• Title/Summary/Keyword: prediction of outcomes

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Investigating the Impact of Establishing Integrated Management Systems on Accidents and Safety Performance Indices: A Case Study

  • Laal, Fereydoon;Pouyakian, Mostafa;Madvari, Rohollah F.;Khoshakhlagh, Amir H.;Halvani, Gholam H.
    • Safety and Health at Work
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    • v.10 no.1
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    • pp.54-60
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    • 2019
  • Background: Increasing the establishment of integrated management systems (IMSs) is done with the purpose of leaving traditional management methods and replacing them with modern management methods. Thus, the present study sought to analyze the events and investigate the impact of IMS on health and safety performance indices in an Iranian combined cycle power plants. Methods: This case study was conducted in 2012 in all units of the Yazd Combined Cycle Power Plant on accident victims before and after the implementation of IMS. For data analysis and prediction of indices after the implementation of IMS, descriptive statistics and Kolmogorov-Smirnov test, Chi-square, linear regression, and Cubic tests were conducted using SPSS software. Results: The number of people employed in the power plant in an 8-year period (2004-2011) was 1,189, and 287 cases of work-related accidents were recorded. The highest accident frequency rate and accident severity rate were in 2004 (32.65) and 2008 (209), respectively. Safe T-score reached to below -3 during 2010-2011. In addition, given the regression results, the relation between all predictor variables with outcomes was significant (p < 0.05), except for the variable $X^1$ belonging to the accident severity rate index. Conclusion: The implementation of safety programs especially that of IMS and its annual audits has had a significant impact on reducing accident indices and improving safety within the study period. Accordingly, health and safety management systems are appropriate tools for reducing accident rate, and the use of regression models and accident indices is also a suitable way for monitoring safety performance.

Comparisons of the Prognostic Predictors of Traumatic Brain Injury According to Admission Glasgow Coma Scale Scores Based on 1- and 6-month Assessments

  • Oh Hyun-Soo;Seo Wha-Sook;Lee Seul;Song Ho-Sook
    • Journal of Korean Academy of Nursing
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    • v.36 no.4
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    • pp.621-629
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    • 2006
  • Purpose. The purpose of this study was to identify the clinical variables that predict functional and cognitive recovery at 1- and 6-month in both severe and moderate/mild traumatic brain injury patients. Methods. The subjects of this study were 82 traumatically brain-injured patients who were admitted to a Neurological Intensive Care Unit at a university hospital. Potential prognostic factors included were age, motor and pupillary response, systolic blood pressure, heart rate, and the presence of intracranial hematoma at admission. Results. The significant predictors of functional disability in severe traumatic brain injury subjects were, age, systolic blood pressure, the presence of intracranial hematoma, motor response, and heart rate at admission. In moderate/mild traumatic brain injury patients, motor response, abnormal pupil reflex, and heart rate at admission were identified as significant predictors of functional disability. On the other hand, the significant predictors of cognitive ability for severe traumatic brain injury patients were motor response and the presence of intracranial hematoma at admission, whereas those for moderate/mild patients were motor response, pupil reflex, systolic blood pressure at admission, and age. Conclusions. The results of the present study indicate that the significant predictors of TBI differ according to TBI severity on admission, outcome type, and outcome measurement time. This can be meaningful to critical care nurses for a better understanding on the prediction of brain injury patients. On the other hand, the model used in the present study appeared to produce relatively low explicabilities for functional and cognitive recovery although a direct comparison of our results with those of others is difficult due to differences in outcome definition and validation methods. This implies that other clinical variables should be added to the model used in the present study to increase its predicting power for determining functional and cognitive outcomes.

Left Ventricular Ejection Fraction Predicts Poststroke Cardiovascular Events and Mortality in Patients without Atrial Fibrillation and Coronary Heart Disease

  • Lee, Jeong-Yoon;Sunwoo, Jun-Sang;Kwon, Kyum-Yil;Roh, Hakjae;Ahn, Moo-Young;Lee, Min-Ho;Park, Byoung-Won;Hyon, Min Su;Lee, Kyung Bok
    • Korean Circulation Journal
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    • v.48 no.12
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    • pp.1148-1156
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    • 2018
  • Background and Objectives: It is controversial that decreased left ventricular function could predict poststroke outcomes. The purpose of this study is to elucidate whether left ventricular ejection fraction (LVEF) can predict cardiovascular events and mortality in acute ischemic stroke (AIS) without atrial fibrillation (AF) and coronary heart disease (CHD). Methods: Transthoracic echocardiography was conducted consecutively in patients with AIS or transient ischemic attack at Soonchunhyang University Hospital between January 2008 and July 2016. The clinical data and echocardiographic LVEF of 1,465 patients were reviewed after excluding AF and CHD. Poststroke disability, major adverse cardiac events (MACE; nonfatal stroke, nonfatal myocardial infarction, and cardiovascular death) and all-cause mortality during 1 year after index stroke were prospectively captured. Cox proportional hazards regressions analysis were applied adjusting traditional risk factors and potential determinants. Results: The mean follow-up time was $259.9{\pm}148.8days$ with a total of 29 non-fatal strokes, 3 myocardial infarctions, 33 cardiovascular deaths, and 53 all-cause mortality. The cumulative incidence of MACE and all-cause mortality were significantly higher in the lowest LVEF (<55) group compared with the others (p=0.022 and 0.009). In prediction models, LVEF (per 10%) had hazards ratios of 0.54 (95% confidence interval [CI], 0.36-0.80, p=0.002) for MACE and 0.61 (95% CI, 0.39-0.97, p=0.037) for all-cause mortality. Conclusions: LVEF could be an independent predictor of cardiovascular events and mortality after AIS in the absence of AF and CHD.

A Study on the Analysis of the Importance of Natural Landscape by the Development Project (개발사업에 의한 자연경관 영향 저감방안 중요도 분석에 관한 연구)

  • Shin, Min-Ji;Shin, Ji-Hoon
    • Journal of Korean Society of Rural Planning
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    • v.25 no.2
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    • pp.99-117
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    • 2019
  • Environmental impact assessment (EIA), which predicts, evaluates, and manages the influences on natural landscape, plays a role of monitoring natural resources for systematic management of natural landscape. However, the function of verification and correction of the system is still insufficient and feed-back, one of the most important features of EIA follow-up, has not been introduced in Korea's EIA system yet. As a procedure, it is required to check if the opinions of the evaluators are properly reflected to the outcomes of the project through a reviewing process after assessing environmental impacts of a development project. In reality, despite the awareness about the importance of follow-up inspection of the conformity with, the system mainly focuses on the agreement during the planning stage of the development project and fails to continuously manage after its completion. There have been various preceding studies related to prediction, evaluation, and management of environmental impacts on natural landscape for better management. They primarily dealt with the problems in the EIA process and suggested improvement measures, including directions for institutional development, step-by-step goals, and operation methods, to address the problems which arise in the EIA follow-up process. However, suggested measures are not actively applied with the focus only put on institutional operation, there are virtually no standardized methods to predict and assess landscape changes due to the development project and to manage landscape after the project. Against this backdrop, this study aims to explore the existing methods to analyze the impacts natural landscape and to establish a system where landscape management is continued after the development project. To this end, we will suggest reducing methods according to the predicted changes in landscape for post-project management of natural landscape. Characteristics of reduction methods by project type were examined through reviewing the guide to natural landscape rating and the importance of development project impacts on natural landscape by type of reduction was evaluated through questionnaire for experts. Evaluated types of reduction are classified and presented by characteristics of each development project and content of reduction type.

A novel analytical evaluation of the laboratory-measured mechanical properties of lightweight concrete

  • S. Sivakumar;R. Prakash;S. Srividhya;A.S. Vijay Vikram
    • Structural Engineering and Mechanics
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    • v.87 no.3
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    • pp.221-229
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    • 2023
  • Urbanization and industrialization have significantly increased the amount of solid waste produced in recent decades, posing considerable disposal problems and environmental burdens. The practice of waste utilization in concrete has gained popularity among construction practitioners and researchers for the efficient use of resources and the transition to the circular economy in construction. This study employed Lytag aggregate, an environmentally friendly pulverized fuel ash-based lightweight aggregate, as a substitute for natural coarse aggregate. At the same time, fly ash, an industrial by-product, was used as a partial substitute for cement. Concrete mix M20 was experimented with using fly ash and Lytag lightweight aggregate. The percentages of fly ash that make up the replacements were 5%, 10%, 15%, 20%, and 25%. The Compressive Strength (CS), Split Tensile Strength (STS), and deflection were discovered at these percentages after 56 days of testing. The concrete cube, cylinder, and beam specimens were examined in the explorations, as mentioned earlier. The results indicate that a 10% substitution of cement with fly ash and a replacement of coarse aggregate with Lytag lightweight aggregate produced concrete that performed well in terms of mechanical properties and deflection. The cementitious composites have varying characteristics as the environment changes. Therefore, understanding their mechanical properties are crucial for safety reasons. CS, STS, and deflection are the essential property of concrete. Machine learning (ML) approaches have been necessary to predict the CS of concrete. The Artificial Fish Swarm Optimization (AFSO), Particle Swarm Optimization (PSO), and Harmony Search (HS) algorithms were investigated for the prediction of outcomes. This work deftly explains the tremendous AFSO technique, which achieves the precise ideal values of the weights in the model to crown the mathematical modeling technique. This has been proved by the minimum, maximum, and sample median, and the first and third quartiles were used as the basis for a boxplot through the standardized method of showing the dataset. It graphically displays the quantitative value distribution of a field. The correlation matrix and confidence interval were represented graphically using the corrupt method.

Survival-Related Factors of Spinal Metastasis with Hepatocellular Carcinoma in Current Surgical Treatment Modalities : A Single Institute Experience

  • Lee, Min Ho;Lee, Sun-Ho;Kim, Eun-Sang;Eoh, Whan;Chung, Sung-Soo;Lee, Chong-Suh
    • Journal of Korean Neurosurgical Society
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    • v.58 no.5
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    • pp.448-453
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    • 2015
  • Objective : Recently, the survival of patients with hepatocellular carcinoma (HCC) has been prolonged with improvements in various diagnostic tools and medical treatment modalities. Consequently, spine metastases from HCC are being diagnosed more frequently. The accurate prediction of prognosis plays a critical role in determining a patient's treatment plan, including surgery for patients with spinal metastases of HCC. We investigated the clinical features, surgical outcomes, and prognostic factors of HCC presenting with spine metastases, in patients who underwent surgery. Methods : A retrospective review was conducted on 33 HCC patients who underwent 36 operations (three patients underwent surgical treatment twice) from February 2006 to December 2013. The median age of the patients was 56 years old (range, 28 to 71; male : female=30 : 3). Results : Overall survival was not correlated with age, sex, level of metastases, preoperative Child-Pugh classification, preoperative ambulatory function, preoperative radiotherapy, type of operation, administration of Sorafenib, or the Tokuhashi scoring system. Only the Tomita scoring system was shown to be an independent prognostic factor for overall survival. Comparing the Child-Pugh classification and ambulatory ability, there were no statistically differences between patients pre- and post-operatively. Conclusion : The Tomita scoring system represents a practicable and highly predictive prognostic tool. Even though surgical intervention may not restore ambulatory function, it should be considered to prevent deterioration of the patient's overall condition. Additionally, aggressive management may be needed if there is any ambulatory ability remaining.

Application of Poisoning aBIG score for Prediction of Fatal Severity in Acute Adult Intoxications (성인 중증 중독환자 예측을 위한 새로운 지표 개발: aBIG score for poisoning)

  • Choe, Michael Sung Pil;Ahn, Jae Yun;Kang, In Gu;Lee, Mi Jin
    • Journal of The Korean Society of Clinical Toxicology
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    • v.12 no.1
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    • pp.14-21
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    • 2014
  • Purpose: The objective of this study was to develop a new scoring tool that is comprehensively applicable and predicts fatality within 24 h of intoxication. Methods: This was a cohort study conducted in two emergency medical centers from 2011 to 2012. We identified factors associated with severe/fatality. Through a discriminant analysis, we devised the aBIG (age, Base deficit, Infection, and Glasgow coma scale) score. To compare the ability of aBIG to predict intoxication severity with that of previous scoring systems such as APACHE II, MODS, SAPS IIe, and SOFA, we determined the receiver operating characteristic curves of each variable in predicting severe-to-fatal toxicity. Results: Compared with the mild/moderate toxicity group (n=211), the severe/fatal group (n=143) had higher incidences of metabolic acidosis, infection, serious mental change, QTc prolongation and hepato-renal failure. Age, base deficit, infection-WBC count, and Glasgow Coma Scale were independently associated with severe/fatal poisoning. These variables were combined into the poisoning "aBIG" score [$0.28{\times}$Age group+$0.38{\times}WBC$ count/$10^3+0.52{\times}$Base deficit+$0.64{\times}$(15-GCS)], which were each calculated to have an area under the curve of 0.904 (95% confidence interval: 0.868-0.933). The aBIG poisoning score had an equivalent level of severity predictability as APACHE II and a superior than MODS, SOFA, and SAPS IIe. Conclusion: We developed a simplified scoring system using the four variables of age, base deficit, infected leukocytosis, and GCS. The poisoning aBIG score was a simple method that could be performed rapidly on admission to evaluate severity of illness and predict fatal severity in patients with acute intoxications.

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Association between the Alu Insertion/Deletion Polymorphism in the Tissue-Type Plasminogen Activator Gene and Mirtazapine Response in Koreans with Major Depression

  • Kim, Daseul;Chang, Hun Soo;Won, Eunsoo;Ham, Byung-Joo;Lee, Min-Soo
    • Korean Journal of Biological Psychiatry
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    • v.23 no.4
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    • pp.140-147
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    • 2016
  • Objectives To determine the relationship between the Alu insertion/deletion (I/D) polymorphism in the tissue-type plasminogen activator (tPA) gene and the clinical outcome of mirtazapine treatment in Korean major depressive disorder (MDD) patients. Methods We enrolled 422 patients in this study. Symptoms were evaluated using the 21-item Hamilton Depression Rating (HAMD-21) Scale. After 1, 2, 4, and 8 weeks of mirtazapine treatment, the association between the Alu I/D polymorphism in the tPA gene and remission/response outcomes were evaluated. Results The proportion of I/I homozygotes in responders was higher than that in non-responders, whereas the proportion of D/D homozygotes in responders was lower than that in non-responders at 8 weeks of treatment (p = 0.032, OR = 1.57). The percentage decline of HAMD-21 scores in I allele carriers was larger than that of D/D homozygotes at 2 and 8 weeks of treatment (p = 0.035 and 0.007, respectively). I allele carriers were associated with remission at 8 weeks of treatment (p = 0.047, OR = 2.2). Conclusions These results show that treatment response and remission to mirtazapine were associated with the Alu I/D polymorphism of the tPA gene. This suggests the Alu I/D polymorphism may be a potential genetic marker for the prediction of therapeutic response to mirtazapine treatment in patients with MDD.

A rock physical approach to understand geo-mechanics of cracked porous media having three fluid phases

  • Ahmad, Qazi Adnan;Wu, Guochen;Zong, Zhaoyun;Wu, Jianlu;Ehsan, Muhammad Irfan;Du, Zeyuan
    • Geomechanics and Engineering
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    • v.23 no.4
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    • pp.327-338
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    • 2020
  • The role of precise prediction of subsurface fluids and discrimination among them cannot be ignored in reservoir characterization and petroleum prospecting. A suitable rock physics model should be build for the extraction of valuable information form seismic data. The main intent of current work is to present a rock physics model to analyze the characteristics of seismic wave propagating through a cracked porous rock saturated by a three phase fluid. Furthermore, the influence on wave characteristics due to variation in saturation of water, oil and gas were also analyzed for oil and water as wet cases. With this approach the objective to explore wave attenuation and dispersion due to wave induce fluid flow (WIFF) at seismic and sub-seismic frequencies can be precisely achieved. We accomplished our proposed approach by using BISQ equations and by applying appropriate boundary conditions to incorporate heterogeneity due to saturation of three immiscible fluids forming a layered system. To authenticate the proposed methodology, we compared our results with White's mesoscopic theory and with the results obtained by using Biot's poroelastic relations. The outcomes reveals that, at low frequencies seismic wave characteristics are in good agreement with White's mesoscopic theory, however a slight increase in attenuation at seismic frequencies is because of the squirt flow. Moreover, our work crop up as a practical tool for the development of rock physical theories with the intention to identify and estimate properties of different fluids from seismic data.

Numerical prediction of the proximity effects on wind loads of low-rise buildings with cylindrical roofs

  • Deepak Sharma;Shilpa Pal;Ritu Raj
    • Wind and Structures
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    • v.36 no.4
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    • pp.277-292
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    • 2023
  • Low-rise structures are generally immersed within the roughness layer of the atmospheric boundary layer flows and represent the largest class of the structures for which wind loads for design are being obtained from the wind standards codes of distinct nations. For low-rise buildings, wind loads are one of the decisive loads when designing a roof. For the case of cylindrical roof structures, the information related to wind pressure coefficient is limited to a single span only. In contrast, for multi-span roofs, the information is not available. In this research, the numerical simulation has been done using ANSYS CFX to determine wind pressure distribution on the roof of low-rise cylindrical structures arranged in rectangular plan with variable spacing in accordance with building width (B=0.2 m) i.e., zero, 0.5B, B, 1.5B and 2B subjected to different wind incidence angles varying from 0° to 90° having the interval of 15°. The wind pressure (P) and pressure coefficients (Cpe) are varying with respect to wind incidence angle and variable spacing. The results of present numerical investigation or wind induced pressure are presented in the form of pressure contours generated by Ansys CFD Post for isolated as well as variable spacing model of cylindrical roofs. It was noted that the effect of wind shielding was reducing on the roofs by increasing spacing between the buildings. The variation pf Coefficient of wind pressure (Cpe) for all the roofs have been presented individually in the form of graphs with respect to angle of attacks of wind (AoA) and variable spacing. The critical outcomes of the present study will be so much beneficial to structural design engineers during the analysis and designing of low-rise buildings with cylindrical roofs in an isolated as well as group formation.