Despite improved availability of simple, relatively inexpensive, and highly effective antiretroviral treatment for HIV/AIDS, the disease remains a major public health challenge for women in sub-Saharan Africa (SSA). Given the numerous barriers in access to care for women in this region, every health issue that brings them into contact with the health system should be optimized as an opportunity to integrate HIV/AIDS prevention. Because most non-condom forms of modern contraception require a clinical appointment for use, contraception appointments could provide a confidential opportunity for access to HIV counseling, testing, and referral to care. This study sought to investigate the relationship between contraceptive methods and HIV testing among women in SSA. Data from the Demographic and Health Survey from four African countries-Congo, Mozambique, Nigeria, and Uganda-was used to examine whether modern (e.g., pills, condom) or traditional (e.g., periodic abstinence, withdrawal) forms of contraception were associated with uptake of HIV testing. Data for the current analyses were restricted to 35,748 women with complete information on the variables of interest. Chi-square tests and logistic regression models were used to assess the relationship between uptake of HIV testing and respondents' baseline characteristics and contraceptive methods. In the total sample and in Mozambique, women who used modern forms of contraception were more likely to be tested for HIV compared to those who did not use contraception. This positive association was not demonstrated in Congo, Nigeria, or Uganda. That many women who access modern contraception are not tested for HIV in high HIV burden areas highlights a missed opportunity to deliver an important intervention to promote maternal and child health. Given the increasing popularity of hormonal contraception methods in low-income countries, there is an urgent need to integrate HIV counseling, testing, and treatment into family planning programs. Women on hormonal contraceptives should be encouraged to continue to use condoms for HIV-prevention.

The optimization theory assumes that males of insects with separate adult generations should preferentially invest into the mating if there are the most fresh females; in other times they should save energy and focus on maintenance activities. Based on this assumption, butterfly behaviour should change with season, population density (mainly the sex ratio) and day time. To explore these assumptions, we used mark recapture data obtained from several mark-recapture studies, which contained records of behaviour of each handled individual. In total, we analysed data on 14 species, 24 ``butterfly-seasons{\crqq}, 21 737 individuals (14 228 males, 7 509 females). We subjected the behavioural data to ordination analyses controlled for weather effects. For daily patterns, morning and afternoon activities comprise mainly of maintenance activities, while mating seems to occur in middays. Regarding seasonal patterns, males of most of the species switched from mating behaviour to maintenance behaviour. No prevailing trend applied to females, in which we found both transitions from mating behaviour to maintenance activities and opposite patterns. Density predictors (sex ration, daily population size) revealed changes in mating behaviour of one sex with changing the abundance of the other sex. In conclusion, exploring mark-recapture data for behavioural patterns proved to be fruitful, but cannot fully replace studying behaviour via more traditional ethological methods.

Territories and home-ranges are the smallest spatial units of species' presence in a landscape and they determine in what ways and on what scales animals perceive and use their environments. Their sufficient sizes encompassing enough resources are critical for survival and reproduction of individuals. Processes and factors affecting territory and home-range sizes therefore belong to fundamental ecological issues. Despite its importance, the knowledge of variation in avian territory and home-range size at large spatial scales is poor. So far it has comprised mainly the findings that the used area is determined by individual's energetic demands, dependent on body size and diet type, and by environmental productivity. Therefore, the aim of this thesis was to use data gathered from available literature to describe the variation in territory and home-range size of birds. I was curious what was the nature of territory and home-range size frequency distribution; whether the sizes were species-specific and whether and how these sizes were affected (beside the body mass and diet type) by various environmental characteristics, such as latitude, temperature, precipitation, seasonality, altitude and habitat type. I have found that the territory and home-range size frequency distribution is approximately...

La compréhension des mécanismes qui contrôlent l'expression des gènes est un enjeu majeur pour la recherche médicale. Elle nécessite un ensemble d'approches pangénomiques telles que les puces à ADN et plus récemment le séquençage à très haut débit qui génèrent une masse toujours plus grande de données numériques à traiter. Au cours de ma thèse, j'ai développé plusieurs outils informatiques innovants pour faciliter leur exploitation. Ainsi, j'ai créé une librairie R (AgiND) qui vérifie la qualité des données de puces à ADN Agilent et permet de les normaliser. Le nombre croissant d'expériences stockées dans Gene Expression Omnibus a motivé la mise en place du projet TBrowser. Une méthode originale DBF-MCL a été créée pour extraire des signatures transcriptionnelles annotées par l'intégration de diverses sources d'information. Stockées dans une base de données, elles sont accessibles à travers une interface Java, un service web SOAP et une librairie R/Bioconductor (RTools4TB). Enfin, un pipeline d'analyse dédié au ChIP-seq a été implémenté. Tous ces outils ont servi pour l'étude de diverses maladies dans le cadre de collaborations. / Understanding the mechanisms that control gene expression is a major challenge for medical research. This requires using a large set of pangenomic approaches such as those using DNA microarrays and high-throughput sequencing that generate an ever growing mass of digital data. During my thesis, I have developed several computer-based tools to facilitate their processing and analysis. I have created a R library (AgiND) that controls the quality of Agilent DNA microarray data and allows their statistical normalization. The growing number of experiences stored in Gene Expression Omnibus has motivated the development of the TBrowser project. An original method, DBF-MCL, was created to extract annotated transcriptional signatures by integrating various sources of information. Stored in a database, these signatures are accessible using a Java interface, a SOAP web service and a R/Bioconductor library (RTools4TB). Finally, a pipeline dedicated to the ChIP-seq analyses has been implemented. All these tools were used to study various diseases in collaborations.

Although, it is well established that regular exercise has a positive effect on various domains of cognitive functions, effects of a single session (acute) exercise on cognitive functions of an young adult is under debate. While a numbers of research have found positive associations between acute exercise and cognitive performance, multiple research have found no effect of acute exercise on the cognitive functions. There are also evidences that suggest that acute exercise reduces brain function of healthy young adults. This thesis took on a meta-analytical approach to determine the effect of a single session exercise on the cognitive functions of healthy young adults, and metaregression analyses were performed to identify the moderators that may influence the effect of acute exercise on cognitive functions of healthy young adults. After a comprehensive electronic search 59 experimental studies were found to be eligible for inclusions based on the pre-specified criteria. Results indicated that acute exercise has a small but significant effect on the cognitive functions of healthy young adults. However, larger effects are possible for particular cognitive outcomes (reaction time), when specific exercise parameters are used (5 minutes of exercise duration, moderate intensity exercise), and when specific assessment task is used (visual span board task, and serial subtraction of 7). The overall findings of this study is consistent with previous research. However, more research is needed to get a clear understanding of the acute exercise effect moderators.

O esôfago de Barrett é o principal fator de risco para o adenocarcinoma e resulta da agressão crônica causada pelo refluxo gastroesofágico. A abordagem terapêutica é controversa, e o tratamento cirúrgico, na presença de neoplasia intraepitelial de alto grau, pode estar indicado. A abordagem endoscópica apresenta-se como a alternativa com menor morbimortalidade e resultados favoráveis. Método: Realizou-se revisão sistemática nas bases de informação científica, com seleção de artigos randomizados e controlados, possibilitando metaanálise e avaliação isolada dos resultados das terapias ablativas da metaplasia intestinal. Considerou-se como terapias ablativas a crioterapia, laser, terapia fotodinâmica, eletrocoagulação multipolar, ablação por plasma de argônio e radiofrequência. Resultados: A revisão sistemática da literatura através do PUBMED recuperou os estudos com maior força de evidência e grau de recomendação disponíveis referentes ao tratamento ablativo do esôfago de Barrett. Nenhuma outra base de dados pesquisada adicionou outros artigos. Os artigos selecionados são estudos randomizados e controlados, classificados como A ou B pela tabela de Oxford. A terapia fotodinâmica apresenta no estudo meta-analítico aumento do risco de falha terapêutica em relação à ablação por plasma de argônio, NNH = -7. Os efeitos colaterais considerados foram dor torácica e estenose, com aumento do risco de dor torácica quando a ablação é realizada por terapia fotodinâmica e números semelhantes de estenoses para as duas terapias. A ablação do esôfago de Barrett por eletrocoagulação multipolar ou plasma de argônio apresenta risco de falhas terapêuticas semelhantes, assim como do efeito colateral de dor torácica na meta-análise. A terapia fotodinâmica associada ao inibidor da bomba de prótons apresenta benefício, em meta-análise, para a ablação do esôfago de Barrett em relação ao uso isolado do inibidor, NNT = 2. Dor torácica, estenose e fotossensibilidade estão associadas à intervenção endoscópica e, desta forma, a terapia fotodinâmica está associada ao aumento do risco com NNH entre - 2 e -3. Não houve aumento do risco de falha terapêutica entre a ablação do esôfago de Barrett por plasma de argônio e inibidor da bomba de prótons versus uso isolado do inibidor da bomba de prótons, em estudo isolado. A radiofrequência associada ao inibidor da bomba de prótons apresenta-se como método eficaz na redução do risco de falha terapêutica, NNT = 1. Conclusões: Não há estudos que demonstrem benefício na indicação da crioterapia ou laser para a abordagem endoscópica do esôfago de Barrett. A ablação por plasma de argônio apresenta eficácia superior à terapia fotodinâmica e a ablação por plasma de argônio e eletrocoagulação multipolar apresentam resultados efetivos e semelhantes. A terapia fotodinâmica apresenta menor número de falhas terapêuticas em relação ao uso isolado do inibidor da bomba de prótons. Não há dados suficientes para demonstrar a eficácia da ablação por plasma de argônio em relação ao uso isolado do inibidor da bomba de prótons. A radiofrequência é a abordagem mais recente e requer estudos comparativos para sua indicação. Os tratamentos endoscópicos ablativos estão associados a um maior risco de eventos colaterais como dor torácica, estenose e fotossensibilidade em relação ao tratamento clínico isolado, embora tais eventos não sejam graves ou limitantes / Barrett´s esophagus is the main risk factor for adenocarcinoma and it results from the chronic aggression produced by gastroesophageal reflux. Its therapeutic approach is controversial and surgical treatment in the presence of high-grade intraepithelial neoplasia may be indicated. Endoscopic approach is an alternative with lower mortality and morbidity rates and favorable results. Methods: A systematic review of scientific databases was conducted and articles of randomized, controlled studies were selected, enabling meta-analysis and the isolated evaluation of the results concerning ablative therapies of intestinal metaplasia. Cryotherapy, laser therapy, photodynamic therapy, multipolar electrocoagulation, and ablation through argon plasma coagulation and radiofrequency were considered ablation therapies. Results: The systematic review through PUBMED retrieved results with higher strength of evidence and available recommendation level regarding the ablative therapy of Barrett´s esophagus. No other database in the research yielded additional articles. The selected articles are randomized, controlled studies classified as A or B according to the Oxford table. Photodynamic therapy was found to present an increase in treatment failure compared to argon plasma coagulation in the meta-analysis, NNH = -7. Chest pain and stenosis were considered side effects with higher risk of chest pain whenever ablation is conducted through photodynamic therapy and similar figures of stenoses for both therapies. Ablation of Barrett´s esophagus with multipolar electrocoagulation or argon plasma was found to have similar risk of treatment failure, as well as the side effect of chest pain in the meta-analysis. Photodynamic therapy associated with proton pump inhibitor is beneficial, in the meta-analysis, for the ablation of Barrett´s esophagus regarding the isolated use of the inhibitor, NNT = 2. Chest pain, stenoses and photosensitivity were found to be associated with the endoscopic intervention and, therefore, photodynamic therapy was found to be associated with higher risk with NNH ranging between -2 and -3. No increase of treatment failure risk between Barrett´s esophagus ablation with argon plasma and proton pump inhibitor versus the isolated use of proton pump inhibitor was verified, in isolated study. Radiofrequency associated with proton pump inhibitor is an efficient method to reduce the risk of treatment failure, NNT = 1. Conclusions: There are no studies demonstrating the benefit of indicating cryotherapy or laser therapy for the endoscopic approach of Barrett´s esophagus. Ablation with argon plasma coagulation was found to have superior efficacy compared to photodynamic therapy and the ablation through argon plasma coagulation and multipolar electrocoagulation was found to present effective and similar results. Photodynamic therapy was found to have lower occurrences of treatment failure compared to the isolated use of proton pump inhibitor. No sufficient data were found to demonstrate the efficacy of ablation with argon plasma compared to the isolated use of proton pump inhibitor. Radiofrequency is the most recent approach and requires comparative studies in order to be indicated. Ablative endoscopic therapies are associated with higher risk of side effects, for instance chest pain, stenoses and photosensitivity compared to clinical treatment alone, although such events are neither severe nor limiting

In recent years, meta-analytic reviews have estimated validities for the use of personality scales in the prediction of job performance from an array of empirical studies. A variety of personality measures were used in the original studies, and procedures and decisions concerning the categorization of these measures into Big Five personality factors have differed among reviewers. An underlying assumption of meta-analysis is that the predictors across included studies are essentially the same, as is the criterion. If this is not the case, then problems arise for both theoretical reasons and practical applications. If predictors that are not highly correlated are combined in a meta-analysis, then the theoretical understanding of antecedents and consequents of the predictors will be clouded. Further, combining predictors that are not essentially the same may obscure different relations between predictors and criteria, that is, test may operate as a moderator. To meet the assumption of similarity, systematic methods of categorizing personality scales are advised. Two indicators of scale commensurability are proposed: 1) high correlations among predictor scales and 2) similar patterns of correlations between predictor scales and job-related criteria. In the current study, the similarity of the most commonly used personality scales in organizational contexts was assessed based on these two indicators. First, meta-analyses of correlations between scales were conducted. Second, subgroup meta-analyses of criterion-related validity were examined, with specific personality scale and criterion as moderators. Correlations between criterion-related validity and certain sample characteristics were also conducted to determine if sample characteristics act as moderators of validity. Additionally, an examination of personality scale reliabilities was conducted. Results reveal that assumptions of similarity among personality measures may not be entirely met. Whereas meta-analyzed reliability and criterion-related validity coefficients seldom differed greatly, scales of the "same" construct were only moderately correlated in many cases. Although these results suggest that previous meta-analytic results concerning reliability and criterion-related validity are generalizable across tests, questions remain about the similarity of personality construct conceptualization and operationalization. Further research into comprehensive measurement of the predictor space is suggested.

O esôfago de Barrett é o principal fator de risco para o adenocarcinoma e resulta da agressão crônica causada pelo refluxo gastroesofágico. A abordagem terapêutica é controversa, e o tratamento cirúrgico, na presença de neoplasia intraepitelial de alto grau, pode estar indicado. A abordagem endoscópica apresenta-se como a alternativa com menor morbimortalidade e resultados favoráveis. Método: Realizou-se revisão sistemática nas bases de informação científica, com seleção de artigos randomizados e controlados, possibilitando metaanálise e avaliação isolada dos resultados das terapias ablativas da metaplasia intestinal. Considerou-se como terapias ablativas a crioterapia, laser, terapia fotodinâmica, eletrocoagulação multipolar, ablação por plasma de argônio e radiofrequência. Resultados: A revisão sistemática da literatura através do PUBMED recuperou os estudos com maior força de evidência e grau de recomendação disponíveis referentes ao tratamento ablativo do esôfago de Barrett. Nenhuma outra base de dados pesquisada adicionou outros artigos. Os artigos selecionados são estudos randomizados e controlados, classificados como A ou B pela tabela de Oxford. A terapia fotodinâmica apresenta no estudo meta-analítico aumento do risco de falha terapêutica em relação à ablação por plasma de argônio, NNH = -7. Os efeitos colaterais considerados foram dor torácica e estenose, com aumento do risco de dor torácica quando a ablação é realizada por terapia fotodinâmica e números semelhantes de estenoses para as duas terapias. A ablação do esôfago de Barrett por eletrocoagulação multipolar ou plasma de argônio apresenta risco de falhas terapêuticas semelhantes, assim como do efeito colateral de dor torácica na meta-análise. A terapia fotodinâmica associada ao inibidor da bomba de prótons apresenta benefício, em meta-análise, para a ablação do esôfago de Barrett em relação ao uso isolado do inibidor, NNT = 2. Dor torácica, estenose e fotossensibilidade estão associadas à intervenção endoscópica e, desta forma, a terapia fotodinâmica está associada ao aumento do risco com NNH entre - 2 e -3. Não houve aumento do risco de falha terapêutica entre a ablação do esôfago de Barrett por plasma de argônio e inibidor da bomba de prótons versus uso isolado do inibidor da bomba de prótons, em estudo isolado. A radiofrequência associada ao inibidor da bomba de prótons apresenta-se como método eficaz na redução do risco de falha terapêutica, NNT = 1. Conclusões: Não há estudos que demonstrem benefício na indicação da crioterapia ou laser para a abordagem endoscópica do esôfago de Barrett. A ablação por plasma de argônio apresenta eficácia superior à terapia fotodinâmica e a ablação por plasma de argônio e eletrocoagulação multipolar apresentam resultados efetivos e semelhantes. A terapia fotodinâmica apresenta menor número de falhas terapêuticas em relação ao uso isolado do inibidor da bomba de prótons. Não há dados suficientes para demonstrar a eficácia da ablação por plasma de argônio em relação ao uso isolado do inibidor da bomba de prótons. A radiofrequência é a abordagem mais recente e requer estudos comparativos para sua indicação. Os tratamentos endoscópicos ablativos estão associados a um maior risco de eventos colaterais como dor torácica, estenose e fotossensibilidade em relação ao tratamento clínico isolado, embora tais eventos não sejam graves ou limitantes / Barrett´s esophagus is the main risk factor for adenocarcinoma and it results from the chronic aggression produced by gastroesophageal reflux. Its therapeutic approach is controversial and surgical treatment in the presence of high-grade intraepithelial neoplasia may be indicated. Endoscopic approach is an alternative with lower mortality and morbidity rates and favorable results. Methods: A systematic review of scientific databases was conducted and articles of randomized, controlled studies were selected, enabling meta-analysis and the isolated evaluation of the results concerning ablative therapies of intestinal metaplasia. Cryotherapy, laser therapy, photodynamic therapy, multipolar electrocoagulation, and ablation through argon plasma coagulation and radiofrequency were considered ablation therapies. Results: The systematic review through PUBMED retrieved results with higher strength of evidence and available recommendation level regarding the ablative therapy of Barrett´s esophagus. No other database in the research yielded additional articles. The selected articles are randomized, controlled studies classified as A or B according to the Oxford table. Photodynamic therapy was found to present an increase in treatment failure compared to argon plasma coagulation in the meta-analysis, NNH = -7. Chest pain and stenosis were considered side effects with higher risk of chest pain whenever ablation is conducted through photodynamic therapy and similar figures of stenoses for both therapies. Ablation of Barrett´s esophagus with multipolar electrocoagulation or argon plasma was found to have similar risk of treatment failure, as well as the side effect of chest pain in the meta-analysis. Photodynamic therapy associated with proton pump inhibitor is beneficial, in the meta-analysis, for the ablation of Barrett´s esophagus regarding the isolated use of the inhibitor, NNT = 2. Chest pain, stenoses and photosensitivity were found to be associated with the endoscopic intervention and, therefore, photodynamic therapy was found to be associated with higher risk with NNH ranging between -2 and -3. No increase of treatment failure risk between Barrett´s esophagus ablation with argon plasma and proton pump inhibitor versus the isolated use of proton pump inhibitor was verified, in isolated study. Radiofrequency associated with proton pump inhibitor is an efficient method to reduce the risk of treatment failure, NNT = 1. Conclusions: There are no studies demonstrating the benefit of indicating cryotherapy or laser therapy for the endoscopic approach of Barrett´s esophagus. Ablation with argon plasma coagulation was found to have superior efficacy compared to photodynamic therapy and the ablation through argon plasma coagulation and multipolar electrocoagulation was found to present effective and similar results. Photodynamic therapy was found to have lower occurrences of treatment failure compared to the isolated use of proton pump inhibitor. No sufficient data were found to demonstrate the efficacy of ablation with argon plasma compared to the isolated use of proton pump inhibitor. Radiofrequency is the most recent approach and requires comparative studies in order to be indicated. Ablative endoscopic therapies are associated with higher risk of side effects, for instance chest pain, stenoses and photosensitivity compared to clinical treatment alone, although such events are neither severe nor limiting

Context: Early prediction of software cost and quality is important for better software planning and controlling. In early development phases, design complexity metrics are considered as useful indicators of software testing effort and some quality attributes. Although many studies investigate the relationship between design complexity and cost and quality, it is unclear what we have learned from these studies, because no systematic synthesis exists to date. Aim: The research presented in this thesis is intended to contribute for the body of knowledge about cost and quality prediction. A major part of this thesis presents the systematic review that provides detail discussion about state of the art of research on relationship between software design metric and cost and software quality. Method: This thesis starts with a literature review to identify the important complexity dimensions and potential predictors for predicting external software quality attributes are identified. Second, we aggregated Spearman correlation coefficients and estimated odds ratios from univariate logistic regression models from 59 different data sets from 57 primary studies by a tailored meta-analysis approach. At last, it is an attempt to evaluate and explain for disagreement among selected studies. Result: There are not enough studies for quantitatively summarizing relationship between design complexity and development cost. Fault proneness and maintainability is the main focused characteristics that consume 75% total number of studies. Within fault proneness and maintainability studies, coupling and scale are two complexity dimensions that are most frequently used. Vote counting shows evidence about positive impact of some design metrics on these two quality attributes. Meta analysis shows the aggregated effect size of Line of code (LOC) is stronger than those of WMC, RFC and CBO. The aggregated effect sizes of LCOM, DIT and NOC are at trivial to small level. In subgroup analysis, defect collections phase explains more than 50% of observed variation in five out of seven investigated metrics. Conclusions: Coupling and scale metrics are stronger correlated to fault proneness than cohesion and inheritance metrics. No design metrics are stronger single predictors than LOC. We found that there is a strong disagreement between the individual studies, and that defect collection phase is able to partially explain the differences between studies.

Acute and chronic pain conditions cause significant patient distress, interference with daily activities, and increased health care costs. It is important to evaluate analgesic interventions to improve pain relief, function, quality of life, and also to prevent persisting pain after surgery. This thesis is a combination of studies evaluating analgesic interventions in the setting of acute surgical pain; prevention of persistent post-surgical pain; and chronic low back pain. In part 1, we report our comparison of morphine and hydromorphone in 402 ambulatory surgery patients, for their ability to achieve satisfactory analgesia with minimal emesis using a design of multicentre randomized controlled trial. We observed no differences in their analgesic potential and common side effects and note that appearance of side effects is likely to be idiosyncratic. In part 2, we report our 2×2 factorial feasibility trial to prevent persistent post-surgical pain in patients having elective video-assisted thoracic surgery lobectomies, comparing N-methyl-D-aspartate antagonists versus placebo, and intravenous steroids versus placebo. As our feasibility outcomes were not met, we suggest appropriate considerations for protocol changes before embarking on a definitive larger trial. In part 3, we report on our systematic review and meta-analysis assessing the effectiveness and safety of gabapentinoids (gabapentin and pregabalin) in adult patients with chronic low back pain. We observed that the existing evidence is small and there is minimal improvement in pain and other outcomes with potential for adverse events. We suggest that the use of gabapentinoids for chronic low back pain merits caution and there is need for large high-quality trials. / Thesis / Doctor of Philosophy (PhD) / It is important to evaluate analgesic interventions to decrease pain, improve function, and lessen health care costs. In a randomized controlled trial of day surgery patients, we demonstrate that there are no differences between morphine and hydromorphone in achieving pain relief and common side effects. To prevent persistent post-surgical pain in patients having elective video-assisted thoracic surgery lobectomies, we performed a 2×2 factorial, feasibility randomized controlled trial, to compare N-methyl-D-aspartate antagonists versus placebo, and intravenous steroids versus placebo. We observe that appropriate protocol changes must be made before embarking on a larger trial. Finally, we report our systematic review and meta-analysis on the use of gabapentinoids in adult patients with chronic low back pain and observe that the existing evidence is small and not supportive, and the use of gabapentinoids for chronic low back pain merits caution.