863 resultados para Determinants of mortality
Resumo:
BACKGROUND: The purpose of this study was to confirm the prognostic value of pancreatic stone protein (PSP) in patients with severe infections requiring ICU management and to develop and validate a model to enhance mortality prediction by combining severity scores with biomarkers. METHODS: We enrolled prospectively patients with severe sepsis or septic shock in mixed tertiary ICUs in Switzerland (derivation cohort) and Brazil (validation cohort). Severity scores (APACHE [Acute Physiology and Chronic Health Evaluation] II or Simplified Acute Physiology Score [SAPS] II) were combined with biomarkers obtained at the time of diagnosis of sepsis, including C-reactive-protein, procalcitonin (PCT), and PSP. Logistic regression models with the lowest prediction errors were selected to predict in-hospital mortality. RESULTS: Mortality rates of patients with septic shock enrolled in the derivation cohort (103 out of 158) and the validation cohort (53 out of 91) were 37% and 57%, respectively. APACHE II and PSP were significantly higher in dying patients. In the derivation cohort, the models combining either APACHE II, PCT, and PSP (area under the receiver operating characteristic curve [AUC], 0.721; 95% CI, 0.632-0.812) or SAPS II, PCT, and PSP (AUC, 0.710; 95% CI, 0.617-0.802) performed better than each individual biomarker (AUC PCT, 0.534; 95% CI, 0.433-0.636; AUC PSP, 0.665; 95% CI, 0.572-0.758) or severity score (AUC APACHE II, 0.638; 95% CI, 0.543-0.733; AUC SAPS II, 0.598; 95% CI, 0.499-0.698). These models were externally confirmed in the independent validation cohort. CONCLUSIONS: We confirmed the prognostic value of PSP in patients with severe sepsis and septic shock requiring ICU management. A model combining severity scores with PCT and PSP improves mortality prediction in these patients.
Resumo:
Both intra- and inter-sexual selection may crucially determine a male's fitness. Their interplay, which has rarely been experimentally investigated, determines a male's optimal reproductive strategy and thus is of fundamental importance to the understanding of a male's behaviour. Here we investigated the relative importance of intra- and inter-sexual selection for male fitness in the common lizard. We investigated which male traits predict a male's access to reproduction allowing for both selective pressures and comparing it with a staged mating experiment excluding all types of intra-sexual selection. We found that qualitatively better males were more likely to reproduce and that sexual selection was two times stronger when allowing for both selective pressures, suggesting that inter- and intra-sexual selection determines male fitness and confirming the existence of multi-factorial sexual selection. Consequently, to optimize fitness, males should trade their investment between the traits, which are important for inter- and intra-sexual selection.
Resumo:
Interest in public accountability and government transparency is increasing worldwide. The literature on the determinants of transparency is evolving but is still in its early stages. So far, it has typically focused on national or regional governments while neglecting the local government level. This paper builds on the scarce knowledge available in order to examine the economic, social, and institutional determinants of local government transparency in Spain. We draw on a 2010 survey and the transparency indexes constructed by the NGO Transparency International (Spain) in order to move beyond the fiscal transparency addressed in previous work. In so doing, we broaden the analysis of transparency to the corporate, social, fiscal, contracting, and planning activities of governments. Our results on overall transparency indicate that large municipalities and left-wing local government leaders are associated with better transparency indexes; while the worst results are presented by provincial capitals, cities where tourist activity is particularly important and local governments that enjoy an absolute majority. The analysis of other transparency categories generally shows the consistent impact of these determinants and the need to consider a wider set of variables to capture their effect.
Resumo:
OBJECTIVE: Periodic limb movements during sleep (PLMS) are sleep phenomena characterized by periodic episodes of repetitive stereotyped limb movements. The aim of this study was to describe the prevalence and determinants of PLMS in a middle to older aged general population. METHODS: Data from 2,162 subjects (51.2% women, mean age = 58.4 ± 11.1 years) participating in a population-based study (HypnoLaus, Lausanne, Switzerland) were collected. Assessments included laboratory tests, sociodemographic data, personal and treatment history, and full polysomnography at home. PLMS index (PLMSI) was determined, and PLMSI > 15/h was considered as significant. RESULTS: Prevalence of PLMSI > 15/h was 28.6% (31.3% in men, 26% in women). Compared to subjects with PLMSI ≤ 15/h, subjects with PLMSI > 15/h were older (p < 0.001), were predominantly males (p = 0.007), had a higher proportion of restless legs syndrome (RLS; p < 0.001), had a higher body mass index (p = 0.001), and had a lower mean glomerular filtration rate (p < 0.001). Subjects with PLMSI > 15/h also had a higher prevalence of diabetes, hypertension, and beta-blocker or hypnotic treatments. The prevalence of antidepressant use was higher, but not statistically significant (p = 0.07). Single nucleotide polymorphisms (SNPs) within BTBD9 (rs3923809), TOX3 (rs3104788), and MEIS1 (rs2300478) genes were significantly associated with PLSMI > 15/h. Conversely, mean hemoglobin and ferritin levels were similar in both groups. In the multivariate analysis, age, male gender, antidepressant intake, RLS, and rs3923809, rs3104788, and rs2300478 SNPs were independently associated with PLMSI > 15/h. INTERPRETATION: PLMS are highly prevalent in our middle-aged European population. Age, male gender, RLS, antidepressant treatment, and specific BTBD9, TOX3, and MEIS1 SNP distribution are independent predictors of PLMSI > 15/h. ANN NEUROL 2016;79:464-474.
Resumo:
Head and neck squamous cell carcinoma (HNSCC) arises in the oral cavity,oropharynx,larynx and hypopharynx.Recent works highlighted a subset of HNSCC related to Human Papilloma Virus (HPV) with complete differet molecular progression and associated with a better prognosis than HPV-negative HNSCC. The aim of this work is to culture HPV-positive tumor cells and transfect them with shRNA-expressing plasmids, to prepare RNA from the control and shRNA-treated cells and to measure gene expression....
Resumo:
Drawing on a database for 1988-2006 containing information on 157 countries, we investigate the effects on military spending of government form, electoral rules, concentration of parliamentary parties, and ideology. From an OLS regression on pooled data, our results show that presidential democracies spend more than parliamentary systems on defense, whereas the presence of a plurality voting system will reduce the defense burden. Our findings suggest that, in contrast to theoretical predictions in the literature, institutions do not have the same impact on the provision of all public goods. We present as well evidence regarding the effect of ideology on defense spending.
Resumo:
We address the question of what determines entrepreneurship in developing countries. In particular, because of the influence that this may have on the design of entrepreneurship policies, our main concern is whether the determinants of entrepreneurship are the same and/or have the same impact in developed and developing countries. To this end, we discuss the arguments put forward in the literature in support of the existence of differences in the determinants of entrepreneurship between developed and developing countries. We also analyse the results found in empirical studies on the determinants of formal firm entry (following the World Bank, our proxy of entrepreneurship) in developing countries and compare these results with those typically found in developed countries. Our main conclusion is that policy makers in developing economies should be careful when using evidence from developed countries to design entrepreneurship-promoting policies. Key words: entrepreneurship, developing countries. JEL: O1; O12; L26; M13
Resumo:
During the first decade of this century, Spain experienced the most important economic and housing boom in its recent history. This situation led the lending industry to dramatically expand through the mortgage market. The high competition among lenders caused a dramatic lowering of credit standards. During this period, lenders operating in the Spanish mortgage market artificially inflated appraised home values in order to draw larger mortgages. By doing this, lenders gave financially constrained households access to mortgage credit. In this paper, we analyze this phenomenon for this first time. To do so, we resort to a unique dataset of matched mortgage-dwelling-borrower characteristics covering the period 2004–2010. Our data allow us to construct an unbiased measure of property’s over-appraisal, since transaction prices in our data also includes any potential side payment in the transactions. Our findings indicate that i) in Spain, appraised home values were inflated on average by around 30% with respect to transaction prices; ii) creditconstrained households were more likely to be involved in mortgages with inflated house values; and iii) a regional indicator of competition in the lending market suggests that inflated appraisal values were also more likely to appear in more competitive regional mortgage markets. Keywords: Housing demand, appraisal values, house prices, housing bubble, credit constraints, mortgage market. JEL Classification: R21, R31
Resumo:
Automobile bodily injury disputes represent one of the main causes of litigation faced by Spanish Courts. In this paper a multinomial model is implemented to analyse which factors determine the decision to appeal against the verdicts of trial courts. Use of a dataset of motor insurance claims revealed differences between the determinants of a claimant’s decision to appeal and those of insurers. Among other results it is shown that discrepancies regarding the permanent disability sustained affect the insurer’s decision to appeal. In contrast, the claimant pays more attention to differences in the stated temporary disability. Conclusions are drawn regarding which factors could reduce the percentage of appealed cases.
Resumo:
A recent publication reported an exciting polygenic effect of schizophrenia (SCZ) risk variants, identified by a large genome-wide association study (GWAS), on total brain and white matter volumes in schizophrenic patients and, even more prominently, in healthy subjects. The aim of the present work was to replicate and then potentially extend these findings. According to the original publication, polygenic risk scores using single nucleotide polymorphism (SNP) information of SCZ GWAS (polygenic SCZ risk scores; PSS) were calculated in 122 healthy subjects, enrolled in a structural magnetic resonance imaging (MRI) study. These scores were computed based on P-values and odds ratios available through the Psychiatric GWAS Consortium. In addition, polygenic white matter scores (PWM) were calculated, using the respective SNP subset in the original publication. None of the polygenic scores, either PSS or PWM, were found to be associated with total brain, white matter or gray matter volume in our replicate sample. Minor differences between the original and the present study that might have contributed to lack of reproducibility (but unlikely explain it fully), are number of subjects, ethnicity, age distribution, array technology, SNP imputation quality and MRI scanner type. In contrast to the original publication, our results do not reveal the slightest signal of association of the described sets of GWAS-identified SCZ risk variants with brain volumes in adults. Caution is indicated in interpreting studies building on polygenic risk scores without replication sample.
Resumo:
Despite the advent of devices to track seabird movements, the extent to which productive areas and oceanic winds influence foraging strategies is still not fully understood. We investigated the main environmental determinants of foraging strategies in Cory"s shearwaters Calonectris diomedea by combining satellite-tracking information from 14 birds breeding on the Canary Islands with concurrent data on chlorophyll a (chl a) concentrations and oceanic winds. Additionally, we took blood samples at the end of each foraging trip and analysed carbon (C) and nitrogen (N) stable isotopes to examine the use of trophic resources. All birds showed commuting trips, concentrating foraging activity exclusively on the African continental shelf. Foraging locations showed a strong association with chl a concentrations, suggesting birds select foraging areas according to prey availability. In contrast with other breeding colonies where Cory"s shearwaters use a dual-foraging method, birds showed a unimodal strategy and did not show differences in C and N isotope signatures in plasma, confirming that close proximity to highly productive areas strongly influences foraging strategies. In addition, birds tracked during 2 consecutive trips foraged in the same area, suggesting that high resource availability promotes fidelity to feeding grounds also at coarse scales. Persistent northeast trade winds blew during the study period, and commuting trips followed a consistent clockwise movement with a southwest heading while the birds foraged along the continental shelf, suggesting that birds used tail winds to reduce their flying costs. Our results corroborate that oceanographic conditions in the vicinity of the breeding colony have a strong effect on foraging strategies of pelagic seabirds.
Resumo:
We estimate the determinants of capital intensity in Japan and the US, characterized by striking different paths. We augment an otherwise standard Constant Elasticity of Substitution (CES) model with demand-side considerations, which we find especially relevant in the US. In this augmented setting, the elasticity of substitution between capital and labor is placed around 0.85 in Japan, and 0.30 in the US. We also find evidence of biased technical change, which is capital-saving in Japan but labor-saving in the US. These differences help us explain the diverse experience in the capital deepening process of these economies, and lead us to conclude that demand-side drivers may also be relevant to account for different growth experiences. A close look at the nature of technological change is also needed before designing one-size-fits-all industrial, economic growth, and/or labor market policies.
Resumo:
The purpose of this study is to define what determinants affect the Credit spread. There are two theoretical frameworks to study this: structural models and reduced form models. Structural models indicate that the main determinants are company leverage, volatility and risk-free interest rate, and other market and firm-specific variables. The purpose is to determine which of these theoretical determinants can explain the CDS spread and also how these theoretical determinants are affected by the financial crisis in 2007. The data is collected from 30 companies in the US Markets, mainly S&P Large Cap. The sample time-frame is 31.1.2004 – 31.12.2009. Empirical studies indicate that structural models can explain the CDS spreads well. Also, there were significant differences between bear and bull markets. The main determinants explaining CDS spreads were leverage and volatility. The other determinants were significant, depending on the sample period. However, these other variables did not explain the spread consistently.
Resumo:
This thesis studies cash and short term investments to net assets ratio of Finnish industrial companies during financial crisis, and how different firm specific and macro economical variables affect cash and short term investments. The data consists of quarter level interim reports. Regression analysis was used to find out the effects of different variables. Regression models were formed based on previous studies on cash holdings. It was found that firms studied held more cash during financial crisis than before it. Cash and short-term investments acted as substitute of net working capital. Leverage had a positive and significant relationship to cash and short term investment ratio. It was also found out that firms have a target cash and short term investments ratio.