916 resultados para Return predictability


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The objective of this work was to identify factors associated with the 56-day non-return rate (56-NRR) in dairy herds in the Galician region, Spain, and to estimate it for individual Holstein bulls. The experiment was carried out in herds originated from North-West Spain, from September 2008 to August 2009. Data of the 76,440 first inseminations performed during this period were gathered. Candidate factors were tested for their association with the 56-NRR by using a logistic model (binomial). Afterwards, 37 sires with a minimum of 150 first performed inseminations were individually evaluated. Logistic models were also estimated for each bull, and predicted individual 56-NRR rate values were calculated as a solution for the model parameters. Logistic regression found four major factors associated with 56-NRR in lactating cows: age at insemination, days from calving to insemination, milk production level at the time of insemination, and herd size. First-service conception rate, when a particular sire was used, was higher for heifers (0.71) than for lactating cows (0.52). Non-return rates were highly variable among bulls. Asignificant part of the herd-level variation of 56-NRR of Holstein cattle seems attributable to the service sire. High correlation level between observed and predicted 56-NRR was found.

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OBJECTIVES: To evaluate the performance of the INTERMED questionnaire score, alone or combined with other criteria, in predicting return to work after a multidisciplinary rehabilitation program in patients with non-specific chronic low back pain. METHODS: The INTERMED questionnaire is a biopsychosocial assessment and clinical classification tool that separates heterogeneous populations into subgroups according to case complexity. We studied 88 patients with chronic low back pain who followed an intensive multidisciplinary rehabilitation program on an outpatient basis. Before the program, we recorded the INTERMED score, radiological abnormalities, subjective pain severity, and sick leave duration. Associations between these variables and return to full-time work within 3 months after the end of the program were evaluated using one-sided Fisher tests and univariate logistic regression followed by multivariate logistic regression. RESULTS: The univariate analysis showed a significant association between the INTERMED score and return to work (P<0.001; odds ratio, 0.90; 95% confidence interval, 0.86-0.96). In the multivariate analysis, prediction was best when the INTERMED score and sick leave duration were used in combination (P=0.03; odds ratio, 0.48; 95% confidence interval, 0.25-0.93). CONCLUSION: The INTERMED questionnaire is useful for evaluating patients with chronic low back pain. It could be used to improve the selection of patients for intensive multidisciplinary programs, thereby improving the quality of care, while reducing healthcare costs.

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BACKGROUND: Workers with persistent disabilities after orthopaedic trauma may need occupational rehabilitation. Despite various risk profiles for non-return-to-work (non-RTW), there is no available predictive model. Moreover, injured workers may have various origins (immigrant workers), which may either affect their return to work or their eligibility for research purposes. The aim of this study was to develop and validate a predictive model that estimates the likelihood of non-RTW after occupational rehabilitation using predictors which do not rely on the worker's background. METHODS: Prospective cohort study (3177 participants, native (51%) and immigrant workers (49%)) with two samples: a) Development sample with patients from 2004 to 2007 with Full and Reduced Models, b) External validation of the Reduced Model with patients from 2008 to March 2010. We collected patients' data and biopsychosocial complexity with an observer rated interview (INTERMED). Non-RTW was assessed two years after discharge from the rehabilitation. Discrimination was assessed by the area under the receiver operating curve (AUC) and calibration was evaluated with a calibration plot. The model was reduced with random forests. RESULTS: At 2 years, the non-RTW status was known for 2462 patients (77.5% of the total sample). The prevalence of non-RTW was 50%. The full model (36 items) and the reduced model (19 items) had acceptable discrimination performance (AUC 0.75, 95% CI 0.72 to 0.78 and 0.74, 95% CI 0.71 to 0.76, respectively) and good calibration. For the validation model, the discrimination performance was acceptable (AUC 0.73; 95% CI 0.70 to 0.77) and calibration was also adequate. CONCLUSIONS: Non-RTW may be predicted with a simple model constructed with variables independent of the patient's education and language fluency. This model is useful for all kinds of trauma in order to adjust for case mix and it is applicable to vulnerable populations like immigrant workers.

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The aim was to examine the capacity of commonly used type 2 diabetes mellitus (T2DM) risk scores to predict overall mortality. The US-based NHANES III (n = 3138; 982 deaths) and the Swiss-based CoLaus study (n = 3946; 191 deaths) were used. The predictive value of eight T2DM risk scores regarding overall mortality was tested. The Griffin score, based on few self-reported parameters, presented the best (NHANES III) and second best (CoLaus) predictive capacity. Generally, the predictive capacity of scores based on clinical (anthropometrics, lifestyle, history) and biological (blood parameters) data was not better than of scores based solely on clinical self-reported data. T2DM scores can be validly used to predict mortality risk in general populations without diabetes. Comparison with other scores could further show whether such scores also suit as a screening tool for quick overall health risk assessment.

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This study offers a statistical analysis of the persistence of annual profits across a sample of firms from different European Union (EU) countries. To this end, a Bayesian dynamic model has been used which enables the annual behaviour of those profits to be broken down into a permanent structural component on the one hand and a transitory component on the other, while also distinguishing between general effects affecting the industry as a whole to which each firm belongs and specific effects affecting each firm in particular. This break down enables the relative importance of those fundamental components to be evaluated. The data analysed come from a sample of 23,293 firms in EU countries selected from the AMADEUS data-base. The period analysed ran from 1999 to 2007 and 21 sectors were analysed, chosen in such a way that there was a sufficiently large number of firms in each country*sector combination for the industry effects to be estimated accurately enough for meaningful comparisons to be made by sector and country. The analysis has been conducted by sector and by country from a Bayesian perspective, thus making the study more flexible and realistic since the estimates obtained do not depend on asymptotic results. In general terms, the study finds that, although the industry effects are significant, more important are the specific effects. That importance varies depending on the sector or the country in which the firm carries out its activity. The influence of firm effects accounts for more than 90% of total variation and display a significantly lower degree of persistence, with adjustment speeds oscillating around 51.1%. However, this pattern is not homogeneous but depends on the sector and country analysed. Industry effects have a more marginal importance, being significantly more persistent, with adjustment speeds oscillating around 10% with this degree of persistence being more homogeneous at both country and sector levels.

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Diplomityön tavoitteena on tutkia ja kehittää menetelmä tuotekehitysprojektin ajalliselle ennustamiselle tuotteen siirtyessä tuotekehityksestä massatuotantoon. Ajallisen ennustamisen merkitys korostuu mitä lähemmäksi uuden tuotteen massatuotannon aloittaminen (ramp-up) tulee, koska strategiset päätökset koskien mm. uusia tuotantolinjoja, materiaalien- ja komponenttien tilaamisia sekä vahvistus asiakastoimitusten aloittamista täytyy tehdä jo paljon aikaisemmin.Työ aloitetaan tutkimalla rinnakkaista insinöörityötä (concurrent engineering) sekä suoritusten mittaamista (performance measurement), joiden sisältämistä ajattelumalleista, työkaluista ja tekniikoista hahmottuivat ajallisen ennustettavuuden onnistumisen edellytykset. Näitä olivat suunnitellun tuotteen ja tuotekehitysprosessin laatu sekä resurssien ja tiimien kompetenssit. Toisaalta ajalliseen ennustettavuuteen vaikuttavat myös projektien riippuvuudet ulkoisista toimittajista ja heidän aikatauluistaan.Teoreettisena viitekehyksenä käytetään Bradford L. Goldense:n luomaa mallia tuotekehityksen proaktiiviseksi mittaamiseksi sekä sovelletaan W. Edward Deming:in jatkuvan parantamisen silmukkaa. Työssä kehitetään Ramp-up Predictability konsepti, joka koostuu keskipitkän ja pitkän aikavälin ennustamisesta. Työhön ei kuulunut mallin käyttöönotto ja seuranta.Toimenpide ehdotuksena esitetään lisätutkimusta mittareiden keskinäisestä korrelaatioista ja niiden luotettavuudesta sekä mallien tarjoamista mahdollisuuksista muille tulosyksiköille.

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Abstract Background: To evaluate the predictability of refraction following immediate sequential bilateral cataract surgery (ISBCS) performed under general anaesthesia. Methods: This is a retrospective review of all ISBCS performed at Kantonsspital Winterthur, Switzerland, between April 2000 and September 2013. The case notes of 250 patients were reviewed. Patients having full refraction reported (110 patients/220 eyes) were included. 210 (95 %) eyes had a straight forward phacoemulsification with posterior chamber intraocular lens implantation, seven eyes had a planned extracapsular cataract extraction (ECCE); three eyes had an intracapsular cataract extraction. Results: Both eyes of 110 patients (64 women, 46 men) with a mean age of 79.0 years, standard deviation (SD) ±11.4 (range 26 to 97 years) were included. Median preoperative best corrected visual acuity (BCVA) was 0.5 LogMAR in the first eye, the interquartile range (IQR) was [0.4, 1.2]; 0.7 LogMAR in the second eye with IQR [0.4, 1.8]. At one month, the median BCVA was 0.2 LogMAR, IQR [0.1, 0.3] in the first eye, median BCVA was 0.1 LogMAR and IQR [0.0, 0.5] in the second eye. There were 3 eyes (3 %) that lost 3 lines or more in BCVA at one month (control vs. pre-operatively). In all three cases, poor visual acuity had been recorded pre-operatively (>1 LogMAR). Achieved refraction was within ±1.0 D of the target in 83 % of eyes. There were only 5 % (n = 6) of cases where if delayed sequential bilateral extraction had been performed could potentially intraocular lens (IOL) choice have been adjusted, in four of these cases, target refraction was within ±1.0 D in the second eye. Conclusions: ISBCS performed under general anaesthesia achieves target refraction in 83 % of eyes after consideration of complications, ocular co-morbidities and systemic restrictions. In the majority of cases where IOL power calculation could be considered, the achieved refraction of the second surgical eye was within ±1.0 D of intended refraction. This undermines the utility of IOL power adjustments in the second surgical eye. Keywords: Cataract, Cataract surgery, Immediate sequential bilateral cataract surgery

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Vuonna 1995 alkanut sähkömarkkinoiden vapautuminen on muuttanut sähköyhtiöiden myyntisopimusten hinnoittelua merkittävästi. Ennen markkinauudistusta voitiin sähkön myyntisopimukset hinnoitella perustuen oman sähkön tuotannon kustannuksiin ja haluttuun katteeseen. Nykyään sähköpörssissä noteerattava sähkön hinta muodostaa perustan kaikkien myyntisopimusten hinnoittelulle. Sähkön markkinahinnan lisäksi on myyntisopimusten hinnoittelussa otettava huomioon sähkömarkkinoiden ominaispiirteistä aiheutuvat riskit sähkön myyjälle. Tässä työssä mallinnetaan Lappeenrannan Energia Oy:n markkinalähtöiset hinnoittelumenetelmät kahdelle sähkönmyyntisopimustyypille. Lisäksi tutkitaan markkinalähtöisen hinnoittelun tärkeimpien riskikomponenttien, aluehintaeron sekä profiililisän, merkitystä markkinalähtöisten myyntisopimusten hinnoittelussa. Aluehintaeron hyväksikäyttöä myyntisopimusten hinnoittelussa on tutkittu selvittämällä Suomen hinta-alueen CfD-johdannaisten riskipreemiot. Profiililisän merkitystä myyntisopimusten hinnoittelussa on tutkittu havainnoimalla profiililisän muutoksia hinta- ja kulutusaikasarjoissa sekä suojaushinta ja tehotasossa tapahtuneiden muutosten suhteen. Ennustetun ja toteutuneen profiililisän eroja on tutkittu laskemalla ne seitsemälle Lappeenrannan Energia Oy:n merkittävälle asiakkaalle. Lisäksi on tarkasteltu profiililisän laskentaan tarvittavan hinta-aikasarjan mallintamiseen käytettyjen termiinituotteiden hintojen merkitystä lasketun profiililisän suuruuteen. Työn lopuksi esitetään kaksi vaihtoehtoista sähkösopimusten hinnoittelumenetelmää ja vertaillaan esitettyjä hinnoittelumenetelmiä keskenään. Työssä havaitaan, että aluehintaerolta suojautumiseen käytettävien CfD-johdannaisten avulla olisi ollut mahdollista lisätä markkinalähtöisten myyntisopimusten tuottoa viimeisen kolmen vuoden aikana. Suoritettujen herkkyysanalyysien perusteella voidaan todeta, että toteutuneen ja ennustetun profiililisän erot johtuvat laskentaan käytettävien hinta- sekä kulutusaikasarjojen epätarkkuudesta. Lappeenrannan Energia Oy:n käyttämät profiililisät osoittautuivat ex-post -tarkastelussa liian suuriksi yhtä asiakasta lukuun ottamatta. Lisäksi tarjousaikana laskettujen profiililisien voidaan katsoa muuttuvan täysin samassa suhteessa hinta-aikasarjan mallintamiseen käytettyjen termiinituotteiden volatiliteettien kanssa. Esiteltyjen vaihtoehtoisten myyntisopimusten hinnoittelumenetelmien voidaan katsoa antavan varsin samanlaisia tuloksia kuin Lappeenrannan Energia Oy:n nykyinen hinnoittelumenetelmä. Saatuihin tuloksiin vaikuttavat kuitenkin painokertoimien estimointiin käytetyn vuoden volatiliteetti sekä profiililisän laskentamenetelmä

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Tutkimuksen tavoitteena on tutkia epänormaalien tuottojen esiintymistä nousu- ja laskusuhdanteen aikana osingonilmoituspäivän ympärillä. Osinkoilmoitukset ovat kerätty Yhdysvaltojen markkinalta (NYSE) ajanjaksoilta 2000 - 2002, jolloin pörssit laskivat teknokuplan jälkeen ja 2005 - 2007, jolloin sijoittajat kokivat suuria kurssivoittoja. Osinkoilmoitushavainnot koostuvat yhtiöistä, jotka nostivat tai pitivät osinko per osake paikallaan. Tavoitteena on tutkia eroja epänormaaleissa tuotoissa näiden kahden ajanjakson välillä. Toiseksi, tavoitteena on tutkia miten epänormaalit tuotot poikkeavat toisistaan eri osinkotuottoluokissa. Kolmanneksi, tavoitteena on tutkia esiintyikö markkinoilla epänormaaleja tuottoja kun suomalaiset yritykset ilmoittivat ylimääräisistä osingoista, pääasiassa vuonna 2004. Yksinkertaisesti ja lyhyesti sanottuna tavoitteena on tutkia arvostavatko sijoittajat osinkoja enemmän laskukauden vai nousukauden aikana. Rahoitusteorian mukaan sijoittajien tulisi arvostaa laskukauden aikana enemmän yhtiöitä, jotka pystyvät maksamaan huonosta taloustilanteesta huolimatta hyvää osinkoa. Empiiriset testit Yhdysvalloista osoittavat, että osingon nostamisesta johtuvat epänormaalit tuotot olivat suuremmat laskusuhdanteen aikana kuin noususuhdanteen aikana. Tämä on linjassa teorian kanssa. Osingon-nostot aiheuttivat nousukauden aikana vähäisiä epänormaaleja tuottoja. Selviä eroja eri osingontuottoluokkien välillä ei pystytty havaitsemaan. Tulokset yhdistetystä aineistosta osoittavat, että sijoittajat kokivat vähäisiä positiivisia epänormaaleja tuottoja laskukauden aikana. Nousukautena tuotot olivat lähellä nollaa. Suomen markkinoilla havaittiin selvä epänormaalituotto osingonilmoituspäivänä. Tulokset ovat pääpiirteittäin linjassa teorian kanssa. Sijoittajat arvostavat osinkoja hieman enemmän lasku- kuin noususuhdanteen aikana.

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AIM: The prediction of return of spontaneous circulation (ROSC) during resuscitation of patients suffering of cardiac arrest (CA) is particularly challenging. Regional cerebral oxygen saturation (rSO2) monitoring through near-infrared spectrometry is feasible during CA and could provide guidance during resuscitation. METHODS: We conducted a systematic review and meta-analysis on the value of rSO2 in predicting ROSC both after in-hospital (IH) or out-of-hospital (OH) CA. Our search included MEDLINE (PubMed) and EMBASE, from inception until April 4th, 2015. We included studies reporting values of rSO2 at the beginning of and/or during resuscitation, according to the achievement of ROSC. RESULTS: A total of nine studies with 315 patients (119 achieving ROSC, 37.7%) were included in the meta-analysis. The majority of those patients had an OHCA (n=225, 71.5%; IHCA: n=90, 28.5%). There was a significant association between higher values of rSO2 and ROSC, both in the overall calculation (standardized mean difference, SMD -1.03; 95%CI -1.39,-0.67; p<0.001), and in the subgroups analyses (rSO2 at the beginning of resuscitation: SMD -0.79; 95%CI -1.29,-0.30; p=0.002; averaged rSO2 value during resuscitation: SMD -1.28; 95%CI -1.74,-0.83; p<0.001). CONCLUSIONS: Higher initial and average regional cerebral oxygen saturation values are both associated with greater chances of achieving ROSC in patients suffering of CA. A note of caution should be made in interpreting these results due to the small number of patients and the heterogeneity in study design: larger studies are needed to clinically validate cut-offs for guiding cardiopulmonary resuscitation.

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Background: The control of gastric residual volume (GRV) is a common nursing intervention in intensive care; however the literature shows a wide variation in clinical practice regarding the management of GRV, potentially affecting patients" clinical outcomes. The aim of this study is to determine the effect of returning or discarding GRV, on gastric emptying delays and feeding, electrolyte and comfort outcomes in critically ill patients. Method: A randomised, prospective, clinical trial design was used to study 125 critically ill patients, assigned to the return or the discard group. Main outcome measure was delayed gastric emptying. Feeding outcomes were determined measuring intolerance indicators, feeding delays and feeding potential complications. Fluid and electrolyte measures included serum potassium, glycaemia control and fluid balance. Discomfort was identified by significant changes in vital signs. Results: Patients in both groups presented similar mean GRV with no significant differences found (p=0.111), but participants in the intervention arm showed a lower incidence and severity of delayed gastric emptying episodes (p=0.001). No significant differences were found for the rest of outcome measurements, except for hyperglycaemia. Conclusions: The results of this study support the recommendation to reintroduce gastric content aspirated to improve GRV management without increasing the risk for potential complications.

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There is an intense debate on the convenience of moving from historical cost (HC) toward the fair value (FV) principle. The debate and academic research is usually concerned with financial instruments, but the IAS 41 requirement of fair valuation for biological assets brings it into the agricultural domain. This paper performs an empirical study with a sample of Spanish farms valuing biological assets at HC and a sample applying FV, finding no significant differences between both valuation methods to assess future cash flows. However, most tests reveal more predictive power of future earnings under fair valuation of biological assets, which is not explained by differences in volatility of earnings and profitability. The study also evidences the existence of flawed HC accounting practices for biological assets in agriculture, which suggests scarce information content of this valuation method in the predominant small business units existing in the agricultural sector in advanced Western countries