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Covid-19 - kortikosteroidbehandling vid svår sjukdom : En jämförande analys / Covid-19 - corticosteroid therapy in severe illness : A comparative analysisWoin, Nicolas January 2021 (has links)
Sammanfattning Sedan sjukdomen Covid-19s uppdykande i början av 2020 har forskning pågått för att karaktärisera sjukdomen ur alla tänkbara vinklar för att på kortast möjliga tid bereda väg för ett fungerande botemedel. Effektiva läkemedel som kan minska risken för allvarligt sjuka patienter att avlida i sjukdomen behövs; många preparat har föreslagits och testats och i Sverige har hittills två läkemedel godkänts för Covid-19. Ett av dessa är kortikosteroiden dexametason som godkänts för Covid-19-patienter i behov av syrgas eller respirator. Syftet med detta arbete var att undersöka hur effektiv kortikosteroidbehandling av svårt sjuka Covid-19-patienter var i jämförelse med standardbehandling utan kortikosteroider. En litteratursökning gjordes i PubMed och i covid-nma efter randomiserade kliniska studier av kortikosteroider jämfört med standardbehandling till patienter med Covid-19. Ur resultatet som inkluderade 7 kontrollerade studier med 7784 svårt sjuka patienter från 11 länder och fem kontinenter, gjordes en sammanvägning av den primära utfallsvariabeln mortalitet 28 dagar efter randomisering varpå relativ risk (RR) räknades ut individuellt per studie och sammanvägt för alla studier. Analysen gjordes också med den mest dominanta studien borträknad. Vidare utforskades möjliga samband mellan sjukdomsgrad och effektstorlek, dels genom ett försök till metaregression av studiemortalitet och andningshjälpsnivå mot RR som var inkonklusivt, men också genom att leta efter speciellt sjuka undergrupper i studierna. 3 studier rapporterade mortalitet efter 28 dagar, 1 studie rapporterade mortalitet efter 21 dagar, 2 studier rapporterade död på sjukhus och en studie rapporterade död efter 15 dagar. Testade preparat var dexametason, hydrokortison och metylprednisolon. Av 2885 patienter som randomiserats till någon kortikosteroid, dog 739, medan det av de 4899 som randomiserats till standardbehandling dog 1347 patienter vilket gav en icke signifikant RR på 0,93 (95% CI 0,86–1,01). Vid borträkning av den största studien som bestod av relativt friskare patienter erhölls en starkare och signifikant effekt med RR 0,80 (95% CI 0,70–0,92) baserat på 257 av 781 döda i steroidgrupperna jämfört med 237av 578 döda i någon kontrollgrupp med standardbehandling. Resultatet var även i linje med analysen av olika sjuka undergrupper från största studien som visade bäst effekt hos de med invasiv mekanisk andningshjälp (absolut riskreduktion 12,1%) samt en icke signifikant försämring hos de friskaste patienterna utan syrgasbehov. Sammantaget tyder dessa resultat på att behandling av svårt sjuka Covid-19-patienter med kortikosteroider minskar mortaliteten efter 28 dagar. Dessutom ger studien en stark indikation på att bästa effekten fås om kortikosteroiderna ges till patienter där den systemiska inflammationen i lungorna nått en gasutbyteshämmande nivå / ABSTRACT Since the emergence of the new corona virus disease, Covid-19, much research effort has gone into characterising every possible angle of the disease to pave the way for a possible cure in the shortest possible time. Effective therapies are needed that will reduce the risk of dying for severely to critically ill Covid-19 patients. Many existing therapies have been suggested, tested and repurposed for the treatment of Covid-19 but so far only two drugs have been approved in Sweden for this indication, namely the antiviral drug remdesivir and the corticosteroid dexamethasone. Corticosteroids are both immunosuppressive and anti-inflammatory and when they were administered previously for severe acute respiratory syndrome (SARS), middle east respiratory syndrome (MERS) and influenza they were found to increase the time to rid the body of virus. The purpose of this study was to investigate evidence found in the research literature of how effective corticosteroids are in reducing the risk of dying as compared to standard treatment with no corticosteroids when administered to hospitalised patients with severe Covid-19. A literature search was made in the PubMed and covid-nma databases for randomized clinical studies of corticosteroids versus standard treatment to patients with Covid-19. The result included 7 studies with 7784 patients from 11 countries and 5 continents which all reported death as an outcome in groups that were receiving corticosteroids compared to groups that were receiving standard care. The studies used one of the following corticosteroids as intervention: dexamethasone, methylprednisolone and hydrocortisone in different doses. In the groups receiving standard care, 1347 patients out of 4899 died while in the corticosteroid groups 739 of 2885 patients died. When doing a statistical calculation these figures indicated that the risk of dying when getting corticosteroids was 93% of the risk when not getting corticosteroids, however the difference was not statistically significant. After omitting the largest study from the material, that contributed the absolute majority of total participants, who were deemed relatively healthy or well taken care of, the results were instead that 257 out of 781 died in the steroid groups and 237 of 578 died in the control groups. This later comparison among supposedly sicker patients, gave a statistically significant 8,1% lower absolute risk of dying in the corticosteroid groups; an effect that could also be expressed as for every 25 patients treated, 2 more lives would be saved. A further control of a more severely sick subgroup of patients from the largest study, in need of invasive mechanical ventilation, revealed an absolute reduction of the risk of dying when given corticosteroids of 12,1%. This group showed the most effectful response to the administered corticosteroids in this study which could also be expressed as 1 more life saved for every 8 patients treated. Another sub group analysis of the patients from the largest study that were not in need of any type of oxygen support, indicated on the other hand a possible harm of corticosteroids. This potentially harmful effect was however not statistically significant. In summary, the results of this study imply that administration of corticosteroids to patients with severe Covid-19 will reduce the risk of dying. The greatest effect is seen in those patients that has reached a level of illness were the gas exchange in the lungs is impaired by the inflammation. Furthermore, caution must be taken not to introduce harm by giving corticosteroids to patients with milder disease in which the immunosuppressive properties of the drug could lead to unintended worsening of the illness.
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[pt] AVALIANDO TÉCNICAS PARA A REFLEXÃO ÉTICA E COMUNICAÇÃO SOBRE MODELOS DE APRENDIZADO DE MÁQUINAS PARA DESENVOLVEDORES / [en] EVALUATING APPROACHES FOR DEVELOPERS ETHICAL REASONING AND COMMUNICATION ABOUT MACHINE LEARNING MODELSJOSE LUIZ NUNES 30 November 2021 (has links)
[pt] O uso de modelos de aprendizado de máquina se tornou ubíquo para
um leque diverso de tarefas. Contudo, ainda não há nenhuma forma estabelecida
para refletir sobre questões éticas em seu processo de desenvolvimento.
Neste trabalho, realizamos um estudo qualitativo para avaliar duas técnicas
propostas pela literatura para auxiliar desenvolvedores a refletirem sobre
questões éticas relacionadas à construção e uso de modelos de aprendizado
de máquina: (i) Model Cards; e o (ii) Template Estendido de Metacomunicação.
Apresentamos nossos resultados a respeito do uso do Model Card
pelos participantes, com o propósito de entender como esses atores interagiram
com a ferramenta, assim como a dimensão ética de sua reflexão durante
nossas entrevistas. Nosso objetivo é melhorar técnicas para desenvolvedores
disponibilizaram informações sobre seus modelos e que a reflexão ética
sobre os sistemas que desenvolveram. Além disso, nosso trabalho tem como
objetivo contribuir para o desenvolvimento de um uso mais justo e ético de
sistemas de aprendizado de máquina. / [en] Machine learning algorithms have become widespread for a wide
array of tasks. However, there is still no established way to deal with the
ethical issues involved in their development and design. Some techniques
have been proposed in the literature to support the reflection and/or
documentation of the design and development of machine learning models,
including ethical considerations, such as: (i) Model Cards and (ii) the
Extended Metacommunication Template. We conducted a qualitative study
to evaluate the use of these tools. We present our results concerning the use
of the Model Card by participants, with the objective of understanding how
these actors interacted with the relevant tool and the ethical dimension of
their reflections during our interviews. Our goal is to improve and support
techniques for developers to disclose information about their models and
reflect ethically about the systems they design. Furthermore, we aim to
contribute to the development of a more ethically informed and fairer use
of machine learning.
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Characteristics of active & inactive credit cardholders: a case studyBong, Kui-mein, Maria., 黃貴敏. January 1985 (has links)
published_or_final_version / Business Administration / Master / Master of Business Administration
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Creative star: the strategic alliance of major transportation operators in Hong KongLo, Chun-chung, Johnny., 盧振忠. January 1996 (has links)
published_or_final_version / Business Administration / Master / Master of Business Administration
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Středověké hry pohledem dětí 21. století / Medieval games in the eyes of children in the 21st centuryFEJTKOVÁ, Ludmila January 2019 (has links)
The diploma thesis deals with the approach of today's elementary school pupils to medieval games. The theoretical part of the thesis characterizes the period of the Middle Ages and the representation of the game in the life of medieval people. It is about the importance of the game, the most famous classification of games are described and the play is described in the school-age pupils. The practical part of the thesis presents the course and results of the research aimed at determining the familiarity of students of school age with medieval games. Partial goals were to analyze the representation of medieval games in the school-age pupils' life and to determine how these pupils look at medieval games, even in the context of today's games. The research file consisted of 282 pupils of the 4th and 7th grades of elementary school. Three research assumptions have been formulated and verified by chi-quadrate. The results found point to the importance of medieval games in the lives of today's children, and the research concept itself offers suggestions for pedagogical activities in the context of the education of primary school pupils, in which the game has an irreplaceable role.
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ANÁLISE DE TÉCNICAS DE LIMIARIZAÇÃO EM PROGRAMAS DE ANÁLISE DE CARTÕES HIDROSSENSÍVEISRibas, Fabrício Barbosa 08 January 2013 (has links)
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Previous issue date: 2013-01-08 / The effect of environmental contamination by pesticides is becoming a major concern and a frequent topic of debate worldwide. Optimize the process of applying the
pesticide, is the most efficient approach found so far to reduce environmental pollution without sacrificing effectiveness in controlling plant diseases. Among the
various techniques available for quality control in the process of application of pesticides, the use of water sensitive cards is one of the most popular, but the
analysis of these cards is very difficult. There are some computer programs for analyzing images of water sensitive cards, but none is available for access online.
Thus, this study aimed to test thresholding techniques for developing an online application for analyzing water sensitive cards. We tested techniques for global
thresholding (Otsu´s method), adaptive local thresholding (Wellner’s method) and multithresholding (Bernsen and Papamarkos’ methods). The Otsu method, which
uses the technique of global thresholding produced the best results and was chosen to be used in our application online. / O efeito da contaminação do meio ambiente por parte de defensivos agrícolas vem se tornando uma grande preocupação e um tema frequente de debate em todo o
mundo. Otimizar o processo de aplicação do defensivo agrícola, é a abordagem mais eficiente encontrada até o momento para diminuir a contaminação ambiental
sem prejudicar a eficácia no controle das doenças de plantas. Dentre as várias técnicas disponíveis para o controle de qualidade no processo de aplicação de
defensivos, o uso dos cartões hidrossensíveis é uma das mais populares, mas a análise desses cartões é muito trabalhosa. Já existem alguns programas computacionais para a análise de imagens digitalizadas de cartões hidrossensíveis, mas nenhum está disponível de forma online. Nesse sentido, este trabalho teve por objetivo testar técnicas de limiarização para o desenvolvimento de uma aplicação online de análise de cartões hidrossensíveis. Foram testadas técnicas de
limiarização global (método de Otsu), limiarização local adaptativa (Método de Wellner) e multilimiarização (métodos de Bernsen e Papamarkos). O método de
Otsu, que utiliza a técnica de limiarização global, produziu os melhores resultados e foi o escolhido para ser utilizado em nossa aplicação online.
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Das estratégias globais ao formato local: o discurso publicitário adaptado às necessidades de cada públicoNascimento, Rodney de Souza 25 February 2011 (has links)
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Previous issue date: 2011-02-25 / THE ADVERTISING CAMPAIGNS of global companies backfi re due to cultural barriers
when they try to come across with the same message in different countries.
The concern and respect with the name of the brands and the language used
in some countries are mainly a result of the regional characteristics of such
countries. Thus, to standardize the language worldwide is the great challenge
for the large corporations and, mostly, for the advertising agencies. In many
cases, the solution was to think globally and to act locally. In such a way, the
companies, through its advertising agencies, had started to develop campaigns
capable of interacting with this new order. The segment of credit cards has been
especially capable of doing so. These companies had changed the concept of
communication within their advertising campaigns, being not only a symbol of
status, but also substituting the paper-currency and becoming the world-wide
accepted plastic money. Thus, this research is a result of the need to understand
how the advertising campaigns have conquered markets in similar ways by
means of a global alignment of communication and standardized language
in different markets. As this research main object is the globalized advertising
discourse; the aim of this research is to understand the strategies used in the
MasterCard credit card s Priceless campaign, which has been able to get a
global alignment in order to pass its message though in a standardized way in
many different cultures, even though it makes use of cultural specifi c values.
In this research, using some background on culture and consumption theories,
we analyze 8 advertisement pieces from the priceless credit card campaign,
all published in the Brazilian printed media from 1998 through 2006 / AS CAMPANHAS PUBLICITÁRIAS de empresas globais esbarram em barreiras culturais
ao tentar transmitir a mesma mensagem para diferentes países. O cuidado e
o respeito com o nome das marcas e a linguagem utilizada em determinados
países devem-se principalmente às características regionais de cada um.
Assim, uniformizar a linguagem mundialmente é o grande desafi o das grandes
corporações e, principalmente, das agências de publicidade. Em muitos
casos, a saída encontrada foi pensar globalmente e agir localmente.
Para tanto, as empresas, através de suas agências de publicidade, passaram
a desenvolver campanhas capazes de interagir com essa nova ordem,
destacando-se o segmento de cartões de crédito. Estas empresas mudaram
o conceito de comunicação de suas campanhas publicitárias, passando
de símbolo de status a substituto do papel-moeda e tornando o dinheiro
de plástico mundialmente aceito e difundido. Logo, esta pesquisa justifi case
a partir da necessidade de conhecer como as campanhas publicitárias
vêm conquistando diversos mercados, de maneira uniforme, por meio do
alinhamento global de comunicação e de uma linguagem padronizada.
Tendo como principal objeto o discurso publicitário globalizado, o objetivo
desta pesquisa está voltado para o entendimento das estratégias da
campanha Não tem preço do cartão de crédito MasterCard que consegue
alinhar-se globalmente e passar a mensagem de maneira uniforme para
culturas diferenciadas, mesmo recorrendo a valores particulares de cada
uma. Seguindo alguns teóricos de consumo e cultura, e tendências semióticas
contemporâneas em publicidade, analisamos 8 peças da campanha Não
tem preço , desse cartão de crédito, veiculadas no Brasil, na mídia impressa,
durante o período de 1998 a 2006
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Interactive generation and rendering of massive models : a parallel procedural approach / Génération interactive et rendu des modèles massifs : une approche procédurale parallèleBuron, Cyprien 04 February 2014 (has links)
Afin de créer des productions toujours plus réalistes, les industries du jeu vidéo et du cinéma cherchent à générer des environnements de plus en plus larges et complexes. Cependant, la modélisation manuelle des objets 3D dans de tels décors se révèle très coûteuse. A l’inverse, les méthodes de génération procédurale permettent de créer facilement une grande variété d’objets, tels que les plantes et les bâtiments. La modélisation par règles de grammaire offre un outil de haut niveau pour décrire ces objets, mais utiliser correctement ces règles s’avère très souvent compliqué. De plus, aucune solution de modélisation basée grammaire ne supporte l’édition et la visualisation d’environnements massifs en temps interactif. Dans un tel scénario, les artistes doivent modifier les objets en dehors de la scène avant de voir le résultat intégré.Dans ces travaux de recherche, nous nous intéressons à la génération procédurale et au rendu d’environnements à grande échelle. Nous voulons aussi faciliter la tâche des artistes avec des outils intuitifs de contrôle de grammaires. Tout d’abord nous proposons un système permettant la génération procédurale en parallèle sur le GPU en temps interactif. Pour cela, nous adoptons une approche d’expansion indépendante par segment, permettant une amplification des données en parallèle. Nous étendons ce système pour générer des modèles basés sur une structure interne, tels que les toits. Nous présentons aussi une solution utilisant des contextes externes pour contrôler facilement les grammaires par le biais de surface ou de texture. Pour finir nous intégrons un système de niveaux de détails et des techniques d’optimisation permettant la génération, l’édition et la visualisation interactives d’environnements à grande échelle. Grâce à notre système il est possible de générer et d’afficher interactivement des scènes comprenant des milliers de bâtiments et d’arbres, représentant environ 2 téraoctets de données. / With the increasing computing and storage capabilities of recent hardware, movie and video games industries desire huger realistic environments. However, modeling such sceneries by hand turns out to be highly time consuming and costly. On the other hand, procedural modeling provides methods to easily generate high diversity of elements such as vegetation and architecture. While grammar rules bring a high-level powerful modeling tool, using these rules is often a tedious task, necessitating frustrating trial and error process. Moreover, as no solution proposes real-time generation and rendering for massive environments, artists have to work on separate parts before integrating the whole and see the results.In this research, we aim to provide interactive generation and rendering of very large sceneries, while offering artist-friendly methods for controlling grammars behavior. We first introduce a GPU-based pipeline providing parallel procedural generation at render time. To this end we propose a segment-based expansion method working on independent elements, thus allowing for parallel amplification. We then extend this pipeline to permit the construction of models relying on internal contexts, such as roofs. We also present external contexts to control grammars with surface and texture data. Finally, we integrate a LOD system with optimization techniques within our pipeline providing interactive generation, edition and visualization of massive environments. We demonstrate the efficiency of our pipeline with a scene comprising hundred thousand trees and buildings each, representing 2 terabytes of data.
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Immunization coverage and factors associated with failure to complete childhood immunization in Kawempe Division, UgandaBataringaya, Cos Kamanda January 2010 (has links)
<p>The aim of the study was to describe immunization coverage for DPT, Polio and Measles among children of ages between 12 to 18 months in Kawempe Division and to investigate factors associated with immunization coverage. A cross-sectional survey was conducted in 239 households with children aged between 12-18 months in five villages that were selected through multi-stage cluster sampling. Information on demographic and socio-economic factors and immunization status was obtained from mothers and caretakers. Immunization coverage and analysis of associations between immunization coverage and demographic and socio-economic factors were done.</p>
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Customer Perceived Value of Credit Card Rewards : A study on Canadian ConsumersSmedley, Lisa January 2013 (has links)
Abstract Title: Customer Perceived Value of Credit Card Rewards - A study on Canadian Consumers Level: Final assignment for Bachelor’s Degree in Business Administration Author: Lisa Smedley Supervisor: Jonas Kågström Date: 2013 - January Aim: The aim of this study is to investigate what influences Customer Perceived Value; where Canadian consumers’ preferences lie in terms of rewards in the Canadian credit card industry. Method: After researching previous studies and determining what constructs have been utilized prior on similar research topics, I implement a quantitative, and to some extend iterative, research approach. Through survey research, I investigate Canadian consumer preferences through a survey sample of 124 Canadian consumers in Calgary, Alberta, Canada. Result & Conclusions: One finding in the study indicates that utilitarian benefits, which provide financial gain for the card holder, are perceived by respondents as the most valuable reward. Another finding is that inexperienced credit card holders see significantly greater value in symbolic benefits than experienced card holders do. The present study does not support the theory that customer involvement influences the customer’s perception of rewards. 2 Suggestions for future research: More extensive research is needed on the subject of whether Canadian consumers’ perceived value of rewards is influenced by their level of involvement in their credit card. Also, studies involving additional factors that could possibly determine a consumer’s perception of rewards, such as income and ethnicity should be investigated for a more well-rounded understanding of customer preferences. Contribution of the thesis: The present study contributes with new findings that can be of substantial significance for Canadian financial institutions as it provides insight into what credit card rewards Canadian consumers perceive as being valuable to them. Key words: Rewards programs, credit cards, customer loyalty, perceived customer value, timing of reward, type of reward, dimension of benefit, utilitarian, hedonic, symbolic
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