45 research outputs found

    Behavioural analytics: Exploring judgments and choices in large data sets

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    The ever-increasing availability of large data-sets that store users’ judgements (such as forecasts and preferences) and choices (such as acquisitions of goods and services) provides a fertile ground for Behavioural Operational Research (BOR). In this paper, we review the streams of Behavioural Decision Research that might be useful for BOR researchers and practitioners to analyse such behavioural data-sets. We then suggest ways that concepts from these streams can be employed in exploring behavioural data-sets for (i) detecting behavioural patterns, (ii) exploiting behavioural findings and (iii) improving judgements and decisions of consumers and citizens. We also illustrate how this taxonomy for behavioural analytics might be utilised in practice, in three real-world studies with behavioural data-sets generated by websites and online user activity

    Clinical and urodynamic findings in women affected by mixed urinary incontinence

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    The definition of mixed urinary incontinence (MUI) of the International Continence Society exclusively assesses patient-reported symptoms without consideration of physical and urodynamic results, what is inadequate to reliably predict the pathophysiology of the underlying pathology. We investigated and compared clinical and urodynamic findings in women with MUI and assessed predictive variables for the different MUI clinical presentations

    Endoplasmic reticulum stress signalling – from basic mechanisms to clinical applications

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    The endoplasmic reticulum (ER) is a membranous intracellular organelle and the first compartment of the secretory pathway. As such, the ER contributes to the production and folding of approximately one‐third of cellular proteins, and is thus inextricably linked to the maintenance of cellular homeostasis and the fine balance between health and disease. Specific ER stress signalling pathways, collectively known as the unfolded protein response (UPR), are required for maintaining ER homeostasis. The UPR is triggered when ER protein folding capacity is overwhelmed by cellular demand and the UPR initially aims to restore ER homeostasis and normal cellular functions. However, if this fails, then the UPR triggers cell death. In this review, we provide a UPR signalling‐centric view of ER functions, from the ER's discovery to the latest advancements in the understanding of ER and UPR biology. Our review provides a synthesis of intracellular ER signalling revolving around proteostasis and the UPR, its impact on other organelles and cellular behaviour, its multifaceted and dynamic response to stress and its role in physiology, before finally exploring the potential exploitation of this knowledge to tackle unresolved biological questions and address unmet biomedical needs. Thus, we provide an integrated and global view of existing literature on ER signalling pathways and their use for therapeutic purposes

    Temporal changes in the epidemiology, management, and outcome from acute respiratory distress syndrome in European intensive care units: a comparison of two large cohorts

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    Background: Mortality rates for patients with ARDS remain high. We assessed temporal changes in the epidemiology and management of ARDS patients requiring invasive mechanical ventilation in European ICUs. We also investigated the association between ventilatory settings and outcome in these patients. Methods: This was a post hoc analysis of two cohorts of adult ICU patients admitted between May 1–15, 2002 (SOAP study, n = 3147), and May 8–18, 2012 (ICON audit, n = 4601 admitted to ICUs in the same 24 countries as the SOAP study). ARDS was defined retrospectively using the Berlin definitions. Values of tidal volume, PEEP, plateau pressure, and FiO2 corresponding to the most abnormal value of arterial PO2 were recorded prospectively every 24 h. In both studies, patients were followed for outcome until death, hospital discharge or for 60 days. Results: The frequency of ARDS requiring mechanical ventilation during the ICU stay was similar in SOAP and ICON (327[10.4%] vs. 494[10.7%], p = 0.793). The diagnosis of ARDS was established at a median of 3 (IQ: 1–7) days after admission in SOAP and 2 (1–6) days in ICON. Within 24 h of diagnosis, ARDS was mild in 244 (29.7%), moderate in 388 (47.3%), and severe in 189 (23.0%) patients. In patients with ARDS, tidal volumes were lower in the later (ICON) than in the earlier (SOAP) cohort. Plateau and driving pressures were also lower in ICON than in SOAP. ICU (134[41.1%] vs 179[36.9%]) and hospital (151[46.2%] vs 212[44.4%]) mortality rates in patients with ARDS were similar in SOAP and ICON. High plateau pressure (> 29 cmH2O) and driving pressure (> 14 cmH2O) on the first day of mechanical ventilation but not tidal volume (> 8 ml/kg predicted body weight [PBW]) were independently associated with a higher risk of in-hospital death. Conclusion: The frequency of and outcome from ARDS remained relatively stable between 2002 and 2012. Plateau pressure > 29 cmH2O and driving pressure > 14 cmH2O on the first day of mechanical ventilation but not tidal volume > 8 ml/kg PBW were independently associated with a higher risk of death. These data highlight the continued burden of ARDS and provide hypothesis-generating data for the design of future studies

    The clinical relevance of oliguria in the critically ill patient : Analysis of a large observational database

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    Funding Information: Marc Leone reports receiving consulting fees from Amomed and Aguettant; lecture fees from MSD, Pfizer, Octapharma, 3 M, Aspen, Orion; travel support from LFB; and grant support from PHRC IR and his institution. JLV is the Editor-in-Chief of Critical Care. The other authors declare that they have no relevant financial interests. Publisher Copyright: © 2020 The Author(s). Copyright: Copyright 2020 Elsevier B.V., All rights reserved.Background: Urine output is widely used as one of the criteria for the diagnosis and staging of acute renal failure, but few studies have specifically assessed the role of oliguria as a marker of acute renal failure or outcomes in general intensive care unit (ICU) patients. Using a large multinational database, we therefore evaluated the occurrence of oliguria (defined as a urine output 16 years) patients in the ICON audit who had a urine output measurement on the day of admission were included. To investigate the association between oliguria and mortality, we used a multilevel analysis. Results: Of the 8292 patients included, 2050 (24.7%) were oliguric during the first 24 h of admission. Patients with oliguria on admission who had at least one additional 24-h urine output recorded during their ICU stay (n = 1349) were divided into three groups: transient - oliguria resolved within 48 h after the admission day (n = 390 [28.9%]), prolonged - oliguria resolved > 48 h after the admission day (n = 141 [10.5%]), and permanent - oliguria persisting for the whole ICU stay or again present at the end of the ICU stay (n = 818 [60.6%]). ICU and hospital mortality rates were higher in patients with oliguria than in those without, except for patients with transient oliguria who had significantly lower mortality rates than non-oliguric patients. In multilevel analysis, the need for RRT was associated with a significantly higher risk of death (OR = 1.51 [95% CI 1.19-1.91], p = 0.001), but the presence of oliguria on admission was not (OR = 1.14 [95% CI 0.97-1.34], p = 0.103). Conclusions: Oliguria is common in ICU patients and may have a relatively benign nature if only transient. The duration of oliguria and need for RRT are associated with worse outcome.publishersversionPeer reviewe

    More-or-less elicitation (MOLE): reducing bias in range estimation and forecasting

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    Biases like overconfidence and anchoring affect values elicited from people in predictable ways – due to people’s inherent cognitive processes. The More-Or-Less Elicitation (MOLE) process takes insights from how biases affect people’s decisions to design an elicitation process to mitigate or eliminate bias. MOLE relies on four, key insights: 1) uncertainty regarding the location of estimates means people can be unwilling to exclude values they would not specifically include; 2) repeated estimates can be averaged to produce a better, final estimate; 3) people are better at relative than absolute judgements; and, 4) consideration of multiple values prevents anchoring on a particular number. MOLE achieves these by having people repeatedly choose between options presented to them by the computerised tool rather than making estimates directly, and constructing a range logically consistent with (i.e., not ruled out by) the person’s choices in the background. Herein, MOLE is compared, across four experiments, with eight elicitation processes – all requiring direct estimation of values – and is shown to greatly reduce overconfidence in estimated ranges and to generate best guesses that are more accurate than directly estimated equivalents. This is demonstrated across three domains – in perceptual and epistemic uncertainty and in a forecasting task.Matthew B. Welsh, Steve H. Beg

    Avaliação de desempenho do processo de orçamento: estudo de caso em uma obra de construção civil

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    O presente trabalho tem como objetivo propor um modelo para avaliar o processo de orçamentação na construção civil. Trata-se de uma pesquisa de caráter exploratório, baseada em um estudo de caso realizado em uma construtora brasileira. Como instrumento de intervenção foi utilizada a Metodologia Multicritério de Apoio à Decisão Construtivista (MCDA-C), a qual permitiu identificar, organizar, mensurar e integrar os fatores necessários e suficientes, quando da avaliação de um orçamento, segundo a percepção do decisor em questão. O trabalho faz uma revisão de literatura sobre avaliação de desempenho e o gerenciamento de projetos no contexto de obras de construção civil. É apresentado o desenvolvimento do modelo construído para apoio à decisão, o qual permitiu ao gerente de engenharia avaliar o desempenho de um orçamento, identificando os fatores que causam desvios, a fim de eliminar ou minimizar suas causas, além de servir de base para propostas de melhorias no processo de orçamentação
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