Casting Without Reduction Versus Closed Reduction With or Without Fixation in the Treatment of Distal Radius Fractures in Children: Protocol for a Randomized Noninferiority Trial

El tratamiento agudo de las fracturas de radio distal, las fracturas más frecuentes en la población pediátrica, representa un reto para el cirujano ortopédico. Decidir sobre la restauración quirúrgica de la alineación o la inmovilización con yeso sin reducir la fractura es una preocupación compleja dado el potencial de remodelación de los huesos en los niños. Además, la falta de límites seguros de acortamiento y angulación basados ​​en la evidencia, que no pongan en peligro la funcionalidad de las extremidades superiores en el futuro, complica aún más esta decisión. Objetivo: El objetivo de los autores es medir los resultados funcionales, evaluados mediante el instrumento de función física pediátrica v2.0 del sistema de información de medición de resultados informados por el paciente (PROMIS). Los autores plantean la hipótesis de que los resultados no serán peores en los niños tratados con inmovilización con yeso in situ en comparación con los tratados con reducción cerrada con o sin fijación percutánea. Los autores también pretenden comparar los siguientes resultados secundarios: variación cubital y alineación de la fractura en los planos sagital y coronal, rango de movimiento, úlceras por presión, control del dolor, osteotomía del radio debido a deformidad, cura de la pseudoartrosis y remanipulación. Métodos: Este es el protocolo de un ensayo aleatorizado de no inferioridad que compara la funcionalidad de la extremidad superior en niños de 5 a 10 años, después de sufrir una fractura de radio distal, tratados con inmovilización con yeso in situ o reducción cerrada con o sin fijación en un solo hospital ortopédico. El seguimiento funcional se proyecta a los 6 meses, mientras que el seguimiento clínico y radiográfico se realizará a las 2 semanas, 3 meses y 9 meses. Resultados: El reclutamiento comenzó en julio de 2021. Hasta enero de 2022, 23 niños fueron aleatorizados. Los autores esperan reclutar un promedio de 5 pacientes mensualmente; por lo tanto, el reclutamiento y el análisis deberían estar completos para octubre de 2024. Conclusiones: Este diseño experimental que aborda la funcionalidad de la extremidad superior después de la inmovilización con yeso in situ en niños que han sufrido una fractura distal del radio puede generar información convincente que podría ayudar al médico a decidir sobre el tratamiento ortopédico más adecuadoQ3Background: Acute treatment for distal radius fractures, the most frequent fractures in the pediatric population, represents a challenge to the orthopedic surgeon. Deciding on surgical restoration of the alignment or cast immobilization without reducing the fracture is a complex concern given the remodeling potential of bones in children. In addition, the lack of evidence-based safe boundaries of shortening and angulation, that will not jeopardize upper-extremity functionality in the future, further complicates this decision. Objective: The authors aim to measure functional outcomes, assessed using the Patient-Reported Outcomes Measurement Information System (PROMIS) Pediatric Physical Function v2.0 instrument. The authors hypothesize that outcomes will not be worse in children treated with cast immobilization in situ compared with those treated with closed reduction with or without percutaneous fixation. The authors also aim to compare the following as secondary outcomes: ulnar variance and fracture alignment in the sagittal and coronal planes, range of motion, pressure ulcers, pain control, radius osteotomy due to deformity, pseudoarthrosis cure, and remanipulation. Methods: This is the protocol of a randomized noninferiority trial comparing upper-extremity functionality in children aged 5 to 10 years, after sustaining a distal radius fracture, treated with either cast immobilization in situ or closed reduction with or without fixation in a single orthopedic hospital. Functional follow-up is projected at 6 months, while clinical and radiographic follow-up will occur at 2 weeks, 3 months, and 9 months. Results: Recruitment commenced in July 2021. As of January 2022, 23 children have been randomized. Authors expect an average of 5 patients to be recruited monthly; therefore, recruitment and analysis should be complete by October 2024. Conclusions: This experimental design that addresses upper-extremity functionality after cast immobilization in situ in children who have sustained a distal fracture of the radius may yield compelling information that could aid the clinician in deciding on the most suitable orthopedic treatment.Revista Nacional - IndexadaS

On the impact of fundamentals, liquidity and coordination on market stability

Complex interactions between fundamentals and liquidity during unstable periods in financial markets are succinctly modeled with coordination games. We propose a flexible framework to estimate such a model and use the efficient method of moments as estimation procedure. We illustrate the model by using exchange rates from the yen–dollar carry trade induced uncertainty in 1998, interest rate spreads and global market volatility. The model fits the data well, with evidence of low information disparities, the market is generally very deep, where global volatility is more important than fundamental uncertainty in the determination of liquidity. There is clear evidence of asymmetry between the buy and sell sides of the market

Portfolio Choice Beyond the Traditional Approach

This paper surveys asset allocation methods that extend the traditional approach. An important feature of the the traditional approach is that measures the risk and return tradeoff in terms of mean and variance of final wealth. However, there are also other important features that are not always made explicit in terms of investor’s wealth, information, and horizon: The investor makes a single portfolio choice based only on the mean and variance of her final financial wealth and she knows the relevant parameters in that computation. First, the paper describes traditional portfolio choice based on four basic assumptions, while the rest of the sections extend those assumptions. Each section will describe the corresponding equilibrium implications in terms of portfolio advice and asset pricing.Keywords: Mean-Variance Analysis, Background Risks, Estimation Error, Expected Utility, Multi-Period Portfolio Choice.JEL: D81, G11, G12

Evaluation of Joint Density Forecasts of Stock and Bond Returns: Predictability and Parameter Uncertainty

One of the most important findings in empirical finance has been the fact that returns are not i.i.d. Predictability, or time variation in the conditional distribution of returns, is one of the basic ingredients of asset pricing and portfolio choice models nowadays.� Under the current renewed interest in its implications for portfolio management, there is a growing literature on the computation of optimal portfolios for a given utility function and a given estimation of a particular model of returns. But there is an obvious problem with that approach. If the estimated model is not an accurate description of the distribution of returns the conclusions may be misleading. The approach in this paper is to study the properties of a particular model by means of the evaluation of its joint density forecasts of stock and bond returns. The focus is not on model testing, the procedure is based instead on out-of-sample checks of real-time density forecasting rules against realizations of returns. That is the relevant context for portfolio management.� In addition, two important and controversial questions are addressed for each model: time-variation in risk premia and parameter uncertainty.

Spanning Tests in Return and Stochastic Discount Factor Mean-Variance Frontiers: A Unifying Approach

We propose new approaches to test for spanning in the return and stochastic discount factor mean-variance frontiers, which assess if either the centred or uncentred mean and cost representing portfolios are shared by the initial and extended sets of assets. We show that our proposed tests are asymptotically equivalent to the existing spanning tests under the null and sequences of local alternatives, and analyse their asymptotic relative e.ciency. We also extend the theory of optimal GMM inference to deal with the singularities that arise in some spanning tests. Finally, we include an empirical application to money markets in Europe.

On the Impact of Fundamentals, Liquidity and Coordination on Market Stability

Complex interactions between fundamentals and liquidity during unstable periods in financial markets are succinctly modeled with coordination games. We propose a flexible framework to estimate such a model and use the efficient method of moments as estimation procedure. We illustrate the model by using exchange rates from the yen–dollar carry trade induced uncertainty in 1998, interest rate spreads and global market volatility. The model fits the data well, with evidence of low information disparities, the market is generally very deep, where global volatility is more important than fundamental uncertainty in the determination of liquidity. There is clear evidence of asymmetry between the buy and sell sides of the market.

Replication data for: A Unifying Approach to the Empirical Evaluation of Asset Pricing Models

Penaranda, Francisco, and Sentana, Enrique, (2015) "A Unifying Approach to the Empirical Evaluation of Asset Pricing Models." Review of Economics 97:2, 412-435

Evaluation of joint density forecasts of stock and bond returns Predictability and parameter uncertainty

Includes bibliographical referencesSIGLEAvailable from British Library Document Supply Centre- DSC:5300. 405(458) / BLDSC - British Library Document Supply CentreGBUnited Kingdo