Trait emotional intelligence: Evidence from italian adolescents and adults

Emotional intelligence (EI) represents an attribute of contemporary attractiveness for the scientific psychology community. Of particular interest for the present thesis are the conundrum related to the representation of this construct conceptualized as a trait (i.e., trait EI), which are in turn reflected in the current lack of agreement upon its constituent elements, posing significant challenges to research and clinical progress. Trait EI is defined as an umbrella personality-alike construct reflecting emotion-related dispositions and self-perceptions. The Trait Emotional Intelligence Questionnaire (TEIQue) was chosen as main measure, given its strong theoretical and psychometrical basis, including superior predictive validity when compared to other trait EI measures. Studies 1 and 2 aimed at validating the Italian 153-items forms of the TEIQue devoted to adolescents and adults. Analyses were done to investigate the structure of the questionnaire, its internal consistencies and gender differences at the facets, factor, and global level of both versions. Despite some low reliabilities, results from Studies 1 and 2 confirm the four-factor structure of the TEIQue. Study 3 investigated the utility of trait EI in a sample of adolescents over internalizing conditions (i.e., symptoms of anxiety and depression) and academic performance (grades at math and Italian language/literacy). Beyond trait EI, concurrent effects of demographic variables, higher order personality dimensions and non-verbal cognitive ability were controlled for. Study 4a and Study 4b addressed analogue research questions, through a meta-analysis and new data in on adults. In the latter case, effects of demographics, emotion regulation strategies, and the Big Five were controlled. Overall, these studies showed the incremental utility of the TEIQue in different domains beyond relevant predictors. Analyses performed at the level of the four-TEIQue factors consistently indicated that its predictive effects were mainly due to the factor Well-Being. Findings are discussed with reference to potential implication for theory and practice.

Tumor burden as assessed by 18 F FDG PET scan as predictive biomarker for immune checkpoint blockers in advanced NSCLC - a multi centric study

Introduction Only a proportion of patients with advanced NSCLC benefit from Immune checkpoint blockers (ICBs). No biomarker is validated to choose between ICBs monotherapy or in combination with chemotherapy (Chemo-ICB) when PD-L1 expression is above 50%. The aim of the present study is to validate the biomarker validity of total Metabolic Tumor Volume (tMTV) as assessed by 2-deoxy-2-[18F]fluoro-d-glucose positron emission tomography ([18F]FDG-PET) Material and methods This is a multicentric retrospective study. Patients with advanced NSCLC treated with ICBs, chemotherapy plus ICBs and chemotherapy were enrolled in 12 institutions from 4 countries. Inclusion criteria was a positive PET scan performed within 42 days from treatment start. TMTV was analyzed at each center based on a 42% SUVmax threshold. High tMTV was defined ad tMTV>median Results 493 patients were included, 163 treated with ICBs alone, 236 with chemo-ICBs and 94 with CT. No correlation was found between PD-L1 expression and tMTV. Median PFS for patients with high tMTV (100.1 cm3) was 3.26 months (95% CI 1.94–6.38) vs 14.70 (95% CI 11.51–22.59) for those with low tMTV (p=0.0005). Similarly median OS for pts with high tMTV was 11.4 months (95% CI 8.42 – 19.1) vs 33.1 months for those with low tMTV (95% CI 22.59 – NA), p .00067. In chemo-ICBs treated patients no correlation was found for OS (p = 0.11) and a borderline correlation was found for PFS (p=0.059). Patients with high tMTV and PD-L1 ≥ 50% had a better PFS when treated with combination of chemotherapy and ICBs respect to ICBs alone, with 3.26 months (95% CI 1.94 – 5.79) for ICBs vs 11.94 (95% CI 5.75 – NA) for Chemo ICBs (p = 0.043). Conclusion tMTV is predictive of ICBs benefit, not to CT benefit. tMTV can help to select the best upfront strategy in patients with high tMTV.

Primary stability in cementless total hip replacement: measurement techniques and aided-surgery

Primary stability of stems in cementless total hip replacements is recognized to play a critical role for long-term survival and thus for the success of the overall surgical procedure. In Literature, several studies addressed this important issue. Different approaches have been explored aiming to evaluate the extent of stability achieved during surgery. Some of these are in-vitro protocols while other tools are coinceived for the post-operative assessment of prosthesis migration relative to the host bone. In vitro protocols reported in the literature are not exportable to the operating room. Anyway most of them show a good overall accuracy. The RSA, EBRA and the radiographic analysis are currently used to check the healing process of the implanted femur at different follow-ups, evaluating implant migration, occurance of bone resorption or osteolysis at the interface. These methods are important for follow up and clinical study but do not assist the surgeon during implantation. At the time I started my Ph.D Study in Bioengineering, only one study had been undertaken to measure stability intra-operatively. No follow-up was presented to describe further results obtained with that device. In this scenario, it was believed that an instrument that could measure intra-operatively the stability achieved by an implanted stem would consistently improve the rate of success. This instrument should be accurate and should give to the surgeon during implantation a quick answer concerning the stability of the implanted stem. With this aim, an intra-operative device was designed, developed and validated. The device is meant to help the surgeon to decide how much to press-fit the implant. It is essentially made of a torsional load cell, able to measure the extent of torque applied by the surgeon to test primary stability, an angular sensor that measure the relative angular displacement between stem and femur, a rigid connector that enable connecting the device to the stem, and all the electronics for signals conditioning. The device was successfully validated in-vitro, showing a good overall accuracy in discriminating stable from unstable implants. Repeatability tests showed that the device was reliable. A calibration procedure was then performed in order to convert the angular readout into a linear displacement measurement, which is an information clinically relevant and simple to read in real-time by the surgeon. The second study reported in my thesis, concerns the evaluation of the possibility to have predictive information regarding the primary stability of a cementless stem, by measuring the micromotion of the last rasp used by the surgeon to prepare the femoral canal. This information would be really useful to the surgeon, who could check prior to the implantation process if the planned stem size can achieve a sufficient degree of primary stability, under optimal press fitting conditions. An intra-operative tool was developed to this aim. It was derived from a previously validated device, which was adapted for the specific purpose. The device is able to measure the relative micromotion between the femur and the rasp, when a torsional load is applied. An in-vitro protocol was developed and validated on both composite and cadaveric specimens. High correlation was observed between one of the parameters extracted form the acquisitions made on the rasp and the stability of the corresponding stem, when optimally press-fitted by the surgeon. After tuning in-vitro the protocol as in a closed loop, verification was made on two hip patients, confirming the results obtained in-vitro and highlighting the independence of the rasp indicator from the bone quality, anatomy and preserving conditions of the tested specimens, and from the sharpening of the rasp blades. The third study is related to an approach that have been recently explored in the orthopaedic community, but that was already in use in other scientific fields. It is based on the vibration analysis technique. This method has been successfully used to investigate the mechanical properties of the bone and its application to evaluate the extent of fixation of dental implants has been explored, even if its validity in this field is still under discussion. Several studies have been published recently on the stability assessment of hip implants by vibration analysis. The aim of the reported study was to develop and validate a prototype device based on the vibration analysis technique to measure intra-operatively the extent of implant stability. The expected advantages of a vibration-based device are easier clinical use, smaller dimensions and minor overall cost with respect to other devices based on direct micromotion measurement. The prototype developed consists of a piezoelectric exciter connected to the stem and an accelerometer attached to the femur. Preliminary tests were performed on four composite femurs implanted with a conventional stem. The results showed that the input signal was repeatable and the output could be recorded accurately. The fourth study concerns the application of the device based on the vibration analysis technique to several cases, considering both composite and cadaveric specimens. Different degrees of bone quality were tested, as well as different femur anatomies and several levels of press-fitting were considered. The aim of the study was to verify if it is possible to discriminate between stable and quasi-stable implants, because this is the most challenging detection for the surgeon in the operation room. Moreover, it was possible to validate the measurement protocol by comparing the results of the acquisitions made with the vibration-based tool to two reference measurements made by means of a validated technique, and a validated device. The results highlighted that the most sensitive parameter to stability is the shift in resonance frequency of the stem-bone system, showing high correlation with residual micromotion on all the tested specimens. Thus, it seems possible to discriminate between many levels of stability, from the grossly loosened implant, through the quasi-stable implants, to the definitely stable one. Finally, an additional study was performed on a different type of hip prosthesis, which has recently gained great interest thus becoming fairly popular in some countries in the last few years: the hip resurfacing prosthesis. The study was motivated by the following rationale: although bone-prosthesis micromotion is known to influence the stability of total hip replacement, its effect on the outcome of resurfacing implants has not been investigated in-vitro yet, but only clinically. Thus the work was aimed at verifying if it was possible to apply to the resurfacing prosthesis one of the intraoperative devices just validated for the measurement of the micromotion in the resurfacing implants. To do that, a preliminary study was performed in order to evaluate the extent of migration and the typical elastic movement for an epiphyseal prosthesis. An in-vitro procedure was developed to measure micromotions of resurfacing implants. This included a set of in-vitro loading scenarios that covers the range of directions covered by hip resultant forces in the most typical motor-tasks. The applicability of the protocol was assessed on two different commercial designs and on different head sizes. The repeatability and reproducibility were excellent (comparable to the best previously published protocols for standard cemented hip stems). Results showed that the procedure is accurate enough to detect micromotions of the order of few microns. The protocol proposed was thus completely validated. The results of the study demonstrated that the application of an intra-operative device to the resurfacing implants is not necessary, as the typical micromovement associated to this type of prosthesis could be considered negligible and thus not critical for the stabilization process. Concluding, four intra-operative tools have been developed and fully validated during these three years of research activity. The use in the clinical setting was tested for one of the devices, which could be used right now by the surgeon to evaluate the degree of stability achieved through the press-fitting procedure. The tool adapted to be used on the rasp was a good predictor of the stability of the stem. Thus it could be useful for the surgeon while checking if the pre-operative planning was correct. The device based on the vibration technique showed great accuracy, small dimensions, and thus has a great potential to become an instrument appreciated by the surgeon. It still need a clinical evaluation, and must be industrialized as well. The in-vitro tool worked very well, and can be applied for assessing resurfacing implants pre-clinically.

The assessment of change in rural landscape and the analysis of the driving forces. Proposal of a spatial model for the rural built environment

The presented study carried out an analysis on rural landscape changes. In particular the study focuses on the understanding of driving forces acting on the rural built environment using a statistical spatial model implemented through GIS techniques. It is well known that the study of landscape changes is essential for a conscious decision making in land planning. From a bibliography review results a general lack of studies dealing with the modeling of rural built environment and hence a theoretical modelling approach for such purpose is needed. The advancement in technology and modernity in building construction and agriculture have gradually changed the rural built environment. In addition, the phenomenon of urbanization of a determined the construction of new volumes that occurred beside abandoned or derelict rural buildings. Consequently there are two types of transformation dynamics affecting mainly the rural built environment that can be observed: the conversion of rural buildings and the increasing of building numbers. It is the specific aim of the presented study to propose a methodology for the development of a spatial model that allows the identification of driving forces that acted on the behaviours of the building allocation. In fact one of the most concerning dynamic nowadays is related to an irrational expansion of buildings sprawl across landscape. The proposed methodology is composed by some conceptual steps that cover different aspects related to the development of a spatial model: the selection of a response variable that better describe the phenomenon under study, the identification of possible driving forces, the sampling methodology concerning the collection of data, the most suitable algorithm to be adopted in relation to statistical theory and method used, the calibration process and evaluation of the model. A different combination of factors in various parts of the territory generated favourable or less favourable conditions for the building allocation and the existence of buildings represents the evidence of such optimum. Conversely the absence of buildings expresses a combination of agents which is not suitable for building allocation. Presence or absence of buildings can be adopted as indicators of such driving conditions, since they represent the expression of the action of driving forces in the land suitability sorting process. The existence of correlation between site selection and hypothetical driving forces, evaluated by means of modeling techniques, provides an evidence of which driving forces are involved in the allocation dynamic and an insight on their level of influence into the process. GIS software by means of spatial analysis tools allows to associate the concept of presence and absence with point futures generating a point process. Presence or absence of buildings at some site locations represent the expression of these driving factors interaction. In case of presences, points represent locations of real existing buildings, conversely absences represent locations were buildings are not existent and so they are generated by a stochastic mechanism. Possible driving forces are selected and the existence of a causal relationship with building allocations is assessed through a spatial model. The adoption of empirical statistical models provides a mechanism for the explanatory variable analysis and for the identification of key driving variables behind the site selection process for new building allocation. The model developed by following the methodology is applied to a case study to test the validity of the methodology. In particular the study area for the testing of the methodology is represented by the New District of Imola characterized by a prevailing agricultural production vocation and were transformation dynamic intensively occurred. The development of the model involved the identification of predictive variables (related to geomorphologic, socio-economic, structural and infrastructural systems of landscape) capable of representing the driving forces responsible for landscape changes.. The calibration of the model is carried out referring to spatial data regarding the periurban and rural area of the study area within the 1975-2005 time period by means of Generalised linear model. The resulting output from the model fit is continuous grid surface where cells assume values ranged from 0 to 1 of probability of building occurrences along the rural and periurban area of the study area. Hence the response variable assesses the changes in the rural built environment occurred in such time interval and is correlated to the selected explanatory variables by means of a generalized linear model using logistic regression. Comparing the probability map obtained from the model to the actual rural building distribution in 2005, the interpretation capability of the model can be evaluated. The proposed model can be also applied to the interpretation of trends which occurred in other study areas, and also referring to different time intervals, depending on the availability of data. The use of suitable data in terms of time, information, and spatial resolution and the costs related to data acquisition, pre-processing, and survey are among the most critical aspects of model implementation. Future in-depth studies can focus on using the proposed model to predict short/medium-range future scenarios for the rural built environment distribution in the study area. In order to predict future scenarios it is necessary to assume that the driving forces do not change and that their levels of influence within the model are not far from those assessed for the time interval used for the calibration.

Model predictive flight control systems for rotorcraft UAS

Constraints are widely present in the flight control problems: actuators saturations or flight envelope limitations are only some examples of that. The ability of Model Predictive Control (MPC) of dealing with the constraints joined with the increased computational power of modern calculators makes this approach attractive also for fast dynamics systems such as agile air vehicles. This PhD thesis presents the results, achieved at the Aerospace Engineering Department of the University of Bologna in collaboration with the Dutch National Aerospace Laboratories (NLR), concerning the development of a model predictive control system for small scale rotorcraft UAS. Several different predictive architectures have been evaluated and tested by means of simulation, as a result of this analysis the most promising one has been used to implement three different control systems: a Stability and Control Augmentation System, a trajectory tracking and a path following system. The systems have been compared with a corresponding baseline controller and showed several advantages in terms of performance, stability and robustness.

Studio dei metodi di valutazione della pericolosità associata ai "debris flow" in ambiente alpino

The present work concerns with the study of debris flows and, in particular, with the related hazard in the Alpine Environment. During the last years several methodologies have been developed to evaluate hazard associated to such a complex phenomenon, whose velocity, impacting force and inappropriate temporal prediction are responsible of the related high hazard level. This research focuses its attention on the depositional phase of debris flows through the application of a numerical model (DFlowz), and on hazard evaluation related to watersheds morphometric, morphological and geological characterization. The main aims are to test the validity of DFlowz simulations and assess sources of errors in order to understand how the empirical uncertainties influence the predictions; on the other side the research concerns with the possibility of performing hazard analysis starting from the identification of susceptible debris flow catchments and definition of their activity level. 25 well documented debris flow events have been back analyzed with the model DFlowz (Berti and Simoni, 2007): derived form the implementation of the empirical relations between event volume and planimetric and cross section inundated areas, the code allows to delineate areas affected by an event by taking into account information about volume, preferential flow path and digital elevation model (DEM) of fan area. The analysis uses an objective methodology for evaluating the accuracy of the prediction and involve the calibration of the model based on factors describing the uncertainty associated to the semi empirical relationships. The general assumptions on which the model is based have been verified although the predictive capabilities are influenced by the uncertainties of the empirical scaling relationships, which have to be necessarily taken into account and depend mostly on errors concerning deposited volume estimation. In addition, in order to test prediction capabilities of physical-based models, some events have been simulated through the use of RAMMS (RApid Mass MovementS). The model, which has been developed by the Swiss Federal Institute for Forest, Snow and Landscape Research (WSL) in Birmensdorf and the Swiss Federal Institute for Snow and Avalanche Research (SLF) takes into account a one-phase approach based on Voellmy rheology (Voellmy, 1955; Salm et al., 1990). The input file combines the total volume of the debris flow located in a release area with a mean depth. The model predicts the affected area, the maximum depth and the flow velocity in each cell of the input DTM. Relatively to hazard analysis related to watersheds characterization, the database collected by the Alto Adige Province represents an opportunity to examine debris-flow sediment dynamics at the regional scale and analyze lithologic controls. With the aim of advancing current understandings about debris flow, this study focuses on 82 events in order to characterize the topographic conditions associated with their initiation , transportation and deposition, seasonal patterns of occurrence and examine the role played by bedrock geology on sediment transfer.

Immunohistochemical and Molecular Prognostic/Predictive Markers in Neoplastic Diseases

Traditional morphological examinations are not anymore sufficient for a complete evaluation of tumoral tissue and the use of neoplastic markers is of utmost importance. Neoplastic markers can be classified in: diagnostic, prognostic and predictive markers. Three markers were analyzed. 1) Insulin-like growth factor binding protein 2 (IGFBP2) was immunohistochemically examined in prostatic tissues: 40 radical prostatectomies from hormonally untreated patients with their preoperative biopsies, 10 radical prostatectomies from patients under complete androgen ablation before surgery and 10 simple prostatectomies from patients with bladder outlet obstruction. Results were compared with α-methylacyl-CoA racemase (AMACR). IGFBP2 was expressed in the cytoplasm of untreated adenocarcinomas and, to a lesser extent, in HG-PIN; the expression was markedly lower in patients after complete androgen ablation. AMACR was similarly expressed in both adenocarcinoma and HG-PIN, the level being similar in both lesions; the expression was slightly lower in patients after complete androgen ablation. IGFBP2 may be used a diagnostic marker of prostatic adenocarcinomas. 2) Heparan surface proteoglycan immunohistochemical expression was examined in 150 oral squamous cell carcinomas. Follow up information was available in 93 patients (range: 6-34 months, mean: 19±7). After surgery, chemotherapy was performed in 8 patients and radiotherapy in 61 patients. Multivariate and univariate overall survival analyses showed that high expression of syndecan-1 (SYN-1) was associated with a poor prognosis. In patients treated with radiotherapy, such association was higher. SYN-1 is a prognostic marker in oral squamous cell carcinomas; it may also represent a predictive factor for responsiveness to radiotherapy. 3) EGFR was studied in 33 pulmonary adenocarcinomas with traditional DNA sequencing methods and with two mutation-specific antibodies. Overall, the two antibodies had 61.1% sensitivity and 100% specificity in detecting EGFR mutations. EGFR mutation-specific antibodies may represent a predictive marker to identify patients candidate to tyrosine kinase inhibitors therapy.

Predictive Ability of NGAL as a Marker of Renal Damage: evaluation of Multiple Clinical Settings

Introduction. Neutrophil Gelatinase-Associated Lipocalin (NGAL) belongs to the family of lipocalins and it is produced by several cell types, including renal tubular epithelium. In the kidney its production increases during acute damage and this is reflected by the increase in serum and urine levels. In animal studies and clinical trials, NGAL was found to be a sensitive and specific indicator of acute kidney injury (AKI). Purpose. The aim of this work was to investigate, in a prospective manner, whether urine NGAL can be used as a marker in preeclampsia, kidney transplantation, VLBI and diabetic nephropathy. Materials and methods. The study involved 44 consecutive patients who received renal transplantation; 18 women affected by preeclampsia (PE); a total of 55 infants weighing ≤1500 g and 80 patients with Type 1 diabetes. Results. A positive correlation was found between urinary NGAL and 24 hours proteinuria within the PE group. The detection of higher uNGAL values in case of severe PE, even in absence of statistical significance, confirms that these women suffer from an initial renal damage. In our population of VLBW infants, we found a positive correlation of uNGAL values at birth with differences in sCreat and eGFR values from birth to day 21, but no correlation was found between uNGAL values at birth and sCreat and eGFR at day 7. systolic an diastolic blood pressure decreased with increasing levels of uNGAL. The patients with uNGAL <25 ng/ml had significantly higher levels of systolic blood pressure compared with the patients with uNGAL >50 ng/ml ( p<0.005). Our results indicate the ability of NGAL to predict the delay in functional recovery of the graft. Conclusions. In acute renal pathology, urinary NGAL confirms to be a valuable predictive marker of the progress and status of acute injury.

Model predictive control in thermal management of multiprocessor systems-on-chip

MultiProcessor Systems-on-Chip (MPSoC) are the core of nowadays and next generation computing platforms. Their relevance in the global market continuously increase, occupying an important role both in everydaylife products (e.g. smartphones, tablets, laptops, cars) and in strategical market sectors as aviation, defense, robotics, medicine. Despite of the incredible performance improvements in the recent years processors manufacturers have had to deal with issues, commonly called “Walls”, that have hindered the processors development. After the famous “Power Wall”, that limited the maximum frequency of a single core and marked the birth of the modern multiprocessors system-on-chip, the “Thermal Wall” and the “Utilization Wall” are the actual key limiter for performance improvements. The former concerns the damaging effects of the high temperature on the chip caused by the large power densities dissipation, whereas the second refers to the impossibility of fully exploiting the computing power of the processor due to the limitations on power and temperature budgets. In this thesis we faced these challenges by developing efficient and reliable solutions able to maximize performance while limiting the maximum temperature below a fixed critical threshold and saving energy. This has been possible by exploiting the Model Predictive Controller (MPC) paradigm that solves an optimization problem subject to constraints in order to find the optimal control decisions for the future interval. A fully-distributedMPC-based thermal controller with a far lower complexity respect to a centralized one has been developed. The control feasibility and interesting properties for the simplification of the control design has been proved by studying a partial differential equation thermal model. Finally, the controller has been efficiently included in more complex control schemes able to minimize energy consumption and deal with mixed-criticalities tasks

The vulnerable carotid plaque. Identification of endothelial markers predictive of plaque weakness, rupture predisposition and neoangiogenesis

Background. Neoangiogenesis is crucial in plaque progression and instability. Previous data from our group demonstrated that intra-plaque neovessels show both a Nestin+/WT+ and a Nestin+/WT1- phenotype, the latter being correlated with complications and plaque instability. Aims. The aims of the present thesis are: (i) to confirm our previous results on Nestin/WT1 phenotype in a larger series of carotid atheromatous plaques, (ii) to evaluate the relationship between the Nestin+/WT1- neoangiogenesis phenotype and plaque morphology, (iii) to evaluate the relationship between the immunohistochemical and histopathological characteristics and the clinical instability of the plaques. Materials and Methods. Seventy-three patients (53 males, 20 females, mean age 71 years) were consecutively enrolled. Symptoms, brain CT scan, 14 histological variables, including intraplaque hemorrhage and diffuse calcifications, were collected. Immunohistochemistry for CD34, Nestin and WT1 was performed. RT-PCR was performed to evaluate Nestin and WT1 mRNA (including 5 healthy arteries as controls). Results. Diffusely calcified plaques (13 out of 73) were found predominantly in females (P=0.017), with a significantly lower incidence of symptoms (TIA/stroke) and brain focal lesions (P=0.019 and P=0.013 respectively) than not-calcified plaques, but with the same incidence of intraplaque complications (P=0.156). Accordingly, both calcified and not calcified plaques showed similar mean densities of positivity for CD34, Nestin and WT1. The density of Nestin and WT1 correlated with the occurrence of intra-plaque hemorrhage in all cases, while the density of CD34 correlated only in not-calcified plaques. Conclusions. We confirmed that the Nestin+/WT1- phenotype characterizes the neovessels of instable plaques, regardless the real amount of CD34-positive neoangiogenesis. The calcified plaques show the same incidence of histological complications, albeit they do not influence symptomatology and plaque vulnerability. Female patients show a much higher incidence of not-complicated or calcified plaques, receiving de facto a sort of protection compared to male patients.

Biomedical engineering for healthy ageing. Predictive tools for falls

Falls are common and burdensome accidents among the elderly. About one third of the population aged 65 years or more experience at least one fall each year. Fall risk assessment is believed to be beneficial for fall prevention. This thesis is about prognostic tools for falls for community-dwelling older adults. We provide an overview of the state of the art. We then take different approaches: we propose a theoretical probabilistic model to investigate some properties of prognostic tools for falls; we present a tool whose parameters were derived from data of the literature; we train and test a data-driven prognostic tool. Finally, we present some preliminary results on prediction of falls through features extracted from wearable inertial sensors. Heterogeneity in validation results are expected from theoretical considerations and are observed from empirical data. Differences in studies design hinder comparability and collaborative research. According to the multifactorial etiology of falls, assessment on multiple risk factors is needed in order to achieve good predictive accuracy.