High-tech diagnostic imaging clinical decision support tools adoption : study using a system dynamics approach

Tese de mestrado integrado. Engenharia Industrial e Gestão. Faculdade de Engenharia. Universidade do Porto, Massachusetts Institute of Technology. Engineering Systems Division. 201

ANÁLISIS POR PROVINCIAS DE LA CONTRIBUCIÓN DEL CAPITAL HUMANO A LA PRODUCCIÓN NACIONAL EN LA DÉCADA DE LOS NOVENTA

This paper contains an analysis of the economic effects of human capital onproduction, measured as Gross Value Added per full-time equivalent worker. To thisend, a Cobb-Douglas type production function has been used, with Gross Value Added(GVA) a function of human capital and private and public physical capital. Provincialdata from the 1990s were used. Results obtained applying the panel-data techniqueshow human capital makes a positive contribution to production. Besides, human capitaldeficits may partly explain GVA differences between Spanish provinces. En este trabajo se presenta un análisis de los efectos económicos que el capital humano, medido en términos de trabajadores equivalentes, tiene sobre la producción. Con este fin se ha utilizado una función de producción tipo Cobb-Douglas, en la que el Valor Añadido Bruto es función del capital humano y del capital físico privado y público. Para ello se utilizan datos provinciales referidos a la década de los noventa. Los resultados que se han obtenido mediante la técnica de datos de panel ponen de manifiesto que el capital humano contribuye positivamente a la producción y que sus déficit explican en parte las diferencias entre el valor añadido bruto de las provincias españolas.datos de panel, capital humano, crecimiento económico, análisis provincial panel data, human capital, economic growth, provincial analysis

O contributo da enfermagem de saúde mental e psiquiátrica na gestão das respostas (des)adaptativas das crianças e adolescentes

A saúde mental das crianças e adolescentes tem vindo a adquirir um interesse crescente no seio da comunidade, dada a suscetibilidade, nestes estádios do ciclo vital, a eventos ou ambientes adversos capazes de influenciar a sua saúde mental. Para além disso, é na adolescência que encontramos uma maior prevalência do aparecimento de perturbações mentais. Ressalvamos o contributo do enfermeiro especialista em Enfermagem de saúde Mental e Psiquiátrica na abordagem a esta população. Através de um conjunto de conhecimentos, capacidades e habilidades especializadas, este intervém sobre dimensões relevantes do desenvolvimento, como a regulação emocional e a gestão de respostas (des)adaptativas. Neste relatório pretendemos apresentar a metodologia de estudo de caso (de uma criança com diagnóstico clínico de mutismo seletivo) desenvolvida em estágio, integrada no processo de cuidados, expondo paralelamente o desenvolvimento de competências inerentes ao grau de Mestre e ao título de enfermeiro especialista em Enfermagem de Saúde Mental e Psiquiátrica.The mental health of young children and adolescents has been increasingly garnering attention within the community due to their vulnerability, during these stages of the life cycle, to adverse events or environments that can influence their mental health. Moreover, it is during adolescence that we find a higher prevalence of the onset of mental disorders. It is important to acknowledge the significant role played by specialized nurses in Mental Health and Psychiatric Nursing in addressing the needs of this population. Leveraging their specialized knowledge, skills and expertise, these nurses intervene to address crucial aspects of development, such as emotional regulation and the management of (mal)adaptive behaviors. This report aims to present the case study methodology employed during an internship, focusing on a child diagnosed with selective mutism, and its integration into the overall care process. Simultaneously, it highlights the development of competencies associated with a Master's degree and the title of specialist nurse in Mental Health and Psychiatric Nursing

Ferramentas contábeis para decisão gerencial : estudo de caso em uma fábrica de vinagres

Durante muitos anos uma determinada linha de produtos foi relegada a segundo plano pela diretoria comercial de uma empresa por entender que as margens de lucro eram menores do que as de outra linha de produtos que tinham preços de venda superiores. Essa impressão sempre direcionou o marketing e o investimento para a linha supostamente mais rentável. Esse trabalho desafiou essa máxima à luz das ferramentas contábeis e modelos de decisão ensinados durante a graduação de Ciências Contábeis na UFRJ. Foram coletados dados de layout, esquemas de produção, custos, preços, despesas, investimentos e demais informações disponíveis nos relatórios contábeis e gerenciais de uma empresa produtora de alimentos – vinagres – situada no Estado de São Paulo. Foram aplicados métodos de custeio e de programação linear ensinados no curso de ciências contábeis da UFRJ para analisar e compreender a situação das rentabilidades de duas linhas de produtos que concorrem por um recurso escasso da empresa, devido à limitação de sua capacidade de produção. As conclusões são surpreendentes e evidenciam a utilidade das ferramentas aplicadas pela contabilidade gerencial moderna em soluções de problemas reais do mundo empresarial, como o apresentado nesse estudo de caso

GNAQ and BRAF mutations show differential activation of the mTOR pathway in human transformed cells

Somatic mutations in GNAQ gene were described as being the main oncogenic activation in uveal melanomas, whereas mutations in BRAF gene have been described as a key genetic alteration that contributes to skin melanoma development. We have previously reported differential activation of the MAPK and AKT/mTOR signalling pathways in uveal and skin melanomas harbouring, respectively, GNAQ and BRAF mutations. The aim of this work was to compare the functional effect of GNAQ and BRAF mutations in mTOR and MAPK pathway activation, cell proliferation and apoptosis. In this work, we performed transient transfection of HEK293 cells with BRAFWT, BRAFV 600E, GNAQWT, GNAQQ209P and GNAQQ209L vectors. We treated melanoma cell lines displaying different BRAF and GNAQ mutational status with the mTOR inhibitor RAD001 and with the MEK1/2 inhibitor U0126 and evaluated the effects in the growth of the cell lines and in mTOR and MAPK pathway effectors expression. At variance with the significant increase in the level of pmTOR Ser2448 and pS6 Ser235/236 proteins observed in cells transfected with BRAF vectors, no significant alteration in mTOR pathway effectors was observed in cells transfected with the three GNAQ expressing vectors. Also, GNAQ overexpression enhances Stat3 activation, which might mediate GNAQ oncogenic effects. None of the vectors led to significant differences in proliferation or apoptosis in the transfected cell lines. Cell lines harbouring a BRAF mutation were more sensitive to RAD001 treatment. U0126 leads to the reduction of MAPK and mTOR pathways activation in all cell lines tested. Our results indicate that GNAQ and BRAF activation drive distinct intracellular signalling pathways that may be useful for therapeutic decisions in human melanomas

Economic impacts of solar thermal electricity technology deployment on Andalusian productive activities: a CGE approach

Solar thermal electricity is a type of renewable energy technology of special interest for Andalusia (southern Spain) because of the large number of annual sunshine hours. This paper estimates the impact on productive activities of increasing the production capacity of the installed solar thermal plants in Andalusia. Using a computable general equilibrium (CGE) approach, estimates of the changes in the economic sectors’ activity under two different scenarios are obtained: i) based on two types of solar thermal electricity plants currently in operation and ii) based on an increase from 11 MW in 2007 to 800 MW installed capacity by 2013 to comply with the ‘Plan Andaluz de Sostenibilidad Energética (PASENER)—Sustainable Energy Plan for Andalusia’. For the case of a parabolic trough solar collector power plant, results show that compliance with the PASENER goal would increase the level of the productive activities by around 30%. For the alternative technology—a solar tower power plant—results show that activities would increase by around 5% for 30 years, the estimated lifetime of this type of plant. Thus, the impact of the solar thermal electricity plants on the productive activities of the PASENER compliant production goal would be remarkable

mTOR pathway overactivation in BRAF mutated papillary thyroid carcinoma

CONTEXT: There are several genetic and molecular evidences suggesting dysregulation of the mammalian target of rapamycin (mTOR) pathway in thyroid neoplasia. Activation of the phosphatidylinositol-3-kinase/AKT pathway by RET/PTC and mutant RAS has already been demonstrated, but no data have been reported for the BRAF(V600E) mutation. OBJECTIVE: The aim of this study was to evaluate the activation pattern of the mTOR pathway in malignant thyroid lesions and whether it may be correlated with known genetic alterations, as well as to explore the mechanisms underlying mTOR pathway activation in these neoplasias. RESULTS: We observed, by immunohistochemical evaluation, an up-regulation/activation of the mTOR pathway proteins in thyroid cancer, particularly in conventional papillary thyroid carcinoma (cPTC). Overactivation of the mTOR signaling was particularly evident in cPTC samples harboring the BRAF(V600E) mutation. Transfection assays with BRAF expression vectors as well as BRAF knockdown by small interfering RNA revealed a positive association between BRAF expression and mTOR pathway activation, which appears to be mediated by pLKB1 Ser428, and emerged as a possible mechanism contributing to the association between BRAF mutation and mTOR pathway up-regulation. When we evaluated the rapamycin in the growth of thyroid cancer cell lines, we detected that cell lines with activating mutations in the MAPK pathway show a higher sensitivity to this drug. CONCLUSIONS: We determined that the AKT/mTOR pathway is particularly overactivated in human cPTC harboring the BRAF(V600E) mutation. Moreover, our results suggest that the mTOR pathway could be a good target to enhance therapy effects in certain types of thyroid carcinoma, namely in those harboring the BRAF(V600E) mutation

Expression and clinical relevance of SOX9 in gastric cancer

Gastric cancer is one of the most frequent tumours and the third leading cause of cancer-related death worldwide. The investigation of new biomarkers that can predict patient outcome more accurately and allow better treatment and follow-up decisions is of crucial importance. SOX9 (sex-determining region Y (SRY)-box 9) is a regulator of cell fate decisions in embryogenesis and adulthood. Here, we sought to ascertain the relevance of SOX9 transcription factor as a prognostic marker in gastric cancer. SOX9 expression was analyzed by immunohistochemistry in 333 gastric adenocarcinoma cases, and its association with clinicopathological and follow-up data was evaluated. SOX9 nuclear expression was absent in 17% of gastric cancer cases and predicted worse disease-free survival (P = 0 03). SOX9 expression was associated with lower risk of relapse in Cox univariable analysis (HR = 0 58; 95% CI = 0 35-0.97; P = 0 04). The prognostic value of SOX9 was more pronounced in tumours with expansive growth (P = 0 01) or with venous invasion (P = 0 02). Two validation cohorts from the Cancer Genome Atlas (TCGA) and the Asian Cancer Research Group (ACRG) confirmed that low SOX9 expression was significantly associated with poor patient outcome. In conclusion, we have identified SOX9 as a biomarker of disease relapse in gastric cancer patients. Further experiments are needed to elucidate its biological relevance at the cellular level.The authors wish to acknowledge the tumour and tissue bank at Hospital de São João for providing all the means to collect the human tissue samples included in this study. This work was supported by FEDER—Fundo Europeu de Desenvolvimento Regional funds through the COMPETE 2020—Operacional Programme for Competitiveness and Internationalisation (POCI), Portugal 2020, and by Portuguese funds through FCT—Fundação para a Ciência e a Tecnologia/Ministério da Ciência, Tecnologia e Inovação in the framework of the project “Institute for Research and Innovation in Health Sciences” (POCI-01-0145-FEDER-007274). This work was also financed by the projects NORTE-01-0145-FEDER-000003 (DOCnet) and NORTE-07-0124-FEDER-000029 supported by Norte Portugal Regional Programme (NORTE 2020), under the PORTUGAL 2020 Partnership Agreement, through the European Regional Development Fund (ERDF). BP and RB acknowledge FCT for financial support (grants SFRH/BPD/109794/2015 and SFRH/BPD/68276/2010, respectively)

Impacto de un incremento de la capacidad de generación de energía a partir de biomasa en plantas de co-generación en Andalucía

[EN] The paper estimates the regional economic impact of renewable energy development (inv) based on the use of biomass. The regional level is Andalusia. The analysis is carried out under the assumption that achieves the goal of renewable energy development set in Andalusian Sustainable Energy Plan (PASENER) 2007-2013. To estimate the economic impact, a General Equilibrium Model (CGE) is used based on the Social Accounting Matrix (SAM) updated for Andalusia in 2008. The results show that if the goal of PASENER is met, there might be an increase production of 4.02%.[ES] El artículo realiza una estimación del impacto económico regional del desarrollo de las energías renovables (ee.rr.) basadas en el uso de la biomasa. El ámbito regional es el de Andalucía y el nivel de desarrollo de las ee.rr. se asume que alcanza el objetivo fijado en el Plan Andaluz de Sostenibilidad Energética (PASENER) 2007-2013. Para la estimación del impacto económico se utiliza un Modelo de Equilibrio General Aplicado (MEGA) construido sobre la Matriz de Contabilidad Social (MCS) actualizada para Andalucía para el año 2008. Los resultados muestan que alcanzar el objetivo del PASENER supondría un aumento productivo del 4,02%.a Agradece la financiación recibida de los proyectos MICINN-ECO2009-11857 ySGR2009-578l y SEJ479. bcd Agradecen la ayuda financiera recibida del proyecto SEJ132. Todo los autores agradecen la ayuda recibida de la Agencia Andaluza de la Energía y los comentarios recibidos de los asistentes al II Workshop on Public Policies: Training Programs Evaluation and Renewable EnergiesPromotion y de los revisores anónimos de la revista.Cardenete, MA.; González, JM.; Pablo-Romero, MDP.; Román, R. (2011). Impact of an increase in the capacity of power generation from biomass in co-generation plants in Andalusia. Economía Agraria y Recursos Naturales - Agricultural and Resource Economics. 10(2):159-182. https://doi.org/10.7201/earn.2010.02.08SWORD15918210

Tendências do carcinoma espinocelular cutâneo no Hospital de Gaia (2004-20013)

Introduction: Cutaneous squamous cell carcinoma (cSCC) is the second most common skin cancer and its incidence has been rising. The objective of our study was to perform a descriptive and analytical analysis of the cutaneous squamous cell carcinoma excised in the Hospital Center Vila Nova de Gaia e Espinho (CHVNGE) over a period of 10 years and establish trends (incidence, survival and mortality).Material and Methods: Information was retrospectively gathered in the CHVNGE, from January 2004 to December 2013, using the regional cancer registry and the histopathological registry of the hospital. The aim of this study was to describe the characteristics and trends of cutaneous squamous cell carcinoma (incidence, association with actinic keratosis or basal cell carcinoma, survival and mortality rates).Results: 485 cutaneous squamous cell carcinoma were surgically removed in a total of 380 patients (56.1% men and 43.9% women). 361 patients presented invasive cutaneous squamous cell carcinoma and 124 in situ cutaneous squamous cell carcinoma. The Dermatology Department removed 70.4% of the cutaneous squamous cell carcinoma, followed by the Plastics (16.4%) and General Surgery Departments (4.7%). Cutaneous squamous cell carcinoma was more prevalent in the age-group ≥75-years in both sexes (p < 0.001).The mean age of invasive cutaneous squamous cell carcinoma was 76.7 years (±11.5 years), women being older than men (79.0 vs 74.0 years, p < 0.001). The face was the most common topographic location (42.1%), in both genders (p < 0.001). We observed a rising incidence in both genders, particularly in the last study period (16.2/100 000 person-year). The 5-year survival rate was 98.7%. The mean age of in situ cutaneous squamous cell carcinoma was lower than invasive disease (75.5 years ± 11.3). A previous basal cell carcinoma occurred in 20.6% and actinic keratosis were diagnosed more frequently in women (p = 0.040). The face was the most common location (30.8%). Incidence rates have risen, particularly in women and age-group ≥ 75-years.Conclusion: Our study reports a rapid increase of the incidence in an ageing Portuguese population and highlights the importance of improving the existing cancer registries in Portugal.Introdução: O carcinoma espinocelular cutâneo é o segundo cancro cutâneo mais comum e a sua incidência tem crescido. O objetivo do nosso estudo foi realizar uma análise descritiva e analítica dos carcinoma espinocelular cutâneo excisados no Centro Hospitalar Vila Nova de Gaia e Espinho (CHVNGE) num período de 10 anos e estabelecer tendências (incidência, sobrevida e mortalidade).Materiais e Métodos: A informação foi retrospetivamente recolhida nos Registos Oncológico e Histológico do CHVNGE entre o período de Janeiro de 2004 e Dezembro de 2013. O objetivo do nosso estudo foi descrever as características e tendências (incidência, associação a queratoses actínicas e carcinomas basocelulares, sobrevida e mortalidade) do carcinoma espinocelular cutâneo.Resultados: Foram removidas 485 lesões em 380 pacientes (56,1% homens e 43,9% mulheres). 361 pacientes apresentavam doença invasora e 124 doença in situ. O serviço de Dermatologia removeu a maioria das lesões (70,4%), seguido pelo serviço de Cirurgia Plástica (16,4%) e Cirurgia Geral (4,7%). A faixa etária ≥ 75 anos foi a mais atingida por carcinoma espinocelular cutâneo em ambos os sexos (p < 0,001). A média de idades dos pacientes com carcinoma espinocelular cutâneo invasor foi de 76,7anos (± 11,5), sendo mais elevada no sexo feminino (79,0 vs 74,0 anos, p < 0,001). A face foi a localização topográfica mais comum (42,1%) nos dois sexos (p = 0,002). Houve um aumento da taxa de incidência ajustada à idade em ambos os sexos, particularmente no último período do estudo (16,2/100 000 pessoas). A sobrevida aos 5 anos foi de 98,7%. A idade média do carcinoma espinocelular cutâneo in situ foi inferior à da doença invasora (75,5 anos ± 11,3). Dos doentes com carcinoma espinocelular cutâneo in situ, 20,6% tinham antecedentes de carcinoma basocelular e as mulheres apresentaram mais queratoses actínicas (p = 0,040). A face foi o local mais comum (30,8%). A taxa de incidência de carcinoma espinocelular cutâneo in situ aumentou, sendo maior nas mulheres e na faixa etária ≥75 anos.Conclusão: Este estudo demonstra um rápido aumento da incidência do carcinoma espinocelular cutâneo numa população portuguesa envelhecida e realça a necessidade de melhorar os registos oncológicos em Portugal