7 research outputs found

    Planificació tèrmica mitjançant una aplicació en VBA per Excel

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    La Planificació Tèrmica a curt termini és un dels problemes a resoldre en la gestió de les companyies elèctriques. La solució indica com distribuir i assignar la generació d’energia elèctrica a les centrals tèrmiques actives durant un període concret, que a curt termini varia entre un dia i una setmana, de forma que és minimitzi la despesa per consum de combustible. En l’optimització a curt termini, la previsió horària de càrrega s’ha de cobrir, satisfent alhora diversos requeriments de reserva rodant fixats per tenir en compte els errors en la previsió de càrrega i les avaries de les màquines. El període d’estudi queda dividit en intervals temporals d’una hora, partint d’unitats enceses o apagades. En aquests intervals considerem conegudes totes les dades, tenint com a variables de decisió la generació d’energia de cada una de les centrals tèrmiques

    Predictors of human papillomavirus infection in women undergoing routine cervical cancer screening in Spain: the CLEOPATRE study

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    Background: Human papillomavirus (HPV) is a sexually transmitted infection that may lead to development of precancerous and cancerous lesions of the cervix. The aim of the current study was to investigate sociodemographic, lifestyle, and medical factors for potential associations with cervical HPV infection in women undergoing cervical cancer screening in Spain. Methods: The CLEOPATRE Spain study enrolled 3 261 women aged 18–65 years attending cervical cancer screening across the 17 Autonomous Communities. Liquid-based cervical samples underwent cytological examination and HPV testing. HPV positivity was determined using the Hybrid Capture II assay, and HPV genotyping was conducted using the INNO-LiPA HPV Genotyping Extra assay. Multivariate logistic regression was used to identify putative risk factors for HPV infection. Results: A lifetime number of two or more sexual partners, young age (18–25 years), a history of genital warts, and unmarried status were the strongest independent risk factors for HPV infection of any type. Living in an urban community, country of birth other than Spain, low level of education, and current smoking status were also independent risk factors for HPV infection. A weak inverse association between condom use and HPV infection was observed. Unlike monogamous women, women with two or more lifetime sexual partners showed a lower risk of infection if their current partner was circumcised (P for interaction, 0.005) and a higher risk of infection if they were current smokers (P for interaction, 0.01). Conclusion: This is the first large-scale, country-wide study exploring risk factors for cervical HPV infection in Spain. The data strongly indicate that variables related to sexual behavior are the main risk factors for HPV infection. In addition, in non-monogamous women, circumcision of the partner is associated with a reduced risk and smoking with an increased risk of HPV infection

    Screening of cervical cancer in Catalonia 2006-2012

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    The early detection of intraepithelial lesions of the cervix, through the periodic examination of cervical cells, has been fundamental for the prevention of invasive cervical cancer and its related mortality. In this report, we summarise the cervical cancer screening activities carried out in Catalonia, Spain, within the National Health System during 2008-2011. The study population covers over two million women resident in the area. The evaluation includes 758,690 cervical cytologies performed on a total of 595,868 women. The three-year coverage of cervical cytology among women aged between 25 and 65 years was 40.8%. About 50% of first screened women with negative results had not returned to the second screening round. The introduction of high-risk human papillomavirus DNA (HPV) detection, as a primary screening cotest with cytology among women over age 40 with a poor screening history, significantly improved the detection of cervical intraepithelial neoplasia grade 2 or worse (CIN2+), being far superior to cytology alone. Cotesting did not improve the detection of CIN2+. The use of the HPV test for the triage of atypical squamous cell undetermined significance (ASC-US) improved the selection of women at high risk of CIN2

    Prevalence and genotype distribution of cervical human papilomavirus infection in the pre-vaccination era: a population-based study in the Canary Islands

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    Objective: National Spanish studies show that prevalence of cervical human papillomavirus (HPV) infection in the female population is increasingly frequent, with an overall estimate of 14% in women aged 18-65 years. The objective of this study is to know the prevalence and distribution of HPV types in the female population of the Canary Islands prior to the introduction of HPV vaccines and to investigate the associated clinical and sociodemographic factors. Methods: Based on the Primary Health Care database, a sample of adult women (aged 18-65 years) of Gran Canaria (GC) and Tenerife (TF) stratified into nine age groups was carried out between 2002 and 2007. Women were contacted by postal letter and telephone call and were visited in their primary care centre. A clinical-epidemiological survey was completed and cervical samples were taken for cytological study and HPV detection. HPV prevalence and its 95% CI were estimated, and multivariate analyses were performed using logistic regression to identify factors associated with the infection. Results: 6010 women participated in the study, 3847 from GC and 2163 from TF. The overall prevalence of HPV infection was 13.6% (CI 12.8%-14.5%) and 11.1% (CI 10.3%-11.9%) for high-risk types. The most frequent HPV type was 16 followed by types 51, 53, 31, 42 and 59. HPV types included in the nonavalent vaccine were detected in 54.1% of infected women. Factors associated with an increased risk of infection were: young ages (18-29 years), the number of sexual partners throughout life, not being married, being a smoker, and having had previous cervical lesions or genital warts. Conclusions: It is confirmed that prevalence of HPV infection in the female population of the Canary Islands is high, but similar to that of Spain, HPV 16 being the most frequent genotype. The determinants of infection are consistent with those of other populations

    The Influence of Hormonal Factors on the Risk of Developing Cervical Cancer and Pre-Cancer: Results from the EPIC Cohort

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    Background: In addition to HPV, high parity and hormonal contraceptives have been associated with cervical cancer (CC). However, most of the evidence comes from retrospective case-control studies. The aim of this study is to prospectively evaluate associations between hormonal factors and risk of developing cervical intraepithelial neoplasia grade 3 (CIN3)/carcinoma in situ (CIS) and invasive cervical cancer (ICC). Methods and Findings: We followed a cohort of 308,036 women recruited in the European Prospective Investigation into Cancer and Nutrition (EPIC) Study. At enrollment, participants completed a questionnaire and provided serum. After a 9-year median follow-up, 261 ICC and 804 CIN3/CIS cases were reported. In a nested case-control study, the sera from 609 cases and 1,218 matched controls were tested for L1 antibodies against HPV types 11,16,18,31,33,35,45, 52,58, and antibodies against Chlamydia trachomatis and Human herpesvirus 2. Multivariate analyses were performed to estimate hazard ratios (HR), odds ratios (OR) and corresponding 95% confidence intervals (CI). The cohort analysis showed that number of fullterm pregnancies was positively associated with CIN3/CIS risk (p-trend = 0.03). Duration of oral contraceptives use was associated with a significantly increased risk of both CIN3/CIS and ICC (HR = 1.6 and HR = 1.8 respectively for >= 15 years versus never use). Ever use of menopausal hormone therapy was associated with a reduced risk of ICC (HR = 0.5, 95% CI: 0.4-0.8). A non-significant reduced risk of ICC with ever use of intrauterine devices (IUD) was found in the nested case-control analysis (OR = 0.6). Analyses restricted to all cases and HPV seropositive controls yielded similar results, revealing a significant inverse association with IUD for combined CIN3/CIS and ICC (OR = 0.7). Conclusions: Even though HPV is the necessary cause of CC, our results suggest that several hormonal factors are risk factors for cervical carcinogenesis. Adherence to current cervical cancer screening guidelines should minimize the increased risk of CC associated with these hormonal risk factors

    Cervical cancer and pre-cancer in the EPIC cohort: the role of environmental cofactors = El càncer de coll uterí i els seus precursos en la cohort EPIC: el rol dels cofactors ambientals

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    [eng] The objective of this thesis is to estimate prospectively the association between environmental cofactors and the risk of developing cervical cancer and pre-cancer, including tobacco smoking, hormonal and reproductive factors, and serological markers of Human Papillomavirus (HPV), Chlamydia trachomatis (CT) and Human Herpesvirus type 2 (HHV-2) infections. We followed a cohort of 308,036 women recruited in the European Prospective Investigation into Cancer and Nutrition (EPIC) study. During a mean follow-up of 9 years, 261 invasive cervical cancer (ICC) cases and 804 cervical intraepithelial neoplasia grade 3 (CIN3) or carcinoma in situ (CIS) cases were reported. A nested case-control study within the EPIC cohort was also performed, including the sera from 184 invasive cases, 425 cases of CIN3/CIS, and 1,218 matched control women. They were tested for L1, E6 and E7 antibodies against several HPV types, CT and HHV-2 to allow the adjustment for these variables in the statistical analyses and thus confirm associations obtained in the cohort study. L1 seropositivity to any mucosal HPV type was significantly associated with both CIN3/CIS and ICC. By HPV type, HPVs 11, 16, 18, and 45 L1 were associated with CIN3/CIS whereas only HPVs 11 and 16 L1 were significantly related to invasive cervical cancer risk. Associations with HPV types 16 and 18 E6 and E7 seropositivity were only significant for invasive cancer, being the strongest association with HPV 16 E6 seropositivity (OR=10.2). Previous exposure to CT was strongly associated with ICC and weakly associated with CIN3/CIS, and HHV-2 seropositivity was marginally associated with both CIN3/CIS and ICC risk. Increasing number of sexually transmitted infections (HPV L1, CT and HHV-2) was associated with increasing both CIN3/CIS and ICC risk. Current smokers showed a two-fold increased risk of CIN3/CIS and ICC compared to never smokers. Smoking duration and intensity increased the risk of cervical cancer and pre-cancer, with a clear dose-response among ever smokers. Overall, smoking cessation was associated with a reduced by a half of the risk of both CIN3/CIS and ICC. Consistent associations were observed after adjustment for HPV L1, CT and HHV-2 serostatus in the nested case-control study, confirming the results obtained in the cohort. Being a parous woman was positively associated with CIN3/CIS risk, with magnitudes of two-fold, but not with ICC. The risk of pre-invasive cancer also increased with increasing number of full-term pregnancies. Duration of oral contraceptives use was associated with a significantly increased risk of CIN3/CIS and ICC, with relative risks of 1.6 and 1.8 respectively for more than 15 years of use compared to never use. Quitting the use for more than 5 years reduced the risk for CIN3/CIS to almost a half. Ever use of menopausal hormone therapy was associated with a significantly reduced risk of ICC (HR=0.5). No association was found between cervical cancer risk and ever use of intrauterine device (IUD). Analyses restricted to all cases and HPV seropositive controls were also conducted, yielding similar results for parity, OC use and hormonal therapy use, and emerging a significant inverse association with IUD for combined CIN3/CIS and ICC (OR=0.7). This large prospective study confirms the role of tobacco smoking as an important cofactor for both CIN3/CIS and ICC. The strong beneficial effect of quitting smoking is an important finding that will further support public health policies for smoking cessation. Our results also suggest that several hormonal and reproductive factors, as well as infections of CT and HHV-2, are involved in cervical carcinogenesis. Adherence to current cervical cancer screening guidelines should minimize the increased risk of cervical cancer associated with hormonal risk factors. Our study further identifies HPV 16 E6 seropositivity as a potential marker to predict invasive cervical cancer before the disease development.[cat] L’objectiu d’aquesta tesi és estimar prospectivament les associacions entre els cofactors ambientals i el risc de desenvolupar un càncer cervical invasor (ICC) o pre-invasor (CIN3/CIS) utilitzant les dades de l’estudi EPIC (European Prospective Investigation into Cancer and Nutrition). Hem seguit una cohort de 308.036 dones durant un període mitjà de 9 anys, identificant 261 casos de ICC i 804 casos de CIN3/CIS, i hem realitzat un estudi de casos i controls aniuat dins la cohort, incloent sèrums de 184 casos invasors, 425 CIN3/CIS i 1.218 controls aparellats, testant anticossos del Virus del Papil·loma Humà (VPH), la Chlamydia trachomatis (CT) i el Herpesvirus Humà tipus 2 (HHV-2). Els principals resultats han determinat que la seropositivitat per la proteïna L1 a qualsevol tipus del VPH mucós està associat a CIN3/CIS i ICC. En canvi les associacions per les oncoproteïnes E6 i E7 dels tipus del VPH 16 i 18 només han estat significatives pel càncer invasor, destacant la del VPH 16 E6 (OR=10.2). L'exposició passada a CT, i en menor mesura a HHV-2, s’ha vist associada a un major risc de desenvolupar un càncer invasor o pre-invasor. Les dones fumadores tenen el doble de risc de desenvolupar un CIN3/CIS o ICC en comparació amb les dones que no han fumat mai, risc que augmenta amb la duració i intensitat d’ús; en canvi el fet de deixar de fumar s’ha associat a una reducció del risc a la meitat. Un major nombre d’embarassos s’ha associat a un augment en el risc de tenir un CIN3/CIS. La durada en l'ús d’anticonceptius orals s’ha associat a un risc significativament major de desenvolupar un CIN3/CIS o ICC, mentre que deixar d’utilitzar-los durant com a mínim 5 anys redueix el risc de CIN3/CIS a gairebé la meitat. L'ús de teràpia hormonal substitutiva s’ha associat a un menor risc de patir un càncer cervical invasor, en canvi no s’ha trobat cap associació significativa entre l'ús de dispositius intrauterins i el càncer cervical. Aquesta cohort prospectiva confirma el rol del tabac, i en menor mesura dels factors hormonals i reproductius i de les infeccions per CT i HHV-2, com a cofactors del càncer de coll uterí

    Planificació tèrmica mitjançant una aplicació en VBA per Excel

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    La Planificació Tèrmica a curt termini és un dels problemes a resoldre en la gestió de les companyies elèctriques. La solució indica com distribuir i assignar la generació d’energia elèctrica a les centrals tèrmiques actives durant un període concret, que a curt termini varia entre un dia i una setmana, de forma que és minimitzi la despesa per consum de combustible. En l’optimització a curt termini, la previsió horària de càrrega s’ha de cobrir, satisfent alhora diversos requeriments de reserva rodant fixats per tenir en compte els errors en la previsió de càrrega i les avaries de les màquines. El període d’estudi queda dividit en intervals temporals d’una hora, partint d’unitats enceses o apagades. En aquests intervals considerem conegudes totes les dades, tenint com a variables de decisió la generació d’energia de cada una de les centrals tèrmiques
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