La presente tesis tiene como objetivo identificar de las principales causas por las cuales el Grupo Graña y Montero no ha sido competitivo en las recientes propuestas presentadas en concursos de proyectos de infraestructura bajo la modalidad de Asociación Publico Privada (APP), específicamente de carreteras. En base a lo obtenido del análisis realizado mediante juicio de expertos se identificó que existen deficiencias en la planificación y la comunicación directa por parte de los stakeholders durante las fases de elaboración de una propuesta, lo cual afecta en el desarrollo de la ingeniería y en el costo de la misma. La propuesta de solución que plantea la tesis tiene como principal enfoque el establecer pautas de gestión integrada para logar apalancar proyectos multidisciplinarios a través de la aplicación de herramientas prácticas, criterios para la estructuración, ejecución y operación de proyectos basados en Lean Project Delivery System (LPDS). Len Project Delivey System (LPDS) propone mejorar las etapas de definición y diseño de los proyectos usando las técnicas “lean”, las cuales se vienen aplicando en el Grupo Graña y Montero con gran éxito, pero solo a la etapa de ejecución del proyecto. Por lo tanto, se busca ampliar la visión del uso de las técnicas “lean”. La tesis se enfoca en lograr la mejor solución de ingeniería a partir de un trabajo colaborativo, la mejora continua y el alineamiento de los satakeholders, lo cual asegurará alcanzar un diseño de ingeniería atractivo para el cliente a un precio competitivo. El diagrama muestra la propuesta de pasar de un enfoque secuencial a un enfoque integrado en donde el impacto de cambios propuestos busca generar valor y no ajustar costos. / The present thesis aims to identify the main reasons why Grupo Graña y Montero has not been competitive in the recent proposals for infrastructure projects presented under the modality of Public Private Partnership (PPP), specifically for road projects. Based on the analysis carried out by expert judgment method, it was identified that there is a deficiency in the planning and direct communication between the stakeholders during the phases of the proposal elaboration, which affects the development of the engineering and the cost of the project. The main objective of the solution proposed by the thesis is to establish integrated management guidelines to leverage multi-disciplinary projects through the application of practical tools, criteria for structuring, execution, and operation of projects based on the Lean Project Delivery System. Len Project Delivery System (LPDS) proposes to improve the stages of definition and design of the project using lean techniques, which have been applied by Graña and Montero Group with great success but only to the project execution stage. Therefore, it seeks to broaden the vision of the use of "lean" techniques. The thesis focuses on achieving the best engineering solution from a collaborative work, continuous improvement, and alignment of the stakeholders, which will ensure an attractive engineering design for the client at a competitive price. / Tesis

Context. With the development of software industry, Integrated Product Development (IPD) is employed by more and more companies(IBM，HUAWEI) in software development processes. Although there have been many fundamental studies on the IPD method, limited work has been done on case studies of the actual development processes. In order for the development team to better deal with the challenges in the integrated product development process, it is necessary to further study the challenges encountered by the development team and how to solve/mitigate these problems. Objectives. The main purpose of this research is to identify the challenges of IPD application in the software development process. Three research objectives were proposed to support the objectives. The first is to investigate the challenges in the integrated product development process. The second is to investigate the factors that cause the challenge. The third is to find solutions to these challenges. Methods. This research used a systematic mapping method to investigate the IPD challenges mentioned in the existing literature and obtain the factors and solutions of IPD challenges. Based on the systematic mapping method, a case study was conducted on a software company using the IPD method for process development. Archival data is used to understand and record the development process of selected projects. Then conduct interviews to obtain the challenges faced by IPD team members in the project development process and the factors leading to the challenges, and obtain the solutions that practitioners adopt when facing these challenges. Results. Through systematic mapping, the research identified 15 primary studies and 9 IPD challenges, the factors and solutions that lead to IPD challenges mentioned in primary studies have also been obtained. This research also conducted a frequency analysis of these challenges, and they will be effective evidence to support the results of the case study. Through case studies, 6 IPD challenges in the actual development process were identified. This research conducted an in-depth analysis of these challenges and obtained the factors and solutions that led to these challenges. Conclusions. This research summarizes the challenges faced by integrated product development in the actual development process, analyzes the factors that lead to the challenges, and proposes solutions/mitigation plans for the identified challenges. This research fills the gaps in the related fields of integrated product development. the research results of this thesis can help teams using integrated product development technologies to identify and avoid similar problems in advance.

Cette mémoire vise à développer une méthode de pondération par l’inverse de le probabilité de traitement (Augmented Inverse Probability of Treatment Weighting; AIPTW) et estimation par maximum de vraisemblance ciblée (Targeted Maximum Likelihood Estimation; TMLE) dans le contexte d'une méta-analyse en réseau avec données individuelles (Individual Patient Data Network Meta-Analysis; IPD-NMA) avec données observationnelles. Nous proposons également des méthodes pour estimer le score de propension généralisé (Generalized Propensity Score; GPS) pour finalement estimer l'effet causal d'une combinaison donnée de traitements (un régime) interprété à partir de d’une population globale. Cette recherche a été motivée par une mise à jour récente des données de patients atteints de la tuberculose multirésistante (Multidrug-Resistant Tuberculosis ; MDR-TB), une maladie infectieuse respiratoire causée par le bacillus mycobactérie avec un taux de mortalité élevé. Une compléxité notable de notre scénario est que toutes les régimes de traitements n'ont pas été observés dans toutes les études. L’inférence causale est définie comme l'étude de l'effet des traitements sur un résultat. Bien que les études cliniques randomisées sont l'étalon-or pour l'investigation des causes et effets, en raison de certaines limitations, leur utilisation n'est pas toujours faisable. Ainsi, l’analyse de données observationnelles est proposée. Donc, il est important de développer des méthodes qui nous permettent d'utiliser les informations provenant des données observationnelles. L'utilisation des informations provenant de plusieurs études individuelles nous permet d'évaluer les associations entre les traitements et les résultats qui sont spécifiques aux sous-populations. Aussi, une méta-analyse en réseau nous permet comparer plusieurs régimes au lieu de seulement deux. Nous estimons le taux de succès d’un régime donné à partir d'un ensemble d'études dans lesquelles le régime était disponible, puis le généralisons à l'ensemble de la population source. La théorie et les résultats d’une étude de simulation démontre que les méthodes développées sont doublement robustes. Cependant, TMLE démontre plus de robustesse, en particulier lorsqu’une méthode nouvellement proposée pour estimer le GPS est utilisée. Le résultat de l'application donne des estimations d’un taux de succès de traitement généralisé entre 50 à 61 % pour le régime {Pyrazinamide,Kanamycin,Ofloxacin,Ethionamide,Cyloserine} tandis que le taux observé de l’ensemble des données était de 59 %. / This thesis aims for developing Augmented Inverse Probability of Treatment Weighting (AIPTW) and Targeted Maximum Likelihood Estimation (TMLE) in the setting of Individual Patient Data Network Meta-Analysis (IPD-NMA) of observational data and propose a method to estimate the Generalized Propensity Score (GPS) to eventually estimate the causal effect of a given combination of treatments (a regimen) and generalize it to a global population. This research was motivated by a recent update on IPD_NMA of Multidrug-Resistant Tuberculosis (MDR-TB) - a respiratory infectious disease caused by bacillus mycobacterium with a high rate of mortality - where not all the regimens observed in all the studies. Although Randomized Controlled Trials (RCTs) are known to be the gold standard in investigating cause-and-effect including in causal inference (defined as the study of the effect of treatments on an outcome), but because of some known limitations using them is not always feasible. Thus, observational data are being proposed. Therefore, developing methods that enable us to use the information from observational data is important. In addition, using the information coming from individual studies allows us to evaluate associations between treatments and outcome which are specific to subpopulations. Also, a network meta-analysis allows us to study the effect of multiple treatments instead of two. We estimate the rate of treatment success for a given regimen from a set of studies where the regimen was available, and then generalize it to the whole network. The simulation result shows that the developed methods are doubly robust, however TMLE shows more robustness specially when the new proposed approach to estimate the GPS is being used. The application result shows a range of 50-61% for the generalized success rate of regimen {Pyrazinamide,Kanamycin,Ofloxacin,Ethionamide,Cyloserine} while the observed rate was 59% from multiple regimens.

No description available.

Virtual Design and Construction (VDC) introducerades tidigt på 2000-talet för att främja ett arbete med datorbaserade modeller samt involvering av produktionsplanering i designfasen. VDC är ett koncept som idag har anammats inom många bygg- och konsultföretag för att utveckla arbetet med Building Information Model (BIM), innovationer och samverkan inom byggprojekt. Konceptet VDC förändras ständigt och omdefinieras av enskilda individer och företag. Det här resulterar i att det råder en begreppsförvirring hur VDC ska definieras och hur arbete med VDC ska genomföras. Vidare tenderar många byggprojekt att vara fragmenterade med projektmedlemmar som främst fokuserar på sitt eget teknikområde. För att minska fragmentering mellan projektmedlemmar kan integrerade arbetsmetoder tillämpas. Syftet med examensarbetet är därför dels att undersöka innebörden av VDC som koncept och även hur VDC kan stimulera integrerade arbetsmetoder. Ämnet utforskas kvalitativt med vetenskaplig litteratur och intervjustudie. Den vetenskapliga litteraturen definierar konceptuellt VDC och två integrerade arbetsmetoder Integrated Concurrent Engineering (ICE) och Integrated Project Delivery (IPD). Varvid intervjustudien inkluderar respondenter från byggsektorn vars reflektioner om det studerade ämnet presenteras. Studien är geografiskt avgränsad till Sverige.  I resultatet påvisas den rådande tvetydigheten huruvida VDC definieras. För att undvika begreppsförvirring kan det vara behövligt med en gemensam definition av VDC i byggbranschen och även nationella riktlinjer vilka beskriver hur arbete med VDC ska utföras. Vidare kan VDC stimulera ett integrerat arbetssätt genom en ökad samhörighet inom byggprojekt med bland annat gemensamma formuleringar av projektmål och gemensam problemlösning mellan projektmedlemmar. / Virtual Design and Construction (VDC) was introduced early in the 21st century in order to encourage work with computer based models and construction planning in the design phase. VDC is a concept that has been embraced by several construction and consulting companies in order to develop their work with Building Information Model (BIM), innovations and cooperation within construction projects. VDC is a concept that keeps evolving and is being redefined by individuals and companies. This has contributed to a conceptual confusion within the construction sector about the definition of VDC. Furthermore, construction projects tend to be fragmented with project members that are working in silos and primarily focusing on their own discipline. In order to decrease the fragmentation within construction projects integrated working methods can be applied. Therefor the purpose of this master thesis is to explore the concept VDC and how it can stimulate integrated working methods.  The study is examined using qualitative methods based on scientific literature and an interview study. The scientific literature is defining VDC conceptually and two integrated working methods Integrated Concurrent Engineering (ICE) and Integrated Project Delivery (IPD). Furthermore, the interview study includes respondents from the construction industry whose reflections and thoughts about the subject are being presented. The study is geographically limited to Sweden.  The result shows the current ambiguity of how VDC is defined. In order to avoid a conceptual confusion a common definition should be formulated with national guidelines that describe how work with VDC should be conducted. Furthermore, VDC can stimulate an integrated approach through increased cohesion within construction projects, including common objectives within the project and joint problem solving between project members.

The goal of this Ph.D. research is to explore the IPD contractual strategies, to highlight the elements that distinguish IPD from a traditional delivery approach, to analyze how trust-based relationships are established and promoted, and to demonstrate if/how trust and IPD contractual principles correlate. The result of this research will promote the understanding of the industry on the strategies that promote trust and integration through real world case studies. The significance of the subject becomes more evident when reflecting on the current industry's crisis: productivity loss, fragmented delivery process, and lack of trust and collaboration. Through a literature review a Project Delivery and Contracting Strategies (PDCS) framework, an IPD traits framework, and a trust-Building framework are developed. The frameworks are used as the organizational tools to structure and inquire relevant information on the two IPD projects. An expert panel is assembled to discuss the frameworks and the findings of literature analysis and to seek the industry's insight on the units of analysis for contract, and the units of measure for trust. The units of analysis for contract are elements, such as strategies for risks/rewards sharing, liability considerations, decision making authority, and governance. The units of measure for trust are the individuals' perception, and the trust-building attributes as outlined in table 4-1. Two IPD projects were selected and their contract agreements were studied. A questionnaire including both open-ended questions and multiple choice questions was developed based on the information collected through: 1. the IPD agreements in each case study, 2. the literature-based frameworks on trust and project delivery contracting strategies. Accordingly, two IPD case studies are developed following the analysis of their IPD agreements and the individual one-on-one interviews with their key IPD players. The trust-building framework presented in this work includes a series of techniques that the contracting parties can follow when establishing their contractual and managerial strategies and also when interacting with each other. / Ph. D.

The question in the study is to what extent the Swedish Real estate sector index acts as a follower of larger and broader stock indexes, and to what extent the index follows the asset values owned by the real estate companies in the asset market? The study is interesting for those trying to understand the development of share values in the Swedish real estate market as well as for those interesting in the “efficient market hypothesis”. The study makes an econometric analysis of the relationship between OMXS30, OMXS Real Estate PI, and the asset value of properties owned by Swedish real estate companies. Indexes are compared with Vector Autoregression (VAR) lag models, tested for dependence of GDP, the repo rent, and inflation. A Granger causality test is also performed. Despite discussed problems with reliability of some tests, the study finds that OMXS30 Granger cause OMX Real Estate PI. The study also finds that, during the period studied, OMXS30 and OMX Real Estate PI develop differently in the initial period but later form a similar path of performance. The asset values of the companies in the real estate market are more strongly correlated with OMXS30 than with their own sector index, OMXS Real Estate PI. No significant effects are found from GDP, the repo rent or inflation on OMXS30 or OMXS Real Estate PI. This may be seen as surprising but follows results from earlier studies.

Background: S. pneumoniae is a major cause of meningitis, pneumonia and sepsis in children. In 2006 universal pneumococcal vaccination was recommended in Germany for all children up to their second birthday. We have compared the prevalence and outcome of IPD at a single hospital before and after the introduction of vaccination. Findings: 55 cases of IPD were identified over an 11 year period. Almost half of the patients were younger than 2 years of age. Most of the children were affected by pneumonia. The second highest incidence seen was for meningitis and sepsis. 17 patients exhibited additional complications. Significant pre-existing and predisposing disorders, such as IRAK 4 defect, ALPS or SLE were identified in 4 patients. Complete recovery was seen in 78% of affected children; 11% had a fatal outcome and 11% suffered from long term complications. Only 31% overall had been vaccinated. The most common serotype was 14. Serotypes not covered by any of the current vaccines were also found. Antibiotic treatment commenced with cephalosporins in over 90%. Conclusion: Frequency of IPD in our hospital did not decrease after initiation of the pneumococcal vaccination. This might be due to vaccinations not being administered satisfactorily as well as to poor education about the need of the vaccination. Pre-existing diseases must be monitored and treated accordingly and rare deficiencies taken into account when IPD takes a foudroyant course. In addition, antibiotic stewardship has been initiated at this hospital centre as a consequence of the high cephalosporin use detected in this study.

Rationale: Cigarette cravings are one of the most important clinical phenomena in tobacco addiction. A wide range of studies and research designs may help to increase understanding of the relationship between physical activity (PA) and cigarette cravings. Aims: (i) To investigate the acute effects of walking and isometric exercise on cigarette cravings, withdrawal, and attentional bias among temporarily abstaining smokers. (ii) To quantify the effects of short bouts of PA on cigarette cravings among temporarily abstaining smokers. (iii) To examine who most benefits from PA, whether changes in affect mediate these effects, and whether a specific attribute of PA is associated with cravings. (iv) To investigate whether any association between habitual PA and cravings in smokers could be found. Methods: A randomised controlled crossover trial with three arms addressed aim (i). A systematic review of literature and individual participant data meta-analysis using hierarchical modelling addressed aims (ii) and (iii). Aim (iv) was achieved by using linear regression modelling of cross-sectional data from a smoking cessation study. Results: No difference in cravings, withdrawal, and attentional bias between walking and isometric exercise versus control was found. Bouts of PA decreased cigarette cravings by approximately 30%. Moderate intensity PA provided increased benefit when compared with light intensity, whereas vigorous intensity did not confer additional benefits compared with moderate intensity PA. Also bouts of medium (10 minutes) and longer duration (≥15minutes) appeared to be more effective than short duration (≤ 5 min). No moderators and mediators of this association were identified. Habitual moderate intensity PA was the strongest predictor of cigarette cravings in smokers, MPSS was an additional predictor and alcohol consumption moderated the effects of habitual PA on cravings. Conclusion: Moderate intensity PA could be recommended to smokers to help decrease cigarette cravings.

Ce travail avait pour ambition de caractériser deux processus collisionnels différents impliquant des paires d'ions. Ces derniers, que ce soit sous forme de cations ou sous forme d'anions, ont une importance majeure pour l'astrochimie. Ainsi, il est vital de pouvoir fournir des données théoriques ou expérimentales sur les processus conduisant tant à la formation qu'à la consommation de ces ions. Le premier processus que nous avons étudié, nommé la dissociation en paires d'ions, conduit à la formation d'ions secondaires. Nous avons caractérisé ce processus tant théoriquement qu'expérimentalement. Ainsi, au moyen de collisions à haute vitesse entre un jet d'atomes d'hélium et un faisceau d'agrégats carbonés neutres ou ionisés, nous avons obtenu les différents rapports de branchements et sections efficaces concernant la dissociation en paires d'ions de ces composés de tailles n et de charges q variées. Grâce à ce travail, qui a permis d'effectuer une étude expérimentale sur l'influence de ces deux paramètres, nous avons ainsi montré que la dissociation en paires d'ions est toujours présente, quelle que soit la taille ou la charge du composé étudié. Dans le but de décrire la dissociation en paires d'ions au moyen de méthodes ab initio, nous avons également calculé les courbes d'énergies potentielles relatives aux états très excités de l'ion moléculaire C_2+. Sur base de l'analyse de population de Mulliken des fonctions d'onde relatives à ces états moléculaires, nous avons ainsi pu mettre en évidence le canal ionique impliqué dans la dissociation en paires d'ions de C_2+, via une méthodologie purement ab initio. Nous avons également calculé les taux théoriques de dissociation en paires d'ions pour les molécules C_2+ et C_3+, au moyen d'un modèle statistique basé sur le nombre de limites de dissociation et d'états moléculaires s'y corrélant. Nous avons ainsi pu comparer les données expérimentales et théoriques pour ces deux systèmes et avons montré que ce modèle, malgré de nombreuses hypothèses, permet de prédire le comportement relatif de la dissociation en paires d'ions au sein de ces composés. Le second processus que nous avons caractérisé est la neutralisation mutuelle d'ions atomiques de charges opposées conduisant ainsi à la consommation de ces ions. Nous avons étudié ce processus au sein des systèmes Li+/H-, Li+/D-, O+/O- et N+/O-, à la fois d'un point de vue théorique mais également expérimental. Ainsi, en utilisant un dispositif de faisceaux confluents, nous avons pu mesurer les sections efficaces totales de neutralisation mutuelle pour ces différents systèmes, à des énergies de collisions inférieures à 1 eV. Nous avons également pu obtenir les différents rapports de branchements associés à chacun des états atomiques peuplés au sein de ces systèmes lors de la neutralisation mutuelle. De manière assez surprenante, les mesures obtenues pour les collisions N+/O- ont permis de mettre en évidence une contribution importante d'un état atomique impliquant un processus à deux électrons. Nous avons caractérisé la neutralisation mutuelle au sein de ces quatre systèmes via différentes méthodes théoriques. Ainsi, nous avons utilisé des méthodes ab initio afin de calculer les courbes d'énergies potentielles et les éléments de couplages non-adiabatiques radiaux impliqués dans les systèmes Li+/H- et Li+/D-, en utilisant et en optimisant différentes bases de calculs ab initio. Au moyen d'une méthodologie Landau-Zener multivoies, nous avons ensuite pu mettre en évidence l'influence de ces bases de calculs sur les différentes sections efficaces totales et les rapports de branchements en découlant, tout en comparant les résultats théoriques aux données expérimentales. Dès lors, nous avons pu montrer que les éléments théoriques clés pour la bonne description de la neutralisation mutuelle Li+/H- et Li+/D- sont l'obligation d'utiliser les éléments de couplages non-adiabatiques radiaux ainsi que la description adéquate des croisements évités entre les états moléculaires. Pour des systèmes complexes tels que N+/O- et O+/O-, les méthodes ab initio habituelles ne peuvent être utilisées vu le nombre conséquent d'états moléculaires à prendre en compte afin de décrire la neutralisation mutuelle au sein de ces systèmes. Cependant, nous avons pu obtenir les sections efficaces totales et rapports de branchements théoriques pour ces deux systèmes en utilisant une méthode asymptotique à un électron afin d'obtenir les couplages impliqués dans la neutralisation mutuelle de ces systèmes. Ces couplages ont ensuite été utilisés dans une méthodologie Landau-Zener multivoies afin d'obtenir les sections efficaces totales et rapports de branchements, malgré la complexité de la description théorique de la neutralisation mutuelle O+/O- et N+/O- Dans ce dernier système, nous avons également utilisé des calculs purement atomiques afin de tenir compte du processus à deux électrons, mis en évidence par les résultats expérimentaux. Ainsi, nous avons pu montrer que les sections efficaces et rapports de branchements prédits sont en assez bon accord avec les résultats expérimentaux obtenus au moyen du dispositif expérimental de faisceaux confluents. / Doctorat en Sciences / info:eu-repo/semantics/nonPublished