This was a retrospective study of a community-based methadone maintenance treatment (MMT) program in Toronto. Participants (N = 170) were federally sentenced adult male offenders admitted to this voluntary program between 1997 and 2009 while subject to community supervision following incarceration. The primary investigation examined correlates of treatment responsivity, with principal outcome measures including MMT clients’ rates of: (i) illicit drug use; and (ii) completion of conditional (parole) or statutory release (SR). For a subset (n = 74), recidivism rates were examined after a 9-year interval. Findings included strong convergent evidence from logistic regression and ROC analyses that an empirically and theoretically derived set of five variables was a stable and highly significant (p <.001) predictor of release outcome. Using five factors related to risk (work/school status, security level of releasing institution, total PCL-R score, history of institutional drug use, and days at risk), release outcome was predicted with an overall classification accuracy of 88%, with high specificity (86%) and sensitivity (89%). The logistic regression model generated an R2 of .55 and the accompanying AUC was .89, both substantial. Work/school status had an extremely large positive association with successful completion of community supervision, accounting for > half of the total variance explained by the five-factor model and increasing the estimated odds of successful release outcome by > 15-fold. Also, when in the MMT program, clients' risk taking behaviour was significantly moderated, with low overall base rates of illicit drug use, yet the rate of parole/SR revocation (71%) was high. The 9-year follow-up showed a high mortality rate (15%) overall. Revocation of release while in the MMT program was associated with a significantly higher rate and more violent recidivism at follow-up. Results are discussed within the context of: (a) Andrews' and Bonta's psychology of criminal conduct; (b) the incompatibility of a harm reduction treatment model with an abstinence-based parole decision-making model; (c) changing drug use profiles among MMT clients; (d) a strength-based approach to correctional intervention focusing on educational and vocational retraining initiatives; and (e) creation of a user friendly case-based screening algorithm for prediction of release outcome for new releases.

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This was a retrospective study of a community-based methadone maintenance treatment (MMT) program in Toronto. Participants (N = 170) were federally sentenced adult male offenders admitted to this voluntary program between 1997 and 2009 while subject to community supervision following incarceration. The primary investigation examined correlates of treatment responsivity, with principal outcome measures including MMT clients’ rates of: (i) illicit drug use; and (ii) completion of conditional (parole) or statutory release (SR). For a subset (n = 74), recidivism rates were examined after a 9-year interval. Findings included strong convergent evidence from logistic regression and ROC analyses that an empirically and theoretically derived set of five variables was a stable and highly significant (p <.001) predictor of release outcome. Using five factors related to risk (work/school status, security level of releasing institution, total PCL-R score, history of institutional drug use, and days at risk), release outcome was predicted with an overall classification accuracy of 88%, with high specificity (86%) and sensitivity (89%). The logistic regression model generated an R2 of .55 and the accompanying AUC was .89, both substantial. Work/school status had an extremely large positive association with successful completion of community supervision, accounting for > half of the total variance explained by the five-factor model and increasing the estimated odds of successful release outcome by > 15-fold. Also, when in the MMT program, clients' risk taking behaviour was significantly moderated, with low overall base rates of illicit drug use, yet the rate of parole/SR revocation (71%) was high. The 9-year follow-up showed a high mortality rate (15%) overall. Revocation of release while in the MMT program was associated with a significantly higher rate and more violent recidivism at follow-up. Results are discussed within the context of: (a) Andrews' and Bonta's psychology of criminal conduct; (b) the incompatibility of a harm reduction treatment model with an abstinence-based parole decision-making model; (c) changing drug use profiles among MMT clients; (d) a strength-based approach to correctional intervention focusing on educational and vocational retraining initiatives; and (e) creation of a user friendly case-based screening algorithm for prediction of release outcome for new releases.

Introdução: Atualmente, o diagnóstico das reações de hipersensibilidade a anti-inflamatórios não esteroidais (AINEs) baseia-se na história relatada pelo paciente e, em determinados casos, é realizado o Teste de Provocação. Todavia, este teste pode expor os pacientes a riscos graves, inclusive anafilaxia. Em busca de ferramenta mais segura, tem-se estudado o Teste de Ativação de Basófilos (BAT). Trata-se de um teste in vitro, no qual é possível testar diversos estímulos em uma única amostra de sangue, avaliando a ativação dos basófilos (indicativo de reação de hipersensibilidade), através do aumento da expressão de moléculas na superfície desses leucócitos, como o CD63. Objetivo: Padronizar e validar o BAT para ácido acetilsalicílico (AAS), diclofenaco, dipirona e paracetamol em pacientes com hipersensibilidade a AINEs. Metodologia: Participaram 20 (testados com os quatro AINEs) + 33 (testados somente com AAS) pacientes atendidos no Serviço de Imunologia Clínica e Alergia do HCFMUSP, que apresentaram manifestações cutâneas em até 24 horas após exposição a um ou múltiplos AINEs, bem como 13 (quatro AINEs) + 26 (AAS) controles. A técnica consistiu em incubar sangue total com os AINEs já mencionados e, depois, marcar as amostras com anticorpos monoclonais (CD45, anti-IgE e CD63) para posterior leitura por citometria de fluxo. Os resultados obtidos foram comparados com as histórias clínicas e os testes de provocação oral, quando realizados. Resultados: Utilizando os critérios de positividade do BAT empregados na literatura (isto é, porcentagem de CD45+IgE+highCD63+ e índice de estimulação), a sensibilidade e a especificidade variaram de acordo com o AINE: para ácido acetilsalicílico foram 75,0% e 16,7%, respectivamente, diclofenaco, 100% e 0%, dipirona, 23,5% e 66,7%, paracetamol, 40,0% e 42,9%. Após a realização de curvas dose-resposta e tempo-resposta somente com AAS, foi encontrado novo critério de positividade: média de intensidade de fluorescência (MFI) menor do que 6575 representava BAT positivo; com isso, os valores de sensibilidade e especificidade foram: 84,4% e 34,6%, respectivamente. O BAT foi mais sensível em pacientes cuja última reação ocorreu há menos de um ano da data de execução do BAT (93,7%). Conclusão: Devido aos baixos valores de sensibilidade e/ou especificidade, não foi possível padronizar e, por conseguinte, validar o BAT para ácido acetilsalicílico, diclofenaco, dipirona e paracetamol. / Introduction: Currently, the diagnosis of nonsteroidal antiinflammatory drugs (NSAIDs) hypersensivitity is based on patients´ clinical history and drug provocation tests, which are done in selected cases. Nevertheless, this test may expose patients to severe risks, including anaphylaxis. Looking for a safer tool, Basophil Activation Test (BAT) for allergy diagnosis has been studied in the last years. It is an in vitro method where a wide variety of stimuli can be tested, incubating them with the patient\'s blood sample, and observing basophil activation (indication of hypersensitivity) through upregulation of CD63 (or other basophil activation markers) on this leucocyte\'s membrane. Objective: To standardize and validate BAT stimulated with acetylsalicylic acid (ASA), diclophenac, dipyrone and paracetamol in NSAID hypersensitive patients. Methods: Patients which reported immediate reactions (less than 24 hours) after exposure to one or multiple NSAIDs, with cutaneous symptoms were enrolled from Clinical Immunology and Allergy outpatient clinic from HC-FMUSP. BAT with the four NSAIDs was tested on 20 patients and 13 controls and BAT with ASA only, on 33 patients and 26 controls. BAT consisted of incubating whole blood with NSAIDs, then triple-labeled with monoclonal antibodies (CD45, anti-IgE, CD63) for analysis by flow cytometry. BAT results were compared to clinical history and oral provocation tests, when available. Results: According to literature\'s positivity criteria (percentage of CD45+IgE+highCD63+ and stimulation index), sensitivity and specificity varied according to the NSAID tested: for ASA was 75.0% and 16.7% respectively, diclophenac, 100.0% and 0.0%, dipyrone, 23.5% and 66.7%, paracetamol, 40.0% and 42.9%. A new positivity criterion was possible to be defined after further dose-response and time-response curves only for ASA: Mean Fluorescence Intensity lower than 6575 (positive BAT). Accordingly, new sensitivity and specificity for BAT in ASA hypersensitivity were 84,4% and 34,6%. Patients that presented the last reaction in the last year were more likely to present a positive BAT (93.7%). Conclusion: Due to low values for sensitivity and/or specificity, it was not possible to standardize and validate BAT for ASA, diclophenac, dipyrone and paracetamol.

Submitted by Luciana Ferreira (lucgeral@gmail.com) on 2016-05-20T12:55:18Z No. of bitstreams: 2 Dissertação - Thales Baliero Takáo - 2015.pdf: 2798998 bytes, checksum: f90a7c928230875abd5873753316f766 (MD5) license_rdf: 23148 bytes, checksum: 9da0b6dfac957114c6a7714714b86306 (MD5) / Approved for entry into archive by Luciana Ferreira (lucgeral@gmail.com) on 2016-05-20T12:56:48Z (GMT) No. of bitstreams: 2 Dissertação - Thales Baliero Takáo - 2015.pdf: 2798998 bytes, checksum: f90a7c928230875abd5873753316f766 (MD5) license_rdf: 23148 bytes, checksum: 9da0b6dfac957114c6a7714714b86306 (MD5) / Made available in DSpace on 2016-05-20T12:56:48Z (GMT). No. of bitstreams: 2 Dissertação - Thales Baliero Takáo - 2015.pdf: 2798998 bytes, checksum: f90a7c928230875abd5873753316f766 (MD5) license_rdf: 23148 bytes, checksum: 9da0b6dfac957114c6a7714714b86306 (MD5) Previous issue date: 2015-07-01 / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - CAPES / The aim of this work was to assess the performance of computational methods to classify ground reaction force (GRF) to identify on which surface was done the gait initiation. Twenty-five subjects were evaluated while performing the gait initiation task in two experimental conditions barefoot on hard surface and barefoot on soft surface (foam). The center of pressure (COP) variables were calculate from the GRF and the principal component analysis was used to retain the main features of medial-lateral, anterior-posterior and vertical force components. The principal components representing each force component were retained using the broken stick test. Then the support vector machines and multilayer neural networks ware trained with Backpropagation and Levenberg-Marquartd algorithm to perform the GRF classification . The evaluation of classifier models was done based on area under ROC curve and accuracy criteria. The Bootstrap cross-validation have produced area under ROC curve a and accuracy criteria using 500 samples database. The support vector machine with linear kernel and margin parameter equal 100 produced the best result using medial-lateral force as input. It registered area under ROC curve and accuracy with 0.7712 and 0.7974. Those results showed significance difference from the vertical and anterior-posterior force. Then we may conclude that the choice of GRF component and the classifier model directly influences the performance of the classification. / O objetivo deste trabalho foi avaliar o desempenho de ferramentas de inteligência computacional para a classificação da força de reação do solo (FRS) identificando em que tipo de superfície foi realizada a inicialização da marcha. A base de dados foi composta pela força de reação do solo de 25 indivíduos, adquiridas por duas plataformas de força, durante a inicialização da marcha sobre uma superfície macia (SM - colchão), e depois sobre uma superfície dura (SD). A partir da FRS foram calculadas as variáveis que descrevem o comportamento do centro de pressão (COP) e também foram extraídas as características relevantes das forças mediolateral (Fx), anteroposterior (Fy) e vertical (Fz) por meio da análise de componentes principais (ACP). A seleção das componentes principais que descrevem cada uma das forças foi feita por meio do teste broken stick . Em seguida, máquinas de vetores de suporte (MVS) e redes neurais artificiais multicamada (MLP) foram treinadas com o algoritmo Backpropagation e de Levenberg-Marquartd (LMA) para realizar a classificação da FRS. Para a avaliação dos modelos implementados a partir das ferramentas de inteligência computacional foram utilizados os índices de acurácia (ACC) e área abaixo da curva ROC (AUC). Estes índices foram obtidos na validação cruzada utilizando a técnicas bootstrap com 500 bases de dados de amostras. O melhor resultado foi obtido para a máquina de vetor de suporte com kernel linear com parâmetro de margem igual a 100 utilizando a Fx como entrada para classificação das amostras. Os índices AUC e ACC foram 0.7712 e 0.7974, respectivamente. Estes resultados apresentaram diferença estatística em relação aos modelos que utilizaram as componentes principais da Fy e Fz, permitindo concluir que a escolha da componente da FRS assim como o modelo a ser implementado influencia diretamente no desempenho dos índices que avaliam a classificação.

INTRODUÇÃO E OBJETIVO: A estenose de junção ureteropélvica (EJUP) é importante causa de obstrução do trato urinário e pode levar a deterioração progressiva da função renal. Há espaço para o aprimoramento de novos métodos diagnósticos capazes de discriminar hidronefrose e uropatia obstrutiva. Acredita-se que os biomarcadores urinários podem fornecer indícios de lesão renal precoce na obstrução urinária. Neste contexto, KIM-1 pode elevar-se na urina por lesão tubular proximal, NGAL por lesão no túbulo proximal, distal ou alça de Henle, CA19-9 por produção excessiva no túbulo obstruído e ?2-microglobulina (beta2M) por injúria ao glomérulo ou ao túbulo proximal. O objetivo do presente estudo foi avaliar as propriedades diagnósticas dos biomarcadores urinários citados em adultos com EJUP, sendo o primeiro estudo na literatura a avaliar tais moléculas nesta população. MÉTODOS: Foram estudados de modo prospectivo pacientes consecutivos acima de 18 anos com diagnóstico de EJUP submetidos a pieloplastia videolaparoscópica de dezembro de 2013 a fevereiro de 2015. Foram excluídos do estudo pacientes com EJUP bilateral, rim contralateral patológico, EJUP em rim único, antecedentes de tratamento cirúrgico para estenose de JUP ou taxa de filtração glomerular inferior a 60 ml/min/1,73m2. Cada paciente forneceu quatro amostras de urina para medição de biomarcadores, uma no pré-operatório e outras com 1, 3 e 6 meses de seguimento pós-operatório. O grupo controle foi constituído por voluntários saudáveis sem hidronefrose à ultrassonografia. RESULTADOS: Foram incluídos 47 pacientes com idade média de 38,6 ± 12,7 anos (intervalo 19 a 64 anos), sendo 17 (36,2%) do sexo masculino e 30 (62,8%) do sexo feminino. O grupo controle foi composto por 40 indivíduos semelhantes ao grupo com EJUP no que concerne idade (p = 0,95) e sexo (p = 0,82). KIM-1 foi o marcador com melhores propriedades diagnósticas, apresentando área sob a curva (AUC) de 0,79 (95% CI 0,70 a 0,89). O NGAL, por sua vez, teve AUC de 0,71 (95% CI 0,61 a 0,83), CA19- 9 teve AUC de 0,70 (95% CI 0,60 a 0,81) e (beta2M) apresentou AUC de 0,61 (95% CI 0,50 a 0,73), sendo o único biomarcador com propriedades inadequadas neste cenário. O KIM-1 foi o marcador mais sensível com o ponto de corte 170,4 pg/mg de creatinina (sensibilidade 91,4%, especificidade 59,1%) e o CA 19-9 o mais específico para o ponto de corte de 51,3 U/mg de creatinina (sensibilidade 48,9%, especificidade 88,0%), enquanto o NGAL foi o que apresentou maior queda após desobstrução, com 90,0% dos pacientes apresentando clareamento superior a 50%. CONCLUSÕES: A avaliação dos biomarcadores urinários é útil no diagnóstico de obstrução em adultos com EJUP submetidos a pieloplastia videolaparoscópica. O KIM-1 foi o marcador mais sensível e o CA 19-9 o mais específico, enquanto o NGAL foi o que apresentou maior que com a desobstrução. Houve queda das concentrações dos marcadores após pieloplastia no período estudado. O papel exato dos biomarcadores urinários no cenário de obstrução em adultos deve ser mais amplamente investigado / INTRODUCTION AND OBJECTIVE: Ureteropelvic junction obstruction (UPJO) is an important cause of urinary tract obstruction and can lead to progressive deterioration of renal function. Thus the development of novel non-invasive methods capable of discriminating obstruction and hydronephrosis may be useful. Elevation of urinary biomarkers may provide early evidence of kidney damage in urinary obstruction. In this scenario, urinary concentrations of KIM-1 may be elevated following proximal tubular injury, while NGAL may increase as result of injury to proximal or distal tubule as well as to loop of Henle, CA19-9 after overproduction in the obstructed tubule and ?2 microglobulin (beta2M) after injury to the glomerulus or the proximal tubule. The aim of this study was to evaluate the diagnostic properties of these urinary biomarkers in adults with UPJO. METHODS: We prospectively studied consecutive patients older than 18 years diagnosed with UPJO undergoing laparoscopic pyeloplasty from December 2013 to February 2015 in our institution. Exclusion criteria included patients with bilateral UPJO, unilateral UPJO with contralateral pathologic kidney, solitary kidney, history of previous surgical treatment for UPJO or glomerular filtration rate below 60 ml/min/1,73m2. Each patient provided four voided urine samples for biomarker measurement, one at preoperative consultation and the others at 1, 3 and 6 months of postoperative follow-up. Healthy individuals with no hydronephrosis on ultrasound evaluation constituted our control group. RESULTS: We included 47 patients with a mean age of 38.6 ± 12.7 years (range 19-64 years), from which 17 (36.2%) were males and 30 (62.8%) were females. The control group consisted of 40 subjects with no statistical difference to the study group regarding age (p = 0.95) and gender (p = 0.82). KIM-1 had an area under the curve (AUC) of 0.79 (95% CI 0.70 to 0.89) and was the biomarker with the best diagnostic properties. CA19-9 had an AUC of 0.70 (95% CI 0.60 to 0.81), NGAL had an AUC of 0.71 (95% CI 0.61 to 0.83) and beta2M had an AUC of 0.61 (95% CI 0.50 to 0.73). KIM-1 was the most sensitive marker with a cutoff of 170.4 pg/mg creatinine (sensitivity 91.4%, specificity 59.1%) whereas CA 19-9 as the most specific one, displaying a cutoff of 51.3 U/mg creatinine (sensitivity 48.9%, specificity 88.0%). NGAL showed the greatest decrease in urinary concentrations after pyeloplasty, in which 90.0% of patients had a clearance greater than 50% in comparison to preoperative values. CONCLUSIONS: The evaluation of urinary biomarkers is useful in the assessment of UPJO in adults undergoing laparoscopic pyeloplasty. Urinary concentrations of CA 19-9, NGAL and KIM-1 were elevated in patients with UPJO and significantly decreased after pyeloplasty. The exact role of those biomarkers in the setting of obstruction in adults should be further evaluated

Aim of this thesis is description of neural network based edge detection methods that are substitute for classic methods of detection using edge operators. First chapters generally discussed the issues of image processing, edge detection and neural networks. The objective of the main part is to show process of generating synthetic images, extracting training datasets and discussing variants of suitable topologies of neural networks for purpose of edge detection. The last part of the thesis is dedicated to evaluating and measuring accuracy values of neural network.

This bachelor thesis in applied mathematics and industrial engineering and management aimed to identify relationships between search parameters in flight comparison search engines and the exit conversion rate, while also investigating how the emergence of such comparison search engines has impacted the airline industry. To identify such relationships, several classification models were employed in conjunction with several sampling methods to produce a predictive model using the program R. To investigate the impact of the emergence of comparison websites, Porter's 5 forces and a SWOT - analysis were employed to analyze findings of a literature study and a qualitative interview. The classification models developed performed poorly with regards to several assessments metrics which suggested that there were little to no significance in the relationship between the search parameters investigated and exit conversion rate. Porter's 5 forces and the SWOT-analysis suggested that the competitive landscape of the airline industry has become more competitive and that airlines which do not manage to adapt to this changing market environment will experience decreasing profitability. / Detta kandidatexamensarbete inriktat på tillämpad matematik och industriell ekonomi syftade till att identifiera samband mellan sökparametrar från flygsökmotorer och konverteringsgraden för utträde till ett flygbolags hemsida, och samtidigt undersöka hur uppkomsten av flygsökmotorer har påverkat flygindustrin för flygbolag. För att identifiera sådana samband, tillämpades flera klassificeringsmodeller tillsammans med stickprovsmetoder för att bygga en predikativ modell i programmet R. För att undersöka påverkan av flygsökmotorer tillämpades Porters 5 krafter och SWOT-analys som teoretiska ramverk för att analysera information uppsamlad genom en litteraturstudie och en intervju. Klassificeringsmodellerna som byggdes presterade undermåligt med avseende på flera utvärderingsmått, vilket antydde att det fanns lite eller inget samband mellan de undersökta sökparametrarna och konverteringsgraden för utträde. Porters 5 krafter och SWOT-analysen visade att flygindustrin hade blivit mer konkurrensutsatt och att flygbolag som inte lyckas anpassa sig efter en omgivning i ändring kommer att uppleva minskande lönsamhet.

Ce travail rassemble les données sur la géologie, la stratigraphie,la structure, la tectonique des formations entre les vallées de l'Arc et de l'Isère. Sont présents dans ce document : Carte structurale détaillée des zones ultradauphinoises et subbriançonnaise entre l'Arc et l'Isère, carte structurale schématique des zones ultradauphinoises et subbriançonnaise entre le Pelvoux et le Mont-Blanc, Schémas des corrélations entre les zones de faciès, Coupes en série des zones ultradauphinoise et subbriançonnaise entre l'Arc et l'Isère, Blocs-diagrammes très schématiques montrant les différentes phases de la mise en place des nappes (Tarentaise et klippes de Savoie)

本研究主要是希望針對採市場資訊的Merton Model、利用財務比率為變數的Logistic Model及混合用市場資訊及財務比率資訊的Hybrid Model做區別力的比較；且觀察出考慮提前違約是否能增加區別效力。進而將模型細分為: （一）以Merton Model為基礎所估出的風險中立下違約機率及客觀違約機率，及尚有為了修正Merton Model公司只會在負債到期日時才發生違約的基本假設的首次通過模型。 （二）採用Altman Z-Score所採用的五個判定公司的財務比率作為Logistic Model的基本變數。 （三）模型五、六、七除了利用Altman Z-Score所採用的五個判定公司的財務比率作為Logistic Model的基本變數。尚將風險中立下違約機率、客觀違約機率及首次通過模型違約機率分別當作的另一個解釋因子，形成同時結合市場資訊及財務資訊的Hybrid Model。 同時，採用了判別隨機性的Chi-Square Test、解釋力的Pesudo R2、區別力的S-K Test及ROC曲線、正確性的Brier Scores，此五個指標作為做為樣本內及樣本外模型的驗證方法。 經由驗證，得到的結論是同時包含市場資訊及財務資訊的模型較佳，且有考慮公司於負債到期日前就發生違約的因素對預警模型的判別效力有提高的正向作用。