deposition (PVD) method. PVD coating is also known as Ion-plating which is the general term of the coating method in which the film is created by attracting ionized metal vapour in this the metal was Titanium and ionized gas onto negatively biased substrate surface. Coating by PVD was chosen because it is done at a temperature of not more than 5000C whereas chemical Vapour Deposition CVD process is done at very high temperature of about 8500C and in two stages of heating up the substrates. The high temperatures involved in CVD affects the strength of the (tool) substrates. In this study, comparative cutting tests using TiN-coated control specimens with no EDM surface structures and TiN-coated EDMed tools with a crater-like surface topography were carried out on mild steel grade EN-3. Various cutting speeds were investigated, up to an increase of 40% of the tool manufacturer’s recommended speed. Fifteen minutes of cutting were carried out for each insert at the speeds investigated. Conventional tool inserts normally have a tool life of approximately 15 minutes of cutting. After every five cuts (passes) microscopic pictures of the tool wear profiles were taken, in order to monitor the progressive wear on the rake face and on the flank of the insert. The power load was monitored for each cut taken using an on-board meter on the CNC machine to establish the amount of power needed for each stage of operation. The spindle drive for the machine is an 11 KW/hr motor. Results obtained confirmed the advantages of cutting at all speeds investigated using EDMed coated inserts, in terms of reduced tool wear and low power loads. Moreover, the surface finish on the workpiece was consistently better for the EDMed inserts. The thesis discusses the relevance of the finite element method in the analysis of metal cutting processes, so that metal machinists can design, manufacture and deliver goods (tools) to the market quickly and on time without going through the hassle of trial and error approach for new products. Improvements in manufacturing technologies require better knowledge of modelling metal cutting processes. Technically the use of computational models has a great value in reducing or even eliminating the number of experiments traditionally used for tool design, process selection, machinability evaluation, and chip breakage investigations. In this work, much interest in theoretical and experimental investigations of metal machining were given special attention. Finite element analysis (FEA) was given priority in this study to predict tool wear and coating deformations during machining. Particular attention was devoted to the complicated mechanisms usually associated with metal cutting, such as interfacial friction; heat generated due to friction and severe strain in the cutting region, and high strain rates. It is therefore concluded that Roughened contact surface comprising of peaks and valleys coated with hard materials (TiN) provide wear-resisting properties as the coatings get entrapped in the valleys and help reduce friction at chip-tool interface. The contributions to knowledge: a. Relates to a wear-resisting surface structure for application in contact surfaces and structures in metal cutting and forming tools with ability to give wear-resisting surface profile. b. Provide technique for designing tool with roughened surface comprising of peaks and valleys covered in conformal coating with a material such as TiN, TiC etc which is wear-resisting structure with surface roughness profile compose of valleys which entrap residual coating material during wear thereby enabling the entrapped coating material to give improved wear resistance. c. Provide knowledge for increased tool life through wear resistance, hardness and chemical stability at high temperatures because of reduced friction at the tool-chip and work-tool interfaces due to tool coating, which leads to reduced heat generation at the cutting zones. d. Establishes that Undulating surface topographies on cutting tips tend to hold coating materials longer in the valleys, thus giving enhanced protection to the tool and the tool can cut faster by 40% and last 60% longer than conventional tools on the markets today.

In Service to Iowa : Public Library Standards, 6th edition, August 8, 2016

The Standards and Accreditation Program exists to encourage the ongoing development of high quality public library services in Iowa. In Service to Iowa: Public Library Standards is the manual for the State Library of Iowa’s standards program. It was first published in 1985 and was updated in 1989, 1997, 2004, 2010, and now in 2016. Iowa’s voluntary public library standards program was established to give public libraries a tool to identify strengths and areas for improvement. It is also used to document the condition of public library service in Iowa, to distribute Direct State Aid funding, and to meet statutory requirements. In 2015, the Iowa Commission of Libraries appointed the Public Library Standards Advisory Task Force to revise In Service to Iowa. The Task Force in turn solicited feedback from the State Library Advisory Panel to ensure that proposed standards meet the changing needs of Iowa’s public libraries. All task force members support and stress the importance of the accreditation process and thank the Iowa public library community for its assistance.

Contributo do sistema integrado de comunicação e manipulação no desenvolvimento e aprendizagem de crianças com paralisia cerebral em contexto educativo/escolar

Dissertação apresentada à Escola Superior de Educação de Lisboa para obtenção do grau de mestre em Educação Especial – ramo de Problemas de Cognição e Multideficiência

Reordenamento viário da Rua da República e acompanhamento da instalação da Biblioteca Ary dos Santos em Sacavém

Relatório de estágio para obtenção do grau de Mestre em Engenharia Civil na Área de Especialização de Edificações

English for tourism : contribution to language use through mobile learning

Tourism is growing and is becoming more competitive. Destinations need to find elements which demonstrate their uniqueness, the singularity which allows them to differentiate themselves from others. This struggle for uniqueness makes economies become more competitive and competition is a central element in the dynamics of Tourism. Technology is also an added value for tourism competitiveness, as it allows destinations to become internationalised and known worldwide. In this scenario, research has increased as a means to study Tourism trends in fields such as sociology and marketing. Nevertheless, there are areas in which there is not much research done and which are fundamental: these are the areas concerned with identities, communication and interpersonal relations. In this regard, Linguistics has a major role for different reasons: firstly, it studies language itself and through it, communication, secondly, language conveys culture and, thirdly, it is by enriching language users that innovation in Tourism and in knowledge, as a whole, is made possible. This innovation, on the other hand, has repercussions in areas such as management, internationalisation and marketing as well. It is, therefore, the objective of this thesis to report on how learning experiences take place in Tourism undergraduate English language classes as well as to give an account of enhanced results in classes where mobile learning was adopted. In this way, an alliance between practice and research was established. This is beneficial for the teaching and learning process because by establishing links between research based insight and practice, the outcome is grounded knowledge which helps make solid educational decisions. This research, therefore, allows to better understand if learners accept working with mobile technologies in their learning process. Before introducing any teaching and learning approach, it was necessary to be informed, as well, of how English for tourism programmes are organised. This thesis also illustrates through the premises of Systemic Functional Linguistics that language use can be enhanced by using mobile technology in Tourism undergraduate language classes.

Combined exposure to multiple mycotoxins in food: are we ready for risk assessment and risk management?

It is nowadays recognized that the risk of human co-exposure to multiple mycotoxins is real. In the last years, a number of studies have approached the issue of co-exposure and the best way to develop a more precise and realistic assessment. Likewise, the growing concern about the combined effects of mycotoxins and their potential impact on human health has been reflected by the increasing number of toxicological studies on the combined toxicity of these compounds. Nevertheless, risk assessment of these toxins, still follows the conventional paradigm of single exposure and single effects, incorporating only the possibility of additivity but not taking into account the complex dynamics associated to interactions between different mycotoxins or between mycotoxins and other food contaminants. Considering that risk assessment is intimately related to the establishment of regulatory guidelines, once the risk assessment is completed, an effort to reduce or manage the risk should be followed to protect public health. Risk assessment of combined human exposure to multiple mycotoxins thus poses several challenges to scientists, risk assessors and risk managers and opens new avenues for research. This presentation aims to give an overview of the different challenges posed by the likelihood of human co-exposure to mycotoxins and the possibility of interactive effects occurring after absorption, towards knowledge generation to support a more accurate human risk assessment and risk management. For this purpose, a physiologically-based framework that includes knowledge on the bioaccessibility, toxicokinetics and toxicodynamics of multiple toxins is proposed. Regarding exposure assessment, the need of harmonized food consumption data, availability of multianalyte methods for mycotoxin quantification, management of left-censored data and use of probabilistic models will be highlight, in order to develop a more precise and realistic exposure assessment. On the other hand, the application of predictive mathematical models to estimate mycotoxins’ combined effects from in vitro toxicity studies will be also discussed. Results from a recent Portuguese project aimed at exploring the toxic effects of mixtures of mycotoxins in infant foods and their potential health impact will be presented as a case study, illustrating the different aspects of risk assessment highlighted in this presentation. Further studies on hazard and exposure assessment of multiple mycotoxins, using harmonized approaches and methodologies, will be crucial towards an improvement in data quality and contributing to holistic risk assessment and risk management strategies for multiple mycotoxins in foodstuffs.

Influência da temperatura de calcinação do fosfogesso no desempenho de cimentos supersulfatados

The supersulfated cement (CSS) basically consist of up to 90% blast furnace slag, 10-20% of a source of calcium sulfate and a small amount of alkali activator, covered by European standard EN 15743/2010. Because of this SSC are considered "green cement" low environmental impact. The source of calcium sulfate used in the preparation of CSS can be obtained from natural sources, such as gypsum or from alternative sources (industrial products), such as phosphogypsum. The phosphogypsum is a by-product of the fertilizer industry, used in the production of phosphoric acid. In this process the phosphate rock is treated with sulfuric acid to give as the major product phosphoric acid (H3PO4), gypsum and a small amount of hydrofluoric acid. The chemical composition of gypsum is basically calcium sulfate dihydrate (CaSO4.2H2O), similar to gypsum, because it can be used in this type of cement. To become anhydrous, the calcination of gypsum is necessary. The availability of the source of calcium sulfate to react with the slag is dependent on its solubility that is directly related to its calcination temperature. The solubility of the anhydrous gypsum decreases with increasing calcination temperature. This study investigated the influence of temperature of calcination of phosphogypsum on the performance of CSS. Samples were prepared with 10 and 20% of phosphogypsum calcinated at 350 to 650 ° C using KOH as an alkaline activator at three different concentrations (0.2, 0.5 and 0.8%). The results showed that all mortars presented the minimum values required by EN 15743/2010 for 7 and 28 days of hydration. In general CSS containing 10% phosphogypsum showed slightly better compressive strength results using a lower calcination temperature (350 °C) and curing all ages. The CSS containing 20% of calcined gypsum at 650 °C exhibit satisfactory compressive strenght at 28 days of hydration, but at later ages (56 to 90 days) it strongly reduced. This indicates that the calcination temperature of phosphogypsum has a strong influence on the performance of the CSS.

Mobility in vehicular networks with multiple access points to the infrastructure

Nowadays there is a huge evolution in the technological world and in the wireless networks. The electronic devices have more capabilities and resources over the years, which makes the users more and more demanding. The necessity of being connected to the global world leads to the arising of wireless access points in the cities to provide internet access to the people in order to keep the constant interaction with the world. Vehicular networks arise to support safety related applications and to improve the traffic flow in the roads; however, nowadays they are also used to provide entertainment to the users present in the vehicles. The best way to increase the utilization of the vehicular networks is to give to the users what they want: a constant connection to the internet. Despite of all the advances in the vehicular networks, there were several issues to be solved. The presence of dedicated infrastructure to vehicular networks is not wide yet, which leads to the need of using the available Wi-Fi hotspots and the cellular networks as access networks. In order to make all the management of the mobility process and to keep the user’s connection and session active, a mobility protocol is needed. Taking into account the huge number of access points present at the range of a vehicle for example in a city, it will be beneficial to take advantage of all available resources in order to improve all the vehicular network, either to the users and to the operators. The concept of multihoming allows to take advantage of all available resources with multiple simultaneous connections. This dissertation has as objectives the integration of a mobility protocol, the Network-Proxy Mobile IPv6 protocol, with a host-multihoming per packet solution in order to increase the performance of the network by using more resources simultaneously, the support of multi-hop communications, either in IPv6 or IPv4, the capability of providing internet access to the users of the network, and the integration of the developed protocol in the vehicular environment, with the WAVE, Wi-Fi and cellular technologies. The performed tests focused on the multihoming features implemented on this dissertation, and on the IPv4 network access for the normal users. The obtained results show that the multihoming addition to the mobility protocol improves the network performance and provides a better resource management. Also, the results show the correct operation of the developed protocol in a vehicular environment.