Testosterone products comprise a multi-billion dollar industry; however, Health Canada and the United States Food and Drug Administration have issued statements of concern about their safety, and their benefits are unclear. In the first phase of this study, we performed a systematic review of the current evidence for the benefits of testosterone replacement therapy. In the second phase, we analyzed the evidence from randomized controlled trials for the benefits of testosterone replacement therapy (depression, quality of life, erectile function, libido, total testosterone level). In the third phase, we analyzed data for harms (cardiovascular death, myocardial infarction, stroke, newly diagnosed prostate cancer, coronary artery disease or diabetes, serious adverse events, withdrawals due to adverse events, erythrocytosis) from randomized controlled trials and non-randomized studies. In general, most included studies had a short duration and were poorly reported. Additional high-quality research into the long-term safety of testosterone products is needed.

As the HIV-positive population ages, managing non-AIDS-related comorbidities such as cardiovascular disease (CVD) complicates HIV care. Effectively treating risk factors for CVD will help reduce its burden in the HIV-infected population. However, the evidence base for the efficacy of statins as lipid-lowering therapies in HIV-infected patients has yet to be synthesized. Most trials do not compare statins directly to each other. In the absence of head-to-head evidence, the relative treatment effects of different statins can be indirectly obtained through a network meta-analysis (NMA). This NMA aims to evaluate the use of statins for treating dyslipidemia in HIV-infected individuals. Bayesian methods were used for obtaining treatment effect estimates and probabilistic rankings of treatments. Among lipid-lowering therapies, statins were most effective in treating dyslipidemia. All statins were found to offer the same treatment benefits. To our knowledge, this is the first NMA on this topic. It provides clinicians, health economists, and policy decision-makers with precise and reliable estimates for making definitive recommendations for the use of statins in dyslipidemic HIV-positive patients.

ACette thèse s’intéresse à l’étude des modèles de transactions plates et étendues dans les SGBD temps réel (SGBDTR). Ce travail est réalisé en deux étapes : (i) la première étape vise à aider les concepteurs à décrire et comparer les modèles de transactions temps réel, (ii) La seconde étape permet de compléter cette étude par la présentation d’une étude stochastique des performances des SGBDTR de deux modèles de transactions temps réel, à savoir le modèle de transactions plates et le modèle de transactions emboîtées. Dans la première étape, nous avons présenté le méta-modèle « MRT-ACTA » qui prend en compte les caractéristiques temporelles des transactions et de données temps réel ainsi que leurs interactions, offrant ainsi aux concepteurs la possibilité de définir de nouveaux modèles de transactions temps réel et de les comparer. La description formelle de « M-RT-ACTA » a permis de valider nos propositions. Pour compléter ce travail et ayant constaté que l’ordonnancement des transactions est un aspect primordial dans les SGBDTR, nous avons proposé dans la seconde étape de présenter une étude stochastique des performances des SGBDTR. Ainsi, nous avons proposé une amélioration des taux de succès des transactions plates avec le protocole GEDF (généralisation de EDF) et nous avons adapté cette étude aux transactions emboîtées. / This thesis presents a study of flat and extended model of transactions in real-time DBMS (RTDBMSs). This study is carried in two steps : (i) the first step aims to help designers to describe and compare models of real-time transactions, (ii) the second step allows to complete this study by presenting a stochastic study of RTDBMSs performance using two models of real-time transactions : flat transactions and nested transactions models. In the first step, we introduced the meta-model « MRT-ACTA » that takes into account the transactions and data temporal characteristics and their realtime interactions. « M-RT-ACTA » allows designers defining and comparing new models of real-time transactions. The formal description of « M-RT-ACTA » validates our proposals. In order to complete this work, we have observed that transactions scheduling is an important area in RTDBMSs, so we proposed in the second step a stochastic study of RTDBMS performance. Thus, we have proposed to improve the success ratio of flat transactions with GEDF protocol (generalization of GEDF) and we have adapted this study to nested transactions.

Class of 2008 Abstract / Objectives: To assess the effect of treatment with placebo on weight loss in obese patients. Methods: The placebo groups from nine orlistat and three sibutramine weight loss studies, as identified from the Padwal meta-analysis, were analyzed for: weight loss in kilograms; change in BMI; type of nutrition and exercise interventions; and bias. The means and standard deviations for weight loss were entered into the Stata meta-analysis program to obtain a forest plot to determine an overall estimate of weight loss. The Potential for Methodological Bias Assessment Tool (PMBAT) was used to create a bias score for each study. Results: Overall, subjects in the placebo group lost 3.8 kg (p<0.001). Placebo subjects in the orlistat trials lost significantly more weight (4.3 kg) than did subjects in the sibutramine trials (1.1 kg, p=0.014). The subjects in the sibutramine studies did not lose a significant amount of weight (p=0.397). There were distinct differences between the sibutramine and orlistat studies with regard to nutrition and exercise interventions. The mean score on the PMBAT was 16.7 ± 3.6; and no study scored higher than 25 out of 45 total points. Conclusions: Overall subjects in the placebo group in the combined orlistat and sibutramine studies lost a significant amount of weight. Differences in study design, bias, and the Hawthorne effect may have contributed to this weight loss.

Despite the large volume of research in the area of loyalty-repurchase-satisfaction, the findings on the relationship between these variables are conflicting. It seems that links between loyalty, repurchase, and satisfaction are not fully understood yet. The study provided the theoretical background on loyalty, repurchase, satisfaction, and their interrelationships. The Theory of Planned Behavior and the Expectation Confirmation Theory were discussed. The loyalty-repurchase differentiation with five contributing factors was addressed. From the literature review nine hypotheses were proposed. The study was conducted in three phases. The purpose of the first phase was to statistically identify the magnitude and the direction of relationships: loyalty-satisfaction, repurchase-satisfaction, and loyalty-repurchase by providing a quantitative review. A Hunter and Schmidt (1990) meta-analysis technique was employed. The results demonstrated that those three constructs have positive, strong relationships. However, the relationships were moderated by a number of factors, including the geographic region of the collected sample, the category (products versus service), and the business setting (B2B versus B2C). The purpose of the second phase was to statistically identify relationships between the research constructs, such as loyalty dimensions (commitment, trust, involvement, and word of mouth), repurchase/repurchase intent, and satisfaction, by conducting a field study with customers of apparel products. A structural equation modeling technique was employed to test the proposed hypotheses. Eight hypotheses were supported. The results indicated that although positive relationships between the research constructs exist, not all relationships are significantly strong. The purpose of the third phase was to compare the meta-analysis results, obtained from the large number of independent empirical studies, with the field study results, obtained from surveying consumers of apparel products. The overall findings of this research indicated that while meta-analysis and the field study results agree on positive relationships between the research constructs, the differences lay within the strength of the investigated relationships. The possible explanation was provided based on the theoretical foundation from the literature review. The study contributes to the growing knowledge of the relationships between loyalty, repurchase, and satisfaction by assessing the current state of the empirical research on those three variables. This research addresses the existing gap in the literature, and attempts to resolve the existing mixed views on the studied concepts. The mixed results of meta-analysis and the field study in terms of the strength of the investigated relationships indicate the need to expand this area of research further.

Meta-parenting, defined as parents thinking about their parenting, has been identified and is a new field of research. The purposes of this study were to add to the existing knowledge of meta-parenting and to compare the influences of gender, work status, and parenting experience on meta-parenting occurring in parents of infants and toddlers. Sixty parents participated either electronically or by completing a written survey and reported engaging from "sometimes" to "usually" in four domains of meta-parenting: anticipating, assessing, reflecting, and problem-solving. Gender, work status, and parenting experience did not significantly influence participants' meta-parenting scores. Parents were found to have a higher sense of satisfaction and overall sense of competence when they engaged in higher levels of meta-parenting.

Orientador: Fernando Antônio Campos Gomide / Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Engenharia Elétrica e de Computação / Made available in DSpace on 2018-08-18T11:42:14Z (GMT). No. of bitstreams: 1 Marques_VitorHugoAlmeida_M.pdf: 2517224 bytes, checksum: e0259e1018ac57ec9a5cb95e0d65284b (MD5) Previous issue date: 2011 / Resumo: Esta dissertação introduz um sistema nebuloso genético (SNG) para adaptação de parâmetros em meta-heurísticas. Duas meta-heurísticas entre as mais usadas foram consideradas como exemplos, algoritmo genético e busca tabu. Os parâmetros trabalhados na busca tabu são relacionados às memórias, de curto prazo e de longo prazo. Já os parâmetros do algoritmo genético a sofrer adaptação são as taxas de reprodução e mutação. Sistemas baseados em regras nebulosas oferecem um mecanismo natural para descrever comportamentos globais como combinação de regras de controle. Eles também herdam um meio de gradualmente alternar entre regras que conjuntamente definem uma estratégia de controle. Dessa forma, esses sistemas são candidatos naturais para construir estratégias de controle de parâmetro porque eles proveem um maneira de desenvolver mecanismos baseados na natureza específica de uma região de busca e as transições entre suas fronteiras. Uma aplicação usando o problema clássico de roteamento de veículos com janela de tempo foi incluído para avaliar o desempenho do sistema nebuloso genético. Resultados experimentais mostram que meta-heurísticas com o mecanismo de adaptação com SNG melhoram o comportamento da busca e a qualidade das soluções quando comparado à versões padrões ( sem SNG ) e com parâmetros constantes dos algoritmos genético e busca tabu. Eles também geram boas soluções sub-ótimas mais rápidas que métodos exatos desenvolvidos para o problema e que são reportados na literatura / Abstract: This dissertation introduces a genetic fuzzy system for parameter adaptation of metaheuristics. Two metaheuristics, among the most used ones, have been considered as examples, genetic algorithm and tabu search. The considered parameters of the tabu search are related to the short and long term memories. Parameters of the genetic algorithm under adaptation are the mutation and reproduction rates. Fuzzy rule-based models offer a natural mechanism to describe global behavior as a combination of control rules. They also inherit a means to gradually shift between control rules which jointly defines a control strategy. They are a natural candidate to construct parameter control strategies because they provide a way to develop decision mechanisms based on the specific nature of search regions and transitions between their boundaries. An application using the classic vehicle routing problem with time windows is included to evaluate the genetic fuzzy system performance. Experimental results show that metaheuristics with GFS improve search behavior and solution quality when compared against standard, constant parameters genetic and tabu search approaches. It also provides reasonably good suboptimal solutions faster than specially tailored exact methods reported in the literature / Mestrado / Engenharia de Computação / Mestre em Engenharia Elétrica

O problema do caixeiro viajante (PCV) é um problema clássico de otimização que possui diversas variações, aplicações e instâncias. Encontrar a solução ótima para muitas instâncias desse problema é geralmente muito difícil devido o alto custo computacional. Vários métodos de otimização, conhecidos como meta-heurísticas (MHs), são capazes de encontrar boas soluções para o PCV. Muitos algoritmos baseados em diversas MHs têm sido propostos e investigados para diferentes variações do PCV. Como não existe um algoritmo universal que encontre a melhor solução para todas as instâncias de um problema, diferentes MHs podem prover a melhor solução para diferentes instâncias do PCV. Desse modo, a seleção a priori da MH que produza a melhor solução para uma dada instância é uma tarefa difícil. A pesquisa desenvolvida nesta tese investiga o uso de abordagens de meta-aprendizado para selecionar as MHs mais promissoras para novas instâncias de PCV. Essas abordagens induzem meta-modelos preditivos a partir do treinamento das técnicas de aprendizado de máquina em um conjunto de meta-dados. Cada meta-exemplo, em nosso conjunto de meta-dados, representa uma instância de PCV descrita por características (meta-atributos) do PCV e pelo desempenho das MHs (meta-atributo alvo) para essa instância. Os meta-modelos induzidos são usados para indicar os valores do meta-atributo alvo para novas instâncias do PCV. Vários experimentos foram realizados durante a investigação desta pesquisa e resultados importantes foram obtidos / The traveling salesman problem (TSP) is a classical optimization problem that has several variations, applications and instances. To find the optimal solution for many instances of this problem is usually a very hard task due to high computational cost. Various optimization methods, known as metaheuristics (MHs), are capable to generate good solutions for the TSP. Many algorithms based on different MHs have been proposed and investigated for different variations of the TSP. Different MHs can provide the best optimization solution for different TSP instances, since there is no a universal algorithm able to find the best solution for all instances. Thus, a priori selection of the MH that produces the best solution for a given instance is a hard task. The research developed in this thesis investigates the use of meta-learning approaches to select the most promising MHs for new TSP instances. These approaches induce predictive meta-models from the training of machine learning techniques on a set of meta-data. In our meta-data, each meta-example is a TSP instance described by problem characteristics (meta-features) and performance of MHs (target meta-features) for this instance. The induced meta-models are used to indicate the values of the target meta-feature for new TSP instances. During the investigation of this research, several experiments were performed and important results were obtained

The purpose of the meta-analysis was to address the varied and somewhat stratified study results within the area of singing ability and instruction by statistically summarizing the data of related studies. An analysis yielded a small overall mean effect size for instruction across 34 studies, 433 unique effects, and 5,497 participants ranging in age from 5- to 11-years old (g = 0.43). The largest overall study effect size across categorical variables included the effects of same and different discrimination techniques on mean score gains. The largest overall effect size across categorical moderator variables included research design: Pretest-posttest 1 group design. Overall mean effects by primary moderator variable ranged from trivial to moderate. Feedback yielded the largest effect regarding teaching condition, 8-year-old children yielded the largest effect regarding age, girls yielded the largest effect regarding gender, the Boardman assessment measure yielded the largest effect regarding measurement instrument, and song accuracy yielded the largest effect regarding measured task. Conclusions address implications for teaching, research pedagogy, and research practice within the field of music education.

Philosophiae Doctor - PhD / Overweight/obesity is a risk factor for non-communicable diseases such as cardiovascular diseases, diabetes, and some cancers. Obesity in childhood is known to predict later obesity in adolescence and adulthood. Understanding the factors associated with overweight/obesity among children may present an opportunity for timely and appropriate interventions in the African setting.