Análise de sobrevivência ao cancro colo-retal nos períodos 2000-2001 e 2007-2008 na região norte de Portugal

O cancro colo-retal é um dos tipos de cancro mais comuns, em ambos os sexos, tendo em conta os dados existentes nos registos oncológicos nas mais diversas regiões do globo, facto que acontece também na região Norte de Portugal. O objetivo desta dissertação foi utilizar métodos de análise de sobrevivência tradicional e de análise de sobrevivência relativa, em dados do cancro colo-retal, considerando um período de observação de 5 anos. Os dados analisados são provenientes do Registo Oncológico Regional do Norte (RORENO), obtendo-se, após inspeção e tratamento prévio, um total de 2855 pacientes aos quais foi diagnosticado cancro colo-retal em dois períodos distintos, 2000-2001 e 2007- 2008. Pretendeu-se também determinar de que forma as covariáveis influenciam a sobrevivência, e como esta evoluiu entre essas duas coortes. Dado não existir informação sobre as causas de morte, foi objetivo deste estudo estimar que parte da mortalidade observada se deve à doença em questão e que parte se deve a outras causas que afetam a mortalidade da população geral. Foram, também, estimados os coeficientes das covariáveis consideradas para os modelos adotados. Todos os resultados foram obtidos utilizando como recurso o software R e seus pacotes adequados. Utilizaram-se diversos métodos tais como Kaplan-Meier, Cox, Ederer II e Net Survival, sendo este último considerado o mais adequado a este tipo de estudo pois é considerado pela comunidade científica o único estimador centrado para análise de sobrevivência relativa e cujas propriedades estatísticas permitem a sua utilização em estudos comparativos entre países. Verificou-se, por este estimador, que não existem diferenças significativas na sobrevivência em função do sexo, idade, distrito ou localização do cancro (cólon ou reto). Por outro lado verificaram-se diferenças significativas para a sobrevivência em função do estadio e das coortes, registando-se um acréscimo global de 8.5% na sobrevivência aos 5 anos de 2000-2001 para 2007-2008. Por fim destacam-se alguns aspetos que merecem atenção em estudos futuros.

Optimized probing states for qubit phase estimation with general quantum noise

International audience

The meaning of implied volatility in pricing stock options traded in options markets

Ph.D. in the Faculty of Business Administration

Marketing channel behaviour and performance

Thesis submitted to University of Manchester for the degree of Doctor of Philosophy in the Faculty of Business Administration.

Prevalence of General and Abdominal Obesity in a Nationally Representative Sample of Iranian Children and Adolescents: The CASPIAN-IV Study

Background: Pediatric obesity is one of the predisposing risk factors for many non-communicable diseases. Objectives: The purpose of this study was to estimate the national prevalence of general and abdominal obesity among Iranian children and adolescents. Patients and Methods: This cross-sectional nation-wide study was performed in 30 provinces in Iran among 14880 school students aged 6 – 18 years, selected by multistage random cluster sampling. The World Health Organization growth curve was used to categorize Body Mass Index (BMI). Obesity was defined as BMI equal to or higher than the age- and gender-specific 95th percentile; abdominal obesity was considered as waist-to-height ratio of more than 0.5. Results: Data of 13486 out of 14880 invited students were complete (response rate of 90.6%). They consisted of 6543 girls and 75.6% urban residents, and had a mean age of 12.45 (95% CI: 12.40 - 12.51) years. The prevalence rate of general and abdominal obesity was 11.89% (13.58% of boys vs. 10.15% of girls) and 19.12% (20.41% of boys vs. 17.79% of girls), respectively. The highest frequency of obesity was found in the middle school students (13.87% general and 20.84% abdominal obesity). The highest prevalence of general obesity was found in Boushehr (19%) followed by Guilan and Mazandaran (18.3%, 18.3%), while the lowest prevalence was observed in Hormozgan (2.6%). The highest frequency of abdominal obesity was found in Mazandaran (30.2%), Ardabil (29.2%) and Tehran (27.9%). Provinces such as Sistan-Baloochestan (8.4%), Hormozagan (7.4%), and Kerman (11.4%) had the lowest prevalence of abdominal obesity. The Southern and South Eastern provinces had the lowest prevalence of general obesity (2.6% and 5.6%) and abdominal obesity (7.4% and 8.8%). Moreover, the highest prevalence of obesity was found in North and North West Iran by maximum frequency of 18.3% general obesity and 30.2% of abdominal obesity. Conclusions: The results showed a high prevalence of general and abdominal obesity among boys living in the Northern provinces of Iran. The present study provides insights that policy makers should consider action-oriented interventions for prevention and control of childhood obesity at national and sub-national level.

Objetos de aprendizaje para el desarrollo del tema: inecuaciones de primer grado e intervalos de solución de noveno de educación general básica.

El presente trabajo tiene como objetivo dar a conocer Objetos de Aprendizaje, como un recurso tecnológico, que sirva de soporte a la educación y que contribuya en la enseñanza de las Inecuaciones de primer grado. Para realizar este proyecto se han planteado cinco capítulos de desarrollo: En el capítulo uno se realiza una investigación bibliográfica donde se describe la Educación, orientándola hacia el constructivismo, que centra al estudiante como constructor de su conocimiento y la importancia de usar material didáctico apto para desarrollar sus habilidades. En el capítulo dos se desarrolla el tema de Inecuaciones de primer grado, dividiéndolo en cuatro subtemas: Inecuaciones de primer grado con una y dos incógnitas, intervalos de solución y sistemas de inecuaciones. En el capítulo tres se presenta un análisis a los recursos educativos de libre acceso en diferentes sitios web, dónde se evidencia el desarrollo de plataformas que buscan consolidar los aprendizajes. En el capítulo cuatro se desarrolla el diseño de los cuatro Objetos de Aprendizaje; a partir de su metodología para la estructuración; además se usará guías para su organización. Y finalmente en el capítulo cinco se aprecia el interés que producen los Objetos de Aprendizaje, en los estudiantes de Noveno de EGB. Permitiendo observar que este recurso fortalece el aprendizaje de forma divertida e interactiva; dando apertura al uso de instrumentos multimedia como material de autoformación.

Bayesian Estimation of Small Proportions Using Binomial Group Test

Group testing has long been considered as a safe and sensible relative to one-at-a-time testing in applications where the prevalence rate p is small. In this thesis, we applied Bayes approach to estimate p using Beta-type prior distribution. First, we showed two Bayes estimators of p from prior on p derived from two different loss functions. Second, we presented two more Bayes estimators of p from prior on π according to two loss functions. We also displayed credible and HPD interval for p. In addition, we did intensive numerical studies. All results showed that the Bayes estimator was preferred over the usual maximum likelihood estimator (MLE) for small p. We also presented the optimal β for different p, m, and k.

Examining the Validity of the GRE General Test Scores and Undergraduate GPA for Predicting Success in Graduate School at a Large Racially and Ethnically Diverse Public University in Southeast Florida

The purpose of the study was to determine the degree of relationships among GRE scores, undergraduate GPA (UGPA), and success in graduate school, as measured by first year graduate GPA (FGPA), cumulative graduate GPA, and degree attainment status. A second aim of the study was to determine whether the relationships between the composite predictor (GRE scores and UGPA) and the three success measures differed by race/ethnicity and sex. A total of 7,367 graduate student records (masters, 5,990; doctoral: 1,377) from 2000 to 2010 were used to evaluate the relationships among GRE scores, UGPA and the three success measures. Pearson’s correlation, multiple linear and logistic regression, and hierarchical multiple linear and logistic regression analyses were performed to answer the research questions. The results of the correlational analyses differed by degree level. For master’s students, the ETS proposed prediction that GRE scores are valid predictors of first year graduate GPA was supported by the findings from the present study; however, for doctoral students, the proposed prediction was only partially supported. Regression and correlational analyses indicated that UGPA was the variable that consistently predicted all three success measures for both degree levels. The hierarchical multiple linear and logistic regression analyses indicated that at master’s degree level, White students with higher GRE Quantitative Reasoning Test scores were more likely to attain a degree than Asian Americans, while International students with higher UGPA were more likely to attain a degree than White students. The relationships between the three predictors and the three success measures were not significantly different between men and women for either degree level. Findings have implications both for practice and research. They will provide graduate school administrators with institution-specific validity data for UGPA and the GRE scores, which can be referenced in making admission decisions, while they will provide empirical and professionally defensible evidence to support the current practice of using UGPA and GRE scores for admission considerations. In addition, new evidence relating to differential predictions will be useful as a resource reference for future GRE validation researchers.

Globalization and the Public Provision of Higher Education: Empirical Evidence from Selected Countries

This research study was designed to examine the relationship between globalization as measured by the KOF index, its related forces (economic, political, cultural and technological) and the public provision of higher education. This study is important since globalization is increasingly being associated with changes in critical aspects of higher education. The public provision of education was measured by government expenditure and educational outcomes; that is participation, gender equity and attainment. The study utilized a non-experimental quantitative research design. Data collected from secondary sources for 139 selected countries was analyzed. The countries were geographically distributed and included both developed and developing countries. The choice of countries for inclusion in the study was based on data availability. The data, which was sourced from international organizations such as the United Nations and the World Bank, were examined for different time periods using five year averages. The period covered was 1970 to 2009. The relationship between globalization and the higher education variables was examined using cross sectional regression analysis while controlling for economic, political and demographic factors. The major findings of the study are as follows. For the two spending models, only one revealed a significant relationship between globalization and education with the R2 s ranging from .222 to .448 over the period. This relationship was however negative indicating that as globalization increased, spending on higher education declined. However, for the education outcomes models, this relationship was not significant. For the sub-indices of globalization, only the political dimension showed significance as shown in the spending model. Political globalization was significant for six periods with R2 s ranging from .31 to .52. The study concluded that the results are mixed for both the spending and outcome models. It also found no robust effects of globalization on government education provision. This finding is not surprising given the existing literature which sees mixed results on the social impact of globalization.

Breaking the curve with candels: a Bayesian approach to reveal the non-universality of the dust-attenuation law at high redshift

Dust attenuation affects nearly all observational aspects of galaxy evolution, yet very little is known about the form of the dust-attenuation law in the distant universe. Here, we model the spectral energy distributions of galaxies at z ~ 1.5–3 from CANDELS with rest-frame UV to near-IR imaging under different assumptions about the dust law, and compare the amount of inferred attenuated light with the observed infrared (IR) luminosities. Some individual galaxies show strong Bayesian evidence in preference of one dust law over another, and this preference agrees with their observed location on the plane of infrared excess (IRX, L_TIR/L_UV) and UV slope (β). We generalize the shape of the dust law with an empirical model, A_ λ,σ =E(B-V)k_ λ (λ / λ v)^ σ where k_λ is the dust law of Calzetti et al., and show that there exists a correlation between the color excess E(B-V) and tilt δ with δ =(0.62±0.05)log(E(B-V))+(0.26±0.02). Galaxies with high color excess have a shallower, starburst-like law, and those with low color excess have a steeper, SMC-like law. Surprisingly, the galaxies in our sample show no correlation between the shape of the dust law and stellar mass, star formation rate, or β. The change in the dust law with color excess is consistent with a model where attenuation is caused by scattering, a mixed star–dust geometry, and/or trends with stellar population age, metallicity, and dust grain size. This rest-frame UV-to-near-IR method shows potential to constrain the dust law at even higher redshifts (z>3).

Atmospheric calibration for sub-millimeter radio astronomy

This thesis is focused on improving the calibration accuracy of sub-millimeter astronomical observations. The wavelength range covered by observational radio astronomy has been extended to sub-millimeter and far infrared with the advancement of receiver technology in recent years. Sub-millimeter observations carried out with airborne and ground-based telescopes typically suffer from 10% to 90% attenuation of the astronomical source signals by the terrestrial atmosphere. The amount of attenuation can be derived from the measured brightness of the atmospheric emission. In order to do this, the knowledge of the atmospheric temperature and chemical composition, as well as the frequency-dependent optical depth at each place along the line of sight is required. The altitude-dependent air temperature and composition are estimated using a parametrized static atmospheric model, which is described in Chapter 2, because direct measurements are technically and financially infeasible. The frequency dependent optical depth of the atmosphere is computed with a radiative transfer model based on the theories of quantum mechanics and, in addition, some empirical formulae. The choice, application, and improvement of third party radiative transfer models are discussed in Chapter 3. The application of the calibration procedure, which is described in Chapter 4, to the astronomical data observed with the SubMillimeter Array Receiver for Two Frequencies (SMART), and the German REceiver for Astronomy at Terahertz Frequencies (GREAT), is presented in Chapters 5 and 6. The brightnesses of atmospheric emission were fitted consistently to the simultaneous multi-band observation data from GREAT at 1.2 ∼ 1.4 and 1.8 ∼ 1.9 THz with a single set of parameters of the static atmospheric model. On the other hand, the cause of the inconsistency between the model parameters fitted from the 490 and 810 GHz data of SMART is found to be the lack of calibration of the effective cold load temperature. Besides the correctness of atmospheric modeling, the stability of the receiver is also important to achieving optimal calibration accuracy. The stabilities of SMART and GREAT are analyzed with a special calibration procedure, namely the “load calibration". The effects of the drift and fluctuation of the receiver gain and noise temperature on calibration accuracy are discussed in Chapters 5 and 6. Alternative observing strategies are proposed to combat receiver instability. The methods and conclusions presented in this thesis are applicable to the atmospheric calibration of sub-millimeter astronomical observations up to at least 4.7 THz (the H channel frequency of GREAT) for observations carried out from ∼ 4 to 14 km altitude. The procedures for receiver gain calibration and stability test are applicable to other instruments using the same calibration approach as that for SMART and GREAT. The structure of the high performance, modular, and extensible calibration program used and further developed for this thesis work is presented in the Appendix C.

Un aporte a la comprensión de las estrategias emergentes en las organizaciones a través del concepto de improvisación y la metáfora musical

Este trabajo se inscribe en uno de los grandes campos de los estudios organizacionales: la estrategia. La perspectiva clásica en este campo promovió la idea de que proyectarse hacia el futuro implica diseñar un plan (una serie de acciones deliberadas). Avances posteriores mostraron que la estrategia podía ser comprendida de otras formas. Sin embargo, la evolución del campo privilegió en alguna medida la mirada clásica estableciendo, por ejemplo, múltiples modelos para ‘formular’ una estrategia, pero dejando en segundo lugar la manera en la que esta puede ‘emerger’. El propósito de esta investigación es, entonces, aportar al actual nivel de comprensión respecto a las estrategias emergentes en las organizaciones. Para hacerlo, se consideró un concepto opuesto —aunque complementario— al de ‘planeación’ y, de hecho, muy cercano en su naturaleza a ese tipo de estrategias: la improvisación. Dado que este se ha nutrido de valiosos aportes del mundo de la música, se acudió al saber propio de este dominio, recurriendo al uso de ‘la metáfora’ como recurso teórico para entenderlo y alcanzar el objetivo propuesto. Los resultados muestran que 1) las estrategias deliberadas y las emergentes coexisten y se complementan, 2) la improvisación está siempre presente en el contexto organizacional, 3) existe una mayor intensidad de la improvisación en el ‘como’ de la estrategia que en el ‘qué’ y, en oposición a la idea convencional al respecto, 4) se requiere cierta preparación para poder improvisar de manera adecuada.

Caracterización sociodemográfica de las enfermedades huérfanas en Colombia

Las enfermedades huérfanas en Colombia, se definen como aquellas crónicamente debilitantes, que amenazan la vida, de baja prevalencia (menor 1/5000) y alta complejidad. Se estima que a nivel mundial existen entre 6000 a 8000 enfermedades raras diferentes(1). Varios países a nivel mundial individual o colectivamente, en los últimos años han creado políticas e incentivos para la investigación y protección de los pacientes con enfermedades raras. Sin embargo, a pesar del creciente número de publicaciones; la información sobre su etiología, fisiología, historia natural y datos epidemiológicos persiste escasa o ausente. Los registros de pacientes, son una valiosa herramienta para la caracterización de las enfermedades, su manejo y desenlaces con o sin tratamiento. Permiten mejorar políticas de salud pública y cuidado del paciente, contribuyendo a mejorar desenlaces sociales, económicos y de calidad de vida. En Colombia, bajo el decreto 1954 de 2012 y las resoluciones 3681 de 2013 y 0430 de 2013 se creó el fundamento legal para la creación de un registro nacional de enfermedades huérfanas. El presente estudio busca determinar la caracterización socio-demográfica y la prevalencia de las enfermedades huérfanas en Colombia en el periodo 2013. Métodos: Se realizó un estudio observacional de corte transversal de fuente secundaria sobre pacientes con enfermedades huérfanas en el territorio nacional; basándose en el registro nacional de enfermedades huérfanas obtenido por el Ministerio de Salud y Protección Social en el periodo 2013 bajo la normativa del decreto 1954 de 2012 y las resoluciones 3681 de 2013 y 0430 de 2013. Las bases de datos obtenidas fueron re-categorizadas en Excel versión 15.17 para la extracción de datos y su análisis estadístico posterior, fue realizado en el paquete estadístico para las ciencias sociales (SPSS v.20, Chicago, IL). Resultados: Se encontraron un total de 13173 pacientes con enfermedades huérfanas para el 2013. De estos, el 53.96% (7132) eran de género femenino y el 46.03% (6083) masculino; la mediana de la edad fue de 28 años con un rango inter-cuartil de 39 años, el 9% de los pacientes presentaron discapacidad. El registro contenía un total de 653 enfermedades huérfanas; el 34% del total de las enfermedades listadas en nuestro país (2). Las patologías más frecuentes fueron el Déficit Congénito del Factor VIII, Miastenia Grave, Enfermedad de Von Willebrand, Estatura Baja por Anomalía de Hormona de Crecimiento y Displasia Broncopulmonar. Discusión: Se estimó que aproximadamente 3.3 millones de colombianos debían tener una enfermedad huérfana para el 2013. El registro nacional logró recolectar datos de 13173 (0.4%). Este bajo número de pacientes, marca un importante sub-registro que se debe al uso de los códigos CIE-10, desconocimiento del personal de salud frente a las enfermedades huérfanas y clasificación errónea de los pacientes. Se encontraron un total de 653 enfermedades, un 34% de las enfermedades reportadas en el listado nacional de enfermedades huérfanas (2) y un 7% del total de enfermedades reportadas en ORPHANET para el periodo 2013 (3). Conclusiones: La recolección de datos y la sensibilización sobre las enfermedades huérfanas al personal de salud, es una estrategia de vital importancia para el diagnóstico temprano, medidas específicas de control e intervenciones de los pacientes. El identificar apropiadamente a los pacientes con este tipo de patologías, permite su ingreso en el registro y por ende mejora el sub-registro de datos. Sin embargo, cabe aclarar que el panorama ideal sería, el uso de un sistema de recolección diferente al CIE-10 y que abarque en mayor medida la totalidad de las enfermedades huérfanas.

Mercadeo farmacéutico de productos bajo prescripción: efectos de las estrategias Direct-to-Consumer-Advertising en el comportamiento de los consumidores y de prescripción de los médicos

Este proyecto se origina en el interés de analizar las estrategias actuales de promoción de productos farmacéuticos, en el marco del debate sobre el efecto persuasivo o informativo que la publicidad directa tiene sobre los consumidores. El objetivo es determinar el efecto de las estrategias de promoción directa para consumidores (Direct to Consumer Advertising [DTCA]) sobre el comportamiento de compra de pacientes y las prescripciones que formulan los médicos en el mercado de productos bajo receta en Estados Unidos. Para tal fin se propuso realizar una monografía que incluyera una revisión de literatura de carácter argumentativo, consultando información de nivel secundario en bases de datos científicas cuyos contenidos obedecieran a criterios metodológicos determinados por la naturaleza argumentativa del estudio. Adicionalmente, se analizó el debate sobre estos anuncios a la luz de dos estudios realizados a pacientes con cáncer de seno, próstata y colon, liderados por el Pennsylvania Cancer Registry con los productos biofarmacéuticos Avodart® y Flomax®. Finalmente, la investigación se fundamentó en la relación del mercado farmacéutico en Estados Unidos con cada uno de los agentes que interactúan en él; consumidores, médicos prescriptores y empresas farmacéuticas, así como el valor que estos comparten través de dichas interacciones. Se concluye que el comportamiento de compra de los consumidores está determinado por la naturaleza de la patología que padecen y el comportamiento de los profesionales que prescriben a sus pacientes se ve influenciado por los anuncios DTCA.

Large scale underground energy storage for renewables integration: general criteria for reservoir identification and viable technologies.

The increasing integration of renewable energies in the electricity grid contributes considerably to achieve the European Union goals on energy and Greenhouse Gases (GHG) emissions reduction. However, it also brings problems to grid management. Large scale energy storage can provide the means for a better integration of the renewable energy sources, for balancing supply and demand, to increase energy security, to enhance a better management of the grid and also to converge towards a low carbon economy. Geological formations have the potential to store large volumes of fluids with minimal impact to environment and society. One of the ways to ensure a large scale energy storage is to use the storage capacity in geological reservoir. In fact, there are several viable technologies for underground energy storage, as well as several types of underground reservoirs that can be considered. The geological energy storage technologies considered in this research were: Underground Gas Storage (UGS), Hydrogen Storage (HS), Compressed Air Energy Storage (CAES), Underground Pumped Hydro Storage (UPHS) and Thermal Energy Storage (TES). For these different types of underground energy storage technologies there are several types of geological reservoirs that can be suitable, namely: depleted hydrocarbon reservoirs, aquifers, salt formations and caverns, engineered rock caverns and abandoned mines. Specific site screening criteria are applicable to each of these reservoir types and technologies, which determines the viability of the reservoir itself, and of the technology for any particular site. This paper presents a review of the criteria applied in the scope of the Portuguese contribution to the EU funded project ESTMAP – Energy Storage Mapping and Planning.