Sample records for risk analysis based

  1. 78 FR 11611 - Current Good Manufacturing Practice and Hazard Analysis and Risk-Based Preventive Controls for...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-02-19

    ... Manufacturing Practice and Hazard Analysis and Risk- Based Preventive Controls for Human Food; Extension of... Analysis and Risk-Based Preventive Controls for Human Food.'' FOR FURTHER INFORMATION CONTACT: Domini Bean... Practice and Hazard Analysis and Risk-Based Preventive Controls for Human Food'' with a 120-day comment...

  2. 78 FR 69604 - Current Good Manufacturing Practice and Hazard Analysis and Risk-Based Preventive Controls for...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-11-20

    ... Manufacturing Practice and Hazard Analysis and Risk- Based Preventive Controls for Human Food; Extension of... Hazard Analysis and Risk- Based Preventive Controls for Human Food'' and its information collection... Manufacturing Practice and Hazard Analysis and Risk-Based Preventive Controls for Human Food.'' IV. How To...

  3. 78 FR 24691 - Current Good Manufacturing Practice and Hazard Analysis and Risk-Based Preventive Controls for...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-04-26

    ... Manufacturing Practice and Hazard Analysis and Risk- Based Preventive Controls for Human Food; Extension of... Manufacturing Practice and Hazard Analysis and Risk-Based Preventive Controls for Human Food'' that appeared in... Manufacturing Practice and Hazard Analysis and Risk-Based Preventive Controls for Human Food'' with a 120-day...

  4. Image Based Biomarker of Breast Cancer Risk: Analysis of Risk Disparity among Minority Populations

    DTIC Science & Technology

    2013-03-01

    TITLE: Image Based Biomarker of Breast Cancer Risk: Analysis of Risk Disparity among Minority Populations PRINCIPAL INVESTIGATOR: Fengshan Liu...SUBTITLE 5a. CONTRACT NUMBER Image Based Biomarker of Breast Cancer Risk: Analysis of Risk Disparity among Minority Populations 5b. GRANT NUMBER...identifying the prevalence of women with incomplete visualization of the breast . We developed a code to estimate the breast cancer risks using the

  5. 78 FR 24693 - Draft Qualitative Risk Assessment of Risk of Activity/Food Combinations for Activities (Outside...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-04-26

    ... Analysis and Risk-Based Preventive Controls for Human Food'' (the proposed preventive controls rule) and... Farm.'' The purpose of the draft RA is to provide a science-based risk analysis of those activity/food... Food, Drug, and Cosmetic Act for hazard analysis and risk-based preventive controls (the proposed...

  6. 77 FR 55371 - System Safety Program

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-09-07

    ...-based rule and FRA seeks comments on all aspects of the proposed rule. An SSP would be implemented by a... SSP would be the risk-based hazard management program and risk-based hazard analysis. A properly implemented risk-based hazard management program and risk-based hazard analysis would identify the hazards and...

  7. A Risk-Analysis Approach to Implementing Web-Based Assessment

    ERIC Educational Resources Information Center

    Ricketts, Chris; Zakrzewski, Stan

    2005-01-01

    Computer-Based Assessment is a risky business. This paper proposes the use of a model for web-based assessment systems that identifies pedagogic, operational, technical (non web-based), web-based and financial risks. The strategies and procedures for risk elimination or reduction arise from risk analysis and management and are the means by which…

  8. Is risk analysis scientific?

    PubMed

    Hansson, Sven Ove; Aven, Terje

    2014-07-01

    This article discusses to what extent risk analysis is scientific in view of a set of commonly used definitions and criteria. We consider scientific knowledge to be characterized by its subject matter, its success in developing the best available knowledge in its fields of study, and the epistemic norms and values that guide scientific investigations. We proceed to assess the field of risk analysis according to these criteria. For this purpose, we use a model for risk analysis in which science is used as a base for decision making on risks, which covers the five elements evidence, knowledge base, broad risk evaluation, managerial review and judgment, and the decision; and that relates these elements to the domains experts and decisionmakers, and to the domains fact-based or value-based. We conclude that risk analysis is a scientific field of study, when understood as consisting primarily of (i) knowledge about risk-related phenomena, processes, events, etc., and (ii) concepts, theories, frameworks, approaches, principles, methods and models to understand, assess, characterize, communicate, and manage risk, in general and for specific applications (the instrumental part). © 2014 Society for Risk Analysis.

  9. Impact of model-based risk analysis for liver surgery planning.

    PubMed

    Hansen, C; Zidowitz, S; Preim, B; Stavrou, G; Oldhafer, K J; Hahn, H K

    2014-05-01

    A model-based risk analysis for oncologic liver surgery was described in previous work (Preim et al. in Proceedings of international symposium on computer assisted radiology and surgery (CARS), Elsevier, Amsterdam, pp. 353–358, 2002; Hansen et al. Int I Comput Assist Radiol Surg 4(5):469–474, 2009). In this paper, we present an evaluation of this method. To prove whether and how the risk analysis facilitates the process of liver surgery planning, an explorative user study with 10 liver experts was conducted. The purpose was to compare and analyze their decision-making. The results of the study show that model-based risk analysis enhances the awareness of surgical risk in the planning stage. Participants preferred smaller resection volumes and agreed more on the safety margins’ width in case the risk analysis was available. In addition, time to complete the planning task and confidence of participants were not increased when using the risk analysis. This work shows that the applied model-based risk analysis may influence important planning decisions in liver surgery. It lays a basis for further clinical evaluations and points out important fields for future research.

  10. Precursor Analysis for Flight- and Ground-Based Anomaly Risk Significance Determination

    NASA Technical Reports Server (NTRS)

    Groen, Frank

    2010-01-01

    This slide presentation reviews the precursor analysis for flight and ground based anomaly risk significance. It includes information on accident precursor analysis, real models vs. models, and probabilistic analysis.

  11. A Benefit-Risk Analysis Approach to Capture Regulatory Decision-Making: Multiple Myeloma.

    PubMed

    Raju, G K; Gurumurthi, Karthik; Domike, Reuben; Kazandjian, Dickran; Landgren, Ola; Blumenthal, Gideon M; Farrell, Ann; Pazdur, Richard; Woodcock, Janet

    2018-01-01

    Drug regulators around the world make decisions about drug approvability based on qualitative benefit-risk analysis. In this work, a quantitative benefit-risk analysis approach captures regulatory decision-making about new drugs to treat multiple myeloma (MM). MM assessments have been based on endpoints such as time to progression (TTP), progression-free survival (PFS), and objective response rate (ORR) which are different than benefit-risk analysis based on overall survival (OS). Twenty-three FDA decisions on MM drugs submitted to FDA between 2003 and 2016 were identified and analyzed. The benefits and risks were quantified relative to comparators (typically the control arm of the clinical trial) to estimate whether the median benefit-risk was positive or negative. A sensitivity analysis was demonstrated using ixazomib to explore the magnitude of uncertainty. FDA approval decision outcomes were consistent and logical using this benefit-risk framework. © 2017 American Society for Clinical Pharmacology and Therapeutics.

  12. 78 FR 15894 - Draft Qualitative Risk Assessment of Risk of Activity/Food Combinations for Activities (Outside...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-03-13

    ... science-based risk analysis of those activity/food combinations that would be considered low risk. We... proposed requirements of the Federal Food, Drug, and Cosmetic Act for hazard analysis and risk-based... DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration 21 CFR Part 117 [Docket No...

  13. [Application of risk-based approach for determination of critical factors in technology transfer of production of medicinal products].

    PubMed

    Beregovykh, V V; Spitskiy, O R

    2014-01-01

    Risk-based approach is used for examination of impact of different factors on quality of medicinal products in technology transfer. A general diagram is offered for risk analysis execution in technology transfer from pharmaceutical development to production. When transferring technology to full- scale commercial production it is necessary to investigate and simulate production process application beforehand in new real conditions. The manufacturing process is the core factorfor risk analysis having the most impact on quality attributes of a medicinal product. Further importantfactors are linked to materials and products to be handled and manufacturing environmental conditions such as premises, equipment and personnel. Usage of risk-based approach in designing of multipurpose production facility of medicinal products is shown where quantitative risk analysis tool RAMM (Risk Analysis and Mitigation Matrix) was applied.

  14. 75 FR 13610 - Office of New Reactors; Interim Staff Guidance on Implementation of a Seismic Margin Analysis for...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-03-22

    ... Staff Guidance on Implementation of a Seismic Margin Analysis for New Reactors Based on Probabilistic... Seismic Margin Analysis for New Reactors Based on Probabilistic Risk Assessment,'' (Agencywide Documents.../COL-ISG-020 ``Implementation of a Seismic Margin Analysis for New Reactors Based on Probabilistic Risk...

  15. Use-related risk analysis for medical devices based on improved FMEA.

    PubMed

    Liu, Long; Shuai, Ma; Wang, Zhu; Li, Ping

    2012-01-01

    In order to effectively analyze and control use-related risk of medical devices, quantitative methodologies must be applied. Failure Mode and Effects Analysis (FMEA) is a proactive technique for error detection and risk reduction. In this article, an improved FMEA based on Fuzzy Mathematics and Grey Relational Theory is developed to better carry out user-related risk analysis for medical devices. As an example, the analysis process using this improved FMEA method for a certain medical device (C-arm X-ray machine) is described.

  16. A Benefit-Risk Analysis Approach to Capture Regulatory Decision-Making: Non-Small Cell Lung Cancer.

    PubMed

    Raju, G K; Gurumurthi, K; Domike, R; Kazandjian, D; Blumenthal, G; Pazdur, R; Woodcock, J

    2016-12-01

    Drug regulators around the world make decisions about drug approvability based on qualitative benefit-risk analyses. There is much interest in quantifying regulatory approaches to benefit and risk. In this work the use of a quantitative benefit-risk analysis was applied to regulatory decision-making about new drugs to treat advanced non-small cell lung cancer (NSCLC). Benefits and risks associated with 20 US Food and Drug Administration (FDA) decisions associated with a set of candidate treatments submitted between 2003 and 2015 were analyzed. For benefit analysis, the median overall survival (OS) was used where available. When not available, OS was estimated based on overall response rate (ORR) or progression-free survival (PFS). Risks were analyzed based on magnitude (or severity) of harm and likelihood of occurrence. Additionally, a sensitivity analysis was explored to demonstrate analysis of systematic uncertainty. FDA approval decision outcomes considered were found to be consistent with the benefit-risk logic. © 2016 American Society for Clinical Pharmacology and Therapeutics.

  17. Risk analysis based on hazards interactions

    NASA Astrophysics Data System (ADS)

    Rossi, Lauro; Rudari, Roberto; Trasforini, Eva; De Angeli, Silvia; Becker, Joost

    2017-04-01

    Despite an increasing need for open, transparent, and credible multi-hazard risk assessment methods, models, and tools, the availability of comprehensive risk information needed to inform disaster risk reduction is limited, and the level of interaction across hazards is not systematically analysed. Risk assessment methodologies for different hazards often produce risk metrics that are not comparable. Hazard interactions (consecutive occurrence two or more different events) are generally neglected, resulting in strongly underestimated risk assessment in the most exposed areas. This study presents cases of interaction between different hazards, showing how subsidence can affect coastal and river flood risk (Jakarta and Bandung, Indonesia) or how flood risk is modified after a seismic event (Italy). The analysis of well documented real study cases, based on a combination between Earth Observation and in-situ data, would serve as basis the formalisation of a multi-hazard methodology, identifying gaps and research frontiers. Multi-hazard risk analysis is performed through the RASOR platform (Rapid Analysis and Spatialisation Of Risk). A scenario-driven query system allow users to simulate future scenarios based on existing and assumed conditions, to compare with historical scenarios, and to model multi-hazard risk both before and during an event (www.rasor.eu).

  18. Application of discriminant analysis-based model for prediction of risk of low back disorders due to workplace design in industrial jobs.

    PubMed

    Ganga, G M D; Esposto, K F; Braatz, D

    2012-01-01

    The occupational exposure limits of different risk factors for development of low back disorders (LBDs) have not yet been established. One of the main problems in setting such guidelines is the limited understanding of how different risk factors for LBDs interact in causing injury, since the nature and mechanism of these disorders are relatively unknown phenomena. Industrial ergonomists' role becomes further complicated because the potential risk factors that may contribute towards the onset of LBDs interact in a complex manner, which makes it difficult to discriminate in detail among the jobs that place workers at high or low risk of LBDs. The purpose of this paper was to develop a comparative study between predictions based on the neural network-based model proposed by Zurada, Karwowski & Marras (1997) and a linear discriminant analysis model, for making predictions about industrial jobs according to their potential risk of low back disorders due to workplace design. The results obtained through applying the discriminant analysis-based model proved that it is as effective as the neural network-based model. Moreover, the discriminant analysis-based model proved to be more advantageous regarding cost and time savings for future data gathering.

  19. Volatility and correlation-based systemic risk measures in the US market

    NASA Astrophysics Data System (ADS)

    Civitarese, Jamil

    2016-10-01

    This paper deals with the problem of how to use simple systemic risk measures to assess portfolio risk characteristics. Using three simple examples taken from previous literature, one based on raw and partial correlations, another based on the eigenvalue decomposition of the covariance matrix and the last one based on an eigenvalue entropy, a Granger-causation analysis revealed some of them are not always a good measure of risk in the S&P 500 and in the VIX. The measures selected do not Granger-cause the VIX index in all windows selected; therefore, in the sense of risk as volatility, the indicators are not always suitable. Nevertheless, their results towards returns are similar to previous works that accept them. A deeper analysis has shown that any symmetric measure based on eigenvalue decomposition of correlation matrices, however, is not useful as a measure of "correlation" risk. The empirical counterpart analysis of this proposition stated that negative correlations are usually small and, therefore, do not heavily distort the behavior of the indicator.

  20. [Reliability theory based on quality risk network analysis for Chinese medicine injection].

    PubMed

    Li, Zheng; Kang, Li-Yuan; Fan, Xiao-Hui

    2014-08-01

    A new risk analysis method based upon reliability theory was introduced in this paper for the quality risk management of Chinese medicine injection manufacturing plants. The risk events including both cause and effect ones were derived in the framework as nodes with a Bayesian network analysis approach. It thus transforms the risk analysis results from failure mode and effect analysis (FMEA) into a Bayesian network platform. With its structure and parameters determined, the network can be used to evaluate the system reliability quantitatively with probabilistic analytical appraoches. Using network analysis tools such as GeNie and AgenaRisk, we are able to find the nodes that are most critical to influence the system reliability. The importance of each node to the system can be quantitatively evaluated by calculating the effect of the node on the overall risk, and minimization plan can be determined accordingly to reduce their influences and improve the system reliability. Using the Shengmai injection manufacturing plant of SZYY Ltd as a user case, we analyzed the quality risk with both static FMEA analysis and dynamic Bayesian Network analysis. The potential risk factors for the quality of Shengmai injection manufacturing were identified with the network analysis platform. Quality assurance actions were further defined to reduce the risk and improve the product quality.

  1. Applicability of risk-based management and the need for risk-based economic decision analysis at hazardous waste contaminated sites.

    PubMed

    Khadam, Ibrahim; Kaluarachchi, Jagath J

    2003-07-01

    Decision analysis in subsurface contamination management is generally carried out through a traditional engineering economic viewpoint. However, new advances in human health risk assessment, namely, the probabilistic risk assessment, and the growing awareness of the importance of soft data in the decision-making process, require decision analysis methodologies that are capable of accommodating non-technical and politically biased qualitative information. In this work, we discuss the major limitations of the currently practiced decision analysis framework, which evolves around the definition of risk and cost of risk, and its poor ability to communicate risk-related information. A demonstration using a numerical example was conducted to provide insight on these limitations of the current decision analysis framework. The results from this simple ground water contamination and remediation scenario were identical to those obtained from studies carried out on existing Superfund sites, which suggests serious flaws in the current risk management framework. In order to provide a perspective on how these limitations may be avoided in future formulation of the management framework, more matured and well-accepted approaches to decision analysis in dam safety and the utility industry, where public health and public investment are of great concern, are presented and their applicability in subsurface remediation management is discussed. Finally, in light of the success of the application of risk-based decision analysis in dam safety and the utility industry, potential options for decision analysis in subsurface contamination management are discussed.

  2. A Comparison of Rule-based Analysis with Regression Methods in Understanding the Risk Factors for Study Withdrawal in a Pediatric Study.

    PubMed

    Haghighi, Mona; Johnson, Suzanne Bennett; Qian, Xiaoning; Lynch, Kristian F; Vehik, Kendra; Huang, Shuai

    2016-08-26

    Regression models are extensively used in many epidemiological studies to understand the linkage between specific outcomes of interest and their risk factors. However, regression models in general examine the average effects of the risk factors and ignore subgroups with different risk profiles. As a result, interventions are often geared towards the average member of the population, without consideration of the special health needs of different subgroups within the population. This paper demonstrates the value of using rule-based analysis methods that can identify subgroups with heterogeneous risk profiles in a population without imposing assumptions on the subgroups or method. The rules define the risk pattern of subsets of individuals by not only considering the interactions between the risk factors but also their ranges. We compared the rule-based analysis results with the results from a logistic regression model in The Environmental Determinants of Diabetes in the Young (TEDDY) study. Both methods detected a similar suite of risk factors, but the rule-based analysis was superior at detecting multiple interactions between the risk factors that characterize the subgroups. A further investigation of the particular characteristics of each subgroup may detect the special health needs of the subgroup and lead to tailored interventions.

  3. A stable systemic risk ranking in China's banking sector: Based on principal component analysis

    NASA Astrophysics Data System (ADS)

    Fang, Libing; Xiao, Binqing; Yu, Honghai; You, Qixing

    2018-02-01

    In this paper, we compare five popular systemic risk rankings, and apply principal component analysis (PCA) model to provide a stable systemic risk ranking for the Chinese banking sector. Our empirical results indicate that five methods suggest vastly different systemic risk rankings for the same bank, while the combined systemic risk measure based on PCA provides a reliable ranking. Furthermore, according to factor loadings of the first component, PCA combined ranking is mainly based on fundamentals instead of market price data. We clearly find that price-based rankings are not as practical a method as fundamentals-based ones. This PCA combined ranking directly shows systemic risk contributions of each bank for banking supervision purpose and reminds banks to prevent and cope with the financial crisis in advance.

  4. Ontology-based specification, identification and analysis of perioperative risks.

    PubMed

    Uciteli, Alexandr; Neumann, Juliane; Tahar, Kais; Saleh, Kutaiba; Stucke, Stephan; Faulbrück-Röhr, Sebastian; Kaeding, André; Specht, Martin; Schmidt, Tobias; Neumuth, Thomas; Besting, Andreas; Stegemann, Dominik; Portheine, Frank; Herre, Heinrich

    2017-09-06

    Medical personnel in hospitals often works under great physical and mental strain. In medical decision-making, errors can never be completely ruled out. Several studies have shown that between 50 and 60% of adverse events could have been avoided through better organization, more attention or more effective security procedures. Critical situations especially arise during interdisciplinary collaboration and the use of complex medical technology, for example during surgical interventions and in perioperative settings (the period of time before, during and after surgical intervention). In this paper, we present an ontology and an ontology-based software system, which can identify risks across medical processes and supports the avoidance of errors in particular in the perioperative setting. We developed a practicable definition of the risk notion, which is easily understandable by the medical staff and is usable for the software tools. Based on this definition, we developed a Risk Identification Ontology (RIO) and used it for the specification and the identification of perioperative risks. An agent system was developed, which gathers risk-relevant data during the whole perioperative treatment process from various sources and provides it for risk identification and analysis in a centralized fashion. The results of such an analysis are provided to the medical personnel in form of context-sensitive hints and alerts. For the identification of the ontologically specified risks, we developed an ontology-based software module, called Ontology-based Risk Detector (OntoRiDe). About 20 risks relating to cochlear implantation (CI) have already been implemented. Comprehensive testing has indicated the correctness of the data acquisition, risk identification and analysis components, as well as the web-based visualization of results.

  5. Risk analysis and its link with standards of the World Organisation for Animal Health.

    PubMed

    Sugiura, K; Murray, N

    2011-04-01

    Among the agreements included in the treaty that created the World Trade Organization (WTO) in January 1995 is the Agreement on the Application of Sanitary and Phytosanitary Measures (SPS Agreement) that sets out the basic rules for food safety and animal and plant health standards. The SPS Agreement designates the World Organisation for Animal Health (OIE) as the organisation responsible for developing international standards for animal health and zoonoses. The SPS Agreement requires that the sanitary measures that WTO members apply should be based on science and encourages them to either apply measures based on the OIE standards or, if they choose to adopt a higher level of protection than that provided by these standards, apply measures based on a science-based risk assessment. The OIE also provides a procedural framework for risk analysis for its Member Countries to use. Despite the inevitable challenges that arise in carrying out a risk analysis of the international trade in animals and animal products, the OIE risk analysis framework provides a structured approach that facilitates the identification, assessment, management and communication of these risks.

  6. Risk based inspection for atmospheric storage tank

    NASA Astrophysics Data System (ADS)

    Nugroho, Agus; Haryadi, Gunawan Dwi; Ismail, Rifky; Kim, Seon Jin

    2016-04-01

    Corrosion is an attack that occurs on a metallic material as a result of environment's reaction.Thus, it causes atmospheric storage tank's leakage, material loss, environmental pollution, equipment failure and affects the age of process equipment then finally financial damage. Corrosion risk measurement becomesa vital part of Asset Management at the plant for operating any aging asset.This paper provides six case studies dealing with high speed diesel atmospheric storage tank parts at a power plant. A summary of the basic principles and procedures of corrosion risk analysis and RBI applicable to the Process Industries were discussed prior to the study. Semi quantitative method based onAPI 58I Base-Resource Document was employed. The risk associated with corrosion on the equipment in terms of its likelihood and its consequences were discussed. The corrosion risk analysis outcome used to formulate Risk Based Inspection (RBI) method that should be a part of the atmospheric storage tank operation at the plant. RBI gives more concern to inspection resources which are mostly on `High Risk' and `Medium Risk' criteria and less on `Low Risk' shell. Risk categories of the evaluated equipment were illustrated through case study analysis outcome.

  7. Program risk analysis handbook

    NASA Technical Reports Server (NTRS)

    Batson, R. G.

    1987-01-01

    NASA regulations specify that formal risk analysis be performed on a program at each of several milestones. Program risk analysis is discussed as a systems analysis approach, an iterative process (identification, assessment, management), and a collection of techniques. These techniques, which range from extremely simple to complex network-based simulation, are described in this handbook in order to provide both analyst and manager with a guide for selection of the most appropriate technique. All program risk assessment techniques are shown to be based on elicitation and encoding of subjective probability estimates from the various area experts on a program. Techniques to encode the five most common distribution types are given. Then, a total of twelve distinct approaches to risk assessment are given. Steps involved, good and bad points, time involved, and degree of computer support needed are listed. Why risk analysis should be used by all NASA program managers is discussed. Tools available at NASA-MSFC are identified, along with commercially available software. Bibliography (150 entries) and a program risk analysis check-list are provided.

  8. The Shift in Emphasis From Risk-Based to Age-Based Hepatitis C Virus (HCV) Testing in the US Tends to Remove Injection Drug Use From Discourse on HCV.

    PubMed

    Jordan, Ashly E; Perlman, David C

    2017-02-23

    Hepatitis C virus (HCV) infection is hyperendemic among people who inject drugs; nonsterile drug injection is the principle risk for HCV acquisition. Due to gaps in the HCV care continuum, there have been recommendations in the United States emphasizing age-rather than risk-based testing strategies. The central research focus of this project is to explore the meanings and implications of the shift in emphasis from risk-based to age-based HCV testing with regard to people who use drugs. Content analysis and critical discourse analysis, informed by eco-social theory, were used to examine relevant documents. Fifteen documents were assessed for eligibility; 6 documents comprised the final set reviewed. In content analysis, age-based testing was both mentioned more frequently and was supported more strongly than risk-based testing. Risk-based testing was frequently mentioned in terms minimizing its use and drug use was often mentioned only euphemistically. The reframed emphasis largely removed discussion of injection drug use from discussion of HCV risks. Shifting the emphasis of HCV testing from testing based on specific routes of transmission and risk to testing based on age removes injection drug use from HCV discourse. This has the potential to either facilitate HCV care for drug users or to further stigmatize and marginalize drug use and people who use drugs. The potential implications of this shift in testing emphasis for public health merit further investigation.

  9. 76 FR 31577 - Notice of Availability of a Pest Risk Analysis for the Importation of Fresh Apricot, Sweet Cherry...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-06-01

    ...] Notice of Availability of a Pest Risk Analysis for the Importation of Fresh Apricot, Sweet Cherry, and... commodities from South Africa. We are making the pest risk analysis available to the public for review and... for approving the importation of commodities that, based on the findings of a pest risk analysis, can...

  10. Probabilistic Scenario-based Seismic Risk Analysis for Critical Infrastructures Method and Application for a Nuclear Power Plant

    NASA Astrophysics Data System (ADS)

    Klügel, J.

    2006-12-01

    Deterministic scenario-based seismic hazard analysis has a long tradition in earthquake engineering for developing the design basis of critical infrastructures like dams, transport infrastructures, chemical plants and nuclear power plants. For many applications besides of the design of infrastructures it is of interest to assess the efficiency of the design measures taken. These applications require a method allowing to perform a meaningful quantitative risk analysis. A new method for a probabilistic scenario-based seismic risk analysis has been developed based on a probabilistic extension of proven deterministic methods like the MCE- methodology. The input data required for the method are entirely based on the information which is necessary to perform any meaningful seismic hazard analysis. The method is based on the probabilistic risk analysis approach common for applications in nuclear technology developed originally by Kaplan & Garrick (1981). It is based (1) on a classification of earthquake events into different size classes (by magnitude), (2) the evaluation of the frequency of occurrence of events, assigned to the different classes (frequency of initiating events, (3) the development of bounding critical scenarios assigned to each class based on the solution of an optimization problem and (4) in the evaluation of the conditional probability of exceedance of critical design parameters (vulnerability analysis). The advantage of the method in comparison with traditional PSHA consists in (1) its flexibility, allowing to use different probabilistic models for earthquake occurrence as well as to incorporate advanced physical models into the analysis, (2) in the mathematically consistent treatment of uncertainties, and (3) in the explicit consideration of the lifetime of the critical structure as a criterion to formulate different risk goals. The method was applied for the evaluation of the risk of production interruption losses of a nuclear power plant during its residual lifetime.

  11. A two-stage method of quantitative flood risk analysis for reservoir real-time operation using ensemble-based hydrologic forecasts

    NASA Astrophysics Data System (ADS)

    Liu, P.

    2013-12-01

    Quantitative analysis of the risk for reservoir real-time operation is a hard task owing to the difficulty of accurate description of inflow uncertainties. The ensemble-based hydrologic forecasts directly depict the inflows not only the marginal distributions but also their persistence via scenarios. This motivates us to analyze the reservoir real-time operating risk with ensemble-based hydrologic forecasts as inputs. A method is developed by using the forecast horizon point to divide the future time into two stages, the forecast lead-time and the unpredicted time. The risk within the forecast lead-time is computed based on counting the failure number of forecast scenarios, and the risk in the unpredicted time is estimated using reservoir routing with the design floods and the reservoir water levels of forecast horizon point. As a result, a two-stage risk analysis method is set up to quantify the entire flood risks by defining the ratio of the number of scenarios that excessive the critical value to the total number of scenarios. The China's Three Gorges Reservoir (TGR) is selected as a case study, where the parameter and precipitation uncertainties are implemented to produce ensemble-based hydrologic forecasts. The Bayesian inference, Markov Chain Monte Carlo, is used to account for the parameter uncertainty. Two reservoir operation schemes, the real operated and scenario optimization, are evaluated for the flood risks and hydropower profits analysis. With the 2010 flood, it is found that the improvement of the hydrologic forecast accuracy is unnecessary to decrease the reservoir real-time operation risk, and most risks are from the forecast lead-time. It is therefore valuable to decrease the avarice of ensemble-based hydrologic forecasts with less bias for a reservoir operational purpose.

  12. STRESSED SEBATES: A TRAIT-BASED EVALUATION OF CLIMATE RISKS TO ROCKFISHES OF THE NORTHEASTERN PACIFIC USING THE COASTAL BIOGEOGRAPHIC RISK ANALYSIS TOOL (CBRAT)

    EPA Science Inventory

    The EPA and USGS have developed a framework to evaluate the relative vulnerability of near-coastal species to impacts of climate change. This framework is implemented in a web-based tool, the Coastal Biogeographic Risk Analysis Tool (CBRAT). We evaluated the vulnerability of the ...

  13. Stressed Sebastes: A Trait-Based Evaluation of Climate Risks to Rockfishes of the Northeastern Pacific Using the Coastal Biogeographic Risk Analysis Tool (CBRAT)

    EPA Science Inventory

    The EPA and USGS have developed a framework to evaluate the relative vulnerability of near-coastal species to impacts of climate change. This framework was implemented in a web-based tool, the Coastal Biogeographic Risk Analysis Tool (CBRAT). We evaluated the vulnerability of the...

  14. 78 FR 63448 - Notice of Decision To Allow Interstate Movement of Sapote Fruit From Puerto Rico Into the...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-10-24

    ... States of fresh sapote fruit from Puerto Rico. Based on the findings of a pest risk analysis, which we... announcing the availability of the pest risk analysis that evaluates the risks associated with the interstate... measures if: (1) No comments were received on the pest risk analysis; (2) the comments on the pest risk...

  15. Different type 2 diabetes risk assessments predict dissimilar numbers at 'high risk': a retrospective analysis of diabetes risk-assessment tools.

    PubMed

    Gray, Benjamin J; Bracken, Richard M; Turner, Daniel; Morgan, Kerry; Thomas, Michael; Williams, Sally P; Williams, Meurig; Rice, Sam; Stephens, Jeffrey W

    2015-12-01

    Use of a validated risk-assessment tool to identify individuals at high risk of developing type 2 diabetes is currently recommended. It is under-reported, however, whether a different risk tool alters the predicted risk of an individual. This study explored any differences between commonly used validated risk-assessment tools for type 2 diabetes. Cross-sectional analysis of individuals who participated in a workplace-based risk assessment in Carmarthenshire, South Wales. Retrospective analysis of 676 individuals (389 females and 287 males) who participated in a workplace-based diabetes risk-assessment initiative. Ten-year risk of type 2 diabetes was predicted using the validated QDiabetes(®), Leicester Risk Assessment (LRA), FINDRISC, and Cambridge Risk Score (CRS) algorithms. Differences between the risk-assessment tools were apparent following retrospective analysis of individuals. CRS categorised the highest proportion (13.6%) of individuals at 'high risk' followed by FINDRISC (6.6%), QDiabetes (6.1%), and, finally, the LRA was the most conservative risk tool (3.1%). Following further analysis by sex, over one-quarter of males were categorised at high risk using CRS (25.4%), whereas a greater percentage of females were categorised as high risk using FINDRISC (7.8%). The adoption of a different valid risk-assessment tool can alter the predicted risk of an individual and caution should be used to identify those individuals who really are at high risk of type 2 diabetes. © British Journal of General Practice 2015.

  16. Breast and ovarian cancer risks to carriers of the BRCA1 5382insC and 185delAG and BRCA2 6174delT mutations: a combined analysis of 22 population based studies

    PubMed Central

    Antoniou, A; Pharoah, P; Narod, S; Risch, H; Eyfjord, J; Hopper, J; Olsson, H; Johannsson, O; Borg, A; Pasini, B; Radice, P; Manoukian, S; Eccles, D; Tang, N; Olah, E; Anton-Culver, H; Warner, E; Lubinski, J; Gronwald, J; Gorski, B; Tulinius, H; Thorlacius, S; Eerola, H; Nevanlinna, H; Syrjakoski, K; Kallioniemi, O; Thompson, D; Evans, C; Peto, J; Lalloo, F; Evans, D; Easton, D

    2005-01-01

    A recent report estimated the breast cancer risks in carriers of the three Ashkenazi founder mutations to be higher than previously published estimates derived from population based studies. In an attempt to confirm this, the breast and ovarian cancer risks associated with the three Ashkenazi founder mutations were estimated using families included in a previous meta-analysis of populatrion based studies. The estimated breast cancer risks for each of the founder BRCA1 and BRCA2 mutations were similar to the corresponding estimates based on all BRCA1 or BRCA2 mutations in the meta-analysis. These estimates appear to be consistent with the observed prevalence of the mutations in the Ashkenazi Jewish population. PMID:15994883

  17. Different type 2 diabetes risk assessments predict dissimilar numbers at ‘high risk’: a retrospective analysis of diabetes risk-assessment tools

    PubMed Central

    Gray, Benjamin J; Bracken, Richard M; Turner, Daniel; Morgan, Kerry; Thomas, Michael; Williams, Sally P; Williams, Meurig; Rice, Sam; Stephens, Jeffrey W

    2015-01-01

    Background Use of a validated risk-assessment tool to identify individuals at high risk of developing type 2 diabetes is currently recommended. It is under-reported, however, whether a different risk tool alters the predicted risk of an individual. Aim This study explored any differences between commonly used validated risk-assessment tools for type 2 diabetes. Design and setting Cross-sectional analysis of individuals who participated in a workplace-based risk assessment in Carmarthenshire, South Wales. Method Retrospective analysis of 676 individuals (389 females and 287 males) who participated in a workplace-based diabetes risk-assessment initiative. Ten-year risk of type 2 diabetes was predicted using the validated QDiabetes®, Leicester Risk Assessment (LRA), FINDRISC, and Cambridge Risk Score (CRS) algorithms. Results Differences between the risk-assessment tools were apparent following retrospective analysis of individuals. CRS categorised the highest proportion (13.6%) of individuals at ‘high risk’ followed by FINDRISC (6.6%), QDiabetes (6.1%), and, finally, the LRA was the most conservative risk tool (3.1%). Following further analysis by sex, over one-quarter of males were categorised at high risk using CRS (25.4%), whereas a greater percentage of females were categorised as high risk using FINDRISC (7.8%). Conclusion The adoption of a different valid risk-assessment tool can alter the predicted risk of an individual and caution should be used to identify those individuals who really are at high risk of type 2 diabetes. PMID:26541180

  18. Risk analysis of heat recovery steam generator with semi quantitative risk based inspection API 581

    NASA Astrophysics Data System (ADS)

    Prayogo, Galang Sandy; Haryadi, Gunawan Dwi; Ismail, Rifky; Kim, Seon Jin

    2016-04-01

    Corrosion is a major problem that most often occurs in the power plant. Heat recovery steam generator (HRSG) is an equipment that has a high risk to the power plant. The impact of corrosion damage causing HRSG power plant stops operating. Furthermore, it could be threaten the safety of employees. The Risk Based Inspection (RBI) guidelines by the American Petroleum Institute (API) 58 has been used to risk analysis in the HRSG 1. By using this methodology, the risk that caused by unexpected failure as a function of the probability and consequence of failure can be estimated. This paper presented a case study relating to the risk analysis in the HRSG, starting with a summary of the basic principles and procedures of risk assessment and applying corrosion RBI for process industries. The risk level of each HRSG equipment were analyzed: HP superheater has a medium high risk (4C), HP evaporator has a medium-high risk (4C), and the HP economizer has a medium risk (3C). The results of the risk assessment using semi-quantitative method of standard API 581 based on the existing equipment at medium risk. In the fact, there is no critical problem in the equipment components. Damage mechanisms were prominent throughout the equipment is thinning mechanism. The evaluation of the risk approach was done with the aim of reducing risk by optimizing the risk assessment activities.

  19. Dose-Dependent Associations between Wine Drinking and Breast Cancer Risk - Meta-Analysis Findings.

    PubMed

    Chen, Jia-Yan; Zhu, Hong-Cheng; Guo, Qing; Shu, Zheng; Bao, Xu-Hui; Sun, Feng; Qin, Qin; Yang, Xi; Zhang, Chi; Cheng, Hong-Yan; Sun, Xin-Chen

    2016-01-01

    To investigate any potential association between wine and breast cancer risk. We quantitatively assessed associations by conducting a meta-analysis based on evidence from observational studies. In May 2014, we performed electronic searches in PubMed, EmBase and the Cochrane Library to identify studies examining the effect of wine drinking on breast cancer incidence. The relative risk (RR) or odds ratio (OR) were used to measure any such association. The analysis was further stratified by confounding factors that could influence the results. A total of twenty-six studies (eight case-control and eighteen cohort studies) involving 21,149 cases were included in our meta-analysis. Our study demonstrated that wine drinking was associated with breast cancer risk. A 36% increase in breast cancer risk was observed across overall studies based on the highest versus lowest model, with a combined RR of 1.0059 (95%CI 0.97-1.05) in dose-response analysis. However, 5 g/d ethanol from wine seemed to have protective value from our non-linear model. Our findings indicate that wine drinking is associated with breast cancer risk in a dose-dependent manner. High consumption of wine contributes to breast cancer risk with protection exerted by low doses. Further investigations are needed for clarification.

  20. 78 FR 48636 - Current Good Manufacturing Practice and Hazard Analysis and Risk-Based Preventive Controls for...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-08-09

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration 21 CFR Parts 1, 16, 106, 110... Manufacturing Practice and Hazard Analysis and Risk- Based Preventive Controls for Human Food; Extension of...-Based Preventive Controls for Human Food,'' that appeared in the Federal Register of January 16, 2013...

  1. Application of a generic bow-tie based risk analysis framework on risk management of sea ports and offshore terminals.

    PubMed

    Mokhtari, Kambiz; Ren, Jun; Roberts, Charles; Wang, Jin

    2011-08-30

    Ports and offshore terminals are critical infrastructure resources and play key roles in the transportation of goods and people. With more than 80 percent of international trade by volume being carried out by sea, ports and offshore terminals are vital for seaborne trade and international commerce. Furthermore in today's uncertain and complex environment there is a need to analyse the participated risk factors in order to prioritise protective measures in these critically logistics infrastructures. As a result of this study is carried out to support the risk assessment phase of the proposed Risk Management (RM) framework used for the purpose of sea ports and offshore terminals operations and management (PTOM). This has been fulfilled by integration of a generic bow-tie based risk analysis framework into the risk assessment phase as a backbone of the phase. For this reason Fault Tree Analysis (FTA) and Event Tree Analysis (ETA) are used to analyse the risk factors associated within the PTOM. This process will eventually help the port professionals and port risk managers to investigate the identified risk factors more in detail. In order to deal with vagueness of the data Fuzzy Set Theory (FST) and possibility approach are used to overcome the disadvantages of the conventional probability based approaches. Copyright © 2011 Elsevier B.V. All rights reserved.

  2. Risk-based maintenance of ethylene oxide production facilities.

    PubMed

    Khan, Faisal I; Haddara, Mahmoud R

    2004-05-20

    This paper discusses a methodology for the design of an optimum inspection and maintenance program. The methodology, called risk-based maintenance (RBM) is based on integrating a reliability approach and a risk assessment strategy to obtain an optimum maintenance schedule. First, the likely equipment failure scenarios are formulated. Out of many likely failure scenarios, the ones, which are most probable, are subjected to a detailed study. Detailed consequence analysis is done for the selected scenarios. Subsequently, these failure scenarios are subjected to a fault tree analysis to determine their probabilities. Finally, risk is computed by combining the results of the consequence and the probability analyses. The calculated risk is compared against known acceptable criteria. The frequencies of the maintenance tasks are obtained by minimizing the estimated risk. A case study involving an ethylene oxide production facility is presented. Out of the five most hazardous units considered, the pipeline used for the transportation of the ethylene is found to have the highest risk. Using available failure data and a lognormal reliability distribution function human health risk factors are calculated. Both societal risk factors and individual risk factors exceeded the acceptable risk criteria. To determine an optimal maintenance interval, a reverse fault tree analysis was used. The maintenance interval was determined such that the original high risk is brought down to an acceptable level. A sensitivity analysis is also undertaken to study the impact of changing the distribution of the reliability model as well as the error in the distribution parameters on the maintenance interval.

  3. Dynamic Attack Tree Tool for Risk Assessments

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Black, Karl

    2012-03-13

    DATT enables interactive visualization, qualitative analysis and recording of cyber and other forms of risk. It facilitates dynamic risk-based approaches (as opposed to static compliance-based) to security and risk management in general. DATT allows decision makers to consistently prioritize risk mitigation strategies and quickly see where attention is most needed across the enterprise.

  4. Bayesian-network-based safety risk assessment for steel construction projects.

    PubMed

    Leu, Sou-Sen; Chang, Ching-Miao

    2013-05-01

    There are four primary accident types at steel building construction (SC) projects: falls (tumbles), object falls, object collapse, and electrocution. Several systematic safety risk assessment approaches, such as fault tree analysis (FTA) and failure mode and effect criticality analysis (FMECA), have been used to evaluate safety risks at SC projects. However, these traditional methods ineffectively address dependencies among safety factors at various levels that fail to provide early warnings to prevent occupational accidents. To overcome the limitations of traditional approaches, this study addresses the development of a safety risk-assessment model for SC projects by establishing the Bayesian networks (BN) based on fault tree (FT) transformation. The BN-based safety risk-assessment model was validated against the safety inspection records of six SC building projects and nine projects in which site accidents occurred. The ranks of posterior probabilities from the BN model were highly consistent with the accidents that occurred at each project site. The model accurately provides site safety-management abilities by calculating the probabilities of safety risks and further analyzing the causes of accidents based on their relationships in BNs. In practice, based on the analysis of accident risks and significant safety factors, proper preventive safety management strategies can be established to reduce the occurrence of accidents on SC sites. Copyright © 2013 Elsevier Ltd. All rights reserved.

  5. A review of recent advances in risk analysis for wildfire management

    Treesearch

    Carol Miller; Alan A. Ager

    2012-01-01

    Risk analysis evolved out of the need to make decisions concerning highly stochastic events, and is well suited to analyze the timing, location and potential effects of wildfires. Over the past 10 years, the application of risk analysis to wildland fire management has seen steady growth with new risk-based analytical tools that support a wide range of fire and fuels...

  6. 75 FR 62500 - Notice of Availability of a Pest Risk Analysis for the Importation of Fresh Strawberries From Jordan

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-10-12

    ...] Notice of Availability of a Pest Risk Analysis for the Importation of Fresh Strawberries From Jordan... importation into the continental United States of fresh strawberries from Jordan. Based on this analysis, we... importation of fresh strawberries from Jordan. We are making the pest risk analysis available to the public...

  7. 76 FR 50992 - Notice of Availability of a Pest Risk Analysis for the Importation of Shredded Lettuce From Egypt

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-08-17

    ...] Notice of Availability of a Pest Risk Analysis for the Importation of Shredded Lettuce From Egypt AGENCY... into the continental United States of fresh shredded lettuce from Egypt. Based on this analysis, we... fresh shredded lettuce from Egypt. We are making the pest risk analysis available to the public for...

  8. SADA: Ecological Risk Based Decision Support System for Selective Remediation

    EPA Science Inventory

    Spatial Analysis and Decision Assistance (SADA) is freeware that implements terrestrial ecological risk assessment and yields a selective remediation design using its integral geographical information system, based on ecological and risk assessment inputs. Selective remediation ...

  9. Risk management of key issues of FPSO

    NASA Astrophysics Data System (ADS)

    Sun, Liping; Sun, Hai

    2012-12-01

    Risk analysis of key systems have become a growing topic late of because of the development of offshore structures. Equipment failures of offloading system and fire accidents were analyzed based on the floating production, storage and offloading (FPSO) features. Fault tree analysis (FTA), and failure modes and effects analysis (FMEA) methods were examined based on information already researched on modules of relex reliability studio (RRS). Equipment failures were also analyzed qualitatively by establishing a fault tree and Boolean structure function based on the shortage of failure cases, statistical data, and risk control measures examined. Failure modes of fire accident were classified according to the different areas of fire occurrences during the FMEA process, using risk priority number (RPN) methods to evaluate their severity rank. The qualitative analysis of FTA gave the basic insight of forming the failure modes of FPSO offloading, and the fire FMEA gave the priorities and suggested processes. The research has practical importance for the security analysis problems of FPSO.

  10. Study of a risk-based piping inspection guideline system.

    PubMed

    Tien, Shiaw-Wen; Hwang, Wen-Tsung; Tsai, Chih-Hung

    2007-02-01

    A risk-based inspection system and a piping inspection guideline model were developed in this study. The research procedure consists of two parts--the building of a risk-based inspection model for piping and the construction of a risk-based piping inspection guideline model. Field visits at the plant were conducted to develop the risk-based inspection and strategic analysis system. A knowledge-based model had been built in accordance with international standards and local government regulations, and the rational unified process was applied for reducing the discrepancy in the development of the models. The models had been designed to analyze damage factors, damage models, and potential damage positions of piping in the petrochemical plants. The purpose of this study was to provide inspection-related personnel with the optimal planning tools for piping inspections, hence, to enable effective predictions of potential piping risks and to enhance the better degree of safety in plant operations that the petrochemical industries can be expected to achieve. A risk analysis was conducted on the piping system of a petrochemical plant. The outcome indicated that most of the risks resulted from a small number of pipelines.

  11. An Emerging New Risk Analysis Science: Foundations and Implications.

    PubMed

    Aven, Terje

    2018-05-01

    To solve real-life problems-such as those related to technology, health, security, or climate change-and make suitable decisions, risk is nearly always a main issue. Different types of sciences are often supporting the work, for example, statistics, natural sciences, and social sciences. Risk analysis approaches and methods are also commonly used, but risk analysis is not broadly accepted as a science in itself. A key problem is the lack of explanatory power and large uncertainties when assessing risk. This article presents an emerging new risk analysis science based on novel ideas and theories on risk analysis developed in recent years by the risk analysis community. It builds on a fundamental change in thinking, from the search for accurate predictions and risk estimates, to knowledge generation related to concepts, theories, frameworks, approaches, principles, methods, and models to understand, assess, characterize, communicate, and (in a broad sense) manage risk. Examples are used to illustrate the importance of this distinct/separate risk analysis science for solving risk problems, supporting science in general and other disciplines in particular. © 2017 The Authors Risk Analysis published by Wiley Periodicals, Inc. on behalf of Society for Risk Analysis.

  12. Risk analysis of heat recovery steam generator with semi quantitative risk based inspection API 581

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Prayogo, Galang Sandy, E-mail: gasandylang@live.com; Haryadi, Gunawan Dwi; Ismail, Rifky

    Corrosion is a major problem that most often occurs in the power plant. Heat recovery steam generator (HRSG) is an equipment that has a high risk to the power plant. The impact of corrosion damage causing HRSG power plant stops operating. Furthermore, it could be threaten the safety of employees. The Risk Based Inspection (RBI) guidelines by the American Petroleum Institute (API) 58 has been used to risk analysis in the HRSG 1. By using this methodology, the risk that caused by unexpected failure as a function of the probability and consequence of failure can be estimated. This paper presentedmore » a case study relating to the risk analysis in the HRSG, starting with a summary of the basic principles and procedures of risk assessment and applying corrosion RBI for process industries. The risk level of each HRSG equipment were analyzed: HP superheater has a medium high risk (4C), HP evaporator has a medium-high risk (4C), and the HP economizer has a medium risk (3C). The results of the risk assessment using semi-quantitative method of standard API 581 based on the existing equipment at medium risk. In the fact, there is no critical problem in the equipment components. Damage mechanisms were prominent throughout the equipment is thinning mechanism. The evaluation of the risk approach was done with the aim of reducing risk by optimizing the risk assessment activities.« less

  13. Accounting for failure: risk-based regulation and the problems of ensuring healthcare quality in the NHS

    PubMed Central

    Beaussier, Anne-Laure; Demeritt, David; Griffiths, Alex; Rothstein, Henry

    2016-01-01

    In this paper, we examine why risk-based policy instruments have failed to improve the proportionality, effectiveness, and legitimacy of healthcare quality regulation in the National Health Service (NHS) in England. Rather than trying to prevent all possible harms, risk-based approaches promise to rationalise and manage the inevitable limits of what regulation can hope to achieve by focusing regulatory standard-setting and enforcement activity on the highest priority risks, as determined through formal assessments of their probability and consequences. As such, risk-based approaches have been enthusiastically adopted by healthcare quality regulators over the last decade. However, by drawing on historical policy analysis and in-depth interviews with 15 high-level UK informants in 2013–2015, we identify a series of practical problems in using risk-based policy instruments for defining, assessing, and ensuring compliance with healthcare quality standards. Based on our analysis, we go on to consider why, despite a succession of failures, healthcare regulators remain committed to developing and using risk-based approaches. We conclude by identifying several preconditions for successful risk-based regulation: goals must be clear and trade-offs between them amenable to agreement; regulators must be able to reliably assess the probability and consequences of adverse outcomes; regulators must have a range of enforcement tools that can be deployed in proportion to risk; and there must be political tolerance for adverse outcomes. PMID:27499677

  14. Accounting for failure: risk-based regulation and the problems of ensuring healthcare quality in the NHS.

    PubMed

    Beaussier, Anne-Laure; Demeritt, David; Griffiths, Alex; Rothstein, Henry

    2016-05-18

    In this paper, we examine why risk-based policy instruments have failed to improve the proportionality, effectiveness, and legitimacy of healthcare quality regulation in the National Health Service (NHS) in England. Rather than trying to prevent all possible harms, risk-based approaches promise to rationalise and manage the inevitable limits of what regulation can hope to achieve by focusing regulatory standard-setting and enforcement activity on the highest priority risks, as determined through formal assessments of their probability and consequences. As such, risk-based approaches have been enthusiastically adopted by healthcare quality regulators over the last decade. However, by drawing on historical policy analysis and in-depth interviews with 15 high-level UK informants in 2013-2015, we identify a series of practical problems in using risk-based policy instruments for defining, assessing, and ensuring compliance with healthcare quality standards. Based on our analysis, we go on to consider why, despite a succession of failures, healthcare regulators remain committed to developing and using risk-based approaches. We conclude by identifying several preconditions for successful risk-based regulation: goals must be clear and trade-offs between them amenable to agreement; regulators must be able to reliably assess the probability and consequences of adverse outcomes; regulators must have a range of enforcement tools that can be deployed in proportion to risk; and there must be political tolerance for adverse outcomes.

  15. System Theoretic Frameworks for Mitigating Risk Complexity in the Nuclear Fuel Cycle

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Williams, Adam David; Mohagheghi, Amir H.; Cohn, Brian

    In response to the expansion of nuclear fuel cycle (NFC) activities -- and the associated suite of risks -- around the world, this project evaluated systems-based solutions for managing such risk complexity in multimodal and multi-jurisdictional international spent nuclear fuel (SNF) transportation. By better understanding systemic risks in SNF transportation, developing SNF transportation risk assessment frameworks, and evaluating these systems-based risk assessment frameworks, this research illustrated interdependency between safety, security, and safeguards risks is inherent in NFC activities and can go unidentified when each "S" is independently evaluated. Two novel system-theoretic analysis techniques -- dynamic probabilistic risk assessment (DPRA) andmore » system-theoretic process analysis (STPA) -- provide integrated "3S" analysis to address these interdependencies and the research results suggest a need -- and provide a way -- to reprioritize United States engagement efforts to reduce global nuclear risks. Lastly, this research identifies areas where Sandia National Laboratories can spearhead technical advances to reduce global nuclear dangers.« less

  16. Risk Analysis of Earth-Rock Dam Failures Based on Fuzzy Event Tree Method

    PubMed Central

    Fu, Xiao; Gu, Chong-Shi; Su, Huai-Zhi; Qin, Xiang-Nan

    2018-01-01

    Earth-rock dams make up a large proportion of the dams in China, and their failures can induce great risks. In this paper, the risks associated with earth-rock dam failure are analyzed from two aspects: the probability of a dam failure and the resulting life loss. An event tree analysis method based on fuzzy set theory is proposed to calculate the dam failure probability. The life loss associated with dam failure is summarized and refined to be suitable for Chinese dams from previous studies. The proposed method and model are applied to one reservoir dam in Jiangxi province. Both engineering and non-engineering measures are proposed to reduce the risk. The risk analysis of the dam failure has essential significance for reducing dam failure probability and improving dam risk management level. PMID:29710824

  17. Cyber Risk Management for Critical Infrastructure: A Risk Analysis Model and Three Case Studies.

    PubMed

    Paté-Cornell, M-Elisabeth; Kuypers, Marshall; Smith, Matthew; Keller, Philip

    2018-02-01

    Managing cyber security in an organization involves allocating the protection budget across a spectrum of possible options. This requires assessing the benefits and the costs of these options. The risk analyses presented here are statistical when relevant data are available, and system-based for high-consequence events that have not happened yet. This article presents, first, a general probabilistic risk analysis framework for cyber security in an organization to be specified. It then describes three examples of forward-looking analyses motivated by recent cyber attacks. The first one is the statistical analysis of an actual database, extended at the upper end of the loss distribution by a Bayesian analysis of possible, high-consequence attack scenarios that may happen in the future. The second is a systems analysis of cyber risks for a smart, connected electric grid, showing that there is an optimal level of connectivity. The third is an analysis of sequential decisions to upgrade the software of an existing cyber security system or to adopt a new one to stay ahead of adversaries trying to find their way in. The results are distributions of losses to cyber attacks, with and without some considered countermeasures in support of risk management decisions based both on past data and anticipated incidents. © 2017 Society for Risk Analysis.

  18. Train integrity detection risk analysis based on PRISM

    NASA Astrophysics Data System (ADS)

    Wen, Yuan

    2018-04-01

    GNSS based Train Integrity Monitoring System (TIMS) is an effective and low-cost detection scheme for train integrity detection. However, as an external auxiliary system of CTCS, GNSS may be influenced by external environments, such as uncertainty of wireless communication channels, which may lead to the failure of communication and positioning. In order to guarantee the reliability and safety of train operation, a risk analysis method of train integrity detection based on PRISM is proposed in this article. First, we analyze the risk factors (in GNSS communication process and the on-board communication process) and model them. Then, we evaluate the performance of the model in PRISM based on the field data. Finally, we discuss how these risk factors influence the train integrity detection process.

  19. Looking beyond borders: integrating best practices in benefit-risk analysis into the field of food and nutrition.

    PubMed

    Tijhuis, M J; Pohjola, M V; Gunnlaugsdóttir, H; Kalogeras, N; Leino, O; Luteijn, J M; Magnússon, S H; Odekerken-Schröder, G; Poto, M; Tuomisto, J T; Ueland, O; White, B C; Holm, F; Verhagen, H

    2012-01-01

    An integrated benefit-risk analysis aims to give guidance in decision situations where benefits do not clearly prevail over risks, and explicit weighing of benefits and risks is thus indicated. The BEPRARIBEAN project aims to advance benefit-risk analysis in the area of food and nutrition by learning from other fields. This paper constitutes the final stage of the project, in which commonalities and differences in benefit-risk analysis are identified between the Food and Nutrition field and other fields, namely Medicines, Food Microbiology, Environmental Health, Economics and Marketing-Finance, and Consumer Perception. From this, ways forward are characterized for benefit-risk analysis in Food and Nutrition. Integrated benefit-risk analysis in Food and Nutrition may advance in the following ways: Increased engagement and communication between assessors, managers, and stakeholders; more pragmatic problem-oriented framing of assessment; accepting some risk; pre- and post-market analysis; explicit communication of the assessment purpose, input and output; more human (dose-response) data and more efficient use of human data; segmenting populations based on physiology; explicit consideration of value judgments in assessment; integration of multiple benefits and risks from multiple domains; explicit recognition of the impact of consumer beliefs, opinions, views, perceptions, and attitudes on behaviour; and segmenting populations based on behaviour; the opportunities proposed here do not provide ultimate solutions; rather, they define a collection of issues to be taken account of in developing methods, tools, practices and policies, as well as refining the regulatory context, for benefit-risk analysis in Food and Nutrition and other fields. Thus, these opportunities will now need to be explored further and incorporated into benefit-risk practice and policy. If accepted, incorporation of these opportunities will also involve a paradigm shift in Food and Nutrition benefit-risk analysis towards conceiving the analysis as a process of creating shared knowledge among all stakeholders. Copyright © 2011 Elsevier Ltd. All rights reserved.

  20. Hazards and occupational risk in hard coal mines - a critical analysis of legal requirements

    NASA Astrophysics Data System (ADS)

    Krause, Marcin

    2017-11-01

    This publication concerns the problems of occupational safety and health in hard coal mines, the basic elements of which are the mining hazards and the occupational risk. The work includes a comparative analysis of selected provisions of general and industry-specific law regarding the analysis of hazards and occupational risk assessment. Based on a critical analysis of legal requirements, basic assumptions regarding the practical guidelines for occupational risk assessment in underground coal mines have been proposed.

  1. Research on the method of information system risk state estimation based on clustering particle filter

    NASA Astrophysics Data System (ADS)

    Cui, Jia; Hong, Bei; Jiang, Xuepeng; Chen, Qinghua

    2017-05-01

    With the purpose of reinforcing correlation analysis of risk assessment threat factors, a dynamic assessment method of safety risks based on particle filtering is proposed, which takes threat analysis as the core. Based on the risk assessment standards, the method selects threat indicates, applies a particle filtering algorithm to calculate influencing weight of threat indications, and confirms information system risk levels by combining with state estimation theory. In order to improve the calculating efficiency of the particle filtering algorithm, the k-means cluster algorithm is introduced to the particle filtering algorithm. By clustering all particles, the author regards centroid as the representative to operate, so as to reduce calculated amount. The empirical experience indicates that the method can embody the relation of mutual dependence and influence in risk elements reasonably. Under the circumstance of limited information, it provides the scientific basis on fabricating a risk management control strategy.

  2. A quality risk management model approach for cell therapy manufacturing.

    PubMed

    Lopez, Fabio; Di Bartolo, Chiara; Piazza, Tommaso; Passannanti, Antonino; Gerlach, Jörg C; Gridelli, Bruno; Triolo, Fabio

    2010-12-01

    International regulatory authorities view risk management as an essential production need for the development of innovative, somatic cell-based therapies in regenerative medicine. The available risk management guidelines, however, provide little guidance on specific risk analysis approaches and procedures applicable in clinical cell therapy manufacturing. This raises a number of problems. Cell manufacturing is a poorly automated process, prone to operator-introduced variations, and affected by heterogeneity of the processed organs/tissues and lot-dependent variability of reagent (e.g., collagenase) efficiency. In this study, the principal challenges faced in a cell-based product manufacturing context (i.e., high dependence on human intervention and absence of reference standards for acceptable risk levels) are identified and addressed, and a risk management model approach applicable to manufacturing of cells for clinical use is described for the first time. The use of the heuristic and pseudo-quantitative failure mode and effect analysis/failure mode and critical effect analysis risk analysis technique associated with direct estimation of severity, occurrence, and detection is, in this specific context, as effective as, but more efficient than, the analytic hierarchy process. Moreover, a severity/occurrence matrix and Pareto analysis can be successfully adopted to identify priority failure modes on which to act to mitigate risks. The application of this approach to clinical cell therapy manufacturing in regenerative medicine is also discussed. © 2010 Society for Risk Analysis.

  3. Risk-Based Sampling: I Don't Want to Weight in Vain.

    PubMed

    Powell, Mark R

    2015-12-01

    Recently, there has been considerable interest in developing risk-based sampling for food safety and animal and plant health for efficient allocation of inspection and surveillance resources. The problem of risk-based sampling allocation presents a challenge similar to financial portfolio analysis. Markowitz (1952) laid the foundation for modern portfolio theory based on mean-variance optimization. However, a persistent challenge in implementing portfolio optimization is the problem of estimation error, leading to false "optimal" portfolios and unstable asset weights. In some cases, portfolio diversification based on simple heuristics (e.g., equal allocation) has better out-of-sample performance than complex portfolio optimization methods due to estimation uncertainty. Even for portfolios with a modest number of assets, the estimation window required for true optimization may imply an implausibly long stationary period. The implications for risk-based sampling are illustrated by a simple simulation model of lot inspection for a small, heterogeneous group of producers. © 2015 Society for Risk Analysis.

  4. A non-stationary cost-benefit analysis approach for extreme flood estimation to explore the nexus of 'Risk, Cost and Non-stationarity'

    NASA Astrophysics Data System (ADS)

    Qi, Wei

    2017-11-01

    Cost-benefit analysis is commonly used for engineering planning and design problems in practice. However, previous cost-benefit based design flood estimation is based on stationary assumption. This study develops a non-stationary cost-benefit based design flood estimation approach. This approach integrates a non-stationary probability distribution function into cost-benefit analysis, and influence of non-stationarity on expected total cost (including flood damage and construction costs) and design flood estimation can be quantified. To facilitate design flood selections, a 'Risk-Cost' analysis approach is developed, which reveals the nexus of extreme flood risk, expected total cost and design life periods. Two basins, with 54-year and 104-year flood data respectively, are utilized to illustrate the application. It is found that the developed approach can effectively reveal changes of expected total cost and extreme floods in different design life periods. In addition, trade-offs are found between extreme flood risk and expected total cost, which reflect increases in cost to mitigate risk. Comparing with stationary approaches which generate only one expected total cost curve and therefore only one design flood estimation, the proposed new approach generate design flood estimation intervals and the 'Risk-Cost' approach selects a design flood value from the intervals based on the trade-offs between extreme flood risk and expected total cost. This study provides a new approach towards a better understanding of the influence of non-stationarity on expected total cost and design floods, and could be beneficial to cost-benefit based non-stationary design flood estimation across the world.

  5. Integrating Household Risk Mitigation Behavior in Flood Risk Analysis: An Agent-Based Model Approach.

    PubMed

    Haer, Toon; Botzen, W J Wouter; de Moel, Hans; Aerts, Jeroen C J H

    2017-10-01

    Recent studies showed that climate change and socioeconomic trends are expected to increase flood risks in many regions. However, in these studies, human behavior is commonly assumed to be constant, which neglects interaction and feedback loops between human and environmental systems. This neglect of human adaptation leads to a misrepresentation of flood risk. This article presents an agent-based model that incorporates human decision making in flood risk analysis. In particular, household investments in loss-reducing measures are examined under three economic decision models: (1) expected utility theory, which is the traditional economic model of rational agents; (2) prospect theory, which takes account of bounded rationality; and (3) a prospect theory model, which accounts for changing risk perceptions and social interactions through a process of Bayesian updating. We show that neglecting human behavior in flood risk assessment studies can result in a considerable misestimation of future flood risk, which is in our case study an overestimation of a factor two. Furthermore, we show how behavior models can support flood risk analysis under different behavioral assumptions, illustrating the need to include the dynamic adaptive human behavior of, for instance, households, insurers, and governments. The method presented here provides a solid basis for exploring human behavior and the resulting flood risk with respect to low-probability/high-impact risks. © 2016 The Authors Risk Analysis published by Wiley Periodicals, Inc. on behalf of Society for Risk Analysis.

  6. Quantitative analysis of factors that affect oil pipeline network accident based on Bayesian networks: A case study in China

    NASA Astrophysics Data System (ADS)

    Zhang, Chao; Qin, Ting Xin; Huang, Shuai; Wu, Jian Song; Meng, Xin Yan

    2018-06-01

    Some factors can affect the consequences of oil pipeline accident and their effects should be analyzed to improve emergency preparation and emergency response. Although there are some qualitative analysis models of risk factors' effects, the quantitative analysis model still should be researched. In this study, we introduce a Bayesian network (BN) model of risk factors' effects analysis in an oil pipeline accident case that happened in China. The incident evolution diagram is built to identify the risk factors. And the BN model is built based on the deployment rule for factor nodes in BN and the expert knowledge by Dempster-Shafer evidence theory. Then the probabilities of incident consequences and risk factors' effects can be calculated. The most likely consequences given by this model are consilient with the case. Meanwhile, the quantitative estimations of risk factors' effects may provide a theoretical basis to take optimal risk treatment measures for oil pipeline management, which can be used in emergency preparation and emergency response.

  7. 78 FR 17142 - Current Good Manufacturing Practice and Hazard Analysis and Risk-Based Preventive Controls for...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-03-20

    ... Manufacturing Practice and Hazard Analysis and Risk- Based Preventive Controls for Human Food; Correction AGENCY... manufacturing, packing, or holding human food (CGMPs) to modernize it and to add requirements for domestic and... ``food-production purposes (i.e., manufacturing, processing, packing, and holding) to consistently use...

  8. Application of hazard analysis and critical control point methodology and risk-based grading to consumer food safety surveys.

    PubMed

    Røssvoll, Elin Halbach; Ueland, Øydis; Hagtvedt, Therese; Jacobsen, Eivind; Lavik, Randi; Langsrud, Solveig

    2012-09-01

    Traditionally, consumer food safety survey responses have been classified as either "right" or "wrong" and food handling practices that are associated with high risk of infection have been treated in the same way as practices with lower risks. In this study, a risk-based method for consumer food safety surveys has been developed, and HACCP (hazard analysis and critical control point) methodology was used for selecting relevant questions. We conducted a nationally representative Web-based survey (n = 2,008), and to fit the self-reported answers we adjusted a risk-based grading system originally developed for observational studies. The results of the survey were analyzed both with the traditional "right" and "wrong" classification and with the risk-based grading system. The results using the two methods were very different. Only 5 of the 10 most frequent food handling violations were among the 10 practices associated with the highest risk. These 10 practices dealt with different aspects of heat treatment (lacking or insufficient), whereas the majority of the most frequent violations involved storing food at room temperature for too long. Use of the risk-based grading system for survey responses gave a more realistic picture of risks associated with domestic food handling practices. The method highlighted important violations and minor errors, which are performed by most people and are not associated with significant risk. Surveys built on a HACCP-based approach with risk-based grading will contribute to a better understanding of domestic food handling practices and will be of great value for targeted information and educational activities.

  9. Towards risk-based drought management in the Netherlands: quantifying the welfare effects of water shortage

    NASA Astrophysics Data System (ADS)

    van der Vat, Marnix; Femke, Schasfoort; Rhee Gigi, Van; Manfred, Wienhoven; Nico, Polman; Joost, Delsman; den Hoek Paul, Van; Maat Judith, Ter; Marjolein, Mens

    2016-04-01

    It is widely acknowledged that drought management should move from a crisis to a risk-based approach. A risk-based approach to managing water resources requires a sound drought risk analysis, quantifying the probability and impacts of water shortage due to droughts. Impacts of droughts are for example crop yield losses, hydropower production losses, and water shortage for municipal and industrial use. Many studies analyse the balance between supply and demand, but there is little experience in translating this into economic metrics that can be used in a decision-making process on investments to reduce drought risk. We will present a drought risk analysis method for the Netherlands, with a focus on the underlying economic method to quantify the welfare effects of water shortage for different water users. Both the risk-based approach as well as the economic valuation of water shortage for various water users was explored in a study for the Dutch Government. First, an historic analysis of the effects of droughts on revenues and prices in agriculture as well as on shipping and nature was carried out. Second, a drought risk analysis method was developed that combines drought hazard and drought impact analysis in a probabilistic way for various sectors. This consists of a stepwise approach, from water availability through water shortage to economic impact, for a range of drought events with a certain return period. Finally, a local case study was conducted to test the applicability of the drought risk analysis method. Through the study, experience was gained into integrating hydrological and economic analyses, which is a prerequisite for drought risk analysis. Results indicate that the risk analysis method is promising and applicable for various sectors. However, it was also found that quantification of economic impacts from droughts is time-consuming, because location- and sector-specific data is needed, which is not always readily available. Furthermore, for some sectors hydrological data was lacking to make a reliable estimate of drought return periods. By 2021, the Netherlands Government aims to agree on the water supply service levels, which should describe water availability and quality that can be delivered with a certain return period. The Netherlands' Ministry of Infrastructure and the Environment, representatives of the regional water boards and Rijkswaterstaat (operating the main water system) as well as several consultants and research institutes are important stakeholders for further development of the method, evaluation of cases and the development of a quantitative risk-informed decision-making tool.

  10. Relative risk analysis of several manufactured nanomaterials: an insurance industry context.

    PubMed

    Robichaud, Christine Ogilvie; Tanzil, Dicksen; Weilenmann, Ulrich; Wiesner, Mark R

    2005-11-15

    A relative risk assessment is presented for the industrial fabrication of several nanomaterials. The production processes for five nanomaterials were selected for this analysis, based on their current or near-term potential for large-scale production and commercialization: single-walled carbon nanotubes, bucky balls (C60), one variety of quantum dots, alumoxane nanoparticles, and nano-titanium dioxide. The assessment focused on the activities surrounding the fabrication of nanomaterials, exclusive of any impacts or risks with the nanomaterials themselves. A representative synthesis method was selected for each nanomaterial based on its potential for scaleup. A list of input materials, output materials, and waste streams for each step of fabrication was developed and entered into a database that included key process characteristics such as temperature and pressure. The physical-chemical properties and quantities of the inventoried materials were used to assess relative risk based on factors such as volatility, carcinogenicity, flammability, toxicity, and persistence. These factors were first used to qualitatively rank risk, then combined using an actuarial protocol developed by the insurance industry for the purpose of calculating insurance premiums for chemical manufacturers. This protocol ranks three categories of risk relative to a 100 point scale (where 100 represents maximum risk): incident risk, normal operations risk, and latent contamination risk. Results from this analysis determined that relative environmental risk from manufacturing each of these five materials was comparatively low in relation to other common industrial manufacturing processes.

  11. Risk analysis of information security in a mobile instant messaging and presence system for healthcare.

    PubMed

    Bønes, Erlend; Hasvold, Per; Henriksen, Eva; Strandenaes, Thomas

    2007-09-01

    Instant messaging (IM) is suited for immediate communication because messages are delivered almost in real time. Results from studies of IM use in enterprise work settings make us believe that IM based services may prove useful also within the healthcare sector. However, today's public instant messaging services do not have the level of information security required for adoption of IM in healthcare. We proposed MedIMob, our own architecture for a secure enterprise IM service for use in healthcare. MedIMob supports IM clients on mobile devices in addition to desktop based clients. Security threats were identified in a risk analysis of the MedIMob architecture. The risk analysis process consists of context identification, threat identification, analysis of consequences and likelihood, risk evaluation, and proposals for risk treatment. The risk analysis revealed a number of potential threats to the information security of a service like this. Many of the identified threats are general when dealing with mobile devices and sensitive data; others are threats which are more specific to our service and architecture. Individual threats identified in the risks analysis are discussed and possible counter measures presented. The risk analysis showed that most of the proposed risk treatment measures must be implemented to obtain an acceptable risk level; among others blocking much of the additional functionality of the smartphone. To conclude on the usefulness of this IM service, it will be evaluated in a trial study of the human-computer interaction. Further work also includes an improved design of the proposed MedIMob architecture. 2006 Elsevier Ireland Ltd

  12. Uncertainty characterization approaches for risk assessment of DBPs in drinking water: a review.

    PubMed

    Chowdhury, Shakhawat; Champagne, Pascale; McLellan, P James

    2009-04-01

    The management of risk from disinfection by-products (DBPs) in drinking water has become a critical issue over the last three decades. The areas of concern for risk management studies include (i) human health risk from DBPs, (ii) disinfection performance, (iii) technical feasibility (maintenance, management and operation) of treatment and disinfection approaches, and (iv) cost. Human health risk assessment is typically considered to be the most important phase of the risk-based decision-making or risk management studies. The factors associated with health risk assessment and other attributes are generally prone to considerable uncertainty. Probabilistic and non-probabilistic approaches have both been employed to characterize uncertainties associated with risk assessment. The probabilistic approaches include sampling-based methods (typically Monte Carlo simulation and stratified sampling) and asymptotic (approximate) reliability analysis (first- and second-order reliability methods). Non-probabilistic approaches include interval analysis, fuzzy set theory and possibility theory. However, it is generally accepted that no single method is suitable for the entire spectrum of problems encountered in uncertainty analyses for risk assessment. Each method has its own set of advantages and limitations. In this paper, the feasibility and limitations of different uncertainty analysis approaches are outlined for risk management studies of drinking water supply systems. The findings assist in the selection of suitable approaches for uncertainty analysis in risk management studies associated with DBPs and human health risk.

  13. Risk-based planning analysis for a single levee

    NASA Astrophysics Data System (ADS)

    Hui, Rui; Jachens, Elizabeth; Lund, Jay

    2016-04-01

    Traditional risk-based analysis for levee planning focuses primarily on overtopping failure. Although many levees fail before overtopping, few planning studies explicitly include intermediate geotechnical failures in flood risk analysis. This study develops a risk-based model for two simplified levee failure modes: overtopping failure and overall intermediate geotechnical failure from through-seepage, determined by the levee cross section represented by levee height and crown width. Overtopping failure is based only on water level and levee height, while through-seepage failure depends on many geotechnical factors as well, mathematically represented here as a function of levee crown width using levee fragility curves developed from professional judgment or analysis. These levee planning decisions are optimized to minimize the annual expected total cost, which sums expected (residual) annual flood damage and annualized construction costs. Applicability of this optimization approach to planning new levees or upgrading existing levees is demonstrated preliminarily for a levee on a small river protecting agricultural land, and a major levee on a large river protecting a more valuable urban area. Optimized results show higher likelihood of intermediate geotechnical failure than overtopping failure. The effects of uncertainty in levee fragility curves, economic damage potential, construction costs, and hydrology (changing climate) are explored. Optimal levee crown width is more sensitive to these uncertainties than height, while the derived general principles and guidelines for risk-based optimal levee planning remain the same.

  14. Study protocol for examining job strain as a risk factor for severe unipolar depression in an individual participant meta-analysis of 14 European cohorts.

    PubMed

    Madsen, Ida E H; Hannerz, Harald; Nyberg, Solja T; Magnusson Hanson, Linda L; Ahola, Kirsi; Alfredsson, Lars; Batty, G David; Bjorner, Jakob B; Borritz, Marianne; Burr, Hermann; Dragano, Nico; Ferrie, Jane E; Hamer, Mark; Jokela, Markus; Knutsson, Anders; Koskenvuo, Markku; Koskinen, Aki; Leineweber, Constanze; Nielsen, Martin L; Nordin, Maria; Oksanen, Tuula; Pejtersen, Jan H; Pentti, Jaana; Salo, Paula; Singh-Manoux, Archana; Suominen, Sakari; Theorell, Töres; Toppinen-Tanner, Salla; Vahtera, Jussi; Väänänen, Ari; Westerholm, Peter J M; Westerlund, Hugo; Fransson, Eleonor; Heikkilä, Katriina; Virtanen, Marianna; Rugulies, Reiner; Kivimäki, Mika

    2013-01-01

    Previous studies have shown that gainfully employed individuals with high work demands and low control at work (denoted "job strain") are at increased risk of common mental disorders, including depression. Most existing studies have, however, measured depression using self-rated symptom scales that do not necessarily correspond to clinically diagnosed depression. In addition, a meta-analysis from 2008 indicated publication bias in the field.   This study protocol describes the planned design and analyses of an individual participant data meta-analysis, to examine whether job strain is associated with an increased risk of clinically diagnosed unipolar depression based on hospital treatment registers.  The study will be based on data from approximately 120,000 individuals who participated in 14 studies on work environment and health in 4 European countries. The self-reported working conditions data will be merged with national registers on psychiatric hospital treatment, primarily hospital admissions. Study-specific risk estimates for the association between job strain and depression will be calculated using Cox regressions. The study-specific risk estimates will be pooled using random effects meta-analysis.   The planned analyses will help clarify whether job strain is associated with an increased risk of clinically diagnosed unipolar depression. As the analysis is based on pre-planned study protocols and an individual participant data meta-analysis, the pooled risk estimates will not be influenced by selective reporting and publication bias. However, the results of the planned study may only pertain to severe cases of unipolar depression, because of the outcome measure applied.

  15. Bayesian dose-response analysis for epidemiological studies with complex uncertainty in dose estimation.

    PubMed

    Kwon, Deukwoo; Hoffman, F Owen; Moroz, Brian E; Simon, Steven L

    2016-02-10

    Most conventional risk analysis methods rely on a single best estimate of exposure per person, which does not allow for adjustment for exposure-related uncertainty. Here, we propose a Bayesian model averaging method to properly quantify the relationship between radiation dose and disease outcomes by accounting for shared and unshared uncertainty in estimated dose. Our Bayesian risk analysis method utilizes multiple realizations of sets (vectors) of doses generated by a two-dimensional Monte Carlo simulation method that properly separates shared and unshared errors in dose estimation. The exposure model used in this work is taken from a study of the risk of thyroid nodules among a cohort of 2376 subjects who were exposed to fallout from nuclear testing in Kazakhstan. We assessed the performance of our method through an extensive series of simulations and comparisons against conventional regression risk analysis methods. When the estimated doses contain relatively small amounts of uncertainty, the Bayesian method using multiple a priori plausible draws of dose vectors gave similar results to the conventional regression-based methods of dose-response analysis. However, when large and complex mixtures of shared and unshared uncertainties are present, the Bayesian method using multiple dose vectors had significantly lower relative bias than conventional regression-based risk analysis methods and better coverage, that is, a markedly increased capability to include the true risk coefficient within the 95% credible interval of the Bayesian-based risk estimate. An evaluation of the dose-response using our method is presented for an epidemiological study of thyroid disease following radiation exposure. Copyright © 2015 John Wiley & Sons, Ltd.

  16. Latent Model Analysis of Substance Use and HIV Risk Behaviors among High-Risk Minority Adults

    ERIC Educational Resources Information Center

    Wang, Min Qi; Matthew, Resa F.; Chiu, Yu-Wen; Yan, Fang; Bellamy, Nikki D.

    2007-01-01

    Objectives: This study evaluated substance use and HIV risk profile using a latent model analysis based on ecological theory, inclusive of a risk and protective factor framework, in sexually active minority adults (N=1,056) who participated in a federally funded substance abuse and HIV prevention health initiative from 2002 to 2006. Methods: Data…

  17. Graduate Education in Risk Analysis for Food, Agriculture, and Veterinary Medicine: Challenges and Opportunities

    ERIC Educational Resources Information Center

    Correia, Ana-Paula; Wolt, Jeffrey D.

    2010-01-01

    The notion of risk in relation to food and food production has heightened the need to educate students to effectively deal with risk in relation to decision making from a science-based perspective. Curricula and related materials were developed and adopted to support graduate learning opportunities in risk analysis and decision making as applied…

  18. Noninvasive Computed Tomography–based Risk Stratification of Lung Adenocarcinomas in the National Lung Screening Trial

    PubMed Central

    Maldonado, Fabien; Duan, Fenghai; Raghunath, Sushravya M.; Rajagopalan, Srinivasan; Karwoski, Ronald A.; Garg, Kavita; Greco, Erin; Nath, Hrudaya; Robb, Richard A.; Bartholmai, Brian J.

    2015-01-01

    Rationale: Screening for lung cancer using low-dose computed tomography (CT) reduces lung cancer mortality. However, in addition to a high rate of benign nodules, lung cancer screening detects a large number of indolent cancers that generally belong to the adenocarcinoma spectrum. Individualized management of screen-detected adenocarcinomas would be facilitated by noninvasive risk stratification. Objectives: To validate that Computer-Aided Nodule Assessment and Risk Yield (CANARY), a novel image analysis software, successfully risk stratifies screen-detected lung adenocarcinomas based on clinical disease outcomes. Methods: We identified retrospective 294 eligible patients diagnosed with lung adenocarcinoma spectrum lesions in the low-dose CT arm of the National Lung Screening Trial. The last low-dose CT scan before the diagnosis of lung adenocarcinoma was analyzed using CANARY blinded to clinical data. Based on their parametric CANARY signatures, all the lung adenocarcinoma nodules were risk stratified into three groups. CANARY risk groups were compared using survival analysis for progression-free survival. Measurements and Main Results: A total of 294 patients were included in the analysis. Kaplan-Meier analysis of all the 294 adenocarcinoma nodules stratified into the Good, Intermediate, and Poor CANARY risk groups yielded distinct progression-free survival curves (P < 0.0001). This observation was confirmed in the unadjusted and adjusted (age, sex, race, and smoking status) progression-free survival analysis of all stage I cases. Conclusions: CANARY allows the noninvasive risk stratification of lung adenocarcinomas into three groups with distinct post-treatment progression-free survival. Our results suggest that CANARY could ultimately facilitate individualized management of incidentally or screen-detected lung adenocarcinomas. PMID:26052977

  19. Noninvasive Computed Tomography-based Risk Stratification of Lung Adenocarcinomas in the National Lung Screening Trial.

    PubMed

    Maldonado, Fabien; Duan, Fenghai; Raghunath, Sushravya M; Rajagopalan, Srinivasan; Karwoski, Ronald A; Garg, Kavita; Greco, Erin; Nath, Hrudaya; Robb, Richard A; Bartholmai, Brian J; Peikert, Tobias

    2015-09-15

    Screening for lung cancer using low-dose computed tomography (CT) reduces lung cancer mortality. However, in addition to a high rate of benign nodules, lung cancer screening detects a large number of indolent cancers that generally belong to the adenocarcinoma spectrum. Individualized management of screen-detected adenocarcinomas would be facilitated by noninvasive risk stratification. To validate that Computer-Aided Nodule Assessment and Risk Yield (CANARY), a novel image analysis software, successfully risk stratifies screen-detected lung adenocarcinomas based on clinical disease outcomes. We identified retrospective 294 eligible patients diagnosed with lung adenocarcinoma spectrum lesions in the low-dose CT arm of the National Lung Screening Trial. The last low-dose CT scan before the diagnosis of lung adenocarcinoma was analyzed using CANARY blinded to clinical data. Based on their parametric CANARY signatures, all the lung adenocarcinoma nodules were risk stratified into three groups. CANARY risk groups were compared using survival analysis for progression-free survival. A total of 294 patients were included in the analysis. Kaplan-Meier analysis of all the 294 adenocarcinoma nodules stratified into the Good, Intermediate, and Poor CANARY risk groups yielded distinct progression-free survival curves (P < 0.0001). This observation was confirmed in the unadjusted and adjusted (age, sex, race, and smoking status) progression-free survival analysis of all stage I cases. CANARY allows the noninvasive risk stratification of lung adenocarcinomas into three groups with distinct post-treatment progression-free survival. Our results suggest that CANARY could ultimately facilitate individualized management of incidentally or screen-detected lung adenocarcinomas.

  20. The role of the RTEL1 rs2297440 polymorphism in the risk of glioma development: a meta-analysis.

    PubMed

    Zhang, Cuiping; Lu, Yu; Zhang, Xiaolian; Yang, Dongmei; Shang, Shuxin; Liu, Denghe; Jiang, Kongmei; Huang, Weiqiang

    2016-07-01

    The regulator of the telomere elongation helicase1 (RTEL1) gene plays a crucial role in the DNA double-stand break-repair pathway by maintaining genomic stability. Recent epidemiological studies showed that the rs2297440 polymorphism in the RTEL1 gene was a potential risk locus for glioma development, but the results were inconclusive. To clarify the association between this polymorphism and the risk of glioma, we performed a comprehensive meta-analysis. The PubMed, EMBASE, Web of Science, and China National Knowledge Infrastructure databases were systematically searched to identify all relevant published studies up to 30 August 2015. Four eligible studies were finally included. The pooled results indicated that the RTEL1 rs2297440 polymorphism moderately increased the risk of glioma in all genetic models. A comparison of the dominant model CT + CC versus TT (OR 1.40; 95 % CI 1.24-1.60; p < 0.001) indicated that having the C allele conferred a 40 % increased risk of developing glioma. In a subgroup analysis based on geographic location (Europe, Asia, and America), there was an association between the rs2297440 polymorphism and the risk of glioma in all three areas. The results of the subgroup analysis based on source of control indicated an elevated risk of glioma in population-based control studies. This meta-analysis demonstrates that the RTEL1 rs2297440 polymorphism plays a moderate, but significant role in the risk of glioma. Further studies with larger sample sizes are necessary to confirm this finding.

  1. 78 FR 64425 - Current Good Manufacturing Practice and Hazard Analysis and Risk-Based Preventive Controls for...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-10-29

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration 21 CFR Parts 16, 225, 500, 507, and 579 [Docket No. FDA-2011-N-0922] Current Good Manufacturing Practice and Hazard Analysis and Risk- Based Preventive Controls for Food for Animals; Public Meeting on Proposed Rule AGENCY: Food and...

  2. Obesity as a risk factor for developing functional limitation among older adults: A conditional inference tree analysis.

    PubMed

    Cheng, Feon W; Gao, Xiang; Bao, Le; Mitchell, Diane C; Wood, Craig; Sliwinski, Martin J; Smiciklas-Wright, Helen; Still, Christopher D; Rolston, David D K; Jensen, Gordon L

    2017-07-01

    To examine the risk factors of developing functional decline and make probabilistic predictions by using a tree-based method that allows higher order polynomials and interactions of the risk factors. The conditional inference tree analysis, a data mining approach, was used to construct a risk stratification algorithm for developing functional limitation based on BMI and other potential risk factors for disability in 1,951 older adults without functional limitations at baseline (baseline age 73.1 ± 4.2 y). We also analyzed the data with multivariate stepwise logistic regression and compared the two approaches (e.g., cross-validation). Over a mean of 9.2 ± 1.7 years of follow-up, 221 individuals developed functional limitation. Higher BMI, age, and comorbidity were consistently identified as significant risk factors for functional decline using both methods. Based on these factors, individuals were stratified into four risk groups via the conditional inference tree analysis. Compared to the low-risk group, all other groups had a significantly higher risk of developing functional limitation. The odds ratio comparing two extreme categories was 9.09 (95% confidence interval: 4.68, 17.6). Higher BMI, age, and comorbid disease were consistently identified as significant risk factors for functional decline among older individuals across all approaches and analyses. © 2017 The Obesity Society.

  3. Development of Rock Engineering Systems-Based Models for Flyrock Risk Analysis and Prediction of Flyrock Distance in Surface Blasting

    NASA Astrophysics Data System (ADS)

    Faramarzi, Farhad; Mansouri, Hamid; Farsangi, Mohammad Ali Ebrahimi

    2014-07-01

    The environmental effects of blasting must be controlled in order to comply with regulatory limits. Because of safety concerns and risk of damage to infrastructures, equipment, and property, and also having a good fragmentation, flyrock control is crucial in blasting operations. If measures to decrease flyrock are taken, then the flyrock distance would be limited, and, in return, the risk of damage can be reduced or eliminated. This paper deals with modeling the level of risk associated with flyrock and, also, flyrock distance prediction based on the rock engineering systems (RES) methodology. In the proposed models, 13 effective parameters on flyrock due to blasting are considered as inputs, and the flyrock distance and associated level of risks as outputs. In selecting input data, the simplicity of measuring input data was taken into account as well. The data for 47 blasts, carried out at the Sungun copper mine, western Iran, were used to predict the level of risk and flyrock distance corresponding to each blast. The obtained results showed that, for the 47 blasts carried out at the Sungun copper mine, the level of estimated risks are mostly in accordance with the measured flyrock distances. Furthermore, a comparison was made between the results of the flyrock distance predictive RES-based model, the multivariate regression analysis model (MVRM), and, also, the dimensional analysis model. For the RES-based model, R 2 and root mean square error (RMSE) are equal to 0.86 and 10.01, respectively, whereas for the MVRM and dimensional analysis, R 2 and RMSE are equal to (0.84 and 12.20) and (0.76 and 13.75), respectively. These achievements confirm the better performance of the RES-based model over the other proposed models.

  4. Cost-effectiveness of risk stratified followup after urethral reconstruction: a decision analysis.

    PubMed

    Belsante, Michael J; Zhao, Lee C; Hudak, Steven J; Lotan, Yair; Morey, Allen F

    2013-10-01

    We propose a novel risk stratified followup protocol for use after urethroplasty and explore potential cost savings. Decision analysis was performed comparing a symptom based, risk stratified protocol for patients undergoing excision and primary anastomosis urethroplasty vs a standard regimen of close followup for urethroplasty. Model assumptions included that excision and primary anastomosis has a 94% success rate, 11% of patients with successful urethroplasty had persistent lower urinary tract symptoms requiring cystoscopic evaluation, patients in whom treatment failed undergo urethrotomy and patients with recurrence on symptom based surveillance have a delayed diagnosis requiring suprapubic tube drainage. The Nationwide Inpatient Sample from 2010 was queried to identify the number of urethroplasties performed per year in the United States. Costs were obtained based on Medicare reimbursement rates. The 5-year cost of a symptom based, risk stratified followup protocol is $430 per patient vs $2,827 per patient using standard close followup practice. An estimated 7,761 urethroplasties were performed in the United States in 2010. Assuming that 60% were excision and primary anastomosis, and with more than 5 years of followup, the risk stratified protocol was projected to yield an estimated savings of $11,165,130. Sensitivity analysis showed that the symptom based, risk stratified followup protocol was far more cost-effective than standard close followup in all settings. Less than 1% of patients would be expected to have an asymptomatic recurrence using the risk stratified followup protocol. A risk stratified, symptom based approach to urethroplasty followup would produce a significant reduction in health care costs while decreasing unnecessary followup visits, invasive testing and radiation exposure. Copyright © 2013 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

  5. Family history assessment for colorectal cancer (CRC) risk analysis - comparison of diagram- and questionnaire-based web interfaces.

    PubMed

    Schultz, Michael; Seo, Steven Bohwan; Holt, Alec; Regenbrecht, Holger

    2015-11-18

    Colorectal cancer (CRC) has a high incidence, especially in New Zealand. The reasons for this are unknown. While most cancers develop sporadically, a positive family history, determined by the number and age at diagnosis of affected first and second degree relatives with CRC is one of the major factors, which may increase an individual's lifetime risk. Before a patient can be enrolled in a surveillance program a detailed assessment and documentation of the family history is important but time consuming and often inaccurate. The documentation is usually paper-based. Our aim was therefore to develop and validate the usability and efficacy of a web-based family history assessment tool for CRC suitable for the general population. The tool was also to calculate the risk and make a recommendation for surveillance. Two versions of an electronic assessment tool, diagram-based and questionnaire-based, were developed with the risk analysis and recommendations for surveillance based on the New Zealand Guidelines Group recommendations. Accuracy of our tool was tested prior to the study by comparing risk calculations based on family history by experienced gastroenterologists with the electronic assessment. The general public, visiting a local science fair were asked to use and comment on the usability of the two interfaces. Ninety people assessed and commented on the two interfaces. Both interfaces were effective in assessing the risk to develop CRC through their familial history for CRC. However, the questionnaire-based interface performed with significantly better satisfaction (p = 0.001) than the diagram-based interface. There was no difference in efficacy though. We conclude that a web-based questionnaire tool can assist in the accurate documentation and analysis of the family history relevant to determine the individual risk of CRC based on local guidelines. The calculator is now implemented and assessable through the web-page of a local charity for colorectal cancer awareness and integral part of the local general practitioners' e-referral system for colonic imaging.

  6. Using risk analysis to reveal opportunities for the management of unplanned ignitions in wilderness

    Treesearch

    Kevin Barnett; Carol Miller; Tyron J. Venn

    2016-01-01

    A goal of fire management in wilderness is to allow fire to play its natural ecological role without intervention. Unfortunately, most unplanned ignitions in wilderness are suppressed, in part because of the risk they might pose to values outside of the wilderness. We capitalize on recent advances in fire risk analysis to demonstrate a risk-based approach for revealing...

  7. Obesity as a risk factor for developing functional limitation among older adults: A conditional inference tree analysis

    USDA-ARS?s Scientific Manuscript database

    Objective: To examine the risk factors of developing functional decline and make probabilistic predictions by using a tree-based method that allows higher order polynomials and interactions of the risk factors. Methods: The conditional inference tree analysis, a data mining approach, was used to con...

  8. The Use of Major Risk Factors for Computer-Based Distinction of Diabetic Patients with Ischemic Stroke and Without Stroke

    DTIC Science & Technology

    2001-10-25

    THE USE of MAJOR RISK FACTORS for COMPUTER-BASED DISTINCTION of DIABETIC PATIENTS with ISCHEMIC STROKE and WITHOUT STROKE Sibel Oge Merey1...highlighting the major risk factors of diabetic patients with non-embolic stroke and without stroke by performing dependency analysis and decision making...of Major Risk Factors for Computer-Based Distinction of Diabetic Patients with Ischemic Stroke and Without Stroke Contract Number Grant Number

  9. Failure mode effect analysis and fault tree analysis as a combined methodology in risk management

    NASA Astrophysics Data System (ADS)

    Wessiani, N. A.; Yoshio, F.

    2018-04-01

    There have been many studies reported the implementation of Failure Mode Effect Analysis (FMEA) and Fault Tree Analysis (FTA) as a method in risk management. However, most of the studies usually only choose one of these two methods in their risk management methodology. On the other side, combining these two methods will reduce the drawbacks of each methods when implemented separately. This paper aims to combine the methodology of FMEA and FTA in assessing risk. A case study in the metal company will illustrate how this methodology can be implemented. In the case study, this combined methodology will assess the internal risks that occur in the production process. Further, those internal risks should be mitigated based on their level of risks.

  10. Vitamin B6 Intake and the Risk of Colorectal Cancer: A Meta-Analysis of Prospective Cohort Studies.

    PubMed

    Jia, Kai; Wang, Rong; Tian, Jingfeng

    2017-07-01

    We performed this meta-analysis to estimate the association between vitamin B 6 intake and colorectal cancer risk. Prospective cohort studies on vitamin B 6 intake and colorectal cancer risk were identified by searching databases from the period of 1960 to 2016. Results from individual studies were synthetically combined using Stata 13.0 software. A total of 10 prospective cohort studies including 13 data sets were included in our meta-analysis, containing 7,817 cases and 784,550 subjects. The combined relative risks (RR) of colorectal cancer for the highest vitamin B 6 intake compared with the lowest vitamin B 6 intake was 0.88 [95% confidence intervals (CIs): 0.77-1.02]. Dose-response meta-analysis based on five eligible studies showed that for each additional 3 and 5 mg of vitamin B 6 intake, the risk would decrease by 11% (RR: 0.89, 95%CI: 0.81-0.98) and 17% (RR: 0.83, 95%CI: 0.71-0.97), respectively. Little evidence of publication bias was found. This meta-analysis provides evidence of a nonsignificant decrease in colorectal cancer risk associated with the high level of vitamin B 6 intake, but the risk in dose-response analysis is significant. However, the latter finding is based on a limited number of studies, which should be interpreted with caution.

  11. Cognitive mapping tools: review and risk management needs.

    PubMed

    Wood, Matthew D; Bostrom, Ann; Bridges, Todd; Linkov, Igor

    2012-08-01

    Risk managers are increasingly interested in incorporating stakeholder beliefs and other human factors into the planning process. Effective risk assessment and management requires understanding perceptions and beliefs of involved stakeholders, and how these beliefs give rise to actions that influence risk management decisions. Formal analyses of risk manager and stakeholder cognitions represent an important first step. Techniques for diagramming stakeholder mental models provide one tool for risk managers to better understand stakeholder beliefs and perceptions concerning risk, and to leverage this new understanding in developing risk management strategies. This article reviews three methodologies for assessing and diagramming stakeholder mental models--decision-analysis-based mental modeling, concept mapping, and semantic web analysis--and assesses them with regard to their ability to address risk manager needs. © 2012 Society for Risk Analysis.

  12. Risk analysis for veterinary biologicals released into the environment.

    PubMed

    Silva, S V; Samagh, B S; Morley, R S

    1995-12-01

    All veterinary biologicals licensed in Canada must be shown to be pure, potent, safe and effective. A risk-based approach is used to evaluate the safety of all biologicals, whether produced by conventional methods or by molecular biological techniques. Traditionally, qualitative risk assessment methods have been used for this purpose. More recently, quantitative risk assessment has become available for complex issues. The quantitative risk assessment method uses "scenario tree analysis' to predict the likelihood of various outcomes and their respective impacts. The authors describe the quantitative risk assessment approach which is used within the broader context of risk analysis (i.e. risk assessment, risk management and risk communication) to develop recommendations for the field release of veterinary biologicals. The general regulatory framework for the licensing of veterinary biologicals in Canada is also presented.

  13. Comprehensive risk analysis for structure type selection.

    DOT National Transportation Integrated Search

    2010-04-01

    Optimization of bridge selection and design traditionally has been sought in terms of the finished structure. This study presents a : more comprehensive risk-based analysis that includes user costs and accidents during the construction phase. Costs f...

  14. Application of multi-criteria decision-making to risk prioritisation in tidal energy developments

    NASA Astrophysics Data System (ADS)

    Kolios, Athanasios; Read, George; Ioannou, Anastasia

    2016-01-01

    This paper presents an analytical multi-criterion analysis for the prioritisation of risks for the development of tidal energy projects. After a basic identification of risks throughout the project and relevant stakeholders in the UK, classified through a political, economic, social, technological, legal and environmental analysis, relevant questionnaires provided scores to each risk and corresponding weights for each of the different sectors. Employing an extended technique for order of preference by similarity to ideal solution as well as the weighted sum method based on the data obtained, the risks identified are ranked based on their criticality, drawing attention of the industry in mitigating the ones scoring higher. Both methods were modified to take averages at different stages of the analysis in order to observe the effects on the final risk ranking. A sensitivity analysis of the results was also carried out with regard to the weighting factors given to the perceived expertise of participants, with different results being obtained whether a linear, squared or square root regression is used. Results of the study show that academics and industry have conflicting opinions with regard to the perception of the most critical risks.

  15. A Serological Biopsy Using Five Stomach-Specific Circulating Biomarkers for Gastric Cancer Risk Assessment: A Multi-Phase Study.

    PubMed

    Tu, Huakang; Sun, Liping; Dong, Xiao; Gong, Yuehua; Xu, Qian; Jing, Jingjing; Bostick, Roberd M; Wu, Xifeng; Yuan, Yuan

    2017-05-01

    We aimed to assess a serological biopsy using five stomach-specific circulating biomarkers-pepsinogen I (PGI), PGII, PGI/II ratio, anti-Helicobacter pylori (H. pylori) antibody, and gastrin-17 (G-17)-for identifying high-risk individuals and predicting risk of developing gastric cancer (GC). Among 12,112 participants with prospective follow-up from an ongoing population-based screening program using both serology and gastroscopy in China, we conducted a multi-phase study involving a cross-sectional analysis, a follow-up analysis, and an integrative risk prediction modeling analysis. In the cross-sectional analysis, the five biomarkers (especially PGII, the PGI/II ratio, and H. pylori sero-positivity) were associated with the presence of precancerous gastric lesions or GC at enrollment. In the follow-up analysis, low PGI levels and PGI/II ratios were associated with higher risk of developing GC, and both low (<0.5 pmol/l) and high (>4.7 pmol/l) G-17 levels were associated with higher risk of developing GC, suggesting a J-shaped association. In the risk prediction modeling analysis, the five biomarkers combined yielded a C statistic of 0.803 (95% confidence interval (CI)=0.789-0.816) and improved prediction beyond traditional risk factors (C statistic from 0.580 to 0.811, P<0.001) for identifying precancerous lesions at enrollment, and higher serological biopsy scores based on the five biomarkers at enrollment were associated with higher risk of developing GC during follow-up (P for trend <0.001). A serological biopsy composed of the five stomach-specific circulating biomarkers could be used to identify high-risk individuals for further diagnostic gastroscopy, and to stratify individuals' risk of developing GC and thus to guide targeted screening and precision prevention.

  16. SCAP: a new methodology for safety management based on feedback from credible accident-probabilistic fault tree analysis system.

    PubMed

    Khan, F I; Iqbal, A; Ramesh, N; Abbasi, S A

    2001-10-12

    As it is conventionally done, strategies for incorporating accident--prevention measures in any hazardous chemical process industry are developed on the basis of input from risk assessment. However, the two steps-- risk assessment and hazard reduction (or safety) measures--are not linked interactively in the existing methodologies. This prevents a quantitative assessment of the impacts of safety measures on risk control. We have made an attempt to develop a methodology in which risk assessment steps are interactively linked with implementation of safety measures. The resultant system tells us the extent of reduction of risk by each successive safety measure. It also tells based on sophisticated maximum credible accident analysis (MCAA) and probabilistic fault tree analysis (PFTA) whether a given unit can ever be made 'safe'. The application of the methodology has been illustrated with a case study.

  17. The East London glaucoma prediction score: web-based validation of glaucoma risk screening tool

    PubMed Central

    Stephen, Cook; Benjamin, Longo-Mbenza

    2013-01-01

    AIM It is difficult for Optometrists and General Practitioners to know which patients are at risk. The East London glaucoma prediction score (ELGPS) is a web based risk calculator that has been developed to determine Glaucoma risk at the time of screening. Multiple risk factors that are available in a low tech environment are assessed to provide a risk assessment. This is extremely useful in settings where access to specialist care is difficult. Use of the calculator is educational. It is a free web based service. Data capture is user specific. METHOD The scoring system is a web based questionnaire that captures and subsequently calculates the relative risk for the presence of Glaucoma at the time of screening. Three categories of patient are described: Unlikely to have Glaucoma; Glaucoma Suspect and Glaucoma. A case review methodology of patients with known diagnosis is employed to validate the calculator risk assessment. RESULTS Data from the patient records of 400 patients with an established diagnosis has been captured and used to validate the screening tool. The website reports that the calculated diagnosis correlates with the actual diagnosis 82% of the time. Biostatistics analysis showed: Sensitivity = 88%; Positive predictive value = 97%; Specificity = 75%. CONCLUSION Analysis of the first 400 patients validates the web based screening tool as being a good method of screening for the at risk population. The validation is ongoing. The web based format will allow a more widespread recruitment for different geographic, population and personnel variables. PMID:23550097

  18. Hazard, Vulnerability and Capacity Mapping for Landslides Risk Analysis using Geographic Information System (GIS)

    NASA Astrophysics Data System (ADS)

    Sari, D. A. P.; Innaqa, S.; Safrilah

    2017-06-01

    This research analyzed the levels of disaster risk in the Citeureup sub-District, Bogor Regency, West Java, based on its potential hazard, vulnerability and capacity, using map to represent the results, then Miles and Huberman analytical techniques was used to analyze the qualitative interviews. The analysis conducted in this study is based on the concept of disaster risk by Wisner. The result shows that the Citeureup sub-District has medium-low risk of landslides. Of the 14 villages, three villages have a moderate risk level, namely Hambalang, Tajur, and Tangkil, or 49.58% of the total land area. Eleven villages have a low level of risk, namely Pasir Mukti, Sanja, Tarikolot, Gunung Sari, Puspasari, East Karang Asem, Citeureup, Leuwinutug, Sukahati, West Karang Asem West and Puspanegara, or 48.68% of the total land area, for high-risk areas only around 1.74%, which is part of Hambalang village. The analysis using Geographic Information System (GIS) prove that areas with a high risk potential does not necessarily have a high level of risk. The capacity of the community plays an important role to minimize the risk of a region. Disaster risk reduction strategy is done by creating a safe condition, which intensified the movement of disaster risk reduction.

  19. Flood risk analysis for flood control and sediment transportation in sandy regions: A case study in the Loess Plateau, China

    NASA Astrophysics Data System (ADS)

    Guo, Aijun; Chang, Jianxia; Wang, Yimin; Huang, Qiang; Zhou, Shuai

    2018-05-01

    Traditional flood risk analysis focuses on the probability of flood events exceeding the design flood of downstream hydraulic structures while neglecting the influence of sedimentation in river channels on regional flood control systems. This work advances traditional flood risk analysis by proposing a univariate and copula-based bivariate hydrological risk framework which incorporates both flood control and sediment transport. In developing the framework, the conditional probabilities of different flood events under various extreme precipitation scenarios are estimated by exploiting the copula-based model. Moreover, a Monte Carlo-based algorithm is designed to quantify the sampling uncertainty associated with univariate and bivariate hydrological risk analyses. Two catchments located on the Loess plateau are selected as study regions: the upper catchments of the Xianyang and Huaxian stations (denoted as UCX and UCH, respectively). The univariate and bivariate return periods, risk and reliability in the context of uncertainty for the purposes of flood control and sediment transport are assessed for the study regions. The results indicate that sedimentation triggers higher risks of damaging the safety of local flood control systems compared with the event that AMF exceeds the design flood of downstream hydraulic structures in the UCX and UCH. Moreover, there is considerable sampling uncertainty affecting the univariate and bivariate hydrologic risk evaluation, which greatly challenges measures of future flood mitigation. In addition, results also confirm that the developed framework can estimate conditional probabilities associated with different flood events under various extreme precipitation scenarios aiming for flood control and sediment transport. The proposed hydrological risk framework offers a promising technical reference for flood risk analysis in sandy regions worldwide.

  20. Association between metabolic syndrome and bone fracture risk: A community-based study using a fracture risk assessment tool.

    PubMed

    Yu, Chia-Ying; Chen, Fang-Ping; Chen, Li-Wei; Kuo, Sheng-Fong; Chien, Rong-Nan

    2017-12-01

    Osteoporosis and metabolic syndrome (MS) share similar risk factors. Previous studies of association between bone marrow density (BMD) and MS are controversial. Moreover, some studies revealed that MS is associated with BMD but not with bone fracture. In clinical practice, patients pay more attention to bone fracture risk than BMD values. Hence, this study aimed to evaluate the association between MS and the 10-year bone fracture risk probability using a fracture risk assessment tool (FRAX) from community-based data. From March 2014 to August 2015, 2689 participants (897 men and 1792 women) were enrolled in this study. Inflammatory cytokines, such as tumor necrosis factor alpha and C-reactive protein, and adipokines were included for analysis.The mean age was 60.2 ± 10.7 years in men and 58.9 ± 9.6 years in women. The percentage of MS was 27.6% in men and 27.9% in women. Participants were divided into 2 groups, those with or without MS. Compared with women without MS, women with MS had a higher rate of fracture risk (22.8% vs 16.3%, P = .001). In contrast, men with MS had a lower rate of fracture risk then men without MS (5.6% vs 12.3%, P = .004). However, MS loss the association with a high bone fracture risk in men based on multivariate logistical regression analysis, after adjusting for confounding factor of body mass index (BMI). Conclusively, the result of regression analysis between MS and the bone fracture risk may be different in men and women, and BMI was an important confounding factor to interfere with the regression analysis. Copyright © 2017 The Authors. Published by Wolters Kluwer Health, Inc. All rights reserved.

  1. A comparison of two prospective risk analysis methods: Traditional FMEA and a modified healthcare FMEA.

    PubMed

    Rah, Jeong-Eun; Manger, Ryan P; Yock, Adam D; Kim, Gwe-Ya

    2016-12-01

    To examine the abilities of a traditional failure mode and effects analysis (FMEA) and modified healthcare FMEA (m-HFMEA) scoring methods by comparing the degree of congruence in identifying high risk failures. The authors applied two prospective methods of the quality management to surface image guided, linac-based radiosurgery (SIG-RS). For the traditional FMEA, decisions on how to improve an operation were based on the risk priority number (RPN). The RPN is a product of three indices: occurrence, severity, and detectability. The m-HFMEA approach utilized two indices, severity and frequency. A risk inventory matrix was divided into four categories: very low, low, high, and very high. For high risk events, an additional evaluation was performed. Based upon the criticality of the process, it was decided if additional safety measures were needed and what they comprise. The two methods were independently compared to determine if the results and rated risks matched. The authors' results showed an agreement of 85% between FMEA and m-HFMEA approaches for top 20 risks of SIG-RS-specific failure modes. The main differences between the two approaches were the distribution of the values and the observation that failure modes (52, 54, 154) with high m-HFMEA scores do not necessarily have high FMEA-RPN scores. In the m-HFMEA analysis, when the risk score is determined, the basis of the established HFMEA Decision Tree™ or the failure mode should be more thoroughly investigated. m-HFMEA is inductive because it requires the identification of the consequences from causes, and semi-quantitative since it allows the prioritization of high risks and mitigation measures. It is therefore a useful tool for the prospective risk analysis method to radiotherapy.

  2. Sexually Transmitted Diseases and Risk Behaviors among California Farmworkers: Results from a Population-Based Survey

    ERIC Educational Resources Information Center

    Brammeier, Monique; Chow, Joan M.; Samuel, Michael C.; Organista, Kurt C.; Miller, Jamie; Bolan, Gail

    2008-01-01

    Context: The prevalence of sexually transmitted diseases and associated risk behaviors among California farmworkers is not well described. Purpose: To estimate the prevalence of sexually transmitted diseases (STDs) and associated risk behaviors among California farmworkers. Methods: Cross-sectional analysis of population-based survey data from 6…

  3. [Risk management--a new aspect of quality assessment in intensive care medicine: first results of an analysis of the DIVI's interdisciplinary quality assessment research group].

    PubMed

    Stiletto, R; Röthke, M; Schäfer, E; Lefering, R; Waydhas, Ch

    2006-10-01

    Patient security has become one of the major aspects of clinical management in recent years. The crucial point in research was focused on malpractice. In contradiction to the economic process in non medical fields, the analysis of errors during the in-patient treatment time was neglected. Patient risk management can be defined as a structured procedure in a clinical unit with the aim to reduce harmful events. A risk point model was created based on a Delphi process and founded on the DIVI data register. The risk point model was evaluated in clinically working ICU departments participating in the register data base. The results of the risk point evaluation will be integrated in the next data base update. This might be a step to improve the reliability of the register to measure quality assessment in the ICU.

  4. Multi-hazard risk analysis using the FP7 RASOR Platform

    NASA Astrophysics Data System (ADS)

    Koudogbo, Fifamè N.; Duro, Javier; Rossi, Lauro; Rudari, Roberto; Eddy, Andrew

    2014-10-01

    Climate change challenges our understanding of risk by modifying hazards and their interactions. Sudden increases in population and rapid urbanization are changing exposure to risk around the globe, making impacts harder to predict. Despite the availability of operational mapping products, there is no single tool to integrate diverse data and products across hazards, update exposure data quickly and make scenario-based predictions to support both short and long-term risk-related decisions. RASOR (Rapid Analysis and Spatialization Of Risk) will develop a platform to perform multi-hazard risk analysis for the full cycle of disaster management, including targeted support to critical infrastructure monitoring and climate change impact assessment. A scenario-driven query system simulates future scenarios based on existing or assumed conditions and compares them with historical scenarios. RASOR will thus offer a single work environment that generates new risk information across hazards, across data types (satellite EO, in-situ), across user communities (global, local, climate, civil protection, insurance, etc.) and across the world. Five case study areas are considered within the project, located in Haiti, Indonesia, Netherlands, Italy and Greece. Initially available over those demonstration areas, RASOR will ultimately offer global services to support in-depth risk assessment and full-cycle risk management.

  5. 78 FR 69640 - Notice of Decision To Authorize the Importation of Swiss Chard From Colombia Into the Continental...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-11-20

    ... States of Swiss chard from Colombia. Based on the findings of a pest risk analysis, which we made..., based on the findings of a pest risk analysis (PRA), can be safely imported subject to one or more of... introducing or disseminating plant pests or noxious weeds via the importation of Swiss chard from Colombia...

  6. A Risk-Based Approach for Aerothermal/TPS Analysis and Testing

    DTIC Science & Technology

    2007-07-01

    RTO-EN-AVT-142 17 - 1 A Risk-Based Approach for Aerothermal/ TPS Analysis and Testing Michael J. Wright∗ and Jay H. Grinstead† NASA Ames...of the thermal protection system ( TPS ) is to protect the payload (crew, cargo, or science) from this entry heating environment. The performance of...the TPS is determined by the efficiency and reliability of this system, typically measured

  7. Influence of Methylenetetrahydrofolate Reductase C677T Polymorphism on the Risk of Lung Cancer and the Clinical Response to Platinum-Based Chemotherapy for Advanced Non-Small Cell Lung Cancer: An Updated Meta-Analysis

    PubMed Central

    Zhu, Ning; Gong, Yi; He, Jian; Xia, Jingwen

    2013-01-01

    Purpose Methylenetetrahydrofolate reductase (MTHFR) has been implicated in lung cancer risk and response to platinum-based chemotherapy in advanced non-small cell lung cancer (NSCLC). However, the results are controversial. We performed meta-analysis to investigate the effect of MTHFR C677T polymorphism on lung cancer risk and response to platinum-based chemotherapy in advanced NSCLC. Materials and Methods The databases of PubMed, Ovid, Wanfang and Chinese Biomedicine were searched for eligible studies. Nineteen studies on MTHFR C677T polymorphism and lung cancer risk and three articles on C677T polymorphism and response to platinum-based chemotherapy in advanced NSCLC, were identified. Results The results indicated that the allelic contrast, homozygous contrast and recessive model of the MTHFR C677T polymorphism were associated significantly with increased lung cancer risk. In the subgroup analysis, the C677T polymorphism was significantly correlated with an increased risk of NSCLC, with the exception of the recessive model. The dominant model and the variant T allele showed a significant association with lung cancer susceptibility of ever smokers. Male TT homozygote carriers had a higher susceptibility, but the allelic contrast and homozygote model had a protective effect in females. No relationship was observed for SCLC in any comparison model. In addition, MTHFR 677TT homozygote carriers had a better response to platinum-based chemotherapy in advanced NSCLC in the recessive model. Conclusion The MTHFR C677T polymorphism might be a genetic marker for lung cancer risk or response to platinum-based chemotherapy in advanced NSCLC. However, our results require further verification. PMID:24142642

  8. A Flexible Hierarchical Bayesian Modeling Technique for Risk Analysis of Major Accidents.

    PubMed

    Yu, Hongyang; Khan, Faisal; Veitch, Brian

    2017-09-01

    Safety analysis of rare events with potentially catastrophic consequences is challenged by data scarcity and uncertainty. Traditional causation-based approaches, such as fault tree and event tree (used to model rare event), suffer from a number of weaknesses. These include the static structure of the event causation, lack of event occurrence data, and need for reliable prior information. In this study, a new hierarchical Bayesian modeling based technique is proposed to overcome these drawbacks. The proposed technique can be used as a flexible technique for risk analysis of major accidents. It enables both forward and backward analysis in quantitative reasoning and the treatment of interdependence among the model parameters. Source-to-source variability in data sources is also taken into account through a robust probabilistic safety analysis. The applicability of the proposed technique has been demonstrated through a case study in marine and offshore industry. © 2017 Society for Risk Analysis.

  9. Seismic Hazard Analysis — Quo vadis?

    NASA Astrophysics Data System (ADS)

    Klügel, Jens-Uwe

    2008-05-01

    The paper is dedicated to the review of methods of seismic hazard analysis currently in use, analyzing the strengths and weaknesses of different approaches. The review is performed from the perspective of a user of the results of seismic hazard analysis for different applications such as the design of critical and general (non-critical) civil infrastructures, technical and financial risk analysis. A set of criteria is developed for and applied to an objective assessment of the capabilities of different analysis methods. It is demonstrated that traditional probabilistic seismic hazard analysis (PSHA) methods have significant deficiencies, thus limiting their practical applications. These deficiencies have their roots in the use of inadequate probabilistic models and insufficient understanding of modern concepts of risk analysis, as have been revealed in some recent large scale studies. These deficiencies result in the lack of ability of a correct treatment of dependencies between physical parameters and finally, in an incorrect treatment of uncertainties. As a consequence, results of PSHA studies have been found to be unrealistic in comparison with empirical information from the real world. The attempt to compensate these problems by a systematic use of expert elicitation has, so far, not resulted in any improvement of the situation. It is also shown that scenario-earthquakes developed by disaggregation from the results of a traditional PSHA may not be conservative with respect to energy conservation and should not be used for the design of critical infrastructures without validation. Because the assessment of technical as well as of financial risks associated with potential damages of earthquakes need a risk analysis, current method is based on a probabilistic approach with its unsolved deficiencies. Traditional deterministic or scenario-based seismic hazard analysis methods provide a reliable and in general robust design basis for applications such as the design of critical infrastructures, especially with systematic sensitivity analyses based on validated phenomenological models. Deterministic seismic hazard analysis incorporates uncertainties in the safety factors. These factors are derived from experience as well as from expert judgment. Deterministic methods associated with high safety factors may lead to too conservative results, especially if applied for generally short-lived civil structures. Scenarios used in deterministic seismic hazard analysis have a clear physical basis. They are related to seismic sources discovered by geological, geomorphologic, geodetic and seismological investigations or derived from historical references. Scenario-based methods can be expanded for risk analysis applications with an extended data analysis providing the frequency of seismic events. Such an extension provides a better informed risk model that is suitable for risk-informed decision making.

  10. A Simplified Approach to Risk Assessment Based on System Dynamics: An Industrial Case Study.

    PubMed

    Garbolino, Emmanuel; Chery, Jean-Pierre; Guarnieri, Franck

    2016-01-01

    Seveso plants are complex sociotechnical systems, which makes it appropriate to support any risk assessment with a model of the system. However, more often than not, this step is only partially addressed, simplified, or avoided in safety reports. At the same time, investigations have shown that the complexity of industrial systems is frequently a factor in accidents, due to interactions between their technical, human, and organizational dimensions. In order to handle both this complexity and changes in the system over time, this article proposes an original and simplified qualitative risk evaluation method based on the system dynamics theory developed by Forrester in the early 1960s. The methodology supports the development of a dynamic risk assessment framework dedicated to industrial activities. It consists of 10 complementary steps grouped into two main activities: system dynamics modeling of the sociotechnical system and risk analysis. This system dynamics risk analysis is applied to a case study of a chemical plant and provides a way to assess the technological and organizational components of safety. © 2016 Society for Risk Analysis.

  11. Guidelines for contingency planning NASA (National Aeronautics and Space Administration) ADP security risk reduction decision studies

    NASA Technical Reports Server (NTRS)

    Tompkins, F. G.

    1984-01-01

    Guidance is presented to NASA Computer Security Officials for determining the acceptability or unacceptability of ADP security risks based on the technical, operational and economic feasibility of potential safeguards. The risk management process is reviewed as a specialized application of the systems approach to problem solving and information systems analysis and design. Reporting the results of the risk reduction analysis to management is considered. Report formats for the risk reduction study are provided.

  12. Risk-Based Prioritization of Research for Aviation Security Using Logic-Evolved Decision Analysis

    NASA Technical Reports Server (NTRS)

    Eisenhawer, S. W.; Bott, T. F.; Sorokach, M. R.; Jones, F. P.; Foggia, J. R.

    2004-01-01

    The National Aeronautics and Space Administration is developing advanced technologies to reduce terrorist risk for the air transportation system. Decision support tools are needed to help allocate assets to the most promising research. An approach to rank ordering technologies (using logic-evolved decision analysis), with risk reduction as the metric, is presented. The development of a spanning set of scenarios using a logic-gate tree is described. Baseline risk for these scenarios is evaluated with an approximate reasoning model. Illustrative risk and risk reduction results are presented.

  13. IT Operational Risk Measurement Model Based on Internal Loss Data of Banks

    NASA Astrophysics Data System (ADS)

    Hao, Xiaoling

    Business operation of banks relies increasingly on information technology (IT) and the most important role of IT is to guarantee the operational continuity of business process. Therefore, IT Risk management efforts need to be seen from the perspective of operational continuity. Traditional IT risk studies focused on IT asset-based risk analysis and risk-matrix based qualitative risk evaluation. In practice, IT risk management practices of banking industry are still limited to the IT department and aren't integrated into business risk management, which causes the two departments to work in isolation. This paper presents an improved methodology for dealing with IT operational risk. It adopts quantitative measurement method, based on the internal business loss data about IT events, and uses Monte Carlo simulation to predict the potential losses. We establish the correlation between the IT resources and business processes to make sure risk management of IT and business can work synergistically.

  14. Risk-Based Explosive Safety Analysis

    DTIC Science & Technology

    2016-11-30

    safety siting of energetic liquids and propellants can be greatly aided by the use of risk-based methodologies. The low probability of exposed...liquids or propellants . 15. SUBJECT TERMS N/A 16. SECURITY CLASSIFICATION OF: 17. LIMITATION OF ABSTRACT 18. NUMBER OF PAGES 19a. NAME OF...of energetic liquids and propellants can be greatly aided by the use of risk-based methodologies. The low probability of exposed personnel and the

  15. Indicators of economic security of the region: a risk-based approach to assessing and rating

    NASA Astrophysics Data System (ADS)

    Karanina, Elena; Loginov, Dmitri

    2017-10-01

    The article presents the results of research of theoretical and methodical problems of strategy development for economic security of a particular region, justified by the composition of risk factors. The analysis of those risk factors is performed. The threshold values of indicators of economic security of regions were determined using the methods of socioeconomic statistics. The authors concluded that in modern Russian conditions it is necessary to pay great attention to the analysis of the composition and level of indicators of economic security of the region and, based on the materials of this analysis, to formulate more accurate decisions concerning the strategy of socio-economic development.

  16. Exploration Laboratory Analysis - ARC

    NASA Technical Reports Server (NTRS)

    Krihak, Michael K.; Fung, Paul P.

    2012-01-01

    The Exploration Laboratory Analysis (ELA) project supports the Exploration Medical Capability (ExMC) risk, Risk of Inability to Adequately Treat an Ill or Injured Crew Member, and ExMC Gap 4.05: Lack of minimally invasive in-flight laboratory capabilities with limited consumables required for diagnosing identified Exploration Medical Conditions. To mitigate this risk, the availability of inflight laboratory analysis instrumentation has been identified as an essential capability in future exploration missions. Mission architecture poses constraints on equipment and procedures that will be available to treat evidence-based medical conditions according to the Space Medicine Exploration Medical Conditions List (SMEMCL). The SMEMCL provided diagnosis and treatment for the evidence-based medical conditions and hence, a basis for developing ELA functional requirements.

  17. Comparison of two occurrence risk assessment methods for collapse gully erosion ——A case study in Guangdong province

    NASA Astrophysics Data System (ADS)

    Sun, K.; Cheng, D. B.; He, J. J.; Zhao, Y. L.

    2018-02-01

    Collapse gully erosion is a specific type of soil erosion in the red soil region of southern China, and early warning and prevention of the occurrence of collapse gully erosion is very important. Based on the idea of risk assessment, this research, taking Guangdong province as an example, adopt the information acquisition analysis and the logistic regression analysis, to discuss the feasibility for collapse gully erosion risk assessment in regional scale, and compare the applicability of the different risk assessment methods. The results show that in the Guangdong province, the risk degree of collapse gully erosion occurrence is high in northeastern and western area, and relatively low in southwestern and central part. The comparing analysis of the different risk assessment methods on collapse gully also indicated that the risk distribution patterns from the different methods were basically consistent. However, the accuracy of risk map from the information acquisition analysis method was slightly better than that from the logistic regression analysis method.

  18. Fracture risk assessment: improved evaluation of vertebral integrity among metastatic cancer patients to aid in surgical decision-making

    NASA Astrophysics Data System (ADS)

    Augustine, Kurt E.; Camp, Jon J.; Holmes, David R.; Huddleston, Paul M.; Lu, Lichun; Yaszemski, Michael J.; Robb, Richard A.

    2012-03-01

    Failure of the spine's structural integrity from metastatic disease can lead to both pain and neurologic deficit. Fractures that require treatment occur in over 30% of bony metastases. Our objective is to use computed tomography (CT) in conjunction with analytic techniques that have been previously developed to predict fracture risk in cancer patients with metastatic disease to the spine. Current clinical practice for cancer patients with spine metastasis often requires an empirical decision regarding spinal reconstructive surgery. Early image-based software systems used for CT analysis are time consuming and poorly suited for clinical application. The Biomedical Image Resource (BIR) at Mayo Clinic, Rochester has developed an image analysis computer program that calculates from CT scans, the residual load-bearing capacity in a vertebra with metastatic cancer. The Spine Cancer Assessment (SCA) program is built on a platform designed for clinical practice, with a workflow format that allows for rapid selection of patient CT exams, followed by guided image analysis tasks, resulting in a fracture risk report. The analysis features allow the surgeon to quickly isolate a single vertebra and obtain an immediate pre-surgical multiple parallel section composite beam fracture risk analysis based on algorithms developed at Mayo Clinic. The analysis software is undergoing clinical validation studies. We expect this approach will facilitate patient management and utilization of reliable guidelines for selecting among various treatment option based on fracture risk.

  19. A clustering approach to segmenting users of internet-based risk calculators.

    PubMed

    Harle, C A; Downs, J S; Padman, R

    2011-01-01

    Risk calculators are widely available Internet applications that deliver quantitative health risk estimates to consumers. Although these tools are known to have varying effects on risk perceptions, little is known about who will be more likely to accept objective risk estimates. To identify clusters of online health consumers that help explain variation in individual improvement in risk perceptions from web-based quantitative disease risk information. A secondary analysis was performed on data collected in a field experiment that measured people's pre-diabetes risk perceptions before and after visiting a realistic health promotion website that provided quantitative risk information. K-means clustering was performed on numerous candidate variable sets, and the different segmentations were evaluated based on between-cluster variation in risk perception improvement. Variation in responses to risk information was best explained by clustering on pre-intervention absolute pre-diabetes risk perceptions and an objective estimate of personal risk. Members of a high-risk overestimater cluster showed large improvements in their risk perceptions, but clusters of both moderate-risk and high-risk underestimaters were much more muted in improving their optimistically biased perceptions. Cluster analysis provided a unique approach for segmenting health consumers and predicting their acceptance of quantitative disease risk information. These clusters suggest that health consumers were very responsive to good news, but tended not to incorporate bad news into their self-perceptions much. These findings help to quantify variation among online health consumers and may inform the targeted marketing of and improvements to risk communication tools on the Internet.

  20. Expert systems in civil engineering

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Kostem, C.N.; Maher, M.L.

    1986-01-01

    This book presents the papers given at a symposium on expert systems in civil engineering. Topics considered at the symposium included problem solving using expert system techniques, construction schedule analysis, decision making and risk analysis, seismic risk analysis systems, an expert system for inactive hazardous waste site characterization, an expert system for site selection, knowledge engineering, and knowledge-based expert systems in seismic analysis.

  1. Regulatory Science in Professional Education.

    PubMed

    Akiyama, Hiroshi

    2017-01-01

    In the field of pharmaceutical sciences, the subject of regulatory science (RS) includes pharmaceuticals, food, and living environments. For pharmaceuticals, considering the balance between efficacy and safety is a point required for public acceptance, and in that balance, more importance is given to efficacy in curing disease. For food, however, safety is the most important consideration for public acceptance because food should be essentially free of risk. To ensure food safety, first, any hazard that is an agent in food or condition of food with the potential to cause adverse health effects should be identified and characterized. Then the risk that it will affect public health is scientifically analyzed. This process is called risk assessment. Second, risk management should be conducted to reduce a risk that has the potential to affect public health found in a risk assessment. Furthermore, risk communication, which is the interactive exchange of information and opinions concerning risk and risk management among risk assessors, risk managers, consumers, and other interested parties, should be conducted. Food safety is ensured based on risk analysis consisting of the three components of risk assessment, risk management, and risk communication. RS in the field of food safety supports risk analysis, such as scientific research and development of test methods to evaluate food quality, efficacy, and safety. RS is also applied in the field of living environments because the safety of environmental chemical substances is ensured based on risk analysis, similar to that conducted for food.

  2. Developing an Integrated, Brief Biobehavioral HIV Prevention Intervention for High-Risk Drug Users in Treatment: The Process and Outcome of Formative Research

    PubMed Central

    Shrestha, Roman; Altice, Frederick; Karki, Pramila; Copenhaver, Michael

    2017-01-01

    To date, HIV prevention efforts have largely relied on singular strategies (e.g., behavioral or biomedical approaches alone) with modest HIV risk-reduction outcomes for people who use drugs (PWUD), many of whom experience a wide range of neurocognitive impairments (NCI). We report on the process and outcome of our formative research aimed at developing an integrated biobehavioral approach that incorporates innovative strategies to address the HIV prevention and cognitive needs of high-risk PWUD in drug treatment. Our formative work involved first adapting an evidence-based behavioral intervention—guided by the Assessment–Decision–Administration–Production–Topical experts–Integration–Training–Testing model—and then combining the behavioral intervention with an evidence-based biomedical intervention for implementation among the target population. This process involved eliciting data through structured focus groups (FGs) with key stakeholders—members of the target population (n = 20) and treatment providers (n = 10). Analysis of FG data followed a thematic analysis approach utilizing several qualitative data analysis techniques, including inductive analysis and cross-case analysis. Based on all information, we integrated the adapted community-friendly health recovery program—a brief evidence-based HIV prevention behavioral intervention—with the evidence-based biomedical component [i.e., preexposure prophylaxis (PrEP)], an approach that incorporates innovative strategies to accommodate individuals with NCI. This combination approach—now called the biobehavioral community-friendly health recovery program—is designed to address HIV-related risk behaviors and PrEP uptake and adherence as experienced by many PWUD in treatment. This study provides a complete example of the process of selecting, adapting, and integrating the evidence-based interventions—taking into account both empirical evidence and input from target population members and target organization stakeholders. The resultant brief evidence-based biobehavioral approach could significantly advance primary prevention science by cost-effectively optimizing PrEP adherence and HIV risk reduction within common drug treatment settings. PMID:28553295

  3. Use of Model-Based Design Methods for Enhancing Resiliency Analysis of Unmanned Aerial Vehicles

    NASA Astrophysics Data System (ADS)

    Knox, Lenora A.

    The most common traditional non-functional requirement analysis is reliability. With systems becoming more complex, networked, and adaptive to environmental uncertainties, system resiliency has recently become the non-functional requirement analysis of choice. Analysis of system resiliency has challenges; which include, defining resilience for domain areas, identifying resilience metrics, determining resilience modeling strategies, and understanding how to best integrate the concepts of risk and reliability into resiliency. Formal methods that integrate all of these concepts do not currently exist in specific domain areas. Leveraging RAMSoS, a model-based reliability analysis methodology for Systems of Systems (SoS), we propose an extension that accounts for resiliency analysis through evaluation of mission performance, risk, and cost using multi-criteria decision-making (MCDM) modeling and design trade study variability modeling evaluation techniques. This proposed methodology, coined RAMSoS-RESIL, is applied to a case study in the multi-agent unmanned aerial vehicle (UAV) domain to investigate the potential benefits of a mission architecture where functionality to complete a mission is disseminated across multiple UAVs (distributed) opposed to being contained in a single UAV (monolithic). The case study based research demonstrates proof of concept for the proposed model-based technique and provides sufficient preliminary evidence to conclude which architectural design (distributed vs. monolithic) is most resilient based on insight into mission resilience performance, risk, and cost in addition to the traditional analysis of reliability.

  4. Evaluation of a Stratified National Breast Screening Program in the United Kingdom: An Early Model-Based Cost-Effectiveness Analysis.

    PubMed

    Gray, Ewan; Donten, Anna; Karssemeijer, Nico; van Gils, Carla; Evans, D Gareth; Astley, Sue; Payne, Katherine

    2017-09-01

    To identify the incremental costs and consequences of stratified national breast screening programs (stratified NBSPs) and drivers of relative cost-effectiveness. A decision-analytic model (discrete event simulation) was conceptualized to represent four stratified NBSPs (risk 1, risk 2, masking [supplemental screening for women with higher breast density], and masking and risk 1) compared with the current UK NBSP and no screening. The model assumed a lifetime horizon, the health service perspective to identify costs (£, 2015), and measured consequences in quality-adjusted life-years (QALYs). Multiple data sources were used: systematic reviews of effectiveness and utility, published studies reporting costs, and cohort studies embedded in existing NBSPs. Model parameter uncertainty was assessed using probabilistic sensitivity analysis and one-way sensitivity analysis. The base-case analysis, supported by probabilistic sensitivity analysis, suggested that the risk stratified NBSPs (risk 1 and risk-2) were relatively cost-effective when compared with the current UK NBSP, with incremental cost-effectiveness ratios of £16,689 per QALY and £23,924 per QALY, respectively. Stratified NBSP including masking approaches (supplemental screening for women with higher breast density) was not a cost-effective alternative, with incremental cost-effectiveness ratios of £212,947 per QALY (masking) and £75,254 per QALY (risk 1 and masking). When compared with no screening, all stratified NBSPs could be considered cost-effective. Key drivers of cost-effectiveness were discount rate, natural history model parameters, mammographic sensitivity, and biopsy rates for recalled cases. A key assumption was that the risk model used in the stratification process was perfectly calibrated to the population. This early model-based cost-effectiveness analysis provides indicative evidence for decision makers to understand the key drivers of costs and QALYs for exemplar stratified NBSP. Copyright © 2017 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

  5. Probabilistic risk analysis and terrorism risk.

    PubMed

    Ezell, Barry Charles; Bennett, Steven P; von Winterfeldt, Detlof; Sokolowski, John; Collins, Andrew J

    2010-04-01

    Since the terrorist attacks of September 11, 2001, and the subsequent establishment of the U.S. Department of Homeland Security (DHS), considerable efforts have been made to estimate the risks of terrorism and the cost effectiveness of security policies to reduce these risks. DHS, industry, and the academic risk analysis communities have all invested heavily in the development of tools and approaches that can assist decisionmakers in effectively allocating limited resources across the vast array of potential investments that could mitigate risks from terrorism and other threats to the homeland. Decisionmakers demand models, analyses, and decision support that are useful for this task and based on the state of the art. Since terrorism risk analysis is new, no single method is likely to meet this challenge. In this article we explore a number of existing and potential approaches for terrorism risk analysis, focusing particularly on recent discussions regarding the applicability of probabilistic and decision analytic approaches to bioterrorism risks and the Bioterrorism Risk Assessment methodology used by the DHS and criticized by the National Academies and others.

  6. Impact of systemic risk in the real estate sector on banking return.

    PubMed

    Li, Shouwei; Pan, Qing; He, Jianmin

    2016-01-01

    In this paper, we measure systemic risk in the real estate sector based on contingent claims analysis, and then investigate its impact on banking return. Based on the data in China, we find that systemic risk in the real estate sector has a negative effect on banking return, but this effect is temporary; banking risk aversion and implicit interest expense have considerable impact on banking return.

  7. Derailment-based Fault Tree Analysis on Risk Management of Railway Turnout Systems

    NASA Astrophysics Data System (ADS)

    Dindar, Serdar; Kaewunruen, Sakdirat; An, Min; Gigante-Barrera, Ángel

    2017-10-01

    Railway turnouts are fundamental mechanical infrastructures, which allow a rolling stock to divert one direction to another. As those are of a large number of engineering subsystems, e.g. track, signalling, earthworks, these particular sub-systems are expected to induce high potential through various kind of failure mechanisms. This could be a cause of any catastrophic event. A derailment, one of undesirable events in railway operation, often results, albeit rare occurs, in damaging to rolling stock, railway infrastructure and disrupt service, and has the potential to cause casualties and even loss of lives. As a result, it is quite significant that a well-designed risk analysis is performed to create awareness of hazards and to identify what parts of the systems may be at risk. This study will focus on all types of environment based failures as a result of numerous contributing factors noted officially as accident reports. This risk analysis is designed to help industry to minimise the occurrence of accidents at railway turnouts. The methodology of the study relies on accurate assessment of derailment likelihood, and is based on statistical multiple factors-integrated accident rate analysis. The study is prepared in the way of establishing product risks and faults, and showing the impact of potential process by Boolean algebra.

  8. Estimation of risk of cancers before occurrence of acquired immunodeficiency syndrome in persons infected with human immunodeficiency virus.

    PubMed

    Li, Yueming; Law, Matthew; McDonald, Ann; Correll, Patty; Kaldor, John M; Grulich, Andrew E

    2002-01-15

    There is methodological debate as to whether cohorts defined by acquired immunodeficiency syndrome (AIDS) diagnosis can be used to estimate risks of cancer in persons with human immunodeficiency virus (HIV) before AIDS. The authors compared risks of non-AIDS-defining cancers before AIDS in persons with HIV using a cohort based on AIDS diagnosis and a second cohort based on HIV diagnosis. National population-based registries of AIDS and HIV diagnoses to August 1999 were matched separately with the National Cancer Registry in Australia. Four analyses were performed. In analysis 1, follow-up was from 5 years before AIDS registration in 8,118 persons with AIDS. Analysis 2 was similar but adjusted expected numbers of cancers for decreased survival. Analysis 3 was based on 7,061 persons registered with HIV, with follow-up from the reported date of diagnosis. Analysis 4 was based on 2,112 AIDS cases previously reported with HIV, with follow-up from 5 years before AIDS diagnosis. In all analyses, follow-up ended at cancer diagnosis, death, 6 months before AIDS, or the end of available cancer data, whichever occurred first. For 10 types of cancer there were at least three cases in any one of the analyses. For these cancers there was no systematic pattern such that one analysis produced consistently higher or lower estimates than the others. These analyses suggest that cancer risk in persons with HIV before AIDS diagnosis may be estimated reliably based on cancer experience 5 years before AIDS.

  9. Red and processed meat consumption and risk of glioma in adults: A systematic review and meta-analysis of observational studies

    PubMed Central

    Saneei, Parvane; Willett, Walter; Esmaillzadeh, Ahmad

    2015-01-01

    Background: These findings from several observational studies, investigated the association between red meat consumption and gliomas, were inconsistent. We conducted a systematic review and meta-analysis of observational studies to summarize available date on the relation between meat intake and risk of glioma. Materials and Methods: A systematic literature search of relevant reports published until May 2014 of the PubMed/Medline, ISI Web of Knowledge, Excerpta Medica database, Ovid database, Google Scholar, and Scopus databases was conducted. From 723 articles yielded in the preliminary literature search, data from eighteen publications (14 case-control, three cohort, and one nested case-control study) on unprocessed red meat, processed meat, and/or total red meat consumption in relation to glioma in adults were included in the analysis. Quality assessment of studies was performed. Random effects model was used to conduct the meta-analysis. Results: We found a positive significant association between unprocessed red meat intake and risk of glioma (relative risk [RR] = 1.30; 95% confidence interval [CI]: 1.08-1.58) after excluding three studies with uncertain type of brain cancer. This analysis included only one cohort study which revealed no relation between unprocessed red meat intake and glioma (RR = 1.75; 95% CI: 0.35-8.77). Consumption of processed meats was not related to increased risk of glioma in population-based case-control studies (RR = 1.26; 95% CI: 1.05-1.51) and reduced risk in hospital-based case-controls (RR = 0.79; 95% CI: 0.65-0.97). No significant association was seen between processed red meat intake and risk of glioma in cohort studies (RR: 1.08; 95% CI: 0.84-1.37). Total red meat consumption was not associated with risk of adult glioma in case-control or cohort studies. Conclusion: In this meta-analysis of 18 observational studies, we found a modest positive association between unprocessed red meat intake and risk of gliomas based almost entirely on case-control studies. Processed red meat was overall not associated with risk of gliomas in case-control or cohort studies. PMID:26600837

  10. The JPL Cost Risk Analysis Approach that Incorporates Engineering Realism

    NASA Technical Reports Server (NTRS)

    Harmon, Corey C.; Warfield, Keith R.; Rosenberg, Leigh S.

    2006-01-01

    This paper discusses the JPL Cost Engineering Group (CEG) cost risk analysis approach that accounts for all three types of cost risk. It will also describe the evaluation of historical cost data upon which this method is based. This investigation is essential in developing a method that is rooted in engineering realism and produces credible, dependable results to aid decision makers.

  11. Risk Based Reliability Centered Maintenance of DOD Fire Protection Systems

    DTIC Science & Technology

    1999-01-01

    2.2.3 Failure Mode and Effect Analysis ( FMEA )............................ 2.2.4 Failure Mode Risk Characterization...Step 2 - System functions and functional failures definition Step 3 - Failure mode and effect analysis ( FMEA ) Step 4 - Failure mode risk...system). The Interface Location column identifies the location where the FMEA of the fire protection system began or stopped. For example, for the fire

  12. GEO Collisional Risk Assessment Based on Analysis of NASA-WISE Data and Modeling

    DTIC Science & Technology

    2015-10-18

    GEO Collisional Risk Assessment Based on Analysis of NASA -WISE Data and Modeling Jeremy Murray Krezan1, Samantha Howard1, Phan D. Dao1, Derek...Surka2 1AFRL Space Vehicles Directorate,2Applied Technology Associates Incorporated From December 2009 through 2011 the NASA Wide-Field Infrared...of known debris. The NASA -WISE GEO belt debris population adds potentially thousands previously uncataloged objects. This paper describes

  13. Defense AT&L. May-June 2010

    DTIC Science & Technology

    2010-06-01

    a storytelling narrative of how the risk was mitigated and what worked or did not work. A knowledge-based risk is also a means of transferring...devel- oping a cadre of trained facilitators to assist teams in using Web-based deci- sion-support technology to support team brain - storming...and use “contextualization” (a.k.a. storytelling ) as an alternative method to analysis? Storytelling Instead of Analysis There have been some

  14. Modeling intelligent adversaries for terrorism risk assessment: some necessary conditions for adversary models.

    PubMed

    Guikema, Seth

    2012-07-01

    Intelligent adversary modeling has become increasingly important for risk analysis, and a number of different approaches have been proposed for incorporating intelligent adversaries in risk analysis models. However, these approaches are based on a range of often-implicit assumptions about the desirable properties of intelligent adversary models. This "Perspective" paper aims to further risk analysis for situations involving intelligent adversaries by fostering a discussion of the desirable properties for these models. A set of four basic necessary conditions for intelligent adversary models is proposed and discussed. These are: (1) behavioral accuracy to the degree possible, (2) computational tractability to support decision making, (3) explicit consideration of uncertainty, and (4) ability to gain confidence in the model. It is hoped that these suggested necessary conditions foster discussion about the goals and assumptions underlying intelligent adversary modeling in risk analysis. © 2011 Society for Risk Analysis.

  15. Are iso-osmolar, as compared to low-osmolar, contrast media cost-effective in patients undergoing cardiac catheterization? An economic analysis.

    PubMed

    Hiremath, Swapnil; Akbari, Ayub; Wells, George A; Chow, Benjamin J W

    2018-04-23

    Contrast-induced acute kidney injury is a prominent complication following cardiac catheterization, though the risk has progressively decreased in recent times with appropriate risk stratification and use of safer contrast agents. Despite data supporting further lowering of risk with the iso-osmolar agent, iodixanol, uptake has lagged, perhaps due to increased upfront cost of this agent. We undertook an economic analysis to estimate the cost-effectiveness of a strategy utilizing iodixanol compared to using a low-osmolar contrast agent. We created a Markov model to evaluate the two strategies, and included a differential relative risk of contrast-induced acute kidney injury, based on a systematic review of the literature. Downstream clinical events, including need for dialysis and mortality, were modeled using data from existing published literature. A third-party payer perspective was utilized for the analysis and presentation of the primary economic analysis. The strategy of using iodixanol dominated in both the low-risk and high-risk base case analyses. However, the difference was quite small in the low-risk scenario (lifetime cost: C$678,034 vs. C$678,059 and life expectancy: 19.80 vs. 19.72 years). The difference was more marked (life expectancy 15.65 vs. 14.15 years and cost C$680,989 vs. C$682,023) in the high-risk case analysis. This was robust across most of the variables tested in sensitivity analyses. The use of iodixanol, compared with low-osmolar contrast agents, for cardiac catheterization, results in a small benefit clinical outcomes, and in a savings in direct healthcare costs. Overall, our analysis supports the use of iodixanol for cardiac catheterization, especially in patients at high risk of acute kidney injury.

  16. When is carotid angioplasty and stenting the cost-effective alternative for revascularization of symptomatic carotid stenosis? A Canadian health system perspective.

    PubMed

    Almekhlafi, M A; Hill, M D; Wiebe, S; Goyal, M; Yavin, D; Wong, J H; Clement, F M

    2014-02-01

    Carotid revascularization procedures can be complicated by stroke. Additional disability adds to the already high costs of the procedure. To weigh the cost and benefit, we estimated the cost-utility of carotid angioplasty and stenting compared with carotid endarterectomy among patients with symptomatic carotid stenosis, with special emphasis on scenario analyses that would yield carotid angioplasty and stenting as the cost-effective alternative relative to carotid endarterectomy. A cost-utility analysis from the perspective of the health system payer was performed by using a Markov analytic model. Clinical estimates were based on a meta-analysis. The procedural costs were derived from a microcosting data base. The costs for hospitalization and rehabilitation of patients with stroke were based on a Canadian multicenter study. Utilities were based on a randomized controlled trial. In the base case analysis, carotid angioplasty and stenting were more expensive (incremental cost of $6107) and had a lower utility (-0.12 quality-adjusted life years) than carotid endarterectomy. The results are sensitive to changes in the risk of clinical events and the relative risk of death and stroke. Carotid angioplasty and stenting were more economically attractive among high-risk surgical patients. For carotid angioplasty and stenting to become the preferred option, their costs would need to fall from more than $7300 to $4350 or less and the risks of the periprocedural and annual minor strokes would have to be equivalent to that of carotid endarterectomy. In the base case analysis, carotid angioplasty and stenting were associated with higher costs and lower utility compared with carotid endarterectomy for patients with symptomatic carotid stenosis. Carotid angioplasty and stenting were cost-effective for patients with high surgical risk.

  17. Health risk assessment of polycyclic aromatic hydrocarbons in the source water and drinking water of China: Quantitative analysis based on published monitoring data.

    PubMed

    Wu, Bing; Zhang, Yan; Zhang, Xu-Xiang; Cheng, Shu-Pei

    2011-12-01

    A carcinogenic risk assessment of polycyclic aromatic hydrocarbons (PAHs) in source water and drinking water of China was conducted using probabilistic techniques from a national perspective. The published monitoring data of PAHs were gathered and converted into BaP equivalent (BaP(eq)) concentrations. Based on the transformed data, comprehensive risk assessment was performed by considering different age groups and exposure pathways. Monte Carlo simulation and sensitivity analysis were applied to quantify uncertainties of risk estimation. The risk analysis indicated that, the risk values for children and teens were lower than the accepted value (1.00E-05), indicating no significant carcinogenic risk. The probability of risk values above 1.00E-05 was 5.8% and 6.7% for adults and lifetime groups, respectively. Overall, carcinogenic risks of PAHs in source water and drinking water of China were mostly accepted. However, specific regions, such as Yellow river of Lanzhou reach and Qiantang river should be paid more attention. Notwithstanding the uncertainties inherent in the risk assessment, this study is the first attempt to provide information on carcinogenic risk of PAHs in source water and drinking water of China, and might be useful for potential strategies of carcinogenic risk management and reduction. Copyright © 2011 Elsevier B.V. All rights reserved.

  18. Risk manager formula for success: Influencing decision making.

    PubMed

    Midgley, Mike

    2017-10-01

    Providing the ultimate decision makers with a quantitative risk analysis based on thoughtful assessment by the organization's experts enables an efficient decision. © 2017 American Society for Healthcare Risk Management of the American Hospital Association.

  19. Advanced uncertainty modelling for container port risk analysis.

    PubMed

    Alyami, Hani; Yang, Zaili; Riahi, Ramin; Bonsall, Stephen; Wang, Jin

    2016-08-13

    Globalization has led to a rapid increase of container movements in seaports. Risks in seaports need to be appropriately addressed to ensure economic wealth, operational efficiency, and personnel safety. As a result, the safety performance of a Container Terminal Operational System (CTOS) plays a growing role in improving the efficiency of international trade. This paper proposes a novel method to facilitate the application of Failure Mode and Effects Analysis (FMEA) in assessing the safety performance of CTOS. The new approach is developed through incorporating a Fuzzy Rule-Based Bayesian Network (FRBN) with Evidential Reasoning (ER) in a complementary manner. The former provides a realistic and flexible method to describe input failure information for risk estimates of individual hazardous events (HEs) at the bottom level of a risk analysis hierarchy. The latter is used to aggregate HEs safety estimates collectively, allowing dynamic risk-based decision support in CTOS from a systematic perspective. The novel feature of the proposed method, compared to those in traditional port risk analysis lies in a dynamic model capable of dealing with continually changing operational conditions in ports. More importantly, a new sensitivity analysis method is developed and carried out to rank the HEs by taking into account their specific risk estimations (locally) and their Risk Influence (RI) to a port's safety system (globally). Due to its generality, the new approach can be tailored for a wide range of applications in different safety and reliability engineering and management systems, particularly when real time risk ranking is required to measure, predict, and improve the associated system safety performance. Copyright © 2016 Elsevier Ltd. All rights reserved.

  20. Improvement of the cost-benefit analysis algorithm for high-rise construction projects

    NASA Astrophysics Data System (ADS)

    Gafurov, Andrey; Skotarenko, Oksana; Plotnikov, Vladimir

    2018-03-01

    The specific nature of high-rise investment projects entailing long-term construction, high risks, etc. implies a need to improve the standard algorithm of cost-benefit analysis. An improved algorithm is described in the article. For development of the improved algorithm of cost-benefit analysis for high-rise construction projects, the following methods were used: weighted average cost of capital, dynamic cost-benefit analysis of investment projects, risk mapping, scenario analysis, sensitivity analysis of critical ratios, etc. This comprehensive approach helped to adapt the original algorithm to feasibility objectives in high-rise construction. The authors put together the algorithm of cost-benefit analysis for high-rise construction projects on the basis of risk mapping and sensitivity analysis of critical ratios. The suggested project risk management algorithms greatly expand the standard algorithm of cost-benefit analysis in investment projects, namely: the "Project analysis scenario" flowchart, improving quality and reliability of forecasting reports in investment projects; the main stages of cash flow adjustment based on risk mapping for better cost-benefit project analysis provided the broad range of risks in high-rise construction; analysis of dynamic cost-benefit values considering project sensitivity to crucial variables, improving flexibility in implementation of high-rise projects.

  1. Genome-wide pathway-based association analysis identifies risk pathways associated with Parkinson's disease.

    PubMed

    Zhang, Mingming; Mu, Hongbo; Shang, Zhenwei; Kang, Kai; Lv, Hongchao; Duan, Lian; Li, Jin; Chen, Xinren; Teng, Yanbo; Jiang, Yongshuai; Zhang, Ruijie

    2017-01-06

    Parkinson's disease (PD) is the second most common neurodegenerative disease. It is generally believed that it is influenced by both genetic and environmental factors, but the precise pathogenesis of PD is unknown to date. In this study, we performed a pathway analysis based on genome-wide association study (GWAS) to detect risk pathways of PD in three GWAS datasets. We first mapped all SNP markers to autosomal genes in each GWAS dataset. Then, we evaluated gene risk values using the minimum P-value of the tagSNPs. We took a pathway as a unit to identify the risk pathways based on the cumulative risks of the genes in the pathway. Finally, we combine the analysis results of the three datasets to detect the high risk pathways associated with PD. We found there were five same pathways in the three datasets. Besides, we also found there were five pathways which were shared in two datasets. Most of these pathways are associated with nervoussystem. Five pathways had been reported to be PD-related pathways in the previous literature. Our findings also implied that there was a close association between immune response and PD. Continued investigation of these pathways will further help us explain the pathogenesis of PD. Copyright © 2016. Published by Elsevier Ltd.

  2. Analysis of dengue fever risk using geostatistics model in bone regency

    NASA Astrophysics Data System (ADS)

    Amran, Stang, Mallongi, Anwar

    2017-03-01

    This research aim is to analysis of dengue fever risk based on Geostatistics model in Bone Regency. Risk levels of dengue fever are denoted by parameter of Binomial distribution. Effect of temperature, rainfalls, elevation, and larvae abundance are investigated through Geostatistics model. Bayesian hierarchical method is used in estimation process. Using dengue fever data in eleven locations this research shows that temperature and rainfall have significant effect of dengue fever risk in Bone regency.

  3. Developing a suitable model for supplier selection based on supply chain risks: an empirical study from Iranian pharmaceutical companies.

    PubMed

    Mehralian, Gholamhossein; Rajabzadeh Gatari, Ali; Morakabati, Mohadese; Vatanpour, Hossein

    2012-01-01

    The supply chain represents the critical link between the development of new product and the market in pharmaceutical industry. Over the years, improvements made in supply chain operations have focused largely on ways to reduce cost and gain efficiencies in scale. In addition, powerful regulatory and market forces have provided new incentives for pharmaceutical firms to basically rethink the way they produce and distribute products, and also to re-imagine the role of the supply chain in driving strategic growth, brand differentiation and economic value in the health continuum. The purpose of this paper is to formulate basic factors involved in risk analysis of pharmaceutical industry, and also determine the effective factors involved in suppliers selection and their priorities. This paper is based on the results of literature review, experts' opinion acquisition, statistical analysis and also using MADM models on data gathered from distributed questionnaires. The model consists of the following steps and components: first factors involved in to supply chain risks are determined. Based on them a framework is considered. According the result of statistical analysis and MADM models the risk factors are formulated. The paper determines the main components and influenceial factors involving in the supply chain risks. Results showed that delivery risk can make an important contribution to mitigate the risk of pharmaceutical industry.

  4. Developing a Suitable Model for Supplier Selection Based on Supply Chain Risks: An Empirical Study from Iranian Pharmaceutical Companies

    PubMed Central

    Mehralian, Gholamhossein; Rajabzadeh Gatari, Ali; Morakabati, Mohadese; Vatanpour, Hossein

    2012-01-01

    The supply chain represents the critical link between the development of new product and the market in pharmaceutical industry. Over the years, improvements made in supply chain operations have focused largely on ways to reduce cost and gain efficiencies in scale. In addition, powerful regulatory and market forces have provided new incentives for pharmaceutical firms to basically rethink the way they produce and distribute products, and also to re-imagine the role of the supply chain in driving strategic growth, brand differentiation and economic value in the health continuum. The purpose of this paper is to formulate basic factors involved in risk analysis of pharmaceutical industry, and also determine the effective factors involved in suppliers selection and their priorities. This paper is based on the results of literature review, experts’ opinion acquisition, statistical analysis and also using MADM models on data gathered from distributed questionnaires. The model consists of the following steps and components: first factors involved in to supply chain risks are determined. Based on them a framework is considered. According the result of statistical analysis and MADM models the risk factors are formulated. The paper determines the main components and influenceial factors involving in the supply chain risks. Results showed that delivery risk can make an important contribution to mitigate the risk of pharmaceutical industry. PMID:24250442

  5. Instability risk analysis and risk assessment system establishment of underground storage caverns in bedded salt rock

    NASA Astrophysics Data System (ADS)

    Jing, Wenjun; Zhao, Yan

    2018-02-01

    Stability is an important part of geotechnical engineering research. The operating experiences of underground storage caverns in salt rock all around the world show that the stability of the caverns is the key problem of safe operation. Currently, the combination of theoretical analysis and numerical simulation are the mainly adopts method of reserve stability analysis. This paper introduces the concept of risk into the stability analysis of underground geotechnical structure, and studies the instability of underground storage cavern in salt rock from the perspective of risk analysis. Firstly, the definition and classification of cavern instability risk is proposed, and the damage mechanism is analyzed from the mechanical angle. Then the main stability evaluating indicators of cavern instability risk are proposed, and an evaluation method of cavern instability risk is put forward. Finally, the established cavern instability risk assessment system is applied to the analysis and prediction of cavern instability risk after 30 years of operation in a proposed storage cavern group in the Huai’an salt mine. This research can provide a useful theoretical base for the safe operation and management of underground storage caverns in salt rock.

  6. "Birds of a Feather" Fail Together: Exploring the Nature of Dependency in SME Defaults.

    PubMed

    Calabrese, Raffaella; Andreeva, Galina; Ansell, Jake

    2017-08-11

    This article studies the effects of incorporating the interdependence among London small business defaults into a risk analysis framework using the data just before the financial crisis. We propose an extension from standard scoring models to take into account the spatial dimensions and the demographic characteristics of small and medium-sized enterprises (SMEs), such as legal form, industry sector, and number of employees. We estimate spatial probit models using different distance matrices based only on the spatial location or on an interaction between spatial locations and demographic characteristics. We find that the interdependence or contagion component defined on spatial and demographic characteristics is significant and that it improves the ability to predict defaults of non-start-ups in London. Furthermore, including contagion effects among SMEs alters the parameter estimates of risk determinants. The approach can be extended to other risk analysis applications where spatial risk may incorporate correlation based on other aspects. © 2017 Society for Risk Analysis.

  7. Topography- and nightlight-based national flood risk assessment in Canada

    NASA Astrophysics Data System (ADS)

    Elshorbagy, Amin; Bharath, Raja; Lakhanpal, Anchit; Ceola, Serena; Montanari, Alberto; Lindenschmidt, Karl-Erich

    2017-04-01

    In Canada, flood analysis and water resource management, in general, are tasks conducted at the provincial level; therefore, unified national-scale approaches to water-related problems are uncommon. In this study, a national-scale flood risk assessment approach is proposed and developed. The study focuses on using global and national datasets available with various resolutions to create flood risk maps. First, a flood hazard map of Canada is developed using topography-based parameters derived from digital elevation models, namely, elevation above nearest drainage (EAND) and distance from nearest drainage (DFND). This flood hazard mapping method is tested on a smaller area around the city of Calgary, Alberta, against a flood inundation map produced by the city using hydraulic modelling. Second, a flood exposure map of Canada is developed using a land-use map and the satellite-based nightlight luminosity data as two exposure parameters. Third, an economic flood risk map is produced, and subsequently overlaid with population density information to produce a socioeconomic flood risk map for Canada. All three maps of hazard, exposure, and risk are classified into five classes, ranging from very low to severe. A simple way to include flood protection measures in hazard estimation is also demonstrated using the example of the city of Winnipeg, Manitoba. This could be done for the entire country if information on flood protection across Canada were available. The evaluation of the flood hazard map shows that the topography-based method adopted in this study is both practical and reliable for large-scale analysis. Sensitivity analysis regarding the resolution of the digital elevation model is needed to identify the resolution that is fine enough for reliable hazard mapping, but coarse enough for computational tractability. The nightlight data are found to be useful for exposure and risk mapping in Canada; however, uncertainty analysis should be conducted to investigate the effect of the overglow phenomenon on flood risk mapping.

  8. Risk-Based Prioritization Method for the Classification of Groundwater Pollution from Hazardous Waste Landfills.

    PubMed

    Yang, Yu; Jiang, Yong-Hai; Lian, Xin-Ying; Xi, Bei-Dou; Ma, Zhi-Fei; Xu, Xiang-Jian; An, Da

    2016-12-01

    Hazardous waste landfill sites are a significant source of groundwater pollution. To ensure that these landfills with a significantly high risk of groundwater contamination are properly managed, a risk-based ranking method related to groundwater contamination is needed. In this research, a risk-based prioritization method for the classification of groundwater pollution from hazardous waste landfills was established. The method encompasses five phases, including risk pre-screening, indicator selection, characterization, classification and, lastly, validation. In the risk ranking index system employed here, 14 indicators involving hazardous waste landfills and migration in the vadose zone as well as aquifer were selected. The boundary of each indicator was determined by K-means cluster analysis and the weight of each indicator was calculated by principal component analysis. These methods were applied to 37 hazardous waste landfills in China. The result showed that the risk for groundwater contamination from hazardous waste landfills could be ranked into three classes from low to high risk. In all, 62.2 % of the hazardous waste landfill sites were classified in the low and medium risk classes. The process simulation method and standardized anomalies were used to validate the result of risk ranking; the results were consistent with the simulated results related to the characteristics of contamination. The risk ranking method was feasible, valid and can provide reference data related to risk management for groundwater contamination at hazardous waste landfill sites.

  9. An analysis of the public perception of flood risk on the Belgian coast.

    PubMed

    Kellens, Wim; Zaalberg, Ruud; Neutens, Tijs; Vanneuville, Wouter; De Maeyer, Philippe

    2011-07-01

    In recent years, perception of flood risks has become an important topic to policy makers concerned with risk management and safety issues. Knowledge of the public risk perception is considered a crucial aspect in modern flood risk management as it steers the development of effective and efficient flood mitigation strategies. This study aimed at gaining insight into the perception of flood risks along the Belgian coast. Given the importance of the tourism industry on the Belgian coast, the survey considered both inhabitants and residential tourists. Based on actual expert's risk assessments, a high and a low risk area were selected for the study. Risk perception was assessed on the basis of scaled items regarding storm surges and coastal flood risks. In addition, various personal and residence characteristics were measured. Using multiple regression analysis, risk perception was found to be primarily influenced by actual flood risk estimates, age, gender, and experience with previous flood hazards. © 2011 Society for Risk Analysis.

  10. The role of building models in the evaluation of heat-related risks

    NASA Astrophysics Data System (ADS)

    Buchin, Oliver; Jänicke, Britta; Meier, Fred; Scherer, Dieter; Ziegler, Felix

    2016-04-01

    Hazard-risk relationships in epidemiological studies are generally based on the outdoor climate, despite the fact that most of humans' lifetime is spent indoors. By coupling indoor and outdoor climates with a building model, the risk concept developed can still be based on the outdoor conditions but also includes exposure to the indoor climate. The influence of non-linear building physics and the impact of air conditioning on heat-related risks can be assessed in a plausible manner using this risk concept. For proof of concept, the proposed risk concept is compared to a traditional risk analysis. As an example, daily and city-wide mortality data of the age group 65 and older in Berlin, Germany, for the years 2001-2010 are used. Four building models with differing complexity are applied in a time-series regression analysis. This study shows that indoor hazard better explains the variability in the risk data compared to outdoor hazard, depending on the kind of building model. Simplified parameter models include the main non-linear effects and are proposed for the time-series analysis. The concept shows that the definitions of heat events, lag days, and acclimatization in a traditional hazard-risk relationship are influenced by the characteristics of the prevailing building stock.

  11. Inhalation Anthrax: Dose Response and Risk Analysis

    PubMed Central

    Thran, Brandolyn; Morse, Stephen S.; Hugh-Jones, Martin; Massulik, Stacey

    2008-01-01

    The notion that inhalation of a single Bacillus anthracis spore is fatal has become entrenched nearly to the point of urban legend, in part because of incomplete articulation of the scientific basis for microbial risk assessment, particularly dose-response assessment. Risk analysis (ie, risk assessment, risk communication, risk management) necessitates transparency: distinguishing scientific facts, hypotheses, judgments, biases in interpretations, and potential misinformation. The difficulty in achieving transparency for biothreat risk is magnified by misinformation and poor characterization of both dose-response relationships and the driving mechanisms that cause susceptibility or resistance to disease progression. Regrettably, this entrenchment unnecessarily restricts preparedness planning to a single response scenario: decontaminate until no spores are detectable in air, water, or on surfaces—essentially forcing a zero-tolerance policy inconsistent with the biology of anthrax. We present evidence about inhalation anthrax dose-response relationships, including reports from multiple studies documenting exposures insufficient to cause inhalation anthrax in laboratory animals and humans. The emphasis of the article is clarification about what is known from objective scientific evidence for doses of anthrax spores associated with survival and mortality. From this knowledge base, we discuss the need for future applications of more formal risk analysis processes to guide development of alternative non-zero criteria or standards based on science to inform preparedness planning and other risk management activities. PMID:18582166

  12. On the Concept and Definition of Terrorism Risk.

    PubMed

    Aven, Terje; Guikema, Seth

    2015-12-01

    In this article, we provide some reflections on how to define and understand the concept of terrorism risk in a professional risk assessment context. As a basis for this discussion we introduce a set of criteria that we believe should apply to any conceptualization of terrorism risk. These criteria are based on both criteria used in other areas of risk analysis and our experience with terrorism risk analysis. That is, these criteria offer our perspective. We show that several of the suggested perspectives and definitions have weaknesses in relation to these criteria. A main problem identified is the idea that terrorism risk can be conceptualized as a function of probability and consequence, not as a function of the interactions between adaptive individuals and organizations. We argue that perspectives based solely on probability and consequence should be used cautiously or not at all because they fail to reflect the essential features of the concept of terrorism risk, the threats and attacks, their consequences, and the uncertainties, all in the context of adaptation by the adversaries. These three elements should in our view constitute the main pillars of the terrorism risk concept. From this concept we can develop methods for assessing the risk by identifying a set of threats, attacks, and consequence measures associated with the possible outcome scenarios together with a description of the uncertainties and interactions between the adversaries. © 2015 Society for Risk Analysis.

  13. Approach to proliferation risk assessment based on multiple objective analysis framework

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Andrianov, A.; Kuptsov, I.; Studgorodok 1, Obninsk, Kaluga region, 249030

    2013-07-01

    The approach to the assessment of proliferation risk using the methods of multi-criteria decision making and multi-objective optimization is presented. The approach allows the taking into account of the specifics features of the national nuclear infrastructure, and possible proliferation strategies (motivations, intentions, and capabilities). 3 examples of applying the approach are shown. First, the approach has been used to evaluate the attractiveness of HEU (high enriched uranium)production scenarios at a clandestine enrichment facility using centrifuge enrichment technology. Secondly, the approach has been applied to assess the attractiveness of scenarios for undeclared production of plutonium or HEU by theft of materialsmore » circulating in nuclear fuel cycle facilities and thermal reactors. Thirdly, the approach has been used to perform a comparative analysis of the structures of developing nuclear power systems based on different types of nuclear fuel cycles, the analysis being based on indicators of proliferation risk.« less

  14. Automation of GIS-based population data-collection for transportation risk analysis

    DOT National Transportation Integrated Search

    1999-11-01

    Estimation of the potential radiological risks associated with highway transport of radioactive : materials (RAM) requires input data describing population densities adjacent to all portions of : the route to be traveled. Previously, aggregated risks...

  15. Haloacetic acids in drinking water and risk for stillbirth

    PubMed Central

    King, W; Dodds, L; Allen, A; Armson, B; Fell, D; Nimrod, C

    2005-01-01

    Aims: To investigate the effects of haloacetic acid (HAA) compounds in drinking water on stillbirth risk. Methods: A population based case-control study was conducted in Nova Scotia and Eastern Ontario, Canada. Estimates of daily exposure to total and specific HAAs were based on household water samples and questionnaire information on water consumption at home and work. Results: The analysis included 112 stillbirth cases and 398 live birth controls. In analysis without adjustment for total THM exposure, a relative risk greater than 2 was observed for an intermediate exposure category for total HAA and dichloroacetic acid measures. After adjustment for total THM exposure, the risk estimates for intermediate exposure categories were diminished, the relative risk associated with the highest category was in the direction of a protective effect, and all confidence intervals included the null value. Conclusions: No association was observed between HAA exposures and stillbirth risk after controlling for THM exposures. PMID:15657195

  16. Work-related musculoskeletal disorders (WMDs) risk assessment at core assembly production of electronic components manufacturing company

    NASA Astrophysics Data System (ADS)

    Yahya, N. M.; Zahid, M. N. O.

    2018-03-01

    This study conducted to assess the work-related musculoskeletal disorders (WMDs) among the workers at core assembly production in an electronic components manufacturing company located in Pekan, Pahang, Malaysia. The study is to identify the WMDs risk factor and risk level. A set of questionnaires survey based on modified Nordic Musculoskeletal Disorder Questionnaires have been distributed to respective workers to acquire the WMDs risk factor identification. Then, postural analysis was conducted in order to measure the respective WMDs risk level. The analysis were based on two ergonomics assessment tools; Rapid Upper Limb Assessment (RULA) and Rapid Entire Body Assessment (REBA). The study found that 30 respondents out of 36 respondents suffered from WMDs especially at shoulder, wrists and lower back. The WMDs risk have been identified from unloading process, pressing process and winding process. In term of the WMDs risk level, REBA and RULA assessment tools have indicated high risk level to unloading and pressing process. Thus, this study had established the WMDs risk factor and risk level of core assembly production in an electronic components manufacturing company at Malaysia environment.

  17. Modeling Finite-Time Failure Probabilities in Risk Analysis Applications.

    PubMed

    Dimitrova, Dimitrina S; Kaishev, Vladimir K; Zhao, Shouqi

    2015-10-01

    In this article, we introduce a framework for analyzing the risk of systems failure based on estimating the failure probability. The latter is defined as the probability that a certain risk process, characterizing the operations of a system, reaches a possibly time-dependent critical risk level within a finite-time interval. Under general assumptions, we define two dually connected models for the risk process and derive explicit expressions for the failure probability and also the joint probability of the time of the occurrence of failure and the excess of the risk process over the risk level. We illustrate how these probabilistic models and results can be successfully applied in several important areas of risk analysis, among which are systems reliability, inventory management, flood control via dam management, infectious disease spread, and financial insolvency. Numerical illustrations are also presented. © 2015 Society for Risk Analysis.

  18. Towards a Fuzzy Bayesian Network Based Approach for Safety Risk Analysis of Tunnel-Induced Pipeline Damage.

    PubMed

    Zhang, Limao; Wu, Xianguo; Qin, Yawei; Skibniewski, Miroslaw J; Liu, Wenli

    2016-02-01

    Tunneling excavation is bound to produce significant disturbances to surrounding environments, and the tunnel-induced damage to adjacent underground buried pipelines is of considerable importance for geotechnical practice. A fuzzy Bayesian networks (FBNs) based approach for safety risk analysis is developed in this article with detailed step-by-step procedures, consisting of risk mechanism analysis, the FBN model establishment, fuzzification, FBN-based inference, defuzzification, and decision making. In accordance with the failure mechanism analysis, a tunnel-induced pipeline damage model is proposed to reveal the cause-effect relationships between the pipeline damage and its influential variables. In terms of the fuzzification process, an expert confidence indicator is proposed to reveal the reliability of the data when determining the fuzzy probability of occurrence of basic events, with both the judgment ability level and the subjectivity reliability level taken into account. By means of the fuzzy Bayesian inference, the approach proposed in this article is capable of calculating the probability distribution of potential safety risks and identifying the most likely potential causes of accidents under both prior knowledge and given evidence circumstances. A case concerning the safety analysis of underground buried pipelines adjacent to the construction of the Wuhan Yangtze River Tunnel is presented. The results demonstrate the feasibility of the proposed FBN approach and its application potential. The proposed approach can be used as a decision tool to provide support for safety assurance and management in tunnel construction, and thus increase the likelihood of a successful project in a complex project environment. © 2015 Society for Risk Analysis.

  19. Monitoring of human brain functions in risk decision-making task by diffuse optical tomography using voxel-wise general linear model

    NASA Astrophysics Data System (ADS)

    Lin, Zi-Jing; Li, Lin; Cazzell, Marry; Liu, Hanli

    2013-03-01

    Functional near-infrared spectroscopy (fNIRS) is a non-invasive imaging technique which measures the hemodynamic changes that reflect the brain activity. Diffuse optical tomography (DOT), a variant of fNIRS with multi-channel NIRS measurements, has demonstrated capability of three dimensional (3D) reconstructions of hemodynamic changes due to the brain activity. Conventional method of DOT image analysis to define the brain activation is based upon the paired t-test between two different states, such as resting-state versus task-state. However, it has limitation because the selection of activation and post-activation period is relatively subjective. General linear model (GLM) based analysis can overcome this limitation. In this study, we combine the 3D DOT image reconstruction with GLM-based analysis (i.e., voxel-wise GLM analysis) to investigate the brain activity that is associated with the risk-decision making process. Risk decision-making is an important cognitive process and thus is an essential topic in the field of neuroscience. The balloon analogue risk task (BART) is a valid experimental model and has been commonly used in behavioral measures to assess human risk taking action and tendency while facing risks. We have utilized the BART paradigm with a blocked design to investigate brain activations in the prefrontal and frontal cortical areas during decision-making. Voxel-wise GLM analysis was performed on 18human participants (10 males and 8females).In this work, we wish to demonstrate the feasibility of using voxel-wise GLM analysis to image and study cognitive functions in response to risk decision making by DOT. Results have shown significant changes in the dorsal lateral prefrontal cortex (DLPFC) during the active choice mode and a different hemodynamic pattern between genders, which are in good agreements with published literatures in functional magnetic resonance imaging (fMRI) and fNIRS studies.

  20. Occupational COPD and job exposure matrices: a systematic review and meta-analysis

    PubMed Central

    Sadhra, Steven; Kurmi, Om P; Sadhra, Sandeep S; Lam, Kin Bong Hubert; Ayres, Jon G

    2017-01-01

    Background The association between occupational exposure and COPD reported previously has mostly been derived from studies relying on self-reported exposure to vapors, gases, dust, or fumes (VGDF), which could be subjective and prone to biases. The aim of this study was to assess the strength of association between exposure and COPD from studies that derived exposure by job exposure matrices (JEMs). Methods A systematic search of JEM-based occupational COPD studies published between 1980 and 2015 was conducted in PubMed and EMBASE, followed by meta-analysis. Meta-analysis was performed using a random-effects model, with results presented as a pooled effect estimate with 95% confidence intervals (CIs). The quality of study (risk of bias and confounding) was assessed by 13 RTI questionnaires. Heterogeneity between studies and its possible sources were assessed by Egger test and meta-regression, respectively. Results In all, 61 studies were identified and 29 were included in the meta-analysis. Based on JEM-based studies, there was 22% (pooled odds ratio =1.22; 95% CI 1.18–1.27) increased risk of COPD among those exposed to airborne pollutants arising from occupation. Comparatively, higher risk estimates were obtained for general populations JEMs (based on expert consensus) than workplace-based JEM were derived using measured exposure data (1.26; 1.20–1.33 vs 1.14; 1.10–1.19). Higher risk estimates were also obtained for self-reported exposure to VGDF than JEMs-based exposure to VGDF (1.91; 1.72–2.13 vs 1.10; 1.06–1.24). Dusts, particularly biological dusts (1.33; 1.17–1.51), had the highest risk estimates for COPD. Although the majority of occupational COPD studies focus on dusty environments, no difference in risk estimates was found for the common forms of occupational airborne pollutants. Conclusion Our findings highlight the need to interpret previous studies with caution as self-reported exposure to VGDF may have overestimated the risk of occupational COPD. PMID:28260879

  1. Research on Risk Manage of Power Construction Project Based on Bayesian Network

    NASA Astrophysics Data System (ADS)

    Jia, Zhengyuan; Fan, Zhou; Li, Yong

    With China's changing economic structure and increasingly fierce competition in the market, the uncertainty and risk factors in the projects of electric power construction are increasingly complex, the projects will face huge risks or even fail if we don't consider or ignore these risk factors. Therefore, risk management in the projects of electric power construction plays an important role. The paper emphatically elaborated the influence of cost risk in electric power projects through study overall risk management and the behavior of individual in risk management, and introduced the Bayesian network to the project risk management. The paper obtained the order of key factors according to both scene analysis and causal analysis for effective risk management.

  2. Fuzzy-based failure mode and effect analysis (FMEA) of a hybrid molten carbonate fuel cell (MCFC) and gas turbine system for marine propulsion

    NASA Astrophysics Data System (ADS)

    Ahn, Junkeon; Noh, Yeelyong; Park, Sung Ho; Choi, Byung Il; Chang, Daejun

    2017-10-01

    This study proposes a fuzzy-based FMEA (failure mode and effect analysis) for a hybrid molten carbonate fuel cell and gas turbine system for liquefied hydrogen tankers. An FMEA-based regulatory framework is adopted to analyze the non-conventional propulsion system and to understand the risk picture of the system. Since the participants of the FMEA rely on their subjective and qualitative experiences, the conventional FMEA used for identifying failures that affect system performance inevitably involves inherent uncertainties. A fuzzy-based FMEA is introduced to express such uncertainties appropriately and to provide flexible access to a risk picture for a new system using fuzzy modeling. The hybrid system has 35 components and has 70 potential failure modes, respectively. Significant failure modes occur in the fuel cell stack and rotary machine. The fuzzy risk priority number is used to validate the crisp risk priority number in the FMEA.

  3. Background Information and User’s Guide for MIL-F-9490

    DTIC Science & Technology

    1975-01-01

    requirements, although different analysis results will apply to each requirement. Basic differences between the two realibility requirements are: MIL-F-8785B...provides the rationale for establishing such limits. The specific risk analysis comprises the same data which formed the average risk analysis , except...statistical analysis will be based on statistical data taken using limited exposure Limes of components and equipment. The exposure times and resulting

  4. Integrated Safety Risk Reduction Approach to Enhancing Human-Rated Spaceflight Safety

    NASA Astrophysics Data System (ADS)

    Mikula, J. F. Kip

    2005-12-01

    This paper explores and defines the current accepted concept and philosophy of safety improvement based on a Reliability enhancement (called here Reliability Enhancement Based Safety Theory [REBST]). In this theory a Reliability calculation is used as a measure of the safety achieved on the program. This calculation may be based on a math model or a Fault Tree Analysis (FTA) of the system, or on an Event Tree Analysis (ETA) of the system's operational mission sequence. In each case, the numbers used in this calculation are hardware failure rates gleaned from past similar programs. As part of this paper, a fictional but representative case study is provided that helps to illustrate the problems and inaccuracies of this approach to safety determination. Then a safety determination and enhancement approach based on hazard, worst case analysis, and safety risk determination (called here Worst Case Based Safety Theory [WCBST]) is included. This approach is defined and detailed using the same example case study as shown in the REBST case study. In the end it is concluded that an approach combining the two theories works best to reduce Safety Risk.

  5. 77 FR 22557 - Notice of Availability of a Pest Risk Analysis for the Importation of Strawberry Fruit From Egypt...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-04-16

    ... Importation of Strawberry Fruit From Egypt Into the Continental United States AGENCY: Animal and Plant Health... importation into the continental United States of fresh strawberry fruit from Egypt. Based on that analysis... importation of fresh strawberry fruit from Egypt. We are making the pest risk analysis available to the public...

  6. Computed tomography-based finite element analysis to assess fracture risk and osteoporosis treatment

    PubMed Central

    Imai, Kazuhiro

    2015-01-01

    Finite element analysis (FEA) is a computer technique of structural stress analysis and developed in engineering mechanics. FEA has developed to investigate structural behavior of human bones over the past 40 years. When the faster computers have acquired, better FEA, using 3-dimensional computed tomography (CT) has been developed. This CT-based finite element analysis (CT/FEA) has provided clinicians with useful data. In this review, the mechanism of CT/FEA, validation studies of CT/FEA to evaluate accuracy and reliability in human bones, and clinical application studies to assess fracture risk and effects of osteoporosis medication are overviewed. PMID:26309819

  7. Atlas-guided volumetric diffuse optical tomography enhanced by generalized linear model analysis to image risk decision-making responses in young adults.

    PubMed

    Lin, Zi-Jing; Li, Lin; Cazzell, Mary; Liu, Hanli

    2014-08-01

    Diffuse optical tomography (DOT) is a variant of functional near infrared spectroscopy and has the capability of mapping or reconstructing three dimensional (3D) hemodynamic changes due to brain activity. Common methods used in DOT image analysis to define brain activation have limitations because the selection of activation period is relatively subjective. General linear model (GLM)-based analysis can overcome this limitation. In this study, we combine the atlas-guided 3D DOT image reconstruction with GLM-based analysis (i.e., voxel-wise GLM analysis) to investigate the brain activity that is associated with risk decision-making processes. Risk decision-making is an important cognitive process and thus is an essential topic in the field of neuroscience. The Balloon Analog Risk Task (BART) is a valid experimental model and has been commonly used to assess human risk-taking actions and tendencies while facing risks. We have used the BART paradigm with a blocked design to investigate brain activations in the prefrontal and frontal cortical areas during decision-making from 37 human participants (22 males and 15 females). Voxel-wise GLM analysis was performed after a human brain atlas template and a depth compensation algorithm were combined to form atlas-guided DOT images. In this work, we wish to demonstrate the excellence of using voxel-wise GLM analysis with DOT to image and study cognitive functions in response to risk decision-making. Results have shown significant hemodynamic changes in the dorsal lateral prefrontal cortex (DLPFC) during the active-choice mode and a different activation pattern between genders; these findings correlate well with published literature in functional magnetic resonance imaging (fMRI) and fNIRS studies. Copyright © 2014 The Authors. Human Brain Mapping Published by Wiley Periodicals, Inc.

  8. Predictors of treatment dropout in self-guided web-based interventions for depression: an 'individual patient data' meta-analysis.

    PubMed

    Karyotaki, E; Kleiboer, A; Smit, F; Turner, D T; Pastor, A M; Andersson, G; Berger, T; Botella, C; Breton, J M; Carlbring, P; Christensen, H; de Graaf, E; Griffiths, K; Donker, T; Farrer, L; Huibers, M J H; Lenndin, J; Mackinnon, A; Meyer, B; Moritz, S; Riper, H; Spek, V; Vernmark, K; Cuijpers, P

    2015-10-01

    It is well known that web-based interventions can be effective treatments for depression. However, dropout rates in web-based interventions are typically high, especially in self-guided web-based interventions. Rigorous empirical evidence regarding factors influencing dropout in self-guided web-based interventions is lacking due to small study sample sizes. In this paper we examined predictors of dropout in an individual patient data meta-analysis to gain a better understanding of who may benefit from these interventions. A comprehensive literature search for all randomized controlled trials (RCTs) of psychotherapy for adults with depression from 2006 to January 2013 was conducted. Next, we approached authors to collect the primary data of the selected studies. Predictors of dropout, such as socio-demographic, clinical, and intervention characteristics were examined. Data from 2705 participants across ten RCTs of self-guided web-based interventions for depression were analysed. The multivariate analysis indicated that male gender [relative risk (RR) 1.08], lower educational level (primary education, RR 1.26) and co-morbid anxiety symptoms (RR 1.18) significantly increased the risk of dropping out, while for every additional 4 years of age, the risk of dropping out significantly decreased (RR 0.94). Dropout can be predicted by several variables and is not randomly distributed. This knowledge may inform tailoring of online self-help interventions to prevent dropout in identified groups at risk.

  9. Safety and Performance Analysis of the Non-Radar Oceanic/Remote Airspace In-Trail Procedure

    NASA Technical Reports Server (NTRS)

    Carreno, Victor A.; Munoz, Cesar A.

    2007-01-01

    This document presents a safety and performance analysis of the nominal case for the In-Trail Procedure (ITP) in a non-radar oceanic/remote airspace. The analysis estimates the risk of collision between the aircraft performing the ITP and a reference aircraft. The risk of collision is only estimated for the ITP maneuver and it is based on nominal operating conditions. The analysis does not consider human error, communication error conditions, or the normal risk of flight present in current operations. The hazards associated with human error and communication errors are evaluated in an Operational Hazards Analysis presented elsewhere.

  10. Assessment of NHTSA’s Report “Relationships Between Fatality Risk, Mass, and Footprint in Model Year 2004-2011 Passenger Cars and LTVs” (LBNL Phase 1)

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Wenzel, Tom P.

    In its 2012 report NHTSA simulated the effect four fleetwide mass reduction scenarios would have on the change in annual fatalities. NHTSA estimated that the most aggressive of these scenarios (reducing mass 5.2% in heavier light trucks and 2.6% in all other vehicles types except lighter cars) would result in a small reduction in societal fatalities. LBNL replicated the methodology NHTSA used to simulate six mass reduction scenarios, including the mass reductions recommended in the 2015 NRC committee report, and estimated in 2021 and 2025 by EPA in the TAR, using the updated data through 2012. The analysis indicates thatmore » the estimated x change in fatalities under each scenario based on the updated analysis is comparable to that in the 2012 analysis, but less beneficial or more detrimental than that in the 2016 analysis. For example, an across the board 100-lb reduction in mass would result in an estimated 157 additional annual fatalities based on the 2012 analysis, but would result in only an estimated 91 additional annual fatalities based on the 2016 analysis, and an additional 87 fatalities based on the current analysis. The mass reductions recommended by the 2015 NRC committee report6 would result in a 224 increase in annual fatalities in the 2012 analysis, a 344 decrease in annual fatalities in the 2016 analysis, and a 141 increase in fatalities in the current analysis. The mass reductions EPA estimated for 2025 in the TAR7 would result in a 203 decrease in fatalities based on the 2016 analysis, but an increase of 39 fatalities based on the current analysis. These results support NHTSA’s conclusion from its 2012 study that, when footprint is held fixed, “no judicious combination of mass reductions in the various classes of vehicles results in a statistically significant fatality increase and many potential combinations are safety-neutral as point estimates.”Like the previous NHTSA studies, this updated report concludes that the estimated effect of mass reduction while maintaining footprint on societal U.S. fatality risk is small, and not statistically significant at the 95% or 90% confidence level for all vehicle types based on the jack-knife method NHTSA used. This report also finds that the estimated effects of other control variables, such as vehicle type, specific safety technologies, and crash conditions such as whether the crash occurred at night, in a rural county, or on a high-speed road, on risk are much larger, in some cases two orders of magnitude larger, than the estimated effect of mass or footprint reduction on risk. Finally, this report shows that after accounting for the many vehicle, driver, and crash variables NHTSA used in its regression analyses, there remains a wide variation in risk by vehicle make and model, and this variation is unrelated to vehicle mass. Although the purpose of the NHTSA and LBNL reports is to estimate the effect of vehicle mass reduction on societal risk, this is not exactly what the regression models are estimating. Rather, they are estimating the recent historical relationship between mass and risk, after accounting for most measurable differences between vehicles, drivers, and crash times and locations. In essence, the regression models are comparing the risk of a 2600-lb Dodge Neon with that of a 2500-lb Honda Civic, after attempting to account for all other differences between the two vehicles. The models are not estimating the effect of literally removing 100 pounds from the Neon, leaving everything else unchanged. In addition, the analyses are based on the relationship of vehicle mass and footprint on risk for recent vehicle designs (model year 2004 to 2011). These relationships may or may not continue into the future as manufacturers utilize new vehicle designs and incorporate new technologies, such as more extensive use of strong lightweight materials and specific safety technologies. Therefore, throughout this report we use the phrase “the estimated effect of mass (or footprint) reduction on risk” as shorthand for “the estimated change in risk as a function of its relationship to mass (or footprint) for vehicle models of recent design.”« less

  11. Novel risk score of contrast-induced nephropathy after percutaneous coronary intervention.

    PubMed

    Ji, Ling; Su, XiaoFeng; Qin, Wei; Mi, XuHua; Liu, Fei; Tang, XiaoHong; Li, Zi; Yang, LiChuan

    2015-08-01

    Contrast-induced nephropathy (CIN) post-percutaneous coronary intervention (PCI) is a major cause of acute kidney injury. In this study, we established a comprehensive risk score model to assess risk of CIN after PCI procedure, which could be easily used in a clinical environment. A total of 805 PCI patients, divided into analysis cohort (70%) and validation cohort (30%), were enrolled retrospectively in this study. Risk factors for CIN were identified using univariate analysis and multivariate logistic regression in the analysis cohort. Risk score model was developed based on multiple regression coefficients. Sensitivity and specificity of the new risk score system was validated in the validation cohort. Comparisons between the new risk score model and previous reported models were applied. The incidence of post-PCI CIN in the analysis cohort (n = 565) was 12%. Considerably high CIN incidence (50%) was observed in patients with chronic kidney disease (CKD). Age >75, body mass index (BMI) >25, myoglobin level, cardiac function level, hypoalbuminaemia, history of chronic kidney disease (CKD), Intra-aortic balloon pump (IABP) and peripheral vascular disease (PVD) were identified as independent risk factors of post-PCI CIN. A novel risk score model was established using multivariate regression coefficients, which showed highest sensitivity and specificity (0.917, 95%CI 0.877-0.957) compared with previous models. A new post-PCI CIN risk score model was developed based on a retrospective study of 805 patients. Application of this model might be helpful to predict CIN in patients undergoing PCI procedure. © 2015 Asian Pacific Society of Nephrology.

  12. Using landslide risk analysis to protect fish habitat

    Treesearch

    R. M. Rice

    1986-01-01

    The protection of anadromous fish habitat is an important water quslity concern in the Pacific Northwest. Sediment from logging-related debris avalanches can cause habitat degradation. Research on conditions associated with the sites where debris avalanches originate has resulted in a risk assessment methodology based on linear discriminant analysis. The probability...

  13. Pitfalls and Precautions When Using Predicted Failure Data for Quantitative Analysis of Safety Risk for Human Rated Launch Vehicles

    NASA Technical Reports Server (NTRS)

    Hatfield, Glen S.; Hark, Frank; Stott, James

    2016-01-01

    Launch vehicle reliability analysis is largely dependent upon using predicted failure rates from data sources such as MIL-HDBK-217F. Reliability prediction methodologies based on component data do not take into account system integration risks such as those attributable to manufacturing and assembly. These sources often dominate component level risk. While consequence of failure is often understood, using predicted values in a risk model to estimate the probability of occurrence may underestimate the actual risk. Managers and decision makers use the probability of occurrence to influence the determination whether to accept the risk or require a design modification. The actual risk threshold for acceptance may not be fully understood due to the absence of system level test data or operational data. This paper will establish a method and approach to identify the pitfalls and precautions of accepting risk based solely upon predicted failure data. This approach will provide a set of guidelines that may be useful to arrive at a more realistic quantification of risk prior to acceptance by a program.

  14. Risk-Based Contaminated Land Investigation and Assessment

    NASA Astrophysics Data System (ADS)

    Davis, Donald R.

    With increasing frequency, problems of environmental contamination are being analyzed from a risk perspective. Risk-Based Contaminated Land Investigation and Assessment is written for those who wish to present the results of their examination of contaminated land in terms of risk.The opening chapters introduce the concepts of risk analysis for contaminated land. Risk management and the risk assessment process are based on a source-pathway-target framework. Readers are warned against an “over-reliance on the identification of contaminants rather than the potential pathways by which targets may be exposed to these hazards.” In the risk management framework presented in this book, risk evaluation and resultant decision making are seen as part of both the risk assessment and risk reduction process. The sharp separation of risk assessment from risk management as seen in the National Academy of Sciences' (NAS) risk assessment paradigm is not advocatedsemi; perhaps this is because the NAS' concern was regulatory decision while the book's concern is the assessment of a specific site.

  15. On some recent definitions and analysis frameworks for risk, vulnerability, and resilience.

    PubMed

    Aven, Terje

    2011-04-01

    Recently, considerable attention has been paid to a systems-based approach to risk, vulnerability, and resilience analysis. It is argued that risk, vulnerability, and resilience are inherently and fundamentally functions of the states of the system and its environment. Vulnerability is defined as the manifestation of the inherent states of the system that can be subjected to a natural hazard or be exploited to adversely affect that system, whereas resilience is defined as the ability of the system to withstand a major disruption within acceptable degradation parameters and to recover within an acceptable time, and composite costs, and risks. Risk, on the other hand, is probability based, defined by the probability and severity of adverse effects (i.e., the consequences). In this article, we look more closely into this approach. It is observed that the key concepts are inconsistent in the sense that the uncertainty (probability) dimension is included for the risk definition but not for vulnerability and resilience. In the article, we question the rationale for this inconsistency. The suggested approach is compared with an alternative framework that provides a logically defined structure for risk, vulnerability, and resilience, where all three concepts are incorporating the uncertainty (probability) dimension. © 2010 Society for Risk Analysis.

  16. Single-visit or multiple-visit root canal treatment: systematic review, meta-analysis and trial sequential analysis

    PubMed Central

    Schwendicke, Falk; Göstemeyer, Gerd

    2017-01-01

    Objectives Single-visit root canal treatment has some advantages over conventional multivisit treatment, but might increase the risk of complications. We systematically evaluated the risk of complications after single-visit or multiple-visit root canal treatment using meta-analysis and trial-sequential analysis. Data Controlled trials comparing single-visit versus multiple-visit root canal treatment of permanent teeth were included. Trials needed to assess the risk of long-term complications (pain, infection, new/persisting/increasing periapical lesions ≥1 year after treatment), short-term pain or flare-up (acute exacerbation of initiation or continuation of root canal treatment). Sources Electronic databases (PubMed, EMBASE, Cochrane Central) were screened, random-effects meta-analyses performed and trial-sequential analysis used to control for risk of random errors. Evidence was graded according to GRADE. Study selection 29 trials (4341 patients) were included, all but 6 showing high risk of bias. Based on 10 trials (1257 teeth), risk of complications was not significantly different in single-visit versus multiple-visit treatment (risk ratio (RR) 1.00 (95% CI 0.75 to 1.35); weak evidence). Based on 20 studies (3008 teeth), risk of pain did not significantly differ between treatments (RR 0.99 (95% CI 0.76 to 1.30); moderate evidence). Risk of flare-up was recorded by 8 studies (1110 teeth) and was significantly higher after single-visit versus multiple-visit treatment (RR 2.13 (95% CI 1.16 to 3.89); very weak evidence). Trial-sequential analysis revealed that firm evidence for benefit, harm or futility was not reached for any of the outcomes. Conclusions There is insufficient evidence to rule out whether important differences between both strategies exist. Clinical significance Dentists can provide root canal treatment in 1 or multiple visits. Given the possibly increased risk of flare-ups, multiple-visit treatment might be preferred for certain teeth (eg, those with periapical lesions). PMID:28148534

  17. Multi-hazard risk analysis for management strategies

    NASA Astrophysics Data System (ADS)

    Kappes, M.; Keiler, M.; Bell, R.; Glade, T.

    2009-04-01

    Risk management is very often operating in a reactive way, responding to an event, instead of proactive starting with risk analysis and building up the whole process of risk evaluation, prevention, event management and regeneration. Since damage and losses from natural hazards raise continuously more and more studies, concepts (e.g. Switzerland or South Tyrol-Bolozano) and software packages (e.g. ARMAGEDOM, HAZUS or RiskScape) are developed to guide, standardize and facilitate the risk analysis. But these approaches focus on different aspects and are mostly closely adapted to the situation (legislation, organization of the administration, specific processes etc.) of the specific country or region. We propose in this study the development of a flexible methodology for multi-hazard risk analysis, identifying the stakeholders and their needs, processes and their characteristics, modeling approaches as well as incoherencies occurring by combining all these different aspects. Based on this concept a flexible software package will be established consisting of ArcGIS as central base and being complemented by various modules for hazard modeling, vulnerability assessment and risk calculation. Not all modules will be developed newly but taken from the current state-of-the-art and connected or integrated into ArcGIS. For this purpose two study sites, Valtellina in Italy and Bacelonnette in France, were chosen and the hazards types debris flows, rockfalls, landslides, avalanches and floods are planned to be included in the tool for a regional multi-hazard risk analysis. Since the central idea of this tool is its flexibility this will only be a first step, in the future further processes and scales can be included and the instrument thus adapted to any study site.

  18. Risk of colorectal cancer in patients with ulcerative colitis: a meta-analysis of population-based cohort studies.

    PubMed

    Jess, Tine; Rungoe, Christine; Peyrin-Biroulet, Laurent

    2012-06-01

    Patients with ulcerative colitis (UC) have an increased risk of developing colorectal cancer (CRC). Studies examining the magnitude of this association have yielded conflicting results. We performed a meta-analysis of population-based cohort studies to determine the risk of CRC in patients with UC. We used MEDLINE, EMBASE, Cochrane, and CINAHL to perform a systematic literature search. We included 8 studies in the meta-analysis on the basis of strict inclusion and exclusion criteria. We calculated pooled standardized incidence ratios (SIRs) with 95% confidence intervals (CIs) for risk of CRC in patients with UC and performed meta-regression analyses of the effect of cohort size, calendar period, observation time, percentage with proctitis, and rates of colectomy on the risk of CRC. An average of 1.6% of patients with UC was diagnosed with CRC during 14 years of follow-up. SIRs ranged from 1.05 to 3.1, with a pooled SIR of 2.4 (95% CI, 2.1-2.7). Men with UC had a greater risk of CRC (SIR, 2.6; 95% CI, 2.2-3.0) than women (SIR, 1.9; 95% CI, 1.5-2.3). Young age was a risk factor for CRC (SIR, 8.6; 95% CI, 3.8-19.5; although this might have resulted from small numbers), as was extensive colitis (SIR, 4.8; 95% CI, 3.9-5.9). In meta-regression analyses, only cohort size was associated with risk of CRC. In population-based cohorts, UC increases the risk of CRC 2.4-fold. Male sex, young age at diagnosis with UC, and extensive colitis increase the risk. Copyright © 2012 AGA Institute. Published by Elsevier Inc. All rights reserved.

  19. Validation of a new mortality risk prediction model for people 65 years and older in northwest Russia: The Crystal risk score.

    PubMed

    Turusheva, Anna; Frolova, Elena; Bert, Vaes; Hegendoerfer, Eralda; Degryse, Jean-Marie

    2017-07-01

    Prediction models help to make decisions about further management in clinical practice. This study aims to develop a mortality risk score based on previously identified risk predictors and to perform internal and external validations. In a population-based prospective cohort study of 611 community-dwelling individuals aged 65+ in St. Petersburg (Russia), all-cause mortality risks over 2.5 years follow-up were determined based on the results obtained from anthropometry, medical history, physical performance tests, spirometry and laboratory tests. C-statistic, risk reclassification analysis, integrated discrimination improvement analysis, decision curves analysis, internal validation and external validation were performed. Older adults were at higher risk for mortality [HR (95%CI)=4.54 (3.73-5.52)] when two or more of the following components were present: poor physical performance, low muscle mass, poor lung function, and anemia. If anemia was combined with high C-reactive protein (CRP) and high B-type natriuretic peptide (BNP) was added the HR (95%CI) was slightly higher (5.81 (4.73-7.14)) even after adjusting for age, sex and comorbidities. Our models were validated in an external population of adults 80+. The extended model had a better predictive capacity for cardiovascular mortality [HR (95%CI)=5.05 (2.23-11.44)] compared to the baseline model [HR (95%CI)=2.17 (1.18-4.00)] in the external population. We developed and validated a new risk prediction score that may be used to identify older adults at higher risk for mortality in Russia. Additional studies need to determine which targeted interventions improve the outcomes of these at-risk individuals. Copyright © 2017 Elsevier B.V. All rights reserved.

  20. Do insurers respond to risk adjustment? A long-term, nationwide analysis from Switzerland.

    PubMed

    von Wyl, Viktor; Beck, Konstantin

    2016-03-01

    Community rating in social health insurance calls for risk adjustment in order to eliminate incentives for risk selection. Swiss risk adjustment is known to be insufficient, and substantial risk selection incentives remain. This study develops five indicators to monitor residual risk selection. Three indicators target activities of conglomerates of insurers (with the same ownership), which steer enrollees into specific carriers based on applicants' risk profiles. As a proxy for their market power, those indicators estimate the amount of premium-, health care cost-, and risk-adjustment transfer variability that is attributable to conglomerates. Two additional indicators, derived from linear regression, describe the amount of residual cost differences between insurers that are not covered by risk adjustment. All indicators measuring conglomerate-based risk selection activities showed increases between 1996 and 2009, paralleling the establishment of new conglomerates. At their maxima in 2009, the indicator values imply that 56% of the net risk adjustment volume, 34% of premium variability, and 51% cost variability in the market were attributable to conglomerates. From 2010 onwards, all indicators decreased, coinciding with a pre-announced risk adjustment reform implemented in 2012. Likewise, the regression-based indicators suggest that the volume and variance of residual cost differences between insurers that are not equaled out by risk adjustment have decreased markedly since 2009 as a result of the latest reform. Our analysis demonstrates that risk-selection, especially by conglomerates, is a real phenomenon in Switzerland. However, insurers seem to have reduced risk selection activities to optimize their losses and gains from the latest risk adjustment reform.

  1. An evaluation of Computational Fluid dynamics model for flood risk analysis

    NASA Astrophysics Data System (ADS)

    Di Francesco, Silvia; Biscarini, Chiara; Montesarchio, Valeria

    2014-05-01

    This work presents an analysis of the hydrological-hydraulic engineering requisites for Risk evaluation and efficient flood damage reduction plans. Most of the research efforts have been dedicated to the scientific and technical aspects of risk assessment, providing estimates of possible alternatives and of the risk associated. In the decision making process for mitigation plan, the contribute of scientist is crucial, due to the fact that Risk-Damage analysis is based on evaluation of flow field ,of Hydraulic Risk and on economical and societal considerations. The present paper will focus on the first part of process, the mathematical modelling of flood events which is the base for all further considerations. The evaluation of potential catastrophic damage consequent to a flood event and in particular to dam failure requires modelling of the flood with sufficient detail so to capture the spatial and temporal evolutions of the event, as well of the velocity field. Thus, the selection of an appropriate mathematical model to correctly simulate flood routing is an essential step. In this work we present the application of two 3D Computational fluid dynamics models to a synthetic and real case study in order to evaluate the correct evolution of flow field and the associated flood Risk . The first model is based on a opensource CFD platform called openFoam. Water flow is schematized with a classical continuum approach based on Navier-Stokes equation coupled with Volume of fluid (VOF) method to take in account the multiphase character of river bottom-water- air systems. The second model instead is based on the Lattice Boltzmann method, an innovative numerical fluid dynamics scheme based on Boltzmann's kinetic equation that represents the flow dynamics at the macroscopic level by incorporating a microscopic kinetic approach. Fluid is seen as composed by particles that can move and collide among them. Simulation results from both models are promising and congruent to experimental results available in literature, thought the LBM model requires less computational effort respect to the NS one.

  2. Planning to Execution Earned Value Risk Management Tool

    DTIC Science & Technology

    2015-09-01

    Experiments ............................................................24 b. Result Analysis ...31 B. STAKEHOLDER ANALYSIS .....................................................................33 C. OPERATIONAL-BASED SCENARIO...42 c. Simulation and Analysis Activity ............................................43 2. Project Management Phase

  3. Multiple Interacting Risk Factors: On Methods for Allocating Risk Factor Interactions.

    PubMed

    Price, Bertram; MacNicoll, Michael

    2015-05-01

    A persistent problem in health risk analysis where it is known that a disease may occur as a consequence of multiple risk factors with interactions is allocating the total risk of the disease among the individual risk factors. This problem, referred to here as risk apportionment, arises in various venues, including: (i) public health management, (ii) government programs for compensating injured individuals, and (iii) litigation. Two methods have been described in the risk analysis and epidemiology literature for allocating total risk among individual risk factors. One method uses weights to allocate interactions among the individual risk factors. The other method is based on risk accounting axioms and finding an optimal and unique allocation that satisfies the axioms using a procedure borrowed from game theory. Where relative risk or attributable risk is the risk measure, we find that the game-theory-determined allocation is the same as the allocation where risk factor interactions are apportioned to individual risk factors using equal weights. Therefore, the apportionment problem becomes one of selecting a meaningful set of weights for allocating interactions among the individual risk factors. Equal weights and weights proportional to the risks of the individual risk factors are discussed. © 2015 Society for Risk Analysis.

  4. Mean-deviation analysis in the theory of choice.

    PubMed

    Grechuk, Bogdan; Molyboha, Anton; Zabarankin, Michael

    2012-08-01

    Mean-deviation analysis, along with the existing theories of coherent risk measures and dual utility, is examined in the context of the theory of choice under uncertainty, which studies rational preference relations for random outcomes based on different sets of axioms such as transitivity, monotonicity, continuity, etc. An axiomatic foundation of the theory of coherent risk measures is obtained as a relaxation of the axioms of the dual utility theory, and a further relaxation of the axioms are shown to lead to the mean-deviation analysis. Paradoxes arising from the sets of axioms corresponding to these theories and their possible resolutions are discussed, and application of the mean-deviation analysis to optimal risk sharing and portfolio selection in the context of rational choice is considered. © 2012 Society for Risk Analysis.

  5. Risk Interfaces to Support Integrated Systems Analysis and Development

    NASA Technical Reports Server (NTRS)

    Mindock, Jennifer; Lumpkins, Sarah; Shelhamer, Mark; Anton, Wilma; Havenhill, Maria

    2016-01-01

    Objectives for systems analysis capability: Develop integrated understanding of how a complex human physiological-socio-technical mission system behaves in spaceflight. Why? Support development of integrated solutions that prevent unwanted outcomes (Implementable approaches to minimize mission resources(mass, power, crew time, etc.)); Support development of tools for autonomy (need for exploration) (Assess and maintain resilience -individuals, teams, integrated system). Output of this exercise: -Representation of interfaces based on Human System Risk Board (HSRB) Risk Summary information and simple status based on Human Research Roadmap; Consolidated HSRB information applied to support communication; Point-of-Departure for HRP Element planning; Ability to track and communicate status of collaborations. 4

  6. The integration methods of fuzzy fault mode and effect analysis and fault tree analysis for risk analysis of yogurt production

    NASA Astrophysics Data System (ADS)

    Aprilia, Ayu Rizky; Santoso, Imam; Ekasari, Dhita Murita

    2017-05-01

    Yogurt is a product based on milk, which has beneficial effects for health. The process for the production of yogurt is very susceptible to failure because it involves bacteria and fermentation. For an industry, the risks may cause harm and have a negative impact. In order for a product to be successful and profitable, it requires the analysis of risks that may occur during the production process. Risk analysis can identify the risks in detail and prevent as well as determine its handling, so that the risks can be minimized. Therefore, this study will analyze the risks of the production process with a case study in CV.XYZ. The method used in this research is the Fuzzy Failure Mode and Effect Analysis (fuzzy FMEA) and Fault Tree Analysis (FTA). The results showed that there are 6 risks from equipment variables, raw material variables, and process variables. Those risks include the critical risk, which is the risk of a lack of an aseptic process, more specifically if starter yogurt is damaged due to contamination by fungus or other bacteria and a lack of sanitation equipment. The results of quantitative analysis of FTA showed that the highest probability is the probability of the lack of an aseptic process, with a risk of 3.902%. The recommendations for improvement include establishing SOPs (Standard Operating Procedures), which include the process, workers, and environment, controlling the starter of yogurt and improving the production planning and sanitation equipment using hot water immersion.

  7. A novel scoring system for gastric cancer risk assessment based on the expression of three CLIP4 DNA methylation-associated genes

    PubMed Central

    Hu, Chenggong; Zhou, Yongfang; Liu, Chang; Kang, Yan

    2018-01-01

    Gastric cancer (GC) is the fifth most common cancer and the third leading cause of cancer-associated mortality worldwide. In the current study, comprehensive bioinformatic analyses were performed to develop a novel scoring system for GC risk assessment based on CAP-Gly domain containing linker protein family member 4 (CLIP4) DNA methylation status. Two GC datasets with methylation sequencing information and mRNA expression profiling were downloaded from the The Cancer Genome Atlas and Gene Expression Omnibus databases. Differentially expressed genes (DEGs) between the CLIP4 hypermethylation and CLIP4 hypomethylation groups were screened using the limma package in R 3.3.1, and survival analysis of these DEGs was performed using the survival package. A risk scoring system was established via regression factor-weighted gene expression based on linear combination to screen the most important genes associated with CLIP4 methylation and prognosis. Genes associated with high/low-risk value were selected using the limma package. Functional enrichment analysis of the top 500 DEGs that positively and negatively associated with risk values was performed using DAVID 6.8 online and the gene set enrichment analysis (GSEA) software. In total, 35 genes were identified to be that significantly associated with prognosis and CLIP4 DNA methylation, and three prognostic signature genes, claudin-11 (CLDN11), apolipoprotein D (APOD), and chordin like 1 (CHRDL1), were used to establish a risk assessment system. The prognostic scoring system exhibited efficiency in classifying patients with different prognoses, where the low-risk groups had significantly longer overall survival times than those in the high-risk groups. CLDN11, APOD and CHRDL1 exhibited reduced expression in the hypermethylation and low-risk groups compare with the hypomethylation and high-risk groups, respectively. Multivariate Cox analysis indicated that risk value could be used as an independent prognostic factor. In functional analysis, six functional gene ontology terms and five GSEA pathways were associated with CLDN11, APOD and CHRDL1. The results established the credibility of the scoring system in this study. Additionally, these three genes, which were significantly associated with CLIP4 DNA methylation and GC risk assessment, were identified as potential prognostic biomarkers. PMID:29901187

  8. An object-oriented approach to risk and reliability analysis : methodology and aviation safety applications.

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Dandini, Vincent John; Duran, Felicia Angelica; Wyss, Gregory Dane

    2003-09-01

    This article describes how features of event tree analysis and Monte Carlo-based discrete event simulation can be combined with concepts from object-oriented analysis to develop a new risk assessment methodology, with some of the best features of each. The resultant object-based event scenario tree (OBEST) methodology enables an analyst to rapidly construct realistic models for scenarios for which an a priori discovery of event ordering is either cumbersome or impossible. Each scenario produced by OBEST is automatically associated with a likelihood estimate because probabilistic branching is integral to the object model definition. The OBEST methodology is then applied to anmore » aviation safety problem that considers mechanisms by which an aircraft might become involved in a runway incursion incident. The resulting OBEST model demonstrates how a close link between human reliability analysis and probabilistic risk assessment methods can provide important insights into aviation safety phenomenology.« less

  9. Probabilistic Risk Assessment of Hydraulic Fracturing in Unconventional Reservoirs by Means of Fault Tree Analysis: An Initial Discussion

    NASA Astrophysics Data System (ADS)

    Rodak, C. M.; McHugh, R.; Wei, X.

    2016-12-01

    The development and combination of horizontal drilling and hydraulic fracturing has unlocked unconventional hydrocarbon reserves around the globe. These advances have triggered a number of concerns regarding aquifer contamination and over-exploitation, leading to scientific studies investigating potential risks posed by directional hydraulic fracturing activities. These studies, balanced with potential economic benefits of energy production, are a crucial source of information for communities considering the development of unconventional reservoirs. However, probabilistic quantification of the overall risk posed by hydraulic fracturing at the system level are rare. Here we present the concept of fault tree analysis to determine the overall probability of groundwater contamination or over-exploitation, broadly referred to as the probability of failure. The potential utility of fault tree analysis for the quantification and communication of risks is approached with a general application. However, the fault tree design is robust and can handle various combinations of regional-specific data pertaining to relevant spatial scales, geological conditions, and industry practices where available. All available data are grouped into quantity and quality-based impacts and sub-divided based on the stage of the hydraulic fracturing process in which the data is relevant as described by the USEPA. Each stage is broken down into the unique basic events required for failure; for example, to quantify the risk of an on-site spill we must consider the likelihood, magnitude, composition, and subsurface transport of the spill. The structure of the fault tree described above can be used to render a highly complex system of variables into a straightforward equation for risk calculation based on Boolean logic. This project shows the utility of fault tree analysis for the visual communication of the potential risks of hydraulic fracturing activities on groundwater resources.

  10. A Balanced Risk-Benefit Analysis to Determine Human Risks Associated with Pyrrolizidine Alkaloids (PA)-The Case of Tea and Herbal Infusions.

    PubMed

    Habs, Michael; Binder, Karin; Krauss, Stefan; Müller, Karolina; Ernst, Brigitte; Valentini, Luzia; Koller, Michael

    2017-07-07

    Humans are exposed to pyrrolizidine alkaloids (PA) through different sources, mainly from contaminated foodstuff. Teas and herbal infusions (T&HI) can be contaminated by PA producing weed. PA can possess toxic, mutagenic, genotoxic, and carcinogenic properties. Thus, possible health risks for the general population are under debate. There is a strong safety record for T&HI and additionally epidemiological evidence for the preventive effects of regular tea consumption on cardiovascular events and certain types of cancer. There is no epidemiological evidence, however, for human risks of regular low dose PA exposure. Recommended regulatory PA-threshold values are based on experimental data only, accepting big uncertainties. If a general risk exists through PA contaminated T&HI, it must be small compared to other frequently accepted risks of daily living and the proven health effects of T&HI. Decision making should be based on a balanced riskbenefit analysis. Based on analyses of the scientific data currently available, it is concluded that the benefits of drinking T&HI clearly outweigh the negligible health risk of possible PA contamination. At the same time, manufacturers must continue their efforts to secure good product quality and to be transparent on their measures of quality control and risk communication.

  11. Knowledge and perceived implementation of food safety risk analysis framework in Latin America and the Caribbean region.

    PubMed

    Cherry, C; Mohr, A Hofelich; Lindsay, T; Diez-Gonzalez, F; Hueston, W; Sampedro, F

    2014-12-01

    Risk analysis is increasingly promoted as a tool to support science-based decisions regarding food safety. An online survey comprising 45 questions was used to gather information on the implementation of food safety risk analysis within the Latin American and Caribbean regions. Professionals working in food safety in academia, government, and private sectors in Latin American and Caribbean countries were contacted by email and surveyed to assess their individual knowledge of risk analysis and perceptions of its implementation in the region. From a total of 279 participants, 97% reported a familiarity with risk analysis concepts; however, fewer than 25% were able to correctly identify its key principles. The reported implementation of risk analysis among the different professional sectors was relatively low (46%). Participants from industries in countries with a long history of trade with the United States and the European Union, such as Mexico, Brazil, and Chile, reported perceptions of a higher degree of risk analysis implementation (56, 50, and 20%, respectively) than those from the rest of the countries, suggesting that commerce may be a driver for achieving higher food safety standards. Disagreement among respondents on the extent of the use of risk analysis in national food safety regulations was common, illustrating a systematic lack of understanding of the current regulatory status of the country. The results of this survey can be used to target further risk analysis training on selected sectors and countries.

  12. Risk assessment of water pollution sources based on an integrated k-means clustering and set pair analysis method in the region of Shiyan, China.

    PubMed

    Li, Chunhui; Sun, Lian; Jia, Junxiang; Cai, Yanpeng; Wang, Xuan

    2016-07-01

    Source water areas are facing many potential water pollution risks. Risk assessment is an effective method to evaluate such risks. In this paper an integrated model based on k-means clustering analysis and set pair analysis was established aiming at evaluating the risks associated with water pollution in source water areas, in which the weights of indicators were determined through the entropy weight method. Then the proposed model was applied to assess water pollution risks in the region of Shiyan in which China's key source water area Danjiangkou Reservoir for the water source of the middle route of South-to-North Water Diversion Project is located. The results showed that eleven sources with relative high risk value were identified. At the regional scale, Shiyan City and Danjiangkou City would have a high risk value in term of the industrial discharge. Comparatively, Danjiangkou City and Yunxian County would have a high risk value in terms of agricultural pollution. Overall, the risk values of north regions close to the main stream and reservoir of the region of Shiyan were higher than that in the south. The results of risk level indicated that five sources were in lower risk level (i.e., level II), two in moderate risk level (i.e., level III), one in higher risk level (i.e., level IV) and three in highest risk level (i.e., level V). Also risks of industrial discharge are higher than that of the agricultural sector. It is thus essential to manage the pillar industry of the region of Shiyan and certain agricultural companies in the vicinity of the reservoir to reduce water pollution risks of source water areas. Copyright © 2016 Elsevier B.V. All rights reserved.

  13. Benefit-Risk Analysis for Decision-Making: An Approach.

    PubMed

    Raju, G K; Gurumurthi, K; Domike, R

    2016-12-01

    The analysis of benefit and risk is an important aspect of decision-making throughout the drug lifecycle. In this work, the use of a benefit-risk analysis approach to support decision-making was explored. The proposed approach builds on the qualitative US Food and Drug Administration (FDA) approach to include a more explicit analysis based on international standards and guidance that enables aggregation and comparison of benefit and risk on a common basis and a lifecycle focus. The approach is demonstrated on six decisions over the lifecycle (e.g., accelerated approval, withdrawal, and traditional approval) using two case studies: natalizumab for multiple sclerosis (MS) and bedaquiline for multidrug-resistant tuberculosis (MDR-TB). © 2016 American Society for Clinical Pharmacology and Therapeutics.

  14. Subgroups of Dutch homeless young adults based on risk- and protective factors for quality of life: Results of a latent class analysis.

    PubMed

    Altena, Astrid M; Beijersbergen, Mariëlle D; Vermunt, Jeroen K; Wolf, Judith R L M

    2018-04-17

    It is important to gain more insight into specific subgroups of homeless young adults (HYA) to enable the development of tailored interventions that adequately meet their diverse needs and to improve their quality of life. Within a heterogeneous sample of HYA, we investigated whether subgroups are distinguishable based on risk- and protective factors for quality of life. In addition, differences between subgroups were examined regarding the socio-demographic characteristics, the use of cognitive coping strategies and quality of life. A total of 393 HYA using shelter facilities in the Netherlands were approached to participate, between December 2011 and March 2013. Structured face-to-face interviews were administered approximately 2 weeks after shelter admission by trained research assistants. A latent class analysis was conducted to empirically distinguish 251 HYA in subgroups based on common risk factors (former abuse, victimisation, psychological symptoms and substance use) and protective factors (resilience, family and social support and perceived health status). Additional analysis of variance and chi-square tests were used to compare subgroups on socio-demographic characteristics, the use of cognitive coping strategies and quality of life. The latent class analysis yielded four highly interpretable subgroups: the at-risk subgroup, the high-risk and least protected subgroup, the low-risk subgroup and the higher functioning and protected subgroup. Subgroups of HYA with lower scores in risk factors showed higher scores in protective factors, the adaptive cognitive coping strategies and quality of life. Our findings confirm the need for targeted and tailored interventions for specific subgroups of HYA. Social workers need to be attentive to the pattern of risk- and protective factors in each individual to determine which risk factors are prominent and need to be targeted and which protective factors need to be enhanced to improve the quality of life of HYA. © 2018 John Wiley & Sons Ltd.

  15. WHY DO YOU NEED TO USE A CARIES RISK ASSESSMENT PROTOCOL TO PROVIDE AN EFFECTIVE CARIES PREVENTIVE REGIME?

    PubMed

    Afuakwah, Charles; Welbury, Richard

    2015-11-01

    Clinical guidelines recommend an individual is given a caries risk status based on analysis of defined clinical and social criteria before implementing a tailored preventive plan. Improve documentation of caries risk assessment (CRA) in a general dental practice setting, using a systems-based approach to quality improvement methods. Investigate the impact of quality improvement efforts on subsequent design and delivery of preventive care. Identify barriers to delivery of CRA and provision of preventive care. Data for patients aged 0-16 years was collected over two cycles using standard audit methodology. The first cycle was a retrospective analysis (n = 400) using random sampling. The second cycle a prospective analysis (n = 513) using consecutive sampling over a 15-week period. Five staff meetings with feedback occurred between cycles. In cycle one, no specific CRA system was identified. CRA status was not stated widely, risk factors were not analysed and there was variation with respect to the prescription and delivery of preventive strategies. These discrepancies were demonstrable for all four participating dentists and at all ages. In cycle two, 100% recorded CRA. All risk factors were analysed and individual caries risk was correctly annotated. There was 100% compliance with the protocol for preventive plans. The use of CRA improved documentation of caries risk status. This has improved subsequent prescription of age specific evidence-based preventive care appropriate to the risk status of that individual. Barriers were identified to the delivery of CRA and the provision of comprehensive preventive care by the dentists and other healthcare professionals.

  16. A Vulnerability-Based, Bottom-up Assessment of Future Riverine Flood Risk Using a Modified Peaks-Over-Threshold Approach and a Physically Based Hydrologic Model

    NASA Astrophysics Data System (ADS)

    Knighton, James; Steinschneider, Scott; Walter, M. Todd

    2017-12-01

    There is a chronic disconnection among purely probabilistic flood frequency analysis of flood hazards, flood risks, and hydrological flood mechanisms, which hamper our ability to assess future flood impacts. We present a vulnerability-based approach to estimating riverine flood risk that accommodates a more direct linkage between decision-relevant metrics of risk and the dominant mechanisms that cause riverine flooding. We adapt the conventional peaks-over-threshold (POT) framework to be used with extreme precipitation from different climate processes and rainfall-runoff-based model output. We quantify the probability that at least one adverse hydrologic threshold, potentially defined by stakeholders, will be exceeded within the next N years. This approach allows us to consider flood risk as the summation of risk from separate atmospheric mechanisms, and supports a more direct mapping between hazards and societal outcomes. We perform this analysis within a bottom-up framework to consider the relevance and consequences of information, with varying levels of credibility, on changes to atmospheric patterns driving extreme precipitation events. We demonstrate our proposed approach using a case study for Fall Creek in Ithaca, NY, USA, where we estimate the risk of stakeholder-defined flood metrics from three dominant mechanisms: summer convection, tropical cyclones, and spring rain and snowmelt. Using downscaled climate projections, we determine how flood risk associated with a subset of mechanisms may change in the future, and the resultant shift to annual flood risk. The flood risk approach we propose can provide powerful new insights into future flood threats.

  17. NASA Applications and Lessons Learned in Reliability Engineering

    NASA Technical Reports Server (NTRS)

    Safie, Fayssal M.; Fuller, Raymond P.

    2011-01-01

    Since the Shuttle Challenger accident in 1986, communities across NASA have been developing and extensively using quantitative reliability and risk assessment methods in their decision making process. This paper discusses several reliability engineering applications that NASA has used over the year to support the design, development, and operation of critical space flight hardware. Specifically, the paper discusses several reliability engineering applications used by NASA in areas such as risk management, inspection policies, components upgrades, reliability growth, integrated failure analysis, and physics based probabilistic engineering analysis. In each of these areas, the paper provides a brief discussion of a case study to demonstrate the value added and the criticality of reliability engineering in supporting NASA project and program decisions to fly safely. Examples of these case studies discussed are reliability based life limit extension of Shuttle Space Main Engine (SSME) hardware, Reliability based inspection policies for Auxiliary Power Unit (APU) turbine disc, probabilistic structural engineering analysis for reliability prediction of the SSME alternate turbo-pump development, impact of ET foam reliability on the Space Shuttle System risk, and reliability based Space Shuttle upgrade for safety. Special attention is given in this paper to the physics based probabilistic engineering analysis applications and their critical role in evaluating the reliability of NASA development hardware including their potential use in a research and technology development environment.

  18. Co-occurrence of behavioral risk factors of common non-communicable diseases among urban slum dwellers in Nairobi, Kenya.

    PubMed

    Haregu, Tilahun Nigatu; Oti, Samuel; Egondi, Thaddaeus; Kyobutungi, Catherine

    2015-01-01

    The four common non-communicable diseases (NCDs) account for 80% of NCD-related deaths worldwide. The four NCDs share four common risk factors. As most of the existing evidence on the common NCD risk factors is based on analysis of a single factor at a time, there is a need to investigate the co-occurrence of the common NCD risk factors, particularly in an urban slum setting in sub-Saharan Africa. To determine the prevalence of co-occurrence of the four common NCDs risk factors among urban slum dwellers in Nairobi, Kenya. This analysis was based on the data collected as part of a cross-sectional survey to assess linkages among socio-economic status, perceived personal risk, and risk factors for cardiovascular and NCDs in a population of slum dwellers in Nairobi, Kenya, in 2008-2009. A total of 5,190 study subjects were included in the analysis. After selecting relevant variables for common NCD risk factors, we computed the prevalence of all possible combinations of the four common NCD risk factors. The analysis was disaggregated by relevant background variables. The weighted prevalences of unhealthy diet, insufficient physical activity, harmful use of alcohol, and tobacco use were found to be 57.2, 14.4, 10.1, and 12.4%, respectively. Nearly 72% of the study participants had at least one of the four NCD risk factors. About 52% of the study population had any one of the four NCD risk factors. About one-fifth (19.8%) had co-occurrence of NCD risk factors. Close to one in six individuals (17.6%) had two NCD risk factors, while only 2.2% had three or four NCD risk factors. One out of five of people in the urban slum settings of Nairobi had co-occurrence of NCD risk factors. Both comprehensive and differentiated approaches are needed for effective NCD prevention and control in these settings.

  19. Towards Risk Based Design for NASA's Missions

    NASA Technical Reports Server (NTRS)

    Tumer, Irem Y.; Barrientos, Francesca; Meshkat, Leila

    2004-01-01

    This paper describes the concept of Risk Based Design in the context of NASA s low volume, high cost missions. The concept of accounting for risk in the design lifecycle has been discussed and proposed under several research topics, including reliability, risk analysis, optimization, uncertainty, decision-based design, and robust design. This work aims to identify and develop methods to enable and automate a means to characterize and optimize risk, and use risk as a tradeable resource to make robust and reliable decisions, in the context of the uncertain and ambiguous stage of early conceptual design. This paper first presents a survey of the related topics explored in the design research community as they relate to risk based design. Then, a summary of the topics from the NASA-led Risk Colloquium is presented, followed by current efforts within NASA to account for risk in early design. Finally, a list of "risk elements", identified for early-phase conceptual design at NASA, is presented. The purpose is to lay the foundation and develop a roadmap for future work and collaborations for research to eliminate and mitigate these risk elements in early phase design.

  20. Flood risk analysis for flood control and sediment transportation: a case study in the catchments of the Loess Plateau, China

    NASA Astrophysics Data System (ADS)

    Wang, Y.; Chang, J.; Guo, A.

    2017-12-01

    Traditional flood risk analysis focuses on the probability of flood events exceeding the design flood of downstream hydraulic structures while neglecting the influence of sedimentation in river channels on flood control systems. Given this focus, a univariate and copula-based bivariate hydrological risk framework focusing on flood control and sediment transport is proposed in the current work. Additionally, the conditional probabilities of occurrence of different flood events under various extreme precipitation scenarios are estimated by exploiting the copula model. Moreover, a Monte Carlo-based algorithm is used to evaluate the uncertainties of univariate and bivariate hydrological risk. Two catchments located on the Loess plateau are selected as study regions: the upper catchments of the Xianyang and Huaxian stations (denoted as UCX and UCH, respectively). The results indicate that (1) 2-day and 3-day consecutive rainfall are highly correlated with the annual maximum flood discharge (AMF) in UCX and UCH, respectively; and (2) univariate and bivariate return periods, risk and reliability for the purposes of flood control and sediment transport are successfully estimated. Sedimentation triggers higher risks of damaging the safety of local flood control systems compared with the AMF, exceeding the design flood of downstream hydraulic structures in the UCX and UCH. Most importantly, there was considerable sampling uncertainty in the univariate and bivariate hydrologic risk analysis, which would greatly challenge measures of future flood mitigation. The proposed hydrological risk framework offers a promising technical reference for flood risk analysis in sandy regions worldwide.

  1. Outpatient management of febrile neutropenia: time to revise the present treatment strategy.

    PubMed

    Carstensen, Mads; Sørensen, Jens Benn

    2008-01-01

    We reviewed medical literature on the efficacy and safety of outpatient versus hospital-based therapy of low-risk febrile neutropenia in adult cancer patients. A PubMed search for all studies evaluating the outpatient treatment of adults diagnosed with solid tumors who suffered from low-risk febrile neutropenia was completed; reference lists from identified articles also were used. In all, 10 trials were included in the analysis, which showed no significant difference in clinical failure rates and mortality for ambulatory regimens and standard hospital-based therapy. Subgroup analysis according to the type of fever episode showed no significant differences in clinical failure rates for fever of unknown origin and fever due to documented infections. Subgroup analyses in two independent trials identified an absolute neutrophil count < 100 cells/ mm3 as being predictive of outpatient treatment failure (P < 0.04). These findings need to be confirmed by further trials. Thus, outpatient management of adult cancer patients with low-risk febrile neutropenia is safe, effective, and comparable to standard hospital-based therapy. Patients at low risk are outpatients and are hemodynamically stable; they have no organ failure, they are able to take oral medications, and they do not suffer from acute leukemia. Low-risk prediction also may be based on the Multinational Association for Supportive Care in Cancer risk index.

  2. A Risk-based Assessment And Management Framework For Multipollutant Air Quality

    PubMed Central

    Frey, H. Christopher; Hubbell, Bryan

    2010-01-01

    The National Research Council recommended both a risk- and performance-based multipollutant approach to air quality management. Specifically, management decisions should be based on minimizing the exposure to, and risk of adverse effects from, multiple sources of air pollution and that the success of these decisions should be measured by how well they achieved this objective. We briefly describe risk analysis and its application within the current approach to air quality management. Recommendations are made as to how current practice could evolve to support a fully risk- and performance-based multipollutant air quality management system. The ability to implement a risk assessment framework in a credible and policy-relevant manner depends on the availability of component models and data which are scientifically sound and developed with an understanding of their application in integrated assessments. The same can be said about accountability assessments used to evaluate the outcomes of decisions made using such frameworks. The existing risk analysis framework, although typically applied to individual pollutants, is conceptually well suited for analyzing multipollutant management actions. Many elements of this framework, such as emissions and air quality modeling, already exist with multipollutant characteristics. However, the framework needs to be supported with information on exposure and concentration response relationships that result from multipollutant health studies. Because the causal chain that links management actions to emission reductions, air quality improvements, exposure reductions and health outcomes is parallel between prospective risk analyses and retrospective accountability assessments, both types of assessment should be placed within a single framework with common metrics and indicators where possible. Improvements in risk reductions can be obtained by adopting a multipollutant risk analysis framework within the current air quality management system, e.g. focused on standards for individual pollutants and with separate goals for air toxics and ambient pollutants. However, additional improvements may be possible if goals and actions are defined in terms of risk metrics that are comparable across criteria pollutants and air toxics (hazardous air pollutants), and that encompass both human health and ecological risks. PMID:21209847

  3. Study Of The Risks Arising From Natural Disasters And Hazards On Urban And Intercity Motorways By Using Failure Mode Effect Analysis (FMEA) Methods

    NASA Astrophysics Data System (ADS)

    DELİCE, Yavuz

    2015-04-01

    Highways, Located in the city and intercity locations are generally prone to many kind of natural disaster risks. Natural hazards and disasters that may occur firstly from highway project making to construction and operation stages and later during the implementation of highway maintenance and repair stages have to be taken into consideration. And assessment of risks that may occur against adverse situations is very important in terms of project design, construction, operation maintenance and repair costs. Making hazard and natural disaster risk analysis is largely depending on the definition of the likelihood of the probable hazards on the highways. However, assets at risk , and the impacts of the events must be examined and to be rated in their own. With the realization of these activities, intended improvements against natural hazards and disasters will be made with the utilization of Failure Mode Effects Analysis (FMEA) method and their effects will be analyzed with further works. FMEA, is a useful method to identify the failure mode and effects depending on the type of failure rate effects priorities and finding the most optimum economic and effective solution. Although relevant measures being taken for the identified risks by this analysis method , it may also provide some information for some public institutions about the nature of these risks when required. Thus, the necessary measures will have been taken in advance in the city and intercity highways. Many hazards and natural disasters are taken into account in risk assessments. The most important of these dangers can be listed as follows; • Natural disasters 1. Meteorological based natural disasters (floods, severe storms, tropical storms, winter storms, avalanches, etc.). 2. Geological based natural disasters (earthquakes, tsunamis, landslides, subsidence, sinkholes, etc) • Human originated disasters 1. Transport accidents (traffic accidents), originating from the road surface defects (icing, signaling caused malfunctions and risks), fire or explosion etc.- In this study, with FMEA method, risk analysis of the urban and intercity motorways against natural disasters and hazards have been performed and found solutions were brought against these risks. Keywords: Failure Modes Effects Analysis (FMEA), Pareto Analyses (PA), Highways, Risk Management.

  4. Analysis of risk factors for persistent infection of asymptomatic women with high-risk human papilloma virus.

    PubMed

    Shi, Nianmin; Lu, Qiang; Zhang, Jiao; Li, Li; Zhang, Junnan; Zhang, Fanglei; Dong, Yanhong; Zhang, Xinyue; Zhang, Zheng; Gao, Wenhui

    2017-06-03

    This study aims to prevent persistentinfection, reduce the incidence of cervical cancer, and improve women's health by understanding the theoretical basis of the risk factors for continuous infection of asymptomatic women with high-risk human papilloma virus (HPV) strains via information collected, which includes the persistent infection rate and the most prevalent HPV strain types of high risk to asymptomatic women in the high-risk area of cervical cancer in Linfen, Shanxi Province. Based on the method of cluster sampling, locations were chosen from the industrial county and agricultural county of Linfen, Shanxi Province, namely the Xiangfen and Quwo counties. Use of the convenience sampling (CS) method enables the identification of women who have sex but without symptoms of abnormal cervix for analyzing risk factors of HPV-DNA detection and performing a retrospective questionnaire survey in these 2 counties. Firstly, cervical exfoliated cell samples were collected for thin-layer liquid-based cytology test (TCT), and simultaneously testing high-risk type HPV DNA, then samples with positive testing results were retested to identify the infected HPV types. The 6-month period of testing was done to derive the 6-month persistent infection rate. The retrospective survey included concepts addressed in the questionnaire: basic situation of the research objects, menstrual history, marital status, pregnancy history, sexual habits and other aspects. The questionnaire was divided into a case group and a comparison group, which are based on the high-risk HPV-DNA testing result to ascertain whether or not there is persistent infection. Statistical analysis employed Epidate3.1 software for date entry, SPSS17.0 for date statistical analysis. Select statistic charts, Chi-Square Analysis, single-factor analysis and multivariate Logistic regression analysis to analyze the protective factors and risk factors of high-risk HPV infection. Risk factors are predicted by using the classification tree. 3000 women participated in the study. The high-risk type HPV infection rate was 8.7%, the persistent infection rate was 7.5%. The persistent infection rates for the 2 age groups (ages 18-26 and 27-30) were 6.9% and 8.7%. The persistent infection rates of Xiangfen county were 7.4% and 7.4% respectively, and those of Quwo county were 7.8% and 11.6% respectively; there was no significant difference between each pair of groups. Single risk-factor analysis showed that first-time sex at age under 20, high school/technical secondary school education or above, multiple sexual partners, having more than 2 sexual partners in the past 6 months, oral sex, and colitis are the risk factors of high-risk type HPV infection. Multivariate analysis showed that the number of sexual partners, smoking and oral sex had an effect on HPV infection. The risk of HPV infection from smoking was 5.0-fold higher, and the risk of HPV infection from oral sex was 6.1-fold higher. Having more than 2 sexual partners increase the risk of HPV infection. By the predicated model analysis, the probability of HPV conveyed by oral sex was 14.8%; if the sexual companion number was zero or more than 2 without oral sex, the probability of HPV infection was 12.1%; if there was one sexual partner who smokes without oral sex, the probability of infection was 18.6%; if there was one sexual partner who does not smoke and without oral sex, the probability of infection was 3.6%. The persistent infection rate of asymptomatic women for high-risk type HPV is lower than those women in all ages. High-risk type HPV infection risk factors include the number of sexual partners, oral sex and smoking. Thus, young women may be able to reduce the risk of infection with high-risk type HPV by reducing the number of sexual partners, forming a correct sexual life habit, and avoiding smoking.

  5. Threat Assessment and Remediation Analysis (TARA)

    DTIC Science & Technology

    2014-10-01

    of countermeasure selection strategies that prescribe the application of countermeasures based on level of risk tolerance. This paper outlines the...catalog data, which are discussed later in this paper . The methodology can be described as conjoined trade studies, where the first trade identifies and...ranks vulnerabilities based on assessed risk, and the second identifies and selects countermeasures based on assessed utility and cost. This paper

  6. Risk factors for Cryptosporidium infection in low and middle income countries: A systematic review and meta-analysis.

    PubMed

    Bouzid, Maha; Kintz, Erica; Hunter, Paul R

    2018-06-07

    Cryptosporidium infection causes gastrointestinal disease and has a worldwide distribution. The highest burden is in developing countries. We sought to conduct a systematic review and meta-analysis to identify Cryptosporidium risk factors in Low and Middle Income countries (LMICs). Medline Ovid and Scopus databases were searched with no restriction on year or language of publication. All references were screened independently in duplicate and were included if they presented data on at least 3 risk factors. Meta-analyses using random effects models were used to calculate overall estimates for each exposure. The most frequently reported risk factors in the 15 included studies were overcrowding, household diarrhoea, poor quality drinking water, animal contact, open defecation/ lack of toilet and breastfeeding. The combined odds ratio for animal contact was 1.98 (95%CI: 1.11-3.54) based on 11 studies and for diarrhoea in the household 1.98 (95%CI: 1.13-3.49) based on 4 studies. Open defecation was associated with a pooled odds ratio of 1.82 (95%CI: 1.19-2.8) based on 5 studies. Poor drinking water quality was not associated with a significant Cryptosporidium risk, odds ratio 1.06 (95%CI: 0.77-1.47). Breastfeeding was protective with pooled odds ratio 0.4 (95%CI: 0.13-1.22), which was not statistically significant. Based on the included studies, crowded living conditions, animal contact and open defecation are responsible for the majority of Cryptosporidium cases in LMICs. Future studies investigating Cryptosporidium risk factors should have a good study design and duration, include appropriate number of cases, select suitable controls, investigate multiple relevant risk factors, fully report data and perform multivariate analysis.

  7. Systematic Differences in HIV, Syphilis and Risk Behaviors among Street Based and Establishment Based Female Sex Workers in Kathmandu Valley of Nepal.

    PubMed

    Kakchapati, Sampurna; Paudel, Tarun; Maharjan, Manju; Lim, Apiradee

    2016-12-01

    Female Sex Workers (FSWs) are main drivers of the HIV epidemic in Nepal. The work environment of sex work in Nepal is differentiated into establishment based (e.g. massage parlors, dance restaurants, hotels and lodges) and street based (e.g. streets, parks and markets). The study compares HIV, syphilis and risk behaviours among establishment-based FSWs and street-based FSWs in Kathmandu Valley of Nepal. Cross-sectional bio-behavioral surveys in 2006, 2008, 2011 and 2015 aimed to sample 2093 FSWs using two stage cluster sampling in the Kathmandu valley. Statistical analysis used chi-squared tests and logistic regression models to assess differences of HIV, syphilis and risk behaviors among street-based FSWs and establishment-based FSWs. The study included 39.7% street-based FSWs and 60.3% establishment-based FSWs. The street-based FSWs had lower education levels, older age groups, separated, longer duration of sex work and inconsistent condom used with clients than establishment-based FSWs (p<0.05). Establishment-based FSWs were lower exposure to HIV intervention programs and pervasive alcohol consumption and use of drugs (p<0.05). The multivariate analysis showed that street-based FSWs were more likely of HIV test (aOR=1.25, 95%CI=1.04, 1.49), HIV (aOR=4.72, 95%CI=2.19, 10.15) and syphilis (aOR=7.96, 95%CI=3.49, 18.15) than establishment-based FSWs. Street-based FSWs possessed higher risk behaviour and have higher HIV and syphilis prevalence. HIV prevention interventions targeting FSWs should consider risks and vulnerability of street-based FSWs. .

  8. Systematic Differences in HIV, Syphilis and Risk Behaviors among Street Based and Establishment Based Female Sex Workers in Kathmandu Valley of Nepal

    PubMed Central

    Paudel, Tarun; Maharjan, Manju; Lim, Apiradee

    2016-01-01

    Background: Female Sex Workers (FSWs) are main drivers of the HIV epidemic in Nepal. The work environment of sex work in Nepal is differentiated into establishment based (e.g. massage parlors, dance restaurants, hotels and lodges) and street based (e.g. streets, parks and markets). The study compares HIV, syphilis and risk behaviours among establishment-based FSWs and street-based FSWs in Kathmandu Valley of Nepal. Materials and Methods: Cross-sectional bio-behavioral surveys in 2006, 2008, 2011 and 2015 aimed to sample 2093 FSWs using two stage cluster sampling in the Kathmandu valley. Statistical analysis used chi-squared tests and logistic regression models to assess differences of HIV, syphilis and risk behaviors among street-based FSWs and establishment-based FSWs. Results: The study included 39.7% street-based FSWs and 60.3% establishment-based FSWs. The street-based FSWs had lower education levels, older age groups, separated, longer duration of sex work and inconsistent condom used with clients than establishment-based FSWs (p<0.05). Establishment-based FSWs were lower exposure to HIV intervention programs and pervasive alcohol consumption and use of drugs (p<0.05). The multivariate analysis showed that street-based FSWs were more likely of HIV test (aOR=1.25, 95%CI=1.04, 1.49), HIV (aOR=4.72, 95%CI=2.19, 10.15) and syphilis (aOR=7.96, 95%CI=3.49, 18.15) than establishment-based FSWs. Conclusion: Street-based FSWs possessed higher risk behaviour and have higher HIV and syphilis prevalence. HIV prevention interventions targeting FSWs should consider risks and vulnerability of street-based FSWs. . PMID:28804674

  9. Study of the propensity for hemorrhage in Hispanic Americans with stroke.

    PubMed

    Frey, James L; Jahnke, Heidi K; Goslar, Pamela W

    2008-01-01

    Multiple sources document a higher proportion of intraparenchymal hemorrhage (HEM) in Hispanic (HIS) than white (WHI) patients with stroke. We sought an explanation for this phenomenon through analysis of multiple variables in our hospital-based stroke population. We performed univariate and multivariate analysis of risk factors in our HIS and WHI patients with stroke to identify differences that might account for a greater propensity for HEM in HIS patients. Multivariate analysis disclosed that the risk of HEM correlated significantly with untreated hypertension (HTN), HIS ethnicity, and heavy alcohol intake. A negative correlation was found for hyperlipidemia and diabetes. Our HIS patients with stroke had a greater prevalence of untreated HTN and heavy alcohol intake, with HIS men being at greatest risk. HIS patients with stroke in our hospital-based population appear relatively more prone to HEM than do WHI patients. This risk correlates with a greater likelihood of having untreated HTN and heavy alcohol intake, more so for HIS men. The explanation appears to be a relative lack of health awareness and involvement in our health care system. The possibility that HIS ethnicity itself constitutes a biological risk factor for HEM remains a matter of speculation. Validation of this work with community data should lead to remediation through a community-based effort.

  10. Analysis of indoor air pollutants checklist using environmetric technique for health risk assessment of sick building complaint in nonindustrial workplace

    PubMed Central

    Syazwan, AI; Rafee, B Mohd; Juahir, Hafizan; Azman, AZF; Nizar, AM; Izwyn, Z; Syahidatussyakirah, K; Muhaimin, AA; Yunos, MA Syafiq; Anita, AR; Hanafiah, J Muhamad; Shaharuddin, MS; Ibthisham, A Mohd; Hasmadi, I Mohd; Azhar, MN Mohamad; Azizan, HS; Zulfadhli, I; Othman, J; Rozalini, M; Kamarul, FT

    2012-01-01

    Purpose To analyze and characterize a multidisciplinary, integrated indoor air quality checklist for evaluating the health risk of building occupants in a nonindustrial workplace setting. Design A cross-sectional study based on a participatory occupational health program conducted by the National Institute of Occupational Safety and Health (Malaysia) and Universiti Putra Malaysia. Method A modified version of the indoor environmental checklist published by the Department of Occupational Health and Safety, based on the literature and discussion with occupational health and safety professionals, was used in the evaluation process. Summated scores were given according to the cluster analysis and principal component analysis in the characterization of risk. Environmetric techniques was used to classify the risk of variables in the checklist. Identification of the possible source of item pollutants was also evaluated from a semiquantitative approach. Result Hierarchical agglomerative cluster analysis resulted in the grouping of factorial components into three clusters (high complaint, moderate-high complaint, moderate complaint), which were further analyzed by discriminant analysis. From this, 15 major variables that influence indoor air quality were determined. Principal component analysis of each cluster revealed that the main factors influencing the high complaint group were fungal-related problems, chemical indoor dispersion, detergent, renovation, thermal comfort, and location of fresh air intake. The moderate-high complaint group showed significant high loading on ventilation, air filters, and smoking-related activities. The moderate complaint group showed high loading on dampness, odor, and thermal comfort. Conclusion This semiquantitative assessment, which graded risk from low to high based on the intensity of the problem, shows promising and reliable results. It should be used as an important tool in the preliminary assessment of indoor air quality and as a categorizing method for further IAQ investigations and complaints procedures. PMID:23055779

  11. Analysis of indoor air pollutants checklist using environmetric technique for health risk assessment of sick building complaint in nonindustrial workplace.

    PubMed

    Syazwan, Ai; Rafee, B Mohd; Juahir, Hafizan; Azman, Azf; Nizar, Am; Izwyn, Z; Syahidatussyakirah, K; Muhaimin, Aa; Yunos, Ma Syafiq; Anita, Ar; Hanafiah, J Muhamad; Shaharuddin, Ms; Ibthisham, A Mohd; Hasmadi, I Mohd; Azhar, Mn Mohamad; Azizan, Hs; Zulfadhli, I; Othman, J; Rozalini, M; Kamarul, Ft

    2012-01-01

    To analyze and characterize a multidisciplinary, integrated indoor air quality checklist for evaluating the health risk of building occupants in a nonindustrial workplace setting. A cross-sectional study based on a participatory occupational health program conducted by the National Institute of Occupational Safety and Health (Malaysia) and Universiti Putra Malaysia. A modified version of the indoor environmental checklist published by the Department of Occupational Health and Safety, based on the literature and discussion with occupational health and safety professionals, was used in the evaluation process. Summated scores were given according to the cluster analysis and principal component analysis in the characterization of risk. Environmetric techniques was used to classify the risk of variables in the checklist. Identification of the possible source of item pollutants was also evaluated from a semiquantitative approach. Hierarchical agglomerative cluster analysis resulted in the grouping of factorial components into three clusters (high complaint, moderate-high complaint, moderate complaint), which were further analyzed by discriminant analysis. From this, 15 major variables that influence indoor air quality were determined. Principal component analysis of each cluster revealed that the main factors influencing the high complaint group were fungal-related problems, chemical indoor dispersion, detergent, renovation, thermal comfort, and location of fresh air intake. The moderate-high complaint group showed significant high loading on ventilation, air filters, and smoking-related activities. The moderate complaint group showed high loading on dampness, odor, and thermal comfort. This semiquantitative assessment, which graded risk from low to high based on the intensity of the problem, shows promising and reliable results. It should be used as an important tool in the preliminary assessment of indoor air quality and as a categorizing method for further IAQ investigations and complaints procedures.

  12. A new multicriteria risk mapping approach based on a multiattribute frontier concept

    Treesearch

    Denys Yemshanov; Frank H. Koch; Yakov Ben-Haim; Marla Downing; Frank Sapio; Marty Siltanen

    2013-01-01

    Invasive species risk maps provide broad guidance on where to allocate resources for pest monitoring and regulation, but they often present individual risk components (such as climatic suitability, host abundance, or introduction potential) as independent entities. These independent risk components are integrated using various multicriteria analysis techniques that...

  13. Malaria Disease Mapping in Malaysia based on Besag-York-Mollie (BYM) Model

    NASA Astrophysics Data System (ADS)

    Azah Samat, Nor; Mey, Liew Wan

    2017-09-01

    Disease mapping is the visual representation of the geographical distribution which give an overview info about the incidence of disease within a population through spatial epidemiology data. Based on the result of map, it helps in monitoring and planning resource needs at all levels of health care and designing appropriate interventions, tailored towards areas that deserve closer scrutiny or communities that lead to further investigations to identify important risk factors. Therefore, the choice of statistical model used for relative risk estimation is important because production of disease risk map relies on the model used. This paper proposes Besag-York-Mollie (BYM) model to estimate the relative risk for Malaria in Malaysia. The analysis involved using the number of Malaria cases that obtained from the Ministry of Health Malaysia. The outcomes of analysis are displayed through graph and map, including Malaria disease risk map that constructed according to the estimation of relative risk. The distribution of high and low risk areas of Malaria disease occurrences for all states in Malaysia can be identified in the risk map.

  14. Fuzzy Risk Evaluation in Failure Mode and Effects Analysis Using a D Numbers Based Multi-Sensor Information Fusion Method.

    PubMed

    Deng, Xinyang; Jiang, Wen

    2017-09-12

    Failure mode and effect analysis (FMEA) is a useful tool to define, identify, and eliminate potential failures or errors so as to improve the reliability of systems, designs, and products. Risk evaluation is an important issue in FMEA to determine the risk priorities of failure modes. There are some shortcomings in the traditional risk priority number (RPN) approach for risk evaluation in FMEA, and fuzzy risk evaluation has become an important research direction that attracts increasing attention. In this paper, the fuzzy risk evaluation in FMEA is studied from a perspective of multi-sensor information fusion. By considering the non-exclusiveness between the evaluations of fuzzy linguistic variables to failure modes, a novel model called D numbers is used to model the non-exclusive fuzzy evaluations. A D numbers based multi-sensor information fusion method is proposed to establish a new model for fuzzy risk evaluation in FMEA. An illustrative example is provided and examined using the proposed model and other existing method to show the effectiveness of the proposed model.

  15. Fuzzy Risk Evaluation in Failure Mode and Effects Analysis Using a D Numbers Based Multi-Sensor Information Fusion Method

    PubMed Central

    Deng, Xinyang

    2017-01-01

    Failure mode and effect analysis (FMEA) is a useful tool to define, identify, and eliminate potential failures or errors so as to improve the reliability of systems, designs, and products. Risk evaluation is an important issue in FMEA to determine the risk priorities of failure modes. There are some shortcomings in the traditional risk priority number (RPN) approach for risk evaluation in FMEA, and fuzzy risk evaluation has become an important research direction that attracts increasing attention. In this paper, the fuzzy risk evaluation in FMEA is studied from a perspective of multi-sensor information fusion. By considering the non-exclusiveness between the evaluations of fuzzy linguistic variables to failure modes, a novel model called D numbers is used to model the non-exclusive fuzzy evaluations. A D numbers based multi-sensor information fusion method is proposed to establish a new model for fuzzy risk evaluation in FMEA. An illustrative example is provided and examined using the proposed model and other existing method to show the effectiveness of the proposed model. PMID:28895905

  16. History of having a macrosomic infant and the risk of diabetes: the Japan public health center-based prospective diabetes study.

    PubMed

    Kabeya, Yusuke; Goto, Atsushi; Kato, Masayuki; Takahashi, Yoshihiko; Matsushita, Yumi; Inoue, Manami; Mizoue, Tetsuya; Tsugane, Shoichiro; Kadowaki, Takashi; Noda, Mitsuhiko

    2013-01-01

    The aim of the present study was to test a hypothesis that a history of having a macrosomic infant (≥ 4000 g) is associated with the risk of diabetes. Data on the Japan Public Health Center-based Prospective diabetes cohort were analyzed, which is a population-based cohort study on diabetes. The survey of diabetes was performed at baseline and at the 5-year follow-up. A history of having a macrosomic infant was assessed using a self-administered questionnaire. A cross-sectional analysis was performed among 12,153 women who participated in the 5-year survey of the cohort. Logistic regression was used to examine the relationship between a history of having a macrosomic infant and the presence of diabetes. A longitudinal analysis was also conducted among 7,300 women without diabetes who participated in the baseline survey. Logistic regression was used to investigate the relationship between a history of having a macrosomic infant and the incidence of diabetes between the baseline survey and the 5-year survey. In the cross-sectional analysis, parous women with a positive history were more likely to have diabetes in relation to parous women without (OR = 1.44, 95% CI = 1.13-1.83). The longitudinal analysis showed a modest but non-significant increased risk of developing diabetes among women with a positive history (OR = 1.24, 95% CI = 0.80-1.94). An increased risk of diabetes was implied among women with a history of having a macrosomic infant although the longitudinal analysis showed a non-significant increased risk.

  17. Evaluation of Contamination Inspection and Analysis Methods through Modeling System Performance

    NASA Technical Reports Server (NTRS)

    Seasly, Elaine; Dever, Jason; Stuban, Steven M. F.

    2016-01-01

    Contamination is usually identified as a risk on the risk register for sensitive space systems hardware. Despite detailed, time-consuming, and costly contamination control efforts during assembly, integration, and test of space systems, contaminants are still found during visual inspections of hardware. Improved methods are needed to gather information during systems integration to catch potential contamination issues earlier and manage contamination risks better. This research explores evaluation of contamination inspection and analysis methods to determine optical system sensitivity to minimum detectable molecular contamination levels based on IEST-STD-CC1246E non-volatile residue (NVR) cleanliness levels. Potential future degradation of the system is modeled given chosen modules representative of optical elements in an optical system, minimum detectable molecular contamination levels for a chosen inspection and analysis method, and determining the effect of contamination on the system. By modeling system performance based on when molecular contamination is detected during systems integration and at what cleanliness level, the decision maker can perform trades amongst different inspection and analysis methods and determine if a planned method is adequate to meet system requirements and manage contamination risk.

  18. Utility of testing patients, on presentation, for serologic features of celiac disease.

    PubMed

    Srinivas, Melpakkam; Basumani, Pandurangan; Podmore, Geoff; Shrimpton, Anna; Bardhan, Karna Dev

    2014-06-01

    Celiac disease shares features of other disorders. It can be diagnosed conclusively only based on duodenal histology analysis, which is not practical for screening purposes. Serologic analysis might be used to identify candidates for biopsy analysis. We aimed to develop a simple diagnostic approach that all clinicians could follow to increase the percentage of patients accurately diagnosed with celiac disease at initial presentation. We performed a retrospective analysis of data from 752 patients (88 with celiac disease, none were IgA deficient) who attended a UK district general hospital from January 2007 through December 2008 and underwent biopsy analysis and serologic tests to measure endomyseal antibodies and IgA antibodies against tissue transglutaminase (tTG). Patients avoiding gluten in their diet were excluded. Patients were assigned to 1 of 4 groups: high-risk (based on presence of anemia, chronic diarrhea, unintentional weight loss, or dermatitis herpetiformis), low-risk (based on such factors as dyspepsia, abnormal liver function, ataxia, or chronic cough), nutrient deficiency (based on levels of iron, vitamins B12 and D, or folate), or screening (because they had type 1 diabetes or a family history of celiac disease). Patients with celiac disease were identified using the modified Marsh criteria (grades 1-3) for interpreting duodenal histology. We compared clinical category, serology profiles, and biopsy results between patients with and without celiac disease. Celiac disease was diagnosed in 64 of 565 patients in the high-risk group (11%), 14 of 156 patients in the low-risk group (9%; P = .47 compared with high-risk group), 7 of 28 patients in the nutrient-deficiency group, and 3 of 3 patients in the screening group. Among 71 patients who tested positive for both antibodies (tTG and endomyseal antibodies), the positive predictive value for celiac disease was 97%; a negative test result for tTG had a negative predictive value of 98%. Among 708 patients with normal-looking biopsy samples, only 62 had celiac disease (9%). Among 44 patients with abnormal biopsy samples, 26 had celiac disease (59%). Based on a retrospective analysis, patients with and without celiac disease cannot be distinguished based on clinical features. Patients who present with symptoms of celiac disease should be tested for tTG, to identify candidates for duodenal biopsy analysis. Copyright © 2014 AGA Institute. Published by Elsevier Inc. All rights reserved.

  19. Refining and validating a two-stage and web-based cancer risk assessment tool for village doctors in China.

    PubMed

    Shen, Xing-Rong; Chai, Jing; Feng, Rui; Liu, Tong-Zhu; Tong, Gui-Xian; Cheng, Jing; Li, Kai-Chun; Xie, Shao-Yu; Shi, Yong; Wang, De-Bin

    2014-01-01

    The big gap between efficacy of population level prevention and expectations due to heterogeneity and complexity of cancer etiologic factors calls for selective yet personalized interventions based on effective risk assessment. This paper documents our research protocol aimed at refining and validating a two-stage and web- based cancer risk assessment tool, from a tentative one in use by an ongoing project, capable of identifying individuals at elevated risk for one or more types of the 80% leading cancers in rural China with adequate sensitivity and specificity and featuring low cost, easy application and cultural and technical sensitivity for farmers and village doctors. The protocol adopted a modified population-based case control design using 72, 000 non-patients as controls, 2, 200 cancer patients as cases, and another 600 patients as cases for external validation. Factors taken into account comprised 8 domains including diet and nutrition, risk behaviors, family history, precancerous diseases, related medical procedures, exposure to environment hazards, mood and feelings, physical activities and anthropologic and biologic factors. Modeling stresses explored various methodologies like empirical analysis, logistic regression, neuro-network analysis, decision theory and both internal and external validation using concordance statistics, predictive values, etc..

  20. Risk analysis for autonomous underwater vehicle operations in extreme environments.

    PubMed

    Brito, Mario Paulo; Griffiths, Gwyn; Challenor, Peter

    2010-12-01

    Autonomous underwater vehicles (AUVs) are used increasingly to explore hazardous marine environments. Risk assessment for such complex systems is based on subjective judgment and expert knowledge as much as on hard statistics. Here, we describe the use of a risk management process tailored to AUV operations, the implementation of which requires the elicitation of expert judgment. We conducted a formal judgment elicitation process where eight world experts in AUV design and operation were asked to assign a probability of AUV loss given the emergence of each fault or incident from the vehicle's life history of 63 faults and incidents. After discussing methods of aggregation and analysis, we show how the aggregated risk estimates obtained from the expert judgments were used to create a risk model. To estimate AUV survival with mission distance, we adopted a statistical survival function based on the nonparametric Kaplan-Meier estimator. We present theoretical formulations for the estimator, its variance, and confidence limits. We also present a numerical example where the approach is applied to estimate the probability that the Autosub3 AUV would survive a set of missions under Pine Island Glacier, Antarctica in January-March 2009. © 2010 Society for Risk Analysis.

  1. Population heterogeneity in the salience of multiple risk factors for adolescent delinquency.

    PubMed

    Lanza, Stephanie T; Cooper, Brittany R; Bray, Bethany C

    2014-03-01

    To present mixture regression analysis as an alternative to more standard regression analysis for predicting adolescent delinquency. We demonstrate how mixture regression analysis allows for the identification of population subgroups defined by the salience of multiple risk factors. We identified population subgroups (i.e., latent classes) of individuals based on their coefficients in a regression model predicting adolescent delinquency from eight previously established risk indices drawn from the community, school, family, peer, and individual levels. The study included N = 37,763 10th-grade adolescents who participated in the Communities That Care Youth Survey. Standard, zero-inflated, and mixture Poisson and negative binomial regression models were considered. Standard and mixture negative binomial regression models were selected as optimal. The five-class regression model was interpreted based on the class-specific regression coefficients, indicating that risk factors had varying salience across classes of adolescents. Standard regression showed that all risk factors were significantly associated with delinquency. Mixture regression provided more nuanced information, suggesting a unique set of risk factors that were salient for different subgroups of adolescents. Implications for the design of subgroup-specific interventions are discussed. Copyright © 2014 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

  2. Nanotoxicology and nanomedicine: making development decisions in an evolving governance environment

    NASA Astrophysics Data System (ADS)

    Rycroft, Taylor; Trump, Benjamin; Poinsatte-Jones, Kelsey; Linkov, Igor

    2018-02-01

    The fields of nanomedicine, risk analysis, and decision science have evolved considerably in the past decade, providing developers of nano-enabled therapies and diagnostic tools with more complete information than ever before and shifting a fundamental requisite of the nanomedical community from the need for more information about nanomaterials to the need for a streamlined method of integrating the abundance of nano-specific information into higher-certainty product design decisions. The crucial question facing nanomedicine developers that must select the optimal nanotechnology in a given situation has shifted from "how do we estimate nanomaterial risk in the absence of good risk data?" to "how can we derive a holistic characterization of the risks and benefits that a given nanomaterial may pose within a specific nanomedical application?" Many decision support frameworks have been proposed to assist with this inquiry; however, those based in multicriteria decision analysis have proven to be most adaptive in the rapidly evolving field of nanomedicine—from the early stages of the field when conditions of significant uncertainty and incomplete information dominated, to today when nanotoxicology and nano-environmental health and safety information is abundant but foundational paradigms such as chemical risk assessment, risk governance, life cycle assessment, safety-by-design, and stakeholder engagement are undergoing substantial reformation in an effort to address the needs of emerging technologies. In this paper, we reflect upon 10 years of developments in nanomedical engineering and demonstrate how the rich knowledgebase of nano-focused toxicological and risk assessment information developed over the last decade enhances the capability of multicriteria decision analysis approaches and underscores the need to continue the transition from traditional risk assessment towards risk-based decision-making and alternatives-based governance for emerging technologies.

  3. Predictors of Shunt-dependent Hydrocephalus After Aneurysmal Subarachnoid Hemorrhage? A Systematic Review and Meta-Analysis.

    PubMed

    Xie, Zhiyi; Hu, Xin; Zan, Xin; Lin, Sen; Li, Hao; You, Chao

    2017-10-01

    Hydrocephalus is a well-recognized complication after aneurysmal subarachnoid hemorrhage (aSAH). This study aimed to identify predictors for shunt-dependent hydrocephalus (SDHC) after aSAH via a systematic review and meta-analysis. A systematic search was conducted using the Embase, MEDLINE, and Web of Science databases for studies pertaining to aSAH and SDHC. Risk factors were assessed by meta-analysis when they were reported by at least 2 studies. The results were presented as odd ratios or risk ratios according to the study design with the corresponding 95% confidence intervals (CI). Twenty-five studies were included. In primary analysis of 14 potential risk factors, 12 were identified as predictors of SDHC after aSAH including age ≥50 years, female gender, high Hunt-Hess grade, Glasgow Coma Scale ≤8, Fisher grade ≥3, acute hydrocephalus, external ventricular drainage insertion, intraventricular hemorrhage, postcirculation aneurysm, anterior communicating artery aneurysm, meningitis, and rebleeding. The meta-analysis based on cohort studies found a significantly increased risk for SDHC in patients with aSAH treated by coiling (risk ratio, 1.16; 95% CI, 1.05-1.29), while the meta-analysis based on case-controlled studies failed to replicate this finding (odds ratio, 1.27; 95% CI, 0.95-1.71). Several new predictors of SDHC after aSAH were identified that may assist with the early recognition and prevention of SDHC. The controversial evidence found in this study was insufficient to support the potential of neurosurgical clipping for reducing the risk of shunt dependency. Further well-designed studies are warranted to explore the effect of treatment modality on SDHC risk. Copyright © 2017 Elsevier Inc. All rights reserved.

  4. Pitfalls and Precautions When Using Predicted Failure Data for Quantitative Analysis of Safety Risk for Human Rated Launch Vehicles

    NASA Technical Reports Server (NTRS)

    Hatfield, Glen S.; Hark, Frank; Stott, James

    2016-01-01

    Launch vehicle reliability analysis is largely dependent upon using predicted failure rates from data sources such as MIL-HDBK-217F. Reliability prediction methodologies based on component data do not take into account risks attributable to manufacturing, assembly, and process controls. These sources often dominate component level reliability or risk of failure probability. While consequences of failure is often understood in assessing risk, using predicted values in a risk model to estimate the probability of occurrence will likely underestimate the risk. Managers and decision makers often use the probability of occurrence in determining whether to accept the risk or require a design modification. Due to the absence of system level test and operational data inherent in aerospace applications, the actual risk threshold for acceptance may not be appropriately characterized for decision making purposes. This paper will establish a method and approach to identify the pitfalls and precautions of accepting risk based solely upon predicted failure data. This approach will provide a set of guidelines that may be useful to arrive at a more realistic quantification of risk prior to acceptance by a program.

  5. Enhancing the Characterization of Epistemic Uncertainties in PM2.5 Risk Analyses.

    PubMed

    Smith, Anne E; Gans, Will

    2015-03-01

    The Environmental Benefits Mapping and Analysis Program (BenMAP) is a software tool developed by the U.S. Environmental Protection Agency (EPA) that is widely used inside and outside of EPA to produce quantitative estimates of public health risks from fine particulate matter (PM2.5 ). This article discusses the purpose and appropriate role of a risk analysis tool to support risk management deliberations, and evaluates the functions of BenMAP in this context. It highlights the importance in quantitative risk analyses of characterization of epistemic uncertainty, or outright lack of knowledge, about the true risk relationships being quantified. This article describes and quantitatively illustrates sensitivities of PM2.5 risk estimates to several key forms of epistemic uncertainty that pervade those calculations: the risk coefficient, shape of the risk function, and the relative toxicity of individual PM2.5 constituents. It also summarizes findings from a review of U.S.-based epidemiological evidence regarding the PM2.5 risk coefficient for mortality from long-term exposure. That review shows that the set of risk coefficients embedded in BenMAP substantially understates the range in the literature. We conclude that BenMAP would more usefully fulfill its role as a risk analysis support tool if its functions were extended to better enable and prompt its users to characterize the epistemic uncertainties in their risk calculations. This requires expanded automatic sensitivity analysis functions and more recognition of the full range of uncertainty in risk coefficients. © 2014 Society for Risk Analysis.

  6. Dietary patterns and risk of colorectal adenoma: a systematic review and meta-analysis of observational studies.

    PubMed

    Godos, J; Bella, F; Torrisi, A; Sciacca, S; Galvano, F; Grosso, G

    2016-12-01

    Current evidence suggests that dietary patterns may play an important role in colorectal cancer risk. The present study aimed to perform a systematic review and meta-analysis of observational studies exploring the association between dietary patterns and colorectal adenomas (a precancerous condition). Pubmed and EMBASE electronic databases were systematically searched to retrieve eligible studies. Only studies exploring the risk or association with colorectal adenomas for the highest versus lowest category of exposure to a posteriori dietary patterns were included in the quantitative analysis. Random-effects models were applied to calculate relative risks (RRs) of colorectal adenomas for high adherence to healthy or unhealthy dietary patterns. Statistical heterogeneity and publication bias were explored. Twelve studies were reviewed. Three studies explored a priori dietary patterns using scores identifying adherence to the Mediterranean, Paleolithic and Dietary Approaches to Stop Hypertension (DASH) diet and reported an association with decreased colorectal adenoma risk. Two studies tested the association with colorectal adenomas between a posteriori dietary patterns showing lower odds of disease related to plant-based compared to meat-based dietary patterns. Seven studies identified 23 a posteriori dietary patterns and the analysis revealed that higher adherence to healthy and unhealthy dietary patterns was significantly associated risk of colorectal adenomas (RR = 0.81, 95% confidence interval = 0.71, 0.94 and RR = 1.24, 95% confidence interval = 1.13, 1.35, respectively) with no evidence of heterogeneity or publication bias. The results of this systematic review and meta-analysis indicate that dietary patterns may be associated with the risk of colorectal adenomas. © 2016 The British Dietetic Association Ltd.

  7. An Agent-Based Model of Evolving Community Flood Risk.

    PubMed

    Tonn, Gina L; Guikema, Seth D

    2018-06-01

    Although individual behavior plays a major role in community flood risk, traditional flood risk models generally do not capture information on how community policies and individual decisions impact the evolution of flood risk over time. The purpose of this study is to improve the understanding of the temporal aspects of flood risk through a combined analysis of the behavioral, engineering, and physical hazard aspects of flood risk. Additionally, the study aims to develop a new modeling approach for integrating behavior, policy, flood hazards, and engineering interventions. An agent-based model (ABM) is used to analyze the influence of flood protection measures, individual behavior, and the occurrence of floods and near-miss flood events on community flood risk. The ABM focuses on the following decisions and behaviors: dissemination of flood management information, installation of community flood protection, elevation of household mechanical equipment, and elevation of homes. The approach is place based, with a case study area in Fargo, North Dakota, but is focused on generalizable insights. Generally, community mitigation results in reduced future damage, and individual action, including mitigation and movement into and out of high-risk areas, can have a significant influence on community flood risk. The results of this study provide useful insights into the interplay between individual and community actions and how it affects the evolution of flood risk. This study lends insight into priorities for future work, including the development of more in-depth behavioral and decision rules at the individual and community level. © 2017 Society for Risk Analysis.

  8. A Retrospective Analysis of Pressure Ulcer Incidence and Modified Braden Scale Score Risk Classifications.

    PubMed

    Chen, Hong-Lin; Cao, Ying-Juan; Wang, Jing; Huai, Bao-Sha

    2015-09-01

    The Braden Scale is the most widely used pressure ulcer risk assessment in the world, but the currently used 5 risk classification groups do not accurately discriminate among their risk categories. To optimize risk classification based on Braden Scale scores, a retrospective analysis of all consecutively admitted patients in an acute care facility who were at risk for pressure ulcer development was performed between January 2013 and December 2013. Predicted pressure ulcer incidence first was calculated by logistic regression model based on original Braden score. Risk classification then was modified based on the predicted pressure ulcer incidence and compared between different risk categories in the modified (3-group) classification and the traditional (5-group) classification using chi-square test. Two thousand, six hundred, twenty-five (2,625) patients (mean age 59.8 ± 16.5, range 1 month to 98 years, 1,601 of whom were men) were included in the study; 81 patients (3.1%) developed a pressure ulcer. The predicted pressure ulcer incidence ranged from 0.1% to 49.7%. When the predicted pressure ulcer incidence was greater than 10.0% (high risk), the corresponding Braden scores were less than 11; when the predicted incidence ranged from 1.0% to 10.0% (moderate risk), the corresponding Braden scores ranged from 12 to 16; and when the predicted incidence was less than 1.0% (mild risk), the corresponding Braden scores were greater than 17. In the modified classification, observed pressure ulcer incidence was significantly different between each of the 3 risk categories (P less than 0.05). However, in the traditional classification, the observed incidence was not significantly different between the high-risk category and moderate-risk category (P less than 0.05) and between the mild-risk category and no-risk category (P less than 0.05). If future studies confirm the validity of these findings, pressure ulcer prevention protocols of care based on Braden Scale scores can be simplified.

  9. New risk metrics and mathematical tools for risk analysis: Current and future challenges

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Skandamis, Panagiotis N., E-mail: pskan@aua.gr; Andritsos, Nikolaos, E-mail: pskan@aua.gr; Psomas, Antonios, E-mail: pskan@aua.gr

    The current status of the food safety supply world wide, has led Food and Agriculture Organization (FAO) and World Health Organization (WHO) to establishing Risk Analysis as the single framework for building food safety control programs. A series of guidelines and reports that detail out the various steps in Risk Analysis, namely Risk Management, Risk Assessment and Risk Communication is available. The Risk Analysis approach enables integration between operational food management systems, such as Hazard Analysis Critical Control Points, public health and governmental decisions. To do that, a series of new Risk Metrics has been established as follows: i) themore » Appropriate Level of Protection (ALOP), which indicates the maximum numbers of illnesses in a population per annum, defined by quantitative risk assessments, and used to establish; ii) Food Safety Objective (FSO), which sets the maximum frequency and/or concentration of a hazard in a food at the time of consumption that provides or contributes to the ALOP. Given that ALOP is rather a metric of the public health tolerable burden (it addresses the total ‘failure’ that may be handled at a national level), it is difficult to be interpreted into control measures applied at the manufacturing level. Thus, a series of specific objectives and criteria for performance of individual processes and products have been established, all of them assisting in the achievement of FSO and hence, ALOP. In order to achieve FSO, tools quantifying the effect of processes and intrinsic properties of foods on survival and growth of pathogens are essential. In this context, predictive microbiology and risk assessment have offered an important assistance to Food Safety Management. Predictive modelling is the basis of exposure assessment and the development of stochastic and kinetic models, which are also available in the form of Web-based applications, e.g., COMBASE and Microbial Responses Viewer), or introduced into user-friendly softwares, (e.g., Seafood Spoilage Predictor) have evolved the use of information systems in the food safety management. Such tools are updateable with new food-pathogen specific models containing cardinal parameters and multiple dependent variables, including plate counts, concentration of metabolic products, or even expression levels of certain genes. Then, these tools may further serve as decision-support tools which may assist in product logistics, based on their scientifically-based and “momentary” expressed spoilage and safety level.« less

  10. New risk metrics and mathematical tools for risk analysis: Current and future challenges

    NASA Astrophysics Data System (ADS)

    Skandamis, Panagiotis N.; Andritsos, Nikolaos; Psomas, Antonios; Paramythiotis, Spyridon

    2015-01-01

    The current status of the food safety supply world wide, has led Food and Agriculture Organization (FAO) and World Health Organization (WHO) to establishing Risk Analysis as the single framework for building food safety control programs. A series of guidelines and reports that detail out the various steps in Risk Analysis, namely Risk Management, Risk Assessment and Risk Communication is available. The Risk Analysis approach enables integration between operational food management systems, such as Hazard Analysis Critical Control Points, public health and governmental decisions. To do that, a series of new Risk Metrics has been established as follows: i) the Appropriate Level of Protection (ALOP), which indicates the maximum numbers of illnesses in a population per annum, defined by quantitative risk assessments, and used to establish; ii) Food Safety Objective (FSO), which sets the maximum frequency and/or concentration of a hazard in a food at the time of consumption that provides or contributes to the ALOP. Given that ALOP is rather a metric of the public health tolerable burden (it addresses the total `failure' that may be handled at a national level), it is difficult to be interpreted into control measures applied at the manufacturing level. Thus, a series of specific objectives and criteria for performance of individual processes and products have been established, all of them assisting in the achievement of FSO and hence, ALOP. In order to achieve FSO, tools quantifying the effect of processes and intrinsic properties of foods on survival and growth of pathogens are essential. In this context, predictive microbiology and risk assessment have offered an important assistance to Food Safety Management. Predictive modelling is the basis of exposure assessment and the development of stochastic and kinetic models, which are also available in the form of Web-based applications, e.g., COMBASE and Microbial Responses Viewer), or introduced into user-friendly softwares, (e.g., Seafood Spoilage Predictor) have evolved the use of information systems in the food safety management. Such tools are updateable with new food-pathogen specific models containing cardinal parameters and multiple dependent variables, including plate counts, concentration of metabolic products, or even expression levels of certain genes. Then, these tools may further serve as decision-support tools which may assist in product logistics, based on their scientifically-based and "momentary" expressed spoilage and safety level.

  11. Risk-Based Approach for Microbiological Food Safety Management in the Dairy Industry: The Case of Listeria monocytogenes in Soft Cheese Made from Pasteurized Milk.

    PubMed

    Tenenhaus-Aziza, Fanny; Daudin, Jean-Jacques; Maffre, Alexandre; Sanaa, Moez

    2014-01-01

    According to Codex Alimentarius Commission recommendations, management options applied at the process production level should be based on good hygiene practices, HACCP system, and new risk management metrics such as the food safety objective. To follow this last recommendation, the use of quantitative microbiological risk assessment is an appealing approach to link new risk-based metrics to management options that may be applied by food operators. Through a specific case study, Listeria monocytogenes in soft cheese made from pasteurized milk, the objective of the present article is to practically show how quantitative risk assessment could be used to direct potential intervention strategies at different food processing steps. Based on many assumptions, the model developed estimates the risk of listeriosis at the moment of consumption taking into account the entire manufacturing process and potential sources of contamination. From pasteurization to consumption, the amplification of a primo-contamination event of the milk, the fresh cheese or the process environment is simulated, over time, space, and between products, accounting for the impact of management options, such as hygienic operations and sampling plans. A sensitivity analysis of the model will help orientating data to be collected prioritarily for the improvement and the validation of the model. What-if scenarios were simulated and allowed for the identification of major parameters contributing to the risk of listeriosis and the optimization of preventive and corrective measures. © 2013 Society for Risk Analysis.

  12. Using probabilistic terrorism risk modeling for regulatory benefit-cost analysis: application to the Western hemisphere travel initiative in the land environment.

    PubMed

    Willis, Henry H; LaTourrette, Tom

    2008-04-01

    This article presents a framework for using probabilistic terrorism risk modeling in regulatory analysis. We demonstrate the framework with an example application involving a regulation under consideration, the Western Hemisphere Travel Initiative for the Land Environment, (WHTI-L). First, we estimate annualized loss from terrorist attacks with the Risk Management Solutions (RMS) Probabilistic Terrorism Model. We then estimate the critical risk reduction, which is the risk-reducing effectiveness of WHTI-L needed for its benefit, in terms of reduced terrorism loss in the United States, to exceed its cost. Our analysis indicates that the critical risk reduction depends strongly not only on uncertainties in the terrorism risk level, but also on uncertainty in the cost of regulation and how casualties are monetized. For a terrorism risk level based on the RMS standard risk estimate, the baseline regulatory cost estimate for WHTI-L, and a range of casualty cost estimates based on the willingness-to-pay approach, our estimate for the expected annualized loss from terrorism ranges from $2.7 billion to $5.2 billion. For this range in annualized loss, the critical risk reduction for WHTI-L ranges from 7% to 13%. Basing results on a lower risk level that results in halving the annualized terrorism loss would double the critical risk reduction (14-26%), and basing the results on a higher risk level that results in a doubling of the annualized terrorism loss would cut the critical risk reduction in half (3.5-6.6%). Ideally, decisions about terrorism security regulations and policies would be informed by true benefit-cost analyses in which the estimated benefits are compared to costs. Such analyses for terrorism security efforts face substantial impediments stemming from the great uncertainty in the terrorist threat and the very low recurrence interval for large attacks. Several approaches can be used to estimate how a terrorism security program or regulation reduces the distribution of risks it is intended to manage. But, continued research to develop additional tools and data is necessary to support application of these approaches. These include refinement of models and simulations, engagement of subject matter experts, implementation of program evaluation, and estimating the costs of casualties from terrorism events.

  13. Carotenoids and risk of fracture: a meta-analysis of observational studies

    PubMed Central

    Song, Xiaochao; Zhang, Xi; Li, Xinli

    2017-01-01

    To quantify the association between dietary and circulating carotenoids and fracture risk, a meta-analysis was conducted by searching MEDLINE and EMBASE databases for eligible articles published before May 2016. Five prospective and 2 case-control studies with 140,265 participants and 4,324 cases were identified in our meta-analysis. Among which 5 studies assessed the association between dietary carotenoids levels and hip fracture risk, 2 studies focused on the association between circulating carotenoids levels and any fracture risk. A random-effects model was employed to summarize the risk estimations and their 95% confidence intervals (CIs). Hip fracture risk among participants with high dietary total carotenoids intake was 28% lower than that in participants with low dietary total carotenoids (OR: 0.72; 95% CI: 0.51, 1.01). A similar risk of hip fracture was found for β-carotene based on 5 studies, the summarized OR for high vs. low dietary β-carotene was 0.72 (95% CI: 0.54, 0.95). However, a significant between-study heterogeneity was found (total carotene: I2 = 59.4%, P = 0.06; β-carotene: I2 = 74.4%, P = 0.04). Other individual carotenoids did not show significant associations with hip fracture risk. Circulating carotene levels had no significant association with any fracture risk, the pooled OR (95% CI) was 0.83 (0.59, 1.17). Based on the evidence from observational studies, our meta-analysis supported the hypothesis that higher dietary total carotenoids or β-carotene intake might be potentially associated with a low risk of hip fracture, however, future well-designed prospective cohort studies and randomized controlled trials are warranted to specify the associations between carotenoids and fracture. PMID:27911854

  14. Carotenoids and risk of fracture: a meta-analysis of observational studies.

    PubMed

    Xu, Jiuhong; Song, Chunli; Song, Xiaochao; Zhang, Xi; Li, Xinli

    2017-01-10

    To quantify the association between dietary and circulating carotenoids and fracture risk, a meta-analysis was conducted by searching MEDLINE and EMBASE databases for eligible articles published before May 2016. Five prospective and 2 case-control studies with 140,265 participants and 4,324 cases were identified in our meta-analysis. Among which 5 studies assessed the association between dietary carotenoids levels and hip fracture risk, 2 studies focused on the association between circulating carotenoids levels and any fracture risk. A random-effects model was employed to summarize the risk estimations and their 95% confidence intervals (CIs). Hip fracture risk among participants with high dietary total carotenoids intake was 28% lower than that in participants with low dietary total carotenoids (OR: 0.72; 95% CI: 0.51, 1.01). A similar risk of hip fracture was found for β-carotene based on 5 studies, the summarized OR for high vs. low dietary β-carotene was 0.72 (95% CI: 0.54, 0.95). However, a significant between-study heterogeneity was found (total carotene: I2 = 59.4%, P = 0.06; β-carotene: I2 = 74.4%, P = 0.04). Other individual carotenoids did not show significant associations with hip fracture risk. Circulating carotene levels had no significant association with any fracture risk, the pooled OR (95% CI) was 0.83 (0.59, 1.17). Based on the evidence from observational studies, our meta-analysis supported the hypothesis that higher dietary total carotenoids or β-carotene intake might be potentially associated with a low risk of hip fracture, however, future well-designed prospective cohort studies and randomized controlled trials are warranted to specify the associations between carotenoids and fracture.

  15. The HTA Risk Analysis Chart: Visualising the Need for and Potential Value of Managed Entry Agreements in Health Technology Assessment.

    PubMed

    Grimm, Sabine Elisabeth; Strong, Mark; Brennan, Alan; Wailoo, Allan J

    2017-12-01

    Recent changes to the regulatory landscape of pharmaceuticals may sometimes require reimbursement authorities to issue guidance on technologies that have a less mature evidence base. Decision makers need to be aware of risks associated with such health technology assessment (HTA) decisions and the potential to manage this risk through managed entry agreements (MEAs). This work develops methods for quantifying risk associated with specific MEAs and for clearly communicating this to decision makers. We develop the 'HTA risk analysis chart', in which we present the payer strategy and uncertainty burden (P-SUB) as a measure of overall risk. The P-SUB consists of the payer uncertainty burden (PUB), the risk stemming from decision uncertainty as to which is the truly optimal technology from the relevant set of technologies, and the payer strategy burden (PSB), the additional risk of approving a technology that is not expected to be optimal. We demonstrate the approach using three recent technology appraisals from the UK National Institute for Health and Clinical Excellence (NICE), each of which considered a price-based MEA. The HTA risk analysis chart was calculated using results from standard probabilistic sensitivity analyses. In all three HTAs, the new interventions were associated with substantial risk as measured by the P-SUB. For one of these technologies, the P-SUB was reduced to zero with the proposed price reduction, making this intervention cost effective with near complete certainty. For the other two, the risk reduced substantially with a much reduced PSB and a slightly increased PUB. The HTA risk analysis chart shows the risk that the healthcare payer incurs under unresolved decision uncertainty and when considering recommending a technology that is not expected to be optimal given current evidence. This allows the simultaneous consideration of financial and data-collection MEA schemes in an easily understood format. The use of HTA risk analysis charts will help to ensure that MEAs are considered within a standard utility-maximising health economic decision-making framework.

  16. The -765G>C polymorphism in the cyclooxygenase-2 gene and digestive system cancer: a meta-analysis.

    PubMed

    Zhao, Fen; Cao, Yue; Zhu, Hong; Huang, Min; Yi, Cheng; Huang, Ying

    2014-01-01

    Published data regarding associations between the -765G>C polymorphism in cyclooxygenase-2 (COX-2) gene and digestive system cancer risk have been inconclusive. The aim of this study was to comprehensively evaluate the genetic risk of the -765G>C polymorphism in the COX-2 gene for digestive system cancer. A search was performed in Pubmed, Medline (Ovid), Embase, CNKI, Weipu, Wanfang and CBM databases, covering all studies until Feb 10, 2014. Statistical analysis was performed using Revman5.2. A total of 10,814 cases and 16,174 controls in 38 case-control studies were included in this meta-analysis. The results indicated that C allele carriers (GC+CC) had a 20% increased risk of digestive system cancer when compared with the homozygote GG (odds ratio (OR)=1.20, 95% confidence interval (CI), 1.00-1.44 for GC+CC vs GG). In the subgroup analysis by ethnicity, significant elevated risks were associated with C allele carriers (GC+CC) in Asians (OR = 1.46, 95% CI=1.07-2.01, and p=0.02) and Africans (OR=2.12, 95% CI=1.57-2.87, and p< 0.00001), but not among Caucasians, Americans and mixed groups. For subgroup analysis by cancer type (GC+CC vs GG), significant associations were found between the -765G>C polymorphism and higher risk for gastric cancer (OR=1.64, 95% CI=1.03-2.61, and p=0.04), but not for colorectal cancer, oral cancer, esophageal cancer, and others. Regarding study design (GC+CC vs GG), no significant associations were found in then population-based case-control (PCC), hospital-based case-control (HCC) and family-based case-control (FCC) studies. This meta-analysis suggested that the -765G>C polymorphism of the COX-2 gene is a potential risk factor for digestive system cancer in Asians and Africans and gastric cancer overall.

  17. Association of N-acetyltransferase 1 polymorphism and bladder cancer risk: an updated meta-analysis and trial sequential analysis.

    PubMed

    Xu, Zicheng; Li, Xiao; Qin, Zhiqiang; Xue, Jianxin; Wang, Jingyuan; Liu, Zhentao; Cai, Hongzhou; Yu, Bin; Xu, Ting; Zou, Qin

    2017-07-24

    Individual studies of the association between N-acetyltransferase 1 (NAT1)*10 allele and bladder cancer susceptibility have shown inconclusive results. To derive a more precise estimation of any such relationship, we performed this systemic review and updated meta-analysis based on 17 publications. A total of 17 studies were investigated with 4,322 bladder cancer cases and 4,944 controls. The pooled odds ratios (ORs) with 95% confidence intervals (CIs) were used to assess the strength of the association. Subgroup analyses were conducted based on ethnicity, sex, source of controls and detecting methods. Then trial sequential analysis was performed to evaluate whether the evidence of the results was sufficient and reduce the risk of type I error. There was no association between NAT1*10 allele and bladder cancer risk in a random-effects model (OR = 0.96, 95% CI, 0.84-1.10) or in a fixed-effects model (OR = 0.95, 95% CI, 0.87-1.03). In addition, no significantly increased risk of bladder cancer was found in any other subgroup analysis. Then, trial sequential analyses demonstrated that the results of our study need to be further verified. Despite its limitations, the results of the present meta-analysis suggested that there was no association between NAT1*10 allele and bladder cancer risk. More importantly, our findings need to be further validated regarding whether being without the NAT1*10 allele could in the future be shown to be a potential marker for the risk of bladder cancer.

  18. The return period analysis of natural disasters with statistical modeling of bivariate joint probability distribution.

    PubMed

    Li, Ning; Liu, Xueqin; Xie, Wei; Wu, Jidong; Zhang, Peng

    2013-01-01

    New features of natural disasters have been observed over the last several years. The factors that influence the disasters' formation mechanisms, regularity of occurrence and main characteristics have been revealed to be more complicated and diverse in nature than previously thought. As the uncertainty involved increases, the variables need to be examined further. This article discusses the importance and the shortage of multivariate analysis of natural disasters and presents a method to estimate the joint probability of the return periods and perform a risk analysis. Severe dust storms from 1990 to 2008 in Inner Mongolia were used as a case study to test this new methodology, as they are normal and recurring climatic phenomena on Earth. Based on the 79 investigated events and according to the dust storm definition with bivariate, the joint probability distribution of severe dust storms was established using the observed data of maximum wind speed and duration. The joint return periods of severe dust storms were calculated, and the relevant risk was analyzed according to the joint probability. The copula function is able to simulate severe dust storm disasters accurately. The joint return periods generated are closer to those observed in reality than the univariate return periods and thus have more value in severe dust storm disaster mitigation, strategy making, program design, and improvement of risk management. This research may prove useful in risk-based decision making. The exploration of multivariate analysis methods can also lay the foundation for further applications in natural disaster risk analysis. © 2012 Society for Risk Analysis.

  19. Vulnerabilities, Influences and Interaction Paths: Failure Data for Integrated System Risk Analysis

    NASA Technical Reports Server (NTRS)

    Malin, Jane T.; Fleming, Land

    2006-01-01

    We describe graph-based analysis methods for identifying and analyzing cross-subsystem interaction risks from subsystem connectivity information. By discovering external and remote influences that would be otherwise unexpected, these methods can support better communication among subsystem designers at points of potential conflict and to support design of more dependable and diagnosable systems. These methods identify hazard causes that can impact vulnerable functions or entities if propagated across interaction paths from the hazard source to the vulnerable target. The analysis can also assess combined impacts of And-Or trees of disabling influences. The analysis can use ratings of hazards and vulnerabilities to calculate cumulative measures of the severity and importance. Identification of cross-subsystem hazard-vulnerability pairs and propagation paths across subsystems will increase coverage of hazard and risk analysis and can indicate risk control and protection strategies.

  20. Risk Driven Outcome-Based Command and Control (C2) Assessment

    DTIC Science & Technology

    2000-01-01

    shaping the risk ranking scores into more interpretable and statistically sound risk measures. Regression analysis was applied to determine what...Architecture Framework Implementation, AFCEA Coursebook 503J, February 8-11, 2000, San Diego, California. [Morgan and Henrion, 1990] M. Granger Morgan and

  1. Quantitative Method for Analyzing the Allocation of Risks in Transportation Construction

    DOT National Transportation Integrated Search

    1979-04-01

    The report presents a conceptual model of risk that was developed to analyze the impact on owner's cost of alternate allocations of risk among owner and contractor in mass transit construction. A model and analysis procedure are developed, based on d...

  2. Risk analysis of gravity dam instability using credibility theory Monte Carlo simulation model.

    PubMed

    Xin, Cao; Chongshi, Gu

    2016-01-01

    Risk analysis of gravity dam stability involves complicated uncertainty in many design parameters and measured data. Stability failure risk ratio described jointly by probability and possibility has deficiency in characterization of influence of fuzzy factors and representation of the likelihood of risk occurrence in practical engineering. In this article, credibility theory is applied into stability failure risk analysis of gravity dam. Stability of gravity dam is viewed as a hybrid event considering both fuzziness and randomness of failure criterion, design parameters and measured data. Credibility distribution function is conducted as a novel way to represent uncertainty of influence factors of gravity dam stability. And combining with Monte Carlo simulation, corresponding calculation method and procedure are proposed. Based on a dam section, a detailed application of the modeling approach on risk calculation of both dam foundation and double sliding surfaces is provided. The results show that, the present method is feasible to be applied on analysis of stability failure risk for gravity dams. The risk assessment obtained can reflect influence of both sorts of uncertainty, and is suitable as an index value.

  3. Risk factors of hepatitis B virus infection among blood donors in Duhok city, Kurdistan Region, Iraq.

    PubMed

    R Hussein, Nawfal

    2018-01-01

    Hepatitis B virus (HBV) infection is a public health problem. The lack of information about the seroprevalence and risk factors is an obstacle for preventive public health plans to reduce the burden of viral hepatitis. Therefore, this study was conducted in Iraq, where no studies had been performed to determine the prevalence and risk factors of HBV infection. Blood samples were collected form 438 blood donors attending blood bank in Duhok city. Serum samples were tested for HBV core-antibodies (HBcAb) and HBV surface-antigen (HBsAg) by ELISA. Various risk factors were recorded and multivariate analysis was performed. 5/438 (1.14%) of the subjects were HBsAg positive (HBsAg and HBcAb positive) and 36/438 (8.2%) were HBcAb positive. Hence, 41 cases were exposed to HBV and data analysis was based on that. Univariate analysis showed that there were significant associations between history of illegitimate sexual contact, history of alcohol or history of dental surgeries and HBV exposure (p<0.05 for all). Then, multivariate analysis was conducted to find HBV exposure predictive factors. It was found that history of dental surgery was a predictive factor for exposure to the virus (P=0.03, OR: 2.397). This study suggested that the history of dental surgery was predictive for HBV transmission in Duhok city. Further population-based study is needed to determine HBV risk factors in the society and public health plan based on that should be considered.

  4. The Associations between RNA Splicing Complex Gene SF3A1 Polymorphisms and Colorectal Cancer Risk in a Chinese Population.

    PubMed

    Chen, Xiaohua; Du, Hua; Liu, Binjian; Zou, Li; Chen, Wei; Yang, Yang; Zhu, Ying; Gong, Yajie; Tian, Jianbo; Li, Feng; Zhong, Shan

    2015-01-01

    Aberrant alternative splicing included alterations in components of the mRNA splicing machinery often occurred in colon cancer. However, the role of SF3A1, one key component of the mRNA splicing machinery, on colorectal cancer (CRC) risk was still not elucidated. We performed a hospital-based case-control study containing 801 CRC patients and 817 cancer-free controls to examine the association between SF3A1 polymorphisms and CRC risk in a Chinese population. Four candidate SNPs (rs10376, rs5753073, rs2839998 and rs2074733) were selected based on bioinformatics analysis and previous findings. The results showed no significant associations between these SNPs and CRC risk (P > 0.05). Besides, the stratified analysis based on the smoking and alcohol use status obtained no statistically significant results. Our study was the first one to investigate the association between SF3A1 polymorphisms and CRC risk. The results suggested these four SNPs in SF3A1 were not associated with CRC risk in a Chinese population, however, further more studies are needed to confirm our findings.

  5. Initial Risk Analysis and Decision Making Framework

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Engel, David W.

    2012-02-01

    Commercialization of new carbon capture simulation initiative (CCSI) technology will include two key elements of risk management, namely, technical risk (will process and plant performance be effective, safe, and reliable) and enterprise risk (can project losses and costs be controlled within the constraints of market demand to maintain profitability and investor confidence). Both of these elements of risk are incorporated into the risk analysis subtask of Task 7. Thus far, this subtask has developed a prototype demonstration tool that quantifies risk based on the expected profitability of expenditures when retrofitting carbon capture technology on a stylized 650 MW pulverized coalmore » electric power generator. The prototype is based on the selection of specific technical and financial factors believed to be important determinants of the expected profitability of carbon capture, subject to uncertainty. The uncertainty surrounding the technical performance and financial variables selected thus far is propagated in a model that calculates the expected profitability of investments in carbon capture and measures risk in terms of variability in expected net returns from these investments. Given the preliminary nature of the results of this prototype, additional work is required to expand the scope of the model to include additional risk factors, additional information on extant and proposed risk factors, the results of a qualitative risk factor elicitation process, and feedback from utilities and other interested parties involved in the carbon capture project. Additional information on proposed distributions of these risk factors will be integrated into a commercial implementation framework for the purpose of a comparative technology investment analysis.« less

  6. Risk evaluation of highway engineering project based on the fuzzy-AHP

    NASA Astrophysics Data System (ADS)

    Yang, Qian; Wei, Yajun

    2011-10-01

    Engineering projects are social activities, which integrate with technology, economy, management and organization. There are uncertainties in each respect of engineering projects, and it needs to strengthen risk management urgently. Based on the analysis of the characteristics of highway engineering, and the study of the basic theory on risk evaluation, the paper built an index system of highway project risk evaluation. Besides based on fuzzy mathematics principle, analytical hierarchy process was used and as a result, the model of the comprehensive appraisal method of fuzzy and AHP was set up for the risk evaluation of express way concessionary project. The validity and the practicability of the risk evaluation of expressway concessionary project were verified after the model was applied to the practice of a project.

  7. An Approach to Risk-Based Design Incorporating Damage Tolerance Analyses

    NASA Technical Reports Server (NTRS)

    Knight, Norman F., Jr.; Glaessgen, Edward H.; Sleight, David W.

    2002-01-01

    Incorporating risk-based design as an integral part of spacecraft development is becoming more and more common. Assessment of uncertainties associated with design parameters and environmental aspects such as loading provides increased knowledge of the design and its performance. Results of such studies can contribute to mitigating risk through a system-level assessment. Understanding the risk of an event occurring, the probability of its occurrence, and the consequences of its occurrence can lead to robust, reliable designs. This paper describes an approach to risk-based structural design incorporating damage-tolerance analysis. The application of this approach to a candidate Earth-entry vehicle is described. The emphasis of the paper is on describing an approach for establishing damage-tolerant structural response inputs to a system-level probabilistic risk assessment.

  8. Risk-based decision making for terrorism applications.

    PubMed

    Dillon, Robin L; Liebe, Robert M; Bestafka, Thomas

    2009-03-01

    This article describes the anti-terrorism risk-based decision aid (ARDA), a risk-based decision-making approach for prioritizing anti-terrorism measures. The ARDA model was developed as part of a larger effort to assess investments for protecting U.S. Navy assets at risk and determine whether the most effective anti-terrorism alternatives are being used to reduce the risk to the facilities and war-fighting assets. With ARDA and some support from subject matter experts, we examine thousands of scenarios composed of 15 attack modes against 160 facility types on two installations and hundreds of portfolios of 22 mitigation alternatives. ARDA uses multiattribute utility theory to solve some of the commonly identified challenges in security risk analysis. This article describes the process and documents lessons learned from applying the ARDA model for this application.

  9. Cumulative Risk Assessment: An Overview of Methodological Approaches for Evaluating Combined Health Effects from Exposure to Multiple Environmental Stressors

    PubMed Central

    Sexton, Ken

    2012-01-01

    Systematic evaluation of cumulative health risks from the combined effects of multiple environmental stressors is becoming a vital component of risk-based decisions aimed at protecting human populations and communities. This article briefly examines the historical development of cumulative risk assessment as an analytical tool, and discusses current approaches for evaluating cumulative health effects from exposure to both chemical mixtures and combinations of chemical and nonchemical stressors. A comparison of stressor-based and effects-based assessment methods is presented, and the potential value of focusing on viable risk management options to limit the scope of cumulative evaluations is discussed. The ultimate goal of cumulative risk assessment is to provide answers to decision-relevant questions based on organized scientific analysis; even if the answers, at least for the time being, are inexact and uncertain. PMID:22470298

  10. Risk management for food and beverage industry using Australia/New Zealand 4360 Standard

    NASA Astrophysics Data System (ADS)

    Kristina, S.; Wijaya, B. M.

    2017-12-01

    This research aims to identifying, measuring and establishing risk in food and beverage industry. The risk management is implemented by referring to Australia/New Zealand 4360 Standard which has four phases such as problem formulation, risk analysis, risk characterization, and risk management. The implementation of risk management is done by case study at Back Alley Café. Based on the risk identification result, there are 59 risks were found in Back Alley Café. The risk identification is conducted based on observation and interview with the café manager who understand the condition of Back Alley Café properly. Based on the assessment of impact and probability, the risk mapping produced four risks at extreme level, 16 risks at high level, 24 risks at medium level, and 18 risks at low level. The strategy was designed as the risk mitigation after the risk mapping for the extreme and high level. The strategy which is given as the prevention or treatment of risk in Back Alley Café is divided into three. There are reducing the risk, sharing the risk and accepting the risk. The strategy is then implemented for each relevant activities.

  11. A methodology for risk analysis based on hybrid Bayesian networks: application to the regasification system of liquefied natural gas onboard a floating storage and regasification unit.

    PubMed

    Martins, Marcelo Ramos; Schleder, Adriana Miralles; Droguett, Enrique López

    2014-12-01

    This article presents an iterative six-step risk analysis methodology based on hybrid Bayesian networks (BNs). In typical risk analysis, systems are usually modeled as discrete and Boolean variables with constant failure rates via fault trees. Nevertheless, in many cases, it is not possible to perform an efficient analysis using only discrete and Boolean variables. The approach put forward by the proposed methodology makes use of BNs and incorporates recent developments that facilitate the use of continuous variables whose values may have any probability distributions. Thus, this approach makes the methodology particularly useful in cases where the available data for quantification of hazardous events probabilities are scarce or nonexistent, there is dependence among events, or when nonbinary events are involved. The methodology is applied to the risk analysis of a regasification system of liquefied natural gas (LNG) on board an FSRU (floating, storage, and regasification unit). LNG is becoming an important energy source option and the world's capacity to produce LNG is surging. Large reserves of natural gas exist worldwide, particularly in areas where the resources exceed the demand. Thus, this natural gas is liquefied for shipping and the storage and regasification process usually occurs at onshore plants. However, a new option for LNG storage and regasification has been proposed: the FSRU. As very few FSRUs have been put into operation, relevant failure data on FSRU systems are scarce. The results show the usefulness of the proposed methodology for cases where the risk analysis must be performed under considerable uncertainty. © 2014 Society for Risk Analysis.

  12. Results of research on development of an intellectual information system of bankruptcy risk assessment of the enterprise

    NASA Astrophysics Data System (ADS)

    Telipenko, E.; Chernysheva, T.; Zakharova, A.; Dumchev, A.

    2015-10-01

    The article represents research results about the knowledge base development for the intellectual information system for the bankruptcy risk assessment of the enterprise. It is described the process analysis of the knowledge base development; the main process stages, some problems and their solutions are given. The article introduces the connectionist model for the bankruptcy risk assessment based on the analysis of industrial enterprise financial accounting. The basis for this connectionist model is a three-layer perceptron with the back propagation of error algorithm. The knowledge base for the intellectual information system consists of processed information and the processing operation method represented as the connectionist model. The article represents the structure of the intellectual information system, the knowledge base, and the information processing algorithm for neural network training. The paper shows mean values of 10 indexes for industrial enterprises; with the help of them it is possible to carry out a financial analysis of industrial enterprises and identify correctly the current situation for well-timed managerial decisions. Results are given about neural network testing on the data of both bankrupt and financially strong enterprises, which were not included into training and test sets.

  13. Assessing population exposure for landslide risk analysis using dasymetric cartography

    NASA Astrophysics Data System (ADS)

    Garcia, Ricardo A. C.; Oliveira, Sergio C.; Zezere, Jose L.

    2015-04-01

    Exposed Population is a major topic that needs to be taken into account in a full landslide risk analysis. Usually, risk analysis is based on an accounting of inhabitants number or inhabitants density, applied over statistical or administrative terrain units, such as NUTS or parishes. However, this kind of approach may skew the obtained results underestimating the importance of population, mainly in territorial units with predominance of rural occupation. Furthermore, the landslide susceptibility scores calculated for each terrain unit are frequently more detailed and accurate than the location of the exposed population inside each territorial unit based on Census data. These drawbacks are not the ideal setting when landslide risk analysis is performed for urban management and emergency planning. Dasymetric cartography, which uses a parameter or set of parameters to restrict the spatial distribution of a particular phenomenon, is a methodology that may help to enhance the resolution of Census data and therefore to give a more realistic representation of the population distribution. Therefore, this work aims to map and to compare the population distribution based on a traditional approach (population per administrative terrain units) and based on dasymetric cartography (population by building). The study is developed in the Region North of Lisbon using 2011 population data and following three main steps: i) the landslide susceptibility assessment based on statistical models independently validated; ii) the evaluation of population distribution (absolute and density) for different administrative territorial units (Parishes and BGRI - the basic statistical unit in the Portuguese Census); and iii) the dasymetric population's cartography based on building areal weighting. Preliminary results show that in sparsely populated administrative units, population density differs more than two times depending on the application of the traditional approach or the dasymetric cartography. This work was supported by the FCT - Portuguese Foundation for Science and Technology.

  14. Evaluating soil risks associated with severe wildfire and ground-based logging

    Treesearch

    Keith M. Reynolds; Paul F. Hessburg; Richard E. Miller; Robert T. Meurisse

    2011-01-01

    Rehabilitation and timber-salvage activities after wildfire require rapid planning and rational decisions. Identifying areas with high risk for erosion and soil productivity losses is important. Moreover, allocation of corrective and mitigative efforts must be rational and prioritized. Our logic-based analysis of forested soil polygons on the Okanogan-Wenatchee...

  15. Evidence based management of polyps of the gall bladder: A systematic review of the risk factors of malignancy.

    PubMed

    Bhatt, Nikita R; Gillis, Amy; Smoothey, Craig O; Awan, Faisal N; Ridgway, Paul F

    2016-10-01

    There are no evidence-based guidelines to dictate when Gallbladder Polyps (GBPs) of varying sizes should be resected. To identify factors that accurately predict malignant disease in GBP; to provide an evidence-based algorithm for management. A systematic review following PRISMA guidelines was performed using terms "gallbladder polyps" AND "polypoid lesion of gallbladder", from January 1993 and September 2013. Inclusion criteria required histopathological report or follow-up of 2 years. RTI-IB tool was used for quality analysis. Correlation with GBP size and malignant potential was analysed using Euclidean distance; a logistics mixed effects model was used for assessing independent risk factors for malignancy. Fifty-three articles were included in review. Data from 21 studies was pooled for analysis. Optimum size cut-off for resection of GBPs was 10 mm. Probability of malignancy is approximately zero at size <4.15 mm. Patient age >50 years, sessile and single polyps were independent risk factors for malignancy. For polyps sized 4 mm-10 mm, a risk assessment model was formulated. This review and analysis has provided an evidence-based algorithm for the management of GBPs. Longitudinal studies are needed to better understand the behaviour of polyps <10 mm, that are not at a high risk of malignancy, but may change over time. Copyright © 2016 Royal College of Surgeons of Edinburgh (Scottish charity number SC005317) and Royal College of Surgeons in Ireland. Published by Elsevier Ltd. All rights reserved.

  16. Demonstration of a modelling-based multi-criteria decision analysis procedure for prioritisation of occupational risks from manufactured nanomaterials.

    PubMed

    Hristozov, Danail; Zabeo, Alex; Alstrup Jensen, Keld; Gottardo, Stefania; Isigonis, Panagiotis; Maccalman, Laura; Critto, Andrea; Marcomini, Antonio

    2016-11-01

    Several tools to facilitate the risk assessment and management of manufactured nanomaterials (MN) have been developed. Most of them require input data on physicochemical properties, toxicity and scenario-specific exposure information. However, such data are yet not readily available, and tools that can handle data gaps in a structured way to ensure transparent risk analysis for industrial and regulatory decision making are needed. This paper proposes such a quantitative risk prioritisation tool, based on a multi-criteria decision analysis algorithm, which combines advanced exposure and dose-response modelling to calculate margins of exposure (MoE) for a number of MN in order to rank their occupational risks. We demonstrated the tool in a number of workplace exposure scenarios (ES) involving the production and handling of nanoscale titanium dioxide, zinc oxide (ZnO), silver and multi-walled carbon nanotubes. The results of this application demonstrated that bag/bin filling, manual un/loading and dumping of large amounts of dry powders led to high emissions, which resulted in high risk associated with these ES. The ZnO MN revealed considerable hazard potential in vivo, which significantly influenced the risk prioritisation results. In order to study how variations in the input data affect our results, we performed probabilistic Monte Carlo sensitivity/uncertainty analysis, which demonstrated that the performance of the proposed model is stable against changes in the exposure and hazard input variables.

  17. Development of the Ovarian Cancer Cohort Consortium: Risk Factor Associations by Heterogeneity of Disease

    DTIC Science & Technology

    2015-10-01

    K05CA154337 from the National Cancer Institute (NCI) and Office of Dietary Supplements (VITAL). R01 CA39742 (Iowa Women’s Health Study). NIH/NCI UM1...did not collect information on a specific risk factor were excluded from the analysis of that factor ( Supplemental Table 1), leading to different... Supplemental Table 3. Associationsa of risk factors with ovarian cancer subtypes based on meta-analysis pooling the results of individual studies

  18. An innovative expression model of human health risk based on the quantitative analysis of soil metals sources contribution in different spatial scales.

    PubMed

    Zhang, Yimei; Li, Shuai; Wang, Fei; Chen, Zhuang; Chen, Jie; Wang, Liqun

    2018-09-01

    Toxicity of heavy metals from industrialization poses critical concern, and analysis of sources associated with potential human health risks is of unique significance. Assessing human health risk of pollution sources (factored health risk) concurrently in the whole and the sub region can provide more instructive information to protect specific potential victims. In this research, we establish a new expression model of human health risk based on quantitative analysis of sources contribution in different spatial scales. The larger scale grids and their spatial codes are used to initially identify the level of pollution risk, the type of pollution source and the sensitive population at high risk. The smaller scale grids and their spatial codes are used to identify the contribution of various sources of pollution to each sub region (larger grid) and to assess the health risks posed by each source for each sub region. The results of case study show that, for children (sensitive populations, taking school and residential area as major region of activity), the major pollution source is from the abandoned lead-acid battery plant (ALP), traffic emission and agricultural activity. The new models and results of this research present effective spatial information and useful model for quantifying the hazards of source categories and human health a t complex industrial system in the future. Copyright © 2018 Elsevier Ltd. All rights reserved.

  19. Heart failure disease management programs: a cost-effectiveness analysis.

    PubMed

    Chan, David C; Heidenreich, Paul A; Weinstein, Milton C; Fonarow, Gregg C

    2008-02-01

    Heart failure (HF) disease management programs have shown impressive reductions in hospitalizations and mortality, but in studies limited to short time frames and high-risk patient populations. Current guidelines thus only recommend disease management targeted to high-risk patients with HF. This study applied a new technique to infer the degree to which clinical trials have targeted patients by risk based on observed rates of hospitalization and death. A Markov model was used to assess the incremental life expectancy and cost of providing disease management for high-risk to low-risk patients. Sensitivity analyses of various long-term scenarios and of reduced effectiveness in low-risk patients were also considered. The incremental cost-effectiveness ratio of extending coverage to all patients was $9700 per life-year gained in the base case. In aggregate, universal coverage almost quadrupled life-years saved as compared to coverage of only the highest quintile of risk. A worst case analysis with simultaneous conservative assumptions yielded an incremental cost-effectiveness ratio of $110,000 per life-year gained. In a probabilistic sensitivity analysis, 99.74% of possible incremental cost-effectiveness ratios were <$50,000 per life-year gained. Heart failure disease management programs are likely cost-effective in the long-term along the whole spectrum of patient risk. Health gains could be extended by enrolling a broader group of patients with HF in disease management.

  20. Baseline characteristics predict risk of progression and response to combined medical therapy for benign prostatic hyperplasia (BPH).

    PubMed

    Kozminski, Michael A; Wei, John T; Nelson, Jason; Kent, David M

    2015-02-01

    To better risk stratify patients, using baseline characteristics, to help optimise decision-making for men with moderate-to-severe lower urinary tract symptoms (LUTS) secondary to benign prostatic hyperplasia (BPH) through a secondary analysis of the Medical Therapy of Prostatic Symptoms (MTOPS) trial. After review of the literature, we identified potential baseline risk factors for BPH progression. Using bivariate tests in a secondary analysis of MTOPS data, we determined which variables retained prognostic significance. We then used these factors in Cox proportional hazard modelling to: i) more comprehensively risk stratify the study population based on pre-treatment parameters and ii) to determine which risk strata stood to benefit most from medical intervention. In all, 3047 men were followed in MTOPS for a mean of 4.5 years. We found varying risks of progression across quartiles. Baseline BPH Impact Index score, post-void residual urine volume, serum prostate-specific antigen (PSA) level, age, American Urological Association Symptom Index score, and maximum urinary flow rate were found to significantly correlate with overall BPH progression in multivariable analysis. Using baseline factors permits estimation of individual patient risk for clinical progression and the benefits of medical therapy. A novel clinical decision tool based on these analyses will allow clinicians to weigh patient-specific benefits against possible risks of adverse effects for a given patient. © 2014 The Authors. BJU International © 2014 BJU International.

  1. Constellation Probabilistic Risk Assessment (PRA): Design Consideration for the Crew Exploration Vehicle

    NASA Technical Reports Server (NTRS)

    Prassinos, Peter G.; Stamatelatos, Michael G.; Young, Jonathan; Smith, Curtis

    2010-01-01

    Managed by NASA's Office of Safety and Mission Assurance, a pilot probabilistic risk analysis (PRA) of the NASA Crew Exploration Vehicle (CEV) was performed in early 2006. The PRA methods used follow the general guidance provided in the NASA PRA Procedures Guide for NASA Managers and Practitioners'. Phased-mission based event trees and fault trees are used to model a lunar sortie mission of the CEV - involving the following phases: launch of a cargo vessel and a crew vessel; rendezvous of these two vessels in low Earth orbit; transit to th$: moon; lunar surface activities; ascension &om the lunar surface; and return to Earth. The analysis is based upon assumptions, preliminary system diagrams, and failure data that may involve large uncertainties or may lack formal validation. Furthermore, some of the data used were based upon expert judgment or extrapolated from similar componentssystemsT. his paper includes a discussion of the system-level models and provides an overview of the analysis results used to identify insights into CEV risk drivers, and trade and sensitivity studies. Lastly, the PRA model was used to determine changes in risk as the system configurations or key parameters are modified.

  2. Failure mode and effects analysis and fault tree analysis of surface image guided cranial radiosurgery.

    PubMed

    Manger, Ryan P; Paxton, Adam B; Pawlicki, Todd; Kim, Gwe-Ya

    2015-05-01

    Surface image guided, Linac-based radiosurgery (SIG-RS) is a modern approach for delivering radiosurgery that utilizes optical stereoscopic imaging to monitor the surface of the patient during treatment in lieu of using a head frame for patient immobilization. Considering the novelty of the SIG-RS approach and the severity of errors associated with delivery of large doses per fraction, a risk assessment should be conducted to identify potential hazards, determine their causes, and formulate mitigation strategies. The purpose of this work is to investigate SIG-RS using the combined application of failure modes and effects analysis (FMEA) and fault tree analysis (FTA), report on the effort required to complete the analysis, and evaluate the use of FTA in conjunction with FMEA. A multidisciplinary team was assembled to conduct the FMEA on the SIG-RS process. A process map detailing the steps of the SIG-RS was created to guide the FMEA. Failure modes were determined for each step in the SIG-RS process, and risk priority numbers (RPNs) were estimated for each failure mode to facilitate risk stratification. The failure modes were ranked by RPN, and FTA was used to determine the root factors contributing to the riskiest failure modes. Using the FTA, mitigation strategies were formulated to address the root factors and reduce the risk of the process. The RPNs were re-estimated based on the mitigation strategies to determine the margin of risk reduction. The FMEA and FTAs for the top two failure modes required an effort of 36 person-hours (30 person-hours for the FMEA and 6 person-hours for two FTAs). The SIG-RS process consisted of 13 major subprocesses and 91 steps, which amounted to 167 failure modes. Of the 91 steps, 16 were directly related to surface imaging. Twenty-five failure modes resulted in a RPN of 100 or greater. Only one of these top 25 failure modes was specific to surface imaging. The riskiest surface imaging failure mode had an overall RPN-rank of eighth. Mitigation strategies for the top failure mode decreased the RPN from 288 to 72. Based on the FMEA performed in this work, the use of surface imaging for monitoring intrafraction position in Linac-based stereotactic radiosurgery (SRS) did not greatly increase the risk of the Linac-based SRS process. In some cases, SIG helped to reduce the risk of Linac-based RS. The FMEA was augmented by the use of FTA since it divided the failure modes into their fundamental components, which simplified the task of developing mitigation strategies.

  3. Comprehensive risk assessment method of catastrophic accident based on complex network properties

    NASA Astrophysics Data System (ADS)

    Cui, Zhen; Pang, Jun; Shen, Xiaohong

    2017-09-01

    On the macro level, the structural properties of the network and the electrical characteristics of the micro components determine the risk of cascading failures. And the cascading failures, as a process with dynamic development, not only the direct risk but also potential risk should be considered. In this paper, comprehensively considered the direct risk and potential risk of failures based on uncertain risk analysis theory and connection number theory, quantified uncertain correlation by the node degree and node clustering coefficient, then established a comprehensive risk indicator of failure. The proposed method has been proved by simulation on the actual power grid. Modeling a network according to the actual power grid, and verified the rationality of the proposed method.

  4. Quantitative assessment of building fire risk to life safety.

    PubMed

    Guanquan, Chu; Jinhua, Sun

    2008-06-01

    This article presents a quantitative risk assessment framework for evaluating fire risk to life safety. Fire risk is divided into two parts: probability and corresponding consequence of every fire scenario. The time-dependent event tree technique is used to analyze probable fire scenarios based on the effect of fire protection systems on fire spread and smoke movement. To obtain the variation of occurrence probability with time, Markov chain is combined with a time-dependent event tree for stochastic analysis on the occurrence probability of fire scenarios. To obtain consequences of every fire scenario, some uncertainties are considered in the risk analysis process. When calculating the onset time to untenable conditions, a range of fires are designed based on different fire growth rates, after which uncertainty of onset time to untenable conditions can be characterized by probability distribution. When calculating occupant evacuation time, occupant premovement time is considered as a probability distribution. Consequences of a fire scenario can be evaluated according to probability distribution of evacuation time and onset time of untenable conditions. Then, fire risk to life safety can be evaluated based on occurrence probability and consequences of every fire scenario. To express the risk assessment method in detail, a commercial building is presented as a case study. A discussion compares the assessment result of the case study with fire statistics.

  5. A New Approach in Applying Systems Engineering Tools and Analysis to Determine Hepatocyte Toxicogenomics Risk Levels to Human Health.

    PubMed

    Gigrich, James; Sarkani, Shahryar; Holzer, Thomas

    2017-03-01

    There is an increasing backlog of potentially toxic compounds that cannot be evaluated with current animal-based approaches in a cost-effective and expeditious manner, thus putting human health at risk. Extrapolation of animal-based test results for human risk assessment often leads to different physiological outcomes. This article introduces the use of quantitative tools and methods from systems engineering to evaluate the risk of toxic compounds by the analysis of the amount of stress that human hepatocytes undergo in vitro when metabolizing GW7647 1 over extended times and concentrations. Hepatocytes are exceedingly connected systems that make it challenging to understand the highly varied dimensional genomics data to determine risk of exposure. Gene expression data of peroxisome proliferator-activated receptor-α (PPARα) 2 binding was measured over multiple concentrations and varied times of GW7647 exposure and leveraging mahalanombis distance to establish toxicity threshold risk levels. The application of these novel systems engineering tools provides new insight into the intricate workings of human hepatocytes to determine risk threshold levels from exposure. This approach is beneficial to decision makers and scientists, and it can help reduce the backlog of untested chemical compounds due to the high cost and inefficiency of animal-based models.

  6. Geotechnical risk analysis user's guide

    DOT National Transportation Integrated Search

    1987-03-01

    All geotechnical predictions involve uncertainties. These are accounted for additionally by conservative factors of safety. Risk based design, on the other hand, attempts to quantify uncertainties and to adjust design conservatism accordingly. Such m...

  7. Risk Analysis of Near-Coastal Species of the U.S. Pacific Coast: Case Study Comparing Risks Associated with Two Future Climate Scenarios

    EPA Science Inventory

    Fundamental questions for climate change policy and adaptation strategies are to what extent does ecological risk change under different climate scenarios and how do any changes in risk vary among taxa and geographically. To evaluate these questions, we developed a rule-based fra...

  8. Developing safety performance functions incorporating reliability-based risk measures.

    PubMed

    Ibrahim, Shewkar El-Bassiouni; Sayed, Tarek

    2011-11-01

    Current geometric design guides provide deterministic standards where the safety margin of the design output is generally unknown and there is little knowledge of the safety implications of deviating from these standards. Several studies have advocated probabilistic geometric design where reliability analysis can be used to account for the uncertainty in the design parameters and to provide a risk measure of the implication of deviation from design standards. However, there is currently no link between measures of design reliability and the quantification of safety using collision frequency. The analysis presented in this paper attempts to bridge this gap by incorporating a reliability-based quantitative risk measure such as the probability of non-compliance (P(nc)) in safety performance functions (SPFs). Establishing this link will allow admitting reliability-based design into traditional benefit-cost analysis and should lead to a wider application of the reliability technique in road design. The present application is concerned with the design of horizontal curves, where the limit state function is defined in terms of the available (supply) and stopping (demand) sight distances. A comprehensive collision and geometric design database of two-lane rural highways is used to investigate the effect of the probability of non-compliance on safety. The reliability analysis was carried out using the First Order Reliability Method (FORM). Two Negative Binomial (NB) SPFs were developed to compare models with and without the reliability-based risk measures. It was found that models incorporating the P(nc) provided a better fit to the data set than the traditional (without risk) NB SPFs for total, injury and fatality (I+F) and property damage only (PDO) collisions. Copyright © 2011 Elsevier Ltd. All rights reserved.

  9. Analysis of the Risks and Benefits of New Chemical Entities Approved by the US Food and Drug Administration (FDA) and Subsequently Withdrawn From the US Market.

    PubMed

    Patriarca, Peter A; Van Auken, R Michael; Kebschull, Scott A

    2018-01-01

    Benefit-risk evaluations of drugs have been conducted since the introduction of modern regulatory systems more than 50 years ago. Such judgments are typically made on the basis of qualitative or semiquantitative approaches, often without the aid of quantitative assessment methods, the latter having often been applied asymmetrically to place emphasis on benefit more so than harm. In an effort to preliminarily evaluate the utility of lives lost or saved, or quality-adjusted life-years (QALY) lost and gained as a means of quantitatively assessing the potential benefits and risks of a new chemical entity, we focused our attention on the unique scenario in which a drug was initially approved based on one set of data, but later withdrawn from the market based on a second set of data. In this analysis, a dimensionless risk to benefit ratio was calculated in each instance, based on the risk and benefit quantified in similar units. The results indicated that FDA decisions to approve the drug corresponded to risk to benefit ratios less than or equal to 0.136, and that decisions to withdraw the drug from the US market corresponded to risk to benefit ratios greater than or equal to 0.092. The probability of FDA approval was then estimated using logistic regression analysis. The results of this analysis indicated that there was a 50% probability of FDA approval if the risk to benefit ratio was 0.121, and that the probability approaches 100% for values much less than 0.121, and the probability approaches 0% for values much greater than 0.121. The large uncertainty in these estimates due to the small sample size and overlapping data may be addressed in the future by applying the methodology to other drugs.

  10. Factors predicting high estimated 10-year stroke risk: thai epidemiologic stroke study.

    PubMed

    Hanchaiphiboolkul, Suchat; Puthkhao, Pimchanok; Towanabut, Somchai; Tantirittisak, Tasanee; Wangphonphatthanasiri, Khwanrat; Termglinchan, Thanes; Nidhinandana, Samart; Suwanwela, Nijasri Charnnarong; Poungvarin, Niphon

    2014-08-01

    The purpose of the study was to determine the factors predicting high estimated 10-year stroke risk based on a risk score, and among the risk factors comprising the risk score, which factors had a greater impact on the estimated risk. Thai Epidemiologic Stroke study was a community-based cohort study, which recruited participants from the general population from 5 regions of Thailand. Cross-sectional baseline data of 16,611 participants aged 45-69 years who had no history of stroke were included in this analysis. Multiple logistic regression analysis was used to identify the predictors of high estimated 10-year stroke risk based on the risk score of the Japan Public Health Center Study, which estimated the projected 10-year risk of incident stroke. Educational level, low personal income, occupation, geographic area, alcohol consumption, and hypercholesterolemia were significantly associated with high estimated 10-year stroke risk. Among these factors, unemployed/house work class had the highest odds ratio (OR, 3.75; 95% confidence interval [CI], 2.47-5.69) followed by illiterate class (OR, 2.30; 95% CI, 1.44-3.66). Among risk factors comprising the risk score, the greatest impact as a stroke risk factor corresponded to age, followed by male sex, diabetes mellitus, systolic blood pressure, and current smoking. Socioeconomic status, in particular, unemployed/house work and illiterate class, might be good proxy to identify the individuals at higher risk of stroke. The most powerful risk factors were older age, male sex, diabetes mellitus, systolic blood pressure, and current smoking. Copyright © 2014 National Stroke Association. Published by Elsevier Inc. All rights reserved.

  11. Extractive waste management: A risk analysis approach.

    PubMed

    Mehta, Neha; Dino, Giovanna Antonella; Ajmone-Marsan, Franco; Lasagna, Manuela; Romè, Chiara; De Luca, Domenico Antonio

    2018-05-01

    Abandoned mine sites continue to present serious environmental hazards because the heavy metals associated with extractive waste are continuously released into the environment, where they threaten human life and the environment. Remediating and securing extractive waste are complex, lengthy and costly processes. Thus, in most European countries, a site is considered for intervention when it poses a risk to human health and the surrounding environment. As a consequence, risk analysis presents a viable decisional approach towards the management of extractive waste. To evaluate the effects posed by extractive waste to human health and groundwater, a risk analysis approach was used for an abandoned nickel extraction site in Campello Monti in North Italy. This site is located in the Southern Italian Alps. The area consists of large and voluminous mafic rocks intruded by mantle peridotite. The mining activities in this area have generated extractive waste. A risk analysis of the site was performed using Risk Based Corrective Action (RBCA) guidelines, considering the properties of extractive waste and water for the properties of environmental matrices. The results showed the presence of carcinogenic risk due to arsenic and risks to groundwater due to nickel. The results of the risk analysis form a basic understanding of the current situation at the site, which is affected by extractive waste. Copyright © 2017 Elsevier B.V. All rights reserved.

  12. A novel eQTL-based analysis reveals the biology of breast cancer risk loci

    PubMed Central

    Li, Qiyuan; Seo, Ji-Heui; Stranger, Barbara; McKenna, Aaron; Pe'er, Itsik; LaFramboise, Thomas; Brown, Myles; Tyekucheva, Svitlana; Freedman, Matthew L.

    2014-01-01

    Summary Germline determinants of gene expression in tumors are less studied due to the complexity of transcript regulation caused by somatically acquired alterations. We performed expression quantitative trait locus (eQTL) based analyses using the multi-level information provided in The Cancer Genome Atlas (TCGA). Of the factors we measured, cis-acting eQTL saccounted for 1.2% of the total variation of tumor gene expression, while somatic copy number alteration and CpG methylation accounted for 7.3% and 3.3%, respectively. eQTL analyses of 15 previously reported breast cancer risk loci resulted in discovery of three variants that are significantly associated with transcript levels (FDR<0.1). In a novel trans- based analysis, an additional three risk loci were identified to act through ESR1, MYC, and KLF4. These findings provide a more comprehensive picture of gene expression determinants in breast cancer as well as insights into the underlying biology of breast cancer risk loci. PMID:23374354

  13. From Physical Process to Economic Cost - Integrated Approaches of Landslide Risk Assessment

    NASA Astrophysics Data System (ADS)

    Klose, M.; Damm, B.

    2014-12-01

    The nature of landslides is complex in many respects, with landslide hazard and impact being dependent on a variety of factors. This obviously requires an integrated assessment for fundamental understanding of landslide risk. Integrated risk assessment, according to the approach presented in this contribution, implies combining prediction of future landslide occurrence with analysis of landslide impact in the past. A critical step for assessing landslide risk in integrated perspective is to analyze what types of landslide damage affected people and property in which way and how people contributed and responded to these damage types. In integrated risk assessment, the focus is on systematic identification and monetization of landslide damage, and analytical tools that allow deriving economic costs from physical landslide processes are at the heart of this approach. The broad spectrum of landslide types and process mechanisms as well as nonlinearity between landslide magnitude, damage intensity, and direct costs are some main factors explaining recent challenges in risk assessment. The two prevailing approaches for assessing the impact of landslides in economic terms are cost survey (ex-post) and risk analysis (ex-ante). Both approaches are able to complement each other, but yet a combination of them has not been realized so far. It is common practice today to derive landslide risk without considering landslide process-based cause-effect relationships, since integrated concepts or new modeling tools expanding conventional methods are still widely missing. The approach introduced in this contribution is based on a systematic framework that combines cost survey and GIS-based tools for hazard or cost modeling with methods to assess interactions between land use practices and landslides in historical perspective. Fundamental understanding of landslide risk also requires knowledge about the economic and fiscal relevance of landslide losses, wherefore analysis of their impact on public budgets is a further component of this approach. In integrated risk assessment, combination of methods plays an important role, with the objective of collecting and integrating complex data sets on landslide risk.

  14. Navigational Traffic Conflict Technique: A Proactive Approach to Quantitative Measurement of Collision Risks in Port Waters

    NASA Astrophysics Data System (ADS)

    Debnath, Ashim Kumar; Chin, Hoong Chor

    Navigational safety analysis relying on collision statistics is often hampered because of the low number of observations. A promising alternative approach that overcomes this problem is proposed in this paper. By analyzing critical vessel interactions this approach proactively measures collision risk in port waters. The proposed method is illustrated for quantitative measurement of collision risks in Singapore port fairways, and validated by examining correlations between the measured risks with those perceived by pilots. This method is an ethically appealing alternative to the collision-based analysis for fast, reliable and effective safety assessment, thus possessing great potential for managing collision risks in port waters.

  15. Remotely Sensed Quantitative Drought Risk Assessment in Vulnerable Agroecosystems

    NASA Astrophysics Data System (ADS)

    Dalezios, N. R.; Blanta, A.; Spyropoulos, N. V.

    2012-04-01

    Hazard may be defined as a potential threat to humans and their welfare and risk (or consequence) as the probability of a hazard occurring and creating loss. Drought is considered as one of the major natural hazards with significant impact to agriculture, environment, economy and society. This paper deals with drought risk assessment, which the first step designed to find out what the problems are and comprises three distinct steps, namely risk identification, risk management which is not covered in this paper, there should be a fourth step to address the need for feedback and to take post-audits of all risk assessment exercises. In particular, quantitative drought risk assessment is attempted by using statistical methods. For the qualification of drought, the Reconnaissance Drought Index (RDI) is employed, which is a new index based on hydrometeorological parameters, such as precipitation and potential evapotranspiration. The remotely sensed estimation of RDI is based on NOA-AVHRR satellite data for a period of 20 years (1981-2001). The study area is Thessaly, central Greece, which is a drought-prone agricultural region characterized by vulnerable agriculture. Specifically, the undertaken drought risk assessment processes are specified as follows: 1. Risk identification: This step involves drought quantification and monitoring based on remotely sensed RDI and extraction of several features such as severity, duration, areal extent, onset and end time. Moreover, it involves a drought early warning system based on the above parameters. 2. Risk estimation: This step includes an analysis of drought severity, frequency and their relationships. 3. Risk evaluation: This step covers drought evaluation based on analysis of RDI images before and after each drought episode, which usually lasts one hydrological year (12month). The results of these three-step drought assessment processes are considered quite satisfactory in a drought-prone region such as Thessaly in central Greece. Moreover, remote sensing has proven very effective in delineating spatial variability and features in drought monitoring and assessment.

  16. Some considerations on the definition of risk based on concepts of systems theory and probability.

    PubMed

    Andretta, Massimo

    2014-07-01

    The concept of risk has been applied in many modern science and technology fields. Despite its successes in many applicative fields, there is still not a well-established vision and universally accepted definition of the principles and fundamental concepts of the risk assessment discipline. As emphasized recently, the risk fields suffer from a lack of clarity on their scientific bases that can define, in a unique theoretical framework, the general concepts in the different areas of application. The aim of this article is to make suggestions for another perspective of risk definition that could be applied and, in a certain sense, generalize some of the previously known definitions (at least in the fields of technical and scientific applications). By drawing on my experience of risk assessment in different applicative situations (particularly in the risk estimation for major industrial accidents, and in the health and ecological risk assessment for contaminated sites), I would like to revise some general and foundational concepts of risk analysis in as consistent a manner as possible from the axiomatic/deductive point of view. My proposal is based on the fundamental concepts of the systems theory and of the probability. In this way, I try to frame, in a single, broad, and general theoretical context some fundamental concepts and principles applicable in many different fields of risk assessment. I hope that this article will contribute to the revitalization and stimulation of useful discussions and new insights into the key issues and theoretical foundations of risk assessment disciplines. © 2013 Society for Risk Analysis.

  17. 78 FR 64735 - Current Good Manufacturing Practice and Hazard Analysis and Risk-Based Preventive Controls for...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-10-29

    ...The Food and Drug Administration (FDA) is proposing regulations for domestic and foreign facilities that are required to register under the Federal Food, Drug, and Cosmetic Act (the FD&C Act) to establish requirements for current good manufacturing practice in manufacturing, processing, packing, and holding of animal food. FDA also is proposing regulations to require that certain facilities establish and implement hazard analysis and risk-based preventive controls for food for animals. FDA is taking this action to provide greater assurance that animal food is safe and will not cause illness or injury to animals or humans and is intended to build an animal food safety system for the future that makes modern, science and risk-based preventive controls the norm across all sectors of the animal food system.

  18. Cancer risk of polycyclic aromatic hydrocarbons (PAHs) in the soils from Jiaozhou Bay wetland.

    PubMed

    Yang, Wei; Lang, Yinhai; Li, Guoliang

    2014-10-01

    To estimate the cancer risk exposed to the PAHs in Jiaozhou Bay wetland soils, a probabilistic health risk assessment was conducted based on Monte Carlo simulations. A sensitivity analysis was performed to determine the input variables that contribute most to the cancer risk assessment. Three age groups were selected to estimate the cancer risk via four exposure pathways (soil ingestion, food ingestion, dermal contact and inhalation). The results revealed that the 95th percentiles cancer risks for children, teens and adults were 9.11×10(-6), 1.04×10(-5) and 7.08×10(-5), respectively. The cancer risks for three age groups were at acceptable range (10(-6)-10(-4)), indicating no potential cancer risk. For different exposure pathways, food ingestion was the major exposure pathway. For 7 carcinogenic PAHs, the cancer risk caused by BaP was the highest. Sensitivity analysis demonstrated that the parameters of exposure duration (ED) and sum of converted 7 carcinogenic PAHs concentrations in soil based on BaPeq (CSsoil) contribute most to the total uncertainty. This study provides a comprehensive risk assessment on carcinogenic PAHs in Jiaozhou Bay wetland soils, and might be useful in providing potential strategies of cancer risk prevention and controlling. Copyright © 2014 Elsevier Ltd. All rights reserved.

  19. Toward a Responsibility-Catering Prioritarian Ethical Theory of Risk.

    PubMed

    Wikman-Svahn, Per; Lindblom, Lars

    2018-03-05

    Standard tools used in societal risk management such as probabilistic risk analysis or cost-benefit analysis typically define risks in terms of only probabilities and consequences and assume a utilitarian approach to ethics that aims to maximize expected utility. The philosopher Carl F. Cranor has argued against this view by devising a list of plausible aspects of the acceptability of risks that points towards a non-consequentialist ethical theory of societal risk management. This paper revisits Cranor's list to argue that the alternative ethical theory responsibility-catering prioritarianism can accommodate the aspects identified by Cranor and that the elements in the list can be used to inform the details of how to view risks within this theory. An approach towards operationalizing the theory is proposed based on a prioritarian social welfare function that operates on responsibility-adjusted utilities. A responsibility-catering prioritarian ethical approach towards managing risks is a promising alternative to standard tools such as cost-benefit analysis.

  20. Risk assessment and optimization (ALARA) analysis for the environmental remediation of Brookhaven National Laboratory`s hazardous waste management facility

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Dionne, B.J.; Morris, S.C. III; Baum, J.W.

    1998-01-01

    The Department of Energy`s (DOE) Office of Environment, Safety, and Health (EH) sought examples of risk-based approaches to environmental restoration to include in their guidance for DOE nuclear facilities. Extensive measurements of radiological contamination in soil and ground water have been made at Brookhaven National Laboratory`s Hazardous Waste Management Facility (HWMF) as part of a Comprehensive Environmental Response, Compensation and Liability Act (CERCLA) remediation process. This provided an ideal opportunity for a case study. This report provides a risk assessment and an {open_quotes}As Low as Reasonably Achievable{close_quotes} (ALARA) analysis for use at other DOE nuclear facilities as an example ofmore » a risk-based decision technique. This document contains the Appendices for the report.« less

  1. Finding Groups Using Model-Based Cluster Analysis: Heterogeneous Emotional Self-Regulatory Processes and Heavy Alcohol Use Risk

    ERIC Educational Resources Information Center

    Mun, Eun Young; von Eye, Alexander; Bates, Marsha E.; Vaschillo, Evgeny G.

    2008-01-01

    Model-based cluster analysis is a new clustering procedure to investigate population heterogeneity utilizing finite mixture multivariate normal densities. It is an inferentially based, statistically principled procedure that allows comparison of nonnested models using the Bayesian information criterion to compare multiple models and identify the…

  2. Decision making for animal health and welfare: integrating risk-benefit analysis with prospect theory.

    PubMed

    Hansson, Helena; Lagerkvist, Carl Johan

    2014-06-01

    This study integrated risk-benefit analysis with prospect theory with the overall objective of identifying the type of management behavior represented by farmers' choices of mastitis control options (MCOs). Two exploratory factor analyses, based on 163 and 175 Swedish farmers, respectively, highlighted attitudes to MCOs related to: (1) grouping cows and applying milking order to prevent spread of existing infection and (2) working in a precautionary way to prevent mastitis occurring. This was interpreted as being based on (1) reactive management behavior on detection of udder-health problems in individual cows and (2) proactive management behavior to prevent mastitis developing. Farmers' assessments of these MCOs were found to be based on asymmetrical evaluations of risks and benefits, suggesting that farmers' management behavior depends on their individual reference point. In particular, attitudes to MCOs related to grouping cows and applying milking order to prevent the spread of mastitis once infected cows were detected were stronger in the risk domain than in the benefit domain, in accordance with loss aversion. In contrast, attitudes to MCOs related to working in a precautionary way to prevent cows from becoming infected in the first place were stronger in the benefit domain than in the risk domain, in accordance with reverse loss aversion. These findings are of practical importance for farmers and agribusiness and in public health protection work to reduce the current extensive use of antibiotics in dairy herds. © 2013 Society for Risk Analysis.

  3. Occupation and malignant lymphoma: a population based case control study in Germany

    PubMed Central

    Mester, B; Nieters, A; Deeg, E; Elsner, G; Becker, N; Seidler, A

    2006-01-01

    Aims To identify occupations suspected to be associated with malignant lymphoma and to generate new hypotheses about occupational risks in a multicentre, population based case control study. Methods Male and female patients with malignant lymphoma (n = 710) aged 18–80 years of age were prospectively recruited in six study regions in Germany. For each newly recruited lymphoma case, a sex, region, and age matched control was drawn from the population registers. Odds ratios and 95% confidence intervals for major occupations and industries were calculated using conditional logistic regression analysis, adjusted for smoking (in pack‐years) and alcohol consumption. Patients with specific lymphoma subentities were additionally compared with the entire control group using unconditional logistic regression analysis. Results The following economic/industrial sectors were positively associated with lymphoma: food products, beverages, tobacco; paper products, publishing and printing; and metals. Chemicals; real estate, renting, and business activities were negatively associated with lymphoma diagnosis. The authors observed an increased overall lymphoma risk among architects; maids; farmers; glass formers; and construction workers. Shoemaking and leather goods making was negatively associated with the lymphoma diagnosis (although based on small numbers). In the occupational group analysis of lymphoma subentities, Hodgkin's lymphoma was significantly associated only with rubber and plastic products making; diffuse large B cell lymphoma risk was considerably increased among metal processors; follicular lymphoma showed highly significant risk increases for several occupational groups (medical, dental, and veterinary workers; sales workers; machinery fitters; and electrical fitters); and multiple myeloma showed a particularly pronounced risk increase for farmers as well as for agriculture and animal husbandry workers. Conclusions The results partly confirm previously defined occupational risks. Occupational risk factors for follicular lymphomas might differ from the overall risk factors for malignant lymphoma. PMID:16361401

  4. Do polypills lead to neglect of lifestyle risk factors? Findings from an individual participant data meta-analysis among 3140 patients at high risk of cardiovascular disease.

    PubMed

    Selak, Vanessa; Bullen, Chris; Stepien, Sandrine; Arroll, Bruce; Bots, Michiel; Bramley, Dale; Cass, Alan; Grobbee, Diederick; Hillis, Graham S; Molanus, Barbara; Neal, Bruce; Patel, Anushka; Rafter, Natasha; Rodgers, Anthony; Thom, Simon; Tonkin, Andrew; Usherwood, Tim; Wadham, Angela; Webster, Ruth

    2016-09-01

    The aim of this study was to investigate whether polypill-based care for the prevention of cardiovascular disease (CVD) is associated with a change in lifestyle risk factors when compared with usual care, among patients with CVD or high calculated cardiovascular risk. We conducted an individual participant data meta-analysis of three trials including patients from Australia, England, India, Ireland, the Netherlands and New Zealand that compared a strategy using a polypill containing aspirin, statin and antihypertensive therapy with usual care in patients with a prior CVD event or who were at high risk of their first event. Analyses investigated any differential effect on anthropometric measures and self-reported lifestyle behaviours. Among 3140 patients (75% male, mean age 62 years and 76% with a prior CVD event) there was no difference in lifestyle risk factors in those randomised to polypill-based care compared with usual care over a median of 15 months, either across all participants combined, or in a range of subgroups. Furthermore, narrow confidence intervals (CIs) excluded any major effect; for example differences between the groups in body mass index was -0.1 (95% CI -0.2 to 0.1) kg/m(2), in weekly duration of moderate intensity physical activity was -2 (-26 to 23) minutes and the proportion of smokers was 16% vs 17% (RR 0.98, 0.84 to 1.15) at the end of trial. This analysis allays concern that polypill-based care may lead to neglect of lifestyle risk factors, at least among high-risk patients. Maximally effective preventive approaches should address lifestyle factors alongside pharmaceutical interventions, as recommended by major international guidelines. © The European Society of Cardiology 2016.

  5. Risk-based audit selection of dairy farms.

    PubMed

    van Asseldonk, M A P M; Velthuis, A G J

    2014-02-01

    Dairy farms are audited in the Netherlands on numerous process standards. Each farm is audited once every 2 years. Increasing demands for cost-effectiveness in farm audits can be met by introducing risk-based principles. This implies targeting subpopulations with a higher risk of poor process standards. To select farms for an audit that present higher risks, a statistical analysis was conducted to test the relationship between the outcome of farm audits and bulk milk laboratory results before the audit. The analysis comprised 28,358 farm audits and all conducted laboratory tests of bulk milk samples 12 mo before the audit. The overall outcome of each farm audit was classified as approved or rejected. Laboratory results included somatic cell count (SCC), total bacterial count (TBC), antimicrobial drug residues (ADR), level of butyric acid spores (BAB), freezing point depression (FPD), level of free fatty acids (FFA), and cleanliness of the milk (CLN). The bulk milk laboratory results were significantly related to audit outcomes. Rejected audits are likely to occur on dairy farms with higher mean levels of SCC, TBC, ADR, and BAB. Moreover, in a multivariable model, maxima for TBC, SCC, and FPD as well as standard deviations for TBC and FPD are risk factors for negative audit outcomes. The efficiency curve of a risk-based selection approach, on the basis of the derived regression results, dominated the current random selection approach. To capture 25, 50, or 75% of the population with poor process standards (i.e., audit outcome of rejected), respectively, only 8, 20, or 47% of the population had to be sampled based on a risk-based selection approach. Milk quality information can thus be used to preselect high-risk farms to be audited more frequently. Copyright © 2014 American Dairy Science Association. Published by Elsevier Inc. All rights reserved.

  6. Gis-Based Multi-Criteria Decision Analysis for Forest Fire Risk Mapping

    NASA Astrophysics Data System (ADS)

    Akay, A. E.; Erdoğan, A.

    2017-11-01

    The forested areas along the coastal zone of the Mediterranean region in Turkey are classified as first-degree fire sensitive areas. Forest fires are major environmental disaster that affects the sustainability of forest ecosystems. Besides, forest fires result in important economic losses and even threaten human lives. Thus, it is critical to determine the forested areas with fire risks and thereby minimize the damages on forest resources by taking necessary precaution measures in these areas. The risk of forest fire can be assessed based on various factors such as forest vegetation structures (tree species, crown closure, tree stage), topographic features (slope and aspect), and climatic parameters (temperature, wind). In this study, GIS-based Multi-Criteria Decision Analysis (MCDA) method was used to generate forest fire risk map. The study was implemented in the forested areas within Yayla Forest Enterprise Chiefs at Dursunbey Forest Enterprise Directorate which is classified as first degree fire sensitive area. In the solution process, "extAhp 2.0" plug-in running Analytic Hierarchy Process (AHP) method in ArcGIS 10.4.1 was used to categorize study area under five fire risk classes: extreme risk, high risk, moderate risk, and low risk. The results indicated that 23.81 % of the area was of extreme risk, while 25.81 % was of high risk. The result indicated that the most effective criterion was tree species, followed by tree stages. The aspect had the least effective criterion on forest fire risk. It was revealed that GIS techniques integrated with MCDA methods are effective tools to quickly estimate forest fire risk at low cost. The integration of these factors into GIS can be very useful to determine forested areas with high fire risk and also to plan forestry management after fire.

  7. Application of risk-based multiple criteria decision analysis for selection of the best agricultural scenario for effective watershed management.

    PubMed

    Javidi Sabbaghian, Reza; Zarghami, Mahdi; Nejadhashemi, A Pouyan; Sharifi, Mohammad Bagher; Herman, Matthew R; Daneshvar, Fariborz

    2016-03-01

    Effective watershed management requires the evaluation of agricultural best management practice (BMP) scenarios which carefully consider the relevant environmental, economic, and social criteria involved. In the Multiple Criteria Decision-Making (MCDM) process, scenarios are first evaluated and then ranked to determine the most desirable outcome for the particular watershed. The main challenge of this process is the accurate identification of the best solution for the watershed in question, despite the various risk attitudes presented by the associated decision-makers (DMs). This paper introduces a novel approach for implementation of the MCDM process based on a comparative neutral risk/risk-based decision analysis, which results in the selection of the most desirable scenario for use in the entire watershed. At the sub-basin level, each scenario includes multiple BMPs with scores that have been calculated using the criteria derived from two cases of neutral risk and risk-based decision-making. The simple additive weighting (SAW) operator is applied for use in neutral risk decision-making, while the ordered weighted averaging (OWA) and induced OWA (IOWA) operators are effective for risk-based decision-making. At the watershed level, the BMP scores of the sub-basins are aggregated to calculate each scenarios' combined goodness measurements; the most desirable scenario for the entire watershed is then selected based on the combined goodness measurements. Our final results illustrate the type of operator and risk attitudes needed to satisfy the relevant criteria within the number of sub-basins, and how they ultimately affect the final ranking of the given scenarios. The methodology proposed here has been successfully applied to the Honeyoey Creek-Pine Creek watershed in Michigan, USA to evaluate various BMP scenarios and determine the best solution for both the stakeholders and the overall stream health. Copyright © 2015 Elsevier Ltd. All rights reserved.

  8. Imputation and subset-based association analysis across different cancer types identifies multiple independent risk loci in the TERT-CLPTM1L region on chromosome 5p15.33

    PubMed Central

    Wang, Zhaoming; Zhu, Bin; Zhang, Mingfeng; Parikh, Hemang; Jia, Jinping; Chung, Charles C.; Sampson, Joshua N.; Hoskins, Jason W.; Hutchinson, Amy; Burdette, Laurie; Ibrahim, Abdisamad; Hautman, Christopher; Raj, Preethi S.; Abnet, Christian C.; Adjei, Andrew A.; Ahlbom, Anders; Albanes, Demetrius; Allen, Naomi E.; Ambrosone, Christine B.; Aldrich, Melinda; Amiano, Pilar; Amos, Christopher; Andersson, Ulrika; Andriole, Gerald; Andrulis, Irene L.; Arici, Cecilia; Arslan, Alan A.; Austin, Melissa A.; Baris, Dalsu; Barkauskas, Donald A.; Bassig, Bryan A.; Beane Freeman, Laura E.; Berg, Christine D.; Berndt, Sonja I.; Bertazzi, Pier Alberto; Biritwum, Richard B.; Black, Amanda; Blot, William; Boeing, Heiner; Boffetta, Paolo; Bolton, Kelly; Boutron-Ruault, Marie-Christine; Bracci, Paige M.; Brennan, Paul; Brinton, Louise A.; Brotzman, Michelle; Bueno-de-Mesquita, H. Bas; Buring, Julie E.; Butler, Mary Ann; Cai, Qiuyin; Cancel-Tassin, Geraldine; Canzian, Federico; Cao, Guangwen; Caporaso, Neil E.; Carrato, Alfredo; Carreon, Tania; Carta, Angela; Chang, Gee-Chen; Chang, I-Shou; Chang-Claude, Jenny; Che, Xu; Chen, Chien-Jen; Chen, Chih-Yi; Chen, Chung-Hsing; Chen, Constance; Chen, Kuan-Yu; Chen, Yuh-Min; Chokkalingam, Anand P.; Chu, Lisa W.; Clavel-Chapelon, Francoise; Colditz, Graham A.; Colt, Joanne S.; Conti, David; Cook, Michael B.; Cortessis, Victoria K.; Crawford, E. David; Cussenot, Olivier; Davis, Faith G.; De Vivo, Immaculata; Deng, Xiang; Ding, Ti; Dinney, Colin P.; Di Stefano, Anna Luisa; Diver, W. Ryan; Duell, Eric J.; Elena, Joanne W.; Fan, Jin-Hu; Feigelson, Heather Spencer; Feychting, Maria; Figueroa, Jonine D.; Flanagan, Adrienne M.; Fraumeni, Joseph F.; Freedman, Neal D.; Fridley, Brooke L.; Fuchs, Charles S.; Gago-Dominguez, Manuela; Gallinger, Steven; Gao, Yu-Tang; Gapstur, Susan M.; Garcia-Closas, Montserrat; Garcia-Closas, Reina; Gastier-Foster, Julie M.; Gaziano, J. Michael; Gerhard, Daniela S.; Giffen, Carol A.; Giles, Graham G.; Gillanders, Elizabeth M.; Giovannucci, Edward L.; Goggins, Michael; Gokgoz, Nalan; Goldstein, Alisa M.; Gonzalez, Carlos; Gorlick, Richard; Greene, Mark H.; Gross, Myron; Grossman, H. Barton; Grubb, Robert; Gu, Jian; Guan, Peng; Haiman, Christopher A.; Hallmans, Goran; Hankinson, Susan E.; Harris, Curtis C.; Hartge, Patricia; Hattinger, Claudia; Hayes, Richard B.; He, Qincheng; Helman, Lee; Henderson, Brian E.; Henriksson, Roger; Hoffman-Bolton, Judith; Hohensee, Chancellor; Holly, Elizabeth A.; Hong, Yun-Chul; Hoover, Robert N.; Hosgood, H. Dean; Hsiao, Chin-Fu; Hsing, Ann W.; Hsiung, Chao Agnes; Hu, Nan; Hu, Wei; Hu, Zhibin; Huang, Ming-Shyan; Hunter, David J.; Inskip, Peter D.; Ito, Hidemi; Jacobs, Eric J.; Jacobs, Kevin B.; Jenab, Mazda; Ji, Bu-Tian; Johansen, Christoffer; Johansson, Mattias; Johnson, Alison; Kaaks, Rudolf; Kamat, Ashish M.; Kamineni, Aruna; Karagas, Margaret; Khanna, Chand; Khaw, Kay-Tee; Kim, Christopher; Kim, In-Sam; Kim, Jin Hee; Kim, Yeul Hong; Kim, Young-Chul; Kim, Young Tae; Kang, Chang Hyun; Jung, Yoo Jin; Kitahara, Cari M.; Klein, Alison P.; Klein, Robert; Kogevinas, Manolis; Koh, Woon-Puay; Kohno, Takashi; Kolonel, Laurence N.; Kooperberg, Charles; Kratz, Christian P.; Krogh, Vittorio; Kunitoh, Hideo; Kurtz, Robert C.; Kurucu, Nilgun; Lan, Qing; Lathrop, Mark; Lau, Ching C.; Lecanda, Fernando; Lee, Kyoung-Mu; Lee, Maxwell P.; Le Marchand, Loic; Lerner, Seth P.; Li, Donghui; Liao, Linda M.; Lim, Wei-Yen; Lin, Dongxin; Lin, Jie; Lindstrom, Sara; Linet, Martha S.; Lissowska, Jolanta; Liu, Jianjun; Ljungberg, Börje; Lloreta, Josep; Lu, Daru; Ma, Jing; Malats, Nuria; Mannisto, Satu; Marina, Neyssa; Mastrangelo, Giuseppe; Matsuo, Keitaro; McGlynn, Katherine A.; McKean-Cowdin, Roberta; McNeill, Lorna H.; McWilliams, Robert R.; Melin, Beatrice S.; Meltzer, Paul S.; Mensah, James E.; Miao, Xiaoping; Michaud, Dominique S.; Mondul, Alison M.; Moore, Lee E.; Muir, Kenneth; Niwa, Shelley; Olson, Sara H.; Orr, Nick; Panico, Salvatore; Park, Jae Yong; Patel, Alpa V.; Patino-Garcia, Ana; Pavanello, Sofia; Peeters, Petra H. M.; Peplonska, Beata; Peters, Ulrike; Petersen, Gloria M.; Picci, Piero; Pike, Malcolm C.; Porru, Stefano; Prescott, Jennifer; Pu, Xia; Purdue, Mark P.; Qiao, You-Lin; Rajaraman, Preetha; Riboli, Elio; Risch, Harvey A.; Rodabough, Rebecca J.; Rothman, Nathaniel; Ruder, Avima M.; Ryu, Jeong-Seon; Sanson, Marc; Schned, Alan; Schumacher, Fredrick R.; Schwartz, Ann G.; Schwartz, Kendra L.; Schwenn, Molly; Scotlandi, Katia; Seow, Adeline; Serra, Consol; Serra, Massimo; Sesso, Howard D.; Severi, Gianluca; Shen, Hongbing; Shen, Min; Shete, Sanjay; Shiraishi, Kouya; Shu, Xiao-Ou; Siddiq, Afshan; Sierrasesumaga, Luis; Sierri, Sabina; Loon Sihoe, Alan Dart; Silverman, Debra T.; Simon, Matthias; Southey, Melissa C.; Spector, Logan; Spitz, Margaret; Stampfer, Meir; Stattin, Par; Stern, Mariana C.; Stevens, Victoria L.; Stolzenberg-Solomon, Rachael Z.; Stram, Daniel O.; Strom, Sara S.; Su, Wu-Chou; Sund, Malin; Sung, Sook Whan; Swerdlow, Anthony; Tan, Wen; Tanaka, Hideo; Tang, Wei; Tang, Ze-Zhang; Tardon, Adonina; Tay, Evelyn; Taylor, Philip R.; Tettey, Yao; Thomas, David M.; Tirabosco, Roberto; Tjonneland, Anne; Tobias, Geoffrey S.; Toro, Jorge R.; Travis, Ruth C.; Trichopoulos, Dimitrios; Troisi, Rebecca; Truelove, Ann; Tsai, Ying-Huang; Tucker, Margaret A.; Tumino, Rosario; Van Den Berg, David; Van Den Eeden, Stephen K.; Vermeulen, Roel; Vineis, Paolo; Visvanathan, Kala; Vogel, Ulla; Wang, Chaoyu; Wang, Chengfeng; Wang, Junwen; Wang, Sophia S.; Weiderpass, Elisabete; Weinstein, Stephanie J.; Wentzensen, Nicolas; Wheeler, William; White, Emily; Wiencke, John K.; Wolk, Alicja; Wolpin, Brian M.; Wong, Maria Pik; Wrensch, Margaret; Wu, Chen; Wu, Tangchun; Wu, Xifeng; Wu, Yi-Long; Wunder, Jay S.; Xiang, Yong-Bing; Xu, Jun; Yang, Hannah P.; Yang, Pan-Chyr; Yatabe, Yasushi; Ye, Yuanqing; Yeboah, Edward D.; Yin, Zhihua; Ying, Chen; Yu, Chong-Jen; Yu, Kai; Yuan, Jian-Min; Zanetti, Krista A.; Zeleniuch-Jacquotte, Anne; Zheng, Wei; Zhou, Baosen; Mirabello, Lisa; Savage, Sharon A.; Kraft, Peter; Chanock, Stephen J.; Yeager, Meredith; Landi, Maria Terese; Shi, Jianxin; Chatterjee, Nilanjan; Amundadottir, Laufey T.

    2014-01-01

    Genome-wide association studies (GWAS) have mapped risk alleles for at least 10 distinct cancers to a small region of 63 000 bp on chromosome 5p15.33. This region harbors the TERT and CLPTM1L genes; the former encodes the catalytic subunit of telomerase reverse transcriptase and the latter may play a role in apoptosis. To investigate further the genetic architecture of common susceptibility alleles in this region, we conducted an agnostic subset-based meta-analysis (association analysis based on subsets) across six distinct cancers in 34 248 cases and 45 036 controls. Based on sequential conditional analysis, we identified as many as six independent risk loci marked by common single-nucleotide polymorphisms: five in the TERT gene (Region 1: rs7726159, P = 2.10 × 10−39; Region 3: rs2853677, P = 3.30 × 10−36 and PConditional = 2.36 × 10−8; Region 4: rs2736098, P = 3.87 × 10−12 and PConditional = 5.19 × 10−6, Region 5: rs13172201, P = 0.041 and PConditional = 2.04 × 10−6; and Region 6: rs10069690, P = 7.49 × 10−15 and PConditional = 5.35 × 10−7) and one in the neighboring CLPTM1L gene (Region 2: rs451360; P = 1.90 × 10−18 and PConditional = 7.06 × 10−16). Between three and five cancers mapped to each independent locus with both risk-enhancing and protective effects. Allele-specific effects on DNA methylation were seen for a subset of risk loci, indicating that methylation and subsequent effects on gene expression may contribute to the biology of risk variants on 5p15.33. Our results provide strong support for extensive pleiotropy across this region of 5p15.33, to an extent not previously observed in other cancer susceptibility loci. PMID:25027329

  9. The impact of communicating genetic risks of disease on risk-reducing health behaviour: systematic review with meta-analysis.

    PubMed

    Hollands, Gareth J; French, David P; Griffin, Simon J; Prevost, A Toby; Sutton, Stephen; King, Sarah; Marteau, Theresa M

    2016-03-15

    To assess the impact of communicating DNA based disease risk estimates on risk-reducing health behaviours and motivation to engage in such behaviours. Systematic review with meta-analysis, using Cochrane methods. Medline, Embase, PsycINFO, CINAHL, and the Cochrane Central Register of Controlled Trials up to 25 February 2015. Backward and forward citation searches were also conducted. Randomised and quasi-randomised controlled trials involving adults in which one group received personalised DNA based estimates of disease risk for conditions where risk could be reduced by behaviour change. Eligible studies included a measure of risk-reducing behaviour. We examined 10,515 abstracts and included 18 studies that reported on seven behavioural outcomes, including smoking cessation (six studies; n=2663), diet (seven studies; n=1784), and physical activity (six studies; n=1704). Meta-analysis revealed no significant effects of communicating DNA based risk estimates on smoking cessation (odds ratio 0.92, 95% confidence interval 0.63 to 1.35, P=0.67), diet (standardised mean difference 0.12, 95% confidence interval -0.00 to 0.24, P=0.05), or physical activity (standardised mean difference -0.03, 95% confidence interval -0.13 to 0.08, P=0.62). There were also no effects on any other behaviours (alcohol use, medication use, sun protection behaviours, and attendance at screening or behavioural support programmes) or on motivation to change behaviour, and no adverse effects, such as depression and anxiety. Subgroup analyses provided no clear evidence that communication of a risk-conferring genotype affected behaviour more than communication of the absence of such a genotype. However, studies were predominantly at high or unclear risk of bias, and evidence was typically of low quality. Expectations that communicating DNA based risk estimates changes behaviour is not supported by existing evidence. These results do not support use of genetic testing or the search for risk-conferring gene variants for common complex diseases on the basis that they motivate risk-reducing behaviour. This is a revised and updated version of a Cochrane review from 2010, adding 11 studies to the seven previously identified. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  10. Critical asset and portfolio risk analysis: an all-hazards framework.

    PubMed

    Ayyub, Bilal M; McGill, William L; Kaminskiy, Mark

    2007-08-01

    This article develops a quantitative all-hazards framework for critical asset and portfolio risk analysis (CAPRA) that considers both natural and human-caused hazards. Following a discussion on the nature of security threats, the need for actionable risk assessments, and the distinction between asset and portfolio-level analysis, a general formula for all-hazards risk analysis is obtained that resembles the traditional model based on the notional product of consequence, vulnerability, and threat, though with clear meanings assigned to each parameter. Furthermore, a simple portfolio consequence model is presented that yields first-order estimates of interdependency effects following a successful attack on an asset. Moreover, depending on the needs of the decisions being made and available analytical resources, values for the parameters in this model can be obtained at a high level or through detailed systems analysis. Several illustrative examples of the CAPRA methodology are provided.

  11. Single-visit or multiple-visit root canal treatment: systematic review, meta-analysis and trial sequential analysis.

    PubMed

    Schwendicke, Falk; Göstemeyer, Gerd

    2017-02-01

    Single-visit root canal treatment has some advantages over conventional multivisit treatment, but might increase the risk of complications. We systematically evaluated the risk of complications after single-visit or multiple-visit root canal treatment using meta-analysis and trial-sequential analysis. Controlled trials comparing single-visit versus multiple-visit root canal treatment of permanent teeth were included. Trials needed to assess the risk of long-term complications (pain, infection, new/persisting/increasing periapical lesions ≥1 year after treatment), short-term pain or flare-up (acute exacerbation of initiation or continuation of root canal treatment). Electronic databases (PubMed, EMBASE, Cochrane Central) were screened, random-effects meta-analyses performed and trial-sequential analysis used to control for risk of random errors. Evidence was graded according to GRADE. 29 trials (4341 patients) were included, all but 6 showing high risk of bias. Based on 10 trials (1257 teeth), risk of complications was not significantly different in single-visit versus multiple-visit treatment (risk ratio (RR) 1.00 (95% CI 0.75 to 1.35); weak evidence). Based on 20 studies (3008 teeth), risk of pain did not significantly differ between treatments (RR 0.99 (95% CI 0.76 to 1.30); moderate evidence). Risk of flare-up was recorded by 8 studies (1110 teeth) and was significantly higher after single-visit versus multiple-visit treatment (RR 2.13 (95% CI 1.16 to 3.89); very weak evidence). Trial-sequential analysis revealed that firm evidence for benefit, harm or futility was not reached for any of the outcomes. There is insufficient evidence to rule out whether important differences between both strategies exist. Dentists can provide root canal treatment in 1 or multiple visits. Given the possibly increased risk of flare-ups, multiple-visit treatment might be preferred for certain teeth (eg, those with periapical lesions). Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  12. Game Theory and Risk-Based Levee System Design

    NASA Astrophysics Data System (ADS)

    Hui, R.; Lund, J. R.; Madani, K.

    2014-12-01

    Risk-based analysis has been developed for optimal levee design for economic efficiency. Along many rivers, two levees on opposite riverbanks act as a simple levee system. Being rational and self-interested, land owners on each river bank would tend to independently optimize their levees with risk-based analysis, resulting in a Pareto-inefficient levee system design from the social planner's perspective. Game theory is applied in this study to analyze decision making process in a simple levee system in which the land owners on each river bank develop their design strategies using risk-based economic optimization. For each land owner, the annual expected total cost includes expected annual damage cost and annualized construction cost. The non-cooperative Nash equilibrium is identified and compared to the social planner's optimal distribution of flood risk and damage cost throughout the system which results in the minimum total flood cost for the system. The social planner's optimal solution is not feasible without appropriate level of compensation for the transferred flood risk to guarantee and improve conditions for all parties. Therefore, cooperative game theory is then employed to develop an economically optimal design that can be implemented in practice. By examining the game in the reversible and irreversible decision making modes, the cost of decision making myopia is calculated to underline the significance of considering the externalities and evolution path of dynamic water resource problems for optimal decision making.

  13. Gender-based violence, alcohol use, and sexual risk among female patrons of drinking venues in Cape Town, South Africa.

    PubMed

    Pitpitan, Eileen V; Kalichman, Seth C; Eaton, Lisa A; Cain, Demetria; Sikkema, Kathleen J; Skinner, Donald; Watt, Melissa H; Pieterse, Desiree

    2013-06-01

    Gender-based violence is a well-recognized risk factor for HIV infection among women. Alcohol use is associated with both gender-based violence and sexual risk behavior, but has not been examined as a correlate of both in a context of both high HIV risk and hazardous drinking. The purpose of this paper is to examine the association between recent abuse by a sex partner with alcohol and sexual risk behavior among female patrons of alcohol serving venues in South Africa. Specifically, the aim of this study is to determine whether sexual risk behaviors are associated with gender-based violence after controlling for levels of alcohol use. We surveyed 1,388 women attending informal drinking establishments in Cape Town, South Africa to assess recent history of gender-based violence, drinking, and sexual risk behaviors. Gender-based violence was associated with both drinking and sexual risk behaviors after controlling for demographics among the women. A hierarchical logistic regression analysis showed that after controlling for alcohol use sexual risk behavior remained significantly associated with gender-based violence, particularly with meeting a new sex partner at the bar, recent STI diagnosis, and engaging in transactional sex, but not protected intercourse or number of partners. In South Africa where heavy drinking is prevalent women may be at particular risk of physical abuse from intimate partners as well as higher sexual risk. Interventions that aim to reduce gender-based violence and sexual risk behaviors must directly work to reduce drinking behavior.

  14. Gender-based Violence, Alcohol use, and Sexual Risk Among Female Patrons of Drinking Venues in Cape Town, South Africa

    PubMed Central

    Pitpitan, Eileen V.; Kalichman, Seth C.; Eaton, Lisa A.; Cain, Demetria; Sikkema, Kathleen J.; Skinner, Donald; Watt, Melissa H.; Pieterse, Desiree

    2013-01-01

    Gender-based violence is a well-recognized risk factor for HIV infection among women. Alcohol use is associated with both gender-based violence and sexual risk behavior, but has not been examined as a correlate of both in a context of both high HIV risk and hazardous drinking. The purpose of this paper is to examine the association between recent abuse by a sex partner with alcohol and sexual risk behavior among female patrons of alcohol serving venues in South Africa. Specifically, the aim of this study is to determine whether sexual risk behaviors are associated with gender-based violence after controlling for levels of alcohol use. We surveyed 1,388 women attending informal drinking establishments in Cape Town, South Africa to assess recent history of gender-based violence, drinking, and sexual risk behaviors. Gender-based violence was associated with both drinking and sexual risk behaviors after controlling for demographics among the women. A hierarchical logistic regression analysis showed that after controlling for alcohol use sexual risk behavior remained significantly associated with gender-based violence, particularly with meeting a new sex partner at the bar, recent STI diagnosis, and engaging in transactional sex, but not protected intercourse or number of partners. In South Africa where heavy drinking is prevalent women may be at particular risk of physical abuse from intimate partners as well as higher sexual risk. Interventions that aim to reduce gender-based violence and sexual risk behaviors must directly work to reduce drinking behavior. PMID:22526526

  15. The role of risk-based prioritization in total quality management

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Bennett, C.T.

    1994-10-01

    The climate in which government managers must make decisions grows more complex and uncertain. All stakeholders - the public, industry, and Congress - are demanding greater consciousness, responsibility, and accountability of programs and their budgets. Yet, managerial decisions have become multifaceted, involve greater risk, and operate over much longer time periods. Over the last four or five decades, as policy analysis and decisions became more complex, scientists from psychology, operations research, systems science, and economics have developed a more or less coherent process called decision analysis to aid program management. The process of decision analysis - a systems theoretic approachmore » - provides the backdrop for this paper. The Laboratory Integrated Prioritization System (LIPS) has been developed as a systems analytic and risk-based prioritization tool to aid the management of the Tri-Labs` (Lawrence Livermore, Los Alamos, and Sandia) operating resources. Preliminary analyses of the effects of LIPS has confirmed the practical benefits of decision and systems sciences - the systematic, quantitative reduction in uncertainty. To date, the use of LIPS - and, hence, its value - has been restricted to resource allocation within the Tri-Labs` operations budgets. This report extends the role of risk-based prioritization to the support of DOE Total Quality Management (TQM) programs. Furthermore, this paper will argue for the requirement to institutionalize an evolutionary, decision theoretic approach to the policy analysis of the Department of Energy`s Program Budget.« less

  16. Chagas disease risk in Texas.

    PubMed

    Sarkar, Sahotra; Strutz, Stavana E; Frank, David M; Rivaldi, Chissa-Louise; Sissel, Blake; Sánchez-Cordero, Victor

    2010-10-05

    Chagas disease, caused by Trypanosoma cruzi, remains a serious public health concern in many areas of Latin America, including México. It is also endemic in Texas with an autochthonous canine cycle, abundant vectors (Triatoma species) in many counties, and established domestic and peridomestic cycles which make competent reservoirs available throughout the state. Yet, Chagas disease is not reportable in Texas, blood donor screening is not mandatory, and the serological profiles of human and canine populations remain unknown. The purpose of this analysis was to provide a formal risk assessment, including risk maps, which recommends the removal of these lacunae. The spatial relative risk of the establishment of autochthonous Chagas disease cycles in Texas was assessed using a five-stage analysis. 1. Ecological risk for Chagas disease was established at a fine spatial resolution using a maximum entropy algorithm that takes as input occurrence points of vectors and environmental layers. The analysis was restricted to triatomine vector species for which new data were generated through field collection and through collation of post-1960 museum records in both México and the United States with sufficiently low georeferenced error to be admissible given the spatial resolution of the analysis (1 arc-minute). The new data extended the distribution of vector species to 10 new Texas counties. The models predicted that Triatoma gerstaeckeri has a large region of contiguous suitable habitat in the southern United States and México, T. lecticularia has a diffuse suitable habitat distribution along both coasts of the same region, and T. sanguisuga has a disjoint suitable habitat distribution along the coasts of the United States. The ecological risk is highest in south Texas. 2. Incidence-based relative risk was computed at the county level using the Bayesian Besag-York-Mollié model and post-1960 T. cruzi incidence data. This risk is concentrated in south Texas. 3. The ecological and incidence-based risks were analyzed together in a multi-criteria dominance analysis of all counties and those counties in which there were as yet no reports of parasite incidence. Both analyses picked out counties in south Texas as those at highest risk. 4. As an alternative to the multi-criteria analysis, the ecological and incidence-based risks were compounded in a multiplicative composite risk model. Counties in south Texas emerged as those with the highest risk. 5. Risk as the relative expected exposure rate was computed using a multiplicative model for the composite risk and a scaled population county map for Texas. Counties with highest risk were those in south Texas and a few counties with high human populations in north, east, and central Texas showing that, though Chagas disease risk is concentrated in south Texas, it is not restricted to it. For all of Texas, Chagas disease should be designated as reportable, as it is in Arizona and Massachusetts. At least for south Texas, lower than N, blood donor screening should be mandatory, and the serological profiles of human and canine populations should be established. It is also recommended that a joint initiative be undertaken by the United States and México to combat Chagas disease in the trans-border region. The methodology developed for this analysis can be easily exported to other geographical and disease contexts in which risk assessment is of potential value.

  17. Assessing and managing the health risk due to ingestion of inorganic arsenic from fish and shellfish farmed in blackfoot disease areas for general Taiwanese.

    PubMed

    Liang, Ching-Ping; Liu, Chen-Wuing; Jang, Cheng-Shin; Wang, Sheng-Wei; Lee, Jin-Jing

    2011-02-15

    This paper assesses health risks due to the ingestion of inorganic arsenic from fish and shellfish farmed in blackfoot disease areas by general public in Taiwan. The provisional tolerable weekly intake of arsenic set by FAO/WHO and the target cancer risk assessment model proposed by USEPA were integrated to evaluate the acceptable consumption rate. Five aquacultural species, tilapia (Oreochromis mossambicus), milkfish (Chanos chanos), mullet (Mugil cephalus), clam (Meretrix lusoria) and oyster (Crassostrea gigas) were included. Monte Carlo analysis was used to propagate the parameter uncertainty and to probabilistically assess the health risk associated with the daily intake of inorganic As from farmed fish and shellfish. The integrated risk-based analysis indicates that the associated 50th and 95th percentile health risk are 2.06×10(-5) and 8.77×10(-5), respectively. Moreover, the acceptable intakes of inorganic As are defined and illustrated by a two dimensional graphical model. According to the relationship between C(inorg) and IR(f) derived from this study, two risk-based curves are constructed. An acceptable risk zone is determined (risk ranging from 1×10(-5) to 6.07×10(-5)) which is recommended for acceptable consumption rates of fish and shellfish. To manage the health risk due to the ingestion of inorganic As from fish and shellfish in BFD areas, a risk-based management scheme is derived which provide a convenient way for general public to self-determine the acceptable seafood consumption rate. Copyright © 2010 Elsevier B.V. All rights reserved.

  18. Cancer Incidence in Physicians: A Taiwan National Population-based Cohort Study.

    PubMed

    Lee, Yu-Sung; Hsu, Chien-Chin; Weng, Shih-Feng; Lin, Hung-Jung; Wang, Jhi-Joung; Su, Shih-Bin; Huang, Chien-Cheng; Guo, How-Ran

    2015-11-01

    Cancer has been the leading cause of death in Taiwan since 1982. Physicians have many health-related risk factors which may contribute to cancer, such as rotating night shift, radiation, poor lifestyle, and higher exposure risk to infection and potential carcinogenic drugs. However, the cancer risk in physicians is not clear. In Taiwan's National Health Insurance Research Database, we identified 14,889 physicians as the study cohort and randomly selected 29,778 nonmedical staff patients as the comparison cohort for this national population-based cohort study. Cox proportional-hazard regression was used to compare the cancer risk between physicians and comparisons. Physician subgroups were also analyzed. Physicians had a lower all-cancer risk than did the comparisons (hazard ratio [HR] 0.86, 95% confidence interval [CI] 0.76-0.97). In the sex-based analysis, male physicians had a lower all-cancer risk than did male comparisons (HR 0.82, 95% CI 0.73-0.94); and female physicians did not (HR 1.29, 95% CI 0.88-1.91). In the cancer-type analysis, male physicians had a higher risk of prostate cancer (HR 1.72, 95% CI 1.12-2.65) and female physicians had twice the risk of breast cancer (HR 2.00, 95% CI 1.11-3.62) than did comparisons. Cancer risk was not significantly associated with physician specialties. Physicians in Taiwan had a lower all-cancer risk but higher risks for prostate and breast cancer than did the general population. These new epidemiological findings require additional study to clarify possible mechanisms.

  19. Parenthood and Worrying About Climate Change: The Limitations of Previous Approaches.

    PubMed

    Ekholm, Sara; Olofsson, Anna

    2017-02-01

    The present study considers the correlation between parenthood and worry about the consequences of climate change. Two approaches to gauging people's perceptions of the risks of climate change are compared: the classic approach, which measures risk perception, and the emotion-based approach, which measures feelings toward a risk object. The empirical material is based on a questionnaire-based survey of 3,529 people in Sweden, of whom 1,376 answered, giving a response rate of 39%. The results show that the correlation of parenthood and climate risk is significant when the emotional aspect is raised, but not when respondents were asked to do cognitive estimates of risk. Parenthood proves significant in all three questions that measure feelings, demonstrating that it is a determinant that serves to increase worry about climate change. © 2016 Society for Risk Analysis.

  20. Functional Behavioral Assessment-Based Interventions for Students with or at Risk for Emotional and/or Behavioral Disorders in School: A Hierarchical Linear Modeling Meta-Analysis

    ERIC Educational Resources Information Center

    Gage, Nicholas A.; Lewis, Timothy J.; Stichter, Janine P.

    2012-01-01

    Of the myriad practices currently utilized for students with disabilities, particularly students with or at risk for emotional and/or behavioral disorder (EBD), functional behavior assessment (FBA) is a practice with an emerging solid research base. However, the FBA research base relies on single-subject design (SSD) and synthesis has relied on…

  1. Problem-Based Teaching in International Management: A Political/Economic Risk Assessment Exercise

    ERIC Educational Resources Information Center

    Daly, Paula S.; White, Marion M.; Zisk, Daniel S.; Cavazos, David E.

    2013-01-01

    This article draws from the current literature to examine problem-based learning (PBL) as a management education tool, and provides an example of how to incorporate PBL into an undergraduate international management course. Also included are an explanation of, and specific guidelines for, a PBL exercise focused on the analysis of "country risk"…

  2. Genetic Polymorphisms of Glutathione-Related Enzymes (GSTM1, GSTT1, and GSTP1) and Schizophrenia Risk: A Meta-Analysis

    PubMed Central

    Kim, Su Kang; Kang, Sang Wook; Chung, Joo-Ho; Park, Hae Jeong; Cho, Kyu Bong; Park, Min-Su

    2015-01-01

    The association between polymorphisms of glutathione-related enzyme (GST) genes and the risk of schizophrenia has been investigated in many published studies. However, their results were inconclusive. Therefore, we performed a meta-analysis to explore the association between the GSTM1, GSTT1, and GSTP1 polymorphisms and the risk of schizophrenia. Twelve case-control studies were included in this meta-analysis. The odds ratio (OR) and 95% confidence interval (95% CI) were used to investigate the strength of the association. Our meta-analysis results revealed that GSTM1, GSTT1, and GSTP1 polymorphisms were not related to risk of schizophrenia (p > 0.05 in each model). Further analyses based on ethnicity, GSTM polymorphism showed weak association with schizophrenia in East Asian population (OR = 1.314, 95% CI = 1.025–1.684, p = 0.031). In conclusion, our meta-analysis indicated the GSTM1 polymorphism may be the only genetic risk factor for schizophrenia in East Asian population. However, more meta-analysis with a larger sample size were needed to provide more precise evidence. PMID:26295386

  3. Port Security Strategy 2012

    DTIC Science & Technology

    2007-06-15

    the base -case, a series analysis can be performed by varying the various inputs to the network to examine the impact of potential changes to improve...successfully interrogated was the primary MOE. • Based solely on the cost benefit analysis , the RSTG found that the addition of an Unmanned Surface...cargo. The CBP uses a risk based analysis and intelligence to pre-screen, assess and examine 100% of suspicious containers. The remaining cargo is

  4. The Effect of XPD Polymorphisms on Digestive Tract Cancers Risk: A Meta-Analysis

    PubMed Central

    Zhang, Qian; Chen, Zhipeng; Lu, Kai; Shu, Yongqian; Chen, Tao; Zhu, Lingjun

    2014-01-01

    Background The Xeroderma pigmento-sum group D gene (XPD) plays a key role in nucleotide excision repair. Single nucleotide polymorphisms (SNP) located in its functional region may alter DNA repair capacity phenotype and cancer risk. Many studies have demonstrated that XPD polymorphisms are significantly associated with digestive tract cancers risk, but the results are inconsistent. We conducted a comprehensive meta-analysis to assess the association between XPD Lys751Gln polymorphism and digestive tract cancers risk. The digestive tract cancers that our study referred to, includes oral cancer, esophageal cancer, gastric cancer and colorectal cancer. Methods We searched PubMed and EmBase up to December 31, 2012 to identify eligible studies. A total of 37 case-control studies including 9027 cases and 16072 controls were involved in this meta-analysis. Statistical analyses were performed with Stata software (version 11.0, USA). Odds ratios (ORs) with 95% confidence intervals (CIs) were used to assess the strength of the association. Results The results showed that XPD Lys751Gln polymorphism was associated with the increased risk of digestive tract cancers (homozygote comparison (GlnGln vs. LysLys): OR = 1.12, 95% CI = 1.01–1.24, P = 0.029, P heterogeneity = 0.133). We found no statistical evidence for a significantly increased digestive tract cancers risk in the other genetic models. In the subgroup analysis, we also found the homozygote comparison increased the susceptibility of Asian population (OR = 1.28, 95% CI = 1.01–1.63, P = 0.045, P heterogeneity = 0.287). Stratified by cancer type and source of control, no significantly increased cancer risk was found in these subgroups. Additionally, risk estimates from hospital-based studies and esophageal studies were heterogeneous. Conclusions Our meta-analysis suggested that the XPD 751Gln/Gln genotype was a low-penetrate risk factor for developing digestive tract cancers, especially in Asian populations. PMID:24787743

  5. The effect of XPD polymorphisms on digestive tract cancers risk: a meta-analysis.

    PubMed

    Du, Haina; Guo, Nannan; Shi, Bin; Zhang, Qian; Chen, Zhipeng; Lu, Kai; Shu, Yongqian; Chen, Tao; Zhu, Lingjun

    2014-01-01

    The Xeroderma pigmento-sum group D gene (XPD) plays a key role in nucleotide excision repair. Single nucleotide polymorphisms (SNP) located in its functional region may alter DNA repair capacity phenotype and cancer risk. Many studies have demonstrated that XPD polymorphisms are significantly associated with digestive tract cancers risk, but the results are inconsistent. We conducted a comprehensive meta-analysis to assess the association between XPD Lys751Gln polymorphism and digestive tract cancers risk. The digestive tract cancers that our study referred to, includes oral cancer, esophageal cancer, gastric cancer and colorectal cancer. We searched PubMed and EmBase up to December 31, 2012 to identify eligible studies. A total of 37 case-control studies including 9027 cases and 16072 controls were involved in this meta-analysis. Statistical analyses were performed with Stata software (version 11.0, USA). Odds ratios (ORs) with 95% confidence intervals (CIs) were used to assess the strength of the association. The results showed that XPD Lys751Gln polymorphism was associated with the increased risk of digestive tract cancers (homozygote comparison (GlnGln vs. LysLys): OR = 1.12, 95% CI = 1.01-1.24, P = 0.029, P heterogeneity = 0.133). We found no statistical evidence for a significantly increased digestive tract cancers risk in the other genetic models. In the subgroup analysis, we also found the homozygote comparison increased the susceptibility of Asian population (OR = 1.28, 95% CI = 1.01-1.63, P = 0.045, P heterogeneity = 0.287). Stratified by cancer type and source of control, no significantly increased cancer risk was found in these subgroups. Additionally, risk estimates from hospital-based studies and esophageal studies were heterogeneous. Our meta-analysis suggested that the XPD 751Gln/Gln genotype was a low-penetrate risk factor for developing digestive tract cancers, especially in Asian populations.

  6. Probabilistic Approaches for Multi-Hazard Risk Assessment of Structures and Systems

    NASA Astrophysics Data System (ADS)

    Kwag, Shinyoung

    Performance assessment of structures, systems, and components for multi-hazard scenarios has received significant attention in recent years. However, the concept of multi-hazard analysis is quite broad in nature and the focus of existing literature varies across a wide range of problems. In some cases, such studies focus on hazards that either occur simultaneously or are closely correlated with each other. For example, seismically induced flooding or seismically induced fires. In other cases, multi-hazard studies relate to hazards that are not dependent or correlated but have strong likelihood of occurrence at different times during the lifetime of a structure. The current approaches for risk assessment need enhancement to account for multi-hazard risks. It must be able to account for uncertainty propagation in a systems-level analysis, consider correlation among events or failure modes, and allow integration of newly available information from continually evolving simulation models, experimental observations, and field measurements. This dissertation presents a detailed study that proposes enhancements by incorporating Bayesian networks and Bayesian updating within a performance-based probabilistic framework. The performance-based framework allows propagation of risk as well as uncertainties in the risk estimates within a systems analysis. Unlike conventional risk assessment techniques such as a fault-tree analysis, a Bayesian network can account for statistical dependencies and correlations among events/hazards. The proposed approach is extended to develop a risk-informed framework for quantitative validation and verification of high fidelity system-level simulation tools. Validation of such simulations can be quite formidable within the context of a multi-hazard risk assessment in nuclear power plants. The efficiency of this approach lies in identification of critical events, components, and systems that contribute to the overall risk. Validation of any event or component on the critical path is relatively more important in a risk-informed environment. Significance of multi-hazard risk is also illustrated for uncorrelated hazards of earthquakes and high winds which may result in competing design objectives. It is also illustrated that the number of computationally intensive nonlinear simulations needed in performance-based risk assessment for external hazards can be significantly reduced by using the power of Bayesian updating in conjunction with the concept of equivalent limit-state.

  7. Which risk models perform best in selecting ever-smokers for lung cancer screening?

    Cancer.gov

    A new analysis by scientists at NCI evaluates nine different individualized lung cancer risk prediction models based on their selections of ever-smokers for computed tomography (CT) lung cancer screening.

  8. Reviewing the economic efficiency of disaster risk management

    NASA Astrophysics Data System (ADS)

    Mechler, Reinhard

    2013-04-01

    There is a lot of rhetoric suggesting that disaster risk management (DRM) pays, yet surprisingly little in the way of hard facts. Cost-benefit analysis (CBA) is one major tool that can provide quantitative information about the prioritization of disaster risk management (DRM) (and climate adaptation) based on economic principles. Yet, on a global scale, there has been surprisingly little robust evidence on the economic efficiency and benefits of risk management measures. This review shows that for the limited evidence reported the economic case for DRM across a range of hazards is strong and that the benefits of investing in DRM outweigh the costs of doing so, on average, by about four times the cost in terms of avoided and reduced losses. Most studies using a CBA approach focus on structural DRM and most information has been made available on physical flood prevention. There have been some limited studies on preparedness and risk financing. The global evidence base is limited and estimates appear not very solid, and overall, in line with the conclusion of the recent IPCC SREX report, there is limited evidence and medium agreement across the literature. Some of the factors behind the limited robustness are inherent to CBA more widely: these challenges comprise the inability to price intangibles, evaluating strategies rather than single projects, difficulties in assessing softer rather than infrastructure-related options, choices regarding a proper discount rate, lack of accounting for the distribution of benefits and costs and difficulties with assessing nonmarket values such as those related to health, the environment, or public goods. Although techniques exist to address some of these challenges, they are not very likely to easily go away. Other challenges associated specifically with DRM, such as the need and difficulty to undertake risk -based analysis can be overcome, and there have been manuals and reports providing a way forward. In an age of austerity, cost-benefit analysis continues to be an important tool for prioritising efficient DRM measures, yet with a shifting emphasis from infrastructure-based options (hard resilience) to preparedness and systemic interventions (soft resilience), other tools such as cost-effectiveness analysis, multi-criteria analysis and robust decision-making approaches deserve more attention.

  9. 75 FR 52302 - Notice of Availability of Pest Risk Analyses for the Importation of Fresh Celery, Arugula, and...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-08-25

    ... Inspection Service [Docket No. APHIS-2010-0074] Notice of Availability of Pest Risk Analyses for the... spinach from Colombia. We are making these pest risk analyses available to the public for review and..., based on the findings of a pest- risk analysis, can be safely imported subject to one or more of the...

  10. Process-based Cost Estimation for Ramjet/Scramjet Engines

    NASA Technical Reports Server (NTRS)

    Singh, Brijendra; Torres, Felix; Nesman, Miles; Reynolds, John

    2003-01-01

    Process-based cost estimation plays a key role in effecting cultural change that integrates distributed science, technology and engineering teams to rapidly create innovative and affordable products. Working together, NASA Glenn Research Center and Boeing Canoga Park have developed a methodology of process-based cost estimation bridging the methodologies of high-level parametric models and detailed bottoms-up estimation. The NASA GRC/Boeing CP process-based cost model provides a probabilistic structure of layered cost drivers. High-level inputs characterize mission requirements, system performance, and relevant economic factors. Design alternatives are extracted from a standard, product-specific work breakdown structure to pre-load lower-level cost driver inputs and generate the cost-risk analysis. As product design progresses and matures the lower level more detailed cost drivers can be re-accessed and the projected variation of input values narrowed, thereby generating a progressively more accurate estimate of cost-risk. Incorporated into the process-based cost model are techniques for decision analysis, specifically, the analytic hierarchy process (AHP) and functional utility analysis. Design alternatives may then be evaluated not just on cost-risk, but also user defined performance and schedule criteria. This implementation of full-trade study support contributes significantly to the realization of the integrated development environment. The process-based cost estimation model generates development and manufacturing cost estimates. The development team plans to expand the manufacturing process base from approximately 80 manufacturing processes to over 250 processes. Operation and support cost modeling is also envisioned. Process-based estimation considers the materials, resources, and processes in establishing cost-risk and rather depending on weight as an input, actually estimates weight along with cost and schedule.

  11. Human health risk constrained naphthalene-contaminated groundwater remediation management through an improved credibility method.

    PubMed

    Li, Jing; Lu, Hongwei; Fan, Xing; Chen, Yizhong

    2017-07-01

    In this study, a human health risk constrained groundwater remediation management program based on the improved credibility is developed for naphthalene contamination. The program integrates simulation, multivariate regression analysis, health risk assessment, uncertainty analysis, and nonlinear optimization into a general framework. The improved credibility-based optimization model for groundwater remediation management with consideration of human health risk (ICOM-HHR) is capable of not only effectively addressing parameter uncertainties and risk-exceeding possibility in human health risk but also providing a credibility level that indicates the satisfaction of the optimal groundwater remediation strategies with multiple contributions of possibility and necessity. The capabilities and effectiveness of ICOM-HHR are illustrated through a real-world case study in Anhui Province, China. Results indicate that the ICOM-HHR would generate double remediation cost yet reduce approximately 10 times of the naphthalene concentrations at monitoring wells, i.e., mostly less than 1 μg/L, which implies that the ICOM-HHR usually results in better environmental and health risk benefits. And it is acceptable to obtain a better environmental quality and a lower health risk level with sacrificing a certain economic benefit.

  12. A Meta-analysis of Studies Comparing Outcomes of Diverse Acellular Dermal Matrices for Implant-Based Breast Reconstruction.

    PubMed

    Lee, Kyeong-Tae; Mun, Goo-Hyun

    2017-07-01

    The current diversity of the available acellular dermal matrix (ADM) materials for implant-based breast reconstruction raises the issue of whether there are any differences in postoperative outcomes according to the kind of ADM used. The present meta-analysis aimed to investigate whether choice of ADM products can affect outcomes. Studies that used multiple kinds of ADM products for implant-based breast reconstruction and compared outcomes between them were searched. Outcomes of interest were rates of postoperative complications: infection, seroma, mastectomy flap necrosis, reconstruction failure, and overall complications. A total of 17 studies met the selection criteria. There was only 1 randomized controlled trial, and the other 16 studies had retrospective designs. Comparison of FlexHD, DermaMatrix, and ready-to-use AlloDerm with freeze-dried AlloDerm was conducted in multiple studies and could be meta-analyzed, in which 12 studies participated. In the meta-analysis comparing FlexHD and freeze-dried AlloDerm, using the results of 6 studies, both products showed similar pooled risks for all kinds of complications. When comparing DermaMatrix and freeze-dried AlloDerm with the results from 4 studies, there were also no differences between the pooled risks of complications of the two. Similarly, the meta-analysis of 4 studies comparing ready-to-use and freeze-dried AlloDerm demonstrated that the pooled risks for the complications did not differ. This meta-analysis demonstrates that the 3 recently invented, human cadaveric skin-based products of FlexHD, DermaMatrix, and ready-to-use AlloDerm have similar risks of complications compared with those of freeze-dried AlloDerm, which has been used for longer. However, as most studies had low levels of evidence, further investigations are needed.

  13. Risk Assessment of Groundwater Contamination: A Multilevel Fuzzy Comprehensive Evaluation Approach Based on DRASTIC Model

    PubMed Central

    Zhang, Yan; Zhong, Ming

    2013-01-01

    Groundwater contamination is a serious threat to water supply. Risk assessment of groundwater contamination is an effective way to protect the safety of groundwater resource. Groundwater is a complex and fuzzy system with many uncertainties, which is impacted by different geological and hydrological factors. In order to deal with the uncertainty in the risk assessment of groundwater contamination, we propose an approach with analysis hierarchy process and fuzzy comprehensive evaluation integrated together. Firstly, the risk factors of groundwater contamination are identified by the sources-pathway-receptor-consequence method, and a corresponding index system of risk assessment based on DRASTIC model is established. Due to the complexity in the process of transitions between the possible pollution risks and the uncertainties of factors, the method of analysis hierarchy process is applied to determine the weights of each factor, and the fuzzy sets theory is adopted to calculate the membership degrees of each factor. Finally, a case study is presented to illustrate and test this methodology. It is concluded that the proposed approach integrates the advantages of both analysis hierarchy process and fuzzy comprehensive evaluation, which provides a more flexible and reliable way to deal with the linguistic uncertainty and mechanism uncertainty in groundwater contamination without losing important information. PMID:24453883

  14. Inventory Control System for a Healthcare Apparel Service Centre with Stockout Risk: A Case Analysis

    PubMed Central

    Hui, Chi-Leung

    2017-01-01

    Based on the real-world inventory control problem of a capacitated healthcare apparel service centre in Hong Kong which provides tailor-made apparel-making services for the elderly and disabled people, this paper studies a partial backordered continuous review inventory control problem in which the product demand follows a Poisson process with a constant lead time. The system is controlled by an (Q,r) inventory policy which incorporate the stockout risk, storage capacity, and partial backlog. The healthcare apparel service centre, under the capacity constraint, aims to minimize the inventory cost and achieving a low stockout risk. To address this challenge, an optimization problem is constructed. A real case-based data analysis is conducted, and the result shows that the expected total cost on an order cycle is reduced substantially at around 20% with our proposed optimal inventory control policy. An extensive sensitivity analysis is conducted to generate additional insights. PMID:29527283

  15. Financial and risk considerations for successful disease management programs.

    PubMed

    Baldwin, A L

    1999-11-01

    Results for disease management [DM] programs have not been as positive as hoped because of clinical issues, lack of access to capital, and administrative issues. The financial experience of DM programs can be quite volatile. Financial projections that are protocol-based, rather than experience-based, may understate the revenue required and the range of possible costs for a DM program by understating the impact of complicating conditions and comorbidities. Actuarial tools (risk analysis and risk projection models) support better understanding of DM contracts. In particular, these models can provide the ability to quantify the impact of the factors that drive costs of a contract and the volatility of those costs. This analysis can assist DM companies in setting appropriate revenue and capital targets. Similar analysis by health plans can identify diseases that are good candidates for DM programs and can provide the basis for performance targets.

  16. Inventory Control System for a Healthcare Apparel Service Centre with Stockout Risk: A Case Analysis.

    PubMed

    Pan, An; Hui, Chi-Leung

    2017-01-01

    Based on the real-world inventory control problem of a capacitated healthcare apparel service centre in Hong Kong which provides tailor-made apparel-making services for the elderly and disabled people, this paper studies a partial backordered continuous review inventory control problem in which the product demand follows a Poisson process with a constant lead time. The system is controlled by an ( Q , r ) inventory policy which incorporate the stockout risk, storage capacity, and partial backlog. The healthcare apparel service centre, under the capacity constraint, aims to minimize the inventory cost and achieving a low stockout risk. To address this challenge, an optimization problem is constructed. A real case-based data analysis is conducted, and the result shows that the expected total cost on an order cycle is reduced substantially at around 20% with our proposed optimal inventory control policy. An extensive sensitivity analysis is conducted to generate additional insights.

  17. Claims-based risk model for first severe COPD exacerbation.

    PubMed

    Stanford, Richard H; Nag, Arpita; Mapel, Douglas W; Lee, Todd A; Rosiello, Richard; Schatz, Michael; Vekeman, Francis; Gauthier-Loiselle, Marjolaine; Merrigan, J F Philip; Duh, Mei Sheng

    2018-02-01

    To develop and validate a predictive model for first severe chronic obstructive pulmonary disease (COPD) exacerbation using health insurance claims data and to validate the risk measure of controller medication to total COPD treatment (controller and rescue) ratio (CTR). A predictive model was developed and validated in 2 managed care databases: Truven Health MarketScan database and Reliant Medical Group database. This secondary analysis assessed risk factors, including CTR, during the baseline period (Year 1) to predict risk of severe exacerbation in the at-risk period (Year 2). Patients with COPD who were 40 years or older and who had at least 1 COPD medication dispensed during the year following COPD diagnosis were included. Subjects with severe exacerbations in the baseline year were excluded. Risk factors in the baseline period were included as potential predictors in multivariate analysis. Performance was evaluated using C-statistics. The analysis included 223,824 patients. The greatest risk factors for first severe exacerbation were advanced age, chronic oxygen therapy usage, COPD diagnosis type, dispensing of 4 or more canisters of rescue medication, and having 2 or more moderate exacerbations. A CTR of 0.3 or greater was associated with a 14% lower risk of severe exacerbation. The model performed well with C-statistics, ranging from 0.711 to 0.714. This claims-based risk model can predict the likelihood of first severe COPD exacerbation. The CTR could also potentially be used to target populations at greatest risk for severe exacerbations. This could be relevant for providers and payers in approaches to prevent severe exacerbations and reduce costs.

  18. School Reform for Youth At Risk: Analysis of Six Change Models. Volume I: Summary and Analysis.

    ERIC Educational Resources Information Center

    McCollum, Heather

    This document analyzes six school-reform models for at-risk youth. Part 1 examines three curriculum-based reform programs that explicitly target curriculum and instruction: Reading Recovery; Success for All; and the Academy model. These programs focus on changes in student achievement and work within the structure of existing schools. Part 2…

  19. Towards Improved Considerations of Risk in Seismic Design (Plinius Medal Lecture)

    NASA Astrophysics Data System (ADS)

    Sullivan, T. J.

    2012-04-01

    The aftermath of recent earthquakes is a reminder that seismic risk is a very relevant issue for our communities. Implicit within the seismic design standards currently in place around the world is that minimum acceptable levels of seismic risk will be ensured through design in accordance with the codes. All the same, none of the design standards specify what the minimum acceptable level of seismic risk actually is. Instead, a series of deterministic limit states are set which engineers then demonstrate are satisfied for their structure, typically through the use of elastic dynamic analyses adjusted to account for non-linear response using a set of empirical correction factors. From the early nineties the seismic engineering community has begun to recognise numerous fundamental shortcomings with such seismic design procedures in modern codes. Deficiencies include the use of elastic dynamic analysis for the prediction of inelastic force distributions, the assignment of uniform behaviour factors for structural typologies irrespective of the structural proportions and expected deformation demands, and the assumption that hysteretic properties of a structure do not affect the seismic displacement demands, amongst other things. In light of this a number of possibilities have emerged for improved control of risk through seismic design, with several innovative displacement-based seismic design methods now well developed. For a specific seismic design intensity, such methods provide a more rational means of controlling the response of a structure to satisfy performance limit states. While the development of such methodologies does mark a significant step forward for the control of seismic risk, they do not, on their own, identify the seismic risk of a newly designed structure. In the U.S. a rather elaborate performance-based earthquake engineering (PBEE) framework is under development, with the aim of providing seismic loss estimates for new buildings. The PBEE framework consists of the following four main analysis stages: (i) probabilistic seismic hazard analysis to give the mean occurrence rate of earthquake events having an intensity greater than a threshold value, (ii) structural analysis to estimate the global structural response, given a certain value of seismic intensity, (iii) damage analysis, in which fragility functions are used to express the probability that a building component exceeds a damage state, as a function of the global structural response, (iv) loss analysis, in which the overall performance is assessed based on the damage state of all components. This final step gives estimates of the mean annual frequency with which various repair cost levels (or other decision variables) are exceeded. The realisation of this framework does suggest that risk-based seismic design is now possible. However, comparing current code approaches with the proposed PBEE framework, it becomes apparent that mainstream consulting engineers would have to go through a massive learning curve in order to apply the new procedures in practice. With this in mind, it is proposed that simplified loss-based seismic design procedures are a logical means of helping the engineering profession transition from what are largely deterministic seismic design procedures in current codes, to more rational risk-based seismic design methodologies. Examples are provided to illustrate the likely benefits of adopting loss-based seismic design approaches in practice.

  20. Evaluation and simplification of the occupational slip, trip and fall risk-assessment test

    PubMed Central

    NAKAMURA, Takehiro; OYAMA, Ichiro; FUJINO, Yoshihisa; KUBO, Tatsuhiko; KADOWAKI, Koji; KUNIMOTO, Masamizu; ODOI, Haruka; TABATA, Hidetoshi; MATSUDA, Shinya

    2016-01-01

    Objective: The purpose of this investigation is to evaluate the efficacy of the occupational slip, trip and fall (STF) risk assessment test developed by the Japan Industrial Safety and Health Association (JISHA). We further intended to simplify the test to improve efficiency. Methods: A previous cohort study was performed using 540 employees aged ≥50 years who took the JISHA’s STF risk assessment test. We conducted multivariate analysis using these previous results as baseline values and answers to questionnaire items or score on physical fitness tests as variables. The screening efficiency of each model was evaluated based on the obtained receiver operating characteristic (ROC) curve. Results: The area under the ROC obtained in multivariate analysis was 0.79 when using all items. Six of the 25 questionnaire items were selected for stepwise analysis, giving an area under the ROC curve of 0.77. Conclusion: Based on the results of follow-up performed one year after the initial examination, we successfully determined the usefulness of the STF risk assessment test. Administering a questionnaire alone is sufficient for screening subjects at risk of STF during the subsequent one-year period. PMID:27021057

  1. An improved method for risk evaluation in failure modes and effects analysis of CNC lathe

    NASA Astrophysics Data System (ADS)

    Rachieru, N.; Belu, N.; Anghel, D. C.

    2015-11-01

    Failure mode and effects analysis (FMEA) is one of the most popular reliability analysis tools for identifying, assessing and eliminating potential failure modes in a wide range of industries. In general, failure modes in FMEA are evaluated and ranked through the risk priority number (RPN), which is obtained by the multiplication of crisp values of the risk factors, such as the occurrence (O), severity (S), and detection (D) of each failure mode. However, the crisp RPN method has been criticized to have several deficiencies. In this paper, linguistic variables, expressed in Gaussian, trapezoidal or triangular fuzzy numbers, are used to assess the ratings and weights for the risk factors S, O and D. A new risk assessment system based on the fuzzy set theory and fuzzy rule base theory is to be applied to assess and rank risks associated to failure modes that could appear in the functioning of Turn 55 Lathe CNC. Two case studies have been shown to demonstrate the methodology thus developed. It is illustrated a parallel between the results obtained by the traditional method and fuzzy logic for determining the RPNs. The results show that the proposed approach can reduce duplicated RPN numbers and get a more accurate, reasonable risk assessment. As a result, the stability of product and process can be assured.

  2. Risk factors of hepatitis B virus infection among blood donors in Duhok city, Kurdistan Region, Iraq

    PubMed Central

    R Hussein, Nawfal

    2018-01-01

    Background: Hepatitis B virus (HBV) infection is a public health problem. The lack of information about the seroprevalence and risk factors is an obstacle for preventive public health plans to reduce the burden of viral hepatitis. Therefore, this study was conducted in Iraq, where no studies had been performed to determine the prevalence and risk factors of HBV infection. Methods: Blood samples were collected form 438 blood donors attending blood bank in Duhok city. Serum samples were tested for HBV core-antibodies (HBcAb) and HBV surface-antigen (HBsAg) by ELISA. Various risk factors were recorded and multivariate analysis was performed. Results: 5/438 (1.14%) of the subjects were HBsAg positive (HBsAg and HBcAb positive) and 36/438 (8.2%) were HBcAb positive. Hence, 41 cases were exposed to HBV and data analysis was based on that. Univariate analysis showed that there were significant associations between history of illegitimate sexual contact, history of alcohol or history of dental surgeries and HBV exposure (p<0.05 for all). Then, multivariate analysis was conducted to find HBV exposure predictive factors. It was found that history of dental surgery was a predictive factor for exposure to the virus (P=0.03, OR: 2.397). Conclusions: This study suggested that the history of dental surgery was predictive for HBV transmission in Duhok city. Further population-based study is needed to determine HBV risk factors in the society and public health plan based on that should be considered. PMID:29387315

  3. Evaluating robustness in rank-based risk assessments of freshwater ecosystems

    USGS Publications Warehouse

    Mattson, K.M.; Angermeier, Paul

    2007-01-01

    Conservation planning aims to protect biodiversity by sustainng the natural physical, chemical, and biological processes within representative ecosystems. Often data to measure these components are inadequate or unavailable. The impact of human activities on ecosystem processes complicates integrity assessments and might alter ecosystem organization at multiple spatial scales. Freshwater conservation targets, such as populations and communities, are influenced by both intrinsic aquatic properties and the surrounding landscape, and locally collected data might not accurately reflect potential impacts. We suggest that changes in five major biotic drivers—energy sources, physical habitat, flow regime, water quality, and biotic interactions—might be used as surrogates to inform conservation planners of the ecological integrity of freshwater ecosystems. Threats to freshwater systems might be evaluated based on their impact to these drivers to provide an overview of potential risk to conservation targets. We developed a risk-based protocol, the Ecological Risk Index (ERI), to identify watersheds with least/most risk to conservation targets. Our protocol combines risk-based components, specifically the frequency and severity of human-induced stressors, with biotic drivers and mappable land- and water-use data to provide a summary of relative risk to watersheds. We illustrate application of our protocol with a case study of the upper Tennessee River basin, USA. Differences in risk patterns among the major drainages in the basin reflect dominant land uses, such as mining and agriculture. A principal components analysis showed that localized, moderately severe threats accounted for most of the threat composition differences among our watersheds. We also found that the relative importance of threats is sensitive to the spatial grain of the analysis. Our case study demonstrates that the ERI is useful for evaluating the frequency and severity of ecosystemwide risk, which can inform local and regional conservation planning.

  4. Risk of large oil spills: a statistical analysis in the aftermath of Deepwater Horizon.

    PubMed

    Eckle, Petrissa; Burgherr, Peter; Michaux, Edouard

    2012-12-04

    The oil spill in the Gulf of Mexico that followed the explosion of the exploration platform Deepwater Horizon on 20 April 2010 was the largest accidental oil spill so far. In this paper we evaluate the risk of such very severe oil spills based on global historical data from our Energy-Related Severe Accident Database (ENSAD) and investigate if an accident of this size could have been "expected". We also compare the risk of oil spills from such accidents in exploration and production to accidental spills from other activities in the oil chain (tanker ship transport, pipelines, storage/refinery) and analyze the two components of risk, frequency and severity (quantity of oil spilled) separately. This detailed analysis reveals the differences in the structure of the risk between different spill sources, differences in trends over time and it allows in particular assessing the risk of very severe events such as the Deepwater Horizon spill. Such top down risk assessment can serve as an important input to decision making by complementing bottom up engineering risk assessment and can be combined with impact assessment in environmental risk analysis.

  5. Influence of green supply chain risk management on performance of Chinese manufacturing enterprises

    NASA Astrophysics Data System (ADS)

    Zhang, Dongying; Yuting, Duan; Junyi, Shen

    2017-12-01

    This paper briefly introduces the background of the research on the impact of green supply chain risk management on corporate performance, reviews the relevant research literature at home and abroad, and uses the gray relational analysis to analyze the impact of the green supply chain risk management on enterprise performance based on 26 industry-related statistical data, from purchasing risk management performance,manufacturing risk management performance and marketing risk management performance.

  6. Pharmacologic therapies for severe steroid refractory hospitalized ulcerative colitis: A network meta-analysis.

    PubMed

    Komaki, Yuga; Komaki, Fukiko; Micic, Dejan; Yamada, Akihiro; Suzuki, Yasuo; Sakuraba, Atsushi

    2017-06-01

    A limited option of therapies is available for hospitalized patients with severe steroid refractory ulcerative colitis (UC). Furthermore, there exists a paucity of direct comparisons between them. To provide a comparative evaluation of the efficacy and safety of pharmacologic therapies, we conducted a network meta-analysis combined with a benefit-risk analysis of randomized controlled trials (RCTs) performed in hospitalized patients with severe steroid refractory UC. Electronic databases were searched through November 2015 for RCTs evaluating the efficacy of therapies for severe steroid refractory hospitalized UC. The outcomes were clinical response, colectomy free rate, and severe adverse events leading to discontinuation of therapy. The primary endpoints were the rank of therapies based on network meta-analysis combined with benefit-risk analysis between clinical response and severe adverse events as well as colectomy free rate and severe adverse events. Eight RCTs of 421 patients were identified. Cyclosporine, infliximab, and tacrolimus as well as placebo were included in our analysis. Network meta-analysis with benefit-risk analysis simultaneously assessing clinical response and severe adverse events demonstrated the rank order of efficacy as infliximab, cyclosporine, tacrolimus, and placebo. Similar analysis for colectomy-free rate and severe adverse events demonstrated the same rank order of efficacy. The differences among infliximab, cyclosporine, and tacrolimus were small in all analyses. The results of the present comprehensive benefit-risk assessment using network meta-analysis provide RCT-based evidence on efficacy and safety of infliximab, cyclosporine, and tacrolimus for hospitalized patients with severe steroid refractory UC. © 2016 Journal of Gastroenterology and Hepatology Foundation and John Wiley & Sons Australia, Ltd.

  7. Risk assessment for enterprise resource planning (ERP) system implementations: a fault tree analysis approach

    NASA Astrophysics Data System (ADS)

    Zeng, Yajun; Skibniewski, Miroslaw J.

    2013-08-01

    Enterprise resource planning (ERP) system implementations are often characterised with large capital outlay, long implementation duration, and high risk of failure. In order to avoid ERP implementation failure and realise the benefits of the system, sound risk management is the key. This paper proposes a probabilistic risk assessment approach for ERP system implementation projects based on fault tree analysis, which models the relationship between ERP system components and specific risk factors. Unlike traditional risk management approaches that have been mostly focused on meeting project budget and schedule objectives, the proposed approach intends to address the risks that may cause ERP system usage failure. The approach can be used to identify the root causes of ERP system implementation usage failure and quantify the impact of critical component failures or critical risk events in the implementation process.

  8. 75 FR 72611 - Assessments, Large Bank Pricing

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-11-24

    ... the worst risk ranking and are included in the statistical analysis. Appendix 1 to the NPR describes the statistical analysis in detail. \\12\\ The percentage approximated by factors is based on the statistical model for that particual year. Actual weights assigned to each scorecard measure are largely based...

  9. Influence of arterial hypertension, type 2 diabetes and cardiovascular risk factors on ALS outcome: a population-based study.

    PubMed

    Moglia, Cristina; Calvo, Andrea; Canosa, Antonio; Bertuzzo, Davide; Cugnasco, Paolo; Solero, Luca; Grassano, Maurizio; Bersano, Enrica; Cammarosano, Stefania; Manera, Umberto; Pisano, Fabrizio; Mazzini, Letizia; Dalla Vecchia, Laura A; Mora, Gabriele; Chiò, Adriano

    2017-11-01

    To assess the prognostic influence of pre-morbid type 2 diabetes mellitus, arterial hypertension and cardiovascular (CV) risk profile on ALS phenotype and outcome in a population-based cohort of Italian patients. A total of 650 ALS patients from the Piemonte/Valle d'Aosta Register for ALS, incident in the 2007-2011 period, were recruited. Information about premorbid presence of type 2 diabetes mellitus, arterial hypertension was collected at the time of diagnosis. Patients' CV risk profile was calculated according to the Joint British Societies' guidelines on prevention of cardiovascular disease in clinical practice (JBS2). At the univariate analysis, the presence of pre-morbid arterial hypertension was associated with a higher age at onset of ALS and a shorter survival, and patients with a high CV risk profile had a worse prognosis than those with a low CV risk profile. The Cox multivariable analysis did not confirm such findings. Type 2 diabetes mellitus did not modify either the phenotype or the prognosis of ALS patients. This study performed on a large population-based cohort of ALS patients has demonstrated that arterial hypertension, type 2 diabetes and CV risk factors, calculated using the Framingham equation, do not influence ALS phenotype and prognosis.

  10. Life cycle cost-based risk model for energy performance contracting retrofits

    NASA Astrophysics Data System (ADS)

    Berghorn, George H.

    Buildings account for 41% of the primary energy consumption in the United States, nearly half of which is accounted for by commercial buildings. Among the greatest energy users are those in the municipalities, universities, schools, and hospitals (MUSH) market. Correctional facilities are in the upper half of all commercial building types for energy intensity. Public agencies have experienced reduced capital budgets to fund retrofits; this has led to the increased use of energy performance contracts (EPC), which are implemented by energy services companies (ESCOs). These companies guarantee a minimum amount of energy savings resulting from the retrofit activities, which in essence transfers performance risk from the owner to the contractor. Building retrofits in the MUSH market, especially correctional facilities, are well-suited to EPC, yet despite this potential and their high energy intensities, efficiency improvements lag behind that of other public building types. Complexities in project execution, lack of support for data requests and sub-metering, and conflicting project objectives have been cited as reasons for this lag effect. As a result, project-level risks must be understood in order to support wider adoption of retrofits in the public market, in particular the correctional facility sub-market. The goal of this research is to understand risks related to the execution of energy efficiency retrofits delivered via EPC in the MUSH market. To achieve this goal, in-depth analysis and improved understanding was sought with regard to ESCO risks that are unique to EPC in this market. The proposed work contributes to this understanding by developing a life cycle cost-based risk model to improve project decision making with regard to risk control and reduction. The specific objectives of the research are: (1) to perform an exploratory analysis of the EPC retrofit process and identify key areas of performance risk requiring in-depth analysis; (2) to construct a framework describing the sources of and mitigation strategies employed for assessing key risks in EPC retrofits; (3) to develop a strategy for analyzing and evaluating risks for EPC retrofits focused on managing expected costs throughout the project life cycle, and use data collected through this strategy to develop and parameterize a risk model; and (4) to demonstrate the applicability of the proposed life cost-based risk model through a pilot application to a case study site. Five major contributions to the body of knowledge resulting from the research include: (1) a consensus-based assessment of ESCO risk management; (2) characterization of EPC retrofit risks borne by ESCOs; (3) an empirical evaluation of scenario failure mode and effects analysis and its application to this domain; (4) development and pilot application of a life cycle cost-based risk model; and (5) future expansion of the research approach to other domains. The researcher envisions that full implementation of the research will further encourage the growth of the energy services industry, and support focused retrofits in complex building types that typically can benefit the most from such work. Ultimately, this will reduce the energy consumption of public sector buildings to levels that are more fitting with the global principles of sustainability and responsible management of constrained resources.

  11. Decision Tree Analysis of Traditional Risk Factors of Carotid Atherosclerosis and a Cutpoint-Based Prevention Strategy

    PubMed Central

    Lv, Lihong; Xiao, Yufei; Tu, Jiangfeng; Tao, Lisha; Wu, Jiaqi; Tang, Xiaoxiao; Pan, Wensheng

    2014-01-01

    Background Reducing the exposure to risk factors for the prevention of cardio-cerebral vascular disease is a crucial issue. Few reports have described practical interventions for preventing cardiovascular disease in different genders and age groups, particularly detailed and specific cutpoint-based prevention strategies. Methods We collected the health examination data of 5822 subjects between 20 and 80 years of age. The administration of medical questionnaires and physical examinations and the measurement of blood pressure, fasting plasma glucose (FPG) and blood lipids [total cholesterol (TC), triglycerides (TG), high density lipoprotein–cholesterol (HDL-C), and low density lipoprotein-cholesterol (LDL-C)] were performed by physicians. Carotid ultrasound was performed to examine the carotid intima-media thickness (CIMT), which was defined as carotid atherosclerosis when CIMT ≥0.9 mm. Decision tree analysis was used to screen for the most important risk factors for carotid atherosclerosis and to identify the relevant cutpoints. Results In the study population, the incidence of carotid atherosclerosis was 12.20% (men: 14.10%, women: 9.20%). The statistical analysis showed significant differences in carotid atherosclerosis incidence between different genders (P<0.0001) and age groups (P<0.001). The decision tree analysis showed that in men, the most important traditional risk factors for carotid atherosclerosis were TC (cutpoint [CP]: 6.31 mmol/L) between the ages of 20–40 and FPG (CP: 5.79 mmol/L) between the ages of 41–59. By comparison, LDL-C (CP: 4.27 mmol/L) became the major risk factor when FPG ≤5.79 mmol/L. FPG (CP: 5.52 mmol/L) and TG (CP: 1.51 mmol/L) were the most important traditional risk factors for women between 20–40 and 41–59 years of age, respectively. Conclusion Traditional risk factors and relevant cutpoints were not identical in different genders and age groups. A specific gender and age group-based cutpoint strategy might contribute to preventing cardiovascular disease. PMID:25398126

  12. Venue-based network analysis to inform HIV prevention efforts among young gay, bisexual, and other men who have sex with men.

    PubMed

    Holloway, Ian W; Rice, Eric; Kipke, Michele D

    2014-06-01

    In the USA, human immunodeficiency virus (HIV) incidence rates continue to increase among young gay, bisexual, and other men have sexual intercourse with men. Young men who have sex with men (YMSM) indicate interest in HIV prevention programming that is implemented in the social venues that they frequent when they want to socialize with other men. We sought to understand YMSM venues as a networked space to provide insights into venue-based HIV prevention intervention delivery. The present study used survey data reported by 526 YMSM (ages 18-24) in 2005 to conduct a venue-based social network analysis. The latter sought to determine if the structure and composition of the networks in Los Angeles could be used to facilitate the delivery of HIV prevention messages to YMSM. Degree of person sharing between venues was used to demonstrate interconnectivity between venues classified as low risk (e.g., coffee shops) and high risk (e.g., bars and clubs) by a Community Advisory Board. Sixty-five percent of the 110 venues nominated were bars and clubs. Nearly all YMSM were connected by a single venue and over 87 % were connected by the six most central venues. A handful of highly connected low-risk venues was central to the venue network and connected to popular high-risk venues. Venue-based network analysis can inform tailored HIV prevention messaging for YMSM. Targeted delivery of prevention messaging at low-risk centralized venues may lead to widespread diffusion among venue-attending YMSM.

  13. Venue-based Network Analysis to Inform HIV Prevention Efforts Among Young Gay, Bisexual and Other Men Who Have Sex With Men

    PubMed Central

    Holloway, Ian W.; Rice, Eric; Kipke, Michele D.

    2014-01-01

    Purpose In the United States, human immunodeficiency virus (HIV) incidence rates continue to increase among young gay, bisexual and other men have sexual intercourse with men. Young men who have sex with men (YMSM) indicate interest in HIV prevention programming that is implemented in the social venues that they frequent when they want to socialize with other men. We sought to understand YMSM venues as a networked space to provide insights into venue-based HIV prevention intervention delivery. Methods The present study used survey data reported by 526 YMSM (ages 18–24) in 2005 to conduct a venue-based social network analysis. The latter sought to determine if the structure and composition of the networks in Los Angeles could be used to facilitate the delivery of HIV prevention messages to YMSM. Degree of person sharing between venues was used to demonstrate interconnectivity between venues classified as low-risk (e.g., coffee shops) and high-risk (e.g., bars, clubs) by a Community Advisory Board. Results Sixty-five percent of the 110 venues nominated were bars and clubs. Nearly all YMSM were connected by a single venue and over 87% were connected by the 6 most central venues. A handful of highly connected low-risk venues were central to the venue network and connected to popular high-risk venues. Conclusions Venue-based network analysis can inform tailored HIV prevention messaging for YMSM. Targeted delivery of prevention messaging at low-risk centralized venues may lead to widespread diffusion among venue-attending YMSM. PMID:24464324

  14. Software for occupational health and safety risk analysis based on a fuzzy model.

    PubMed

    Stefanovic, Miladin; Tadic, Danijela; Djapan, Marko; Macuzic, Ivan

    2012-01-01

    Risk and safety management are very important issues in healthcare systems. Those are complex systems with many entities, hazards and uncertainties. In such an environment, it is very hard to introduce a system for evaluating and simulating significant hazards. In this paper, we analyzed different types of hazards in healthcare systems and we introduced a new fuzzy model for evaluating and ranking hazards. Finally, we presented a developed software solution, based on the suggested fuzzy model for evaluating and monitoring risk.

  15. Multidimensional analysis of the effect of occupational exposure to organic solvents on lung cancer risk: the ICARE study

    PubMed Central

    Mattei, Francesca; Liverani, Silvia; Guida, Florence; Matrat, Mireille; Cenée, Sylvie; Azizi, Lamiae; Menvielle, Gwenn; Sanchez, Marie; Pilorget, Corinne; Lapôtre-Ledoux, Bénédicte; Luce, Danièle; Richardson, Sylvia; Stücker, Isabelle

    2016-01-01

    Background The association between lung cancer and occupational exposure to organic solvents is discussed. Since different solvents are often used simultaneously, it is difficult to assess the role of individual substances. Objectives The present study is focused on an in-depth investigation of the potential association between lung cancer risk and occupational exposure to a large group of organic solvents, taking into account the well-known risk factors for lung cancer, tobacco smoking and occupational exposure to asbestos. Methods We analysed data from the Investigation of occupational and environmental causes of respiratory cancers (ICARE) study, a large French population-based case–control study, set up between 2001 and 2007. A total of 2276 male cases and 2780 male controls were interviewed, and long-life occupational history was collected. In order to overcome the analytical difficulties created by multiple correlated exposures, we carried out a novel type of analysis based on Bayesian profile regression. Results After analysis with conventional logistic regression methods, none of the 11 solvents examined were associated with lung cancer risk. Through a profile regression approach, we did not observe any significant association between solvent exposure and lung cancer. However, we identified clusters at high risk that are related to occupations known to be at risk of developing lung cancer, such as painters. Conclusions Organic solvents do not appear to be substantial contributors to the occupational risk of lung cancer for the occupations known to be at risk. PMID:26911986

  16. Cost-effectiveness analysis of risk-reduction measures to reach water safety targets.

    PubMed

    Lindhe, Andreas; Rosén, Lars; Norberg, Tommy; Bergstedt, Olof; Pettersson, Thomas J R

    2011-01-01

    Identifying the most suitable risk-reduction measures in drinking water systems requires a thorough analysis of possible alternatives. In addition to the effects on the risk level, also the economic aspects of the risk-reduction alternatives are commonly considered important. Drinking water supplies are complex systems and to avoid sub-optimisation of risk-reduction measures, the entire system from source to tap needs to be considered. There is a lack of methods for quantification of water supply risk reduction in an economic context for entire drinking water systems. The aim of this paper is to present a novel approach for risk assessment in combination with economic analysis to evaluate risk-reduction measures based on a source-to-tap approach. The approach combines a probabilistic and dynamic fault tree method with cost-effectiveness analysis (CEA). The developed approach comprises the following main parts: (1) quantification of risk reduction of alternatives using a probabilistic fault tree model of the entire system; (2) combination of the modelling results with CEA; and (3) evaluation of the alternatives with respect to the risk reduction, the probability of not reaching water safety targets and the cost-effectiveness. The fault tree method and CEA enable comparison of risk-reduction measures in the same quantitative unit and consider costs and uncertainties. The approach provides a structured and thorough analysis of risk-reduction measures that facilitates transparency and long-term planning of drinking water systems in order to avoid sub-optimisation of available resources for risk reduction. Copyright © 2010 Elsevier Ltd. All rights reserved.

  17. Pesticide Cumulative Risk Assessment: Framework for Screening Analysis

    EPA Pesticide Factsheets

    This document provides guidance on how to screen groups of pesticides for cumulative evaluation using a two-step approach: begin with evaluation of available toxicological information and, if necessary, follow up with a risk-based screening approach.

  18. Multiple Primary Cancer Monograph

    Cancer.gov

    To identify groups of cancer survivors that are at increased risk for multiple primary cancers, investigators led an effort to provide the first comprehensive population-based analysis of the risk of subsequent cancer in the U.S., resulting in a monograph.

  19. A GIS-based approach for comparative analysis of potential fire risk assessment

    NASA Astrophysics Data System (ADS)

    Sun, Ying; Hu, Lieqiu; Liu, Huiping

    2007-06-01

    Urban fires are one of the most important sources of property loss and human casualty and therefore it is necessary to assess the potential fire risk with consideration of urban community safety. Two evaluation models are proposed, both of which are integrated with GIS. One is the single factor model concerning the accessibility of fire passage and the other is grey clustering approach based on the multifactor system. In the latter model, fourteen factors are introduced and divided into four categories involving security management, evacuation facility, construction resistance and fire fighting capability. A case study on campus of Beijing Normal University is presented to express the potential risk assessment models in details. A comparative analysis of the two models is carried out to validate the accuracy. The results are approximately consistent with each other. Moreover, modeling with GIS promotes the efficiency the potential risk assessment.

  20. A metric-based assessment of flood risk and vulnerability of rural communities in the Lower Shire Valley, Malawi

    NASA Astrophysics Data System (ADS)

    Adeloye, A. J.; Mwale, F. D.; Dulanya, Z.

    2015-06-01

    In response to the increasing frequency and economic damages of natural disasters globally, disaster risk management has evolved to incorporate risk assessments that are multi-dimensional, integrated and metric-based. This is to support knowledge-based decision making and hence sustainable risk reduction. In Malawi and most of Sub-Saharan Africa (SSA), however, flood risk studies remain focussed on understanding causation, impacts, perceptions and coping and adaptation measures. Using the IPCC Framework, this study has quantified and profiled risk to flooding of rural, subsistent communities in the Lower Shire Valley, Malawi. Flood risk was obtained by integrating hazard and vulnerability. Flood hazard was characterised in terms of flood depth and inundation area obtained through hydraulic modelling in the valley with Lisflood-FP, while the vulnerability was indexed through analysis of exposure, susceptibility and capacity that were linked to social, economic, environmental and physical perspectives. Data on these were collected through structured interviews of the communities. The implementation of the entire analysis within GIS enabled the visualisation of spatial variability in flood risk in the valley. The results show predominantly medium levels in hazardousness, vulnerability and risk. The vulnerability is dominated by a high to very high susceptibility. Economic and physical capacities tend to be predominantly low but social capacity is significantly high, resulting in overall medium levels of capacity-induced vulnerability. Exposure manifests as medium. The vulnerability and risk showed marginal spatial variability. The paper concludes with recommendations on how these outcomes could inform policy interventions in the Valley.

  1. Application impact analysis: a risk-based approach to business continuity and disaster recovery.

    PubMed

    Epstein, Beth; Khan, Dawn Christine

    2014-01-01

    There are many possible disruptions that can occur in business. Overlooking or under planning for Business Continuity requires time, understanding and careful planning. Business Continuity Management is far more than producing a document and declaring business continuity success. What is the recipe for businesses to achieve continuity management success? Application Impact Analysis is a method for understanding the unique Business Attributes. This AIA Cycle involves a risk based approach to understanding the business priority and considering business aspects such as Financial, Operational, Service Structure, Contractual Legal, and Brand. The output of this analysis provides a construct for viewing data, evaluating impact, and delivering results, for an approved valuation of Recovery Time Objectives (RTO).

  2. CREATING A DECISION CONTEXT FOR COMPARATIVE ANALYSIS AND CONSISTENT APPLICATION OF INHALATION DOSIMETRY MODELS IN CHILDREN'S RISK ASSESSMENT

    EPA Science Inventory

    Estimation of risks to children from exposure to airborne pollutants is often complicated by the lack of reliable epidemiological data specific to this age group. As a result, risks are generally estimated from extrapolations based on data obtained in other human age groups (e.g....

  3. Lung Cancer Screening May Benefit Those at Highest Risk

    Cancer.gov

    People at the highest risk for lung cancer, based on a risk model, may be more likely to benefit from screening with low-dose CT, a new analysis suggests. The study authors believe the findings may better define who should undergo lung cancer screening, as this Cancer Currents blog post explains.

  4. Assessing risk factors in the organic control system: evidence from inspection data in Italy.

    PubMed

    Zanoli, Raffaele; Gambelli, Danilo; Solfanelli, Francesco

    2014-12-01

    Certification is an essential feature in organic farming, and it is based on inspections to verify compliance with respect to European Council Regulation-EC Reg. No 834/2007. A risk-based approach to noncompliance that alerts the control bodies to activate planning inspections would contribute to a more efficient and cost-effective certification system. An analysis of factors that can affect the probability of noncompliance in organic farming has thus been developed. This article examines the application of zero-inflated count data models to farm-level panel data from inspection results and sanctions obtained from the Ethical and Environmental Certification Institute, one of the main control bodies in Italy. We tested many a priori hypotheses related to the risk of noncompliance. We find evidence of an important role for past noncompliant behavior in predicting future noncompliance, while farm size and the occurrence of livestock also have roles in an increased probability of noncompliance. We conclude the article proposing that an efficient risk-based inspection system should be designed, weighting up the known probability of occurrence of a given noncompliance according to the severity of its impact. © 2014 Society for Risk Analysis.

  5. Apgar Score Is Related to Development of Atopic Dermatitis: Cotwin Control Study

    PubMed Central

    Naeser, Vibeke; Kahr, Niklas; Stensballe, Lone Graff; Kyvik, Kirsten Ohm; Skytthe, Axel; Backer, Vibeke

    2013-01-01

    Aim. To study the impact of birth characteristics on the risk of atopic dermatitis in a twin population. Methods. In a population-based questionnaire study of 10,809 twins, 3–9 years of age, from the Danish Twin Registry, we identified 907 twin pairs discordant for parent-reported atopic dermatitis. We cross-linked with data from the Danish National Birth Registry and performed cotwin control analysis in order to test the impact of birth characteristics on the risk of atopic dermatitis. Results. Apgar score, OR (per unit) = 1.23 (1.06–1.44), P = 0.008, and female sex, OR = 1.31 (1.06–1.61), P = 0.012, were risk factors for atopic dermatitis in cotwin control analysis, whereas birth anthropometric factors were not significantly related to disease development. Risk estimates in monozygotic and dizygotic twins were not significantly different for the identified risk factors. Conclusions. In this population-based cotwin control study, high Apgar score was a risk factor for atopic dermatitis. This novel finding must be confirmed in subsequent studies. PMID:24222775

  6. Occupational exposure and risk of chronic obstructive pulmonary disease: a systematic review and meta-analysis.

    PubMed

    Alif, Sheikh M; Dharmage, Shyamali C; Bowatte, Gayan; Karahalios, Amalia; Benke, Geza; Dennekamp, Martine; Mehta, Amar J; Miedinger, David; Künzli, Nino; Probst-Hensch, Nicole; Matheson, Melanie C

    2016-08-01

    Due to contradictory literature we have performed a systematic review and meta-analyse of population-based studies that have used Job Exposure Matrices to assess occupational exposure and risk of Chronic Obstructive Pulmonary Disease (COPD). Two researchers independently searched databases for published articles using predefined inclusion criteria. Study quality was assessed, and results pooled for COPD and chronic bronchitis for exposure to biological dust, mineral dust, and gases/fumes using a fixed and random effect model. Five studies met predetermined inclusion criteria. The meta-analysis showed low exposure to mineral dust, and high exposure to gases/fumes were associated with an increased risk of COPD. We also found significantly increased the risk of chronic bronchitis for low and high exposure to biological dust and mineral dust. Expert commentary: The relationship between occupational exposure assessed by the JEM and the risk of COPD and chronic bronchitis shows significant association with occupational exposure. However, the heterogeneity of the meta-analyses suggests more wide population-based studies with older age groups and longitudinal phenotype assessment of COPD to clarify the role of occupational exposure to COPD risk.

  7. Haloacetic acids in drinking water and risk for stillbirth.

    PubMed

    King, W D; Dodds, L; Allen, A C; Armson, B A; Fell, D; Nimrod, C

    2005-02-01

    Trihalomethanes (THMs) occurring in public drinking water sources have been investigated in several epidemiological studies of fetal death and results support a modest association. Other classes of disinfection by-products found in drinking water have not been investigated. To investigate the effects of haloacetic acid (HAA) compounds in drinking water on stillbirth risk. A population based case-control study was conducted in Nova Scotia and Eastern Ontario, Canada. Estimates of daily exposure to total and specific HAAs were based on household water samples and questionnaire information on water consumption at home and work. The analysis included 112 stillbirth cases and 398 live birth controls. In analysis without adjustment for total THM exposure, a relative risk greater than 2 was observed for an intermediate exposure category for total HAA and dichloroacetic acid measures. After adjustment for total THM exposure, the risk estimates for intermediate exposure categories were diminished, the relative risk associated with the highest category was in the direction of a protective effect, and all confidence intervals included the null value. No association was observed between HAA exposures and stillbirth risk after controlling for THM exposures.

  8. Risk management of PPP project in the preparation stage based on Fault Tree Analysis

    NASA Astrophysics Data System (ADS)

    Xing, Yuanzhi; Guan, Qiuling

    2017-03-01

    The risk management of PPP(Public Private Partnership) project can improve the level of risk control between government departments and private investors, so as to make more beneficial decisions, reduce investment losses and achieve mutual benefit as well. Therefore, this paper takes the PPP project preparation stage venture as the research object to identify and confirm four types of risks. At the same time, fault tree analysis(FTA) is used to evaluate the risk factors that belong to different parts, and quantify the influencing degree of risk impact on the basis of risk identification. In addition, it determines the importance order of risk factors by calculating unit structure importance on PPP project preparation stage. The result shows that accuracy of government decision-making, rationality of private investors funds allocation and instability of market returns are the main factors to generate the shared risk on the project.

  9. Risk-adjusted capitation payments for catastrophic risks based on multi-year prior costs.

    PubMed

    van Barneveld, E M; van Vliet, R C; van de Ven, W P

    1997-02-01

    In many countries regulated competition among health insurance companies has recently been proposed or implemented. A crucial issue is whether or not the benefits package offered by competing insurers should also cover catastrophic risks (like several forms of expensive long-term care) in addition to non-catastrophic risks (like hospital care and physician services). In 1988 the Dutch government proposed compulsory national health insurance based on regulated competition among insurer as well as among providers of care. The competing insurers should offer a benefits package covering both non-catastrophic risks and catastrophic risks. The insurers would be largely financed via risk-adjusted capitation payments. The government intended to use a capitation formula that is, besides some demographic variables, based on multi-year prior costs. This paper presents the results of an explorative empirical analysis of the possible consequences of such a capitation formula for catastrophic risks. The main conclusion is that this formula would be inadequate because it would leave ample room for cream skimming.

  10. Cable Overheating Risk Warning Method Based on Impedance Parameter Estimation in Distribution Network

    NASA Astrophysics Data System (ADS)

    Yu, Zhang; Xiaohui, Song; Jianfang, Li; Fei, Gao

    2017-05-01

    Cable overheating will lead to the cable insulation level reducing, speed up the cable insulation aging, even easy to cause short circuit faults. Cable overheating risk identification and warning is nessesary for distribution network operators. Cable overheating risk warning method based on impedance parameter estimation is proposed in the paper to improve the safty and reliability operation of distribution network. Firstly, cable impedance estimation model is established by using least square method based on the data from distribiton SCADA system to improve the impedance parameter estimation accuracy. Secondly, calculate the threshold value of cable impedance based on the historical data and the forecast value of cable impedance based on the forecasting data in future from distribiton SCADA system. Thirdly, establish risks warning rules library of cable overheating, calculate the cable impedance forecast value and analysis the change rate of impedance, and then warn the overheating risk of cable line based on the overheating risk warning rules library according to the variation relationship between impedance and line temperature rise. Overheating risk warning method is simulated in the paper. The simulation results shows that the method can identify the imedance and forecast the temperature rise of cable line in distribution network accurately. The result of overheating risk warning can provide decision basis for operation maintenance and repair.

  11. Antiviral treatment of Bell's palsy based on baseline severity: a systematic review and meta-analysis.

    PubMed

    Turgeon, Ricky D; Wilby, Kyle J; Ensom, Mary H H

    2015-06-01

    We conducted a systematic review with meta-analysis to evaluate the efficacy of antiviral agents on complete recovery of Bell's palsy. We searched CENTRAL, Embase, MEDLINE, International Pharmaceutical Abstracts, and sources of unpublished literature to November 1, 2014. Primary and secondary outcomes were complete and satisfactory recovery, respectively. To evaluate statistical heterogeneity, we performed subgroup analysis of baseline severity of Bell's palsy and between-study sensitivity analyses based on risk of allocation and detection bias. The 10 included randomized controlled trials (2419 patients; 807 with severe Bell's palsy at onset) had variable risk of bias, with 9 trials having a high risk of bias in at least 1 domain. Complete recovery was not statistically significantly greater with antiviral use versus no antiviral use in the random-effects meta-analysis of 6 trials (relative risk, 1.06; 95% confidence interval, 0.97-1.16; I(2) = 65%). Conversely, random-effects meta-analysis of 9 trials showed a statistically significant difference in satisfactory recovery (relative risk, 1.10; 95% confidence interval, 1.02-1.18; I(2) = 63%). Response to antiviral agents did not differ visually or statistically between patients with severe symptoms at baseline and those with milder disease (test for interaction, P = .11). Sensitivity analyses did not show a clear effect of bias on outcomes. Antiviral agents are not efficacious in increasing the proportion of patients with Bell's palsy who achieved complete recovery, regardless of baseline symptom severity. Copyright © 2015 Elsevier Inc. All rights reserved.

  12. Safety distance assessment of industrial toxic releases based on frequency and consequence: a case study in Shanghai, China.

    PubMed

    Yu, Q; Zhang, Y; Wang, X; Ma, W C; Chen, L M

    2009-09-15

    A case study on the safety distance assessment of a chemical industry park in Shanghai, China, is presented in this paper. Toxic releases were taken into consideration. A safety criterion based on frequency and consequence of major hazard accidents was set up for consequence analysis. The exposure limits for the accidents with the frequency of more than 10(-4), 10(-5)-10(-4) and 10(-6)-10(-5) per year were mortalities of 1% (or SLOT), 50% (SLOD) and 75% (twice of SLOD) respectively. Accidents with the frequency of less than 10(-6) per year were considered incredible and ignored in the consequence analysis. Taking the safety distance of all the hazard installations in a chemical plant into consideration, the results based on the new criterion were almost smaller than those based on LC50 or SLOD. The combination of the consequence and risk based results indicated that the hazard installations in two of the chemical plants may be dangerous to the protection targets and measurements had to be taken to reduce the risk. The case study showed that taking account of the frequency of occurrence in the consequence analysis would give more feasible safety distances for major hazard accidents and the results were more comparable to those calculated by risk assessment.

  13. Why Breast Cancer Risk by the Numbers Is Not Enough: Evaluation of a Decision Aid in Multi-Ethnic, Low-Numerate Women

    PubMed Central

    Yi, Haeseung; Xiao, Tong; Thomas, Parijatham; Aguirre, Alejandra; Smalletz, Cindy; David, Raven; Crew, Katherine

    2015-01-01

    Background Breast cancer risk assessment including genetic testing can be used to classify people into different risk groups with screening and preventive interventions tailored to the needs of each group, yet the implementation of risk-stratified breast cancer prevention in primary care settings is complex. Objective To address barriers to breast cancer risk assessment, risk communication, and prevention strategies in primary care settings, we developed a Web-based decision aid, RealRisks, that aims to improve preference-based decision-making for breast cancer prevention, particularly in low-numerate women. Methods RealRisks incorporates experience-based dynamic interfaces to communicate risk aimed at reducing inaccurate risk perceptions, with modules on breast cancer risk, genetic testing, and chemoprevention that are tailored. To begin, participants learn about risk by interacting with two games of experience-based risk interfaces, demonstrating average 5-year and lifetime breast cancer risk. We conducted four focus groups in English-speaking women (age ≥18 years), a questionnaire completed before and after interacting with the decision aid, and a semistructured group discussion. We employed a mixed-methods approach to assess accuracy of perceived breast cancer risk and acceptability of RealRisks. The qualitative analysis of the semistructured discussions assessed understanding of risk, risk models, and risk appropriate prevention strategies. Results Among 34 participants, mean age was 53.4 years, 62% (21/34) were Hispanic, and 41% (14/34) demonstrated low numeracy. According to the Gail breast cancer risk assessment tool (BCRAT), the mean 5-year and lifetime breast cancer risk were 1.11% (SD 0.77) and 7.46% (SD 2.87), respectively. After interacting with RealRisks, the difference in perceived and estimated breast cancer risk according to BCRAT improved for 5-year risk (P=.008). In the qualitative analysis, we identified potential barriers to adopting risk-appropriate breast cancer prevention strategies, including uncertainty about breast cancer risk and risk models, distrust toward the health care system, and perception that risk assessment to pre-screen women for eligibility for genetic testing may be viewed as rationing access to care. Conclusions In a multi-ethnic population, we demonstrated a significant improvement in accuracy of perceived breast cancer risk after exposure to RealRisks. However, we identified potential barriers that suggest that accurate risk perceptions will not suffice as the sole basis to support informed decision making and the acceptance of risk-appropriate prevention strategies. Findings will inform the iterative design of the RealRisks decision aid. PMID:26175193

  14. The association between maternal smoking and placenta abruption: a meta-analysis.

    PubMed

    Shobeiri, Fatemeh; Masoumi, Seyedeh Zahra; Jenabi, Ensiyeh

    2017-08-01

    Several epidemiological studies have determined that maternal smoking can increase the risk of placenta abruption. To date, only a meta-analysis has been performed for assessing the relationship between smoking and placenta abruption. This meta-analysis was conducted to estimate the association between smoking and the risk of placenta abruption. A literature search was conducted in major databases such as PubMed, Web of Science, and Scopus from the earliest possible year to April 2016. The heterogeneity across studies was explored by Q-test and I 2 statistic. The publication bias was assessed using Begg's and Egger's tests. The results were reported using odds ratio (OR) estimate with its 95% confidence intervals (CI) using a random effects model. The literature search yielded 1167 publications until April 2016 with 4 309 610 participants. Based on OR estimates obtained from case-control and cohort studies, there was a significant association between smoking and placenta abruption (1.80; 95% CI: 1.75, 1.85). Based on the results of cohort studies, smoking and placenta abruption had a significant association (relative risk ratio: 1.65; 95% CI: 1.51, 1.80). Based on reports in epidemiological studies, we showed that smoking is a risk factor for placenta abruption.

  15. Do we see how they perceive risk? An integrated analysis of risk perception and its effect on workplace safety behavior.

    PubMed

    Xia, Nini; Wang, Xueqing; Griffin, Mark A; Wu, Chunlin; Liu, Bingsheng

    2017-09-01

    While risk perception is a key factor influencing safety behavior, the academia lacks specific attention to the ways that workers perceive risk, and thus little is known about the mechanisms through which different risk perceptions influence safety behavior. Most previous research in the workplace safety domain argues that people tend to perceive risk based on rational formulations of risk criticality. However, individuals' emotions can be also useful in understanding their perceptions. Therefore, this research employs an integrated analysis concerning the rational and emotional perspectives. Specifically, it was expected that the identified three rational ways of perceiving risk, i.e., perceived probability, severity, and negative utility, would influence the direct emotional risk perception. Furthermore, these four risk perceptions were all expected to positively but differently influence safety behavior. The hypotheses were tested using a sample of 120 construction workers. It was found that all the three rational risk perceptions significantly influenced workers' direct perception of risk that is mainly based on emotions. Furthermore, safety behavior among workers relied mainly on emotional perception but not rational calculations of risk. This research contributes to workplace safety research by highlighting the importance of integrating the emotional assessment of risk, especially when workers' risk perception and behavior are concerned. Suggested avenues for improving safety behavior through improvement in risk perception include being aware of the possibility of different ways of perceiving risk, promoting experience sharing and accident simulation, and uncovering risk information. Copyright © 2017 Elsevier Ltd. All rights reserved.

  16. 77 FR 29588 - Notice of Decision To Issue Permits for the Importation of Fresh Celery, Arugula, and Spinach...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-05-18

    ..., arugula, and spinach from Colombia. Based on the findings of three pest risk analyses, which we made..., based on the findings of a pest risk analysis (PRA), can be safely imported subject to one or more of... or disseminating plant pests or noxious weeds via the importation of fresh celery, arugula, and...

  17. Finding Groups Using Model-based Cluster Analysis: Heterogeneous Emotional Self-regulatory Processes and Heavy Alcohol Use Risk

    PubMed Central

    Mun, Eun-Young; von Eye, Alexander; Bates, Marsha E.; Vaschillo, Evgeny G.

    2010-01-01

    Model-based cluster analysis is a new clustering procedure to investigate population heterogeneity utilizing finite mixture multivariate normal densities. It is an inferentially based, statistically principled procedure that allows comparison of non-nested models using the Bayesian Information Criterion (BIC) to compare multiple models and identify the optimum number of clusters. The current study clustered 36 young men and women based on their baseline heart rate (HR) and HR variability (HRV), chronic alcohol use, and reasons for drinking. Two cluster groups were identified and labeled High Alcohol Risk and Normative groups. Compared to the Normative group, individuals in the High Alcohol Risk group had higher levels of alcohol use and more strongly endorsed disinhibition and suppression reasons for use. The High Alcohol Risk group showed significant HRV changes in response to positive and negative emotional and appetitive picture cues, compared to neutral cues. In contrast, the Normative group showed a significant HRV change only to negative cues. Findings suggest that the individuals with autonomic self-regulatory difficulties may be more susceptible to heavy alcohol use and use alcohol for emotional regulation. PMID:18331138

  18. The Construct and Measurement of Perceived Risk of Nonremunerated Blood Donation: Evidence from the Chinese Public

    PubMed Central

    Chen, Liangyong

    2015-01-01

    The perceived risk of nonremunerated blood donation (NRBD) is one of the most important factors which hinder the Chinese public from donating blood. To understand deeply and measure scientifically the public's perceived risk of NRBD, in this paper the qualitative and quantitative methods were used to explore the construct of perceived risk of NRBD in Chinese context. Firstly, the preliminary construct of perceived risk of NRBD was developed based on the grounded theory. Then, a measurement scale of perceived risk of NRBD was designed. Finally, the exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were adopted for testing and verifying the construct. The results show that the construct of perceived risk of NRBD has three core dimensions, namely, trust risk, psychological risk, and health risk, which provides a clear construct and concise scale to better capture the Chinese public's perceived risk of NRBD. Blood collection agencies can strategically make polices about perceived risk reduction to maximize the public's NRBD behavior. PMID:26526570

  19. The Construct and Measurement of Perceived Risk of Nonremunerated Blood Donation: Evidence from the Chinese Public.

    PubMed

    Chen, Liangyong; Ma, Zujun

    2015-01-01

    The perceived risk of nonremunerated blood donation (NRBD) is one of the most important factors which hinder the Chinese public from donating blood. To understand deeply and measure scientifically the public's perceived risk of NRBD, in this paper the qualitative and quantitative methods were used to explore the construct of perceived risk of NRBD in Chinese context. Firstly, the preliminary construct of perceived risk of NRBD was developed based on the grounded theory. Then, a measurement scale of perceived risk of NRBD was designed. Finally, the exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were adopted for testing and verifying the construct. The results show that the construct of perceived risk of NRBD has three core dimensions, namely, trust risk, psychological risk, and health risk, which provides a clear construct and concise scale to better capture the Chinese public's perceived risk of NRBD. Blood collection agencies can strategically make polices about perceived risk reduction to maximize the public's NRBD behavior.

  20. Polygenic risk score analysis of pathologically confirmed Alzheimer disease.

    PubMed

    Escott-Price, Valentina; Myers, Amanda J; Huentelman, Matt; Hardy, John

    2017-08-01

    Previous estimates of the utility of polygenic risk score analysis for the prediction of Alzheimer disease have given area under the curve (AUC) estimates of <80%. However, these have been based on the genetic analysis of clinical case-control series. Here, we apply the same analytic approaches to a pathological case-control series and show a predictive AUC of 84%. We suggest that this analysis has clinical utility and that there is limited room for further improvement using genetic data. Ann Neurol 2017;82:311-314. © 2017 American Neurological Association.

  1. Risk, Robustness and Water Resources Planning Under Uncertainty

    NASA Astrophysics Data System (ADS)

    Borgomeo, Edoardo; Mortazavi-Naeini, Mohammad; Hall, Jim W.; Guillod, Benoit P.

    2018-03-01

    Risk-based water resources planning is based on the premise that water managers should invest up to the point where the marginal benefit of risk reduction equals the marginal cost of achieving that benefit. However, this cost-benefit approach may not guarantee robustness under uncertain future conditions, for instance under climatic changes. In this paper, we expand risk-based decision analysis to explore possible ways of enhancing robustness in engineered water resources systems under different risk attitudes. Risk is measured as the expected annual cost of water use restrictions, while robustness is interpreted in the decision-theoretic sense as the ability of a water resource system to maintain performance—expressed as a tolerable risk of water use restrictions—under a wide range of possible future conditions. Linking risk attitudes with robustness allows stakeholders to explicitly trade-off incremental increases in robustness with investment costs for a given level of risk. We illustrate the framework through a case study of London's water supply system using state-of-the -art regional climate simulations to inform the estimation of risk and robustness.

  2. Use of Monte Carlo analysis in a risk-based prioritization of toxic constituents in house dust.

    PubMed

    Ginsberg, Gary L; Belleggia, Giuliana

    2017-12-01

    Many chemicals have been detected in house dust with exposures to the general public and particularly young children of potential health concern. House dust is also an indicator of chemicals present in consumer products and the built environment that may constitute a health risk. The current analysis compiles a database of recent house dust concentrations from the United States and Canada, focusing upon semi-volatile constituents. Seven constituents from the phthalate and flame retardant categories were selected for risk-based screening and prioritization: diethylhexyl phthalate (DEHP), butyl benzyl phthalate (BBzP), diisononyl phthalate (DINP), a pentabrominated diphenyl ether congener (BDE-99), hexabromocyclododecane (HBCDD), tris(1,3-dichloro-2-propyl) phosphate (TDCIPP) and tris(2-chloroethyl) phosphate (TCEP). Monte Carlo analysis was used to represent the variability in house dust concentration as well as the uncertainty in the toxicology database in the estimation of children's exposure and risk. Constituents were prioritized based upon the percentage of the distribution of risk results for cancer and non-cancer endpoints that exceeded a hazard quotient (HQ) of 1. The greatest percent HQ exceedances were for DEHP (cancer and non-cancer), BDE-99 (non-cancer) and TDCIPP (cancer). Current uses and the potential for reducing levels of these constituents in house dust are discussed. Exposure and risk for other phthalates and flame retardants in house dust may increase if they are used to substitute for these prioritized constituents. Therefore, alternative assessment and green chemistry solutions are important elements in decreasing children's exposure to chemicals of concern in the indoor environment. Copyright © 2017 Elsevier Ltd. All rights reserved.

  3. Aircraft Conceptual Design and Risk Analysis Using Physics-Based Noise Prediction

    NASA Technical Reports Server (NTRS)

    Olson, Erik D.; Mavris, Dimitri N.

    2006-01-01

    An approach was developed which allows for design studies of commercial aircraft using physics-based noise analysis methods while retaining the ability to perform the rapid trade-off and risk analysis studies needed at the conceptual design stage. A prototype integrated analysis process was created for computing the total aircraft EPNL at the Federal Aviation Regulations Part 36 certification measurement locations using physics-based methods for fan rotor-stator interaction tones and jet mixing noise. The methodology was then used in combination with design of experiments to create response surface equations (RSEs) for the engine and aircraft performance metrics, geometric constraints and take-off and landing noise levels. In addition, Monte Carlo analysis was used to assess the expected variability of the metrics under the influence of uncertainty, and to determine how the variability is affected by the choice of engine cycle. Finally, the RSEs were used to conduct a series of proof-of-concept conceptual-level design studies demonstrating the utility of the approach. The study found that a key advantage to using physics-based analysis during conceptual design lies in the ability to assess the benefits of new technologies as a function of the design to which they are applied. The greatest difficulty in implementing physics-based analysis proved to be the generation of design geometry at a sufficient level of detail for high-fidelity analysis.

  4. Real-time web-based assessment of total population risk of future emergency department utilization: statewide prospective active case finding study.

    PubMed

    Hu, Zhongkai; Jin, Bo; Shin, Andrew Y; Zhu, Chunqing; Zhao, Yifan; Hao, Shiying; Zheng, Le; Fu, Changlin; Wen, Qiaojun; Ji, Jun; Li, Zhen; Wang, Yong; Zheng, Xiaolin; Dai, Dorothy; Culver, Devore S; Alfreds, Shaun T; Rogow, Todd; Stearns, Frank; Sylvester, Karl G; Widen, Eric; Ling, Xuefeng B

    2015-01-13

    An easily accessible real-time Web-based utility to assess patient risks of future emergency department (ED) visits can help the health care provider guide the allocation of resources to better manage higher-risk patient populations and thereby reduce unnecessary use of EDs. Our main objective was to develop a Health Information Exchange-based, next 6-month ED risk surveillance system in the state of Maine. Data on electronic medical record (EMR) encounters integrated by HealthInfoNet (HIN), Maine's Health Information Exchange, were used to develop the Web-based surveillance system for a population ED future 6-month risk prediction. To model, a retrospective cohort of 829,641 patients with comprehensive clinical histories from January 1 to December 31, 2012 was used for training and then tested with a prospective cohort of 875,979 patients from July 1, 2012, to June 30, 2013. The multivariate statistical analysis identified 101 variables predictive of future defined 6-month risk of ED visit: 4 age groups, history of 8 different encounter types, history of 17 primary and 8 secondary diagnoses, 8 specific chronic diseases, 28 laboratory test results, history of 3 radiographic tests, and history of 25 outpatient prescription medications. The c-statistics for the retrospective and prospective cohorts were 0.739 and 0.732 respectively. Integration of our method into the HIN secure statewide data system in real time prospectively validated its performance. Cluster analysis in both the retrospective and prospective analyses revealed discrete subpopulations of high-risk patients, grouped around multiple "anchoring" demographics and chronic conditions. With the Web-based population risk-monitoring enterprise dashboards, the effectiveness of the active case finding algorithm has been validated by clinicians and caregivers in Maine. The active case finding model and associated real-time Web-based app were designed to track the evolving nature of total population risk, in a longitudinal manner, for ED visits across all payers, all diseases, and all age groups. Therefore, providers can implement targeted care management strategies to the patient subgroups with similar patterns of clinical histories, driving the delivery of more efficient and effective health care interventions. To the best of our knowledge, this prospectively validated EMR-based, Web-based tool is the first one to allow real-time total population risk assessment for statewide ED visits.

  5. Systems resilience for multihazard environments: definition, metrics, and valuation for decision making.

    PubMed

    Ayyub, Bilal M

    2014-02-01

    The United Nations Office for Disaster Risk Reduction reported that the 2011 natural disasters, including the earthquake and tsunami that struck Japan, resulted in $366 billion in direct damages and 29,782 fatalities worldwide. Storms and floods accounted for up to 70% of the 302 natural disasters worldwide in 2011, with earthquakes producing the greatest number of fatalities. Average annual losses in the United States amount to about $55 billion. Enhancing community and system resilience could lead to massive savings through risk reduction and expeditious recovery. The rational management of such reduction and recovery is facilitated by an appropriate definition of resilience and associated metrics. In this article, a resilience definition is provided that meets a set of requirements with clear relationships to the metrics of the relevant abstract notions of reliability and risk. Those metrics also meet logically consistent requirements drawn from measure theory, and provide a sound basis for the development of effective decision-making tools for multihazard environments. Improving the resiliency of a system to meet target levels requires the examination of system enhancement alternatives in economic terms, within a decision-making framework. Relevant decision analysis methods would typically require the examination of resilience based on its valuation by society at large. The article provides methods for valuation and benefit-cost analysis based on concepts from risk analysis and management. © 2013 Society for Risk Analysis.

  6. Use of benzodiazepine and risk of cancer: A meta-analysis of observational studies.

    PubMed

    Kim, Hong-Bae; Myung, Seung-Kwon; Park, Yon Chul; Park, Byoungjin

    2017-02-01

    Several observational epidemiological studies have reported inconsistent results on the association between the use of benzodiazepine and the risk of cancer. We investigated the association by using a meta-analysis. We searched PubMed, EMBASE, and the bibliographies of relevant articles to locate additional publications in January 2016. Three evaluators independently reviewed and selected eligible studies based on predetermined selection criteria. Of 796 articles meeting our initial criteria, a total of 22 observational epidemiological studies with 18 case-control studies and 4 cohort studies were included in the final analysis. Benzodiazepine use was significantly associated with an increased risk of cancer (odds ratio [OR] or relative risk [RR] 1.19; 95% confidence interval 1.16-1.21) in a random-effects meta-analysis of all studies. Subgroup meta-analyses by various factors such as study design, type of case-control study, study region, and methodological quality of study showed consistent findings. Also, a significant dose-response relationship was observed between the use of benzodiazepine and the risk of cancer (p for trend <0.01). The current meta-analysis of observational epidemiological studies suggests that benzodiazepine use is associated with an increased risk of cancer. © 2016 UICC.

  7. Body mass index and risk of BPH: a meta-analysis.

    PubMed

    Wang, S; Mao, Q; Lin, Y; Wu, J; Wang, X; Zheng, X; Xie, L

    2012-09-01

    Epidemiological studies have reported conflicting results relating obesity to BPH. A meta-analysis of cohort and case-control studies was conducted to pool the risk estimates of the association between obesity and BPH. Eligible studies were retrieved by both computer searches and review of references. We analyzed abstracted data with random effects models to obtain the summary risk estimates. Dose-response meta-analysis was performed for studies reporting categorical risk estimates for a series of exposure levels. A total of 19 studies met the inclusion criteria of the meta-analysis. Positive association with body mass index (BMI) was observed in BPH and lower urinary tract symptoms (LUTS) combined group (odds ratio=1.27, 95% confidence intervals 1.05-1.53). In subgroup analysis, BMI exhibited a positive dose-response relationship with BPH/LUTS in population-based case-control studies and a marginal positive association was observed between risk of BPH and increased BMI. However, no association between BPH/LUTS and BMI was observed in other subgroups stratified by study design, geographical region or primary outcome. The overall current literatures suggested that BMI was associated with increased risk of BPH. Further efforts should be made to confirm these findings and clarify the underlying biological mechanisms.

  8. [Ecological risk assessment of land use based on exploratory spatial data analysis (ESDA): a case study of Haitan Island, Fujian Province].

    PubMed

    Wu, Jian; Chen, Peng; Wen, Chao-Xiang; Fu, Shi-Feng; Chen, Qing-Hui

    2014-07-01

    As a novel environment management tool, ecological risk assessment has provided a new perspective for the quantitative evaluation of ecological effects of land-use change. In this study, Haitan Island in Fujian Province was taken as a case. Based on the Landsat TM obtained in 1990, SPOT5 RS images obtained in 2010, general layout planning map of Pingtan Comprehensive Experimental Zone in 2030, as well as the field investigation data, we established an ecological risk index to measure ecological endpoints. By using spatial autocorrelation and semivariance analysis of Exploratory Spatial Data Analysis (ESDA), the ecological risk of Haitan Island under different land-use situations was assessed, including the past (1990), present (2010) and future (2030), and the potential risk and its changing trend were analyzed. The results revealed that the ecological risk index showed obvious scale effect, with strong positive correlation within 3000 meters. High-high (HH) and low-low (LL) aggregations were predominant types in spatial distribution of ecological risk index. The ecological risk index showed significant isotropic characteristics, and its spatial distribution was consistent with Anselin Local Moran I (LISA) distribution during the same period. Dramatic spatial distribution change of each ecological risk area was found among 1990, 2010 and 2030, and the fluctuation trend and amplitude of different ecological risk areas were diverse. The low ecological risk area showed a rise-to-fall trend while the medium and high ecological risk areas showed a fall-to-rise trend. In the planning period, due to intensive anthropogenic disturbance, the high ecological risk area spread throughout the whole region. To reduce the ecological risk in land-use and maintain the regional ecological security, the following ecological risk control strategies could be adopted, i.e., optimizing the spatial pattern of land resources, protecting the key ecoregions and controlling the scale of construction land use.

  9. Implications of prognostic factors and risk groups in the management of differentiated thyroid cancer.

    PubMed

    Shaha, Ashok R

    2004-03-01

    The outcome in differentiated thyroid cancer generally depends on the stage of the disease at the time of presentation; prognostic factors such as age, grade, size, extension, or distant metastasis; and risk groups (eg, low or high risk). The author has reviewed a large number of patients with differentiated thyroid cancer to analyze their hypothesis and to confirm that various risk groups have a major implication in relation to extent of the treatment and outcome. Differentiated thyroid cancers make up 90% of all thyroid tumors. The prognostic factors are well defined, such as age, size of the tumor, extrathyroidal extension, presence of distant metastasis, histological appearance, and grade of the tumor. The author has previously divided the risk groups into low-, intermediate-, and high-risk categories based on prognostic factors. The study describes the author's treatment approach related to the extent of thyroidectomy and adjuvant therapy based on various risk groups and the long-term survival. Retrospective. In a retrospective review of 1038 patients with differentiated thyroid carcinoma, various prognostic factors were studied by univariate and multivariate analysis. The significant prognostic factors were studied in detail and, based on these prognostic factors, the patients were divided into low-, intermediate- and high-risk groups. The survival curves were plotted by Kaplan-Meier method. The long-term survivals in low-, intermediate- and high-risk groups were 99%, 87%, and 57% respectively. Based on these risk groups, a decision tree was made regarding extent of thyroidectomy and adjuvant treatment. In the high-risk group and selected patients in the intermediate-risk group, aggressive surgery including removal of all gross disease and extrathyroidal extension with postoperative radioactive iodine ablation is recommended. In the low-risk group and selected patients in the intermediate-risk group, lobectomy appears to be satisfactory with excellent long-term outcome. The surgical treatment offers the best long-term results in low-risk patients, and the role of adjuvant treatment in this group is questionable. The decisions in the management of well-differentiated thyroid cancer should be based on various prognostic factors and risk groups. The long-term survival in the low-risk group is excellent, and consideration should be given to conservative surgical resection depending on the extent of the disease. In the high-risk group and selected patients in the intermediate-risk group, total thyroidectomy with radioactive ablation is warranted. A consideration may be given to external-beam radiation therapy in selected high-risk patients. It is apparent, based on the author's clinical experience and critical retrospective analysis, that the author's hypothesis that risk groups are extremely important in the long-term outcome of patients with differentiated thyroid cancer is correct. Based on various risk groups, the author currently is able to guide the treatment policies for thyroid cancer.

  10. Advanced space-based InSAR risk analysis of planned and existing transportation infrastructure.

    DOT National Transportation Integrated Search

    2017-03-21

    The purpose of this document is to summarize activities by Stanford University and : MDA Geospatial Services Inc. (MDA) to estimate surface deformation and associated : risk to transportation infrastructure using SAR Interferometric methods for the :...

  11. PROBABILITY SURVEYS , CONDITIONAL PROBABILITIES AND ECOLOGICAL RISK ASSESSMENT

    EPA Science Inventory

    We show that probability-based environmental resource monitoring programs, such as the U.S. Environmental Protection Agency's (U.S. EPA) Environmental Monitoring and Assessment Program, and conditional probability analysis can serve as a basis for estimating ecological risk over ...

  12. A Risk Analysis Approach to Prioritizing Epidemics: Ebola Virus Disease in West Africa as a Case Study.

    PubMed

    Ajisegiri, Whenayon Simeon; Chughtai, Abrar Ahmad; MacIntyre, C Raina

    2018-03-01

    The 2014 Ebola virus disease (EVD) outbreak affected several countries worldwide, including six West African countries. It was the largest Ebola epidemic in the history and the first to affect multiple countries simultaneously. Significant national and international delay in response to the epidemic resulted in 28,652 cases and 11,325 deaths. The aim of this study was to develop a risk analysis framework to prioritize rapid response for situations of high risk. Based on findings from the literature, sociodemographic features of the affected countries, and documented epidemic data, a risk scoring framework using 18 criteria was developed. The framework includes measures of socioeconomics, health systems, geographical factors, cultural beliefs, and traditional practices. The three worst affected West African countries (Guinea, Sierra Leone, and Liberia) had the highest risk scores. The scores were much lower in developed countries that experienced Ebola compared to West African countries. A more complex risk analysis framework using 18 measures was compared with a simpler one with 10 measures, and both predicted risk equally well. A simple risk scoring system can incorporate measures of hazard and impact that may otherwise be neglected in prioritizing outbreak response. This framework can be used by public health personnel as a tool to prioritize outbreak investigation and flag outbreaks with potentially catastrophic outcomes for urgent response. Such a tool could mitigate costly delays in epidemic response. © 2017 The Authors Risk Analysis published by Wiley Periodicals, Inc. on behalf of Society for Risk Analysis.

  13. A Framework for Flood Risk Analysis and Benefit Assessment of Flood Control Measures in Urban Areas

    PubMed Central

    Li, Chaochao; Cheng, Xiaotao; Li, Na; Du, Xiaohe; Yu, Qian; Kan, Guangyuan

    2016-01-01

    Flood risk analysis is more complex in urban areas than that in rural areas because of their closely packed buildings, different kinds of land uses, and large number of flood control works and drainage systems. The purpose of this paper is to propose a practical framework for flood risk analysis and benefit assessment of flood control measures in urban areas. Based on the concept of disaster risk triangle (hazard, vulnerability and exposure), a comprehensive analysis method and a general procedure were proposed for urban flood risk analysis. Urban Flood Simulation Model (UFSM) and Urban Flood Damage Assessment Model (UFDAM) were integrated to estimate the flood risk in the Pudong flood protection area (Shanghai, China). S-shaped functions were adopted to represent flood return period and damage (R-D) curves. The study results show that flood control works could significantly reduce the flood risk within the 66-year flood return period and the flood risk was reduced by 15.59%. However, the flood risk was only reduced by 7.06% when the flood return period exceeded 66-years. Hence, it is difficult to meet the increasing demands for flood control solely relying on structural measures. The R-D function is suitable to describe the changes of flood control capacity. This frame work can assess the flood risk reduction due to flood control measures, and provide crucial information for strategy development and planning adaptation. PMID:27527202

  14. Multivariate logistic regression analysis of postoperative complications and risk model establishment of gastrectomy for gastric cancer: A single-center cohort report.

    PubMed

    Zhou, Jinzhe; Zhou, Yanbing; Cao, Shougen; Li, Shikuan; Wang, Hao; Niu, Zhaojian; Chen, Dong; Wang, Dongsheng; Lv, Liang; Zhang, Jian; Li, Yu; Jiao, Xuelong; Tan, Xiaojie; Zhang, Jianli; Wang, Haibo; Zhang, Bingyuan; Lu, Yun; Sun, Zhenqing

    2016-01-01

    Reporting of surgical complications is common, but few provide information about the severity and estimate risk factors of complications. If have, but lack of specificity. We retrospectively analyzed data on 2795 gastric cancer patients underwent surgical procedure at the Affiliated Hospital of Qingdao University between June 2007 and June 2012, established multivariate logistic regression model to predictive risk factors related to the postoperative complications according to the Clavien-Dindo classification system. Twenty-four out of 86 variables were identified statistically significant in univariate logistic regression analysis, 11 significant variables entered multivariate analysis were employed to produce the risk model. Liver cirrhosis, diabetes mellitus, Child classification, invasion of neighboring organs, combined resection, introperative transfusion, Billroth II anastomosis of reconstruction, malnutrition, surgical volume of surgeons, operating time and age were independent risk factors for postoperative complications after gastrectomy. Based on logistic regression equation, p=Exp∑BiXi / (1+Exp∑BiXi), multivariate logistic regression predictive model that calculated the risk of postoperative morbidity was developed, p = 1/(1 + e((4.810-1.287X1-0.504X2-0.500X3-0.474X4-0.405X5-0.318X6-0.316X7-0.305X8-0.278X9-0.255X10-0.138X11))). The accuracy, sensitivity and specificity of the model to predict the postoperative complications were 86.7%, 76.2% and 88.6%, respectively. This risk model based on Clavien-Dindo grading severity of complications system and logistic regression analysis can predict severe morbidity specific to an individual patient's risk factors, estimate patients' risks and benefits of gastric surgery as an accurate decision-making tool and may serve as a template for the development of risk models for other surgical groups.

  15. Analysis of interactions among barriers in project risk management

    NASA Astrophysics Data System (ADS)

    Dandage, Rahul V.; Mantha, Shankar S.; Rane, Santosh B.; Bhoola, Vanita

    2018-03-01

    In the context of the scope, time, cost, and quality constraints, failure is not uncommon in project management. While small projects have 70% chances of success, large projects virtually have no chance of meeting the quadruple constraints. While there is no dearth of research on project risk management, the manifestation of barriers to project risk management is a less dwelt topic. The success of project management is oftentimes based on the understanding of barriers to effective risk management, application of appropriate risk management methodology, proactive leadership to avoid barriers, workers' attitude, adequate resources, organizational culture, and involvement of top management. This paper represents various risk categories and barriers to risk management in domestic and international projects through literature survey and feedback from project professionals. After analysing the various modelling methods used in project risk management literature, interpretive structural modelling (ISM) and MICMAC analysis have been used to analyse interactions among the barriers and prioritize them. The analysis indicates that lack of top management support, lack of formal training, and lack of addressing cultural differences are the high priority barriers, among many others.

  16. A clinical economics workstation for risk-adjusted health care cost management.

    PubMed Central

    Eisenstein, E. L.; Hales, J. W.

    1995-01-01

    This paper describes a healthcare cost accounting system which is under development at Duke University Medical Center. Our approach differs from current practice in that this system will dynamically adjust its resource usage estimates to compensate for variations in patient risk levels. This adjustment is made possible by introducing a new cost accounting concept, Risk-Adjusted Quantity (RQ). RQ divides case-level resource usage variances into their risk-based component (resource consumption differences attributable to differences in patient risk levels) and their non-risk-based component (resource consumption differences which cannot be attributed to differences in patient risk levels). Because patient risk level is a factor in estimating resource usage, this system is able to simultaneously address the financial and quality dimensions of case cost management. In effect, cost-effectiveness analysis is incorporated into health care cost management. PMID:8563361

  17. Regional earthquake loss estimation in the Autonomous Province of Bolzano - South Tyrol (Italy)

    NASA Astrophysics Data System (ADS)

    Huttenlau, Matthias; Winter, Benjamin

    2013-04-01

    Beside storm events geophysical events cause a majority of natural hazard losses on a global scale. However, in alpine regions with a moderate earthquake risk potential like in the study area and thereupon connected consequences on the collective memory this source of risk is often neglected in contrast to gravitational and hydrological hazards processes. In this context, the comparative analysis of potential disasters and emergencies on a national level in Switzerland (Katarisk study) has shown that earthquakes are the most serious source of risk in general. In order to estimate the potential losses of earthquake events for different return periods and loss dimensions of extreme events the following study was conducted in the Autonomous Province of Bolzano - South Tyrol (Italy). The applied methodology follows the generally accepted risk concept based on the risk components hazard, elements at risk and vulnerability, whereby risk is not defined holistically (direct, indirect, tangible and intangible) but with the risk category losses on buildings and inventory as a general risk proxy. The hazard analysis is based on a regional macroseismic scenario approach. Thereby, the settlement centre of each community (116 communities) is defined as potential epicentre. For each epicentre four different epicentral scenarios (return periods of 98, 475, 975 and 2475 years) are calculated based on the simple but approved and generally accepted attenuation law according to Sponheuer (1960). The relevant input parameters to calculate the epicentral scenarios are (i) the macroseismic intensity and (ii) the focal depth. The considered macroseismic intensities are based on a probabilistic seismic hazard analysis (PSHA) of the Italian earthquake catalogue on a community level (Dipartimento della Protezione Civile). The relevant focal depth are considered as a mean within a defined buffer of the focal depths of the harmonized earthquake catalogues of Italy and Switzerland as well as earthquake data of the US Geological Survey (USGS). The asset database to identify the elements at risk is developed under consideration of an address dataset, the land-use plan, official building footprints, building heights based on a normalized digital surface model, official construction costs for different building types (buildings cross cubatures), official statistical data concerning households on community level and insurance data based mean inventory values. To analyse the structural vulnerability and consequently the potential structural losses, community specific mean damage ratios based on the EMS-98 approach and the historic development of the building stock within the individual communities are estimated. Inventory losses are assumed with 30 percent of the structural losses. Thus, for each epicentre a loss-frequency-relationship can be calculated and the most severe epicentral scenarios can be identified.

  18. Introducing Risk Management Techniques Within Project Based Software Engineering Courses

    NASA Astrophysics Data System (ADS)

    Port, Daniel; Boehm, Barry

    2002-03-01

    In 1996, USC switched its core two-semester software engineering course from a hypothetical-project, homework-and-exam course based on the Bloom taxonomy of educational objectives (knowledge, comprehension, application, analysis, synthesis, and evaluation). The revised course is a real-client team-project course based on the CRESST model of learning objectives (content understanding, problem solving, collaboration, communication, and self-regulation). We used the CRESST cognitive demands analysis to determine the necessary student skills required for software risk management and the other major project activities, and have been refining the approach over the last 5 years of experience, including revised versions for one-semester undergraduate and graduate project course at Columbia. This paper summarizes our experiences in evolving the risk management aspects of the project course. These have helped us mature more general techniques such as risk-driven specifications, domain-specific simplifier and complicator lists, and the schedule as an independent variable (SAIV) process model. The largely positive results in terms of review of pass / fail rates, client evaluations, product adoption rates, and hiring manager feedback are summarized as well.

  19. Using Fuzzy Analytic Hierarchy Process multicriteria and Geographical information system for coastal vulnerability analysis in Morocco: The case of Mohammedia

    NASA Astrophysics Data System (ADS)

    Tahri, Meryem; Maanan, Mohamed; Hakdaoui, Mustapha

    2016-04-01

    This paper shows a method to assess the vulnerability of coastal risks such as coastal erosion or submarine applying Fuzzy Analytic Hierarchy Process (FAHP) and spatial analysis techniques with Geographic Information System (GIS). The coast of the Mohammedia located in Morocco was chosen as the study site to implement and validate the proposed framework by applying a GIS-FAHP based methodology. The coastal risk vulnerability mapping follows multi-parametric causative factors as sea level rise, significant wave height, tidal range, coastal erosion, elevation, geomorphology and distance to an urban area. The Fuzzy Analytic Hierarchy Process methodology enables the calculation of corresponding criteria weights. The result shows that the coastline of the Mohammedia is characterized by a moderate, high and very high level of vulnerability to coastal risk. The high vulnerability areas are situated in the east at Monika and Sablette beaches. This technical approach is based on the efficiency of the Geographic Information System tool based on Fuzzy Analytical Hierarchy Process to help decision maker to find optimal strategies to minimize coastal risks.

  20. Cost Risk Analysis Based on Perception of the Engineering Process

    NASA Technical Reports Server (NTRS)

    Dean, Edwin B.; Wood, Darrell A.; Moore, Arlene A.; Bogart, Edward H.

    1986-01-01

    In most cost estimating applications at the NASA Langley Research Center (LaRC), it is desirable to present predicted cost as a range of possible costs rather than a single predicted cost. A cost risk analysis generates a range of cost for a project and assigns a probability level to each cost value in the range. Constructing a cost risk curve requires a good estimate of the expected cost of a project. It must also include a good estimate of expected variance of the cost. Many cost risk analyses are based upon an expert's knowledge of the cost of similar projects in the past. In a common scenario, a manager or engineer, asked to estimate the cost of a project in his area of expertise, will gather historical cost data from a similar completed project. The cost of the completed project is adjusted using the perceived technical and economic differences between the two projects. This allows errors from at least three sources. The historical cost data may be in error by some unknown amount. The managers' evaluation of the new project and its similarity to the old project may be in error. The factors used to adjust the cost of the old project may not correctly reflect the differences. Some risk analyses are based on untested hypotheses about the form of the statistical distribution that underlies the distribution of possible cost. The usual problem is not just to come up with an estimate of the cost of a project, but to predict the range of values into which the cost may fall and with what level of confidence the prediction is made. Risk analysis techniques that assume the shape of the underlying cost distribution and derive the risk curve from a single estimate plus and minus some amount usually fail to take into account the actual magnitude of the uncertainty in cost due to technical factors in the project itself. This paper addresses a cost risk method that is based on parametric estimates of the technical factors involved in the project being costed. The engineering process parameters are elicited from the engineer/expert on the project and are based on that expert's technical knowledge. These are converted by a parametric cost model into a cost estimate. The method discussed makes no assumptions about the distribution underlying the distribution of possible costs, and is not tied to the analysis of previous projects, except through the expert calibrations performed by the parametric cost analyst.

  1. Neuromorphic Computing for Very Large Test and Evaluation Data Analysis

    DTIC Science & Technology

    2014-05-01

    analysis and utilization of newly available hardware- based artificial neural network chips. These two aspects of the program are complementary. The...neuromorphic architectures research focused on long term disruptive technologies with high risk but revolutionary potential. The hardware- based neural...today. Overall, hardware- based neural processing research allows us to study the fundamental system and architectural issues relevant for employing

  2. Framing environmental risks in the Baltic Sea: a news media analysis.

    PubMed

    Jönsson, Anna Maria

    2011-03-01

    Scientific complexity and uncertainty is a key challenge for environmental risk governance and to understand how risks are framed and communicated is of utmost importance. The Baltic Sea ecosystem is stressed and exposed to different risks like eutrophication, overfishing, and hazardous chemicals. Based on an analysis of the Swedish newspaper Dagens Nyheter, this study discusses media representations of these risks. The results show that the reporting on the Baltic Sea has been fairly stable since the beginning of the 1990s. Many articles acknowledge several risks, but eutrophication receives the most attention and is also considered the biggest threat. Authorities, experts, organizations, and politicians are the dominating actors, while citizens and industry representatives are more or less invisible. Eutrophication is not framed in terms of uncertainty concerning the risk and consequences, but rather in terms of main causes.

  3. Tutorial: Parallel Computing of Simulation Models for Risk Analysis.

    PubMed

    Reilly, Allison C; Staid, Andrea; Gao, Michael; Guikema, Seth D

    2016-10-01

    Simulation models are widely used in risk analysis to study the effects of uncertainties on outcomes of interest in complex problems. Often, these models are computationally complex and time consuming to run. This latter point may be at odds with time-sensitive evaluations or may limit the number of parameters that are considered. In this article, we give an introductory tutorial focused on parallelizing simulation code to better leverage modern computing hardware, enabling risk analysts to better utilize simulation-based methods for quantifying uncertainty in practice. This article is aimed primarily at risk analysts who use simulation methods but do not yet utilize parallelization to decrease the computational burden of these models. The discussion is focused on conceptual aspects of embarrassingly parallel computer code and software considerations. Two complementary examples are shown using the languages MATLAB and R. A brief discussion of hardware considerations is located in the Appendix. © 2016 Society for Risk Analysis.

  4. The Research on the Factors of Purchase Intention for Fresh Agricultural Products in an E-Commerce Environment

    NASA Astrophysics Data System (ADS)

    Han, Dan; Mu, Jing

    2017-12-01

    Based on the characteristics of e-commerce of fresh agricultural products in China, and using the correlation analysis method, the relational model between product knowledge, perceived benefit, perceived risk and purchase intention is constructed. The Logistic model is used to carry in the empirical analysis. The influence factors and the mechanism of online purchase intention are explored. The results show that consumers’ product knowledge, perceived benefit and perceived risk can affect their purchase intention. Consumers’ product knowledge has a positive effect on perceived benefit and perceived benefit has a positive effect on purchase intention. Consumers’ product knowledge has a negative effect on perceived risk, and perceived profit has a negative effect on perceived risk, and perceived risk has a negative effect on purchase intention. Through the empirical analysis, some feasible suggestions for the government and electricity supplier enterprises can be provided.

  5. Examining the Nature of the Association Between Attention-Deficit/Hyperactivity Disorder and Nicotine Dependence: A Familial Risk Analysis

    PubMed Central

    Biederman, Joseph; Petty, Carter R.; Hammerness, Paul; Woodworth, K. Yvonne; Faraone, Stephen V.

    2013-01-01

    Objective The main aim of this study was to use familial risk analysis to examine the association between attention-deficit/hyperactivity disorder (ADHD) and nicotine dependence. Methods Subjects were children with (n = 257) and without (n = 229) ADHD of both sexes ascertained form pediatric and psychiatric referral sources and their first-degree relatives (N = 1627). Results Nicotine dependence in probands increased the risk for nicotine dependence in relatives irrespective of ADHD status. There was no evidence of cosegregation or assortative mating between these disorders. Patterns of familial risk analysis suggest that the association between ADHD and nicotine dependence is most consistent with the hypothesis of independent transmission of these disorders. Conclusions These findings may have important implications for the identification of a subgroup of children with ADHD at high risk for nicotine dependence based on parental history of nicotine dependence. PMID:23461889

  6. Developing a Comprehensive Risk Assessment Framework for Geological Storage CO 2

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Duncan, Ian

    2014-08-31

    The operational risks for CCS projects include: risks of capturing, compressing, transporting and injecting CO₂; risks of well blowouts; risk that CO 2 will leak into shallow aquifers and contaminate potable water; and risk that sequestered CO 2 will leak into the atmosphere. This report examines these risks by using information on the risks associated with analogue activities such as CO 2 based enhanced oil recovery (CO 2-EOR), natural gas storage and acid gas disposal. We have developed a new analysis of pipeline risk based on Bayesian statistical analysis. Bayesian theory probabilities may describe states of partial knowledge, even perhapsmore » those related to non-repeatable events. The Bayesian approach enables both utilizing existing data and at the same time having the capability to adsorb new information thus to lower uncertainty in our understanding of complex systems. Incident rates for both natural gas and CO 2 pipelines have been widely used in papers and reports on risk of CO 2 pipelines as proxies for the individual risk created by such pipelines. Published risk studies of CO 2 pipelines suggest that the individual risk associated with CO2 pipelines is between 10 -3 and 10 -4, which reflects risk levels approaching those of mountain climbing, which many would find unacceptably high. This report concludes, based on a careful analysis of natural gas pipeline failures, suggests that the individual risk of CO 2 pipelines is likely in the range of 10-6 to 10-7, a risk range considered in the acceptable to negligible range in most countries. If, as is commonly thought, pipelines represent the highest risk component of CCS outside of the capture plant, then this conclusion suggests that most (if not all) previous quantitative- risk assessments of components of CCS may be orders of magnitude to high. The potential lethality of unexpected CO 2 releases from pipelines or wells are arguably the highest risk aspects of CO 2 enhanced oil recovery (CO2-EOR), carbon capture, and storage (CCS). Assertions in the CCS literature, that CO 2 levels of 10% for ten minutes, or 20 to 30% for a few minutes are lethal to humans, are not supported by the available evidence. The results of published experiments with animals exposed to CO 2, from mice to monkeys, at both normal and depleted oxygen levels, suggest that lethal levels of CO 2 toxicity are in the range 50 to 60%. These experiments demonstrate that CO 2 does not kill by asphyxia, but rather is toxic at high concentrations. It is concluded that quantitative risk assessments of CCS have overestimated the risk of fatalities by using values of lethality a factor two to six lower than the values estimated in this paper. In many dispersion models of CO 2 releases from pipelines, no fatalities would be predicted if appropriate levels of lethality for CO 2 had been used in the analysis.« less

  7. Risk Analysis of a Fuel Storage Terminal Using HAZOP and FTA

    PubMed Central

    Baixauli-Pérez, Mª Piedad

    2017-01-01

    The size and complexity of industrial chemical plants, together with the nature of the products handled, means that an analysis and control of the risks involved is required. This paper presents a methodology for risk analysis in chemical and allied industries that is based on a combination of HAZard and OPerability analysis (HAZOP) and a quantitative analysis of the most relevant risks through the development of fault trees, fault tree analysis (FTA). Results from FTA allow prioritizing the preventive and corrective measures to minimize the probability of failure. An analysis of a case study is performed; it consists in the terminal for unloading chemical and petroleum products, and the fuel storage facilities of two companies, in the port of Valencia (Spain). HAZOP analysis shows that loading and unloading areas are the most sensitive areas of the plant and where the most significant danger is a fuel spill. FTA analysis indicates that the most likely event is a fuel spill in tank truck loading area. A sensitivity analysis from the FTA results show the importance of the human factor in all sequences of the possible accidents, so it should be mandatory to improve the training of the staff of the plants. PMID:28665325

  8. Risk Analysis of a Fuel Storage Terminal Using HAZOP and FTA.

    PubMed

    Fuentes-Bargues, José Luis; González-Cruz, Mª Carmen; González-Gaya, Cristina; Baixauli-Pérez, Mª Piedad

    2017-06-30

    The size and complexity of industrial chemical plants, together with the nature of the products handled, means that an analysis and control of the risks involved is required. This paper presents a methodology for risk analysis in chemical and allied industries that is based on a combination of HAZard and OPerability analysis (HAZOP) and a quantitative analysis of the most relevant risks through the development of fault trees, fault tree analysis (FTA). Results from FTA allow prioritizing the preventive and corrective measures to minimize the probability of failure. An analysis of a case study is performed; it consists in the terminal for unloading chemical and petroleum products, and the fuel storage facilities of two companies, in the port of Valencia (Spain). HAZOP analysis shows that loading and unloading areas are the most sensitive areas of the plant and where the most significant danger is a fuel spill. FTA analysis indicates that the most likely event is a fuel spill in tank truck loading area. A sensitivity analysis from the FTA results show the importance of the human factor in all sequences of the possible accidents, so it should be mandatory to improve the training of the staff of the plants.

  9. Laboratory-based and office-based risk scores and charts to predict 10-year risk of cardiovascular disease in 182 countries: a pooled analysis of prospective cohorts and health surveys.

    PubMed

    Ueda, Peter; Woodward, Mark; Lu, Yuan; Hajifathalian, Kaveh; Al-Wotayan, Rihab; Aguilar-Salinas, Carlos A; Ahmadvand, Alireza; Azizi, Fereidoun; Bentham, James; Cifkova, Renata; Di Cesare, Mariachiara; Eriksen, Louise; Farzadfar, Farshad; Ferguson, Trevor S; Ikeda, Nayu; Khalili, Davood; Khang, Young-Ho; Lanska, Vera; León-Muñoz, Luz; Magliano, Dianna J; Margozzini, Paula; Msyamboza, Kelias P; Mutungi, Gerald; Oh, Kyungwon; Oum, Sophal; Rodríguez-Artalejo, Fernando; Rojas-Martinez, Rosalba; Valdivia, Gonzalo; Wilks, Rainford; Shaw, Jonathan E; Stevens, Gretchen A; Tolstrup, Janne S; Zhou, Bin; Salomon, Joshua A; Ezzati, Majid; Danaei, Goodarz

    2017-03-01

    Worldwide implementation of risk-based cardiovascular disease (CVD) prevention requires risk prediction tools that are contemporarily recalibrated for the target country and can be used where laboratory measurements are unavailable. We present two cardiovascular risk scores, with and without laboratory-based measurements, and the corresponding risk charts for 182 countries to predict 10-year risk of fatal and non-fatal CVD in adults aged 40-74 years. Based on our previous laboratory-based prediction model (Globorisk), we used data from eight prospective studies to estimate coefficients of the risk equations using proportional hazard regressions. The laboratory-based risk score included age, sex, smoking, blood pressure, diabetes, and total cholesterol; in the non-laboratory (office-based) risk score, we replaced diabetes and total cholesterol with BMI. We recalibrated risk scores for each sex and age group in each country using country-specific mean risk factor levels and CVD rates. We used recalibrated risk scores and data from national surveys (using data from adults aged 40-64 years) to estimate the proportion of the population at different levels of CVD risk for ten countries from different world regions as examples of the information the risk scores provide; we applied a risk threshold for high risk of at least 10% for high-income countries (HICs) and at least 20% for low-income and middle-income countries (LMICs) on the basis of national and international guidelines for CVD prevention. We estimated the proportion of men and women who were similarly categorised as high risk or low risk by the two risk scores. Predicted risks for the same risk factor profile were generally lower in HICs than in LMICs, with the highest risks in countries in central and southeast Asia and eastern Europe, including China and Russia. In HICs, the proportion of people aged 40-64 years at high risk of CVD ranged from 1% for South Korean women to 42% for Czech men (using a ≥10% risk threshold), and in low-income countries ranged from 2% in Uganda (men and women) to 13% in Iranian men (using a ≥20% risk threshold). More than 80% of adults were similarly classified as low or high risk by the laboratory-based and office-based risk scores. However, the office-based model substantially underestimated the risk among patients with diabetes. Our risk charts provide risk assessment tools that are recalibrated for each country and make the estimation of CVD risk possible without using laboratory-based measurements. National Institutes of Health. Copyright © 2017 Elsevier Ltd. All rights reserved.

  10. Laboratory-based and office-based risk scores and charts to predict 10-year risk of cardiovascular disease in 182 countries: a pooled analysis of prospective cohorts and health surveys

    PubMed Central

    Ueda, Peter; Woodward, Mark; Lu, Yuan; Hajifathalian, Kaveh; Al-Wotayan, Rihab; Aguilar-Salinas, Carlos A; Ahmadvand, Alireza; Azizi, Fereidoun; Bentham, James; Cifkova, Renata; Di Cesare, Mariachiara; Eriksen, Louise; Farzadfar, Farshad; Ferguson, Trevor S; Ikeda, Nayu; Khalili, Davood; Khang, Young-Ho; Lanska, Vera; León-Muñoz, Luz; Magliano, Dianna J; Margozzini, Paula; Msyamboza, Kelias P; Mutungi, Gerald; Oh, Kyungwon; Oum, Sophal; Rodríguez-Artalejo, Fernando; Rojas-Martinez, Rosalba; Valdivia, Gonzalo; Wilks, Rainford; Shaw, Jonathan E; Stevens, Gretchen A; Tolstrup, Janne S; Zhou, Bin; Salomon, Joshua A; Ezzati, Majid; Danaei, Goodarz

    2017-01-01

    Summary Background Worldwide implementation of risk-based cardiovascular disease (CVD) prevention requires risk prediction tools that are contemporarily recalibrated for the target country and can be used where laboratory measurements are unavailable. We present two cardiovascular risk scores, with and without laboratory-based measurements, and the corresponding risk charts for 182 countries to predict 10-year risk of fatal and non-fatal CVD in adults aged 40–74 years. Methods Based on our previous laboratory-based prediction model (Globorisk), we used data from eight prospective studies to estimate coefficients of the risk equations using proportional hazard regressions. The laboratory-based risk score included age, sex, smoking, blood pressure, diabetes, and total cholesterol; in the non-laboratory (office-based) risk score, we replaced diabetes and total cholesterol with BMI. We recalibrated risk scores for each sex and age group in each country using country-specific mean risk factor levels and CVD rates. We used recalibrated risk scores and data from national surveys (using data from adults aged 40–64 years) to estimate the proportion of the population at different levels of CVD risk for ten countries from different world regions as examples of the information the risk scores provide; we applied a risk threshold for high risk of at least 10% for high-income countries (HICs) and at least 20% for low-income and middle-income countries (LMICs) on the basis of national and international guidelines for CVD prevention. We estimated the proportion of men and women who were similarly categorised as high risk or low risk by the two risk scores. Findings Predicted risks for the same risk factor profile were generally lower in HICs than in LMICs, with the highest risks in countries in central and southeast Asia and eastern Europe, including China and Russia. In HICs, the proportion of people aged 40–64 years at high risk of CVD ranged from 1% for South Korean women to 42% for Czech men (using a ≥10% risk threshold), and in low-income countries ranged from 2% in Uganda (men and women) to 13% in Iranian men (using a ≥20% risk threshold). More than 80% of adults were similarly classified as low or high risk by the laboratory-based and office-based risk scores. However, the office-based model substantially underestimated the risk among patients with diabetes. Interpretation Our risk charts provide risk assessment tools that are recalibrated for each country and make the estimation of CVD risk possible without using laboratory-based measurements. PMID:28126460

  11. Gender, Race, and Risk: Intersectional Risk Management in the Sale of Sex Online.

    PubMed

    Moorman, Jessica D; Harrison, Kristen

    2016-09-01

    Sex worker experience of risk (e.g., physical violence or rape) is shaped by race, gender, and context. For web-based sex workers, experience of risk is comparatively minimal; what is unclear is how web-based sex workers manage risk and if online advertising plays a role in risk management. Building on intersectionality theory and research exploring risk management in sex work, we content-analyzed 600 escort advertisements from Backpage.com ( http://www.backpage.com ) to explore risk management in web-based sex work. To guide our research we asked: Do advertisements contain risk management messages? Does the use of risk management messaging differ by sex worker race or gender? Which groups have the highest overall use of risk management messages? Through a multivariate analysis of covariance (MANCOVA) we found that advertisements contained risk management messages and that uses of these phrases varied by race and gender. Blacks, women, and transgender women drove the use of risk management messages. Black and White transgender women had the highest overall use of these phrases. We conclude that risk management is an intersectional practice and that the use of risk management messages is a venue-specific manifestation of broader risk management priorities found in all venues where sex is sold.

  12. Priority of a Hesitant Fuzzy Linguistic Preference Relation with a Normal Distribution in Meteorological Disaster Risk Assessment.

    PubMed

    Wang, Lihong; Gong, Zaiwu

    2017-10-10

    As meteorological disaster systems are large complex systems, disaster reduction programs must be based on risk analysis. Consequently, judgment by an expert based on his or her experience (also known as qualitative evaluation) is an important link in meteorological disaster risk assessment. In some complex and non-procedural meteorological disaster risk assessments, a hesitant fuzzy linguistic preference relation (HFLPR) is often used to deal with a situation in which experts may be hesitant while providing preference information of a pairwise comparison of alternatives, that is, the degree of preference of one alternative over another. This study explores hesitation from the perspective of statistical distributions, and obtains an optimal ranking of an HFLPR based on chance-restricted programming, which provides a new approach for hesitant fuzzy optimisation of decision-making in meteorological disaster risk assessments.

  13. Bayesian analysis of time-series data under case-crossover designs: posterior equivalence and inference.

    PubMed

    Li, Shi; Mukherjee, Bhramar; Batterman, Stuart; Ghosh, Malay

    2013-12-01

    Case-crossover designs are widely used to study short-term exposure effects on the risk of acute adverse health events. While the frequentist literature on this topic is vast, there is no Bayesian work in this general area. The contribution of this paper is twofold. First, the paper establishes Bayesian equivalence results that require characterization of the set of priors under which the posterior distributions of the risk ratio parameters based on a case-crossover and time-series analysis are identical. Second, the paper studies inferential issues under case-crossover designs in a Bayesian framework. Traditionally, a conditional logistic regression is used for inference on risk-ratio parameters in case-crossover studies. We consider instead a more general full likelihood-based approach which makes less restrictive assumptions on the risk functions. Formulation of a full likelihood leads to growth in the number of parameters proportional to the sample size. We propose a semi-parametric Bayesian approach using a Dirichlet process prior to handle the random nuisance parameters that appear in a full likelihood formulation. We carry out a simulation study to compare the Bayesian methods based on full and conditional likelihood with the standard frequentist approaches for case-crossover and time-series analysis. The proposed methods are illustrated through the Detroit Asthma Morbidity, Air Quality and Traffic study, which examines the association between acute asthma risk and ambient air pollutant concentrations. © 2013, The International Biometric Society.

  14. Nonlinear reduction in risk for colorectal cancer by fruit and vegetable intake based on meta-analysis of prospective studies.

    PubMed

    Aune, Dagfinn; Lau, Rosa; Chan, Doris S M; Vieira, Rui; Greenwood, Darren C; Kampman, Ellen; Norat, Teresa

    2011-07-01

    The association between fruit and vegetable intake and colorectal cancer risk has been investigated by many studies but is controversial because of inconsistent results and weak observed associations. We summarized the evidence from cohort studies in categorical, linear, and nonlinear, dose-response meta-analyses. We searched PubMed for studies of fruit and vegetable intake and colorectal cancer risk that were published until the end of May 2010. We included 19 prospective studies that reported relative risk estimates and 95% confidence intervals (CIs) of colorectal cancer-associated with fruit and vegetable intake. Random effects models were used to estimate summary relative risks. The summary relative risk for the highest vs the lowest intake was 0.92 (95% CI: 0.86-0.99) for fruit and vegetables combined, 0.90 (95% CI: 0.83-0.98) for fruit, and 0.91 (95% CI: 0.86-0.96) for vegetables (P for heterogeneity=.24, .05, and .54, respectively). The inverse associations appeared to be restricted to colon cancer. In linear dose-response analysis, only intake of vegetables was significantly associated with colorectal cancer risk (summary relative risk=0.98; 95% CI: 0.97-0.99), per 100 g/d. However, significant inverse associations emerged in nonlinear models for fruits (Pnonlinearity<.001) and vegetables (Pnonlinearity=.001). The greatest risk reduction was observed when intake increased from very low levels of intake. There was generally little evidence of heterogeneity in the analyses and there was no evidence of small-study bias. Based on meta-analysis of prospective studies, there is a weak but statistically significant nonlinear inverse association between fruit and vegetable intake and colorectal cancer risk. Copyright © 2011 AGA Institute. Published by Elsevier Inc. All rights reserved.

  15. The physical vulnerability of elements at risk: a methodology based on fluid and classical mechanics

    NASA Astrophysics Data System (ADS)

    Mazzorana, B.; Fuchs, S.; Levaggi, L.

    2012-04-01

    The impacts of the flood events occurred in autumn 2011 in the Italian regions Liguria and Tuscany revived the engagement of the public decision makers to enhance in synergy flood control and land use planning. In this context, the design of efficient flood risk mitigation strategies and their subsequent implementation critically relies on a careful vulnerability analysis of both, the immobile and mobile elements at risk potentially exposed to flood hazards. Based on fluid and classical mechanics notions we developed computation schemes enabling for a dynamic vulnerability and risk analysis facing a broad typological variety of elements at risk. The methodological skeleton consists of (1) hydrodynamic computation of the time-varying flood intensities resulting for each element at risk in a succession of loading configurations; (2) modelling the mechanical response of the impacted elements through static, elasto-static and dynamic analyses; (3) characterising the mechanical response through proper structural damage variables and (4) economic valuation of the expected losses as a function of the quantified damage variables. From a computational perspective we coupled the description of the hydrodynamic flow behaviour and the induced structural modifications of the elements at risk exposed. Valuation methods, suitable to support a correct mapping from the value domains of the physical damage variables to the economic loss values are discussed. In such a way we target to complement from a methodological perspective the existing, mainly empirical, vulnerability and risk assessment approaches to refine the conceptual framework of the cost-benefit analysis. Moreover, we aim to support the design of effective flood risk mitigation strategies by diminishing the main criticalities within the systems prone to flood risk.

  16. Risk analysis procedure for post-wildfire natural hazards in British Columbia

    NASA Astrophysics Data System (ADS)

    Jordan, Peter

    2010-05-01

    Following a severe wildfire season in 2003, and several subsequent damaging debris flow and flood events, the British Columbia Forest Service developed a procedure for analysing risks to public safety and infrastructure from such events. At the same time, the Forest Service undertook a research program to determine the extent of post-wildfire hazards, and examine the hydrologic and geomorphic processes contributing to the hazards. The risk analysis procedure follows the Canadian Standards Association decision-making framework for risk management (which in turn is based on international standards). This has several steps: identification of risk, risk analysis and estimation, evaluation of risk tolerability, developing control or mitigation strategies, and acting on these strategies. The Forest Service procedure deals only with the first two steps. The results are passed on to authorities such as the Provincial Emergency Program and local government, who are responsible for evaluating risks, warning residents, and applying mitigation strategies if appropriate. The objective of the procedure is to identify and analyse risks to public safety and infrastructure. The procedure is loosely based on the BAER (burned area emergency response) program in the USA, with some important differences. Our procedure focuses on identifying risks and warning affected parties, not on mitigation activities such as broadcast erosion control measures. Partly this is due to limited staff and financial resources. Also, our procedure is not multi-agency, but is limited to wildfires on provincial forest land; in British Columbia about 95% of forest land is in the publicly-owned provincial forest. Each fire season, wildfires are screened by size and proximity to values at risk such as populated areas. For selected fires, when the fire is largely contained, the procedure begins with an aerial reconnaissance of the fire, and photography with a hand-held camera, which can be used to make a preliminary map of vegetation burn severity if desired. The next steps include mapping catchment boundaries, field traverses to collect data on soil burn severity and water repellency, identification of unstable hillslopes and channels, and inspection of values at risk from hazards such as debris flows or flooding. BARC (burned area reflectance classification) maps based on satellite imagery are prepared for some fires, although these are typically not available for several weeks. Our objective is to make a preliminary risk analysis report available about two weeks after the fire is contained. If high risks to public safety or infrastructure are identified, the risk analysis reports may make recommendations for mitigation measures to be considered; however, acting on these recommendations is the responsibility of local land managers, local government, or landowners. Mitigation measures for some fires have included engineering treatments to reduce the hydrologic impact of logging roads, protective structures such as dykes or berms, and straw mulching to reduce runoff and erosion on severely burned areas. The Terrace Mountain Fire, with burned 9000 hectares in the Okanagan Valley in 2009, is used as an example of the application of the procedure.

  17. Convergent evidence from systematic analysis of GWAS revealed genetic basis of esophageal cancer.

    PubMed

    Gao, Xue-Xin; Gao, Lei; Wang, Jiu-Qiang; Qu, Su-Su; Qu, Yue; Sun, Hong-Lei; Liu, Si-Dang; Shang, Ying-Li

    2016-07-12

    Recent genome-wide association studies (GWAS) have identified single nucleotide polymorphisms (SNPs) associated with risk of esophageal cancer (EC). However, investigation of genetic basis from the perspective of systematic biology and integrative genomics remains scarce.In this study, we explored genetic basis of EC based on GWAS data and implemented a series of bioinformatics methods including functional annotation, expression quantitative trait loci (eQTL) analysis, pathway enrichment analysis and pathway grouped network analysis.Two hundred and thirteen risk SNPs were identified, in which 44 SNPs were found to have significantly differential gene expression in esophageal tissues by eQTL analysis. By pathway enrichment analysis, 170 risk genes mapped by risk SNPs were enriched into 38 significant GO terms and 17 significant KEGG pathways, which were significantly grouped into 9 sub-networks by pathway grouped network analysis. The 9 groups of interconnected pathways were mainly involved with muscle cell proliferation, cellular response to interleukin-6, cell adhesion molecules, and ethanol oxidation, which might participate in the development of EC.Our findings provide genetic evidence and new insight for exploring the molecular mechanisms of EC.

  18. Applying the partitioned multiobjective risk method (PMRM) to portfolio selection.

    PubMed

    Reyes Santos, Joost; Haimes, Yacov Y

    2004-06-01

    The analysis of risk-return tradeoffs and their practical applications to portfolio analysis paved the way for Modern Portfolio Theory (MPT), which won Harry Markowitz a 1992 Nobel Prize in Economics. A typical approach in measuring a portfolio's expected return is based on the historical returns of the assets included in a portfolio. On the other hand, portfolio risk is usually measured using volatility, which is derived from the historical variance-covariance relationships among the portfolio assets. This article focuses on assessing portfolio risk, with emphasis on extreme risks. To date, volatility is a major measure of risk owing to its simplicity and validity for relatively small asset price fluctuations. Volatility is a justified measure for stable market performance, but it is weak in addressing portfolio risk under aberrant market fluctuations. Extreme market crashes such as that on October 19, 1987 ("Black Monday") and catastrophic events such as the terrorist attack of September 11, 2001 that led to a four-day suspension of trading on the New York Stock Exchange (NYSE) are a few examples where measuring risk via volatility can lead to inaccurate predictions. Thus, there is a need for a more robust metric of risk. By invoking the principles of the extreme-risk-analysis method through the partitioned multiobjective risk method (PMRM), this article contributes to the modeling of extreme risks in portfolio performance. A measure of an extreme portfolio risk, denoted by f(4), is defined as the conditional expectation for a lower-tail region of the distribution of the possible portfolio returns. This article presents a multiobjective problem formulation consisting of optimizing expected return and f(4), whose solution is determined using Evolver-a software that implements a genetic algorithm. Under business-as-usual market scenarios, the results of the proposed PMRM portfolio selection model are found to be compatible with those of the volatility-based model. However, under extremely unfavorable market conditions, results indicate that f(4) can be a more valid measure of risk than volatility.

  19. RAMPART (TM): Risk Assessment Method-Property Analysis and Ranking Tool v.4.0

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Carson, Susan D.; Hunter, Regina L.; Link, Madison D.

    RAMPART{trademark}, Risk Assessment Method-property Analysis and Ranking Tool, is a new type of computer software package for the assessment of risk to buildings. RAMPART{trademark} has been developed by Sandia National Laboratories (SNL) for the U.S. General Services Administration (GSA). RAMPART {trademark} has been designed and developed to be a risk-based decision support tool that requires no risk analysis expertise on the part of the user. The RAMPART{trademark} user interface elicits information from the user about the building. The RAMPART{trademark} expert system is a set of rules that embodies GSA corporate knowledge and SNL's risk assessment experience. The RAMPART{trademark} database containsmore » both data entered by the user during a building analysis session and large sets of natural hazard and crime data. RAMPART{trademark} algorithms use these data to assess the risk associated with a given building in the face of certain hazards. Risks arising from five natural hazards (earthquake, hurricane, winter storm, tornado and flood); crime (inside and outside the building); fire and terrorism are calculated. These hazards may cause losses of various kinds. RAMPART{trademark} considers death, injury, loss of mission, loss of property, loss of contents, loss of building use, and first-responder loss. The results of each analysis are presented graphically on the screen and in a written report.« less

  20. The association between dietary zinc intake and risk of pancreatic cancer: a meta-analysis.

    PubMed

    Li, Li; Gai, Xuesong

    2017-06-30

    Previous reports have suggested a potential association on dietary zinc intake with the risk of pancreatic cancer. Since the associations between different studies were controversial, we therefore conducted a meta-analysis to reassess the relationship between dietary zinc intake and pancreatic cancer risk. A comprehensive search from the databases of PubMed, Embase, Web of Science, and Medline was performed until January 31, 2017. Relative risk (RR) with 95% confidence intervals (CI) derived by using random effect model was used. Sensitivity analysis and publication bias were conducted. Our meta-analysis was based on seven studies involving 1659 cases, including two prospective cohort studies and five case-control studies. The total RR of pancreatic cancer risk for the highest versus the lowest categories of dietary zinc intake was 0.798 (0.621-0.984), with its significant heterogeneity among studies ( I 2 =58.2%, P =0.026). The average Newcastle-Ottawa scale (NOS) score was 7.29, suggesting a high quality. There was no publication bias in the meta-analysis about dietary zinc intake on the risk of pancreatic cancer. Subgroup analyses showed that dietary zinc intake could reduce the risk of pancreatic cancer in case-control studies and among American populations. In conclusion, we found that highest category of dietary zinc intake can significantly reduce the risk of pancreatic cancer, especially among American populations. © 2017 The Author(s).

  1. Correlates of HIV infection among street-based and venue-based sex workers in Vietnam.

    PubMed

    Le, Thuy Tc; Nguyen, Quoc C; Tran, Ha Tt; Schwandt, Michael; Lim, Hyun J

    2016-10-01

    Commercial sex work is one of the driving forces of the HIV epidemic across the world. In Vietnam, although female sex workers (FSWs) carry a disproportionate burden of HIV, little is known about the risk profile and associated factors for HIV infection among this population. There is a need for large-scale research to obtain reliable and representative estimates of the measures of association. This study involved secondary data analysis of the 'HIV/STI Integrated Biological and Behavioral Surveillance' study in Vietnam in 2009-2010 to examine the correlates of HIV among FSWs. Data collected from 5298 FSWs, including 2530 street-based sex workers and 2768 venue-based sex workers from 10 provinces in Vietnam, were analyzed using descriptive statistics and bivariate and multivariate logistic regression analyses. HIV prevalence among the overall FSW population was 8.6% (n = 453). However, when stratified by FSW subpopulations, HIV prevalence was 10.6% (n = 267) for street-based sex workers and 6.7% (n = 186) for venue-based sex workers. Factors independently associated with HIV infection in the multivariate analysis, regardless of sex work types, were injecting drug use, high self-perceived HIV risk, and age ≥ 25 years. Additional factors independently associated with HIV risk within each FSW subpopulation included having ever been married among street-based sex workers and inconsistent condom use with clients and having sex partners who injected drugs among venue-based sex workers. Apart from strategies addressing modifiable risk behaviours among all FSWs, targeted strategies to address specific risk behaviours within each FSW subpopulation should be adopted. © The Author(s) 2016.

  2. Thromboembolic events in cancer patients on active treatment with cisplatin-based chemotherapy: another look!

    PubMed

    Abdel-Razeq, Hikmat; Mansour, Asem; Abdulelah, Hazem; Al-Shwayat, Anas; Makoseh, Mohammad; Ibrahim, Mohammad; Abunasser, Mahmoud; Rimawi, Dalia; Al-Rabaiah, Abeer; Alfar, Rozan; Abufara, Alaa'; Ibrahim, Alaa; Bawaliz, Anas; Ismael, Yousef

    2018-01-01

    The risk of thromboembolic events is higher among cancer patients, especially in patients undergoing chemotherapy. Cisplatin-based regimens claim to be associated with a very high thromboembolic rate. In this study, we report on our own experience with thrombosis among patients on active cisplatin-based chemotherapy. Medical records and hospital databases were searched for all the patients treated with any cisplatin-based regimen for any kind of cancer. Thrombosis was considered cisplatin-related if diagnosed any time after the first dose and up to 4 weeks after the last. The Khorana risk assessment model was performed in all cases. A total of 1677 patients (65.5% males, median age: 50 years) treated with cisplatin-based regimens were identified. Head and neck (22.9%), lung (22.2%), lymphoma and gastric (11.4% each) were the most common primary tumors. Thromboembolic events were reported in 110 (6.6%); the highest was in patients with gastric cancer (20.9%) and the lowest in patients with head and neck cancers (2.3%) and lymphoma (1.6%). Thrombosis included deep vein thrombosis (DVT) in 69 (62.7%), pulmonary embolism (PE) in 18 (16.9%) and arterial thrombosis in 17 (15.6%). A majority (51.1%) of the patients had stage IV disease and only 16% had stage I or II.In a multivariate analysis, significantly higher rates of thrombosis were associated with gastric as the primary tumor, advanced-stage disease, female sex but not age, and the Khorana risk score or type of cisplatin regimen. While the presence of CVC was significantly associated with the risk of thrombosis ( p  < 0.0001) in the univariate analysis, and such significance was lost in the multivariate analysis (odds ratio, 1.098; 95%CI, 0.603-1.999, p  = 0.7599). Thromboembolic events in cancer patients on active cisplatin-based chemotherapy were commonly encountered. Gastric cancer, regardless of other clinical variables, was associated with the highest risk.

  3. The development of a 3D risk analysis method.

    PubMed

    I, Yet-Pole; Cheng, Te-Lung

    2008-05-01

    Much attention has been paid to the quantitative risk analysis (QRA) research in recent years due to more and more severe disasters that have happened in the process industries. Owing to its calculation complexity, very few software, such as SAFETI, can really make the risk presentation meet the practice requirements. However, the traditional risk presentation method, like the individual risk contour in SAFETI, is mainly based on the consequence analysis results of dispersion modeling, which usually assumes that the vapor cloud disperses over a constant ground roughness on a flat terrain with no obstructions and concentration fluctuations, which is quite different from the real situations of a chemical process plant. All these models usually over-predict the hazardous regions in order to maintain their conservativeness, which also increases the uncertainty of the simulation results. On the other hand, a more rigorous model such as the computational fluid dynamics (CFD) model can resolve the previous limitations; however, it cannot resolve the complexity of risk calculations. In this research, a conceptual three-dimensional (3D) risk calculation method was proposed via the combination of results of a series of CFD simulations with some post-processing procedures to obtain the 3D individual risk iso-surfaces. It is believed that such technique will not only be limited to risk analysis at ground level, but also be extended into aerial, submarine, or space risk analyses in the near future.

  4. Development of risk-based decision methodology for facility design.

    DOT National Transportation Integrated Search

    2014-06-01

    This report develops a methodology for CDOT to use in the risk analysis of various types of facilities and provides : illustrative examples for the use of the proposed framework. An overview of the current practices and applications to : illustrate t...

  5. Probability Surveys, Conditional Probability, and Ecological Risk Assessment

    EPA Science Inventory

    We show that probability-based environmental resource monitoring programs, such as the U.S. Environmental Protection Agency’s (U.S. EPA) Environmental Monitoring and Assessment Program, and conditional probability analysis can serve as a basis for estimating ecological risk over ...

  6. Comparison of SMR, PMR, and PCMR in a cohort of union members potentially exposed to diesel exhaust emissions.

    PubMed Central

    Wong, O; Morgan, R W; Kheifets, L; Larson, S R

    1985-01-01

    A comparison of cause specific standarised mortality ratios (SMRs) and proportionate mortality ratios (PMRs) or proportionate cancer mortality ratios (PCMRs) was made based on the mortality experience of a cohort of 34 156 members of a heavy equipment operators union. Two types of PMRs or PCMRs were used in the comparison: those based on all deaths and those based on deaths known to the union only. The comparison indicated that, for the entire cohort, both types of PMRs were poor indicators for cancer risk and produced a large number of false positives. On the other hand, PCMRs appeared to be better than PMRs for assessing the direction of site specific cancer risk, but they tended to overstate the magnitude of risk. Analysis by duration of union membership or latency indicated that PMRs or PCMRs based on deaths known to the union tended to overestimate the risk of lung cancer by disproportionately larger amounts in groups with shorter time than in groups with longer time. This differential bias had the net effect of reducing the gradient of any trend or eliminating the trend entirely. In conclusion, PMR or PCMR, based on reasonably sufficient death ascertainment, has a certain usefulness in generating hypotheses, but they are not useful or reliable in measuring the magnitude of risk or in detecting trends in dose response analysis. No conclusion should be drawn from either PMR or PCMR. PMID:2410011

  7. Modelling Risk to US Military Populations from Stopping Blanket Mandatory Polio Vaccination.

    PubMed

    Burgess, Colleen; Burgess, Andrew; McMullen, Kellie

    2017-01-01

    Transmission of polio poses a threat to military forces when deploying to regions where such viruses are endemic. US-born soldiers generally enter service with immunity resulting from childhood immunization against polio; moreover, new recruits are routinely vaccinated with inactivated poliovirus vaccine (IPV), supplemented based upon deployment circumstances. Given residual protection from childhood vaccination, risk-based vaccination may sufficiently protect troops from polio transmission. This analysis employed a mathematical system for polio transmission within military populations interacting with locals in a polio-endemic region to evaluate changes in vaccination policy. Removal of blanket immunization had no effect on simulated polio incidence among deployed military populations when risk-based immunization was employed; however, when these individuals reintegrated with their base populations, risk of transmission to nondeployed personnel increased by 19%. In the absence of both blanket- and risk-based immunization, transmission to nondeployed populations increased by 25%. The overall number of new infections among nondeployed populations was negligible for both scenarios due to high childhood immunization rates, partial protection against transmission conferred by IPV, and low global disease incidence levels. Risk-based immunization driven by deployment to polio-endemic regions is sufficient to prevent transmission among both deployed and nondeployed US military populations.

  8. Risk taking in first and second generation Afro-Caribbean adolescents: an emerging challenge for school nurses.

    PubMed

    Jolly, Kim; Archibald, Cynthia; Liehr, Patricia

    2013-10-01

    School nurses are well positioned to address risk-taking behaviors for adolescents in their care. The purpose of this mixed-method exploratory study was to explore risk taking in Afro-Caribbean adolescents in South Florida, comparing first- to second-generation adolescents. Quantitative and qualitative data were collected from an immigrant group using the adolescent risk-taking instrument to evaluate risk-taking attitudes, behaviors, and self-described riskiest activities. One-hundred and six adolescents participated; 44% were first generation Afro-Caribbean. Data analysis included analysis of variance, frequencies, and content analysis. There were no differences in risk-taking attitudes; smaller percentages of first generation Afro-Caribbean adolescents reported sexual activity, substance use, and violence. Over one third of the sample, regardless of generational status, reported alcohol use, but did not note alcohol or other health-compromising behaviors as "riskiest" activities. It is important to better understand Afro-Caribbean adolescents' perspectives about risky behaviors, and school-based venues offer the best promise for reaching these adolescents.

  9. Applicability and feasibility of systematic review for performing evidence-based risk assessment in food and feed safety.

    PubMed

    Aiassa, E; Higgins, J P T; Frampton, G K; Greiner, M; Afonso, A; Amzal, B; Deeks, J; Dorne, J-L; Glanville, J; Lövei, G L; Nienstedt, K; O'connor, A M; Pullin, A S; Rajić, A; Verloo, D

    2015-01-01

    Food and feed safety risk assessment uses multi-parameter models to evaluate the likelihood of adverse events associated with exposure to hazards in human health, plant health, animal health, animal welfare, and the environment. Systematic review and meta-analysis are established methods for answering questions in health care, and can be implemented to minimize biases in food and feed safety risk assessment. However, no methodological frameworks exist for refining risk assessment multi-parameter models into questions suitable for systematic review, and use of meta-analysis to estimate all parameters required by a risk model may not be always feasible. This paper describes novel approaches for determining question suitability and for prioritizing questions for systematic review in this area. Risk assessment questions that aim to estimate a parameter are likely to be suitable for systematic review. Such questions can be structured by their "key elements" [e.g., for intervention questions, the population(s), intervention(s), comparator(s), and outcome(s)]. Prioritization of questions to be addressed by systematic review relies on the likely impact and related uncertainty of individual parameters in the risk model. This approach to planning and prioritizing systematic review seems to have useful implications for producing evidence-based food and feed safety risk assessment.

  10. Bayesian inference on risk differences: an application to multivariate meta-analysis of adverse events in clinical trials.

    PubMed

    Chen, Yong; Luo, Sheng; Chu, Haitao; Wei, Peng

    2013-05-01

    Multivariate meta-analysis is useful in combining evidence from independent studies which involve several comparisons among groups based on a single outcome. For binary outcomes, the commonly used statistical models for multivariate meta-analysis are multivariate generalized linear mixed effects models which assume risks, after some transformation, follow a multivariate normal distribution with possible correlations. In this article, we consider an alternative model for multivariate meta-analysis where the risks are modeled by the multivariate beta distribution proposed by Sarmanov (1966). This model have several attractive features compared to the conventional multivariate generalized linear mixed effects models, including simplicity of likelihood function, no need to specify a link function, and has a closed-form expression of distribution functions for study-specific risk differences. We investigate the finite sample performance of this model by simulation studies and illustrate its use with an application to multivariate meta-analysis of adverse events of tricyclic antidepressants treatment in clinical trials.

  11. An Analysis of Risk and Function Information in Early Stage Design

    NASA Technical Reports Server (NTRS)

    Barrientos, Francesca; Tumer, Irem; Grantham, Katie; VanWie, Michael; Stone, Robert

    2005-01-01

    The concept of function offers a high potential for thinking and reasoning about designs as well as providing a common thread for relating together other design information. This paper focuses specifically on the relation between function and risk by examining how this information is addressed for a design team conducting early stage design for space missions. Risk information is decomposed into a set of key attributes which are then used to scrutinize the risk information using three approaches from the pragmatics sub-field of linguistics: i) Gricean, ii) Relevance Theory, and Functional Analysis. Results of this linguistics-based approach descriptively account for the context of designer communication with respect to function and risk, and offer prescriptive guidelines for improving designer communication.

  12. Risks associated with antiretroviral treatment for human immunodeficiency virus (HIV): qualitative analysis of social media data and health state utility valuation.

    PubMed

    Matza, Louis S; Chung, Karen C; Kim, Katherine J; Paulus, Trena M; Davies, Evan W; Stewart, Katie D; McComsey, Grace A; Fordyce, Marshall W

    2017-07-01

    Despite benefits of antiretroviral therapies (ART), people with HIV infection have increased risk of cardiovascular disease, kidney disease, and low bone mineral density. Some ARTs increase risk of these events. The purpose of this study was to examine patients' perspectives of these risks and estimate health state utilities associated with these risks for use in cost-utility models. Qualitative thematic analysis was conducted to examine messages posted to the POZ/AIDSmeds Internet community forums, focusing on bone, kidney, and cardiovascular side effects and risks of HIV/AIDS medications. Then, health state vignettes were drafted based on this qualitative analysis, literature review, and clinician interviews. The health states (representing HIV, plus treatment-related risks) were valued in time trade-off interviews with general population participants in the UK. Qualitative analysis of the Internet forums documented patient concerns about ART risks, as well as treatment decisions made because of these risks. A total of 208 participants completed utility interviews (51.4% female; mean age 44.6 years). The mean utility of the HIV health state (virologically suppressed, treated with ART) was 0.86. Adding a description of risk resulted in statistically significant disutility (i.e., utility decreases): renal risk (disutility = -0.02), bone risk (-0.03), and myocardial infarction risk (-0.05). Patient concerns and treatment decisions were documented via qualitative analysis of Internet forum discussions, and the impact of these concerns was quantified in terms of health state utilities. The resulting disutilities may be useful for differentiating among ARTs in economic modeling of treatment for patients with HIV.

  13. Systems Analysis of NASA Aviation Safety Program: Final Report

    NASA Technical Reports Server (NTRS)

    Jones, Sharon M.; Reveley, Mary S.; Withrow, Colleen A.; Evans, Joni K.; Barr, Lawrence; Leone, Karen

    2013-01-01

    A three-month study (February to April 2010) of the NASA Aviation Safety (AvSafe) program was conducted. This study comprised three components: (1) a statistical analysis of currently available civilian subsonic aircraft data from the National Transportation Safety Board (NTSB), the Federal Aviation Administration (FAA), and the Aviation Safety Information Analysis and Sharing (ASIAS) system to identify any significant or overlooked aviation safety issues; (2) a high-level qualitative identification of future safety risks, with an assessment of the potential impact of the NASA AvSafe research on the National Airspace System (NAS) based on these risks; and (3) a detailed, top-down analysis of the NASA AvSafe program using an established and peer-reviewed systems analysis methodology. The statistical analysis identified the top aviation "tall poles" based on NTSB accident and FAA incident data from 1997 to 2006. A separate examination of medical helicopter accidents in the United States was also conducted. Multiple external sources were used to develop a compilation of ten "tall poles" in future safety issues/risks. The top-down analysis of the AvSafe was conducted by using a modification of the Gibson methodology. Of the 17 challenging safety issues that were identified, 11 were directly addressed by the AvSafe program research portfolio.

  14. Systematic reviews of randomised clinical trials examining the effects of psychotherapeutic interventions versus "no intervention" for acute major depressive disorder and a randomised trial examining the effects of "third wave" cognitive therapy versus mentalization-based treatment for acute major depressive disorder.

    PubMed

    Jakobsen, Janus Christian

    2014-10-01

    Major depressive disorder afflicts an estimated 17% of individuals during their lifetimes at tremendous suffering and costs. Cognitive therapy and psychodynamic therapy may be effective treatment options for major depressive disorder, but the effects have only had limited assessment in systematic reviews. The two modern forms of psychotherapy, "third wave" cognitive therapy and mentalization-based treatment, have both gained some ground as treatments of psychiatric disorders. No randomised trial has compared the effects of these two interventions for major depressive disorder. We performed two systematic reviews with meta-analyses and trial sequential analyses using The Cochrane Collaboration methodology examining the effects of cognitive therapy and psycho-dynamic therapy for major depressive disorder. We developed a thorough treatment protocol for a randomised trial with low risks of bias (systematic error) and low risks of random errors ("play of chance") examining the effects of third wave' cognitive therapy versus mentalization-based treatment for major depressive disorder. We conducted a randomised trial according to good clinical practice examining the effects of "third wave" cognitive therapy versus mentalisation-based treatment for major depressive disorder. The first systematic review included five randomised trials examining the effects of psychodynamic therapy versus "no intervention' for major depressive disorder. Altogether the five trials randomised 365 participants who in each trial received similar antidepressants as co-interventions. All trials had high risk of bias. Four trials assessed "interpersonal psychotherapy" and one trial "short psychodynamic supportive psychotherapy". Both of these interventions are different forms of psychodynamic therapy. Meta-analysis showed that psychodynamic therapy significantly reduced depressive symptoms on the Hamilton Depression Rating Scale (HDRS) compared with "no intervention" (mean difference -3.01 (95% confidence interval -3.98 to -2.03; p = 0.00001), no significant heterogeneity between trials). Trial sequential analysis confirmed this result. The second systematic review included 12 randomised trials examining the effects of cognitive therapy versus "no intervention" for major depressive disorder. Altogether a total of 669 participants were randomised. All trials had high risk of bias. Meta-analysis showed that cognitive therapy significantly reduced depressive symptoms on the HDRS compared with "no intervention" (four trials; mean difference -3.05 (95% confidence interval, -5.23 to -0.87; p = 0.006)). Trial sequential analysis could not confirm this result. The trial protocol showed that it seemed feasible to conduct a randomised trial with low risks of bias and low risks of random errors examining the effects of "third wave" cognitive therapy versus mentalization-based therapy in a setting in the Danish healthcare system. It turned out to be much more difficult to recruit participants in the randomised trial than expected. We only included about half of the planned participants. The results from the randomised trial showed that participants randomised to "third wave" therapy compared with participants randomised to mentalization-based treatment had borderline significantly lower HDRS scores at 18 weeks in an unadjusted analysis (mean difference -4.14 score; 95% CI -8.30 to 0.03; p = 0.051). In the adjusted analysis, the difference was significant (p = 0.039). Five (22.7%) of the participants randomised to "third wave" cognitive therapy had remission at 18 weeks versus none of the participants randomised to mentalization-based treatment (p = 0.049). Sequential analysis showed that these findings could be due to random errors. No significant differences between the two groups was found regarding Beck's Depression Inventory (BDI II), Symptom Checklist 90 Revised (SCL 90-R), and The World Health Organization-Five Well-being Index 1999 (WHO 5). We concluded that cognitive therapy and psychodynamic therapy might be effective interventions for depression measured on HDRS and BDI, but the review results might be erroneous due to risks of bias and random errors. Furthermore, the effects seem relatively small. The trial protocol showed that it was possible to develop a protocol for a randomised trial examining the effects of "third wave" cognitive therapy versus mentalization-based treatment with low risks of bias and low risks of random errors. Our trial results showed that "third wave" cognitive therapy might be a more effective intervention for depressive symptoms measured on the HDRS compared with mentalization-based treatment. The two interventions did not seem to differ significantly regarding BDI II, SCL 90-R, and WHO 5. More randomised trials with low risks of bias and low risks of random errors are needed to assess the effects of cognitive therapy, psychodynamic therapy, "third wave" cognitive therapy, and mentalization-based treatment.

  15. A risk-based decision support framework for selection of appropriate safety measure system for underground coal mines.

    PubMed

    Samantra, Chitrasen; Datta, Saurav; Mahapatra, Siba Sankar

    2017-03-01

    In the context of underground coal mining industry, the increased economic issues regarding implementation of additional safety measure systems, along with growing public awareness to ensure high level of workers safety, have put great pressure on the managers towards finding the best solution to ensure safe as well as economically viable alternative selection. Risk-based decision support system plays an important role in finding such solutions amongst candidate alternatives with respect to multiple decision criteria. Therefore, in this paper, a unified risk-based decision-making methodology has been proposed for selecting an appropriate safety measure system in relation to an underground coal mining industry with respect to multiple risk criteria such as financial risk, operating risk, and maintenance risk. The proposed methodology uses interval-valued fuzzy set theory for modelling vagueness and subjectivity in the estimates of fuzzy risk ratings for making appropriate decision. The methodology is based on the aggregative fuzzy risk analysis and multi-criteria decision making. The selection decisions are made within the context of understanding the total integrated risk that is likely to incur while adapting the particular safety system alternative. Effectiveness of the proposed methodology has been validated through a real-time case study. The result in the context of final priority ranking is seemed fairly consistent.

  16. Investigation of the Study Characteristics Affecting Clinical Trial Quality Using the Protocol Deviations Leading to Exclusion of Subjects From the Per Protocol Set Data in Studies for New Drug Application: A Retrospective Analysis.

    PubMed

    Kohara, Norihito; Kaneko, Masayuki; Narukawa, Mamoru

    2018-01-01

    The concept of the risk-based approach has been introduced as an effort to secure the quality of clinical trials. In the risk-based approach, identification and evaluation of risk in advance are considered important. For recently completed clinical trials, we investigated the relationship between study characteristics and protocol deviations leading to the exclusion of subjects from Per Protocol Set (PPS) efficacy analysis. New drugs approved in Japan in the fiscal year 2014-2015 were targeted in the research. The reasons for excluding subjects from the PPS efficacy analysis were described in 102 trials out of 492 in the summary of new drug application documents, which was publicly disclosed after the drug's regulatory approval. The author extracted these reasons along with the numbers of the cases and the study characteristics of each clinical trial. Then, the direct comparison, univariate regression analysis, and multivariate regression analysis was carried out based on the exclusion rate. The study characteristics for which exclusion of subjects from the PPS efficacy analysis were frequently observed was multiregional clinical trials in study region; inhalant and external use in administration route; Anti-infective for systemic use; Respiratory system, Dermatologicals, and Nervous system in therapeutic drug under the Anatomical Therapeutic Chemical Classification. In the multivariate regression analysis, the clinical trial variables of inhalant, Respiratory system, or Dermatologicals were selected as study characteristics leading to a higher exclusion rate. The characteristics of the clinical trial that is likely to cause protocol deviations that will affect efficacy analysis were suggested. These studies should be considered for specific attention and priority observation in the trial protocol or its monitoring plan and execution, such as a clear description of inclusion/exclusion criteria in the protocol, development of training materials to site staff, and/or trial subjects as specific risk-alleviating measures.

  17. TU-AB-BRD-03: Fault Tree Analysis

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Dunscombe, P.

    2015-06-15

    Current quality assurance and quality management guidelines provided by various professional organizations are prescriptive in nature, focusing principally on performance characteristics of planning and delivery devices. However, published analyses of events in radiation therapy show that most events are often caused by flaws in clinical processes rather than by device failures. This suggests the need for the development of a quality management program that is based on integrated approaches to process and equipment quality assurance. Industrial engineers have developed various risk assessment tools that are used to identify and eliminate potential failures from a system or a process before amore » failure impacts a customer. These tools include, but are not limited to, process mapping, failure modes and effects analysis, fault tree analysis. Task Group 100 of the American Association of Physicists in Medicine has developed these tools and used them to formulate an example risk-based quality management program for intensity-modulated radiotherapy. This is a prospective risk assessment approach that analyzes potential error pathways inherent in a clinical process and then ranks them according to relative risk, typically before implementation, followed by the design of a new process or modification of the existing process. Appropriate controls are then put in place to ensure that failures are less likely to occur and, if they do, they will more likely be detected before they propagate through the process, compromising treatment outcome and causing harm to the patient. Such a prospective approach forms the basis of the work of Task Group 100 that has recently been approved by the AAPM. This session will be devoted to a discussion of these tools and practical examples of how these tools can be used in a given radiotherapy clinic to develop a risk based quality management program. Learning Objectives: Learn how to design a process map for a radiotherapy process Learn how to perform failure modes and effects analysis analysis for a given process Learn what fault trees are all about Learn how to design a quality management program based upon the information obtained from process mapping, failure modes and effects analysis and fault tree analysis. Dunscombe: Director, TreatSafely, LLC and Center for the Assessment of Radiological Sciences; Consultant to IAEA and Varian Thomadsen: President, Center for the Assessment of Radiological Sciences Palta: Vice President of the Center for the Assessment of Radiological Sciences.« less

  18. TU-AB-BRD-02: Failure Modes and Effects Analysis

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Huq, M.

    2015-06-15

    Current quality assurance and quality management guidelines provided by various professional organizations are prescriptive in nature, focusing principally on performance characteristics of planning and delivery devices. However, published analyses of events in radiation therapy show that most events are often caused by flaws in clinical processes rather than by device failures. This suggests the need for the development of a quality management program that is based on integrated approaches to process and equipment quality assurance. Industrial engineers have developed various risk assessment tools that are used to identify and eliminate potential failures from a system or a process before amore » failure impacts a customer. These tools include, but are not limited to, process mapping, failure modes and effects analysis, fault tree analysis. Task Group 100 of the American Association of Physicists in Medicine has developed these tools and used them to formulate an example risk-based quality management program for intensity-modulated radiotherapy. This is a prospective risk assessment approach that analyzes potential error pathways inherent in a clinical process and then ranks them according to relative risk, typically before implementation, followed by the design of a new process or modification of the existing process. Appropriate controls are then put in place to ensure that failures are less likely to occur and, if they do, they will more likely be detected before they propagate through the process, compromising treatment outcome and causing harm to the patient. Such a prospective approach forms the basis of the work of Task Group 100 that has recently been approved by the AAPM. This session will be devoted to a discussion of these tools and practical examples of how these tools can be used in a given radiotherapy clinic to develop a risk based quality management program. Learning Objectives: Learn how to design a process map for a radiotherapy process Learn how to perform failure modes and effects analysis analysis for a given process Learn what fault trees are all about Learn how to design a quality management program based upon the information obtained from process mapping, failure modes and effects analysis and fault tree analysis. Dunscombe: Director, TreatSafely, LLC and Center for the Assessment of Radiological Sciences; Consultant to IAEA and Varian Thomadsen: President, Center for the Assessment of Radiological Sciences Palta: Vice President of the Center for the Assessment of Radiological Sciences.« less

  19. Landscape ecological risk assessment study in arid land

    NASA Astrophysics Data System (ADS)

    Gong, Lu; Amut, Aniwaer; Shi, Qingdong; Wang, Gary Z.

    2007-09-01

    The ecosystem risk assessment is an essential decision making system for predicting the reconstruction and recovery of a damaged ecosystem after intensive mankind activities. The sustainability of environment and resources of the lake ecosystem in arid districts have been paid close attention to by international communities as well as numerous experts and scholars. The ecological risk assessment offered a scientific foundation for making the decision and execution of ecological risk management. Bosten Lake, the largest inland freshwater lake in China, is the main water source of the industrial and agricultural production as well as the local residence in Yanqi basin, Kuara city and Yuri County in the southern Xinjiang. Bosten Lake also provides a direct water source for emergency transportation in the Lower Reaches of Tarim River. However, with the intensive utilizations of water and soil resources, the environmental condition in the Bosten Lake has become more and more serious. In this study, the theory and method of landscape ecological risk assessment has been practiced using 3S technologies combined with the frontier theory of landscape ecology. Defining the mainly risk resource including flood, drought, water pollution and rich nutrition of water has been evaluated based on the ecosystem risk assessment system. The main process includes five stages: regional natural resources analysis, risk receptor selection, risk sources evaluation, exposure and hazard analysis, and integrated risk assessment. Based on the risk assessment results, the environmental risk management countermeasure has been determined.

  20. PRA and Risk Informed Analysis

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Bernsen, Sidney A.; Simonen, Fredric A.; Balkey, Kenneth R.

    2006-01-01

    The Boiler and Pressure Vessel Code (BPVC) of the American Society of Mechanical Engineers (ASME) has introduced a risk based approach into Section XI that covers Rules for Inservice Inspection of Nuclear Power Plant Components. The risk based approach requires application of the probabilistic risk assessments (PRA). Because no industry consensus standard existed for PRAs, ASME has developed a standard to evaluate the quality level of an available PRA needed to support a given risk based application. The paper describes the PRA standard, Section XI application of PRAs, and plans for broader applications of PRAs to other ASME nuclear codesmore » and standards. The paper addresses several specific topics of interest to Section XI. Important consideration are special methods (surrogate components) used to overcome the lack of PRA treatments of passive components in PRAs. The approach allows calculations of conditional core damage probabilities both for component failures that cause initiating events and failures in standby systems that decrease the availability of these systems. The paper relates the explicit risk based methods of the new Section XI code cases to the implicit consideration of risk used in the development of Section XI. Other topics include the needed interactions of ISI engineers, plant operating staff, PRA specialists, and members of expert panels that review the risk based programs.« less

  1. Allometric scaling: analysis of LD50 data.

    PubMed

    Burzala-Kowalczyk, Lidia; Jongbloed, Geurt

    2011-04-01

    The need to identify toxicologically equivalent doses across different species is a major issue in toxicology and risk assessment. In this article, we investigate interspecies scaling based on the allometric equation applied to the single, oral LD (50) data previously analyzed by Rhomberg and Wolff. We focus on the statistical approach, namely, regression analysis of the mentioned data. In contrast to Rhomberg and Wolff's analysis of species pairs, we perform an overall analysis based on the whole data set. From our study it follows that if one assumes one single scaling rule for all species and substances in the data set, then β = 1 is the most natural choice among a set of candidates known in the literature. In fact, we obtain quite narrow confidence intervals for this parameter. However, the estimate of the variance in the model is relatively high, resulting in rather wide prediction intervals. © 2010 Society for Risk Analysis.

  2. Value-based formulas for purchasing. PEHP's designated service provider program: value-based purchasing through global fees.

    PubMed

    Emery, D W

    1997-01-01

    In many circles, managed care and capitation have become synonymous; unfortunately, the assumptions informing capitation are based on a flawed unidimensional model of risk. PEHP of Utah has rejected the unidimensional model and has therefore embraced a multidimensional model of risk that suggests that global fees are the optimal purchasing modality. A globally priced episode of care forms a natural unit of analysis that enhances purchasing clarity, allows providers to more efficiently focus on the Marginal Rate of Technical Substitution, and conforms to the multidimensional reality of risk. Most importantly, global fees simultaneously maximize patient choice and provider cost consciousness.

  3. Mapping Natech risk due to earthquakes using RAPID-N

    NASA Astrophysics Data System (ADS)

    Girgin, Serkan; Krausmann, Elisabeth

    2013-04-01

    Natural hazard-triggered technological accidents (so-called Natech accidents) at hazardous installations are an emerging risk with possibly serious consequences due to the potential for release of hazardous materials, fires or explosions. For the reduction of Natech risk, one of the highest priority needs is the identification of Natech-prone areas and the systematic assessment of Natech risks. With hardly any Natech risk maps existing within the EU the European Commission's Joint Research Centre has developed a Natech risk analysis and mapping tool called RAPID-N, that estimates the overall risk of natural-hazard impact to industrial installations and its possible consequences. The results are presented as risk summary reports and interactive risk maps which can be used for decision making. Currently, RAPID-N focuses on Natech risk due to earthquakes at industrial installations. However, it will be extended to also analyse and map Natech risk due to floods in the near future. The RAPID-N methodology is based on the estimation of on-site natural hazard parameters, use of fragility curves to determine damage probabilities of plant units for various damage states, and the calculation of spatial extent, severity, and probability of Natech events potentially triggered by the natural hazard. The methodology was implemented as a web-based risk assessment and mapping software tool which allows easy data entry, rapid local or regional risk assessment and mapping. RAPID-N features an innovative property estimation framework to calculate on-site natural hazard parameters, industrial plant and plant unit characteristics, and hazardous substance properties. Custom damage states and fragility curves can be defined for different types of plant units. Conditional relationships can be specified between damage states and Natech risk states, which describe probable Natech event scenarios. Natech consequences are assessed using a custom implementation of U.S. EPA's Risk Management Program (RMP) Guidance for Offsite Consequence Analysis methodology. This custom implementation is based on the property estimation framework and allows the easy modification of model parameters and the substitution of equations with alternatives. RAPID-N can be applied at different stages of the Natech risk management process: It allows on the one hand the analysis of hypothetical Natech scenarios to prevent or prepare for a Natech accident by supporting land-use and emergency planning. On the other hand, once a natural disaster occurs RAPID-N can be used for rapidly locating facilities with potential Natech accident damage based on actual natural-hazard information. This provides a means to warn the population in the vicinity of the facilities in a timely manner. This presentation will introduce the specific features of RAPID-N and show the use of the tool by application to a case-study area.

  4. Environmental contaminants in freshwater fish and their risk to piscivorous wildlife based on a national monitoring program

    USGS Publications Warehouse

    Hinck, J.E.; Schmitt, C.J.; Chojnacki, K.A.; Tillitt, D.E.

    2009-01-01

    Organochlorine chemical residues and elemental concentrations were measured in piscivorous and benthivorous fish at 111 sites from large U.S. river basins. Potential contaminant sources such as urban and agricultural runoff, industrial discharges, mine drainage, and irrigation varied among the sampling sites. Our objectives were to provide summary statistics for chemical contaminants and to determine if contaminant concentrations in the fish were a risk to wildlife that forage at these sites. Concentrations of dieldrin, total DDT, total PCBs, toxaphene, TCDD-EQ, cadmium, chromium, mercury, lead, selenium, and zinc exceeded toxicity thresholds to protect fish and piscivorous wildlife in samples from at least one site; most exceedences were for total PCBs, mercury, and zinc. Chemical concentrations in fish from the Mississippi River Basin exceeded the greatest number of toxicity thresholds. Screening level wildlife risk analysis models were developed for bald eagle and mink using no adverse effect levels (NOAELs), which were derived from adult dietary exposure or tissue concentration studies and based primarily on reproductive endpoints. No effect hazard concentrations (NEHC) were calculated by comparing the NOAEL to the food ingestion rate (dietary-based NOAEL) or biomagnification factor (tissue-based NOAEL) of each receptor. Piscivorous wildlife may be at risk from a contaminant if the measured concentration in fish exceeds the NEHC. Concentrations of most organochlorine residues and elemental contaminants represented no to low risk to bald eagle and mink at most sites. The risk associated with pentachloroanisole, aldrin, Dacthal, methoxychlor, mirex, and toxaphene was unknown because NOAELs for these contaminants were not available for bald eagle or mink. Risk differed among modeled species and sites. Our screening level analysis indicates that the greatest risk to piscivorous wildlife was from total DDT, total PCBs, TCDD-EQ, mercury, and selenium. Bald eagles were at greater risk to total DDT and total PCBs than mink, whereas risks of TCDD-EQ, mercury, and selenium were greater to mink than bald eagle. ?? Springer Science+Business Media B.V. 2008.

  5. Withdrawal Phenomena: A Concept Analysis for the Development of a Nursing Diagnosis.

    PubMed

    Dändliker, This; Kolbe, Nina

    This study explored the concept of withdrawal phenomena from the perspective of nurses, with the aim of developing a nursing diagnosis. Concept analysis was used as the framework of the study, a systematized review was conducted to identify relevant studies, and interpretation was based on qualitative content analysis. Specifying aspects, defining characteristics, related factors, and risk factors were extracted and classified into categories. Thirteen studies were identified as a basis for the construction of two nursing diagnoses: "withdrawal phenomena" and "risk of withdrawal complications." The proposed nursing diagnoses require further discussion. The NANDA International Diagnosis Development Committee was asked to examine the proposed diagnoses. However, it was too early to determine implications for nursing practice based on the results of this study.

  6. Source Apportionment and Risk Assessment of Emerging Contaminants: An Approach of Pharmaco-Signature in Water Systems

    PubMed Central

    Jiang, Jheng Jie; Lee, Chon Lin; Fang, Meng Der; Boyd, Kenneth G.; Gibb, Stuart W.

    2015-01-01

    This paper presents a methodology based on multivariate data analysis for characterizing potential source contributions of emerging contaminants (ECs) detected in 26 river water samples across multi-scape regions during dry and wet seasons. Based on this methodology, we unveil an approach toward potential source contributions of ECs, a concept we refer to as the “Pharmaco-signature.” Exploratory analysis of data points has been carried out by unsupervised pattern recognition (hierarchical cluster analysis, HCA) and receptor model (principal component analysis-multiple linear regression, PCA-MLR) in an attempt to demonstrate significant source contributions of ECs in different land-use zone. Robust cluster solutions grouped the database according to different EC profiles. PCA-MLR identified that 58.9% of the mean summed ECs were contributed by domestic impact, 9.7% by antibiotics application, and 31.4% by drug abuse. Diclofenac, ibuprofen, codeine, ampicillin, tetracycline, and erythromycin-H2O have significant pollution risk quotients (RQ>1), indicating potentially high risk to aquatic organisms in Taiwan. PMID:25874375

  7. Major Accidents (Gray Swans) Likelihood Modeling Using Accident Precursors and Approximate Reasoning.

    PubMed

    Khakzad, Nima; Khan, Faisal; Amyotte, Paul

    2015-07-01

    Compared to the remarkable progress in risk analysis of normal accidents, the risk analysis of major accidents has not been so well-established, partly due to the complexity of such accidents and partly due to low probabilities involved. The issue of low probabilities normally arises from the scarcity of major accidents' relevant data since such accidents are few and far between. In this work, knowing that major accidents are frequently preceded by accident precursors, a novel precursor-based methodology has been developed for likelihood modeling of major accidents in critical infrastructures based on a unique combination of accident precursor data, information theory, and approximate reasoning. For this purpose, we have introduced an innovative application of information analysis to identify the most informative near accident of a major accident. The observed data of the near accident were then used to establish predictive scenarios to foresee the occurrence of the major accident. We verified the methodology using offshore blowouts in the Gulf of Mexico, and then demonstrated its application to dam breaches in the United Sates. © 2015 Society for Risk Analysis.

  8. Adoption of Building Information Modelling in project planning risk management

    NASA Astrophysics Data System (ADS)

    Mering, M. M.; Aminudin, E.; Chai, C. S.; Zakaria, R.; Tan, C. S.; Lee, Y. Y.; Redzuan, A. A.

    2017-11-01

    An efficient and effective risk management required a systematic and proper methodology besides knowledge and experience. However, if the risk management is not discussed from the starting of the project, this duty is notably complicated and no longer efficient. This paper presents the adoption of Building Information Modelling (BIM) in project planning risk management. The objectives is to identify the traditional risk management practices and its function, besides, determine the best function of BIM in risk management and investigating the efficiency of adopting BIM-based risk management during the project planning phase. In order to obtain data, a quantitative approach is adopted in this research. Based on data analysis, the lack of compliance with project requirements and failure to recognise risk and develop responses to opportunity are the risks occurred when traditional risk management is implemented. When using BIM in project planning, it works as the tracking of cost control and cash flow give impact on the project cycle to be completed on time. 5D cost estimation or cash flow modeling benefit risk management in planning, controlling and managing budget and cost reasonably. There were two factors that mostly benefit a BIM-based technology which were formwork plan with integrated fall plan and design for safety model check. By adopting risk management, potential risks linked with a project and acknowledging to those risks can be identified to reduce them to an acceptable extent. This means recognizing potential risks and avoiding threat by reducing their negative effects. The BIM-based risk management can enhance the planning process of construction projects. It benefits the construction players in various aspects. It is important to know the application of BIM-based risk management as it can be a lesson learnt to others to implement BIM and increase the quality of the project.

  9. Autonomic dysfunction assessed by EZSCAN and subclinical atherosclerosis.

    PubMed

    Sun, Jichao; Zhang, Yinfei; Xu, Baihui; Lv, Xiaofei; Ding, Lin; Chen, Ying; Sun, Wanwan; Lu, Jieli; Xu, Min; Bi, Yufang; Ning, Guang

    2014-09-01

    The present study aimed to explore the association between autonomic dysfunction and measurements of atherosclerosis in a middle-aged and elderly Chinese population. A population-based cross-sectional study was performed in Shanghai, China, from March to August 2010, with 5076 participants included in the analysis. Autonomic function was assessed by a novel EZSCAN test based on sudomotor function analysis. Carotid intima-media thickness (CIMT) was measured using B-mode ultrasonography and brachial-ankle pulse wave velocity (ba-PWV) was measured using an autonomic device. Participants were divided into three groups based on EZSCAN values: Group 1: EZSCAN 0-24; Group 2, EZSCAN 25-49; and Group 3, EZSCAN 50-100. These groups denoted autonomic dysfunction risk groups as follows: no risk, moderate risk and high risk, respectively. The prevalence of elevated CIMT and ba-PWV increased markedly with increasing EZSCAN values (elevated CIMT 7.4%, 17.5%, and 29.7%, elevated ba-PWV 3.2%, 19.7%, and 36.5%, in Groups 1, 2, and 3, respectively; both Ptrend < 0.0001). Logistic regressions revealed that EZSCAN values ≥50 were associated with a non-significantly higher risk of elevated CIMT (odds ratio [OR] = 1.43; 95% confidence interval [CI] 0.98-2.07) and a significantly higher risk of elevated ba-PWV (OR = 2.16; 95% CI 1.25-3.71) compared with EZSCAN values <25, after controlling for conventional risk factors. A higher EZSCAN value (≥50), an index of high autonomic dysfunction risk, was associated with an increased risk of elevated ba-PWV and CIMT. Such associations were partially explained by traditional atherosclerotic risk factors. © 2014 Ruijin Hospital, Shanghai Jiaotong University School of Medicine and Wiley Publishing Asia Pty Ltd.

  10. Method and system for dynamic probabilistic risk assessment

    NASA Technical Reports Server (NTRS)

    Dugan, Joanne Bechta (Inventor); Xu, Hong (Inventor)

    2013-01-01

    The DEFT methodology, system and computer readable medium extends the applicability of the PRA (Probabilistic Risk Assessment) methodology to computer-based systems, by allowing DFT (Dynamic Fault Tree) nodes as pivot nodes in the Event Tree (ET) model. DEFT includes a mathematical model and solution algorithm, supports all common PRA analysis functions and cutsets. Additional capabilities enabled by the DFT include modularization, phased mission analysis, sequence dependencies, and imperfect coverage.

  11. Computer-based video analysis identifies infants with absence of fidgety movements.

    PubMed

    Støen, Ragnhild; Songstad, Nils Thomas; Silberg, Inger Elisabeth; Fjørtoft, Toril; Jensenius, Alexander Refsum; Adde, Lars

    2017-10-01

    BackgroundAbsence of fidgety movements (FMs) at 3 months' corrected age is a strong predictor of cerebral palsy (CP) in high-risk infants. This study evaluates the association between computer-based video analysis and the temporal organization of FMs assessed with the General Movement Assessment (GMA).MethodsInfants were eligible for this prospective cohort study if referred to a high-risk follow-up program in a participating hospital. Video recordings taken at 10-15 weeks post term age were used for GMA and computer-based analysis. The variation of the spatial center of motion, derived from differences between subsequent video frames, was used for quantitative analysis.ResultsOf 241 recordings from 150 infants, 48 (24.1%) were classified with absence of FMs or sporadic FMs using the GMA. The variation of the spatial center of motion (C SD ) during a recording was significantly lower in infants with normal (0.320; 95% confidence interval (CI) 0.309, 0.330) vs. absence of or sporadic (0.380; 95% CI 0.361, 0.398) FMs (P<0.001). A triage model with C SD thresholds chosen for sensitivity of 90% and specificity of 80% gave a 40% referral rate for GMA.ConclusionQuantitative video analysis during the FMs' period can be used to triage infants at high risk of CP to early intervention or observational GMA.

  12. The use of failure mode and effect analysis in a radiation oncology setting: the Cancer Treatment Centers of America experience.

    PubMed

    Denny, Diane S; Allen, Debra K; Worthington, Nicole; Gupta, Digant

    2014-01-01

    Delivering radiation therapy in an oncology setting is a high-risk process where system failures are more likely to occur because of increasing utilization, complexity, and sophistication of the equipment and related processes. Healthcare failure mode and effect analysis (FMEA) is a method used to proactively detect risks to the patient in a particular healthcare process and correct potential errors before adverse events occur. FMEA is a systematic, multidisciplinary team-based approach to error prevention and enhancing patient safety. We describe our experience of using FMEA as a prospective risk-management technique in radiation oncology at a national network of oncology hospitals in the United States, capitalizing not only on the use of a team-based tool but also creating momentum across a network of collaborative facilities seeking to learn from and share best practices with each other. The major steps of our analysis across 4 sites and collectively were: choosing the process and subprocesses to be studied, assembling a multidisciplinary team at each site responsible for conducting the hazard analysis, and developing and implementing actions related to our findings. We identified 5 areas of performance improvement for which risk-reducing actions were successfully implemented across our enterprise. © 2012 National Association for Healthcare Quality.

  13. Measuring the impact of air pollution on respiratory infection risk in China.

    PubMed

    Tang, Sanyi; Yan, Qinling; Shi, Wei; Wang, Xia; Sun, Xiaodan; Yu, Pengbo; Wu, Jianhong; Xiao, Yanni

    2018-01-01

    China is now experiencing major public health challenges caused by air pollution. Few studies have quantified the dynamics of air pollution and its impact on the risk of respiratory infection. We conducted an integrated data analysis to quantify the association among air quality index (AQI), meteorological variables and respiratory infection risk in Shaanxi province of China in the period of November 15th, 2010 to November 14th, 2016. Our analysis illustrated a statistically significantly positive correlation between the number of influenza-like illness (ILI) cases and AQI, and the respiratory infection risk has increased progressively with increased AQI with a time lag of 0-3 days. We also developed mathematical models for the AQI trend and respiratory infection dynamics, incorporating AQI-dependent incidence and AQI-based behaviour change interventions. Our combined data and modelling analysis estimated the basic reproduction number for the respiratory infection during the studying period to be 2.4076, higher than the basic reproduction number of the 2009 pandemic influenza in the same province. Our modelling-based simulations concluded that, in terms of respiratory infection risk reduction, the persistent control of emission in the China's blue-sky programme is much more effective than substantial social-economic interventions implemented only during the smog days. Copyright © 2017 Elsevier Ltd. All rights reserved.

  14. Divorce and Death: A Meta-Analysis and Research Agenda for Clinical, Social, and Health Psychology.

    PubMed

    Sbarra, David A; Law, Rita W; Portley, Robert M

    2011-09-01

    Divorce is a relatively common stressful life event that is purported to increase risk for all-cause mortality. One problem in the literature on divorce and health is that it is fragmented and spread across many disciplines; most prospective studies of mortality are based in epidemiology and sociology, whereas most mechanistic studies are based in psychology. This review integrates research on divorce and death via meta-analysis and outlines a research agenda for better understanding the potential mechanisms linking marital dissolution and risk for all-cause mortality. Random effects meta-analysis with a sample of 32 prospective studies (involving more than 6.5 million people, 160,000 deaths, and over 755,000 divorces in 11 different countries) revealed a significant increase in risk for early death among separated/divorced adults in comparison to their married counterparts. Men and younger adults evidenced significantly greater risk for early death following marital separation/divorce than did women and older adults. Quantification of the overall effect size linking marital separation/divorce to risk for early death reveals a number of important research questions, and this article discusses what remains to be learned about four plausible mechanisms of action: social selection, resource disruptions, changes in health behaviors, and chronic psychological distress. © Association for Psychological Science 2011.

  15. Adjuvant treatment may benefit patients with high-risk upper rectal cancer: A nomogram and recursive partitioning analysis of 547 patients.

    PubMed

    Wang, Xin; Jin, Jing; Yang, Yong; Liu, Wen-Yang; Ren, Hua; Feng, Yan-Ru; Xiao, Qin; Li, Ning; Deng, Lei; Fang, Hui; Jing, Hao; Lu, Ning-Ning; Tang, Yu; Wang, Jian-Yang; Wang, Shu-Lian; Wang, Wei-Hu; Song, Yong-Wen; Liu, Yue-Ping; Li, Ye-Xiong

    2016-10-04

    The role of adjuvant chemoradiotherapy (ACRT) or adjuvant chemotherapy (ACT) in treating patients with locally advanced upper rectal cancer (URC) after total mesorectal excision (TME) surgery remains unclear. We developed a clinical nomogram and a recursive partitioning analysis (RPA)-based risk stratification system for predicting 5-year cancer-specific survival (CSS) to determine whether these individuals require ACRT or ACT. This retrospective analysis included 547 patients with primary URC. A nomogram was developed based on the Cox regression model. The performance of the model was assessed by concordance index (C-index) and calibration curve in internal validation with bootstrapping. RPA stratified patients into risk groups based on their tumor characteristics. Five independent prognostic factors (age, preoperative increased carcinoembryonic antigen and carcinoma antigen 19-9, positive lymph node [PLN] number, tumor deposit [TD], pathological T classification) were identified and entered into the predictive nomogram. The bootstrap-corrected C-index was 0.757. RPA stratification of the three prognostic groups showed obviously different prognosis. Only the high-risk group (patients with PLN ≤ 6 and TD, or PLN > 6) benefited from ACRT plus ACT when compared with surgery followed by ACRT or ACT, and surgery alone (5-year CSS: 70.8% vs. 57.8% vs. 15.6%, P < 0.001). Our nomogram predicts 5-year CSS after TME surgery for locally advanced rectal cancer and RPA-based stratification indicates that ACRT plus ACT post-surgery may be an important treatment plan with potentially ignificant survival advantages in high-risk URC. This may help to select candidates of adjuvant treatment in prospective studies.

  16. Assessing the risk posed by natural hazards to infrastructures

    NASA Astrophysics Data System (ADS)

    Eidsvig, Unni; Kristensen, Krister; Vidar Vangelsten, Bjørn

    2015-04-01

    The modern society is increasingly dependent on infrastructures to maintain its function, and disruption in one of the infrastructure systems may have severe consequences. The Norwegian municipalities have, according to legislation, a duty to carry out a risk and vulnerability analysis and plan and prepare for emergencies in a short- and long term perspective. Vulnerability analysis of the infrastructures and their interdependencies is an important part of this analysis. This paper proposes a model for assessing the risk posed by natural hazards to infrastructures. The model prescribes a three level analysis with increasing level of detail, moving from qualitative to quantitative analysis. This paper focuses on the second level, which consists of a semi-quantitative analysis. The purpose of this analysis is to perform a screening of the scenarios of natural hazards threatening the infrastructures identified in the level 1 analysis and investigate the need for further analyses, i.e. level 3 quantitative analyses. The proposed level 2 analysis considers the frequency of the natural hazard, different aspects of vulnerability including the physical vulnerability of the infrastructure itself and the societal dependency on the infrastructure. An indicator-based approach is applied, ranking the indicators on a relative scale. The proposed indicators characterize the robustness of the infrastructure, the importance of the infrastructure as well as interdependencies between society and infrastructure affecting the potential for cascading effects. Each indicator is ranked on a 1-5 scale based on pre-defined ranking criteria. The aggregated risk estimate is a combination of the semi-quantitative vulnerability indicators, as well as quantitative estimates of the frequency of the natural hazard and the number of users of the infrastructure. Case studies for two Norwegian municipalities are presented, where risk to primary road, water supply and power network threatened by storm and landslide is assessed. The application examples show that the proposed model provides a useful tool for screening of undesirable events, with the ultimate goal to reduce the societal vulnerability.

  17. Risk analysis with a fuzzy-logic approach of a complex installation

    NASA Astrophysics Data System (ADS)

    Peikert, Tim; Garbe, Heyno; Potthast, Stefan

    2016-09-01

    This paper introduces a procedural method based on fuzzy logic to analyze systematic the risk of an electronic system in an intentional electromagnetic environment (IEME). The method analyzes the susceptibility of a complex electronic installation with respect to intentional electromagnetic interference (IEMI). It combines the advantages of well-known techniques as fault tree analysis (FTA), electromagnetic topology (EMT) and Bayesian networks (BN) and extends the techniques with an approach to handle uncertainty. This approach uses fuzzy sets, membership functions and fuzzy logic to handle the uncertainty with probability functions and linguistic terms. The linguistic terms add to the risk analysis the knowledge from experts of the investigated system or environment.

  18. Spatial epidemiology of Toxoplasma gondii infection in goats in Serbia.

    PubMed

    Djokic, Vitomir; Klun, Ivana; Musella, Vincenzo; Rinaldi, Laura; Cringoli, Giuseppe; Sotiraki, Smaragda; Djurkovic-Djakovic, Olgica

    2014-05-01

    A major risk factor for Toxoplasma gondii infection is consumption of undercooked meat. Increasing demand for goat meat is likely to promote the role of this animal for human toxoplasmosis. As there are virtually no data on toxoplasmosis in goats in Serbia, we undertook a cross-sectional serological study, including prediction modelling using geographical information systems (GIS). Sera from 431 goats reared in 143 households/farms throughout Serbia, sampled between January 2010 and September 2011, were examined for T. gondii antibodies by a modified agglutination test. Seroprevalence was 73.3% at the individual level and 84.6% at the farm level. Risk factor analysis showed above two-fold higher risk of infection for goats used for all purposes compared to dairy goats (P = 0.012), almost seven-fold higher risk for goats kept as sole species versus those kept with other animals (P = 0.001) and a two-fold lower risk for goats introduced from outside the farm compared to those raised on the farm (P = 0.027). Moreover, households/farms located in centre-eastern Serbia were found to be less often infected than those in northern Serbia (P = 0.004). The risk factor analysis was fully supported by spatial analysis based on a GIS database containing data on origin, serology, land cover, elevation, meteorology and a spatial prediction map based on kriging analysis, which showed western Serbia as the area most likely for finding goats positive for T. gondii and centre-eastern Serbia as the least likely. In addition, rainfall favoured seropositivity, whereas temperature, humidity and elevation did not.

  19. Preoperative Staging With 11C-Choline PET/CT Is Adequately Accurate in Patients With Very High-Risk Prostate Cancer.

    PubMed

    Schiavina, Riccardo; Bianchi, Lorenzo; Mineo Bianchi, Federico; Borghesi, Marco; Pultrone, Cristian Vincenzo; Dababneh, Hussam; Castellucci, Paolo; Ceci, Francesco; Nanni, Cristina; Gaudiano, Caterina; Fiorentino, Michelangelo; Porreca, Angelo; Chessa, Francesco; Minervini, Andrea; Fanti, Stefano; Brunocilla, Eugenio

    2018-05-30

    To evaluate the accuracy of 11 C-choline positron emission tomography (PET)/computed tomography (CT) for nodal staging of prostate cancer (PCa) in different populations of high-risk patients. We evaluated 262 individuals with intermediate- or high-risk PCa submitted to radical prostatectomy and extended pelvic lymph node dissection. Within men with high-risk disease, we identified a subgroup of individuals harboring very high-risk (VHR, n = 28) disease: clinical stage ≥ T2c and more than 5 cores with Gleason score 8-10; primary biopsy Gleason score of 5; 3 high-risk features; or prostate-specific antigen ≥ 30 ng/mL. The diagnostic accuracy of PET/CT and contrast-enhanced CT (CECT) was assessed after stratifying patients according to risk group classification on a patient- and anatomic region-based analysis. On patient-based analysis, considering high-risk patients (n = 155), 11 C-choline PET/CT versus CECT had sensitivity and specificity of 50% and 76% versus 21% and 92%, respectively. Considering VHR men as separate subgroups (n = 28), 11 C-choline PET/CT versus CECT had sensitivity and specificity of 71% and 93% versus 25% and 79%, respectively. Accordingly, in the VHR category, the area under the curve of 11 C-choline PET/CT versus CECT was 0.86 (95% confidence interval, 0.71-1.0) versus 0.69 (95% confidence interval, 0.52-0.86), respectively. On anatomic region-based analysis, considering the VHR group, 11 C-choline PET/CT versus CECT had sensitivity and specificity of 70.6% and 95.5% versus 35.3% and 98.5%, respectively. Patients with VHR characteristics could represent the ideal candidate to undergo disease staging with PET/CT before surgery with the highest cost efficacy. Copyright © 2018 Elsevier Inc. All rights reserved.

  20. TU-FG-201-11: Evaluating the Validity of Prospective Risk Analysis Methods: A Comparison of Traditional FMEA and Modified Healthcare FMEA

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Lah, J; Manger, R; Kim, G

    Purpose: To examine the ability of traditional Failure mode and effects analysis (FMEA) and a light version of Healthcare FMEA (HFMEA), called Scenario analysis of FMEA (SAFER) by comparing their outputs in terms of the risks identified and their severity rankings. Methods: We applied two prospective methods of the quality management to surface image guided, linac-based radiosurgery (SIG-RS). For the traditional FMEA, decisions on how to improve an operation are based on risk priority number (RPN). RPN is a product of three indices: occurrence, severity and detectability. The SAFER approach; utilized two indices-frequency and severity-which were defined by a multidisciplinarymore » team. A criticality matrix was divided into 4 categories; very low, low, high and very high. For high risk events, an additional evaluation was performed. Based upon the criticality of the process, it was decided if additional safety measures were needed and what they comprise. Results: Two methods were independently compared to determine if the results and rated risks were matching or not. Our results showed an agreement of 67% between FMEA and SAFER approaches for the 15 riskiest SIG-specific failure modes. The main differences between the two approaches were the distribution of the values and the failure modes (No.52, 54, 154) that have high SAFER scores do not necessarily have high FMEA RPN scores. In our results, there were additional risks identified by both methods with little correspondence. In the SAFER, when the risk score is determined, the basis of the established decision tree or the failure mode should be more investigated. Conclusion: The FMEA method takes into account the probability that an error passes without being detected. SAFER is inductive because it requires the identification of the consequences from causes, and semi-quantitative since it allow the prioritization of risks and mitigation measures, and thus is perfectly applicable to clinical parts of radiotherapy.« less

  1. The Comprehensive Evaluation Method of Supervision Risk in Electricity Transaction Based on Unascertained Rational Number

    NASA Astrophysics Data System (ADS)

    Haining, Wang; Lei, Wang; Qian, Zhang; Zongqiang, Zheng; Hongyu, Zhou; Chuncheng, Gao

    2018-03-01

    For the uncertain problems in the comprehensive evaluation of supervision risk in electricity transaction, this paper uses the unidentified rational numbers to evaluation the supervision risk, to obtain the possible result and corresponding credibility of evaluation and realize the quantification of risk indexes. The model can draw the risk degree of various indexes, which makes it easier for the electricity transaction supervisors to identify the transaction risk and determine the risk level, assisting the decision-making and realizing the effective supervision of the risk. The results of the case analysis verify the effectiveness of the model.

  2. Uncertainty and sensitivity assessment of flood risk assessments

    NASA Astrophysics Data System (ADS)

    de Moel, H.; Aerts, J. C.

    2009-12-01

    Floods are one of the most frequent and costly natural disasters. In order to protect human lifes and valuable assets from the effect of floods many defensive structures have been build. Despite these efforts economic losses due to catastrophic flood events have, however, risen substantially during the past couple of decades because of continuing economic developments in flood prone areas. On top of that, climate change is expected to affect the magnitude and frequency of flood events. Because these ongoing trends are expected to continue, a transition can be observed in various countries to move from a protective flood management approach to a more risk based flood management approach. In a risk based approach, flood risk assessments play an important role in supporting decision making. Most flood risk assessments assess flood risks in monetary terms (damage estimated for specific situations or expected annual damage) in order to feed cost-benefit analysis of management measures. Such flood risk assessments contain, however, considerable uncertainties. This is the result from uncertainties in the many different input parameters propagating through the risk assessment and accumulating in the final estimate. Whilst common in some other disciplines, as with integrated assessment models, full uncertainty and sensitivity analyses of flood risk assessments are not so common. Various studies have addressed uncertainties regarding flood risk assessments, but have mainly focussed on the hydrological conditions. However, uncertainties in other components of the risk assessment, like the relation between water depth and monetary damage, can be substantial as well. This research therefore tries to assess the uncertainties of all components of monetary flood risk assessments, using a Monte Carlo based approach. Furthermore, the total uncertainty will also be attributed to the different input parameters using a variance based sensitivity analysis. Assessing and visualizing the uncertainties of the final risk estimate will be helpful to decision makers to make better informed decisions and attributing this uncertainty to the input parameters helps to identify which parameters are most important when it comes to uncertainty in the final estimate and should therefore deserve additional attention in further research.

  3. Imputation and subset-based association analysis across different cancer types identifies multiple independent risk loci in the TERT-CLPTM1L region on chromosome 5p15.33.

    PubMed

    Wang, Zhaoming; Zhu, Bin; Zhang, Mingfeng; Parikh, Hemang; Jia, Jinping; Chung, Charles C; Sampson, Joshua N; Hoskins, Jason W; Hutchinson, Amy; Burdette, Laurie; Ibrahim, Abdisamad; Hautman, Christopher; Raj, Preethi S; Abnet, Christian C; Adjei, Andrew A; Ahlbom, Anders; Albanes, Demetrius; Allen, Naomi E; Ambrosone, Christine B; Aldrich, Melinda; Amiano, Pilar; Amos, Christopher; Andersson, Ulrika; Andriole, Gerald; Andrulis, Irene L; Arici, Cecilia; Arslan, Alan A; Austin, Melissa A; Baris, Dalsu; Barkauskas, Donald A; Bassig, Bryan A; Beane Freeman, Laura E; Berg, Christine D; Berndt, Sonja I; Bertazzi, Pier Alberto; Biritwum, Richard B; Black, Amanda; Blot, William; Boeing, Heiner; Boffetta, Paolo; Bolton, Kelly; Boutron-Ruault, Marie-Christine; Bracci, Paige M; Brennan, Paul; Brinton, Louise A; Brotzman, Michelle; Bueno-de-Mesquita, H Bas; Buring, Julie E; Butler, Mary Ann; Cai, Qiuyin; Cancel-Tassin, Geraldine; Canzian, Federico; Cao, Guangwen; Caporaso, Neil E; Carrato, Alfredo; Carreon, Tania; Carta, Angela; Chang, Gee-Chen; Chang, I-Shou; Chang-Claude, Jenny; Che, Xu; Chen, Chien-Jen; Chen, Chih-Yi; Chen, Chung-Hsing; Chen, Constance; Chen, Kuan-Yu; Chen, Yuh-Min; Chokkalingam, Anand P; Chu, Lisa W; Clavel-Chapelon, Francoise; Colditz, Graham A; Colt, Joanne S; Conti, David; Cook, Michael B; Cortessis, Victoria K; Crawford, E David; Cussenot, Olivier; Davis, Faith G; De Vivo, Immaculata; Deng, Xiang; Ding, Ti; Dinney, Colin P; Di Stefano, Anna Luisa; Diver, W Ryan; Duell, Eric J; Elena, Joanne W; Fan, Jin-Hu; Feigelson, Heather Spencer; Feychting, Maria; Figueroa, Jonine D; Flanagan, Adrienne M; Fraumeni, Joseph F; Freedman, Neal D; Fridley, Brooke L; Fuchs, Charles S; Gago-Dominguez, Manuela; Gallinger, Steven; Gao, Yu-Tang; Gapstur, Susan M; Garcia-Closas, Montserrat; Garcia-Closas, Reina; Gastier-Foster, Julie M; Gaziano, J Michael; Gerhard, Daniela S; Giffen, Carol A; Giles, Graham G; Gillanders, Elizabeth M; Giovannucci, Edward L; Goggins, Michael; Gokgoz, Nalan; Goldstein, Alisa M; Gonzalez, Carlos; Gorlick, Richard; Greene, Mark H; Gross, Myron; Grossman, H Barton; Grubb, Robert; Gu, Jian; Guan, Peng; Haiman, Christopher A; Hallmans, Goran; Hankinson, Susan E; Harris, Curtis C; Hartge, Patricia; Hattinger, Claudia; Hayes, Richard B; He, Qincheng; Helman, Lee; Henderson, Brian E; Henriksson, Roger; Hoffman-Bolton, Judith; Hohensee, Chancellor; Holly, Elizabeth A; Hong, Yun-Chul; Hoover, Robert N; Hosgood, H Dean; Hsiao, Chin-Fu; Hsing, Ann W; Hsiung, Chao Agnes; Hu, Nan; Hu, Wei; Hu, Zhibin; Huang, Ming-Shyan; Hunter, David J; Inskip, Peter D; Ito, Hidemi; Jacobs, Eric J; Jacobs, Kevin B; Jenab, Mazda; Ji, Bu-Tian; Johansen, Christoffer; Johansson, Mattias; Johnson, Alison; Kaaks, Rudolf; Kamat, Ashish M; Kamineni, Aruna; Karagas, Margaret; Khanna, Chand; Khaw, Kay-Tee; Kim, Christopher; Kim, In-Sam; Kim, Jin Hee; Kim, Yeul Hong; Kim, Young-Chul; Kim, Young Tae; Kang, Chang Hyun; Jung, Yoo Jin; Kitahara, Cari M; Klein, Alison P; Klein, Robert; Kogevinas, Manolis; Koh, Woon-Puay; Kohno, Takashi; Kolonel, Laurence N; Kooperberg, Charles; Kratz, Christian P; Krogh, Vittorio; Kunitoh, Hideo; Kurtz, Robert C; Kurucu, Nilgun; Lan, Qing; Lathrop, Mark; Lau, Ching C; Lecanda, Fernando; Lee, Kyoung-Mu; Lee, Maxwell P; Le Marchand, Loic; Lerner, Seth P; Li, Donghui; Liao, Linda M; Lim, Wei-Yen; Lin, Dongxin; Lin, Jie; Lindstrom, Sara; Linet, Martha S; Lissowska, Jolanta; Liu, Jianjun; Ljungberg, Börje; Lloreta, Josep; Lu, Daru; Ma, Jing; Malats, Nuria; Mannisto, Satu; Marina, Neyssa; Mastrangelo, Giuseppe; Matsuo, Keitaro; McGlynn, Katherine A; McKean-Cowdin, Roberta; McNeill, Lorna H; McWilliams, Robert R; Melin, Beatrice S; Meltzer, Paul S; Mensah, James E; Miao, Xiaoping; Michaud, Dominique S; Mondul, Alison M; Moore, Lee E; Muir, Kenneth; Niwa, Shelley; Olson, Sara H; Orr, Nick; Panico, Salvatore; Park, Jae Yong; Patel, Alpa V; Patino-Garcia, Ana; Pavanello, Sofia; Peeters, Petra H M; Peplonska, Beata; Peters, Ulrike; Petersen, Gloria M; Picci, Piero; Pike, Malcolm C; Porru, Stefano; Prescott, Jennifer; Pu, Xia; Purdue, Mark P; Qiao, You-Lin; Rajaraman, Preetha; Riboli, Elio; Risch, Harvey A; Rodabough, Rebecca J; Rothman, Nathaniel; Ruder, Avima M; Ryu, Jeong-Seon; Sanson, Marc; Schned, Alan; Schumacher, Fredrick R; Schwartz, Ann G; Schwartz, Kendra L; Schwenn, Molly; Scotlandi, Katia; Seow, Adeline; Serra, Consol; Serra, Massimo; Sesso, Howard D; Severi, Gianluca; Shen, Hongbing; Shen, Min; Shete, Sanjay; Shiraishi, Kouya; Shu, Xiao-Ou; Siddiq, Afshan; Sierrasesumaga, Luis; Sierri, Sabina; Loon Sihoe, Alan Dart; Silverman, Debra T; Simon, Matthias; Southey, Melissa C; Spector, Logan; Spitz, Margaret; Stampfer, Meir; Stattin, Par; Stern, Mariana C; Stevens, Victoria L; Stolzenberg-Solomon, Rachael Z; Stram, Daniel O; Strom, Sara S; Su, Wu-Chou; Sund, Malin; Sung, Sook Whan; Swerdlow, Anthony; Tan, Wen; Tanaka, Hideo; Tang, Wei; Tang, Ze-Zhang; Tardon, Adonina; Tay, Evelyn; Taylor, Philip R; Tettey, Yao; Thomas, David M; Tirabosco, Roberto; Tjonneland, Anne; Tobias, Geoffrey S; Toro, Jorge R; Travis, Ruth C; Trichopoulos, Dimitrios; Troisi, Rebecca; Truelove, Ann; Tsai, Ying-Huang; Tucker, Margaret A; Tumino, Rosario; Van Den Berg, David; Van Den Eeden, Stephen K; Vermeulen, Roel; Vineis, Paolo; Visvanathan, Kala; Vogel, Ulla; Wang, Chaoyu; Wang, Chengfeng; Wang, Junwen; Wang, Sophia S; Weiderpass, Elisabete; Weinstein, Stephanie J; Wentzensen, Nicolas; Wheeler, William; White, Emily; Wiencke, John K; Wolk, Alicja; Wolpin, Brian M; Wong, Maria Pik; Wrensch, Margaret; Wu, Chen; Wu, Tangchun; Wu, Xifeng; Wu, Yi-Long; Wunder, Jay S; Xiang, Yong-Bing; Xu, Jun; Yang, Hannah P; Yang, Pan-Chyr; Yatabe, Yasushi; Ye, Yuanqing; Yeboah, Edward D; Yin, Zhihua; Ying, Chen; Yu, Chong-Jen; Yu, Kai; Yuan, Jian-Min; Zanetti, Krista A; Zeleniuch-Jacquotte, Anne; Zheng, Wei; Zhou, Baosen; Mirabello, Lisa; Savage, Sharon A; Kraft, Peter; Chanock, Stephen J; Yeager, Meredith; Landi, Maria Terese; Shi, Jianxin; Chatterjee, Nilanjan; Amundadottir, Laufey T

    2014-12-15

    Genome-wide association studies (GWAS) have mapped risk alleles for at least 10 distinct cancers to a small region of 63 000 bp on chromosome 5p15.33. This region harbors the TERT and CLPTM1L genes; the former encodes the catalytic subunit of telomerase reverse transcriptase and the latter may play a role in apoptosis. To investigate further the genetic architecture of common susceptibility alleles in this region, we conducted an agnostic subset-based meta-analysis (association analysis based on subsets) across six distinct cancers in 34 248 cases and 45 036 controls. Based on sequential conditional analysis, we identified as many as six independent risk loci marked by common single-nucleotide polymorphisms: five in the TERT gene (Region 1: rs7726159, P = 2.10 × 10(-39); Region 3: rs2853677, P = 3.30 × 10(-36) and PConditional = 2.36 × 10(-8); Region 4: rs2736098, P = 3.87 × 10(-12) and PConditional = 5.19 × 10(-6), Region 5: rs13172201, P = 0.041 and PConditional = 2.04 × 10(-6); and Region 6: rs10069690, P = 7.49 × 10(-15) and PConditional = 5.35 × 10(-7)) and one in the neighboring CLPTM1L gene (Region 2: rs451360; P = 1.90 × 10(-18) and PConditional = 7.06 × 10(-16)). Between three and five cancers mapped to each independent locus with both risk-enhancing and protective effects. Allele-specific effects on DNA methylation were seen for a subset of risk loci, indicating that methylation and subsequent effects on gene expression may contribute to the biology of risk variants on 5p15.33. Our results provide strong support for extensive pleiotropy across this region of 5p15.33, to an extent not previously observed in other cancer susceptibility loci. Published by Oxford University Press 2014. This work is written by (a) US Government employee(s) and is in the public domain in the US.

  4. Apolipoprotein C3 Gene Polymorphisms Are Not a Risk Factor for Developing Non-Alcoholic Fatty Liver Disease: A Meta-Analysis

    PubMed Central

    Zhang, Haiying; Chen, Lizhen; Xin, Yongning; Lou, Yuangui; Liu, Yang; Xuan, Shiying

    2014-01-01

    Context: Our objective was to evaluate the effect of gene polymorphisms of apolipoprotein C3 (APOC3) on the development of non-alcoholic fatty liver disease (NAFLD) in different populations. Evidence Acquisition: We performed a meta-analysis of all relevant studies published in the literature. A total of 115 clinical trials or reports were identified, but only seven trials met our inclusion criteria. A meta-analysis was performed according to the Cochrane Reviewers’ Handbook recommendations. Results: Five hospital-based and two population-based case-control studies were included in the final analysis. The overall frequency of APOC3 gene polymorphisms was 67.5% (1177/1745) in NAFLD and 68.8% (988/1437) in controls. The summary odds ratio for the association of gene polymorphisms of APOC3 and the risk of NAFLD was 1.03 (95% CI: 0.89-1.22),which was not statistically significant (P > 0.05). Conclusions: Our meta-analysis, while not ruling out possible publication bias, showed no association between gene polymorphisms of APOC3 and the risk of NAFLD development in different populations in the world. PMID:25477977

  5. Risk factors for granuloma formation in children induced by tracheobronchial foreign bodies.

    PubMed

    Huang, Zhenghua; Zhou, Ai; Zhang, Jianya; Xie, Lisheng; Li, Qi

    2015-12-01

    The aim of this study was to analyze the risk factors for granuloma formation caused by plant-based tracheobronchial foreign bodies in children, and investigate the underlying pathogenesis. In this retrospective analysis of 153 cases with tracheobronchial foreign bodies (peanuts and watermelon seeds), 35 cases of granuloma formation as granulation group (G), and 118 cases of no granuloma formation as non-granulation group (NG) were studied. Clinical data pertaining to sex (S), age (A), foreign body surface smoothness (SF), foreign body shape (SH), foreign body oil release state (O), the location of foreign bodies (L), and foreign body retention time (T) were collected for statistical analysis. Univariate analysis showed no significant difference between the two groups (G and NG) with respect to S, A, SH and L. Significant factors based on univariate analysis included SF, O and T. Multivariate logistic regression analysis revealed that SF and T were independent risk factors associated with development of granuloma. SF, O and T had relationship with the granuloma formation. Local trauma caused by an irregular and sharp foreign body, and extended period of time represent the main factors causing granuloma formation. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  6. Ecological Risk Assessment with MCDM of Some Invasive Alien Plants in China

    NASA Astrophysics Data System (ADS)

    Xie, Guowen; Chen, Weiguang; Lin, Meizhen; Zheng, Yanling; Guo, Peiguo; Zheng, Yisheng

    Alien plant invasion is an urgent global issue that threatens the sustainable development of the ecosystem health. The study of its ecological risk assessment (ERA) could help us to prevent and reduce the invasion risk more effectively. Based on the theory of ERA and methods of the analytic hierarchy process (AHP) of multi-criteria decision-making (MCDM), and through the analyses of the characteristics and processes of alien plant invasion, this paper discusses the methodologies of ERA of alien plant invasion. The assessment procedure consisted of risk source analysis, receptor analysis, exposure and hazard assessment, integral assessment, and countermeasure of risk management. The indicator system of risk source assessment as well as the indices and formulas applied to measure the ecological loss and risk were established, and the method for comprehensively assessing the ecological risk of alien plant invasion was worked out. The result of ecological risk analysis to 9 representative invasive alien plants in China shows that the ecological risk of Erigeron annuus, Ageratum conyzoides, Alternanthera philoxeroides and Mikania midrantha is high (grade1-2), that of Oxalis corymbosa and Wedelia chinensis comes next (grade3), while Mirabilis jalapa, Pilea microphylla and Calendula officinalis of the last (grade 4). Risk strategies are put forward on this basis.

  7. Predicting the risk of malignancy in adnexal masses based on the Simple Rules from the International Ovarian Tumor Analysis group.

    PubMed

    Timmerman, Dirk; Van Calster, Ben; Testa, Antonia; Savelli, Luca; Fischerova, Daniela; Froyman, Wouter; Wynants, Laure; Van Holsbeke, Caroline; Epstein, Elisabeth; Franchi, Dorella; Kaijser, Jeroen; Czekierdowski, Artur; Guerriero, Stefano; Fruscio, Robert; Leone, Francesco P G; Rossi, Alberto; Landolfo, Chiara; Vergote, Ignace; Bourne, Tom; Valentin, Lil

    2016-04-01

    Accurate methods to preoperatively characterize adnexal tumors are pivotal for optimal patient management. A recent metaanalysis concluded that the International Ovarian Tumor Analysis algorithms such as the Simple Rules are the best approaches to preoperatively classify adnexal masses as benign or malignant. We sought to develop and validate a model to predict the risk of malignancy in adnexal masses using the ultrasound features in the Simple Rules. This was an international cross-sectional cohort study involving 22 oncology centers, referral centers for ultrasonography, and general hospitals. We included consecutive patients with an adnexal tumor who underwent a standardized transvaginal ultrasound examination and were selected for surgery. Data on 5020 patients were recorded in 3 phases from 2002 through 2012. The 5 Simple Rules features indicative of a benign tumor (B-features) and the 5 features indicative of malignancy (M-features) are based on the presence of ascites, tumor morphology, and degree of vascularity at ultrasonography. Gold standard was the histopathologic diagnosis of the adnexal mass (pathologist blinded to ultrasound findings). Logistic regression analysis was used to estimate the risk of malignancy based on the 10 ultrasound features and type of center. The diagnostic performance was evaluated by area under the receiver operating characteristic curve, sensitivity, specificity, positive likelihood ratio (LR+), negative likelihood ratio (LR-), positive predictive value (PPV), negative predictive value (NPV), and calibration curves. Data on 4848 patients were analyzed. The malignancy rate was 43% (1402/3263) in oncology centers and 17% (263/1585) in other centers. The area under the receiver operating characteristic curve on validation data was very similar in oncology centers (0.917; 95% confidence interval, 0.901-0.931) and other centers (0.916; 95% confidence interval, 0.873-0.945). Risk estimates showed good calibration. In all, 23% of patients in the validation data set had a very low estimated risk (<1%) and 48% had a high estimated risk (≥30%). For the 1% risk cutoff, sensitivity was 99.7%, specificity 33.7%, LR+ 1.5, LR- 0.010, PPV 44.8%, and NPV 98.9%. For the 30% risk cutoff, sensitivity was 89.0%, specificity 84.7%, LR+ 5.8, LR- 0.13, PPV 75.4%, and NPV 93.9%. Quantification of the risk of malignancy based on the Simple Rules has good diagnostic performance both in oncology centers and other centers. A simple classification based on these risk estimates may form the basis of a clinical management system. Patients with a high risk may benefit from surgery by a gynecological oncologist, while patients with a lower risk may be managed locally. Copyright © 2016 Elsevier Inc. All rights reserved.

  8. Long-Term Unemployment and Suicide: A Systematic Review and Meta-Analysis

    PubMed Central

    Milner, Allison; Page, Andrew; LaMontagne, Anthony D.

    2013-01-01

    Purpose There have been a number of reviews on the association+ between unemployment and suicide, but none have investigated how this relationship is influenced by duration of unemployment. Method A systematic review and meta-analysis was conducted of those studies that assessed duration of unemployment as a risk factor for suicide. Studies considered as eligible for inclusion were population-based cohort or case-control designs; population-based ecological designs, or hospital based clinical cohort or case-control designs published in the year 1980 or later. Results The review identified 16 eligible studies, out of a possible 10,358 articles resulting from a search of four databases: PubMed, Web of Knowledge, Scopus and Proquest. While all 16 studies measured unemployment duration in different ways, a common finding was that longer duration of unemployment was related to greater risk of suicide and suicide attempt. A random effects meta-analysis on a subsample of six cohort studies indicated that the pooled relative risk of suicide in relation to average follow-up time after unemployment was 1.70 (95% CI 1.22 to 2.18). However, results also suggested a possible habituation effect to unemployment over time, with the greatest risk of suicide occurring within five years of unemployment compared to the employed population (RR = 2.50, 95% CI 1.83 to 3.17). Relative risk appeared to decline in studies of those unemployed between 12 and 16 years compared to those currently employed (RR = 1.21, 95% CI 1.10 to 1.33). Conclusion Findings suggest that long-term unemployment is associated with greater incidence of suicide. Results of the meta-analysis suggest that risk is greatest in the first five years, and persists at a lower but elevated level up to 16 years after unemployment. These findings are limited by the paucity of data on this topic. PMID:23341881

  9. Fews-Risk: A step towards risk-based flood forecasting

    NASA Astrophysics Data System (ADS)

    Bachmann, Daniel; Eilander, Dirk; de Leeuw, Annemargreet; Diermanse, Ferdinand; Weerts, Albrecht; de Bruijn, Karin; Beckers, Joost; Boelee, Leonore; Brown, Emma; Hazlewood, Caroline

    2015-04-01

    Operational flood prediction and the assessment of flood risk are important components of flood management. Currently, the model-based prediction of discharge and/or water level in a river is common practice for operational flood forecasting. Based on the prediction of these values decisions about specific emergency measures are made within operational flood management. However, the information provided for decision support is restricted to pure hydrological or hydraulic aspects of a flood. Information about weak sections within the flood defences, flood prone areas and assets at risk in the protected areas are rarely used in a model-based flood forecasting system. This information is often available for strategic planning, but is not in an appropriate format for operational purposes. The idea of FEWS-Risk is the extension of existing flood forecasting systems with elements of strategic flood risk analysis, such as probabilistic failure analysis, two dimensional flood spreading simulation and the analysis of flood impacts and consequences. Thus, additional information is provided to the decision makers, such as: • Location, timing and probability of failure of defined sections of the flood defence line; • Flood spreading, extent and hydraulic values in the hinterland caused by an overflow or a breach flow • Impacts and consequences in case of flooding in the protected areas, such as injuries or casualties and/or damages to critical infrastructure or economy. In contrast with purely hydraulic-based operational information, these additional data focus upon decision support for answering crucial questions within an operational flood forecasting framework, such as: • Where should I reinforce my flood defence system? • What type of action can I take to mend a weak spot in my flood defences? • What are the consequences of a breach? • Which areas should I evacuate first? This presentation outlines the additional required workflows towards risk-based flood forecasting systems. In a cooperation between HR Wallingford and Deltares, the extended workflows are being integrated into the Delft-FEWS software system. Delft-FEWS provides modules for managing the data handling and forecasting process. Results of a pilot study that demonstrates the new tools are presented. The value of the newly generated information for decision support during a flood event is discussed.

  10. A stochastic multicriteria model for evidence-based decision making in drug benefit-risk analysis.

    PubMed

    Tervonen, Tommi; van Valkenhoef, Gert; Buskens, Erik; Hillege, Hans L; Postmus, Douwe

    2011-05-30

    Drug benefit-risk (BR) analysis is based on firm clinical evidence regarding various safety and efficacy outcomes. In this paper, we propose a new and more formal approach for constructing a supporting multi-criteria model that fully takes into account the evidence on efficacy and adverse drug reactions. Our approach is based on the stochastic multi-criteria acceptability analysis methodology, which allows us to compute the typical value judgments that support a decision, to quantify decision uncertainty, and to compute a comprehensive BR profile. We construct a multi-criteria model for the therapeutic group of second-generation antidepressants. We assess fluoxetine and venlafaxine together with placebo according to incidence of treatment response and three common adverse drug reactions by using data from a published study. Our model shows that there are clear trade-offs among the treatment alternatives. Copyright © 2011 John Wiley & Sons, Ltd.

  11. Effectiveness of landslide risk mitigation strategies in Shihmen Watershed, Taiwan

    NASA Astrophysics Data System (ADS)

    Wu, Chun-Yi; Chen, Su-Chin

    2015-04-01

    The purpose of this study was to establish landslide risk analysis procedures that can be used to analyze landslide risk in a watershed scale and to assess the effectiveness of risk mitigation strategies. Landslide risk analysis encompassed the landslide hazard, the vulnerability of elements at risk, and community resilience capacity. First, landslide spatial probability, landslide temporal probability, and landslide area probability were joined to estimate the probability of landslides with an area exceeding a certain threshold in each slope unit. Second, the expected property and life losses were both analyzed in vulnerability analysis. Different elements at risk were assigned corresponding values, and then used in conjunction with the vulnerabilities to carry out quantitative analysis. Third, the resilience capacity of different communities was calculated based on the scores obtained through community checklists and the weights of individual items, including "the participation experience of disaster prevention drill," "real-time monitoring mechanism of community," "autonomous monitoring of residents," and "disaster prevention volunteer." Finally, the landslide probabilities, vulnerability analysis results, and resilience capacities were combined to assess landslide risk in Shihmen Watershed. In addition, the risks before and after the implementation of non-structural disaster prevention strategies were compared to determine the benefits of various strategies, and subsequently benefit-cost analysis was performed. Communities with high benefit-cost ratios included Hualing, Yisheng, Siouluan, and Gaoyi. The watershed as a whole had a benefit-cost ratio far greater than 1, indicating that the effectiveness of strategies was greater than the investment cost, and these measures were thus cost-effective. The results of factor sensitivity analysis revealed that changes in vulnerability and mortality rates would increase the uncertainty of risk, and that raise in annual interest rates or reduction in life cycle of measures would decrease the benefit-cost ratio. However, with regard to effectiveness analysis, these changes did not reverse the cost-effective inference.

  12. Efficient and Flexible Climate Analysis with Python in a Cloud-Based Distributed Computing Framework

    NASA Astrophysics Data System (ADS)

    Gannon, C.

    2017-12-01

    As climate models become progressively more advanced, and spatial resolution further improved through various downscaling projects, climate projections at a local level are increasingly insightful and valuable. However, the raw size of climate datasets presents numerous hurdles for analysts wishing to develop customized climate risk metrics or perform site-specific statistical analysis. Four Twenty Seven, a climate risk consultancy, has implemented a Python-based distributed framework to analyze large climate datasets in the cloud. With the freedom afforded by efficiently processing these datasets, we are able to customize and continually develop new climate risk metrics using the most up-to-date data. Here we outline our process for using Python packages such as XArray and Dask to evaluate netCDF files in a distributed framework, StarCluster to operate in a cluster-computing environment, cloud computing services to access publicly hosted datasets, and how this setup is particularly valuable for generating climate change indicators and performing localized statistical analysis.

  13. Cost-effectiveness analysis of lopinavir/ritonavir and atazanavir+ritonavir regimens in the CASTLE study.

    PubMed

    Simpson, Kit N; Rajagopalan, Rukmini; Dietz, Birgitta

    2009-02-01

    The purpose of the study was to conduct a cost-effectiveness analysis and budget impact analysis comparing lopinavir with ritonavir (LPV/r) and atazanavir plus ritonavir (ATV+RTV) for antiretroviral-naïve patients with a baseline CD4+ T-cell distribution and total cholesterol (TC) profile as reported in the CASTLE study. This decision analysis study used a previously published Markov model of HIV disease, incorporating coronary heart disease (CHD) events to compare the short- and long-term budget impacts and CHD consequences expected for the two regimens. Patients were assumed to have a baseline CHD risk of 4.6% (based on demographic data) and it was also assumed that 50% of the population in the CASTLE study were smokers. The CHD risk differences (based on percent of patients with TC >240 mg/dL) in favor of ATV+RTV resulted in an average improvement in life expectancy of 0.031 quality-adjusted life years (QALYs) (11 days), and an incremental cost-effectiveness ratio of $1,409,734/QALY. Use of the LPV/r regimen saved $24,518 and $36,651 at 5 and 10 years, respectively, with lifetime cost savings estimated at $38,490. A sensitivity analysis using a cohort of all smokers on antihypertensive medication estimated an average improvement in life expectancy of 31 quality-adjusted days in favor of ATV+RTV, and a cost-effectiveness ratio of $520,861/QALY: a ratio that is still above the acceptable limit within the US. The use of an LPV/r-based regimen in antiretroviral-naïve patients with a baseline CHD risk similar to patients in the CASTLE study appears to be a more cost-effective use of resources compared with an ATV+RTV-based regimen. The very small added CHD risk predicted by LPV/r treatment is more than offset by the substantial short- and long-term cost savings expected with the use of LPV/r in antiretroviral-naïve individuals with average to moderately elevated CHD risk.

  14. MO-E-9A-01: Risk Based Quality Management: TG100 In Action

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Huq, M; Palta, J; Dunscombe, P

    2014-06-15

    One of the goals of quality management in radiation therapy is to gain high confidence that patients will receive the prescribed treatment correctly. To accomplish these goals professional societies such as the American Association of Physicists in Medicine (AAPM) has published many quality assurance (QA), quality control (QC), and quality management (QM) guidance documents. In general, the recommendations provided in these documents have emphasized on performing device-specific QA at the expense of process flow and protection of the patient against catastrophic errors. Analyses of radiation therapy incidents find that they are most often caused by flaws in the overall therapymore » process, from initial consult through final treatment, than by isolated hardware or computer failures detectable by traditional physics QA. This challenge is shared by many intrinsically hazardous industries. Risk assessment tools and analysis techniques have been developed to define, identify, and eliminate known and/or potential failures, problems, or errors, from a system, process and/or service before they reach the customer. These include, but are not limited to, process mapping, failure modes and effects analysis (FMEA), fault tree analysis (FTA), and establishment of a quality management program that best avoids the faults and risks that have been identified in the overall process. These tools can be easily adapted to radiation therapy practices because of their simplicity and effectiveness to provide efficient ways to enhance the safety and quality of treatment processes. Task group 100 (TG100) of AAPM has developed a risk-based quality management program that uses these tools. This session will be devoted to a discussion of these tools and how these tools can be used in a given radiotherapy clinic to develop a risk based QM program. Learning Objectives: Learn how to design a process map for a radiotherapy process. Learn how to perform a FMEA analysis for a given process. Learn what Fault tree analysis is all about. Learn how to design a quality management program based upon the information obtained from process mapping, FMEA and FTA.« less

  15. A method for scenario-based risk assessment for robust aerospace systems

    NASA Astrophysics Data System (ADS)

    Thomas, Victoria Katherine

    In years past, aircraft conceptual design centered around creating a feasible aircraft that could be built and could fly the required missions. More recently, aircraft viability entered into conceptual design, allowing that the product's potential to be profitable should also be examined early in the design process. While examining an aerospace system's feasibility and viability early in the design process is extremely important, it is also important to examine system risk. In traditional aerospace systems risk analysis, risk is examined from the perspective of performance, schedule, and cost. Recently, safety and reliability analysis have been brought forward in the design process to also be examined during late conceptual and early preliminary design. While these analyses work as designed, existing risk analysis methods and techniques are not designed to examine an aerospace system's external operating environment and the risks present there. A new method has been developed here to examine, during the early part of concept design, the risk associated with not meeting assumptions about the system's external operating environment. The risks are examined in five categories: employment, culture, government and politics, economics, and technology. The risks are examined over a long time-period, up to the system's entire life cycle. The method consists of eight steps over three focus areas. The first focus area is Problem Setup. During problem setup, the problem is defined and understood to the best of the decision maker's ability. There are four steps in this area, in the following order: Establish the Need, Scenario Development, Identify Solution Alternatives, and Uncertainty and Risk Identification. There is significant iteration between steps two through four. Focus area two is Modeling and Simulation. In this area the solution alternatives and risks are modeled, and a numerical value for risk is calculated. A risk mitigation model is also created. The four steps involved in completing the modeling and simulation are: Alternative Solution Modeling, Uncertainty Quantification, Risk Assessment, and Risk Mitigation. Focus area three consists of Decision Support. In this area a decision support interface is created that allows for game playing between solution alternatives and risk mitigation. A multi-attribute decision making process is also implemented to aid in decision making. A demonstration problem inspired by Airbus' mid 1980s decision to break into the widebody long-range market was developed to illustrate the use of this method. The results showed that the method is able to capture additional types of risk than previous analysis methods, particularly at the early stages of aircraft design. It was also shown that the method can be used to help create a system that is robust to external environmental factors. The addition of an external environment risk analysis in the early stages of conceptual design can add another dimension to the analysis of feasibility and viability. The ability to take risk into account during the early stages of the design process can allow for the elimination of potentially feasible and viable but too-risky alternatives. The addition of a scenario-based analysis instead of a traditional probabilistic analysis enabled uncertainty to be effectively bound and examined over a variety of potential futures instead of only a single future. There is also potential for a product to be groomed for a specific future that one believes is likely to happen, or for a product to be steered during design as the future unfolds.

  16. Development and Validation of Methods for Applying Pharmacokinetic Data in Risk Assessment. Volume 3. Tetrachloroethylene

    DTIC Science & Technology

    1990-12-01

    Armstrong Aerospace Medical Research Laboratory, Wright Paterson Air Force Base, and Drs. Melvin Andersen and Michael Cargas , formerly with the Harry G...based on the arterial blood concentration surrogate were more III-1-10 similar to those de ’!ved in the traditional manner than were the estimates based on...pharmacokinetic modeling. Prepared by Office of Risk Analysis, Oak Ridge National L-ioratory, Oak Pidge, Tenn.zsee. Prepared under Contract No. DE -ACO5-84

  17. Association between Work-Related Stress and Risk for Type 2 Diabetes: A Systematic Review and Meta-Analysis of Prospective Cohort Studies.

    PubMed

    Sui, Hua; Sun, Nijing; Zhan, Libin; Lu, Xiaoguang; Chen, Tuo; Mao, Xinyong

    2016-01-01

    The prevalence of type 2 diabetes is increasing rapidly around the world. Work-related stress is thought to be a major risk factor for type 2 diabetes; however, this association has not been widely studied, and the findings that have been reported are inconsistent. Therefore, we conducted a meta-analysis of prospective cohort studies to explore the association between work-related stress and risk for type 2 diabetes. A systematic literature search and manual search limited to articles published in English were performed to select the prospective cohort studies evaluated the association between work-related stress and risk for type 2 diabetes up to September 2014 from four electronic databases including PubMed, EMBASE, the Cochrane Library and Web of Science. A random-effects model was used to estimate the overall risk. No significant association was found between work-related stress and risk for type 2 diabetes based on meta-analysis of seven prospective cohort studies involving 214,086 participants and 5,511 cases (job demands: relative risk 0.94 [95% confidence interval 0.72-1.23]; decision latitude: relative risk 1.16 [0.85-1.58]; job strain: relative risk 1.12 [.0.95-1.32]). However, an association between work-related stress and risk for type 2 diabetes was observed in women (job strain: relative risk 1.22 [1.01-1.46]) (P = 0.04). A sensitivity analysis conducted by excluding one study in each turn yielded similar results. No publication bias was detected with a funnel plot despite the limited number of studies included in the analysis. The results of this meta-analysis did not confirm a direct association between work-related stress and risk for type 2 diabetes. In subgroup analyses we found job strain was a risk factor for type 2 diabetes in women.

  18. Fuzzy Trace Theory and Medical Decisions by Minors: Differences in Reasoning between Adolescents and Adults

    PubMed Central

    Wilhelms, Evan A.

    2013-01-01

    Standard models of adolescent risk taking posit that the cognitive abilities of adolescents and adults are equivalent, and that increases in risk taking that occur during adolescence are the result of socio emotional differences in impulsivity, sensation seeking, and lack of self-control. Fuzzy-trace theory incorporates these socio emotional differences. However, it predicts that there are also cognitive differences between adolescents and adults, specifically that there are developmental increases in gist-based intuition that reflects understanding. Gist understanding, as opposed to verbatim-based analysis, generally has been hypothesized to have a protective effect on risk taking in adolescence. Gist understanding is also an essential element of informed consent regarding risks in medical decision- making. Evidence thus supports the argument that adolescents’ status as mature minors should be treated as an exception rather than a presumption, because accuracy in verbatim analysis is not mature gist understanding. Use of the exception should be accompanied by medical experts’ input on the bottom-line gist of risks involved in treatment. PMID:23606728

  19. Quantitative risk management in gas injection project: a case study from Oman oil and gas industry

    NASA Astrophysics Data System (ADS)

    Khadem, Mohammad Miftaur Rahman Khan; Piya, Sujan; Shamsuzzoha, Ahm

    2017-09-01

    The purpose of this research was to study the recognition, application and quantification of the risks associated in managing projects. In this research, the management of risks in an oil and gas project is studied and implemented within a case company in Oman. In this study, at first, the qualitative data related to risks in the project were identified through field visits and extensive interviews. These data were then translated into numerical values based on the expert's opinion. Further, the numerical data were used as an input to Monte Carlo simulation. RiskyProject Professional™ software was used to simulate the system based on the identified risks. The simulation result predicted a delay of about 2 years as a worse case with no chance of meeting the project's on stream date. Also, it has predicted 8% chance of exceeding the total estimated budget. The result of numerical analysis from the proposed model is validated by comparing it with the result of qualitative analysis, which was obtained through discussion with various project managers of company.

  20. TA-54 (Area G) Risk Assessment from Extreme Wildfire Scenarios

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Linn, Rodman Ray; Koo, Eunmo; Honig, Kristen Ann

    2016-08-10

    Los Alamos National Laboratory (LANL) and surrounding areas have been exposed to at least four significant wildfires since 1977 and there have been numerous others within 50 miles of LANL. Based on this history, wildfires are considered a risk to LANL facilities and their contents. While many LANL facilities are at risk to wildfire to some degree, they are found in a wide variety of conditions, thus they have varying sensitivities to wildfires. Additionally, LANL facilities have various functions and different assets, so they have a wide range of values or consequences if compromised. Therefore, determining the risks and precautionsmore » that are warranted to mitigate these risks must be done on a case-by-case basis. In an effort to assess possible wildfire risks to sensitive materials stored in a Perma-Con ® in dome TA-54-0375, a conventional fire risk analysis was performed. This conventional risk analysis is documented in Engineering Evaluation Form AP-FIRE-001-FM1, which is dated 9/28/2015 and was titled ‘Wildland Fire Exposure Evaluation for Building TA-54-0375’ (Hall 2015). This analysis acknowledged that there was significant chance of wildfire in the vicinity of TA-54-0375, but the amount of combustible material surrounding the building was deemed low. The wildland fuels that were closest to the building were largely fine fuels and were not expected to have significant duration of heat release. The prevailing winds at this location are from the south and southwest and the nearest significant upwind fuels (tree crowns or unmown grasses) are at least 300 feet away. Based on these factors the conventional wildland fire risk to TA-54-0375 was deemed minimal, “Acceptable As Is, No Action Required.” This risk evaluation was based on a combined assessment of low probability of wildfires arriving at the site from other directions (where higher fuel loadings might be present) as well as the effective setback of fuels in the direction that fire is expected to arrive from.« less

  1. Advances on a Decision Analytic Approach to Exposure-Based Chemical Prioritization.

    PubMed

    Wood, Matthew D; Plourde, Kenton; Larkin, Sabrina; Egeghy, Peter P; Williams, Antony J; Zemba, Valerie; Linkov, Igor; Vallero, Daniel A

    2018-05-11

    The volume and variety of manufactured chemicals is increasing, although little is known about the risks associated with the frequency and extent of human exposure to most chemicals. The EPA and the recent signing of the Lautenberg Act have both signaled the need for high-throughput methods to characterize and screen chemicals based on exposure potential, such that more comprehensive toxicity research can be informed. Prior work of Mitchell et al. using multicriteria decision analysis tools to prioritize chemicals for further research is enhanced here, resulting in a high-level chemical prioritization tool for risk-based screening. Reliable exposure information is a key gap in currently available engineering analytics to support predictive environmental and health risk assessments. An elicitation with 32 experts informed relative prioritization of risks from chemical properties and human use factors, and the values for each chemical associated with each metric were approximated with data from EPA's CP_CAT database. Three different versions of the model were evaluated using distinct weight profiles, resulting in three different ranked chemical prioritizations with only a small degree of variation across weight profiles. Future work will aim to include greater input from human factors experts and better define qualitative metrics. © 2018 Society for Risk Analysis.

  2. The Toxic Truth About Carbon Nanotubes in Water Purification: a Perspective View.

    PubMed

    Das, Rasel; Leo, Bey Fen; Murphy, Finbarr

    2018-06-18

    Without nanosafety guidelines, the long-term sustainability of carbon nanotubes (CNTs) for water purifications is questionable. Current risk measurements of CNTs are overshadowed by uncertainties. New risks associated with CNTs are evolving through different waste water purification routes, and there are knowledge gaps in the risk assessment of CNTs based on their physical properties. Although scientific efforts to design risk estimates are evolving, there remains a paucity of knowledge on the unknown health risks of CNTs. The absence of universal CNT safety guidelines is a specific hindrance. In this paper, we close these gaps and suggested several new risk analysis roots and framework extrapolations from CNT-based water purification technologies. We propose a CNT safety clock that will help assess risk appraisal and management. We suggest that this could form the basis of an acceptable CNT safety guideline. We pay particular emphasis on measuring risks based on CNT physico-chemical properties such as diameter, length, aspect ratio, type, charge, hydrophobicity, functionalities and so on which determine CNT behaviour in waste water treatment plants and subsequent release into the environment.

  3. Grades and Graduation: A Longitudinal Risk Perspective to Identify Student Dropouts

    ERIC Educational Resources Information Center

    Bowers, Alex J.

    2010-01-01

    Studies of student risk of school dropout have shown that present predictors of at-risk status do not accurately identify a large percentage of students who eventually drop out. Through the analysis of the entire Grade 1-12 longitudinal cohort-based grading histories of the class of 2006 for two school districts in the United States, the author…

  4. Risk analysis and management

    NASA Technical Reports Server (NTRS)

    Smith, H. E.

    1990-01-01

    Present software development accomplishments are indicative of the emerging interest in and increasing efforts to provide risk assessment backbone tools in the manned spacecraft engineering community. There are indications that similar efforts are underway in the chemical processes industry and are probably being planned for other high risk ground base environments. It appears that complex flight systems intended for extended manned planetary exploration will drive this technology.

  5. HIV Risk Behavior among Amphetamine Injectors at U.S. Syringe Exchange Programs

    ERIC Educational Resources Information Center

    Braine, Naomi; Des Jarlais, Don C.; Goldblatt, Cullen; Zadoretzky, Cathy; Turner, Charles

    2005-01-01

    The goal of this study was to compare HIV risk behaviors of amphetamine and non-amphetamine injectors at syringe exchange programs (SEP) in the United States and to identify factors associated with injection risk. This analysis is based on data from a random cross-section of participants at 13 SEPs in different parts of the country. All interviews…

  6. Risk Factors of Falls in Community-Dwelling Older Adults: Logistic Regression Tree Analysis

    ERIC Educational Resources Information Center

    Yamashita, Takashi; Noe, Douglas A.; Bailer, A. John

    2012-01-01

    Purpose of the Study: A novel logistic regression tree-based method was applied to identify fall risk factors and possible interaction effects of those risk factors. Design and Methods: A nationally representative sample of American older adults aged 65 years and older (N = 9,592) in the Health and Retirement Study 2004 and 2006 modules was used.…

  7. Risk Management using Dependency Stucture Matrix

    NASA Astrophysics Data System (ADS)

    Petković, Ivan

    2011-09-01

    An efficient method based on dependency structure matrix (DSM) analysis is given for ranking risks in a complex system or process whose entities are mutually dependent. This rank is determined according to the element's values of the unique positive eigenvector which corresponds to the matrix spectral radius modeling the considered engineering system. For demonstration, the risk problem of NASA's robotic spacecraft is analyzed.

  8. DOE Office of Scientific and Technical Information (OSTI.GOV)

    Ramuhalli, Pradeep; Hirt, Evelyn H.; Veeramany, Arun

    This research report summaries the development and evaluation of a prototypic enhanced risk monitor (ERM) methodology (framework) that includes alternative risk metrics and uncertainty analysis. This updated ERM methodology accounts for uncertainty in the equipment condition assessment (ECA), the prognostic result, and the probabilistic risk assessment (PRA) model. It is anticipated that the ability to characterize uncertainty in the estimated risk and update the risk estimates in real time based on equipment condition assessment (ECA) will provide a mechanism for optimizing plant performance while staying within specified safety margins. These results (based on impacting active component O&M using real-time equipmentmore » condition information) are a step towards ERMs that, if integrated with AR supervisory plant control systems, can help control O&M costs and improve affordability of advanced reactors.« less

  9. America's Elderly at Risk. A Report Presented by the Chairman of the Select Committee on Aging. House of Representatives, Ninety-Ninth Congress, First Session.

    ERIC Educational Resources Information Center

    Congress of the U.S., Washington, DC. House Select Committee on Aging.

    This report examines the health risks and related financial risks faced by America's elderly. Documentation of the elderly's increased financial risk is presented which is based on data from a case study of the elderly in Massachusetts and on an analysis of the elderly's out-of-pocket health care costs using data from the Health Care Financing…

  10. Bio-Terrorism: Steps to Effective Public Health Risk Communication and Fear Management

    DTIC Science & Technology

    2004-06-01

    outline the challenges of communicating risk prior to, during and following a bio-terrorism event as well as the relationship between the content of...particularly challenging for a system based on thorough research and data analysis. Risk communication in a bio-terrorism event will involve...Ultimately, the Anthrax events confirmed the difficulty in communicating risk when scientific data is not available. Adding to the challenges imposed by an

  11. TU-FG-201-12: Designing a Risk-Based Quality Assurance Program for a Newly Implemented Y-90 Microspheres Procedure

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Vile, D; Zhang, L; Cuttino, L

    2016-06-15

    Purpose: To create a quality assurance program based upon a risk-based assessment of a newly implemented SirSpheres Y-90 procedure. Methods: A process map was created for a newly implemented SirSpheres procedure at a community hospital. The process map documented each step of this collaborative procedure, as well as the roles and responsibilities of each member. From the process map, different potential failure modes were determined as well as any current controls in place. From this list, a full failure mode and effects analysis (FMEA) was performed by grading each failure mode’s likelihood of occurrence, likelihood of detection, and potential severity.more » These numbers were then multiplied to compute the risk priority number (RPN) for each potential failure mode. Failure modes were then ranked based on their RPN. Additional controls were then added, with failure modes corresponding to the highest RPNs taking priority. Results: A process map was created that succinctly outlined each step in the SirSpheres procedure in its current implementation. From this, 72 potential failure modes were identified and ranked according to their associated RPN. Quality assurance controls and safety barriers were then added for failure modes associated with the highest risk being addressed first. Conclusion: A quality assurance program was created from a risk-based assessment of the SirSpheres process. Process mapping and FMEA were effective in identifying potential high-risk failure modes for this new procedure, which were prioritized for new quality assurance controls. TG 100 recommends the fault tree analysis methodology to design a comprehensive and effective QC/QM program, yet we found that by simply introducing additional safety barriers to address high RPN failure modes makes the whole process simpler and safer.« less

  12. Comparative cost-effectiveness of metformin-based dual therapies associated with risk of cardiovascular diseases among Chinese patients with type 2 diabetes: Evidence from a population-based national cohort in Taiwan.

    PubMed

    Ou, Huang-Tz; Chen, Yen-Ting; Liu, Ya-Ming; Wu, Jin-Shang

    2016-06-01

    To assess the cost-effectiveness of metformin-based dual therapies associated with cardiovascular disease (CVD) risk in a Chinese population with type 2 diabetes. We utilized Taiwan's National Health Insurance Research Database (NHIRD) 1997-2011, which is derived from the claims of National Health Insurance, a mandatory-enrollment single-payer system that covers over 99% of Taiwan's population. Four metformin-based dual therapy cohorts were used, namely a reference group of metformin plus sulfonylureas (Metformin-SU) and metformin plus acarbose, metformin plus thiazolidinediones (Metformin-TZD), and metformin plus glinides (Metformin-glinides). Using propensity scores, each subject in a comparison cohort was 1:1 matched to a referent. The effectiveness outcome was CVD risk. Only direct medical costs were included. The Markov chain model was applied to project lifetime outcomes, discounted at 3% per annum. The bootstrapping technique was performed to assess uncertainty in analysis. Metformin-glinides was most cost-effective in the base-case analysis; Metformin-glinides saved $194 USD for one percentage point of reduction in CVD risk, as compared to Metformin-SU. However, for the elderly or those with severe diabetic complications, Metformin-TZD, especially pioglitazone, was more suitable; as compared to Metformin-SU, Metformin-TZD saved $840.1 USD per percentage point of reduction in CVD risk. Among TZDs, Metformin-pioglitazone saved $1831.5 USD per percentage point of associated CVD risk reduction, as compared to Metformin-rosiglitazone. When CVD is considered an important clinical outcome, Metformin-pioglitazone is cost-effective, in particular for the elderly and those with severe diabetic complications. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  13. Software reliability through fault-avoidance and fault-tolerance

    NASA Technical Reports Server (NTRS)

    Vouk, Mladen A.; Mcallister, David F.

    1993-01-01

    Strategies and tools for the testing, risk assessment and risk control of dependable software-based systems were developed. Part of this project consists of studies to enable the transfer of technology to industry, for example the risk management techniques for safety-concious systems. Theoretical investigations of Boolean and Relational Operator (BRO) testing strategy were conducted for condition-based testing. The Basic Graph Generation and Analysis tool (BGG) was extended to fully incorporate several variants of the BRO metric. Single- and multi-phase risk, coverage and time-based models are being developed to provide additional theoretical and empirical basis for estimation of the reliability and availability of large, highly dependable software. A model for software process and risk management was developed. The use of cause-effect graphing for software specification and validation was investigated. Lastly, advanced software fault-tolerance models were studied to provide alternatives and improvements in situations where simple software fault-tolerance strategies break down.

  14. School profiles of at-risk student concentration: Differential growth in oral reading fluency

    PubMed Central

    Logan, Jessica A.R.; Petscher, Yaacov

    2010-01-01

    The present study provides a data-driven approach to identifying groups of schools based on the concentration of at-risk students the school serves. The percentage of English language learners, minority students, and students eligible for free or reduced priced lunch were used as indicators in a latent profile analysis of 569 schools. The goal of the present study was to determine whether school-level average student reading performance varied as a function of the groups identified in the latent profile analysis. To do so, groups extracted by the latent profile analysis were used as school-level predictors of growth in oral reading fluency, which was modeled at the within-student level of a three-level hierarchical growth curve model. Oral reading fluency was measured at four points during the year in a large cross-sectional sample of first-, second-, and third-grade students. Results indicated that schools were able to be classified into four distinct groups based on their concentrations and types of at-risk students. Further, in all three grades, there were significant differences between the four identified groups observed in average reading fluency scores at the beginning of the year, the end of the year, and growth during the year indicating that groups based on school-concentration of at-risk students were significantly related to average student achievement in reading ability. PMID:20159224

  15. Fish intake and risk of heart failure: A meta-analysis of five prospective cohort studies

    PubMed Central

    HOU, LI-NA; LI, FEI; ZHOU, YOU; NIE, SHI-HUAI; SU, LIANG; CHEN, PING-AN; TAN, WAN-LONG; XU, DING-LI

    2012-01-01

    The findings on the association between fish intake and the risk of heart failure (HF) have been inconsistent. The purpose of this study was to clarify this potential association. We searched for relevant studies in the PubMed database through January 2012 and manually reviewed references. Five independent prospective cohort studies involving 5,273 cases and 144,917 participants were included. The summary relative risk estimates (SRRE) based on the highest compared with the lowest category of fish consumption were estimated by variance-based meta-analysis. In addition, we performed sensitivity and dose-response analyses to examine the association. Overall, an absence of an association between fish intake and HF was observed (SRRE=1.00; 95% CI, 0.81–1.24). However, fried fish intake positively associated with HF (SRRE=1.40; 95% CI, 1.22–1.61). In addition, dose-response analysis of fried fish suggested that each increment of six fried fish per month corresponded to a 37% increase of HF rate (RR=1.37; 95% CI, 1.20–1.56). In conclusion, our findings suggest that there is no significant association between fish intake and risk of HF, with the exception of a possible positive correlation with individuals comsuming fried fish, based on a limited number of studies. Future studies are required to confirm these findings. PMID:23181122

  16. Surging Seas Risk Finder: A Simple Search-Based Web Tool for Local Sea Level Rise Projections, Coastal Flood Risk Forecasts, and Inundation Exposure Analysis

    NASA Astrophysics Data System (ADS)

    Strauss, B.; Dodson, D.; Kulp, S. A.; Rizza, D. H.

    2016-12-01

    Surging Seas Risk Finder (riskfinder.org) is an online tool for accessing extensive local projections and analysis of sea level rise; coastal floods; and land, populations, contamination sources, and infrastructure and other assets that may be exposed to inundation. Risk Finder was first published in 2013 for Florida, New York and New Jersey, expanding to all states in the contiguous U.S. by 2016, when a major new version of the tool was released with a completely new interface. The revised tool was informed by hundreds of survey responses from and conversations with planners, local officials and other coastal stakeholders, plus consideration of modern best practices for responsive web design and user interfaces, and social science-based principles for science communication. Overarching design principles include simplicity and ease of navigation, leading to a landing page with Google-like sparsity and focus on search, and to an architecture based on search, so that each coastal zip code, city, county, state or other place type has its own webpage gathering all relevant analysis in modular, scrollable units. Millions of users have visited the Surging Seas suite of tools to date, and downloaded thousands of files, for stated purposes ranging from planning to business to education to personal decisions; and from institutions ranging from local to federal government agencies, to businesses, to NGOs, and to academia.

  17. Traceability and Risk Analysis Strategies for Addressing Counterfeit Electronics in Supply Chains for Complex Systems.

    PubMed

    DiMase, Daniel; Collier, Zachary A; Carlson, Jinae; Gray, Robin B; Linkov, Igor

    2016-10-01

    Within the microelectronics industry, there is a growing concern regarding the introduction of counterfeit electronic parts into the supply chain. Even though this problem is widespread, there have been limited attempts to implement risk-based approaches for testing and supply chain management. Supply chain risk management tends to focus on the highly visible disruptions of the supply chain instead of the covert entrance of counterfeits; thus counterfeit risk is difficult to mitigate. This article provides an overview of the complexities of the electronics supply chain, and highlights some gaps in risk assessment practices. In particular, this article calls for enhanced traceability capabilities to track and trace parts at risk through various stages of the supply chain. Placing the focus on risk-informed decision making through the following strategies is needed, including prioritization of high-risk parts, moving beyond certificates of conformance, incentivizing best supply chain management practices, adoption of industry standards, and design and management for supply chain resilience. © 2016 Society for Risk Analysis.

  18. [Uncertainty characterization approaches for ecological risk assessment of polycyclic aromatic hydrocarbon in Taihu Lake].

    PubMed

    Guo, Guang-Hui; Wu, Feng-Chang; He, Hong-Ping; Feng, Cheng-Lian; Zhang, Rui-Qing; Li, Hui-Xian

    2012-04-01

    Probabilistic approaches, such as Monte Carlo Sampling (MCS) and Latin Hypercube Sampling (LHS), and non-probabilistic approaches, such as interval analysis, fuzzy set theory and variance propagation, were used to characterize uncertainties associated with risk assessment of sigma PAH8 in surface water of Taihu Lake. The results from MCS and LHS were represented by probability distributions of hazard quotients of sigma PAH8 in surface waters of Taihu Lake. The probabilistic distribution of hazard quotient were obtained from the results of MCS and LHS based on probabilistic theory, which indicated that the confidence intervals of hazard quotient at 90% confidence level were in the range of 0.000 18-0.89 and 0.000 17-0.92, with the mean of 0.37 and 0.35, respectively. In addition, the probabilities that the hazard quotients from MCS and LHS exceed the threshold of 1 were 9.71% and 9.68%, respectively. The sensitivity analysis suggested the toxicity data contributed the most to the resulting distribution of quotients. The hazard quotient of sigma PAH8 to aquatic organisms ranged from 0.000 17 to 0.99 using interval analysis. The confidence interval was (0.001 5, 0.016 3) at the 90% confidence level calculated using fuzzy set theory, and the confidence interval was (0.000 16, 0.88) at the 90% confidence level based on the variance propagation. These results indicated that the ecological risk of sigma PAH8 to aquatic organisms were low. Each method has its own set of advantages and limitations, which was based on different theory; therefore, the appropriate method should be selected on a case-by-case to quantify the effects of uncertainties on the ecological risk assessment. Approach based on the probabilistic theory was selected as the most appropriate method to assess the risk of sigma PAH8 in surface water of Taihu Lake, which provided an important scientific foundation of risk management and control for organic pollutants in water.

  19. A case study of liquefaction risk analysis based on the thickness and depth of the liquefaction layer using CPT and electric resistivity data in the Hinode area, Itako City, Ibaraki Prefecture, Japan

    NASA Astrophysics Data System (ADS)

    Jinguuji, Motoharu; Toprak, Selcuk

    2017-12-01

    The Hinode area of Itako City in Ibaraki Prefecture, Japan, suffered some of the most severe liquefaction damage of any areas in the Great Eastern Japan Earthquake in 2011. This liquefaction damage has been investigated by Itako City, as well as by universities and research institutes in Japan. The National Institute of Advanced Industrial Science and Technology (AIST) has carried out numerous investigations along the Tone River, and in particular, intensive surveys were done in the Hinode area. We have conducted a risk analysis based on the thickness and depth of the liquefaction layer measured using cone penetration testing (CPT) data and electric resistivity data obtained in the Hinode area. The distribution of the risk estimated from CPT at 143 points, and that obtained from analysis of the resistivity survey data, agreed with the distribution of actual damage. We also carried out conventional risk analyses method using the liquefaction resistance factor (FL) and liquefaction potential index (PL) methods with CPT data. The results show high PL values over the entire area, but their distribution did not agree well with actual damage in some parts of the study area. Because the analysis of the thickness and depth of the liquefaction layer, using geophysical prospecting methods, can cover a widespread area, this method will be very useful in investigating liquefaction risk, especially for gas and water pipelines.

  20. Exposure to pesticides as risk factor for non-Hodgkin's lymphoma and hairy cell leukemia: pooled analysis of two Swedish case-control studies.

    PubMed

    Hardell, Lennart; Eriksson, Mikael; Nordstrom, Marie

    2002-05-01

    Increased risk for non-Hodgkin's lymphoma (NHL) following exposure to certain pesticides has previously been reported. To further elucidate the importance of phenoxyacetic acids and other pesticides in the etiology of NHL a pooled analysis was performed on two case-control studies, one on NHL and another on hairy cell leukemia (HCL), a rare subtype of NHL. The studies were population based with cases identified from cancer registry and controls from population registry. Data assessment was ascertained by questionnaires supplemented over the telephone by specially trained interviewers. The pooled analysis of NHL and HCL was based on 515 cases and 1141 controls. Increased risks in univariate analysis were found for subjects exposed to herbicides (OR 1.75, CI 95% 1.26-2.42), insecticides (OR 1.43, CI 95% 1.08-1.87), fungicides (OR 3.11, CI 95% 1.56-6.27) and impregnating agents (OR 1.48, CI 95% 1.11-1.96). Among herbicides, significant associations were found for glyphosate (OR 3.04, CI 95% 1.08-8.52) and 4-chloro-2-methyl phenoxyacetic acid (MCPA) (OR 2.62, CI 95% 1.40-4.88). For several categories of pesticides the highest risk was found for exposure during the latest decades before diagnosis. However, in multivariate analyses the only significantly increased risk was for a heterogeneous category of other herbicides than above.

  1. Quantitative evaluation of the risk induced by dominant geomorphological processes on different land uses, based on GIS spatial analysis models

    NASA Astrophysics Data System (ADS)

    Ştefan, Bilaşco; Sanda, Roşca; Ioan, Fodorean; Iuliu, Vescan; Sorin, Filip; Dănuţ, Petrea

    2017-12-01

    Maramureş Land is mostly characterized by agricultural and forestry land use due to its specific configuration of topography and its specific pedoclimatic conditions. Taking into consideration the trend of the last century from the perspective of land management, a decrease in the surface of agricultural lands to the advantage of built-up and grass lands, as well as an accelerated decrease in the forest cover due to uncontrolled and irrational forest exploitation, has become obvious. The field analysis performed on the territory of Maramureş Land has highlighted a high frequency of two geomorphologic processes — landslides and soil erosion — which have a major negative impact on land use due to their rate of occurrence. The main aim of the present study is the GIS modeling of the two geomorphologic processes, determining a state of vulnerability (the USLE model for soil erosion and a quantitative model based on the morphometric characteristics of the territory, derived from the HG. 447/2003) and their integration in a complex model of cumulated vulnerability identification. The modeling of the risk exposure was performed using a quantitative approach based on models and equations of spatial analysis, which were developed with modeled raster data structures and primary vector data, through a matrix highlighting the correspondence between vulnerability and land use classes. The quantitative analysis of the risk was performed by taking into consideration the exposure classes as modeled databases and the land price as a primary alphanumeric database using spatial analysis techniques for each class by means of the attribute table. The spatial results highlight the territories with a high risk to present geomorphologic processes that have a high degree of occurrence and represent a useful tool in the process of spatial planning.

  2. Quantitative evaluation of the risk induced by dominant geomorphological processes on different land uses, based on GIS spatial analysis models

    NASA Astrophysics Data System (ADS)

    Ştefan, Bilaşco; Sanda, Roşca; Ioan, Fodorean; Iuliu, Vescan; Sorin, Filip; Dănuţ, Petrea

    2018-06-01

    Maramureş Land is mostly characterized by agricultural and forestry land use due to its specific configuration of topography and its specific pedoclimatic conditions. Taking into consideration the trend of the last century from the perspective of land management, a decrease in the surface of agricultural lands to the advantage of built-up and grass lands, as well as an accelerated decrease in the forest cover due to uncontrolled and irrational forest exploitation, has become obvious. The field analysis performed on the territory of Maramureş Land has highlighted a high frequency of two geomorphologic processes — landslides and soil erosion — which have a major negative impact on land use due to their rate of occurrence. The main aim of the present study is the GIS modeling of the two geomorphologic processes, determining a state of vulnerability (the USLE model for soil erosion and a quantitative model based on the morphometric characteristics of the territory, derived from the HG. 447/2003) and their integration in a complex model of cumulated vulnerability identification. The modeling of the risk exposure was performed using a quantitative approach based on models and equations of spatial analysis, which were developed with modeled raster data structures and primary vector data, through a matrix highlighting the correspondence between vulnerability and land use classes. The quantitative analysis of the risk was performed by taking into consideration the exposure classes as modeled databases and the land price as a primary alphanumeric database using spatial analysis techniques for each class by means of the attribute table. The spatial results highlight the territories with a high risk to present geomorphologic processes that have a high degree of occurrence and represent a useful tool in the process of spatial planning.

  3. Season and preterm birth in Norway: A cautionary tale

    PubMed Central

    Weinberg, Clarice R; Shi, Min; DeRoo, Lisa A; Basso, Olga; Skjærven, Rolv

    2015-01-01

    Background: Preterm birth is a common, costly and dangerous pregnancy complication. Seasonality of risk would suggest modifiable causes. Methods: We examine seasonal effects on preterm birth, using data from the Medical Birth Registry of Norway (2 321 652 births), and show that results based on births are misleading and a fetuses-at-risk approach is essential. In our harmonic-regression Cox proportional hazards model we consider fetal risk of birth between 22 and 37 completed weeks of gestation. We examine effects of both day of year of conception (for early effects) and day of ongoing gestation (for seasonal effects on labour onset) as modifiers of gestational-age-based risk. Results: Naïve analysis of preterm rates across days of birth shows compelling evidence for seasonality (P < 10−152). However, the reconstructed numbers of conceptions also vary with season (P < 10−307), confounding results by inducing seasonal variation in the age distribution of the fetal population at risk. When we instead properly treat fetuses as the individuals at risk, restrict analysis to pregnancies with relatively accurate ultrasound-based assessment of gestational age (available since 1998) and adjust for socio-demographic factors and maternal smoking, we find modest effects of both time of year of conception and time of year at risk, with peaks for early preterm near early January and early July. Conclusions: Analyses of seasonal effects on preterm birth are demonstrably vulnerable to confounding by seasonality of conception, measurement error in conception dating, and socio-demographic factors. The seasonal variation based on fetuses reveals two peaks for early preterm, coinciding with New Year’s Day and the early July beginning of Norway’s summer break, and may simply reflect a holiday-related pattern of unintended conception. PMID:26045507

  4. Insomnia and risk of dementia in older adults: Systematic review and meta-analysis.

    PubMed

    de Almondes, Katie Moraes; Costa, Mônica Vieira; Malloy-Diniz, Leandro Fernandes; Diniz, Breno Satler

    2016-06-01

    There are cross-sectional evidences of an association between sleep disorders and cognitive impairment on older adults. However, there are no consensus by means of longitudinal studies data on the increased risk of developing dementia related to insomnia. We conduct a systematic review and meta-analysis to evaluate the risk of incident all-cause dementia in individuals with insomnia in population-based prospective cohort studies. Five studies of 5.242 retrieved references were included in the meta-analysis. We used the generic inverse variance method with a random effects model to calculate the pooled risk of dementia in older adults with insomnia. We assessed heterogeneity in the meta-analysis by means of the Q-test and I2 index. Study quality was assessed with the Newcastle-Ottawa Scale The results showed that Insomnia was associated with a significant risk of all-cause dementia (RR = 1.53 CI95% (1.07-2.18), z = 2.36, p = 0.02). There was evidence for significant heterogeneity in the analysis (q-value = 2.4, p < 0.001 I2 = 82%). Insomnia is associated with an increased risk for dementia. This results provide evidences that future studies should investigate dementia prevention among elderly individuals through screening and proper management of insomnia. Copyright © 2016 Elsevier Ltd. All rights reserved.

  5. Case-based Influence in Conflict Management

    DTIC Science & Technology

    2014-10-31

    AFRL-OSR-VA-TR-2014-0337 CASE-BASED INFLUENCE IN CONFLICT MANAGEMENT Robert Axelrod ARTIS RESEARCH & RISK MODELING Final Report 10/31/2014...FA9550-10-1-0373 Dr. Robert Axelrod - PI Dr. Richard Davis- PD ARTIS Research & Risk Modeling ARTIS 5741 Canyon Ridge North Cave Creek, AZ 85331-9318...analysis of the timing of cyber conflict that quickly received attention from over 30 countries. 3 1 Axelrod , Final Report and Publications Final

  6. Gemitis : an integrated and participative risk reduction strategy for the sustainable development of cities

    NASA Astrophysics Data System (ADS)

    Masure, P.

    2003-04-01

    The GEMITIS method has been implemented since 1995 into a global and integrated Risk Reduction Strategy for improving the seismic risk-assessment effectiveness in urban areas, including the generation of crisis scenarios and mid- to long term- seismic impact assessment. GEMITIS required us to provide more precise definitions of notions in common use by natural-hazard specialists, such as elements at risk and vulnerability. Until then, only the physical and human elements had been considered, and analysis of their vulnerability referred to their fragility in the face of aggression by nature. We have completed this approach by also characterizing the social and cultural vulnerability of a city and its inhabitants, and, with a wider scope, the functional vulnerability of the "urban system". This functional vulnerability depends upon the relations between the system elements (weak links in chains, functional relays, and defense systems) and upon the city's relations with the outside world (interdependence). Though well developed in methods for evaluating industrial risk (fault-tree analysis, event-tree analysis, multiple defense barriers, etc.), this aspect had until now been ignored by the "hard-science" specialists working on natural hazards. Based on the implementation of an Urban System Exposure methodology, we were able to identify specific human, institutional, or functional vulnerability factors for each urban system, which until had been very little discussed by risk-analysis and civil-protection specialists. In addition, we have defined the new concept of "main stakes" of the urban system, ranked by order of social value (or collective utility). Obviously, vital or strategic issues must be better resistant or protected against natural hazards than issues of secondary importance. The ranking of exposed elements of a city in terms of "main stakes" provides a very useful guide for adapting vulnerability studies and for orienting preventive actions. For this, GEMITIS is based on a systemic approach of the city and on value analysis of exposed elements. It facilitates a collective expertise for the definition of a preventive action plan based on the participation of the main urban actors (crisis preparedness, construction, land-use, etc.).

  7. Is nutritional labeling associated with individual health? The effects of labeling-based awareness on dyslipidemia risk in a South Korean population.

    PubMed

    Kim, Jong Yeob; Kweon, Ki Hong; Kim, Min Jae; Park, Eun-Cheol; Jang, Suk-Yong; Kim, Woorim; Han, Kyu-Tae

    2016-09-15

    In 1995, the South Korean government made nutrition labeling compulsory, which has positively impacted patients with certain chronic diseases, such as dyslipidemia. We investigated the association between nutrition labeling-based awareness and the risk of dyslipidemia among individuals not yet diagnosed. Our study used data from the fifth Korea National Health and Nutrition Examination Surveys administered during 2010-2014 (n = 17,687). We performed multiple or logistic regression analysis to examine the association between nutritional analysis and various outcome variables. Approximately 70 % of the respondents (n = 11,513) were familiar with nutrition labeling, of which 20 % (n = 3172) decided what food to buy based on that information. This awareness yielded mostly positive results on outcome indicators, such as triglyceride and high-density lipoprotein cholesterol levels. In general, individuals who used nutritional labels to make decisions regarding food purchases had a lower risk of dyslipidemia than individuals who did not (OR: 0.806, 95 % CI: 0.709-0.917). Utilizing nutrition labels for making food choices correlated with a lower risk of dyslipidemia in certain subgroups. Based on our findings, we recommend that health policymakers and medical professionals consider promoting nutrition labeling as an alternative method for managing certain chronic diseases in South Korean patients.

  8. A Risk Stratification Model for Lung Cancer Based on Gene Coexpression Network and Deep Learning

    PubMed Central

    2018-01-01

    Risk stratification model for lung cancer with gene expression profile is of great interest. Instead of previous models based on individual prognostic genes, we aimed to develop a novel system-level risk stratification model for lung adenocarcinoma based on gene coexpression network. Using multiple microarray, gene coexpression network analysis was performed to identify survival-related networks. A deep learning based risk stratification model was constructed with representative genes of these networks. The model was validated in two test sets. Survival analysis was performed using the output of the model to evaluate whether it could predict patients' survival independent of clinicopathological variables. Five networks were significantly associated with patients' survival. Considering prognostic significance and representativeness, genes of the two survival-related networks were selected for input of the model. The output of the model was significantly associated with patients' survival in two test sets and training set (p < 0.00001, p < 0.0001 and p = 0.02 for training and test sets 1 and 2, resp.). In multivariate analyses, the model was associated with patients' prognosis independent of other clinicopathological features. Our study presents a new perspective on incorporating gene coexpression networks into the gene expression signature and clinical application of deep learning in genomic data science for prognosis prediction. PMID:29581968

  9. Characterising bias in regulatory risk and decision analysis: An analysis of heuristics applied in health technology appraisal, chemicals regulation, and climate change governance.

    PubMed

    MacGillivray, Brian H

    2017-08-01

    In many environmental and public health domains, heuristic methods of risk and decision analysis must be relied upon, either because problem structures are ambiguous, reliable data is lacking, or decisions are urgent. This introduces an additional source of uncertainty beyond model and measurement error - uncertainty stemming from relying on inexact inference rules. Here we identify and analyse heuristics used to prioritise risk objects, to discriminate between signal and noise, to weight evidence, to construct models, to extrapolate beyond datasets, and to make policy. Some of these heuristics are based on causal generalisations, yet can misfire when these relationships are presumed rather than tested (e.g. surrogates in clinical trials). Others are conventions designed to confer stability to decision analysis, yet which may introduce serious error when applied ritualistically (e.g. significance testing). Some heuristics can be traced back to formal justifications, but only subject to strong assumptions that are often violated in practical applications. Heuristic decision rules (e.g. feasibility rules) in principle act as surrogates for utility maximisation or distributional concerns, yet in practice may neglect costs and benefits, be based on arbitrary thresholds, and be prone to gaming. We highlight the problem of rule-entrenchment, where analytical choices that are in principle contestable are arbitrarily fixed in practice, masking uncertainty and potentially introducing bias. Strategies for making risk and decision analysis more rigorous include: formalising the assumptions and scope conditions under which heuristics should be applied; testing rather than presuming their underlying empirical or theoretical justifications; using sensitivity analysis, simulations, multiple bias analysis, and deductive systems of inference (e.g. directed acyclic graphs) to characterise rule uncertainty and refine heuristics; adopting "recovery schemes" to correct for known biases; and basing decision rules on clearly articulated values and evidence, rather than convention. Copyright © 2017. Published by Elsevier Ltd.

  10. Simulation Assisted Risk Assessment: Blast Overpressure Modeling

    NASA Technical Reports Server (NTRS)

    Lawrence, Scott L.; Gee, Ken; Mathias, Donovan; Olsen, Michael

    2006-01-01

    A probabilistic risk assessment (PRA) approach has been developed and applied to the risk analysis of capsule abort during ascent. The PRA is used to assist in the identification of modeling and simulation applications that can significantly impact the understanding of crew risk during this potentially dangerous maneuver. The PRA approach is also being used to identify the appropriate level of fidelity for the modeling of those critical failure modes. The Apollo launch escape system (LES) was chosen as a test problem for application of this approach. Failure modes that have been modeled and/or simulated to date include explosive overpressure-based failure, explosive fragment-based failure, land landing failures (range limits exceeded either near launch or Mode III trajectories ending on the African continent), capsule-booster re-contact during separation, and failure due to plume-induced instability. These failure modes have been investigated using analysis tools in a variety of technical disciplines at various levels of fidelity. The current paper focuses on the development and application of a blast overpressure model for the prediction of structural failure due to overpressure, including the application of high-fidelity analysis to predict near-field and headwinds effects.

  11. Fault and event tree analyses for process systems risk analysis: uncertainty handling formulations.

    PubMed

    Ferdous, Refaul; Khan, Faisal; Sadiq, Rehan; Amyotte, Paul; Veitch, Brian

    2011-01-01

    Quantitative risk analysis (QRA) is a systematic approach for evaluating likelihood, consequences, and risk of adverse events. QRA based on event (ETA) and fault tree analyses (FTA) employs two basic assumptions. The first assumption is related to likelihood values of input events, and the second assumption is regarding interdependence among the events (for ETA) or basic events (for FTA). Traditionally, FTA and ETA both use crisp probabilities; however, to deal with uncertainties, the probability distributions of input event likelihoods are assumed. These probability distributions are often hard to come by and even if available, they are subject to incompleteness (partial ignorance) and imprecision. Furthermore, both FTA and ETA assume that events (or basic events) are independent. In practice, these two assumptions are often unrealistic. This article focuses on handling uncertainty in a QRA framework of a process system. Fuzzy set theory and evidence theory are used to describe the uncertainties in the input event likelihoods. A method based on a dependency coefficient is used to express interdependencies of events (or basic events) in ETA and FTA. To demonstrate the approach, two case studies are discussed. © 2010 Society for Risk Analysis.

  12. USEPA’s Land‐Based Materials Management Exposure and Risk Assessment Tool System

    EPA Science Inventory

    It is recognized that some kinds of 'waste' materials can in fact be reused as input materials for making safe products that benefit society. RIMM (Risk-Informed Materials Management) provides an integrated data gathering and analysis capability to enable scientifically rigorous ...

  13. Predictive Analytics for Safer Food Supply

    USDA-ARS?s Scientific Manuscript database

    Science based risk analysis improves the USDA Food Safety Inspection Service’s ability to combat threats to public health from food-borne illness by allowing the Agency to focus resources on hazards that pose the greatest risk. Innovative algorithms enable detection and containment of threat by an...

  14. Fatality Reduction by Air Bags: Analyses of Accident Data through Early 1996

    DOT National Transportation Integrated Search

    1996-08-01

    The fatality risk of front-seat occupants of passenger cars and light trucks equipped with air bags is compared to the corresponding risk in similar vehicles without air bags, based on statistical analysis of Fatal Accident Reporting System (FARS)dat...

  15. Evolving dynamics of trading behavior based on coordination game in complex networks

    NASA Astrophysics Data System (ADS)

    Bian, Yue-tang; Xu, Lu; Li, Jin-sheng

    2016-05-01

    This work concerns the modeling of evolvement of trading behavior in stock markets. Based on the assumption of the investors' limited rationality, the evolution mechanism of trading behavior is modeled according to the investment strategy of coordination game in network, that investors are prone to imitate their neighbors' activity through comprehensive analysis on the risk dominance degree of certain investment behavior, the network topology of their relationship and its heterogeneity. We investigate by mean-field analysis and extensive simulations the evolution of investors' trading behavior in various typical networks under different risk dominance degree of investment behavior. Our results indicate that the evolution of investors' behavior is affected by the network structure of stock market and the effect of risk dominance degree of investment behavior; the stability of equilibrium states of investors' behavior dynamics is directly related with the risk dominance degree of some behavior; connectivity and heterogeneity of the network plays an important role in the evolution of the investment behavior in stock market.

  16. Predicting Geriatric Falls Following an Episode of Emergency Department Care: A Systematic Review

    PubMed Central

    Carpenter, Christopher R.; Avidan, Michael S.; Wildes, Tanya; Stark, Susan; Fowler, Susan A.; Lo, Alexander X.

    2015-01-01

    Background Falls are the leading cause of traumatic mortality in geriatric adults. Despite recent multispecialty guideline recommendations that advocate for proactive fall prevention protocols in the emergency department (ED), the ability of risk factors or risk stratification instruments to identify subsets of geriatric patients at increased risk for short-term falls is largely unexplored. Objectives This was a systematic review and meta-analysis of ED-based history, physical examination, and fall risk stratification instruments with the primary objective of providing a quantitative estimate for each risk factor’s accuracy to predict future falls. A secondary objective was to quantify ED fall risk assessment test and treatment thresholds using derived estimates of sensitivity and specificity. Methods A medical librarian and two emergency physicians (EPs) conducted a medical literature search of PUBMED, EMBASE, CINAHL, CENTRAL, DARE, the Cochrane Registry, and Clinical Trials. Unpublished research was located by a hand search of emergency medicine (EM) research abstracts from national meetings. Inclusion criteria for original studies included ED-based assessment of pre-ED or post-ED fall risk in patients 65 years and older with sufficient detail to reproduce contingency tables for meta-analysis. Original study authors were contacted for additional details when necessary. The Quality Assessment Tool for Diagnostic Accuracy Studies (QUADAS-2) was used to assess individual study quality for those studies that met inclusion criteria. When more than one qualitatively similar study assessed the same risk factor for falls at the same interval following an ED evaluation, then meta-analysis was performed using Meta-DiSc software. The primary outcomes were sensitivity, specificity, and likelihood ratios for fall risk factors or risk stratification instruments. Secondary outcomes included estimates of test and treatment thresholds using the Pauker method based on accuracy, screening risk, and the projected benefits or harms of fall prevention interventions in the ED. Results A total of 608 unique and potentially relevant studies were identified, but only three met our inclusion criteria. Two studies that included 660 patients assessed 29 risk factors and two risk stratification instruments for falls in geriatric patients in the 6 months following an ED evaluation, while one study of 107 patients assessed the risk of falls in the preceding 12 months. A self-report of depression was associated with the highest positive likelihood ratio (LR) of 6.55 (95% confidence interval [CI] = 1.41 to 30.48). Six fall predictors were identified in more than one study (past falls, living alone, use of walking aid, depression, cognitive deficit, and more than six medications) and meta-analysis was performed for these risk factors. One screening instrument was sufficiently accurate to identify a subset of geriatric ED patients at low risk for falls with a negative LR of 0.11 (95% CI = 0.06 to 0.20). The test threshold was 6.6% and the treatment threshold was 27.5%. Conclusions This study demonstrates the paucity of evidence in the literature regarding ED-based screening for risk of future falls among older adults. The screening tools and individual characteristics identified in this study provide an evidentiary basis on which to develop screening protocols for geriatrics adults in the ED to reduce fall risk PMID:25293956

  17. Predicting geriatric falls following an episode of emergency department care: a systematic review.

    PubMed

    Carpenter, Christopher R; Avidan, Michael S; Wildes, Tanya; Stark, Susan; Fowler, Susan A; Lo, Alexander X

    2014-10-01

    Falls are the leading cause of traumatic mortality in geriatric adults. Despite recent multispecialty guideline recommendations that advocate for proactive fall prevention protocols in the emergency department (ED), the ability of risk factors or risk stratification instruments to identify subsets of geriatric patients at increased risk for short-term falls is largely unexplored. This was a systematic review and meta-analysis of ED-based history, physical examination, and fall risk stratification instruments with the primary objective of providing a quantitative estimate for each risk factor's accuracy to predict future falls. A secondary objective was to quantify ED fall risk assessment test and treatment thresholds using derived estimates of sensitivity and specificity. A medical librarian and two emergency physicians (EPs) conducted a medical literature search of PUBMED, EMBASE, CINAHL, CENTRAL, DARE, the Cochrane Registry, and Clinical Trials. Unpublished research was located by a hand search of emergency medicine (EM) research abstracts from national meetings. Inclusion criteria for original studies included ED-based assessment of pre-ED or post-ED fall risk in patients 65 years and older with sufficient detail to reproduce contingency tables for meta-analysis. Original study authors were contacted for additional details when necessary. The Quality Assessment Tool for Diagnostic Accuracy Studies (QUADAS-2) was used to assess individual study quality for those studies that met inclusion criteria. When more than one qualitatively similar study assessed the same risk factor for falls at the same interval following an ED evaluation, then meta-analysis was performed using Meta-DiSc software. The primary outcomes were sensitivity, specificity, and likelihood ratios for fall risk factors or risk stratification instruments. Secondary outcomes included estimates of test and treatment thresholds using the Pauker method based on accuracy, screening risk, and the projected benefits or harms of fall prevention interventions in the ED. A total of 608 unique and potentially relevant studies were identified, but only three met our inclusion criteria. Two studies that included 660 patients assessed 29 risk factors and two risk stratification instruments for falls in geriatric patients in the 6 months following an ED evaluation, while one study of 107 patients assessed the risk of falls in the preceding 12 months. A self-report of depression was associated with the highest positive likelihood ratio (LR) of 6.55 (95% confidence interval [CI] = 1.41 to 30.48). Six fall predictors were identified in more than one study (past falls, living alone, use of walking aid, depression, cognitive deficit, and more than six medications) and meta-analysis was performed for these risk factors. One screening instrument was sufficiently accurate to identify a subset of geriatric ED patients at low risk for falls with a negative LR of 0.11 (95% CI = 0.06 to 0.20). The test threshold was 6.6% and the treatment threshold was 27.5%. This study demonstrates the paucity of evidence in the literature regarding ED-based screening for risk of future falls among older adults. The screening tools and individual characteristics identified in this study provide an evidentiary basis on which to develop screening protocols for geriatrics adults in the ED to reduce fall risk. © 2014 by the Society for Academic Emergency Medicine.

  18. DISEASE RISK ANALYSIS--A TOOL FOR POLICY MAKING WHEN EVIDENCE IS LACKING: IMPORT OF RABIES-SUSCEPTIBLE ZOO MAMMALS AS A MODEL.

    PubMed

    Hartley, Matt; Roberts, Helen

    2015-09-01

    Disease control management relies on the development of policy supported by an evidence base. The evidence base for disease in zoo animals is often absent or incomplete. Resources for disease research in these species are limited, and so in order to develop effective policies, novel approaches to extrapolating knowledge and dealing with uncertainty need to be developed. This article demonstrates how qualitative risk analysis techniques can be used to aid decision-making in circumstances in which there is a lack of specific evidence using the import of rabies-susceptible zoo mammals into the United Kingdom as a model.

  19. Effect of vitamin B supplementation on cancer incidence, death due to cancer, and total mortality: A PRISMA-compliant cumulative meta-analysis of randomized controlled trials.

    PubMed

    Zhang, Sui-Liang; Chen, Ting-Song; Ma, Chen-Yun; Meng, Yong-Bin; Zhang, Yu-Fei; Chen, Yi-Wei; Zhou, Yu-Hao

    2016-08-01

    Observational studies have suggested that vitamin B supplementation is associated with cancer risk, but this association remains controversial. A pooled data-based meta-analysis was conducted to summarize the evidence from randomized controlled trials (RCTs) investigating the effects of vitamin B supplementation on cancer incidence, death due to cancer, and total mortality. PubMed, EmBase, and the Cochrane Library databases were searched to identify trials to fit our analysis through August 2015. Relative risk (RR) was used to measure the effect of vitamin B supplementation on the risk of cancer incidence, death due to cancer, and total mortality using a random-effect model. Cumulative meta-analysis, sensitivity analysis, subgroup analysis, heterogeneity tests, and tests for publication bias were also conducted. Eighteen RCTs reporting the data on 74,498 individuals were included in the meta-analysis. Sixteen of these trials included 4103 cases of cancer; in 6 trials, 731 cancer-related deaths occurred; and in 15 trials, 7046 deaths occurred. Vitamin B supplementation had little or no effect on the incidence of cancer (RR: 1.04; 95% confidence interval [CI]: 0.98-1.10; P = 0.216), death due to cancer (RR, 1.05; 95% CI: 0.90-1.22; P = 0.521), and total mortality (RR, 1.00; 95% CI: 0.94-1.06; P = 0.952). Upon performing a cumulative meta-analysis for cancer incidence, death due to cancer, and total mortality, the nonsignificance of the effect of vitamin B persisted. With respect to specific types of cancer, vitamin B supplementation significantly reduced the risk of skin melanoma (RR, 0.47; 95% CI: 0.23-0.94; P = 0.032). Vitamin B supplementation does not have an effect on cancer incidence, death due to cancer, or total mortality. It is associated with a lower risk of skin melanoma, but has no effect on other cancers.

  20. [Risk factors in the living environment of early spontaneous abortion pregnant women].

    PubMed

    Liu, Xin-yan; Bian, Xu-ming; Han, Jing-xiu; Cao, Zhao-jin; Fan, Guang-sheng; Zhang, Chao; Zhang, Wen-li; Zhang, Shu-zhen; Sun, Xiao-guang

    2007-10-01

    To study the relationship between early spontaneous abortion and living environment, and explore the risk factors of spontaneous abortion. We conducted analysis based on the interview of 200 spontaneous abortion cases and the matched control (age +/- 2 years) by using multifactor Logistic regression analysis. The proportions of watching TV > or =10 hours/week, operating computer > or =45 hours/week, using copycat, microwave oven and mobile phone, electromagnetism equipment near the dwell or work place, e. g. switch room < or =50 m and launching tower < or =500 m in the cases are significantly higher than those in the controls in single factor analysis (all P < 0.05). After adjusted the effect of other risk factors by multifactor analysis, using microwave oven and mobile phone, contacting abnormal smell of fitment material > or =3 months, having emotional stress during the first term of pregnancy and spontaneous abortion history were significantly associated with risk of spontaneous abortion. The odds ratios of these risk factors were 2.23 and 4.63, respectively. Using microwave oven and mobile phone, contacting abnormal smell of fitment material > or =3 months, having emotional stress during the first term of pregnancy, and spontaneous abortion history are risk factors of early spontaneous abortion.

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