A comparison of endoscopy versus pathology sizing of colorectal adenomas and potential implications for surveillance colonoscopy

Background and AimsTo compare endoscopy and pathology sizing in a large population-based series of colorectal adenomas and to evaluate the implications for patient stratification into surveillance colonoscopy.MethodsEndoscopy and pathology sizes available from intact adenomas removed at colonoscopies performed as part of the Northern Ireland Bowel Cancer Screening Programme, from 2010 to 2015, were included in this study. Chi-squared tests were applied to compare size categories in relation to clinicopathological parameters and colonoscopy surveillance strata according to current American Gastroenterology Association and British Society of Gastroenterology guidelines.ResultsA total of 2521 adenomas from 1467 individuals were included. There was a trend toward larger endoscopy than pathology sizing in 4 of the 5 study centers, but overall sizing concordance was good. Significantly greater clustering with sizing to the nearest 5 mm was evident in endoscopy versus pathology sizing (30% vs 19%, p<0.001), which may result in lower accuracy. Applying a 10-mm cut-off relevant to guidelines on risk stratification, 7.3% of all adenomas and 28.3% of those 8 to 12 mm in size had discordant endoscopy and pathology size categorization. Depending upon which guidelines are applied, 4.8% to 9.1% of individuals had differing risk stratification for surveillance recommendations, with the use of pathology sizing resulting in marginally fewer recommended surveillance colonoscopies.ConclusionsChoice of pathology or endoscopy approaches to determine adenoma size will potentially influence surveillance colonoscopy follow-up in 4.8% to 9.1% of individuals. Pathology sizing appears more accurate than endoscopy sizing, and preferential use of pathology size would result in a small, but clinically important, decreased burden on surveillance colonoscopy demand. Careful endoscopy sizing is required for adenomas removed piecemeal.

Bioethanol production from a sub-product of pulping industry

A vida da sociedade atual é dependente dos recursos fósseis, tanto a nível de energia como de materiais. No entanto, tem-se verificado uma redução das reservas destes recursos, ao mesmo tempo que as necessidades da sociedade continuam a aumentar, tornando cada vez mais necessárias, a produção de biocombustíveis e produtos químicos. Atualmente o etanol é produzido industrialmente a partir da cana-de-açúcar e milho, matérias-primas usadas na alimentação humana e animal. Este fato desencadeou o aumento de preços dos alimentos em todo o mundo e, como consequência, provocou uma série de distúrbios sociais. Os subprodutos industriais, recursos independentes das cadeias alimentares, têm-se posicionado como fonte de matérias-primas potenciais para bioprocessamento. Neste sentido, surgem os subprodutos gerados em grande quantidade pela indústria papeleira. Os licores de cozimento da madeira ao sulfito ácido (SSLs) são uma matériaprima promissora, uma vez que durante este processo os polissacarídeos da madeira são hidrolisados originando açúcares fermentáveis. A composição dos SSLs varia consoante o tipo de madeira usada no processo de cozimento (de árvores resinosas, folhosas ou a mistura de ambas). O bioprocessamento do SSL proveniente de folhosas (HSSL) é uma metodologia ainda pouco explorada. O HSSL contém elevadas concentrações de açúcares (35-45 g.L-1), na sua maioria pentoses. A fermentação destes açúcares a bioetanol é ainda um desafio, uma vez que nem todos os microrganismos são capazes de fermentar as pentoses a etanol. De entre as leveduras capazes de fermentar naturalmente as pentoses, destaca-se a Scheffersomyces stipitis, que apresenta uma elevada eficiência de fermentação. No entanto, o HSSL contém também compostos conhecidos por inibirem o crescimento de microrganismos, dificultando assim o seu bioprocessamento. Neste sentido, o principal objetivo deste trabalho foi a produção de bioetanol pela levedura S. stipitis a partir de HSSL, resultante do cozimento ao sulfito ácido da madeira de Eucalyptus globulus. Para alcançar este objetivo, estudaram-se duas estratégias de operação diferentes. Em primeiro lugar estudou-se a bio-desintoxicação do HSSL com o fungo filamentoso Paecilomyces variotii, conhecido por crescer em resíduos industriais. Estudaram-se duas tecnologias fermentativas diferentes para a biodesintoxicação do HSSL: um reator descontínuo e um reator descontínuo sequencial (SBR). A remoção biológica de inibidores do HSSL foi mais eficaz quando se usou o SBR. P. variotii assimilou alguns inibidores microbianos como o ácido acético, o ácido gálico e o pirogalol, entre outros. Após esta desintoxicação, o HSSL foi submetido à fermentação com S. stipitis, na qual foi atingida a concentração máxima de etanol de 2.36 g.L-1 com um rendimento de 0.17 g.g-1. P. variotti, além de desintoxicar o HSSL, também é útil na produção de proteína microbiana (SCP) para a alimentação animal pois, a sua biomassa é rica em proteína. O estudo da produção de SCP por P. variotii foi efetuado num SBR com HSSL sem suplementos e suplementado com sais. A melhor produção de biomassa foi obtida no HSSL sem adição de sais, tendo-se obtido um teor de proteína elevado (82,8%), com uma baixa concentração de DNA (1,1%). A proteína continha 6 aminoácidos essenciais, mostrando potencial para o uso desta SCP na alimentação animal e, eventualmente, em nutrição humana. Assim, a indústria papeleira poderá integrar a produção de bioetanol após a produção SCP e melhorar a sustentabilidade da indústria de pastas. A segunda estratégia consistiu em adaptar a levedura S. stipitis ao HSSL de modo a que esta levedura conseguisse crescer e fermentar o HSSL sem remoção de inibidores. Operou-se um reator contínuo (CSTR) com concentrações crescentes de HSSL, entre 20 % e 60 % (v/v) durante 382 gerações em HSSL, com uma taxa de diluição de 0.20 h-1. A população adaptada, recolhida no final do CSTR (POP), apresentou uma melhoria na fermentação do HSSL (60 %), quando comparada com a estirpe original (PAR). Após esta adaptação, a concentração máxima de etanol obtida foi de 6.93 g.L-1, com um rendimento de 0.26 g.g-1. POP possuía também a capacidade de metabolizar, possivelmente por ativação de vias oxidativas, compostos derivados da lenhina e taninos dissolvidos no HSSL, conhecidos inibidores microbianos. Por fim, verificou-se também que a pré-cultura da levedura em 60 % de HSSL fez com que a estirpe PAR melhorasse o processo fermentativo em HSSL, em comparação com o ensaio sem pré-cultura em HSSL. No entanto, no caso da estirpe POP, o seu metabolismo foi redirecionado para a metabolização dos inibidores sendo que a produção de etanol decresceu.

Caracterização da marcação imunohistoquímica da protein gene product 9.5 (PGP 9.5) em células astrocitárias

Tese de mestrado, Neurociências, Faculdade de Medicina, Universidade de Lisboa, 2015

Impact of energy-using product policies

Energy-using products (EuPs), such as domestic appliances, audio-visual and ICT equipment contribute significantly to CO2 emissions, both in the domestic and non-domestic sectors. Policies that encourage the use of more energy efficient products can therefore generate significant reductions in overall energy consumption and hence, CO2 emissions. To the extent that these policies cause an increase the average production cost of EuPs, they may impose economic costs on producers, or on consumers, or on both. In this theoretical paper, an adaptation of a simple vertical product differentiation model – in which products are characterised in terms of their quality and their energy consumption – is used to analyse the impact of the different EuP polices on product innovation and to assess the resultant economic impacts on producers and consumers. It is shown that whereas the imposition of a binding product standard for energy efficiency unambiguously reduces aggregate profit and increases the average market price in the absence of any learning effects, the introduction or strengthening of demand-side measures (such as energy labelling) may reduce, or increase, aggregate profit. Even in the case where the overall impact is unambiguously negative, the effects of product innovation and learning can be in either direction.

Product innovation and the costs of energy-using product policies

Energy-using Products (EuPs) contribute significantly to the United Kingdom’s CO2 emissions, both in the domestic and non-domestic sectors. Policies that encourage the use of more energy efficient products (such as minimum performance standards, energy labelling, enhanced capital allowances, etc.) can therefore generate significant reductions in overall energy consumption and hence, CO2 emissions. While these policies can impose costs on the producers and consumers of these products in the short run, the process of product innovation may reduce the magnitude of these costs over time. If this is the case, then it is important that the impacts of innovation are taken into account in policy impact assessments. Previous studies have found considerable evidence of experience curve effects for EuP categories (e.g. refrigerators, televisions, etc.), with learning rates of around 20% for both average unit costs and average prices; similar to those found for energy supply technologies. Moreover, the decline in production costs has been accompanied by a significant improvement in the energy efficiency of EuPs. Building on these findings and the results of an empirical analysis of UK sales data for a range of product categories, this paper sets out an analytic framework for assessing the impact of EuP policy interventions on consumers and producers which takes explicit account of the product innovation process. The impact of the product innovation process can be seen in the continuous evolution of the energy class profiles of EuP categories over time; with higher energy classes (e.g. A, A+, etc.) entering the market and increasing their market share, while lower classes (e.g. E, F, etc.) lose share and then leave the market. Furthermore, the average prices of individual energy classes have declined over their respective lives, while new classes have typically entered the market at successively lower “launch prices”. Based on two underlying assumptions regarding the shapes of the “lifecycle profiles” for the relative sales and the relative average mark-ups of individual energy classes, a simple simulation model is developed that can replicate the observed market dynamics in terms of the evolution of market shares and average prices. The model is used to assess the effect of two alternative EuP policy interventions – a minimum energy performance standard and an energy-labelling scheme – on the average unit cost trajectory and the average price trajectory of a typical EuP category, and hence the financial impacts on producers and consumers.

Evaluation and Potential Cost-Effectiveness of Active Surveillance Pharmacovigilance for First-Line HAART in Namibia

Thesis (Ph.D.)--University of Washington, 2016-02

Cross-Industry Product Diversification and Contagion in Risk and Return: The Case of Bank-Insurance and Insurance-Bank Takeovers

We investigate the impact of domestic/international bancassurance deals on the risk-return profiles of announcing and non-announcing banks and insurers within a GARCH model. Bank-insurance deals produce intra- and inter-industry contagion in both risk and return, with larger deals producing greater contagion. Bidder banks and peers experience positive abnormal returns, with the effects on insurer peers being stronger than those on bank peers. Insurance-bank deals produce insignificant excess returns for bidder and peer insurers and positive valuations for peer banks. Following the deal, the bank bidders’ idiosyncratic (systematic) risk falls (increases), while insurance bidders exhibit a lower systematic risk and maintain their idiosyncratic risk.

Integrating Social Knowledge and Collaboration Tools into Dispersed Product Development

Employee collaboration and knowledge sharing is vital for manufacturing organisations wishing to be successful in an ever-changing global market place; Product Development (PD) teams, in particular, rely heavily on these activities to generate innovative designs and enhancements to existing product ranges. To this end, the purpose of this paper is to present the results of a validation study carried out during an Engineering Education Scheme project to confirm the benefits of using bespoke Web 2.0-based groupware to improve employee collaboration and knowledge sharing between dispersed PD teams. The results of a cross-sectional survey concluded that employees would welcome greater usage of social computing technologies. The study confirmed that groupware offers the potential to deliver a more effective collaborative and knowledge sharing environment with additional communication channels on offer. Furthermore, a series of recommended guidelines are presented to show how PD teams, operating in globally dispersed organisations, may use Web 2.0 tools to improve employee collaboration and knowledge sharing.

Global nation product equity depending on a level of cultural diffusion

Purpose This paper aims to propose the global nation product equity model (GNPE) to measure global consumers’ equity of a product that a country produces, especially a nation’s cultural products (i.e. culducts). The model also examines the significant difference of GNPE depending on a cultural diffusion level. GNPE model proposes that depending on the level of people’s recognition/acceptance/preference of a culture from another country (i.e. cultural diffusion level), the equity of a product from that country could be different in different countries. As variables that affect GNPE, global nation product equity in general, global nation product equity of a product category and nation cultural equity are included in the model. Design/methodology/approach To test the model, this study developed Hallyu (Korean cultural diffusion)-related Korean culducts and measured global consumers’ equity for the Korean culducts. In all, 351 surveys were collected from China, France, England and the USA. Findings The results show the significantly different equities and relationships among equities depending on the level of Hallyu diffusion in each country. Therefore, Korea is suggested to focus on different equities in different countries. Originality/value This research proposed a new model that extends the previous brand equity models to non-branded products (i.e. cultural products). This model proposed new variables that affect equity of a product mentioned above and suggests different equities to improve in different countries depending on their level of cultural diffusion. Also, this cross-cultural study suggests a direction of culduct design, distribution and promotion strategies in the global market.

Ferramenta de gestão de redes MESH

Mestrado em Engenharia Electrotécnica e de Computadores - Área de Especialização de Telecomunicações

Employment of the side product of biodiesel production in the formation of surfactant like molecules

Dissertação apresentada na Faculdade de Ciências e Tecnologia da Universidade Nova de Lisboa para obtenção do grau de Mestre em Engenharia Química e Bioquímica

Derivation and consistency checking of models in early software product line engineering

Dissertação para obtenção do Grau de Doutor em Engenharia Informática