• Title/Summary/Keyword: Risk Prediction

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Correlation of Basal AMH & Ovarian Response in IVF Cycles; Predictive Value of AMH (과배란유도 시 혈중 AMH와 난소 반응성과의 상관관계; 예측 인자로서의 효용성)

  • Ahn, Young-Sun;Kim, Jin-Yeong;Cho, Yun-Jin;Kim, Min-Ji;Kim, Hye-Ok;Park, Chan-Woo;Song, In-Ok;Koong, Mi-Kyoung;Kang, Inn-Soo
    • Clinical and Experimental Reproductive Medicine
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    • v.35 no.4
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    • pp.309-317
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    • 2008
  • Objectives: The aim of this study was to evaluate the usefulness of Anti-mullerian hormone (AMH) as a predictive marker for ovarian response and cycle outcome in IVF cycles. Methods: From Jan., to Aug., 2007, 111 patients undergoing IVF/ICSI stimulated by short or antagonist protocol were selected. On cycle day 3, basal serum AMH level and FSH level were measured. The correlation between basal serum AMH or FSH, and COH outcome was analyzed and IVF outcome was compared according to the AMH levels. To determine the threshold value of AMH for poor- and hyper-response, ROC curve was analyzed. Results: Serum AMH showed higher correlation coefficient (r=0.792, p<0.001) with the number of retrieved mature oocyte than serum FSH (r=-0.477, p<0.001). According to ovarian response, FSH and AMH leves showed significant differences among poor, normal, and hyperresponder. For predicting poor (${\leq}2$ oocytes) and hyperresponse (${\geq}17$ oocyets), AMH cut-off values were 0.5 ng/ml (the sensitivity 88.9% and the specificity 89.5%) and 2.5 ng/ml (sensitivity 85.7%, specificity 87.0%), respectively. According to the AMH level, patients were divided into 3 groups: low (${\leq}0.60\;ng/ml$), normal ($0.60{\sim}2.60\;ng/ml$), and high AMH (${\geq}2.60\;ng/ml$). The number of retrieved mature oocytes was significantly higher ($2.7{\pm}2.2$, $8.1{\pm}4.8$, $16.5{\pm}5.7$) and total gonadotropin dose was lower ($3530.5{\pm}1251.0$, $2957.1{\pm}1057.6$, and $2219.2{\pm}751.9\;IU$) in high AMH group (p<0.001). There was no significant difference in fertilization rates and pregnancy rates (23.8%, 34.0%, 37.5%) among the groups. Conclusions: Basal serum AMH level correlated better with the number of retrieved mature oocytes than FSH level, suggesting its usefulness for predicting ovarian response. However, IVF outcome was not significantly different according to the AMH levels. Serum AMH level presented good cut-off value for poor- or hyper-responders, therefore it could be useful in prediction of cycle cancellation, gonadotropin dose, and OHSS risk in IVF cycles.

Effect of the Suicide Prevention Program to the Impulsive Psychology of the Elementary School Student (자살예방 프로그램이 초등학교 충동심리에 미치는 영향)

  • Kang, Soo Jin;Kang, Ho Jung;Cho, Won Cheol;Lee, Tae Shik
    • Journal of Korean Society of Disaster and Security
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    • v.6 no.1
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    • pp.65-72
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    • 2013
  • In this study, the early suicide prevention program was applied to the elementary school students and compared the prior & post effect of the program, and verified the status of psychology change like emotional status, or temptation to take a suicide, and presented the possibility as a suicide prevention program. The period of adolescence is the very unstable period in the process of growth being cognitively immature, emotionally impulsive period. It is the period emotionally unstable and unpredictable possible to select the method of suicide as an extreme method to escape the reality, or impulsive problem solving against small conflict or dispute situation. Many stress of the student such as recent nuclear family, expectation of parents to their children, education problem, socio-environmental elements, individual psychological factor lead students to the extreme activity of suicide in recent days. In this study, the scope of stress experienced in the elementary school as well as idea and degree of temptation regarding suicide by the suicide prevention program were identified, and through prevention program such as meditation training, breath training and through experience of anger control, emotion-expression, self overcome and establish positive self-identity and make understanding Self-control, Self-esteem & preciousness of life based on which the effect to suicide prevention was analyzed. The study was made targeting 51 students of 2 classes of 6th grade of elementary school of Goyang-si and processed 30 minutes every morning focused on through experience & activity of the principle & method of brain science. The data was collected for 20 times before starting morning class by using Suicide Probability Scale(herein SPS-A) designed to predict effectively suicide Probability, suicide risk prediction scale, surveyed by 7 areas such as Positive outlook, Within the family closeness, Impulsivity, Interpersonal hostility, Hopelessness, Hopelessness syndrome, suicide accident. Analytical methods and validation was used the Wilcoxon's signed rank test using SPSS Program. Though the process of program in short period, but there was a effective and positive results in the 7 areas in the average comparison. But in the t-test result, there was a different outcome. It indicated changes in the 3 questionnaires (No.7, No.14, No.19) out of 31 SPS-A questionnaires, and there was a no change to the rest item. It also indicated more changes of the students in the class A than class B. And in case of the class A students, psychological changes were verified in the areas of Hopelessness syndrome, suicide accident among 7 areas after the program was processed. Through this study, it could be verified that different results could be derived depending on the Student tendency, program professional(teacher in charge, processing lecturer). The suicide prevention program presented in this article can be a help in learning and suicide prevention with consistent systematization, activation through emotion and impulse control based on emotional stress relief and positive self-identity recovery, stabilization of brain waves, and let the short period program not to be died out but to be continued connecting from childhood to adolescence capable to make surrounding environment for spiritual, physical healthy growth for which this could be an effective program for suicide prevention of the social problem.

Development of a Stock Trading System Using M & W Wave Patterns and Genetic Algorithms (M&W 파동 패턴과 유전자 알고리즘을 이용한 주식 매매 시스템 개발)

  • Yang, Hoonseok;Kim, Sunwoong;Choi, Heung Sik
    • Journal of Intelligence and Information Systems
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    • v.25 no.1
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    • pp.63-83
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    • 2019
  • Investors prefer to look for trading points based on the graph shown in the chart rather than complex analysis, such as corporate intrinsic value analysis and technical auxiliary index analysis. However, the pattern analysis technique is difficult and computerized less than the needs of users. In recent years, there have been many cases of studying stock price patterns using various machine learning techniques including neural networks in the field of artificial intelligence(AI). In particular, the development of IT technology has made it easier to analyze a huge number of chart data to find patterns that can predict stock prices. Although short-term forecasting power of prices has increased in terms of performance so far, long-term forecasting power is limited and is used in short-term trading rather than long-term investment. Other studies have focused on mechanically and accurately identifying patterns that were not recognized by past technology, but it can be vulnerable in practical areas because it is a separate matter whether the patterns found are suitable for trading. When they find a meaningful pattern, they find a point that matches the pattern. They then measure their performance after n days, assuming that they have bought at that point in time. Since this approach is to calculate virtual revenues, there can be many disparities with reality. The existing research method tries to find a pattern with stock price prediction power, but this study proposes to define the patterns first and to trade when the pattern with high success probability appears. The M & W wave pattern published by Merrill(1980) is simple because we can distinguish it by five turning points. Despite the report that some patterns have price predictability, there were no performance reports used in the actual market. The simplicity of a pattern consisting of five turning points has the advantage of reducing the cost of increasing pattern recognition accuracy. In this study, 16 patterns of up conversion and 16 patterns of down conversion are reclassified into ten groups so that they can be easily implemented by the system. Only one pattern with high success rate per group is selected for trading. Patterns that had a high probability of success in the past are likely to succeed in the future. So we trade when such a pattern occurs. It is a real situation because it is measured assuming that both the buy and sell have been executed. We tested three ways to calculate the turning point. The first method, the minimum change rate zig-zag method, removes price movements below a certain percentage and calculates the vertex. In the second method, high-low line zig-zag, the high price that meets the n-day high price line is calculated at the peak price, and the low price that meets the n-day low price line is calculated at the valley price. In the third method, the swing wave method, the high price in the center higher than n high prices on the left and right is calculated as the peak price. If the central low price is lower than the n low price on the left and right, it is calculated as valley price. The swing wave method was superior to the other methods in the test results. It is interpreted that the transaction after checking the completion of the pattern is more effective than the transaction in the unfinished state of the pattern. Genetic algorithms(GA) were the most suitable solution, although it was virtually impossible to find patterns with high success rates because the number of cases was too large in this simulation. We also performed the simulation using the Walk-forward Analysis(WFA) method, which tests the test section and the application section separately. So we were able to respond appropriately to market changes. In this study, we optimize the stock portfolio because there is a risk of over-optimized if we implement the variable optimality for each individual stock. Therefore, we selected the number of constituent stocks as 20 to increase the effect of diversified investment while avoiding optimization. We tested the KOSPI market by dividing it into six categories. In the results, the portfolio of small cap stock was the most successful and the high vol stock portfolio was the second best. This shows that patterns need to have some price volatility in order for patterns to be shaped, but volatility is not the best.

Optimum Radiotherapy Schedule for Uterine Cervical Cancer based-on the Detailed Information of Dose Fractionation and Radiotherapy Technique (처방선량 및 치료기법별 치료성적 분석 결과에 기반한 자궁경부암 환자의 최적 방사선치료 스케줄)

  • Cho, Jae-Ho;Kim, Hyun-Chang;Suh, Chang-Ok;Lee, Chang-Geol;Keum, Ki-Chang;Cho, Nam-Hoon;Lee, Ik-Jae;Shim, Su-Jung;Suh, Yang-Kwon;Seong, Jinsil;Kim, Gwi-Eon
    • Radiation Oncology Journal
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    • v.23 no.3
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    • pp.143-156
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    • 2005
  • Background: The best dose-fractionation regimen of the definitive radiotherapy for cervix cancer remains to be clearly determined. It seems to be partially attributed to the complexity of the affecting factors and the lack of detailed information on external and intra-cavitary fractionation. To find optimal practice guidelines, our experiences of the combination of external beam radiotherapy (EBRT) and high-dose-rate intracavitary brachytherapy (HDR-ICBT) were reviewed with detailed information of the various treatment parameters obtained from a large cohort of women treated homogeneously at a single institute. Materials and Methods: The subjects were 743 cervical cancer patients (Stage IB 198, IIA 77, IIB 364, IIIA 7, IIIB 89 and IVA 8) treated by radiotherapy alone, between 1990 and 1996. A total external beam radiotherapy (EBRT) dose of $23.4\~59.4$ Gy (Median 45.0) was delivered to the whole pelvis. High-dose-rate intracavitary brachytherapy (HDR-IBT) was also peformed using various fractionation schemes. A Midline block (MLB) was initiated after the delivery of $14.4\~43.2$ Gy (Median 36.0) of EBRT in 495 patients, while In the other 248 patients EBRT could not be used due to slow tumor regression or the huge initial bulk of tumor. The point A, actual bladder & rectal doses were individually assessed in all patients. The biologically effective dose (BED) to the tumor ($\alpha/\beta$=10) and late-responding tissues ($\alpha/\beta$=3) for both EBRT and HDR-ICBT were calculated. The total BED values to point A, the actual bladder and rectal reference points were the summation of the EBRT and HDR-ICBT. In addition to all the details on dose-fractionation, the other factors (i.e. the overall treatment time, physicians preference) that can affect the schedule of the definitive radiotherapy were also thoroughly analyzed. The association between MD-BED $Gy_3$ and the risk of complication was assessed using serial multiple logistic regression models. The associations between R-BED $Gy_3$ and rectal complications and between V-BED $Gy_3$ and bladder complications were assessed using multiple logistic regression models after adjustment for age, stage, tumor size and treatment duration. Serial Coxs proportional hazard regression models were used to estimate the relative risks of recurrence due to MD-BED $Gy_{10}$, and the treatment duration. Results: The overall complication rate for RTOG Grades $1\~4$ toxicities was $33.1\%$. The 5-year actuarial pelvic control rate for ail 743 patients was $83\%$. The midline cumulative BED dose, which is the sum of external midline BED and HDR-ICBT point A BED, ranged from 62.0 to 121.9 $Gy_{10}$ (median 93.0) for tumors and from 93.6 to 187.3 $Gy_3$ (median 137.6) for late responding tissues. The median cumulative values of actual rectal (R-BED $Gy_3$) and bladder Point BED (V-BED $Gy_3$) were 118.7 $Gy_3$ (range $48.8\~265.2$) and 126.1 $Gy_3$ (range: $54.9\~267.5$), respectively. MD-BED $Gy_3$ showed a good correlation with rectal (p=0.003), but not with bladder complications (p=0.095). R-BED $Gy_3$ had a very strong association (p=<0.0001), and was more predictive of rectal complications than A-BED $Gy_3$. B-BED $Gy_3$ also showed significance in the prediction of bladder complications in a trend test (p=0.0298). No statistically significant dose-response relationship for pelvic control was observed. The Sandwich and Continuous techniques, which differ according to when the ICR was inserted during the EBRT and due to the physicians preference, showed no differences in the local control and complication rates; there were also no differences in the 3 vs. 5 Gy fraction size of HDR-ICBT. Conclusion: The main reasons optimal dose-fractionation guidelines are not easily established is due to the absence of a dose-response relationship for tumor control as a result of the high-dose gradient of HDR-ICBT, individual differences In tumor responses to radiation therapy and the complexity of affecting factors. Therefore, in our opinion, there is a necessity for individualized tailored therapy, along with general guidelines, in the definitive radiation treatment for cervix cancer. This study also demonstrated the strong predictive value of actual rectal and bladder reference dosing therefore, vaginal gauze packing might be very Important. To maintain the BED dose to less than the threshold resulting in complication, early midline shielding, the HDR-ICBT total dose and fractional dose reduction should be considered.

A Study on Interactions of Competitive Promotions Between the New and Used Cars (신차와 중고차간 프로모션의 상호작용에 대한 연구)

  • Chang, Kwangpil
    • Asia Marketing Journal
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    • v.14 no.1
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    • pp.83-98
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    • 2012
  • In a market where new and used cars are competing with each other, we would run the risk of obtaining biased estimates of cross elasticity between them if we focus on only new cars or on only used cars. Unfortunately, most of previous studies on the automobile industry have focused on only new car models without taking into account the effect of used cars' pricing policy on new cars' market shares and vice versa, resulting in inadequate prediction of reactive pricing in response to competitors' rebate or price discount. However, there are some exceptions. Purohit (1992) and Sullivan (1990) looked into both new and used car markets at the same time to examine the effect of new car model launching on the used car prices. But their studies have some limitations in that they employed the average used car prices reported in NADA Used Car Guide instead of actual transaction prices. Some of the conflicting results may be due to this problem in the data. Park (1998) recognized this problem and used the actual prices in his study. His work is notable in that he investigated the qualitative effect of new car model launching on the pricing policy of the used car in terms of reinforcement of brand equity. The current work also used the actual price like Park (1998) but the quantitative aspect of competitive price promotion between new and used cars of the same model was explored. In this study, I develop a model that assumes that the cross elasticity between new and used cars of the same model is higher than those amongst new cars and used cars of the different model. Specifically, I apply the nested logit model that assumes the car model choice at the first stage and the choice between new and used cars at the second stage. This proposed model is compared to the IIA (Independence of Irrelevant Alternatives) model that assumes that there is no decision hierarchy but that new and used cars of the different model are all substitutable at the first stage. The data for this study are drawn from Power Information Network (PIN), an affiliate of J.D. Power and Associates. PIN collects sales transaction data from a sample of dealerships in the major metropolitan areas in the U.S. These are retail transactions, i.e., sales or leases to final consumers, excluding fleet sales and including both new car and used car sales. Each observation in the PIN database contains the transaction date, the manufacturer, model year, make, model, trim and other car information, the transaction price, consumer rebates, the interest rate, term, amount financed (when the vehicle is financed or leased), etc. I used data for the compact cars sold during the period January 2009- June 2009. The new and used cars of the top nine selling models are included in the study: Mazda 3, Honda Civic, Chevrolet Cobalt, Toyota Corolla, Hyundai Elantra, Ford Focus, Volkswagen Jetta, Nissan Sentra, and Kia Spectra. These models in the study accounted for 87% of category unit sales. Empirical application of the nested logit model showed that the proposed model outperformed the IIA (Independence of Irrelevant Alternatives) model in both calibration and holdout samples. The other comparison model that assumes choice between new and used cars at the first stage and car model choice at the second stage turned out to be mis-specfied since the dissimilarity parameter (i.e., inclusive or categroy value parameter) was estimated to be greater than 1. Post hoc analysis based on estimated parameters was conducted employing the modified Lanczo's iterative method. This method is intuitively appealing. For example, suppose a new car offers a certain amount of rebate and gains market share at first. In response to this rebate, a used car of the same model keeps decreasing price until it regains the lost market share to maintain the status quo. The new car settle down to a lowered market share due to the used car's reaction. The method enables us to find the amount of price discount to main the status quo and equilibrium market shares of the new and used cars. In the first simulation, I used Jetta as a focal brand to see how its new and used cars set prices, rebates or APR interactively assuming that reactive cars respond to price promotion to maintain the status quo. The simulation results showed that the IIA model underestimates cross elasticities, resulting in suggesting less aggressive used car price discount in response to new cars' rebate than the proposed nested logit model. In the second simulation, I used Elantra to reconfirm the result for Jetta and came to the same conclusion. In the third simulation, I had Corolla offer $1,000 rebate to see what could be the best response for Elantra's new and used cars. Interestingly, Elantra's used car could maintain the status quo by offering lower price discount ($160) than the new car ($205). In the future research, we might want to explore the plausibility of the alternative nested logit model. For example, the NUB model that assumes choice between new and used cars at the first stage and brand choice at the second stage could be a possibility even though it was rejected in the current study because of mis-specification (A dissimilarity parameter turned out to be higher than 1). The NUB model may have been rejected due to true mis-specification or data structure transmitted from a typical car dealership. In a typical car dealership, both new and used cars of the same model are displayed. Because of this fact, the BNU model that assumes brand choice at the first stage and choice between new and used cars at the second stage may have been favored in the current study since customers first choose a dealership (brand) then choose between new and used cars given this market environment. However, suppose there are dealerships that carry both new and used cars of various models, then the NUB model might fit the data as well as the BNU model. Which model is a better description of the data is an empirical question. In addition, it would be interesting to test a probabilistic mixture model of the BNU and NUB on a new data set.

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