Search results for: cox proportional hazard regression
4199 Risk Factors of Hospital Acquired Infection Mortality in a Tunisian Intensive Care Unit
Authors: Ben Cheikh Asma, Bouafia Nabiha, Ammar Asma, Ezzi Olfa, Meddeb Khaoula, Chouchène Imed, Boussarsar Hamadi, Njah Mansour
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Background: Hospital Acquired Infection (HAI) constitutes an important worldwide health problem. It was associated with high mortality rate in intensive care units (ICU). This study aimed to determine HAI mortality rate in Tunisian intensive care units and identify its risk factors. Methods: We conducted a prospective observational cohort study over a 12 months period (September 15th 2015 to September 15 th 2016) in the adult medical ICU of University Hospital-Farhat Hached (Sousse-Tunisia). All patients admitted in the ICU for more than 48 hours were included in the study. We used an anonymous standardized survey record form to collect data by a medical hygienist assisted by an intensivist. We adopted definitions of Center for Diseases Control and prevention of Atlanta to detect HAI, Kaplan Meier survival analysis and Cox proportional hazard regression to identify independent risk factor of HAI mortality. Results: Of 171 patients, 67 developed ICU-acquired infection (global incidence rate=39.2%). The mean age of patients was 59 ± 21.2 years and 60.8% were male. The most frequently identified infections were pulmonary acquired infection (ventilator associated pneumonia (VAP) and infected atelectasis with density rates 21.4 VAP/1000 days of mechanical ventilation and 9.4 infected atelectasis /1000 days of mechanical ventilation; respectively) and central venous catheter associated infection (CVC - AI) with density rate 28.4 CVC-AI / 1000 CVC-days). HAI mortality rate was 66.7% (n=44). The median survival was 20 days 3.36, 95% Confidential Interval [13.39 – 26.60]. Specific mortality rates according to infectious site were 65.5%, 36.4% and 4.5% respectively for VAP, CVC associated infection and infected atelectasis. In univariate analysis, a significant associations between mortality and cardiovascular history (p=0.04) tracheotomy (p=0.00), peripheral venous catheterization (p=0.04), VAP (p=0.04) and infected atelectasis (p=0.04) were detected. Independent risk factors for HAI mortality were VAP with Hazard Ratio = 3.14, 95% Confidential Interval [1.63 – 6.05] (p=0.001) and tracheotomy (Hazard Ratio=0.22, 95% Confidential Interval [0.10 – 0.44], p=0.000). Conclusions: In the present study, hospital acquired infection mortality rate was relatively high. We need to intensify the fight against these infections especially ventilator-associated pneumonia that is associated with higher risk of mortality in many studies. Thus, more effective infection control interventions were necessary in our hospital.Keywords: hospital acquired infection, intensive care unit, mortality, risk factors
Procedia PDF Downloads 4844198 Hazard Alert in Malaysia Related to Occupational Safety and Health
Authors: Atikah Binti Azudin, Nurin Nazlah Binti Muhamad Yani, Nur Alya Nadhirah Binti Naaidith, Nur Amylia Wahida Binti Mat Ayob, Nurshamimi Shakirah Binti Suboh, Nur Auni Batrisyia Binti Md. Zaini, Nur Aziemah Binti Mohamad, Nurul Suffiyah Binti Sa’Dun, Sabrina Sasha Izzati Binti Zubaile, Umi Huwaina Binti Ahmiruddin, Wan Nur Shafawati Binti Wan Ghazali
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A hazard alert is intended to provide brief information about significant incidents or existing difficulties in Department workplaces. The alert gives guidelines for proper processes, practices, and controls to be applied. When operated in accordance with the manufacturer's instructions, any machine or tool utilized at work provides a safe and dependable platform for workers to accomplish job duties. However, when not utilized appropriately, the machine might pose a major hazard to employees. Employers have a duty to keep employees safe in this scenario. This Hazard Alert outlines specific occupational dangers and the controls that employers must apply to prevent injury or fatal accidents. There have been several cases of hazard alerts in Malaysia, which have had a negative impact on a few workers. Looking on the bright side, we can overcome every incident in a variety of ways. One of these is that only qualified individuals operate mobile machinery and equipment. In addition, employees may also perform frequent pre-use inspections of machinery to discover and fix flaws. Hazard alert is very important, and this study would cover a variety of subjects, including the methods employed.Keywords: safe, hazard, impacts, duties.
Procedia PDF Downloads 924197 Optimization of Machine Learning Regression Results: An Application on Health Expenditures
Authors: Songul Cinaroglu
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Machine learning regression methods are recommended as an alternative to classical regression methods in the existence of variables which are difficult to model. Data for health expenditure is typically non-normal and have a heavily skewed distribution. This study aims to compare machine learning regression methods by hyperparameter tuning to predict health expenditure per capita. A multiple regression model was conducted and performance results of Lasso Regression, Random Forest Regression and Support Vector Machine Regression recorded when different hyperparameters are assigned. Lambda (λ) value for Lasso Regression, number of trees for Random Forest Regression, epsilon (ε) value for Support Vector Regression was determined as hyperparameters. Study results performed by using 'k' fold cross validation changed from 5 to 50, indicate the difference between machine learning regression results in terms of R², RMSE and MAE values that are statistically significant (p < 0.001). Study results reveal that Random Forest Regression (R² ˃ 0.7500, RMSE ≤ 0.6000 ve MAE ≤ 0.4000) outperforms other machine learning regression methods. It is highly advisable to use machine learning regression methods for modelling health expenditures.Keywords: machine learning, lasso regression, random forest regression, support vector regression, hyperparameter tuning, health expenditure
Procedia PDF Downloads 2264196 Seismic Hazard Analysis for a Multi Layer Fault System: Antalya (SW Turkey) Example
Authors: Nihat Dipova, Bulent Cangir
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This article presents the results of probabilistic seismic hazard analysis (PSHA) for Antalya (SW Turkey). South west of Turkey is characterized by large earthquakes resulting from the continental collision between the African, Arabian and Eurasian plates and crustal faults. Earthquakes around the study area are grouped into two; crustal earthquakes (D=0-50 km) and subduction zone earthquakes (50-140 km). Maximum observed magnitude of subduction earthquakes is Mw=6.0. Maximum magnitude of crustal earthquakes is Mw=6.6. Sources for crustal earthquakes are faults which are related with Isparta Angle and Cyprus Arc tectonic structures. A new earthquake catalogue for Antalya, with unified moment magnitude scale has been prepared and seismicity of the area around Antalya city has been evaluated by defining ‘a’ and ‘b’ parameters of the Gutenberg-Richter recurrence relationship. The Standard Cornell-McGuire method has been used for hazard computation utilizing CRISIS2007 software. Attenuation relationships proposed by Chiou and Youngs (2008) has been used for 0-50 km earthquakes and Youngs et. al (1997) for deep subduction earthquakes. Finally, Seismic hazard map for peak horizontal acceleration on a uniform site condition of firm rock (average shear wave velocity of about 1130 m/s) at a hazard level of 10% probability of exceedance in 50 years has been prepared.Keywords: Antalya, peak ground acceleration, seismic hazard assessment, subduction
Procedia PDF Downloads 3714195 Efficient Estimation for the Cox Proportional Hazards Cure Model
Authors: Khandoker Akib Mohammad
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While analyzing time-to-event data, it is possible that a certain fraction of subjects will never experience the event of interest, and they are said to be cured. When this feature of survival models is taken into account, the models are commonly referred to as cure models. In the presence of covariates, the conditional survival function of the population can be modelled by using the cure model, which depends on the probability of being uncured (incidence) and the conditional survival function of the uncured subjects (latency), and a combination of logistic regression and Cox proportional hazards (PH) regression is used to model the incidence and latency respectively. In this paper, we have shown the asymptotic normality of the profile likelihood estimator via asymptotic expansion of the profile likelihood and obtain the explicit form of the variance estimator with an implicit function in the profile likelihood. We have also shown the efficient score function based on projection theory and the profile likelihood score function are equal. Our contribution in this paper is that we have expressed the efficient information matrix as the variance of the profile likelihood score function. A simulation study suggests that the estimated standard errors from bootstrap samples (SMCURE package) and the profile likelihood score function (our approach) are providing similar and comparable results. The numerical result of our proposed method is also shown by using the melanoma data from SMCURE R-package, and we compare the results with the output obtained from the SMCURE package.Keywords: Cox PH model, cure model, efficient score function, EM algorithm, implicit function, profile likelihood
Procedia PDF Downloads 1434194 A Comparison of Smoothing Spline Method and Penalized Spline Regression Method Based on Nonparametric Regression Model
Authors: Autcha Araveeporn
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This paper presents a study about a nonparametric regression model consisting of a smoothing spline method and a penalized spline regression method. We also compare the techniques used for estimation and prediction of nonparametric regression model. We tried both methods with crude oil prices in dollars per barrel and the Stock Exchange of Thailand (SET) index. According to the results, it is concluded that smoothing spline method performs better than that of penalized spline regression method.Keywords: nonparametric regression model, penalized spline regression method, smoothing spline method, Stock Exchange of Thailand (SET)
Procedia PDF Downloads 4404193 Evaluation of Computer Usage and Related Health Hazards
Authors: B. O. Adegoke, B. O. Ola, D. T. Ademiluyi
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This paper examines the use of computer and its related health hazard among computer users in South-Western zone of Nigeria. Two hundred and eighteen (218) computer users constituted the population used to evaluate association between posture, extensive computer use and related health hazard. The instruments for the study are a questionnaire on demographics, lifestyle, body features and work ability index while mean rating, standard deviation and t test were used for data analysis. Identified health related hazard include damages to the eyesight, bad posture, arthritis, musculoskeletal disorders, headache, stress and so on. The results showed that factors such as work demand, posture, closeness to computer screen and excessive working hours on computers constitute health hazards in both old and young computer users of various gender. It is therefore recommended that total number of hours spent with computer should be monitored and controlled.Keywords: computer-related health hazard, musculoskeletal disorders, computer usage, work ability index
Procedia PDF Downloads 4894192 Deriving an Index of Adoption Rate and Assessing Factors Affecting Adoption of an Agroforestry-Based Farming System in Dhanusha District, Nepal
Authors: Arun Dhakal, Geoff Cockfield, Tek Narayan Maraseni
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This paper attempts to fulfil the gap in measuring adoption in agroforestry studies. It explains the derivation of an index of adoption rate in a Nepalese context and examines the factors affecting adoption of agroforestry-based land management practice (AFLMP) in the Dhanusha District of Nepal. Data about the different farm practices and the factors (bio-physical, socio-economic) influencing adoption were collected during focus group discussion and from the randomly selected households using a household survey questionnaire, respectively. A multivariate regression model was used to determine the factors. The factors (variables) found to significantly affect adoption of AFLMP were: farm size, availability of irrigation water, education of household heads, agricultural labour force, frequency of visits by extension workers, expenditure on farm inputs purchase, household’s experience in agroforestry, and distance from home to government forest. The regression model explained about 75% of variation in adoption decision. The model rejected ‘erosion hazard’, ‘flood hazard’ and ‘gender’ as determinants of adoption, which in case of single agroforestry practice were major variables and played positive role. Out of eight variables, farm size played the most powerful role in explaining the variation in adoption, followed by availability of irrigation water and education of household heads. The results of this study suggest that policies to promote the provision of irrigation water, extension services and motivation to obtaining higher education would probably provide the incentive to adopt agroforestry elsewhere in the terai of Nepal.Keywords: agroforestry, adoption index, determinants of adoption, step-wise linear regression, Nepal
Procedia PDF Downloads 5034191 Assessing Social Vulnerability and Policy Adaption Application Responses Based on Landslide Risk Map
Authors: Z. A. Ahmad, R. C. Omar, I. Z. Baharuddin, R. Roslan
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Assessments of social vulnerability, carried out holistically, can provide an important guide to the planning process and to decisions on resource allocation at various levels, and can help to raise public awareness of geo-hazard risks. The assessments can help to provide answers for basic questions such as the human vulnerability at the geo-hazard prone or disaster areas causing health damage, economic loss, loss of natural heritage and vulnerability impact of extreme natural hazard event. To overcome these issues, integrated framework for assessing the increasing human vulnerability to environmental changes caused by geo-hazards will be introduced using an indicator from landslide risk map that is related to agent based modeling platform. The indicators represent the underlying factors, which influence a community’s ability to deal with and recover from the damage associated with geo-hazards. Scope of this paper is particularly limited to landslides.Keywords: social, vulnerability, geo-hazard, methodology, indicators
Procedia PDF Downloads 2854190 Seismic Hazard Response of Bhairabi-Sairang Tunnel Due to the Effect of Faulting
Authors: Tauhidur Rahman, Subhrajit Pathak
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In this study, structural response of Bhairabi-Sairang Tunnel due to presence of seismic faults has been thoroughly examined. There may be several active faults located in and around the project. Faults are the key seismic sources from where earthquakes are originated. The magnitude of earthquake will depend on the length of the fault. A long fault more than 200 km can produce earthquake of magnitude (Mw ) more than 8.0 and smaller length less than 10 km will produce small magnitude earthquake. Now-a-days it is very much essential to identify the distance and length of a fault from the project site. Based on this, in the present paper, a case study of the Bhairabi Sairang Tunnel of 1.73 Km length located in the North Eastern Region of India has been selected to calculate the seismic hazard from the surrounding effect of faults. A comparative study of seismic hazard at the tunnel site has been made based on the location of faults with the seismic hazard obtained from the Indian Standards code of Practice. In this paper, a practical problem of a tunnel has been analysed based on the available faults around the project site accounting the soil factor.Keywords: seismic hazard, effect of fault, soil factor, Bhairabi Sairang tunnel
Procedia PDF Downloads 5664189 Incidence and Predictors of Mortality Among HIV Positive Children on Art in Public Hospitals of Harer Town, Enrolled From 2011 to 2021
Authors: Getahun Nigusie
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Background; antiretroviral treatment reduce HIV-related morbidity, and prolonged survival of patients however, there is lack of up-to-date information concerning the treatment long term effect on the survival of HIV positive children especially in the study area. Objective: To assess incidence and predictors of mortality among HIV positive children on ART in public hospitals of Harer town who were enrolled from 2011 to 2021. Methodology: Institution based retrospective cohort study was conducted among 429 HIV positive children enrolled in ART clinic from January 1st 2011 to December30th 2021. Data were collected from medical cards by using a data extraction form, Descriptive analyses were used to Summarized the results, and life table was used to estimate survival probability at specific point of time after introduction of ART. Kaplan Meier survival curve together with log rank test was used to compare survival between different categories of covariates, and Multivariate Cox-proportional hazard regression model was used to estimate adjusted Hazard rate. Variables with p-values ≤0.25 in bivariable analysis were candidates to the multivariable analysis. Finally, variables with p-values < 0.05 were considered as significant variables. Results: The study participants had followed for a total of 2549.6 child-years (30596 child months) with an overall mortality rate of 1.5 (95% CI: 1.1, 2.04) per 100 child-years. Their median survival time was 112 months (95% CI: 101–117). There were 38 children with unknown outcome, 39 deaths, and 55 children transfer out to different facility. The overall survival at 6, 12, 24, 48 months were 98%, 96%, 95%, 94% respectively. being in WHO clinical Stage four (AHR=4.55, 95% CI:1.36, 15.24), having anemia(AHR=2.56, 95% CI:1.11, 5.93), baseline low absolute CD4 count (AHR=2.95, 95% CI: 1.22, 7.12), stunting (AHR=4.1, 95% CI: 1.11, 15.42), wasting (AHR=4.93, 95% CI: 1.31, 18.76), poor adherence to treatment (AHR=3.37, 95% CI: 1.25, 9.11), having TB infection at enrollment (AHR=3.26, 95% CI: 1.25, 8.49),and no history of change their regimen(AHR=7.1, 95% CI: 2.74, 18.24), were independent predictors of death. Conclusion: more than half of death occurs within 2 years. Prevalent tuberculosis, anemia, wasting, and stunting nutritional status, socioeconomic factors, and baseline opportunistic infection were independent predictors of death. Increasing early screening and managing those predictors are required.Keywords: human immunodeficiency virus-positive children, anti-retroviral therapy, survival, Ethiopia
Procedia PDF Downloads 224188 Developing an Integrated Seismic Risk Model for Existing Buildings in Northern Algeria
Authors: R. Monteiro, A. Abarca
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Large scale seismic risk assessment has become increasingly popular to evaluate the physical vulnerability of a given region to seismic events, by putting together hazard, exposure and vulnerability components. This study, developed within the scope of the EU-funded project ITERATE (Improved Tools for Disaster Risk Mitigation in Algeria), explains the steps and expected results for the development of an integrated seismic risk model for assessment of the vulnerability of residential buildings in Northern Algeria. For this purpose, the model foresees the consideration of an updated seismic hazard model, as well as ad-hoc exposure and physical vulnerability models for local residential buildings. The first results of this endeavor, such as the hazard model and a specific taxonomy to be used for the exposure and fragility components of the model are presented, using as starting point the province of Blida, in Algeria. Specific remarks and conclusions regarding the characteristics of the Northern Algerian in-built are then made based on these results.Keywords: Northern Algeria, risk, seismic hazard, vulnerability
Procedia PDF Downloads 2014187 Identifying Model to Predict Deterioration of Water Mains Using Robust Analysis
Authors: Go Bong Choi, Shin Je Lee, Sung Jin Yoo, Gibaek Lee, Jong Min Lee
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In South Korea, it is difficult to obtain data for statistical pipe assessment. In this paper, to address these issues, we find that various statistical model presented before is how data mixed with noise and are whether apply in South Korea. Three major type of model is studied and if data is presented in the paper, we add noise to data, which affects how model response changes. Moreover, we generate data from model in paper and analyse effect of noise. From this we can find robustness and applicability in Korea of each model.Keywords: proportional hazard model, survival model, water main deterioration, ecological sciences
Procedia PDF Downloads 7434186 Flood Hazard Assessment and Land Cover Dynamics of the Orai Khola Watershed, Bardiya, Nepal
Authors: Loonibha Manandhar, Rajendra Bhandari, Kumud Raj Kafle
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Nepal’s Terai region is a part of the Ganges river basin which is one of the most disaster-prone areas of the world, with recurrent monsoon flooding causing millions in damage and the death and displacement of hundreds of people and households every year. The vulnerability of human settlements to natural disasters such as floods is increasing, and mapping changes in land use practices and hydro-geological parameters is essential in developing resilient communities and strong disaster management policies. The objective of this study was to develop a flood hazard zonation map of Orai Khola watershed and map the decadal land use/land cover dynamics of the watershed. The watershed area was delineated using SRTM DEM, and LANDSAT images were classified into five land use classes (forest, grassland, sediment and bare land, settlement area and cropland, and water body) using pixel-based semi-automated supervised maximum likelihood classification. Decadal changes in each class were then quantified using spatial modelling. Flood hazard mapping was performed by assigning weights to factors slope, rainfall distribution, distance from the river and land use/land cover on the basis of their estimated influence in causing flood hazard and performing weighed overlay analysis to identify areas that are highly vulnerable. The forest and grassland coverage increased by 11.53 km² (3.8%) and 1.43 km² (0.47%) from 1996 to 2016. The sediment and bare land areas decreased by 12.45 km² (4.12%) from 1996 to 2016 whereas settlement and cropland areas showed a consistent increase to 14.22 km² (4.7%). Waterbody coverage also increased to 0.3 km² (0.09%) from 1996-2016. 1.27% (3.65 km²) of total watershed area was categorized into very low hazard zone, 20.94% (60.31 km²) area into low hazard zone, 37.59% (108.3 km²) area into moderate hazard zone, 29.25% (84.27 km²) area into high hazard zone and 31 villages which comprised 10.95% (31.55 km²) were categorized into high hazard zone area.Keywords: flood hazard, land use/land cover, Orai river, supervised maximum likelihood classification, weighed overlay analysis
Procedia PDF Downloads 3524185 Assessment of Incidence and Predictors of Mortality Among HIV Positive Children on Art in Public Hospitals of Harer Town Who Were Enrolled From 2011 to 2021
Authors: Getahun Nigusie Demise
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Background; antiretroviral treatment reduce HIV-related morbidity, and prolonged survival of patients however, there is lack of up-to-date information concerning the treatment long term effect on the survival of HIV positive children especially in the study area. Objective: The aim of this study is to assess the incidence and predictors of mortality among HIV positive children on antiretroviral therapy (ART) in public hospitals of Harer town who were enrolled from 2011 to 2021. Methodology: Institution based retrospective cohort study was conducted among 429 HIV positive children enrolled in ART clinic from January 1st 2011 to December30th 2021. Data were collected from medical cards by using a data extraction form, Descriptive analyses were used to Summarized the results, and life table was used to estimate survival probability at specific point of time after introduction of ART. Kaplan Meier survival curve together with log rank test was used to compare survival between different categories of covariates, and Multivariate Cox-proportional hazard regression model was used to estimate adjusted Hazard rate. Variables with p-values ≤0.25 in bivariable analysis were candidates to the multivariable analysis. Finally, variables with p-values < 0.05 were considered as significant variables. Results: The study participants had followed for a total of 2549.6 child-years (30596 child months) with an overall mortality rate of 1.5 (95% CI: 1.1, 2.04) per 100 child-years. Their median survival time was 112 months (95% CI: 101–117). There were 38 children with unknown outcome, 39 deaths, and 55 children transfer out to different facility. The overall survival at 6, 12, 24, 48 months were 98%, 96%, 95%, 94% respectively. being in WHO clinical Stage four (AHR=4.55, 95% CI:1.36, 15.24), having anemia(AHR=2.56, 95% CI:1.11, 5.93), baseline low absolute CD4 count (AHR=2.95, 95% CI: 1.22, 7.12), stunting (AHR=4.1, 95% CI: 1.11, 15.42), wasting (AHR=4.93, 95% CI: 1.31, 18.76), poor adherence to treatment (AHR=3.37, 95% CI: 1.25, 9.11), having TB infection at enrollment (AHR=3.26, 95% CI: 1.25, 8.49),and no history of change their regimen(AHR=7.1, 95% CI: 2.74, 18.24), were independent predictors of death. Conclusion: more than half of death occurs within 2 years. Prevalent tuberculosis, anemia, wasting, and stunting nutritional status, socioeconomic factors, and baseline opportunistic infection were independent predictors of death. Increasing early screening and managing those predictors are required.Keywords: human immunodeficiency virus-positive children, anti-retroviral therapy, survival, treatment, Ethiopia
Procedia PDF Downloads 484184 Ziegler Nichols Based Integral Proportional Controller for Superheated Steam Temperature Control System
Authors: Amil Daraz, Suheel Abdullah Malik, Tahir Saleem, Sajid Ali Bhati
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In this paper, Integral Proportional (I-P) controller is employed for superheated steam temperature control system. The Ziegler-Nichols (Z-N) method is used for the tuning of I-P controller. The performance analysis of Z-N based I-P controller is assessed on superheated steam system of 500-MW boiler. The comparison of transient response parameters such as rise time, settling time, and overshoot is made with Z-N based Proportional Integral (PI) controller. It is observed from the results that Z-N based I-P controller completely eliminates the overshoot in the output response.Keywords: superheated steam, process reaction curve, PI and I-P controller, Ziegler-Nichols Tuning
Procedia PDF Downloads 3314183 The Effect of a Multidisciplinary Spine Clinic on Treatment Rates and Lead Times to Care
Authors: Ishan Naidu, Jessica Ryvlin, Devin Videlefsky
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Introduction: Back pain is a leading cause of years lived with disability and economic burden, exceeding over $20 billion in healthcare costs not including indirect costs such as absence from work and caregiving. The multifactorial nature of back pain leads to treatment modalities administered by a variety of specialists, which are often disjointed. Multiple studies have found that patients receiving delayed physical therapy for lower back pain had higher medical-related costs from increased health service utilization as well as a reduced improvement in pain severity compared to early management. Uncoordinated health care delivery can exacerbate the physical and economic toll of the chronic condition, thus improvements in interdisciplinary, shared decision-making may improve outcomes. Objective: To assess whether a multidisciplinary spine clinic (MSC), consisting of orthopedic surgery, neurosurgery, pain medicine, and physiatry, alters interventional and non-interventional planning and treatment compared to a traditional unidisciplinary spine clinic (USC) including only orthopedic surgery. Methods: We conducted a retrospective cohort study with patients initially presenting for spine care to orthopedic surgeons between July 1, 2018 to June 30, 2019. Time to treatment recommendation, time to treatment and rates of treatment recommendations were assessed, including physical therapy, injections and surgery. Treatment rates were compared between MSC and USC using Pearson’s chi-square test logistic regression. Time to treatment recommendation and time to treatment were compared using log-rank test and Cox proportional hazard regression. All analyses were repeated for the propensity score (PS) matched subsample. Results: This study included 1,764 patients, with 692 at MSC and 1,072 at USC. Patients in MSC were more likely to be recommended injection when compared to USC (8.5% vs. 5.4%, p=0.01). When adjusted for confounders, the likelihood of injection recommendation remained greater in MSC than USC (Odds ratio [OR]=2.22, 95% CI: (1.39, 3.53), p=0.001). MSC was also associated with a shorter time to receiving injection recommendation versus USC (median: 21 vs. 32 days, log-rank: p<0.001; hazard ratio [HR]=1.90, 95% CI: (1.25, 2.90), p=0.003). MSC was associated with a higher likelihood of injection treatment (OR=2.27, 95% CI: (1.39, 3.73), p=0.001) and shorter lead time (HR=1.98, 95% CI: (1.27, 3.09), p=0.003). PS-matched analyses yielded similar conclusions. Conclusions: Care delivered at a multidisciplinary spine clinic was associated with a higher likelihood of recommending injection and a shorter lead time to injection administration when compared to a traditional unidisciplinary spine surgery clinic. Multidisciplinary clinics may facilitate coordinated care amongst different specialties resulting in increased utilization of less invasive treatment modalities while also improving care efficiency. The multidisciplinary clinic model is an important advancement in care delivery and communication, which can be used as a powerful method of improving patient outcomes as treatment guidelines evolve.Keywords: coordinated care, epidural steroid injection, multi-disciplinary, non-invasive
Procedia PDF Downloads 1404182 Experimental Study on the Effect of Storage Conditions on Thermal Hazard of Nitrocellulose
Authors: Hua Chai, Qiangling Duan, Huiqi Cao, Mi Li, Jinhua Sun
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Nitrocellulose (NC), a kind of energetic material, has been widely used in the industrial and military fields. However, this material can also cause serious social disasters due to storage conditions. Thermal hazard of nitrocellulose (NC) was experimentally investigated using the CALVET heat flux calorimeter C80, and three kinds of storage conditions were considered in the experiments: (1) drying time, (2) moisture content, (3) cycles. The results showed that the heat flow curves of NC moved to the low-temperature direction firstly and then slightly moved back by increasing the drying hours. Moisture that was responsible for the appearance of small exothermic peaks was proven to be the unfavorable safety factor yet it could increase the onset temperature of the main peak to some extent. And cycles could both lower the onset temperature and the maximum heat flow but enlarged the peak temperature. Besides, relevant kinetic parameters such as the heat of reaction (ΔH) and the activation energy (Ea) were obtained and compared. It was found that all the three conditions could reduce the values of Ea and most of them produced larger reaction heat. In addition, the critical explosion temperature (Tb) of the NC samples were derived. It was clear that not only the drying time but also the cycles would increase the thermal hazard of the NC. Yet, the right amount of water helped to reduce the thermal hazard.Keywords: C80, nitrocellulose, storage conditions, the critical explosion temperature, thermal hazard
Procedia PDF Downloads 1644181 Application of Failure Mode and Effects Analysis (FMEA) on the Virtual Process Hazard Analysis of Acetone Production Process
Authors: Princes Ann E. Prieto, Denise F. Alpuerto, John Rafael C. Unlayao, Neil Concibido, Monet Concepcion Maguyon-Detras
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Failure Mode and Effects Analysis (FMEA) has been used in the virtual Process Hazard Analysis (PHA) of the Acetone production process through the dehydrogenation of isopropyl alcohol, for which very limited process risk assessment has been published. In this study, the potential failure modes, effects, and possible causes of selected major equipment in the process were identified. During the virtual FMEA mock sessions, the risks in the process were evaluated and recommendations to reduce and/or mitigate the process risks were formulated. The risk was estimated using the calculated risk priority number (RPN) and was classified into four (4) levels according to their effects on acetone production. Results of this study were also used to rank the criticality of equipment in the process based on the calculated criticality rating (CR). Bow tie diagrams were also created for the critical hazard scenarios identified in the study.Keywords: chemical process safety, failure mode and effects analysis (FMEA), process hazard analysis (PHA), process safety management (PSM)
Procedia PDF Downloads 1374180 The Impact of Technology on Computer Systems and Technology
Authors: Bishoy Abouelsoud Saad Amin
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This paper examines the use of computer and its related health hazard among computer users in South-Western zone of Nigeria. Two hundred and eighteen (218) computer users constituted the population used to evaluate association between posture, extensive computer use and related health hazard. The instruments for the study are a questionnaire on demographics, lifestyle, body features and work ability index while mean rating, standard deviation and t test were used for data analysis. Identified health related hazard include damages to the eyesight, bad posture, arthritis, musculoskeletal disorders, headache, stress and so on. The results showed that factors such as work demand, posture, closeness to computer screen and excessive working hours on computers constitute health hazards in both old and young computer users of various gender. It is therefore recommended that total number of hours spent with computer should be monitored and controlled.Keywords: computer game, metaphor, middle school students, virtual environments computer auditing, risk, measures to prevent, information management computer-related health hazard, musculoskeletal disorders, computer usage, work ability index
Procedia PDF Downloads 674179 Utilization of Online Risk Mapping Techniques versus Desktop Geospatial Tools in Making Multi-Hazard Risk Maps for Italy
Authors: Seyed Vahid Kamal Alavi
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Italy has experienced a notable quantity and impact of disasters due to natural hazards and technological accidents caused by diverse risk sources on its physical, technological, and human/sociological infrastructures during past decade. This study discusses the frequency and impacts of the most three physical devastating natural hazards in Italy for the period 2000–2013. The approach examines the reliability of a range of open source WebGIS techniques versus a proposed multi-hazard risk management methodology. Spatial and attribute data which include USGS publically available hazard data and thirteen years Munich RE recorded data for Italy with different severities have been processed, visualized in a GIS (Geographic Information System) framework. Comparison of results from the study showed that the multi-hazard risk maps generated using open source techniques do not provide a reliable system to analyze the infrastructures losses in respect to national risk sources while they can be adopted for general international risk management purposes. Additionally, this study establishes the possibility to critically examine and calibrate different integrated techniques in evaluating what better protection measures can be taken in an area.Keywords: multi-hazard risk mapping, risk management, GIS, Italy
Procedia PDF Downloads 3714178 Seismic Microzonation of El-Fayoum New City, Egypt
Authors: Suzan Salem, Heba Moustafa, Abd El-Aziz Abd El-Aal
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Seismic micro hazard zonation for urban areas is the first step towards a seismic risk analysis and mitigation strategy. Essential here is to obtain a proper understanding of the local subsurface conditions and to evaluate ground-shaking effects. In the present study, an attempt has been made to evaluate the seismic hazard considering local site effects by carrying out detailed geotechnical and geophysical site characterization in El-Fayoum New City. Seismic hazard analysis and microzonation of El-Fayoum New City are addressed in three parts: in the first part, estimation of seismic hazard is done using seismotectonic and geological information. The second part deals with site characterization using geotechnical and shallow geophysical techniques. In the last part, local site effects are assessed by carrying out one-dimensional (1-D) ground response analysis using the equivalent linear method by program SHAKE 2000. Finally, microzonation maps have been prepared. The detailed methodology, along with experimental details, collected data, results and maps are presented in this paper.Keywords: El-Fayoum, microzonation, seismotectonic, Egypt
Procedia PDF Downloads 3814177 Evaluating Closed-List Proportional Representation System and Its Compatibility in Contemporary Indonesian Election
Authors: Ridho Al-Hamdi, Sakir, Tanto Lailam
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During the democratic period of 1999-present, Indonesia has consistently applied a List Proportional Representation (List PR) system in the parliamentary election. Between 1999 and 2004, it adopted a closed-list proportional representation (CLPR) system. In the meantime, it employed open-list proportional representation (OLPR) system from 2009 to 2019. Recently, some parties intended to propose the application of CLPR while others are still consistent in adopting OLPR. An unfinished debate is taking place. Thus, this article aims to evaluate the application of CLPR in Indonesia and, in turn, analyze its compatibility in contemporary parliamentary election system. From a methodological standpoint, it is qualitative research by applying a case study approach. Data-gathering relies on field data, mainly focus group discussion (FGD) and in-depth interviews with political parties, electoral management bodies (EMBs), NGO activists, and scholars spread in six provinces and nine regencies/cities across the country. Using SWOT analysis and the compatibility of CLPR and embedded democracy framework, the finding demonstrates that CLPR is no longer relevant for contemporary Indonesian elections. This paper recommends OLPR by considering that CLPR has numerous weaknesses and threats that can jeopardize embedded democracy. More importantly, CLPR can remove inclusive suffrage significantly.Keywords: closed-list proportional representation, embedded democracy, Indonesia, parliamentary election
Procedia PDF Downloads 1584176 Flood Hazard and Risk Mapping to Assess Ice-Jam Flood Mitigation Measures
Authors: Karl-Erich Lindenschmidt, Apurba Das, Joel Trudell, Keanne Russell
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In this presentation, we explore options for mitigating ice-jam flooding along the Athabasca River in western Canada. Not only flood hazard, expressed in this case as the probability of flood depths and extents being exceeded, but also flood risk, in which annual expected damages are calculated. Flood risk is calculated, which allows a cost-benefit analysis to be made so that decisions on the best mitigation options are not based solely on flood hazard but also on the costs related to flood damages and the benefits of mitigation. The river ice model is used to simulate extreme ice-jam flood events with which scenarios are run to determine flood exposure and damages in flood-prone areas along the river. We will concentrate on three mitigation options – the placement of a dike, artificial breakage of the ice cover along the river, the installation of an ice-control structure, and the construction of a reservoir. However, any mitigation option is not totally failsafe. For example, dikes can still be overtopped and breached, and ice jams may still occur in areas of the river where ice covers have been artificially broken up. Hence, for all options, it is recommended that zoning of building developments away from greater flood hazard areas be upheld. Flood mitigation can have a negative effect of giving inhabitants a false sense of security that flooding may not happen again, leading to zoning policies being relaxed. (Text adapted from Lindenschmidt [2022] "Ice Destabilization Study - Phase 2", submitted to the Regional Municipality of Wood Buffalo, Alberta, Canada)Keywords: ice jam, flood hazard, flood risk river ice modelling, flood risk
Procedia PDF Downloads 1854175 Orthogonal Regression for Nonparametric Estimation of Errors-In-Variables Models
Authors: Anastasiia Yu. Timofeeva
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Two new algorithms for nonparametric estimation of errors-in-variables models are proposed. The first algorithm is based on penalized regression spline. The spline is represented as a piecewise-linear function and for each linear portion orthogonal regression is estimated. This algorithm is iterative. The second algorithm involves locally weighted regression estimation. When the independent variable is measured with error such estimation is a complex nonlinear optimization problem. The simulation results have shown the advantage of the second algorithm under the assumption that true smoothing parameters values are known. Nevertheless the use of some indexes of fit to smoothing parameters selection gives the similar results and has an oversmoothing effect.Keywords: grade point average, orthogonal regression, penalized regression spline, locally weighted regression
Procedia PDF Downloads 4164174 A Learning-Based EM Mixture Regression Algorithm
Authors: Yi-Cheng Tian, Miin-Shen Yang
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The mixture likelihood approach to clustering is a popular clustering method where the expectation and maximization (EM) algorithm is the most used mixture likelihood method. In the literature, the EM algorithm had been used for mixture regression models. However, these EM mixture regression algorithms are sensitive to initial values with a priori number of clusters. In this paper, to resolve these drawbacks, we construct a learning-based schema for the EM mixture regression algorithm such that it is free of initializations and can automatically obtain an approximately optimal number of clusters. Some numerical examples and comparisons demonstrate the superiority and usefulness of the proposed learning-based EM mixture regression algorithm.Keywords: clustering, EM algorithm, Gaussian mixture model, mixture regression model
Procedia PDF Downloads 5104173 Dividend Policy, Overconfidence and Moral Hazard
Authors: Richard Fairchild, Abdullah Al-Ghazali, Yilmaz Guney
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This study analyses the relationship between managerial overconfidence, dividends, and firm value by developing theoretical models that examine the condition under which managerial overconfident, dividends, and firm value may be positive or negative. Furthermore, the models incorporate moral hazard, in terms of managerial effort shirking, and the potential for the manager to choose negative NPV projects, due to private benefits. Our models demonstrate that overconfidence can lead to higher dividends (when the manager is overconfident about his current ability) or lower dividends (when the manager is overconfident about his future ability). The models also demonstrate that higher overconfidence may result in an increase or a decrease in firm value. Numerical examples are illustrated for both models which interestingly support the models’ propositions.Keywords: behavioural corporate finance, dividend policy, overconfidence, moral hazard
Procedia PDF Downloads 3394172 Analysis of Rockfall Hazard along Himalayan Road Cut Slopes
Authors: Sarada Prasad Pradhan, Vikram Vishal, Tariq Siddique
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With a vast area of India comprising of hilly terrain and road cut slopes, landslides and rockfalls are a common phenomenon. However, while landslide studies have received much attention in the past in India, very little literature and analysis is available regarding rockfall hazard of many rockfall prone areas, specifically in Uttarakhand Himalaya, India. The subsequent lack of knowledge and understanding of the rockfall phenomenon as well as frequent incidences of rockfall led fatalities urge the necessity of conducting site-specific rockfall studies to highlight the importance of addressing this issue as well as to provide data for safe design of preventive structures. The present study has been conducted across 10 rockfall prone road cut slopes for a distance of 15 km starting from Devprayag, India along National Highway 58 (NH-58). In order to make a qualitative assessment of Rockfall Hazard posed by these slopes, Rockfall Hazard Rating using standards for Indian Rockmass has been conducted at 10 locations under different slope conditions. Moreover, to accurately predict the characteristics of the possible rockfall phenomenon, numerical simulation was carried out to calculate the maximum bounce heights, total kinetic energies, translational velocities and trajectories of the falling rockmass blocks when simulated on each of these slopes according to real-life conditions. As it was observed that varying slope geometry had more fatal impacts on Rockfall hazard than size of rock masses, several optimizations have been suggested for each slope regarding location of barriers and modification of slope geometries in order to minimize damage by falling rocks. This study can be extremely useful in emphasizing the significance of rockfall studies and construction of mitigative barriers and structures along NH-58 around Devprayag.Keywords: rockfall, slope stability, rockmass, hazard
Procedia PDF Downloads 2084171 Bayesian Using Markov Chain Monte Carlo and Lindley's Approximation Based on Type-I Censored Data
Authors: Al Omari Moahmmed Ahmed
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These papers describe the Bayesian Estimator using Markov Chain Monte Carlo and Lindley’s approximation and the maximum likelihood estimation of the Weibull distribution with Type-I censored data. The maximum likelihood method can’t estimate the shape parameter in closed forms, although it can be solved by numerical methods. Moreover, the Bayesian estimates of the parameters, the survival and hazard functions cannot be solved analytically. Hence Markov Chain Monte Carlo method and Lindley’s approximation are used, where the full conditional distribution for the parameters of Weibull distribution are obtained via Gibbs sampling and Metropolis-Hastings algorithm (HM) followed by estimate the survival and hazard functions. The methods are compared to Maximum Likelihood counterparts and the comparisons are made with respect to the Mean Square Error (MSE) and absolute bias to determine the better method in scale and shape parameters, the survival and hazard functions.Keywords: weibull distribution, bayesian method, markov chain mote carlo, survival and hazard functions
Procedia PDF Downloads 4794170 A Comparative Study on a Tilt-Integral-Derivative Controller with Proportional-Integral-Derivative Controller for a Pacemaker
Authors: Aysan Esgandanian, Sabalan Daneshvar
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The study is done to determine the comparison between proportional-integral-derivative controller (PID controller) and tilt-integral-derivative (TID controller) for cardiac pacemaker systems, which can automatically control the heart rate to accurately track a desired preset profile. The controller offers good adaption of heart to the physiological needs of the patient. The parameters of the both controllers are tuned by particle swarm optimization (PSO) algorithm which uses the integral of time square error as a fitness function to be minimized. Simulation results are performed on the developed cardiovascular system of humans and results demonstrate that the TID controller produces superior control performance than PID controllers. In this paper, all simulations were performed in Matlab.Keywords: integral of time square error, pacemaker systems, proportional-integral-derivative controller, PSO algorithm, tilt-integral-derivative controller
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