Eficiência no judiciário? : um missing link entre a acessibilidade, escala produtiva e o grau de especialização

Orientador: Prof. Dr. Thiago Henrique Moreira GoesDissertação (mestrado) - Universidade Federal do Paraná, Setor de Ciências Sociais Aplicadas, Programa de Pós-Graduação em Economia. Defesa : Curitiba, 12/12/2022Inclui referências: p. 86-106Resumo: O ramo da justiça estadual é a que concentra a grande maioria dos processos judiciais brasileiros. Suas unidades, ou comarcas – como são chamadas, espalham-se ao longo do território dos entes federados a fim de atender à população. Todavia, o grau de especialização dessas comarcas varia consoante à quantidade de varas que a demanda de sua região possibilita criar. No estado do Paraná as comarcas são classificadas de acordo com o seu porte e assumem a classe de entrância inicial, intermediária, final ou de regiões metropolitanas. Assim, o objetivo deste estudo é verificar se existe diferença de eficiência de escala, aferindo-a através da Análise Envoltória de Dados em dois estágios. A região de estudo abrangeu todas as 161 comarcas do Tribunal de Justiça do Paraná ao longo dos anos entre 2017 e 2021, cujos dados foram extraídos do banco de dados do Conselho Nacional de Justiça; compilados em planilhas do MS Excel; e analisados pela Plataforma R. Os resultados mostraram que, para o nível atual de tecnologia e combinação de insumos, as comarcas de entrância intermediária (que possuem entre duas e quatro varas) são as que possuem maior eficiência de escala, ou seja, consistem no porte e nível de especialização mais eficiente do TJPR. Os eventuais ganhos de eficiência podem estar sendo mitigados com a melhoria de outros elementos que ainda fogem do radar na implementação das políticas públicas do órgão.Abstract: The branch of state justice is the one that concentrates the vast majority of Brazilian legal proceedings. Its units, or comarcas – as they are called, spread throughout the territory of the federal entities in order to serve the population. However, the degree of specialization of these districts varies according to the number of courts that the demand of their region makes possible the creation. In the state of Paraná, comarcas are classified according to their size and assume the class of initial, intermediate, final and metropolitan regions. Thus, the aim of this study is to verify whether there is a difference in scale efficiency, measured through two-stage Data Envelopment Analysis. The study region covered all 161 districts of the Court of Justice of Paraná over the years between 2017 and 2021, whose data were extracted from the National Council of Justice database, compiled in MS Excel spreadsheets and analyzed by the R platform. The results showed that, for the current level of technology and combination of inputs, the comarcas of intermediate entrance (which have between two and four courts) are the ones with the greatest scale efficiency, that is, they consist of the largest efficient size and level of specialization in TJPR. Any efficiency gains may be being mitigated with the improvement of other elements that still escape the radar in the implementation of the agency's public policies

A Landmark Point Analysis with Cytotoxic Agents for Advanced NSCLC

IntroductionAs a result of recent publications, we hypothesized that period of 8 weeks after initiation of treatment is a useful landmark point for cytotoxic agents for advanced non-small cell lung cancer (NSCLC). To test this hypothesis, we conducted landmark analyses with clinical trials employing cytotoxic agents. Our goal was to assess the proper design of clinical trials with cytotoxic agents for NSCLC for maximizing patients’ benefit.MethodsWe conducted landmark analyses of a phase II study of pemetrexed in locally advanced or metastatic NSCLC and a phase III study of Four-Arm Cooperative Study for advanced NSCLC. A total of 806 patients who received chemotherapy (pemetrexed, cisplatin and irinotecan, paclitaxel and carboplatin, cisplatin and gemcitabine, cisplatin and vinorelbine) were included in this assessment.ResultsTumor-shrinkage rate at 8 weeks was significantly associated with longer survival in the study with pemetrexed (p = 0.043), whereas tumor-shrinkage rate at 4 weeks did not correlated with survival (p = 0.139). Similarly, using the Four-Arm Cooperative Study data, the optimal landmark point was 8 weeks (p = 0.002), not 4 weeks (p = 0.190).ConclusionThe landmark point for NSCLC was 8 weeks with all cytotoxic agents in our analysis when the therapy was given as a frontline or subsequent therapy. Our result suggests the concept of a disease-specific landmark point, which may lead to a change of phase II/III clinical study design to evaluate cytotoxic agents and clinical investigators, and their sponsors may consider an early look to assess the efficacy of cytotoxic agents for NSCLC

Produtividade do serviço público : uma abordagem através dos dilemas sociais e da motivação

Orientador : Adriana Sbicca FernandesMonografia (graduação) - Universidade Federal do Paraná, Setor de Ciências Sociais Aplicadas, Curso de Ciências EconômicasInclui referênciasResumo : Trata-se de uma análise da produtividade do setor público por uma ótica multidisciplinar, com elementos do Direito, da Engenharia, da Psicologia, da Sociologia e da Economia. Utilizando conceitos dessas diversas áreas, é identificado que a falta de indicadores, o problema da seleção adversa, do risco moral, e do agente-principal reduzem a performance na produção de bens públicos levando em consideração as instituições que se encontram em ação sobre os servidores públicos. Seu Poder Discricionário combinado com a falta de transparência dos outputs dos órgãos exercem papel fundamental nesta redução. Os servidores públicos, como um grupo, são avaliados para saber como se comportam diante do benefício coletivo como um produto de seu esforço. A Lógica da Ação Coletiva de Olson não é a regra e a abordagem da Reciprocidade de Ostrom e o papel da Cultura de Stiglitz e Hoff podem contribuir na explicação dos patamares de produção em que os departamentos se encontram. A motivação é apresentada como fator de aumento de produtividade em um contexto de complexidade institucional. Como evidência empírica, a produtividade das Varas Criminais do Tribunal de Justiça do Paraná (TJPR) no ano de 2017 é analisada pela metodologia de Análise Envoltória de Dados e constata-se heterogeneidade no desempenho de suas unidades, com acúmulo de mais da metade das Varas em níveis médios de produtividade relativa. O nível motivacional do 1º Grau de Jurisdição do TJPR pôde ser capturado através de dados secundários e pode explicar parte da produtividade das Varas Criminais. Verificou-se a presença de retornos crescentes de escala em suas unidades criminais a partir do efeito que a carga relativa de trabalho exerce sobre a motivação dos servidores e da taxa de sucesso das diligências processuais

A CASE OF RUPTURED MITRAL VALVE ANEURYSM DUE TO INFECTIVE ENDOCARDITIS

58-year-old woman with aortic regurgitation was admitted to our hospi- tal because of high grade fever. She had infective endocarditis and an aneurysm of the anterior mitral leaflet. Doppler echocardiography indicated a ruptured mitral valve aneurysm. Aortic regurgitant flow along the anterior mitral leaflet was suspected to have contributed to mitral valve endocarditis, aneurysm formation and rupture. She was initially treated with high-dose intravenous penicillin, but congestive heart failure worsened. Mitral valve replacement was then successfully performed

Is Pulse Pressure a Predictor of New-Onset Diabetes in High-Risk Hypertensive Patients?: A subanalysis of the Candesartan Antihypertensive Survival Evaluation in Japan (CASE-J) trial

OBJECTIVE: Hypertensive patients have an increased risk of developing diabetes. Accumulating evidence suggests a close relation between metabolic disturbance and increased arterial stiffness. Here, we examined the association between pulse pressure and the risk of new-onset diabetes in high-risk Japanese hypertensive patients. RESEARCH DESIGN AND METHODS: The Candesartan Antihypertensive Survival Evaluation in Japan (CASE-J) trial examined the effects of candesartan and amlodipine on the incidence of cardiovascular events in 4, 728 high-risk Japanese hypertensive patients. In the present study, we analyzed the relationship between pulse pressure at baseline and new-onset diabetes in 2, 685 patients without diabetes at baseline (male 1, 471; mean age 63.7 years; mean BMI 24.8 kg/m(2)) as a subanalysis of the CASE-J trial. RESULTS: During 3.3 +/- 0.8 years of follow-up, 97 patients (3.6%) developed diabetes. In multiple Cox regression analysis, pulse pressure was an independent predictor for new-onset diabetes (hazard ratio [HR] per 1 SD increase 1.44 [95% CI 1.15-1.79]) as were male sex, BMI, and additional use of diuretics, whereas age and heart rate were not. Plots of HRs for new-onset diabetes considering both systolic and diastolic blood pressure (DBP) revealed that a higher pulse pressure with a lower DBP, indicating that the increased pulse pressure was largely due to increased arterial stiffness, was strongly associated with the risk of new-onset diabetes. CONCLUSIONS: Pulse pressure is an independent predictor of new-onset diabetes in high-risk Japanese hypertensive patients. Increased arterial stiffness may be involved in the development of diabetes

Completely resected N1 non–small cell lung cancer: Factors affecting recurrence and long-term survival

ObjectiveN1 disease in non–small cell lung cancer represents a heterogeneous patient subgroup with a 5-year survival of approximately 40%. Few reports have evaluated the correlation between N1 disease and tumor recurrence or which subgroup of patients would most benefit from adjuvant chemotherapy.MethodsFrom 1997 through 2002, all patients with pathologic T1-4 N1 M0 non–small cell lung cancer who had a complete resection with systematic mediastinal lymphadenectomy were retrospectively analyzed and evaluated for factors associated with recurrence and long-term survival.ResultsOne hundred eighty patients with N1 disease were evaluated. Sixty-six (37%) patients had either locoregional recurrence (n = 39 [22%]), distant metastasis (n = 41 [23%]), or both during follow-up. Univariate analysis demonstrated that visceral pleural invasion and age were associated with locoregional recurrence, whereas visceral pleural invasion, distinct N1 metastasis (as opposed to direct N1 invasion by the primary tumor), and multistation lymph node involvement were associated with distant metastasis (P < .05). Multivariable analysis demonstrated that visceral pleural invasion, multistation N1 involvement, and distinct N1 metastasis were the only independent predisposing factors for locoregional recurrence and distant metastasis. Overall 5-year survival was 42.5%. Survival was significantly decreased by advanced pathologic T classification (P = .015), visceral pleural invasion (P < .0001), and higher tumor grade (P = .014).ConclusionsIn patients with N1-positive non–small cell lung cancer, visceral pleural invasion, multistation N1 disease, and distinct N1 metastasis are independent predictors of subsequent locoregional recurrence and distant metastasis. Advanced T classification, visceral pleural invasion, and higher tumor grade were predictors of poor survival. These patients represent a subgroup of patients with N1 disease who might benefit from additional therapy, including adjuvant chemotherapy

Inhibition of Uterine Sarcoma Cell Growth through Suppression of Endogenous Tyrosine Kinase B Signaling

Uterine leiomyosarcoma is an aggressive tumor typically found at advanced stages due to difficulties with early diagnosis. Because uterine leiomyosarcoma is resistant to conventional radiation and chemotherapy, the development of more potent medical therapeutics is anticipated. Using quantitative real-time RT-PCR and immunostaining, we found the expression of brain-derived neurotrophic factor (BDNF) and neurotropin-4/5, together with their receptor, tyrosine kinase B (TrkB), in different uterine sarcoma cell lines and primary tumor samples from uterine leiomyosarcoma patients. We noted that levels of BDNF were more abundant than those of neurotropin-4/5. Moreover, the expression of TrkB and its ligands was elevated in a multidrug-resistant cell line and samples obtained from patients with leiomyosarcoma. In cultured uterine sarcoma cells, inhibition of endogenous TrkB signaling by treatment with either the soluble TrkB ectodomain or the Trk receptor inhibitor, K252a, suppressed cell proliferation and increased apoptosis based on cell viability and proliferation, in situ terminal deoxynucleotidyl transferase-mediated 2\u27-deoxyuridine 5\u27-triphosphate nick end-labeling and caspase-3/7 assays, whereas an inactive plasma membrane nonpermeable K252b was ineffective. Correspondingly, treatment with exogenous BDNF increased cell proliferation. In in vivo studies in athymic nude mice bearing multidrug-resistant uterine sarcoma cell tumors, we demonstrate suppression of tumor growth by treatment with K252a, but not K252b, as reflected by decreased cell proliferation and increased levels of apoptosis and caspase-3/7 activities without obvious side effects. Our findings indicated that endogenous signaling of the TrkB pathway contributed to uterine sarcoma cell growth, and inhibition of TrkB signaling in these tumors could provide a novel medical therapy for patients with uterine sarcomas

A sporadic case of CTLA4 haploinsufficiency manifesting as Epstein–Barr virus-positive diffuse large B-cell lymphoma

Cytotoxic T-lymphocyte-associated antigen 4 (CTLA4) is a coinhibitory receptor that plays an essential role in maintaining immune system homeostasis by suppressing T-cell activation. We report a sporadic case of CTLA4 haploinsufficiency in a patient with Epstein-Barr virus-positive diffuse large B-cell lymphoma and subsequent benign lymphadenopathy. A missense mutation in exon 2 of the CTLA4 gene (c.251T>C, p.V84A) was found in the patient's peripheral blood and buccal cell DNA, but not in her parents' DNA. CTLA4 expression decreased in the peripheral regulatory T cells upon stimulation, whereas CTLA4 and PD-1-positive T cell subsets increased, possibly to compensate for the defective CTLA4 function. This case suggests that some adult lymphoma patients with no remarkable medical history have primary immune disorder. As immune-targeted therapies are now widely used for the treatment of malignancies, it is increasingly important to recognize the underlying primary immune disorders to properly manage the disease and avoid unexpected complications of immunotherapies

Development of an adiabatic demagnetization refrigerator for X-ray microcalorimeter operations

金沢大学理工研究域数物科学系An X-ray microcalorimeter is a non-dispersive spectrometer that measures the energy of an incident X-ray photon as a temperature rise. Operated at < 0.1 K, it achieves very high resolving power. We are developing X-ray microcalorimeters for future γ-ray burst observations, and are now setting up a compact adiabatic demagnetization refrigerator (ADR) for X-ray microcalorimeter operations. We fabricated a paramagnetic salt pill, and integrated it with a superconducting magnet and a heat-switch in a dedicated He cryostat. By applying a magnetic field of 2.6 T at the bath temperature of 1.8 K, it achieved 0.1 K. The attainable temperature and the hold time were, however, limited due to unexpected heat load. We also successfully measured a resistance-temperature characteristics of a superconducting transition edge. © 2010 American Institute of Physics