Sample records for risk evaluation system

  1. Assessment of three risk evaluation systems for patients aged ≥70 in East China: performance of SinoSCORE, EuroSCORE II and the STS risk evaluation system.

    PubMed

    Shan, Lingtong; Ge, Wen; Pu, Yiwei; Cheng, Hong; Cang, Zhengqiang; Zhang, Xing; Li, Qifan; Xu, Anyang; Wang, Qi; Gu, Chang; Zhang, Yangyang

    2018-01-01

    To assess and compare the predictive ability of three risk evaluation systems (SinoSCORE, EuroSCORE II and the STS risk evaluation system) in patients aged ≥70, and who underwent coronary artery bypass grafting (CABG) in East China. Three risk evaluation systems were applied to 1,946 consecutive patients who underwent isolated CABG from January 2004 to September 2016 in two hospitals. Patients were divided into two subsets according to their age: elderly group (age ≥70) with a younger group (age <70) used for comparison. The outcome of interest in this study was in-hospital mortality. The entire cohort and subsets of patients were analyzed. The calibration and discrimination in total and in subsets were assessed by the Hosmer-Lemeshow and the C statistics respectively. Institutional overall mortality was 2.52%. The expected mortality rates of SinoSCORE, EuroSCORE II and the STS risk evaluation system were 0.78(0.64)%, 1.43(1.14)% and 0.78(0.77)%, respectively. SinoSCORE achieved the best discrimination (the area under the receiver operating characteristic curve (AUC) = 0.829), followed by the STS risk evaluation system (AUC = 0.790) and EuroSCORE II (AUC = 0.769) in the entire cohort. In the elderly group, the observed mortality rate was 4.82% while it was 1.38% in the younger group. SinoSCORE (AUC = .829) also achieved the best discrimination in the elderly group, followed by the STS risk evaluation system (AUC = .730) and EuroSCORE II (AUC = 0.640) while all three risk evaluation systems all had good performances in the younger group. SinoSCORE, EuroSCORE II and the STS risk evaluation system all achieved positive calibrations in the entire cohort and subsets. The performance of the three risk evaluation systems was not ideal in the entire cohort. In the elderly group, SinoSCORE appeared to achieve better predictive efficiency than EuroSCORE II and the STS risk evaluation system.

  2. Risk Evaluation of Bogie System Based on Extension Theory and Entropy Weight Method

    PubMed Central

    Du, Yanping; Zhang, Yuan; Zhao, Xiaogang; Wang, Xiaohui

    2014-01-01

    A bogie system is the key equipment of railway vehicles. Rigorous practical evaluation of bogies is still a challenge. Presently, there is overreliance on part-specific experiments in practice. In the present work, a risk evaluation index system of a bogie system has been established based on the inspection data and experts' evaluation. Then, considering quantitative and qualitative aspects, the risk state of a bogie system has been evaluated using an extension theory and an entropy weight method. Finally, the method has been used to assess the bogie system of four different samples. Results show that this method can assess the risk state of a bogie system exactly. PMID:25574159

  3. Risk evaluation of bogie system based on extension theory and entropy weight method.

    PubMed

    Du, Yanping; Zhang, Yuan; Zhao, Xiaogang; Wang, Xiaohui

    2014-01-01

    A bogie system is the key equipment of railway vehicles. Rigorous practical evaluation of bogies is still a challenge. Presently, there is overreliance on part-specific experiments in practice. In the present work, a risk evaluation index system of a bogie system has been established based on the inspection data and experts' evaluation. Then, considering quantitative and qualitative aspects, the risk state of a bogie system has been evaluated using an extension theory and an entropy weight method. Finally, the method has been used to assess the bogie system of four different samples. Results show that this method can assess the risk state of a bogie system exactly.

  4. A risk evaluation model and its application in online retailing trustfulness

    NASA Astrophysics Data System (ADS)

    Ye, Ruyi; Xu, Yingcheng

    2017-08-01

    Building a general model for risks evaluation in advance could improve the convenience, normality and comparability of the results of repeating risks evaluation in the case that the repeating risks evaluating are in the same area and for a similar purpose. One of the most convenient and common risks evaluation models is an index system including of several index, according weights and crediting method. One method to build a risk evaluation index system that guarantees the proportional relationship between the resulting credit and the expected risk loss is proposed and an application example is provided in online retailing in this article.

  5. Unmanned aircraft system sense and avoid integrity and continuity

    NASA Astrophysics Data System (ADS)

    Jamoom, Michael B.

    This thesis describes new methods to guarantee safety of sense and avoid (SAA) functions for Unmanned Aircraft Systems (UAS) by evaluating integrity and continuity risks. Previous SAA efforts focused on relative safety metrics, such as risk ratios, comparing the risk of using an SAA system versus not using it. The methods in this thesis evaluate integrity and continuity risks as absolute measures of safety, as is the established practice in commercial aircraft terminal area navigation applications. The main contribution of this thesis is a derivation of a new method, based on a standard intruder relative constant velocity assumption, that uses hazard state estimates and estimate error covariances to establish (1) the integrity risk of the SAA system not detecting imminent loss of '"well clear," which is the time and distance required to maintain safe separation from intruder aircraft, and (2) the probability of false alert, the continuity risk. Another contribution is applying these integrity and continuity risk evaluation methods to set quantifiable and certifiable safety requirements on sensors. A sensitivity analysis uses this methodology to evaluate the impact of sensor errors on integrity and continuity risks. The penultimate contribution is an integrity and continuity risk evaluation where the estimation model is refined to address realistic intruder relative linear accelerations, which goes beyond the current constant velocity standard. The final contribution is an integrity and continuity risk evaluation addressing multiple intruders. This evaluation is a new innovation-based method to determine the risk of mis-associating intruder measurements. A mis-association occurs when the SAA system incorrectly associates a measurement to the wrong intruder, causing large errors in the estimated intruder trajectories. The new methods described in this thesis can help ensure safe encounters between aircraft and enable SAA sensor certification for UAS integration into the National Airspace System.

  6. 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

  7. The Application of a Residual Risk Evaluation Technique Used for Expendable Launch Vehicles

    NASA Technical Reports Server (NTRS)

    Latimer, John A.

    2009-01-01

    This presentation provides a Residual Risk Evaluation Technique (RRET) developed by Kennedy Space Center (KSC) Safety and Mission Assurance (S&MA) Launch Services Division. This technique is one of many procedures used by S&MA at KSC to evaluate residual risks for each Expendable Launch Vehicle (ELV) mission. RRET is a straight forward technique that incorporates the proven methodology of risk management, fault tree analysis, and reliability prediction. RRET derives a system reliability impact indicator from the system baseline reliability and the system residual risk reliability values. The system reliability impact indicator provides a quantitative measure of the reduction in the system baseline reliability due to the identified residual risks associated with the designated ELV mission. An example is discussed to provide insight into the application of RRET.

  8. Multi Criteria Evaluation Module for RiskChanges Spatial Decision Support System

    NASA Astrophysics Data System (ADS)

    Olyazadeh, Roya; Jaboyedoff, Michel; van Westen, Cees; Bakker, Wim

    2015-04-01

    Multi-Criteria Evaluation (MCE) module is one of the five modules of RiskChanges spatial decision support system. RiskChanges web-based platform aims to analyze changes in hydro-meteorological risk and provides tools for selecting the best risk reduction alternative. It is developed under CHANGES framework (changes-itn.eu) and INCREO project (increo-fp7.eu). MCE tool helps decision makers and spatial planners to evaluate, sort and rank the decision alternatives. The users can choose among different indicators that are defined within the system using Risk and Cost Benefit analysis results besides they can add their own indicators. Subsequently the system standardizes and prioritizes them. Finally, the best decision alternative is selected by using the weighted sum model (WSM). The Application of this work is to facilitate the effect of MCE for analyzing changing risk over the time under different scenarios and future years by adopting a group decision making into practice and comparing the results by numeric and graphical view within the system. We believe that this study helps decision-makers to achieve the best solution by expressing their preferences for strategies under future scenarios. Keywords: Multi-Criteria Evaluation, Spatial Decision Support System, Weighted Sum Model, Natural Hazard Risk Management

  9. Risk analysis of computer system designs

    NASA Technical Reports Server (NTRS)

    Vallone, A.

    1981-01-01

    Adverse events during implementation can affect final capabilities, schedule and cost of a computer system even though the system was accurately designed and evaluated. Risk analysis enables the manager to forecast the impact of those events and to timely ask for design revisions or contingency plans before making any decision. This paper presents a structured procedure for an effective risk analysis. The procedure identifies the required activities, separates subjective assessments from objective evaluations, and defines a risk measure to determine the analysis results. The procedure is consistent with the system design evaluation and enables a meaningful comparison among alternative designs.

  10. Summary

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

    Powell, Danny H; Elwood Jr, Robert H

    2011-01-01

    An effective risk assessment system is needed to address the threat posed by an active or passive insider who, acting alone or in collusion, could attempt diversion or theft of nuclear material. The material control and accountability (MC&A) system effectiveness tool (MSET) is a self-assessment or inspection tool utilizing probabilistic risk assessment (PRA) methodology to calculate the system effectiveness of a nuclear facility's material protection, control, and accountability (MPC&A) system. The MSET process is divided into four distinct and separate parts: (1) Completion of the questionnaire that assembles information about the operations of every aspect of the MPC&A system; (2)more » Conversion of questionnaire data into numeric values associated with risk; (3) Analysis of the numeric data utilizing the MPC&A fault tree and the SAPHIRE computer software; and (4) Self-assessment using the MSET reports to perform the effectiveness evaluation of the facility's MPC&A system. The process should lead to confirmation that mitigating features of the system effectively minimize the threat, or it could lead to the conclusion that system improvements or upgrades are necessary to achieve acceptable protection against the threat. If the need for system improvements or upgrades is indicated when the system is analyzed, MSET provides the capability to evaluate potential or actual system improvements or upgrades. A facility's MC&A system can be evaluated at a point in time. The system can be reevaluated after upgrades are implemented or after other system changes occur. The total system or specific subareas within the system can be evaluated. Areas of potential system improvement can be assessed to determine where the most beneficial and cost-effective improvements should be made. Analyses of risk importance factors show that sustainability is essential for optimal performance and reveals where performance degradation has the greatest impact on total system risk. The risk importance factors show the amount of risk reduction achievable with potential upgrades and the amount of risk reduction achieved after upgrades are completed. Applying the risk assessment tool gives support to budget prioritization by showing where budget support levels must be sustained for MC&A functions most important to risk. Results of the risk assessment are also useful in supporting funding justifications for system improvements that significantly reduce system risk. The functional model, the system risk assessment tool, and the facility evaluation questionnaire are valuable educational tools for MPC&A personnel. These educational tools provide a framework for ongoing dialogue between organizations regarding the design, development, implementation, operation, assessment, and sustainability of MPC&A systems. An organization considering the use of MSET as an analytical tool for evaluating the effectiveness of its MPC&A system will benefit from conducting a complete MSET exercise at an existing nuclear facility.« less

  11. [Biological evaluation within a risk management process].

    PubMed

    Zhuang, Fei; Ding, Biao

    2007-07-01

    Bio-evaluation within the medical device quality/risk management system is a risk analyzing and assessing process. On the basis of data from characterization of materials, scientific literatures, application history, bio-toxicology testing and so on, weighing the benefit and the risk, bio-evaluation does a conclusion to "take" or "quit" the product design. There is no "zero risk" though "no toxicity" always is the most desirable conclusion in a testing report. The application history data is the most comprehensive among the information available, since no testing system can "clone" the human body. In addition, the capital cost has to be taken into account when bringing the sophisticated testing technologies into the evaluating system. Investigating the #G95-1 of FDA CDRH and the changes of ISO 10993-1, the trend to integrate bio-evaluation into a quality/risk management process can be figured out.

  12. 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.

  13. Innovative neuro-fuzzy system of smart transport infrastructure for road traffic safety

    NASA Astrophysics Data System (ADS)

    Beinarovica, Anna; Gorobetz, Mikhail; Levchenkov, Anatoly

    2017-09-01

    The proposed study describes applying of neural network and fuzzy logic in transport control for safety improvement by evaluation of accidents’ risk by intelligent infrastructure devices. Risk evaluation is made by following multiple-criteria: danger, changeability and influence of changes for risk increasing. Neuro-fuzzy algorithms are described and proposed for task solution. The novelty of the proposed system is proved by deep analysis of known studies in the field. The structure of neuro-fuzzy system for risk evaluation and mathematical model is described in the paper. The simulation model of the intelligent devices for transport infrastructure is proposed to simulate different situations, assess the risks and propose the possible actions for infrastructure or vehicles to minimize the risk of possible accidents.

  14. Credit Risk Evaluation of Large Power Consumers Considering Power Market Transaction

    NASA Astrophysics Data System (ADS)

    Fulin, Li; Erfeng, Xu; ke, Sun; Dunnan, Liu; Shuyi, Shen

    2018-03-01

    Large power users will participate in power market in various forms after power system reform. Meanwhile, great importance has always attached to the construction of the credit system in power industry. Due to the difference between the awareness of performance and the ability to perform, credit risk of power customer will emerge accordingly. Therefore, it is critical to evaluate credit risk of large power customers in the new situation of power market. Firstly, this paper constructs index system of credit risk of large power customers, and establishes evaluation model of interval number and AHP-entropy weight method.

  15. Risk Assessment for Mobile Systems Through a Multilayered Hierarchical Bayesian Network.

    PubMed

    Li, Shancang; Tryfonas, Theo; Russell, Gordon; Andriotis, Panagiotis

    2016-08-01

    Mobile systems are facing a number of application vulnerabilities that can be combined together and utilized to penetrate systems with devastating impact. When assessing the overall security of a mobile system, it is important to assess the security risks posed by each mobile applications (apps), thus gaining a stronger understanding of any vulnerabilities present. This paper aims at developing a three-layer framework that assesses the potential risks which apps introduce within the Android mobile systems. A Bayesian risk graphical model is proposed to evaluate risk propagation in a layered risk architecture. By integrating static analysis, dynamic analysis, and behavior analysis in a hierarchical framework, the risks and their propagation through each layer are well modeled by the Bayesian risk graph, which can quantitatively analyze risks faced to both apps and mobile systems. The proposed hierarchical Bayesian risk graph model offers a novel way to investigate the security risks in mobile environment and enables users and administrators to evaluate the potential risks. This strategy allows to strengthen both app security as well as the security of the entire system.

  16. Evaluating Risk Communication After the Fukushima Disaster Based on Nudge Theory.

    PubMed

    Murakami, Michio; Tsubokura, Masaharu

    2017-03-01

    Using nudge theory and some examples of risk communication that followed the Fukushima disaster, this article discusses the influences and justifications of risk communication, in addition to how risk communication systems are designed. To assist people in making decisions based on their own value systems, we provide three suggestions, keeping in mind that people can be influenced (ie, "nudged") depending on how risk communication takes place: (1) accumulate knowledge on the process of evaluating how the method of risk communication and a system's default design could impact people; (2) clarify the purpose and outcomes of risk communication; and (3) see what risk communication might be ethically unjustifiable. Quantitative studies on risk communication and collective narratives will provide some ideas for how to design better risk communication systems and to help people make decisions. Furthermore, we have shown examples of unjustifiable risk communication.

  17. Combining glass box and black box evaluations in the identification of heart disease risk factors and their temporal relations from clinical records.

    PubMed

    Grouin, Cyril; Moriceau, Véronique; Zweigenbaum, Pierre

    2015-12-01

    The determination of risk factors and their temporal relations in natural language patient records is a complex task which has been addressed in the i2b2/UTHealth 2014 shared task. In this context, in most systems it was broadly decomposed into two sub-tasks implemented by two components: entity detection, and temporal relation determination. Task-level ("black box") evaluation is relevant for the final clinical application, whereas component-level evaluation ("glass box") is important for system development and progress monitoring. Unfortunately, because of the interaction between entity representation and temporal relation representation, glass box and black box evaluation cannot be managed straightforwardly at the same time in the setting of the i2b2/UTHealth 2014 task, making it difficult to assess reliably the relative performance and contribution of the individual components to the overall task. To identify obstacles and propose methods to cope with this difficulty, and illustrate them through experiments on the i2b2/UTHealth 2014 dataset. We outline several solutions to this problem and examine their requirements in terms of adequacy for component-level and task-level evaluation and of changes to the task framework. We select the solution which requires the least modifications to the i2b2 evaluation framework and illustrate it with our system. This system identifies risk factor mentions with a CRF system complemented by hand-designed patterns, identifies and normalizes temporal expressions through a tailored version of the Heideltime tool, and determines temporal relations of each risk factor with a One Rule classifier. Giving a fixed value to the temporal attribute in risk factor identification proved to be the simplest way to evaluate the risk factor detection component independently. This evaluation method enabled us to identify the risk factor detection component as most contributing to the false negatives and false positives of the global system. This led us to redirect further effort to this component, focusing on medication detection, with gains of 7 to 20 recall points and of 3 to 6 F-measure points depending on the corpus and evaluation. We proposed a method to achieve a clearer glass box evaluation of risk factor detection and temporal relation detection in clinical texts, which can provide an example to help system development in similar tasks. This glass box evaluation was instrumental in refocusing our efforts and obtaining substantial improvements in risk factor detection. Copyright © 2015 Elsevier Inc. All rights reserved.

  18. Earth Sciences Data and Information System (ESDIS) program planning and evaluation methodology development

    NASA Technical Reports Server (NTRS)

    Dickinson, William B.

    1995-01-01

    An Earth Sciences Data and Information System (ESDIS) Project Management Plan (PMP) is prepared. An ESDIS Project Systems Engineering Management Plan (SEMP) consistent with the developed PMP is also prepared. ESDIS and related EOS program requirements developments, management and analysis processes are evaluated. Opportunities to improve the effectiveness of these processes and program/project responsiveness to requirements are identified. Overall ESDIS cost estimation processes are evaluated, and recommendations to improve cost estimating and modeling techniques are developed. ESDIS schedules and scheduling tools are evaluated. Risk assessment, risk mitigation strategies and approaches, and use of risk information in management decision-making are addressed.

  19. Evaluation on Cost Overrun Risks of Long-distance Water Diversion Project Based on SPA-IAHP Method

    NASA Astrophysics Data System (ADS)

    Yuanyue, Yang; Huimin, Li

    2018-02-01

    Large investment, long route, many change orders and etc. are main causes for costs overrun of long-distance water diversion project. This paper, based on existing research, builds a full-process cost overrun risk evaluation index system for water diversion project, apply SPA-IAHP method to set up cost overrun risk evaluation mode, calculate and rank weight of every risk evaluation indexes. Finally, the cost overrun risks are comprehensively evaluated by calculating linkage measure, and comprehensive risk level is acquired. SPA-IAHP method can accurately evaluate risks, and the reliability is high. By case calculation and verification, it can provide valid cost overrun decision making information to construction companies.

  20. Risk assessment of logistics outsourcing based on BP neural network

    NASA Astrophysics Data System (ADS)

    Liu, Xiaofeng; Tian, Zi-you

    The purpose of this article is to evaluate the risk of the enterprises logistics outsourcing. To get this goal, the paper first analysed he main risks existing in the logistics outsourcing, and then set up a risk evaluation index system of the logistics outsourcing; second applied BP neural network into the logistics outsourcing risk evaluation and used MATLAB to the simulation. It proved that the network error is small and has strong practicability. And this method can be used by enterprises to evaluate the risks of logistics outsourcing.

  1. Human System Drivers for Exploration Missions

    NASA Technical Reports Server (NTRS)

    Kundrot, Craig E.; Steinberg, Susan; Charles, John B.

    2010-01-01

    Evaluation of DRM4 in terms of the human system includes the ability to meet NASA standards, the inclusion of the human system in the design trade space, preparation for future missions and consideration of a robotic precursor mission. Ensuring both the safety and the performance capability of the human system depends upon satisfying NASA Space Flight Human System Standards.1 These standards in turn drive the development of program-specific requirements for Near-earth Object (NEO) missions. In evaluating DRM4 in terms of these human system standards, the currently existing risk models, technologies and biological countermeasures were used. A summary of this evaluation is provided below in a structure that supports a mission architecture planning activities. 1. Unacceptable Level of Risk The duration of the DRM4 mission leads to an unacceptable level of risk for two aspects of human system health: A. The permissible exposure limit for space flight radiation exposure (a human system standard) would be exceeded by DRM4. B. The risk of visual alterations and abnormally high intracranial pressure would be too high. 1

  2. ORANGES evaluation phase I risk assessment report : phase I of the US DOT sponsored evaluation of the ORANGES electronic payment system field operational test

    DOT National Transportation Integrated Search

    2004-03-11

    This document is the US DOT evaluation Risk Assessment report for Phase I of the ORANGES field operational test. This document consolidates working papers and incorporates an assessment of issues, risks, mitigation strategies and lessons learned look...

  3. Vulnerability Analysis and Evaluation of Urban Road System in Tianjin

    NASA Astrophysics Data System (ADS)

    Liu, Y. Q.; Wu, X.

    In recent years, with the development of economy, the road construction of our country has entered into a period of rapid growth. The road transportation network has been expanding and the risk of disasters is increasing. In this paper we study the vulnerability of urban road system in Tianjin. After analyzed many risk factors of the urban road system security, including road construction, road traffic and the natural environment, we proposed an evaluation index of vulnerability of urban road system and established the corresponding evaluation index system. Based on the results of analysis and comprehensive evaluation, appropriate improvement measures and suggestions which may reduce the vulnerability of the road system and improve the safety and reliability of the road system are proposed.

  4. Integrated risk assessment and screening analysis of drinking water safety of a conventional water supply system.

    PubMed

    Sun, F; Chen, J; Tong, Q; Zeng, S

    2007-01-01

    Management of drinking water safety is changing towards an integrated risk assessment and risk management approach that includes all processes in a water supply system from catchment to consumers. However, given the large number of water supply systems in China and the cost of implementing such a risk assessment procedure, there is a necessity to first conduct a strategic screening analysis at a national level. An integrated methodology of risk assessment and screening analysis is thus proposed to evaluate drinking water safety of a conventional water supply system. The violation probability, indicating drinking water safety, is estimated at different locations of a water supply system in terms of permanganate index, ammonia nitrogen, turbidity, residual chlorine and trihalomethanes. Critical parameters with respect to drinking water safety are then identified, based on which an index system is developed to prioritize conventional water supply systems in implementing a detailed risk assessment procedure. The evaluation results are represented as graphic check matrices for the concerned hazards in drinking water, from which the vulnerability of a conventional water supply system is characterized.

  5. Occupational health and safety: Designing and building with MACBETH a value risk-matrix for evaluating health and safety risks

    NASA Astrophysics Data System (ADS)

    Lopes, D. F.; Oliveira, M. D.; Costa, C. A. Bana e.

    2015-05-01

    Risk matrices (RMs) are commonly used to evaluate health and safety risks. Nonetheless, they violate some theoretical principles that compromise their feasibility and use. This study describes how multiple criteria decision analysis methods have been used to improve the design and the deployment of RMs to evaluate health and safety risks at the Occupational Health and Safety Unit (OHSU) of the Regional Health Administration of Lisbon and Tagus Valley. ‘Value risk-matrices’ (VRMs) are built with the MACBETH approach in four modelling steps: a) structuring risk impacts, involving the construction of descriptors of impact that link risk events with health impacts and are informed by scientific evidence; b) generating a value measurement scale of risk impacts, by applying the MACBETH-Choquet procedure; c) building a system for eliciting subjective probabilities that makes use of a numerical probability scale that was constructed with MACBETH qualitative judgments on likelihood; d) and defining a classification colouring scheme for the VRM. A VRM built with OHSU members was implemented in a decision support system which will be used by OHSU members to evaluate health and safety risks and to identify risk mitigation actions.

  6. Human System Risk Management - Tools of our Trade

    NASA Technical Reports Server (NTRS)

    Ott, C. Mark

    2009-01-01

    The risk of infectious disease to select individuals has historically been difficult to predict in either spaceflight or on Earth with health care efforts relying on broad-based prevention and post-infection treatment. Over the past 10 years, quantitative microbial risk assessment evaluations have evolved to formalize the assessment process and quantify the risk. This process of hazard identification, exposure assessment, dose-response assessment, and risk characterization has been applied by the water and food safety industries to address the public health impacts associated with the occurrence of and human exposure to pathogens in water and food for the development of preventive strategies for microbial disease. NASA is currently investigating the feasibility of using these techniques to better understand the risks to astronauts and refine their microbiological requirements. To assess these techniques, NASA began an evaluation of the potable water system on the International Space Station to determine how the microbial risk from water consumption during flight differed from terrestrial sources, such as municipal water systems. The ultimate goal of this work is to optimize microbial requirements which would minimize unnecessary cargo and use of crew time, while still protecting the health of the crew. Successful demonstration of this risk assessment framework with the water system holds the potential to maximize the use of available resources during spaceflight missions and facilitate investigations into the evaluation of other routes of infection, such as through the spaceflight foods system.

  7. A Risk Score Model for Evaluation and Management of Patients with Thyroid Nodules.

    PubMed

    Zhang, Yongwen; Meng, Fanrong; Hong, Lianqing; Chu, Lanfang

    2018-06-12

    The study is aimed to establish a simplified and practical tool for analyzing thyroid nodules. A novel risk score model was designed, risk factors including patient history, patient characteristics, physical examination, symptoms of compression, thyroid function, ultrasonography (US) of thyroid and cervical lymph nodes were evaluated and classified into high risk factors, intermediate risk factors, and low risk factors. A total of 243 thyroid nodules in 162 patients were assessed with risk score system and Thyroid Imaging-Reporting and Data System (TI-RADS). The diagnostic performance of risk score system and TI-RADS was compared. The accuracy in the diagnosis of thyroid nodules was 89.3% for risk score system, 74.9% for TI-RADS respectively. The specificity, accuracy and positive predictive value (PPV) of risk score system were significantly higher than the TI-RADS system (χ 2 =26.287, 17.151, 11.983; p <0.05), statistically significant differences were not observed in the sensitivity and negative predictive value (NPV) between the risk score system and TI-RADS (χ 2 =1.276, 0.290; p>0.05). The area under the curve (AUC) for risk score diagnosis system was 0.963, standard error 0.014, 95% confidence interval (CI)=0.934-0.991, the AUC for TI-RADS diagnosis system was 0.912 with standard error 0.021, 95% CI=0.871-0.953, the AUC for risk score system was significantly different from that of TI-RADS (Z=2.02; p <0.05). Risk score model is a reliable, simplified and cost-effective diagnostic tool used in diagnosis of thyroid cancer. The higher the score is, the higher the risk of malignancy will be. © Georg Thieme Verlag KG Stuttgart · New York.

  8. DTREEv2, a computer-based support system for the risk assessment of genetically modified plants.

    PubMed

    Pertry, Ine; Nothegger, Clemens; Sweet, Jeremy; Kuiper, Harry; Davies, Howard; Iserentant, Dirk; Hull, Roger; Mezzetti, Bruno; Messens, Kathy; De Loose, Marc; de Oliveira, Dulce; Burssens, Sylvia; Gheysen, Godelieve; Tzotzos, George

    2014-03-25

    Risk assessment of genetically modified organisms (GMOs) remains a contentious area and a major factor influencing the adoption of agricultural biotech. Methodologically, in many countries, risk assessment is conducted by expert committees with little or no recourse to databases and expert systems that can facilitate the risk assessment process. In this paper we describe DTREEv2, a computer-based decision support system for the identification of hazards related to the introduction of GM-crops into the environment. DTREEv2 structures hazard identification and evaluation by means of an Event-Tree type of analysis. The system produces an output flagging identified hazards and potential risks. It is intended to be used for the preparation and evaluation of biosafety dossiers and, as such, its usefulness extends to researchers, risk assessors and regulators in government and industry. Copyright © 2013 Elsevier B.V. All rights reserved.

  9. Research on efficiency evaluation model of integrated energy system based on hybrid multi-attribute decision-making.

    PubMed

    Li, Yan

    2017-05-25

    The efficiency evaluation model of integrated energy system, involving many influencing factors, and the attribute values are heterogeneous and non-deterministic, usually cannot give specific numerical or accurate probability distribution characteristics, making the final evaluation result deviation. According to the characteristics of the integrated energy system, a hybrid multi-attribute decision-making model is constructed. The evaluation model considers the decision maker's risk preference. In the evaluation of the efficiency of the integrated energy system, the evaluation value of some evaluation indexes is linguistic value, or the evaluation value of the evaluation experts is not consistent. These reasons lead to ambiguity in the decision information, usually in the form of uncertain linguistic values and numerical interval values. In this paper, the risk preference of decision maker is considered when constructing the evaluation model. Interval-valued multiple-attribute decision-making method and fuzzy linguistic multiple-attribute decision-making model are proposed. Finally, the mathematical model of efficiency evaluation of integrated energy system is constructed.

  10. Assessing the Fire Risk for a Historic Hangar

    NASA Technical Reports Server (NTRS)

    Datta, Koushik; Morrison, Richard S.

    2010-01-01

    NASA Ames Research Center (ARC) is evaluating options of reuse of its historic Hangar 1. As a part of this evaluation, a qualitative fire risk assessment study was performed to evaluate the potential threat of combustion of the historic hangar. The study focused on the fire risk trade-off of either installing or not installing a Special Hazard Fire Suppression System in the Hangar 1 deck areas. The assessment methodology was useful in discussing the important issues among various groups within the Center. Once the methodology was deemed acceptable, the results were assessed. The results showed that the risk remained in the same risk category, whether Hangar 1 does or does not have a Special Hazard Fire Suppression System. Note that the methodology assessed the risk to Hangar 1 and not the risk to an aircraft in the hangar. If one had a high value aircraft, the aircraft risk analysis could potentially show a different result. The assessed risk results were then communicated to management and other stakeholders.

  11. Evaluating the Effectiveness of Auditing Rules for Electronic Health Record Systems

    PubMed Central

    Hedda, Monica; Malin, Bradley A.; Yan, Chao; Fabbri, Daniel

    2017-01-01

    Healthcare organizations (HCOs) often deploy rule-based auditing systems to detect insider threats to sensitive patient health information in electronic health record (EHR) systems. These rule-based systems define behavior deemed to be high-risk a priori (e.g., family member, co-worker access). While such rules seem logical, there has been little scientific investigation into the effectiveness of these auditing rules in identifying inappropriate behavior. Thus, in this paper, we introduce an approach to evaluate the effectiveness of individual high-risk rules and rank them according to their potential risk. We investigate the rate of high-risk access patterns and minimum rate of high-risk accesses that can be explained with appropriate clinical reasons in a large EHR system. An analysis of 8M accesses from one-week of data shows that specific high-risk flags occur more frequently than theoretically expected and the rate at which accesses can be explained away with five simple reasons is 16 - 43%. PMID:29854153

  12. Evaluating the Effectiveness of Auditing Rules for Electronic Health Record Systems.

    PubMed

    Hedda, Monica; Malin, Bradley A; Yan, Chao; Fabbri, Daniel

    2017-01-01

    Healthcare organizations (HCOs) often deploy rule-based auditing systems to detect insider threats to sensitive patient health information in electronic health record (EHR) systems. These rule-based systems define behavior deemed to be high-risk a priori (e.g., family member, co-worker access). While such rules seem logical, there has been little scientific investigation into the effectiveness of these auditing rules in identifying inappropriate behavior. Thus, in this paper, we introduce an approach to evaluate the effectiveness of individual high-risk rules and rank them according to their potential risk. We investigate the rate of high-risk access patterns and minimum rate of high-risk accesses that can be explained with appropriate clinical reasons in a large EHR system. An analysis of 8M accesses from one-week of data shows that specific high-risk flags occur more frequently than theoretically expected and the rate at which accesses can be explained away with five simple reasons is 16 - 43%.

  13. A Study on the Perceived Risk of Surface Sample Collection Systems in Proposal Formulation

    NASA Technical Reports Server (NTRS)

    Sunday, Cecily M.

    2012-01-01

    This project compares design and proposal elements from multiple proposals and presents conclusions and recommendations for sampling systems. Contributions from this project include a list of common evaluation themes, concept and proposal-related strengths and weaknesses and ways in which self-identified risks relate the evaluation of the mission.

  14. [Study on building index system of risk assessment of post-marketing Chinese patent medicine based on AHP-fuzzy neural network].

    PubMed

    Li, Yuanyuan; Xie, Yanming; Fu, Yingkun

    2011-10-01

    Currently massive researches have been launched about the safety, efficiency and economy of post-marketing Chinese patent medicine (CPM) proprietary Chinese medicine, but it was lack of a comprehensive interpretation. Establishing the risk evaluation index system and risk assessment model of CPM is the key to solve drug safety problems and protect people's health. The clinical risk factors of CPM exist similarities with the Western medicine, can draw lessons from foreign experience, but also have itself multi-factor multivariate multi-level complex features. Drug safety risk assessment for the uncertainty and complexity, using analytic hierarchy process (AHP) to empower the index weights, AHP-based fuzzy neural network to build post-marketing CPM risk evaluation index system and risk assessment model and constantly improving the application of traditional Chinese medicine characteristic is accord with the road and feasible beneficial exploration.

  15. Models of evaluating efficiency and risks on integration of cloud-base IT-services of the machine-building enterprise: a system approach

    NASA Astrophysics Data System (ADS)

    Razumnikov, S.; Kurmanbay, A.

    2016-04-01

    The present paper suggests a system approach to evaluation of the effectiveness and risks resulted from the integration of cloud-based services in a machine-building enterprise. This approach makes it possible to estimate a set of enterprise IT applications and choose the applications to be migrated to the cloud with regard to specific business requirements, a technological strategy and willingness to risk.

  16. Management of high-risk perioperative systems.

    PubMed

    Dain, Steven

    2006-06-01

    The perioperative system is a complex system that requires people, materials, and processes to come together in a highly ordered and timely manner. However, when working in this high-risk system, even well-organized, knowledgeable, vigilant, and well-intentioned individuals will eventually make errors. All systems need to be evaluated on a continual basis to reduce the risk of errors, make errors more easily recognizable, and provide methods for error mitigation. A simple approach to risk management that may be applied in clinical medicine is discussed.

  17. Metal Vapor Arcing Risk Assessment Tool

    NASA Technical Reports Server (NTRS)

    Hill, Monika C.; Leidecker, Henning W.

    2010-01-01

    The Tin Whisker Metal Vapor Arcing Risk Assessment Tool has been designed to evaluate the risk of metal vapor arcing and to help facilitate a decision toward a researched risk disposition. Users can evaluate a system without having to open up the hardware. This process allows for investigating components at risk rather than spending time and money analyzing every component. The tool points to a risk level and provides direction for appropriate action and documentation.

  18. Evaluation of forest management systems under risk of wildfire

    Treesearch

    Kari Hyytiainen; Robert G. Haight

    2010-01-01

    We evaluate the economic efficiency of even- and uneven-aged management systems under risk of wildfire. The management problems are formulated for a mixed-conifer stand and approximations of the optimal solutions are obtained using simulation optimization. The Northern Idaho variant of the Forest Vegetation Simulator and its Fire and Fuels Extension is used to predict...

  19. NASA System Safety Handbook. Volume 2: System Safety Concepts, Guidelines, and Implementation Examples

    NASA Technical Reports Server (NTRS)

    Dezfuli, Homayoon; Benjamin, Allan; Everett, Christopher; Feather, Martin; Rutledge, Peter; Sen, Dev; Youngblood, Robert

    2015-01-01

    This is the second of two volumes that collectively comprise the NASA System Safety Handbook. Volume 1 (NASASP-210-580) was prepared for the purpose of presenting the overall framework for System Safety and for providing the general concepts needed to implement the framework. Volume 2 provides guidance for implementing these concepts as an integral part of systems engineering and risk management. This guidance addresses the following functional areas: 1.The development of objectives that collectively define adequate safety for a system, and the safety requirements derived from these objectives that are levied on the system. 2.The conduct of system safety activities, performed to meet the safety requirements, with specific emphasis on the conduct of integrated safety analysis (ISA) as a fundamental means by which systems engineering and risk management decisions are risk-informed. 3.The development of a risk-informed safety case (RISC) at major milestone reviews to argue that the systems safety objectives are satisfied (and therefore that the system is adequately safe). 4.The evaluation of the RISC (including supporting evidence) using a defined set of evaluation criteria, to assess the veracity of the claims made therein in order to support risk acceptance decisions.

  20. A neural network model for credit risk evaluation.

    PubMed

    Khashman, Adnan

    2009-08-01

    Credit scoring is one of the key analytical techniques in credit risk evaluation which has been an active research area in financial risk management. This paper presents a credit risk evaluation system that uses a neural network model based on the back propagation learning algorithm. We train and implement the neural network to decide whether to approve or reject a credit application, using seven learning schemes and real world credit applications from the Australian credit approval datasets. A comparison of the system performance under the different learning schemes is provided, furthermore, we compare the performance of two neural networks; with one and two hidden layers following the ideal learning scheme. Experimental results suggest that neural networks can be effectively used in automatic processing of credit applications.

  1. Overview and Demonstration of USEPA’s Risk-Informed Materials Management (RIMM) Tool System

    EPA Science Inventory

    The Risk-Informed Materials Management (RIMM) Tool System is a data gathering and analysis platform for conducting material disposal and beneficial use assessments. Users can evaluate risks to human and ecological receptors associated with exposures to organic and inorganic chemi...

  2. Constellation Program (CxP) Crew Exploration Vehicle (CEV) Project Integrated Landing System

    NASA Technical Reports Server (NTRS)

    Baker, John D.; Yuchnovicz, Daniel E.; Eisenman, David J.; Peer, Scott G.; Fasanella, Edward L.; Lawrence, Charles

    2009-01-01

    Crew Exploration Vehicle (CEV) Chief Engineer requested a risk comparison of the Integrated Landing System design developed by NASA and the design developed by Contractor- referred to as the LM 604 baseline. Based on the results of this risk comparison, the CEV Chief engineer requested that the NESC evaluate identified risks and develop strategies for their reduction or mitigation. The assessment progressed in two phases. A brief Phase I analysis was performed by the Water versus Land-Landing Team to compare the CEV Integrated Landing System proposed by the Contractor against the NASA TS-LRS001 baseline with respect to risk. A phase II effort examined the areas of critical importance to the overall landing risk, evaluating risk to the crew and to the CEV Crew Module (CM) during a nominal land-landing. The findings of the assessment are contained in this report.

  3. 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.

  4. Evaluation of a Real-Time Monitoring System for River Quality-A Trade-off between Risk Attitudes, Costs, and Uncertainly.

    ERIC Educational Resources Information Center

    Varis, Olli; And Others

    1993-01-01

    Presents one approach to handling the trade-off between reducing uncertainty in environmental assessment and management and additional expenses. Uses the approach in the evaluation of three alternatives for a real time river water quality forecasting system. Analysis of risk attitudes, costs and uncertainty indicated the levels of socioeconomic…

  5. 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.

  6. 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

  7. 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.

  8. Low-thrust mission risk analysis, with application to a 1980 rendezvous with the comet Encke

    NASA Technical Reports Server (NTRS)

    Yen, C. L.; Smith, D. B.

    1973-01-01

    A computerized failure process simulation procedure is used to evaluate the risk in a solar electric space mission. The procedure uses currently available thrust-subsystem reliability data and performs approximate simulations of the thrust sybsystem burn operation, the system failure processes, and the retargeting operations. The method is applied to assess the risks in carrying out a 1980 rendezvous mission to the comet Encke. Analysis of the results and evaluation of the effects of various risk factors on the mission show that system component failure rates are the limiting factors in attaining a high mission relability. It is also shown that a well-designed trajectory and system operation mode can be used effectively to partially compensate for unreliable thruster performance.

  9. A quantitative evaluation of a qualitative risk assessment framework: Examining the assumptions and predictions of the Productivity Susceptibility Analysis (PSA)

    PubMed Central

    2018-01-01

    Qualitative risk assessment frameworks, such as the Productivity Susceptibility Analysis (PSA), have been developed to rapidly evaluate the risks of fishing to marine populations and prioritize management and research among species. Despite being applied to over 1,000 fish populations, and an ongoing debate about the most appropriate method to convert biological and fishery characteristics into an overall measure of risk, the assumptions and predictive capacity of these approaches have not been evaluated. Several interpretations of the PSA were mapped to a conventional age-structured fisheries dynamics model to evaluate the performance of the approach under a range of assumptions regarding exploitation rates and measures of biological risk. The results demonstrate that the underlying assumptions of these qualitative risk-based approaches are inappropriate, and the expected performance is poor for a wide range of conditions. The information required to score a fishery using a PSA-type approach is comparable to that required to populate an operating model and evaluating the population dynamics within a simulation framework. In addition to providing a more credible characterization of complex system dynamics, the operating model approach is transparent, reproducible and can evaluate alternative management strategies over a range of plausible hypotheses for the system. PMID:29856869

  10. 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.

  11. A Knowledge-Base for a Personalized Infectious Disease Risk Prediction System.

    PubMed

    Vinarti, Retno; Hederman, Lucy

    2018-01-01

    We present a knowledge-base to represent collated infectious disease risk (IDR) knowledge. The knowledge is about personal and contextual risk of contracting an infectious disease obtained from declarative sources (e.g. Atlas of Human Infectious Diseases). Automated prediction requires encoding this knowledge in a form that can produce risk probabilities (e.g. Bayesian Network - BN). The knowledge-base presented in this paper feeds an algorithm that can auto-generate the BN. The knowledge from 234 infectious diseases was compiled. From this compilation, we designed an ontology and five rule types for modelling IDR knowledge in general. The evaluation aims to assess whether the knowledge-base structure, and its application to three disease-country contexts, meets the needs of personalized IDR prediction system. From the evaluation results, the knowledge-base conforms to the system's purpose: personalization of infectious disease risk.

  12. Assessment of Risk Evaluation Procedures for USACE Bridges

    DTIC Science & Technology

    2018-03-19

    upon a well-suited inventory management system, it is too heavily dependent upon subjective assessments by select individuals and that risk of failure...3 Bridge Management Systems...4 3 USACE Bridge Management

  13. Risk Management for Weapon Systems Acquisition: A Decision Support System

    DTIC Science & Technology

    1985-02-28

    includes the program evaluation and review technique (PERT) for network analysis, the PMRM for quantifying risk , an optimization package for generating...Despite the inclusion of uncertainty in time, PERT can at best be considered as a tool for quantifying risk with regard to the time element only. Moreover

  14. Developing and evaluating an automated appendicitis risk stratification algorithm for pediatric patients in the emergency department.

    PubMed

    Deleger, Louise; Brodzinski, Holly; Zhai, Haijun; Li, Qi; Lingren, Todd; Kirkendall, Eric S; Alessandrini, Evaline; Solti, Imre

    2013-12-01

    To evaluate a proposed natural language processing (NLP) and machine-learning based automated method to risk stratify abdominal pain patients by analyzing the content of the electronic health record (EHR). We analyzed the EHRs of a random sample of 2100 pediatric emergency department (ED) patients with abdominal pain, including all with a final diagnosis of appendicitis. We developed an automated system to extract relevant elements from ED physician notes and lab values and to automatically assign a risk category for acute appendicitis (high, equivocal, or low), based on the Pediatric Appendicitis Score. We evaluated the performance of the system against a manually created gold standard (chart reviews by ED physicians) for recall, specificity, and precision. The system achieved an average F-measure of 0.867 (0.869 recall and 0.863 precision) for risk classification, which was comparable to physician experts. Recall/precision were 0.897/0.952 in the low-risk category, 0.855/0.886 in the high-risk category, and 0.854/0.766 in the equivocal-risk category. The information that the system required as input to achieve high F-measure was available within the first 4 h of the ED visit. Automated appendicitis risk categorization based on EHR content, including information from clinical notes, shows comparable performance to physician chart reviewers as measured by their inter-annotator agreement and represents a promising new approach for computerized decision support to promote application of evidence-based medicine at the point of care.

  15. Credit Risk Evaluation of Power Market Players with Random Forest

    NASA Astrophysics Data System (ADS)

    Umezawa, Yasushi; Mori, Hiroyuki

    A new method is proposed for credit risk evaluation in a power market. The credit risk evaluation is to measure the bankruptcy risk of the company. The power system liberalization results in new environment that puts emphasis on the profit maximization and the risk minimization. There is a high probability that the electricity transaction causes a risk between companies. So, power market players are concerned with the risk minimization. As a management strategy, a risk index is requested to evaluate the worth of the business partner. This paper proposes a new method for evaluating the credit risk with Random Forest (RF) that makes ensemble learning for the decision tree. RF is one of efficient data mining technique in clustering data and extracting relationship between input and output data. In addition, the method of generating pseudo-measurements is proposed to improve the performance of RF. The proposed method is successfully applied to real financial data of energy utilities in the power market. A comparison is made between the proposed and the conventional methods.

  16. The safer clinical systems project in renal care.

    PubMed

    Weale, Andy R

    2013-09-01

    Current systems in place in healthcare are designed to detect harm after it has happened (e.g critical incident reports) and make recommendations based on an assessment of that event. Safer Clinical Systems, a Health Foundation funded project, is designed to proactively search for risk within systems, rather than being reactive to harm. The aim of the Safer Clinical Systems project in Renal Care was to reduce the risks associated with shared care for patients who are undergoing surgery but are looked after peri-operatively by nephrology teams on nephrology wards. This report details our findings of the diagnostic phase of Safer Clinical Systems: the proactive search for risk. We have evaluated the current system of care using a set of risk evaluation and process mapping tools (Failure Modes and Effects Analysis (FMEA) and Hierarchical Task Analysis HTA). We have engaged staff with the process mapping and risk assessment tools. We now understand our system and understand where the highest risk tasks are undertaken during a renal in-patient stay during which a patient has an operation. These key tasks occur across the perioperaive period and are not confined to one aspect of care. A measurement strategy and intervention plan have been designed around these tasks. Safer Clinical Systems has identified high risk, low reliability tasks in our system. We look forward to fully reporting these data in 2014. © 2013 European Dialysis and Transplant Nurses Association/European Renal Care Association.

  17. [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.

  18. [Development and clinical evaluation of an anesthesia information management system].

    PubMed

    Feng, Jing-yi; Chen, Hua; Zhu, Sheng-mei

    2010-09-21

    To study the design, implementation and clinical evaluation of an anesthesia information management system. To record, process and store peri-operative patient data automatically, all kinds of bedside monitoring equipments are connected into the system based on information integrating technology; after a statistical analysis of those patient data by data mining technology, patient status can be evaluated automatically based on risk prediction standard and decision support system, and then anesthetist could perform reasonable and safe clinical processes; with clinical processes electronically recorded, standard record tables could be generated, and clinical workflow is optimized, as well. With the system, kinds of patient data could be collected, stored, analyzed and archived, kinds of anesthesia documents could be generated, and patient status could be evaluated to support clinic decision. The anesthesia information management system is useful for improving anesthesia quality, decreasing risk of patient and clinician, and aiding to provide clinical proof.

  19. Interim reliability-evaluation program: analysis of the Browns Ferry, Unit 1, nuclear plant. Appendix B - system descriptions and fault trees

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

    Mays, S.E.; Poloski, J.P.; Sullivan, W.H.

    1982-07-01

    This report describes a risk study of the Browns Ferry, Unit 1, nuclear plant. The study is one of four such studies sponsored by the NRC Office of Research, Division of Risk Assessment, as part of its Interim Reliability Evaluation Program (IREP), Phase II. This report is contained in four volumes: a main report and three appendixes. Appendix B provides a description of Browns Ferry, Unit 1, plant systems and the failure evaluation of those systems as they apply to accidents at Browns Ferry. Information is presented concerning front-line system fault analysis; support system fault analysis; human error models andmore » probabilities; and generic control circuit analyses.« less

  20. Loss of Coolant Accident (LOCA) / Emergency Core Coolant System (ECCS Evaluation of Risk-Informed Margins Management Strategies for a Representative Pressurized Water Reactor (PWR)

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

    Szilard, Ronaldo Henriques

    A Risk Informed Safety Margin Characterization (RISMC) toolkit and methodology are proposed for investigating nuclear power plant core, fuels design and safety analysis, including postulated Loss-of-Coolant Accident (LOCA) analysis. This toolkit, under an integrated evaluation model framework, is name LOCA toolkit for the US (LOTUS). This demonstration includes coupled analysis of core design, fuel design, thermal hydraulics and systems analysis, using advanced risk analysis tools and methods to investigate a wide range of results.

  1. International Space Station (ISS) Orbital Replaceable Unit (ORU) Wet Storage Risk Assessment

    NASA Technical Reports Server (NTRS)

    Squire, Michael D.; Rotter, Henry A.; Lee, Jason; Packham, Nigel; Brady, Timothy K.; Kelly, Robert; Ott, C. Mark

    2014-01-01

    The International Space Station (ISS) Program requested the NASA Engineering and Safety Center (NESC) to evaluate the risks posed by the practice of long-term wet storage of ISS Environmental Control and Life Support (ECLS) regeneration system orbital replacement units (ORUs). The ISS ECLS regeneration system removes water from urine and humidity condensate and converts it into potable water and oxygen. A total of 29 ORUs are in the ECLS system, each designed to be replaced by the ISS crew when necessary. The NESC assembled a team to review the ISS ECLS regeneration system and evaluate the potential for biofouling and corrosion. This document contains the outcome of the evaluation.

  2. [Evaluation of public health risk. A new instrument for environmental management in Chile].

    PubMed

    Matus C, Patricia

    2011-08-01

    One of the main challenges in environmental management is to prevent the public health impact of projects that can cause pollution. To tackle this problem, the new Chilean bill on environmental management has defined the need to determine the potential health risks of a given Project. This paper gives a summary of the method used for risk evaluation and its evolution. Its incorporation in the Environmental Impact Evaluation System is proposed, to guarantee an effective prevention of the potential risks on health of new projects.

  3. [Study on the risk assessment method of regional groundwater pollution].

    PubMed

    Yang, Yan; Yu, Yun-Jiang; Wang, Zong-Qing; Li, Ding-Long; Sun, Hong-Wei

    2013-02-01

    Based on the boundary elements of system risk assessment, the regional groundwater pollution risk assessment index system was preliminarily established, which included: regional groundwater specific vulnerability assessment, the regional pollution sources characteristics assessment and the health risk assessment of regional featured pollutants. The three sub-evaluation systems were coupled with the multi-index comprehensive method, the risk was characterized with the Spatial Analysis of ArcMap, and a new method to evaluate regional groundwater pollution risk that suitable for different parts of natural conditions, different types of pollution was established. Take Changzhou as an example, the risk of shallow groundwater pollution was studied with the new method, and found that the vulnerability index of groundwater in Changzhou is high and distributes unevenly; The distribution of pollution sources is concentrated and has a great impact on groundwater pollution risks; Influenced by the pollutants and pollution sources, the values of health risks are high in the urban area of Changzhou. The pollution risk of shallow groundwater is high and distributes unevenly, and distributes in the north of the line of Anjia-Xuejia-Zhenglu, the center of the city and the southeast, where the human activities are more intense and the pollution sources are intensive.

  4. Evaluating the Benefits of Adaptation of Critical Infrastructures to Hydrometeorological Risks.

    PubMed

    Thacker, Scott; Kelly, Scott; Pant, Raghav; Hall, Jim W

    2018-01-01

    Infrastructure adaptation measures provide a practical way to reduce the risk from extreme hydrometeorological hazards, such as floods and windstorms. The benefit of adapting infrastructure assets is evaluated as the reduction in risk relative to the "do nothing" case. However, evaluating the full benefits of risk reduction is challenging because of the complexity of the systems, the scarcity of data, and the uncertainty of future climatic changes. We address this challenge by integrating methods from the study of climate adaptation, infrastructure systems, and complex networks. In doing so, we outline an infrastructure risk assessment that incorporates interdependence, user demands, and potential failure-related economic losses. Individual infrastructure assets are intersected with probabilistic hazard maps to calculate expected annual damages. Protection measure costs are integrated to calculate risk reduction and associated discounted benefits, which are used to explore the business case for investment in adaptation. A demonstration of the methodology is provided for flood protection of major electricity substations in England and Wales. We conclude that the ongoing adaptation program for major electricity assets is highly cost beneficial. © 2017 Society for Risk Analysis.

  5. Polycyclic aromatic hydrocarbons (PAH) in superficial water from a tropical estuarine system: Distribution, seasonal variations, sources and ecological risk assessment.

    PubMed

    Santos, Ewerton; Souza, Michel R R; Vilela Junior, Antônio R; Soares, Laiane S; Frena, Morgana; Alexandre, Marcelo R

    2018-02-01

    This study aimed to evaluate the PAH distribution, sources, seasonal variations and ecological risk assessment in superficial water from the Japaratuba River, Brazil. PAH concentrations ranged from 4 to 119ngL -1 . It was observed that the PAH total concentrations and profiles showed significant differences when comparing the dry season (summer) with the rainy season (winter). Furthermore, most of the PAH originated from pyrogenic sources in the winter, whereas a mixture of sources was observed in the summer. PAH concentration levels found in this study were considered lower than those obtained in other estuarine systems. Ecological risk assessment was determined for individual PAH, based on the risk quotient (RQ) to evaluate the risk of aquatic biota's exposure to PAH. Results suggested that the Japaratuba River has achieved a moderate degree of ecological risk for high molecular weight, showing the importance of identifying these carcinogenic and mutagenic compounds in aquatic systems. Copyright © 2017 Elsevier Ltd. All rights reserved.

  6. Reliability of Modern Scores to Predict Long-Term Mortality After Isolated Aortic Valve Operations.

    PubMed

    Barili, Fabio; Pacini, Davide; D'Ovidio, Mariangela; Ventura, Martina; Alamanni, Francesco; Di Bartolomeo, Roberto; Grossi, Claudio; Davoli, Marina; Fusco, Danilo; Perucci, Carlo; Parolari, Alessandro

    2016-02-01

    Contemporary scores for estimating perioperative death have been proposed to also predict also long-term death. The aim of the study was to evaluate the performance of the updated European System for Cardiac Operative Risk Evaluation II, The Society of Thoracic Surgeons Predicted Risk of Mortality score, and the Age, Creatinine, Left Ventricular Ejection Fraction score for predicting long-term mortality in a contemporary cohort of isolated aortic valve replacement (AVR). We also sought to develop for each score a simple algorithm based on predicted perioperative risk to predict long-term survival. Complete data on 1,444 patients who underwent isolated AVR in a 7-year period were retrieved from three prospective institutional databases and linked with the Italian Tax Register Information System. Data were evaluated with performance analyses and time-to-event semiparametric regression. Survival was 83.0% ± 1.1% at 5 years and 67.8 ± 1.9% at 8 years. Discrimination and calibration of all three scores both worsened for prediction of death at 1 year and 5 years. Nonetheless, a significant relationship was found between long-term survival and quartiles of scores (p < 0.0001). The estimated perioperative risk by each model was used to develop an algorithm to predict long-term death. The hazard ratios for death were 1.1 (95% confidence interval, 1.07 to 1.12) for European System for Cardiac Operative Risk Evaluation II, 1.34 (95% CI, 1.28 to 1.40) for the Society of Thoracic Surgeons score, and 1.08 (95% CI, 1.06 to 1.10) for the Age, Creatinine, Left Ventricular Ejection Fraction score. The predicted risk generated by European System for Cardiac Operative Risk Evaluation II, The Society of Thoracic Surgeons score, and Age, Creatinine, Left Ventricular Ejection Fraction scores cannot also be considered a direct estimate of the long-term risk for death. Nonetheless, the three scores can be used to derive an estimate of long-term risk of death in patients who undergo isolated AVR with the use of a simple algorithm. Copyright © 2016 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

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

    PIEPHO, M.G.

    Four bounding accidents postulated for the K West Basin integrated water treatment system are evaluated against applicable risk evaluation guidelines. The accidents are a spray leak during fuel retrieval, spray leak during backflushing a hydrogen explosion, and a fire breaching filter vessel and enclosure. Event trees and accident probabilities are estimated. In all cases, the unmitigated dose consequences are below the risk evaluation guidelines.

  8. Trade Studies of Space Launch Architectures using Modular Probabilistic Risk Analysis

    NASA Technical Reports Server (NTRS)

    Mathias, Donovan L.; Go, Susie

    2006-01-01

    A top-down risk assessment in the early phases of space exploration architecture development can provide understanding and intuition of the potential risks associated with new designs and technologies. In this approach, risk analysts draw from their past experience and the heritage of similar existing systems as a source for reliability data. This top-down approach captures the complex interactions of the risk driving parts of the integrated system without requiring detailed knowledge of the parts themselves, which is often unavailable in the early design stages. Traditional probabilistic risk analysis (PRA) technologies, however, suffer several drawbacks that limit their timely application to complex technology development programs. The most restrictive of these is a dependence on static planning scenarios, expressed through fault and event trees. Fault trees incorporating comprehensive mission scenarios are routinely constructed for complex space systems, and several commercial software products are available for evaluating fault statistics. These static representations cannot capture the dynamic behavior of system failures without substantial modification of the initial tree. Consequently, the development of dynamic models using fault tree analysis has been an active area of research in recent years. This paper discusses the implementation and demonstration of dynamic, modular scenario modeling for integration of subsystem fault evaluation modules using the Space Architecture Failure Evaluation (SAFE) tool. SAFE is a C++ code that was originally developed to support NASA s Space Launch Initiative. It provides a flexible framework for system architecture definition and trade studies. SAFE supports extensible modeling of dynamic, time-dependent risk drivers of the system and functions at the level of fidelity for which design and failure data exists. The approach is scalable, allowing inclusion of additional information as detailed data becomes available. The tool performs a Monte Carlo analysis to provide statistical estimates. Example results of an architecture system reliability study are summarized for an exploration system concept using heritage data from liquid-fueled expendable Saturn V/Apollo launch vehicles.

  9. America's Youth Are at Risk: Developing Models for Action in the Nation's Public Libraries.

    ERIC Educational Resources Information Center

    Flum, Judith G.; Weisner, Stan

    1993-01-01

    Discussion of public library support systems for at-risk teens focuses on the Bay Area Library and Information System (BALIS) that was developed to improve library services to at-risk teenagers in the San Francisco Bay area. Highlights include needs assessment; staff training; intervention models; and project evaluation. (10 references) (LRW)

  10. The Risk-Informed Materials Management (RIMM) Tool System for Determining Safe-Levels of Contaminated Materials Managed on the Land

    EPA Science Inventory

    EPA’s Risk-Informed Materials Management (RIMM) tool system is a modeling approach that helps risk assessors evaluate the safety of managing raw, reused, or waste material streams via a variety of common scenarios (e.g., application to farms, use as a component in road cons...

  11. Evaluation of a proposed expert system development methodology: Two case studies

    NASA Technical Reports Server (NTRS)

    Gilstrap, Lewey

    1990-01-01

    Two expert system development projects were studied to evaluate a proposed Expert Systems Development Methodology (ESDM). The ESDM was developed to provide guidance to managers and technical personnel and serve as a standard in the development of expert systems. It was agreed that the proposed ESDM must be evaluated before it could be adopted; therefore a study was planned for its evaluation. This detailed study is now underway. Before the study began, however, two ongoing projects were selected for a retrospective evaluation. They were the Ranging Equipment Diagnostic Expert System (REDEX) and the Backup Control Mode Analysis and Utility System (BCAUS). Both projects were approximately 1 year into development. Interviews of project personnel were conducted, and the resulting data was used to prepare the retrospective evaluation. Decision models of the two projects were constructed and used to evaluate the completeness and accuracy of key provisions of ESDM. A major conclusion reached from these case studies is that suitability and risk analysis should be required for all AI projects, large and small. Further, the objectives of each stage of development during a project should be selected to reduce the next largest area of risk or uncertainty on the project.

  12. The Effect of Balance Training by Tetraks Interactive Balance System on Balance and Fall Risk in Parkinson's Patients: A Report of Four Cases.

    PubMed

    Balci, Nilay Çömük; Tonga, Eda; Gülşen, Mustafa

    2013-09-01

    This pilot study aimed to investigate the effect of balance training by Tetraks Interactive Balance System (TIBS) on balance and fall risk in patients with mild to moderate Parkinson's disease. Four patients with Parkinson's disease between the ages of 56 and 70 years (61.25±6.70) were applied balance training for 3 weeks by TIBS. Sociodemographic features and physical properties of the subjects were recorded. Their motor performance was evaluated by the Unified Parkinson's Disease Rating Scale (UPDRS), balance was measured using the Berg Balance Scale (BBS), Functional Reach Test (FRT), Timed Up and Go Test (TUG), and the Standing on One Leg Balance Test (SOL) and, their fall risks were evaluated by TIBS. Evaluations were performed twice, before and after treatment. Following training, Parkinson's patients showed improvements in UPDRS, TUG, BBS, FRT, SOL and fall risk. Balance training by TIBS has positive effects on balance and decreases fall risk in Parkinson's disease patients.

  13. A quantitative risk-assessment system (QR-AS) evaluating operation safety of Organic Rankine Cycle using flammable mixture working fluid.

    PubMed

    Tian, Hua; Wang, Xueying; Shu, Gequn; Wu, Mingqiang; Yan, Nanhua; Ma, Xiaonan

    2017-09-15

    Mixture of hydrocarbon and carbon dioxide shows excellent cycle performance in Organic Rankine Cycle (ORC) used for engine waste heat recovery, but the unavoidable leakage in practical application is a threat for safety due to its flammability. In this work, a quantitative risk assessment system (QR-AS) is established aiming at providing a general method of risk assessment for flammable working fluid leakage. The QR-AS covers three main aspects: analysis of concentration distribution based on CFD simulations, explosive risk assessment based on the TNT equivalent method and risk mitigation based on evaluation results. A typical case of propane/carbon dioxide mixture leaking from ORC is investigated to illustrate the application of QR-AS. According to the assessment results, proper ventilation speed, safe mixture ratio and location of gas-detecting devices have been proposed to guarantee the security in case of leakage. The results revealed that this presented QR-AS was reliable for the practical application and the evaluation results could provide valuable guidance for the design of mitigation measures to improve the safe performance of ORC system. Copyright © 2017 Elsevier B.V. All rights reserved.

  14. Investment appraisal using quantitative risk analysis.

    PubMed

    Johansson, Henrik

    2002-07-01

    Investment appraisal concerned with investments in fire safety systems is discussed. Particular attention is directed at evaluating, in terms of the Bayesian decision theory, the risk reduction that investment in a fire safety system involves. It is shown how the monetary value of the change from a building design without any specific fire protection system to one including such a system can be estimated by use of quantitative risk analysis, the results of which are expressed in terms of a Risk-adjusted net present value. This represents the intrinsic monetary value of investing in the fire safety system. The method suggested is exemplified by a case study performed in an Avesta Sheffield factory.

  15. 75 FR 25239 - Integrated Risk Information System (IRIS); Announcement of Availability of Literature Searches...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-05-07

    ... human health assessment program that evaluates quantitative and qualitative risk information on effects... quantitative and qualitative risk information on effects that may result from exposure to specific chemical...

  16. Selecting Students at Risk of Academic Difficulties

    ERIC Educational Resources Information Center

    Cummings, Kelli D.; Smolkowski, Keith

    2015-01-01

    This paper aims to translate for practitioners the principles and methods for evaluating screening measures in education, including benchmark goals and cut points, from our technical manuscript "Evaluation of Diagnostic Systems: The Selection of Students at Risk of Academic Difficulties" (this issue). We offer a brief description of…

  17. A risk-based auditing process for pharmaceutical manufacturers.

    PubMed

    Vargo, Susan; Dana, Bob; Rangavajhula, Vijaya; Rönninger, Stephan

    2014-01-01

    The purpose of this article is to share ideas on developing a risk-based model for the scheduling of audits (both internal and external). Audits are a key element of a manufacturer's quality system and provide an independent means of evaluating the manufacturer's or the supplier/vendor's compliance status. Suggestions for risk-based scheduling approaches are discussed in the article. Pharmaceutical manufacturers are required to establish and implement a quality system. The quality system is an organizational structure defining responsibilities, procedures, processes, and resources that the manufacturer has established to ensure quality throughout the manufacturing process. Audits are a component of the manufacturer's quality system and provide a systematic and an independent means of evaluating the manufacturer's overall quality system and compliance status. Audits are performed at defined intervals for a specified duration. The intention of the audit process is to focus on key areas within the quality system and may not cover all relevant areas during each audit. In this article, the authors provide suggestions for risk-based scheduling approaches to aid pharmaceutical manufacturers in identifying the key focus areas for an audit.

  18. Risk as a Driver for Innovation

    NASA Technical Reports Server (NTRS)

    Davis, Jeff; Fogarty, Jennifer; Perchonok, Michele; Zapp, Neal; Ferebee, Melvin; Edwards, J. Michelle

    2010-01-01

    The Space Life Sciences directorate (SLSD) and Human Research Program (HRP) at NASA Johnson Space Center has implemented a system for managing human systems risks. These risks are defined as the health and performance risks posed to crew during and after spaceflight. Identification and evaluation of these risks has led to the identification of gaps in knowledge about the risks as well as gaps in technology needed to mitigate them. Traditional routes of closing technology gaps have, in some cases, proven to be too slow when a solution was required quickly. Therefore, certain gaps were used to drive the development of "challenges" for the scientific community. Partnering with open innovation service providers such as InnoCentive and Yet2.com, SLSD and HRP have decreased the amount of time from identification of a need to the evaluation of a solution. Although not all proposed solutions will result in a risk mitigation strategy or tool, the process has allowed faster evaluation of proposed solutions providing the researcher the ability to move to another possible solution if the first does not sufficiently address the problem. Moreover, this process engages the community outside of NASA and broadens the population from which to draw solutions. In the traditional grant funding structure, only those in the specific field will apply for the grant. However, using open innovation, solutions can come from individuals in many different fields. This can expand the general view of a field (way of thinking within a field) and the application of solutions form new fields while providing a pathway for the acquisition of novel solutions or refinements of current mitigations. Identification of the human systems risks has helped drive the development and evaluation of innovative solutions as well as engaging a broader scientific audience in working with NASA.

  19. SYN-OP-SYS™: A Computerized Management Information System for Quality Assurance and Risk Management

    PubMed Central

    Thomas, David J.; Weiner, Jayne; Lippincott, Ronald C.

    1985-01-01

    SYN·OP·SYS™ is a computerized management information system for quality assurance and risk management. Computer software for the efficient collection and analysis of “occurrences” and the clinical data associated with these kinds of patient events is described. The system is evaluated according to certain computer design criteria, and the system's implementation is assessed.

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

    Mankamo, T.; Kim, I.S.; Yang, Ji Wu

    Failures in the auxiliary feedwater (AFW) system of pressurized water reactors (PWRs) are considered to involve substantial risk whether a decision is made to either continue power operation while repair is being done, or to shut down the plant to undertake repairs. Technical specification action requirements usually require immediate plant shutdown in the case of multiple failures in the system (in some cases, immediate repair of one train is required when all AFW trains fail). This paper presents a probabilistic risk assessment-based method to quantitatively evaluate and compare both the risks of continued power operation and of shutting the plantmore » down, given known failures in the system. The method is applied to the AFW system for four different PWRs. Results show that the risk of continued power operation and plant shutdown both are substantial, but the latter is larger than the former over the usual repair time. This was proven for four plants with different designs: two operating Westinghouse plants, one operating Asea-Brown Boveri Combustion Engineering Plant, and one of evolutionary design. The method can be used to analyze individual plant design and to improve AFW action requirements using risk-informed evaluations.« less

  1. A model study of the Haihe river passenger ferry risk based on AHP

    NASA Astrophysics Data System (ADS)

    Du, Jinyin; Xu, Yanming; Du, Chunzhi; Jin, Zhenhua

    2017-05-01

    The core function of maritime is water safety supervision, whose emphasis and difficulty is ferry. In combination with the practical situation of Haihe river passenger ferry operation management, this paper analyzes Haihe river passenger ferry risk from four aspects "human, machinery, environment and management", and establishes the ferry risk index system. By using AHP (Analytic Hierarchy Process), the ferry risk evaluation model is established. By using the ferry model, the application of Ferry Zhengyanfa7 in Tianjin Haihe river crossing is evaluated, whose safety situation is verified to be between "relatively high risk" and "high risk".

  2. Data Analysis

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

    Powell, Danny H; Elwood Jr, Robert H

    2011-01-01

    Analysis of the material protection, control, and accountability (MPC&A) system is necessary to understand the limits and vulnerabilities of the system to internal threats. A self-appraisal helps the facility be prepared to respond to internal threats and reduce the risk of theft or diversion of nuclear material. The material control and accountability (MC&A) system effectiveness tool (MSET) fault tree was developed to depict the failure of the MPC&A system as a result of poor practices and random failures in the MC&A system. It can also be employed as a basis for assessing deliberate threats against a facility. MSET uses faultmore » tree analysis, which is a top-down approach to examining system failure. The analysis starts with identifying a potential undesirable event called a 'top event' and then determining the ways it can occur (e.g., 'Fail To Maintain Nuclear Materials Under The Purview Of The MC&A System'). The analysis proceeds by determining how the top event can be caused by individual or combined lower level faults or failures. These faults, which are the causes of the top event, are 'connected' through logic gates. The MSET model uses AND-gates and OR-gates and propagates the effect of event failure using Boolean algebra. To enable the fault tree analysis calculations, the basic events in the fault tree are populated with probability risk values derived by conversion of questionnaire data to numeric values. The basic events are treated as independent variables. This assumption affects the Boolean algebraic calculations used to calculate results. All the necessary calculations are built into the fault tree codes, but it is often useful to estimate the probabilities manually as a check on code functioning. The probability of failure of a given basic event is the probability that the basic event primary question fails to meet the performance metric for that question. The failure probability is related to how well the facility performs the task identified in that basic event over time (not just one performance or exercise). Fault tree calculations provide a failure probability for the top event in the fault tree. The basic fault tree calculations establish a baseline relative risk value for the system. This probability depicts relative risk, not absolute risk. Subsequent calculations are made to evaluate the change in relative risk that would occur if system performance is improved or degraded. During the development effort of MSET, the fault tree analysis program used was SAPHIRE. SAPHIRE is an acronym for 'Systems Analysis Programs for Hands-on Integrated Reliability Evaluations.' Version 1 of the SAPHIRE code was sponsored by the Nuclear Regulatory Commission in 1987 as an innovative way to draw, edit, and analyze graphical fault trees primarily for safe operation of nuclear power reactors. When the fault tree calculations are performed, the fault tree analysis program will produce several reports that can be used to analyze the MPC&A system. SAPHIRE produces reports showing risk importance factors for all basic events in the operational MC&A system. The risk importance information is used to examine the potential impacts when performance of certain basic events increases or decreases. The initial results produced by the SAPHIRE program are considered relative risk values. None of the results can be interpreted as absolute risk values since the basic event probability values represent estimates of risk associated with the performance of MPC&A tasks throughout the material balance area (MBA). The RRR for a basic event represents the decrease in total system risk that would result from improvement of that one event to a perfect performance level. Improvement of the basic event with the greatest RRR value produces a greater decrease in total system risk than improvement of any other basic event. Basic events with the greatest potential for system risk reduction are assigned performance improvement values, and new fault tree calculations show the improvement in total system risk. The operational impact or cost-effectiveness from implementing the performance improvements can then be evaluated. The improvements being evaluated can be system performance improvements, or they can be potential, or actual, upgrades to the system. The RIR for a basic event represents the increase in total system risk that would result from failure of that one event. Failure of the basic event with the greatest RIR value produces a greater increase in total system risk than failure of any other basic event. Basic events with the greatest potential for system risk increase are assigned failure performance values, and new fault tree calculations show the increase in total system risk. This evaluation shows the importance of preventing performance degradation of the basic events. SAPHIRE identifies combinations of basic events where concurrent failure of the events results in failure of the top event.« less

  3. Evaluation of Time- and Concentration-dependent Toxic Effect Models for use in Aquatic Risk Assessments, Oral Presentation

    EPA Science Inventory

    Various models have been proposed for describing the time- and concentration-dependence of toxic effects to aquatic organisms, which would improve characterization of risks in natural systems. Selected models were evaluated using results from a study on the lethality of copper t...

  4. Ergonomic evaluation of a wheelchair transportation securement system.

    PubMed

    Ahmed, Madiha; Campbell-Kyureghyan, Naira; Frost, Karen; Bertocci, Gina

    2012-01-01

    The Americans with Disabilities Act (ADA) specifies guidelines covering the securement system and environment for wheeled mobility device (WhMD) passengers on the public bus system in the United States, referred to as the wheelchair tiedown and occupant restraint system (WTORS). The misuse or disuse of the WTORS system can be a source of injury for WhMD passengers riding the buses. The purpose of this study was to quantify the risks posed to the bus driver while performing the WTORS procedure using traditional ergonomic analysis methods. Four bus drivers completed the WTORS procedure for a representative passenger seated in three different WhMDs: manual wheelchair (MWC), scooter (SCTR), and power wheelchair (PWC). Potential work-related risks were identified using the four most applicable ergonomic assessment tools: PLIBEL, RULA, REBA, and iLMM. Task evaluation results revealed high levels of risk to be present to drivers during the WTORS procedure. The securement station space design and equipment layout were identified as contributing factors forcing drivers to adopt awkward postures while performing the WTORS task. These risk factors are known contributors to injury and the drivers could opt to improperly secure the passengers to avoid that risk.

  5. Test and Evaluation Master Plan (TEMP) for the Ports and Waterways Safety System (PAWSS) Project

    DOT National Transportation Integrated Search

    1997-01-01

    This document outlines the Test Concept for the Ports and Waterways Safety System (PAWSS) Project. This Test and Evaluation Master Plan (TEMP) purpose is to reduce risk and ensure the PAWSS project meets all System Specification and Statement of Work...

  6. Ecosystem Risk Assessment Using the Comprehensive Assessment of Risk to Ecosystems (CARE) Tool

    NASA Astrophysics Data System (ADS)

    Battista, W.; Fujita, R.; Karr, K.

    2016-12-01

    Effective Ecosystem Based Management requires a localized understanding of the health and functioning of a given system as well as of the various factors that may threaten the ongoing ability of the system to support the provision of valued services. Several risk assessment models are available that can provide a scientific basis for understanding these factors and for guiding management action, but these models focus mainly on single species and evaluate only the impacts of fishing in detail. We have developed a new ecosystem risk assessment model - the Comprehensive Assessment of Risk to Ecosystems (CARE) - that allows analysts to consider the cumulative impact of multiple threats, interactions among multiple threats that may result in synergistic or antagonistic impacts, and the impacts of a suite of threats on whole-ecosystem productivity and functioning, as well as on specific ecosystem services. The CARE model was designed to be completed in as little as two hours, and uses local and expert knowledge where data are lacking. The CARE tool can be used to evaluate risks facing a single site; to compare multiple sites for the suitability or necessity of different management options; or to evaluate the effects of a proposed management action aimed at reducing one or more risks. This analysis can help users identify which threats are the most important at a given site, and therefore where limited management resources should be targeted. CARE can be applied to virtually any system, and can be modified as knowledge is gained or to better match different site characteristics. CARE builds on previous ecosystem risk assessment tools to provide a comprehensive assessment of fishing and non-fishing threats that can be used to inform environmental management decisions across a broad range of systems.

  7. Ecosystem Risk Assessment Using the Comprehensive Assessment of Risk to Ecosystems (CARE) Tool

    NASA Astrophysics Data System (ADS)

    Battista, W.; Fujita, R.; Karr, K.

    2016-02-01

    Effective Ecosystem Based Management requires a localized understanding of the health and functioning of a given system as well as of the various factors that may threaten the ongoing ability of the system to support the provision of valued services. Several risk assessment models are available that can provide a scientific basis for understanding these factors and for guiding management action, but these models focus mainly on single species and evaluate only the impacts of fishing in detail. We have developed a new ecosystem risk assessment model - the Comprehensive Assessment of Risk to Ecosystems (CARE) - that allows analysts to consider the cumulative impact of multiple threats, interactions among multiple threats that may result in synergistic or antagonistic impacts, and the impacts of a suite of threats on whole-ecosystem productivity and functioning, as well as on specific ecosystem services. The CARE model was designed to be completed in as little as two hours, and uses local and expert knowledge where data are lacking. The CARE tool can be used to evaluate risks facing a single site; to compare multiple sites for the suitability or necessity of different management options; or to evaluate the effects of a proposed management action aimed at reducing one or more risks. This analysis can help users identify which threats are the most important at a given site, and therefore where limited management resources should be targeted. CARE can be applied to virtually any system, and can be modified as knowledge is gained or to better match different site characteristics. CARE builds on previous ecosystem risk assessment tools to provide a comprehensive assessment of fishing and non-fishing threats that can be used to inform environmental management decisions across a broad range of systems.

  8. IRIS Toxicological Review of Ammonia (External Review Draft ...

    EPA Pesticide Factsheets

    EPA is conducting a peer review of the scientific basis supporting the human health hazard and dose-response assessment of ammonia that will appear in the Integrated Risk Information System (IRIS) database. EPA is undertaking an Integrated Risk Information System (IRIS) health assessment for ammonia. IRIS is an EPA database containing Agency scientific positions on potential adverse human health effects that may result from chronic (or lifetime) exposure to chemicals in the environment. IRIS contains chemical-specific summaries of qualitative and quantitative health information in support of two steps of the risk assessment paradigm, i.e., hazard identification and dose-response evaluation. IRIS assessments are used in combination with specific situational exposure assessment information to evaluate potential public health risk associated with environmental contaminants.

  9. IRIS Toxicological Review of n-Butanol (External Review Draft ...

    EPA Pesticide Factsheets

    EPA is conducting a peer review of the scientific basis supporting the human health hazard and dose-response assessment of n-butanol that will appear in the Integrated Risk Information System (IRIS) database. EPA is undertaking an Integrated Risk Information System (IRIS) health assessment for n-butanol. IRIS is an EPA database containing Agency scientific positions on potential adverse human health effects that may result from chronic (or lifetime) exposure to chemicals in the environment. IRIS contains chemical-specific summaries of qualitative and quantitative health information in support of two steps of the risk assessment paradigm, i.e., hazard identification and dose-response evaluation. IRIS assessments are used in combination with specific situational exposure assessment information to evaluate potential public health risk associated with environmental contaminants.

  10. 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.

  11. Risk Evaluation in the Pre-Phase A Conceptual Design of Spacecraft

    NASA Technical Reports Server (NTRS)

    Fabisinski, Leo L., III; Maples, Charlotte Dauphne

    2010-01-01

    Typically, the most important decisions in the design of a spacecraft are made in the earliest stages of its conceptual design the Pre-Phase A stages. It is in these stages that the greatest number of design alternatives is considered, and the greatest number of alternatives is rejected. The focus of Pre-Phase A conceptual development is on the evaluation and comparison of whole concepts and the larger-scale systems comprising those concepts. This comparison typically uses general Figures of Merit (FOMs) to quantify the comparative benefits of designs and alternative design features. Along with mass, performance, and cost, risk should be one of the major FOMs in evaluating design decisions during the conceptual design phases. However, risk is often given inadequate consideration in conceptual design practice. The reasons frequently given for this lack of attention to risk include: inadequate mission definition, lack of rigorous design requirements in early concept phases, lack of fidelity in risk assessment methods, and under-evaluation of risk as a viable FOM for design evaluation. In this paper, the role of risk evaluation in early conceptual design is discussed. The various requirements of a viable risk evaluation tool at the Pre-Phase A level are considered in light of the needs of a typical spacecraft design study. A technique for risk identification and evaluation is presented. The application of the risk identification and evaluation approach to the conceptual design process is discussed. Finally, a computational tool for risk profiling is presented and applied to assess the risk for an existing Pre-Phase A proposal. The resulting profile is compared to the risks identified for the proposal by other means.

  12. Research on the Application of Risk-based Inspection for the Boiler System in Power Plant

    NASA Astrophysics Data System (ADS)

    Li, Henan

    2017-12-01

    Power plant boiler is one of the three main equipment of coal-fired power plants, is very tall to the requirement of the safe and stable operation, in a significant role in the whole system of thermal power generation, a risk-based inspection is a kind of pursuit of security and economy of unified system management idea and method, can effectively evaluate equipment risk and reduce the operational cost.

  13. High Pressure Coolant Injection (HPCI) System Risk-Based Inspection Guide for Browns Ferry Nuclear Power Station

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

    Wong, S.; DiBiasio, A.; Gunther, W.

    1993-09-01

    The High Pressure Coolant Injection (HPCI) system has been examined from a risk perspective. A System Risk-Based Inspection Guide (S-RIG) has been developed as an aid to HPCI system inspections at the Browns Ferry Nuclear Power Plant, Units 1, 2 and 3. The role of. the HPCI system in mitigating accidents is discussed in this S-RIG, along with insights on identified risk-based failure modes which could prevent proper operation of the system. The S-RIG provides a review of industry-wide operating experience, including plant-specific illustrative examples to augment the PRA and operational considerations in identifying a catalogue of basic PRA failuremore » modes for the HPCI system. It is designed to be used as a reference for routine inspections, self-initiated safety system functional inspections (SSFIs), and the evaluation of risk significance of component failures at the nuclear power plant.« less

  14. System for decision analysis support on complex waste management issues

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

    Shropshire, D.E.

    1997-10-01

    A software system called the Waste Flow Analysis has been developed and applied to complex environmental management processes for the United States Department of Energy (US DOE). The system can evaluate proposed methods of waste retrieval, treatment, storage, transportation, and disposal. Analysts can evaluate various scenarios to see the impacts to waste slows and schedules, costs, and health and safety risks. Decision analysis capabilities have been integrated into the system to help identify preferred alternatives based on a specific objectives may be to maximize the waste moved to final disposition during a given time period, minimize health risks, minimize costs,more » or combinations of objectives. The decision analysis capabilities can support evaluation of large and complex problems rapidly, and under conditions of variable uncertainty. The system is being used to evaluate environmental management strategies to safely disposition wastes in the next ten years and reduce the environmental legacy resulting from nuclear material production over the past forty years.« less

  15. Risk Assessment of Carbon Fiber Composite in Surface Transportation

    NASA Technical Reports Server (NTRS)

    Hathaway, W. T.; Hergenrother, K. M.

    1980-01-01

    The vulnerability of surface transportation to airborne carbon fibers and the national risk associated with the potential use of carbon fibers in the surface transportation system were evaluated. Results show airborne carbon fibers may cause failure rates in surface transportation of less than one per year by 1995. The national risk resulting from the use of carbon fibers in the surface transportation system is discussed.

  16. Developing an Android-Based Patient Decision Aid Based on Ottawa Standards for Patients After Kidney Transplant and Its Usability Evaluation.

    PubMed

    Zare Moayedi, Mahboobeh; Aslani, Azam; Fakhrahmad, Mostafa; Ezzatzadegan J, Shahrokh

    2018-01-01

    This study was conducted to develop an android based patient decision aid (PDA) as a self-care instrument for patients after kidney transplant and its usability evaluation. In this study, the systematic development process of Android-based self-care application for patients after kidney transplant based on Ottawa standard was included: scoping, assemble steering group, analysis of requirements, designing, develop of a prototype and system evaluation. The PDA is a self-triage system that will help early identification of risk symptoms in patients, and help manage them. System recommendations for risk signs are: Refer to the nearest hospital or healthcare center without delay, refer to the doctor and tell your doctor in the next visit. To identify patient care needs, a semi-structured interview with members of steering group, including patients and clinical experts, was conducted by the researchers. A prototype of the decision aid was made according to identified needs in the previous step. Finally, in order to evaluate its usability rate by using the System Usability Scale (SUS) questionnaire, it was used by exerts and patients. This study identified information needs, risk signs and steps that patients need to make appropriate decisions about them. The main capabilities of the decision aid are features such as reminders for appointment/test, time of taking medication, registration of symptoms, weight, blood pressure, body temperature, advising to patient in case of signs of risk, weight, blood pressure, body temperature and test results which were reported in the diagram. The mean score of system's usability evaluated by medical informatics specialists, clinicians, and patients were 88.33, 95, and 91. PDAs was usable and desirable from the point of view of medical informatics specialists, clinicians and patients.

  17. 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.

  18. Determining Risk - How to Evaluate the Environmental Effects of Marine and Hydrokinetic Energy Development

    NASA Astrophysics Data System (ADS)

    Copping, A. E.; Blake, K.; Zdanski, L.

    2011-12-01

    As marine and hydrokinetic (MHK) energy development projects progress towards early deployments in the U.S., the process of determining the risks to aquatic animals, habitats, and ecosystem processes from these engineered systems continues to be a significant barrier to efficient siting and permitting. Understanding the risk of MHK installations requires that the two elements of risk - consequence and probability - be evaluated. However, standard risk assessment methodologies are not easily applied to MHK interactions with marine and riverine environment as there are few data that describe the interaction of stressors (MHK devices, anchors, foundations, mooring lines and power cables) and receptors (aquatic animals, habitats and ecosystem processes). The number of possible combinations and permutations of stressors and receptors in MHK systems is large: there are many different technologies designed to harvest energy from the tides, waves and flowing rivers; each device is planned for a specific waterbody that supports an endemic ecosystem of animals and habitats, tied together by specific physical and chemical processes. With few appropriate analogue industries in the oceans and rivers, little information on the effects of these technologies on the living world is available. Similarly, without robust data sets of interactions, mathematical probability models are difficult to apply. Pacific Northwest National Laboratory scientists are working with MHK developers, researchers, engineers, and regulators to rank the consequences of planned MHK projects on living systems, and exploring alternative methodologies to estimate probabilities of these encounters. This paper will present the results of ERES, the Environmental Risk Evaluation System, which has been used to rank consequences for major animal groups and habitats for five MHK projects that are in advanced stages of development and/or early commercial deployment. Probability analyses have been performed for high priority stressor/receptor interactions where data are adaptable from other industries. In addition, a methodology for evaluating the probability of encounter, and therefore risk, to an endangered marine mammal from tidal turbine blades will be presented.

  19. Decision-Making for Systemic Water Risks: Insights From a Participatory Risk Assessment Process in Vietnam

    NASA Astrophysics Data System (ADS)

    Wyrwoll, Paul R.; Grafton, R. Quentin; Daniell, Katherine A.; Chu, Hoang Long; Ringler, Claudia; Lien, Le Thi Ha; Khoi, Dang Kim; Do, Thang Nam; Tuan, Nguyen Do Anh

    2018-03-01

    Systemic threats to food-energy-environment-water systems require national policy responses. Yet complete control of these complex systems is impossible and attempts to mitigate systemic risks can generate unexpected feedback effects. Perverse outcomes from national policy can emerge from the diverse responses of decision-makers across different levels and scales of resource governance. Participatory risk assessment processes can help planners to understand subnational dynamics and ensure that policies do not undermine the resilience of social-ecological systems and infrastructure networks. Researchers can play an important role in participatory processes as both technical specialists and brokers of stakeholder knowledge on the feedbacks generated by systemic risks and policy decisions. Here, we evaluate the use of causal modeling and participatory risk assessment to develop national policy on systemic water risks. We present an application of the Risks and Options Assessment for Decision-Making (ROAD) process to a district of Vietnam where national agricultural water reforms are being piloted. The methods and results of this project provide general insights about how to support resilient decision-making, including the transfer of knowledge across administrative levels, identification of feedback effects, and the effective implementation of risk assessment processes.

  20. Situation-Dependent Medical Device Risk Estimation: Design and Evaluation of an Equipment Management Center For Vendor-Independent Integrated Operating Rooms.

    PubMed

    Maktabi, Marianne; Neumuth, Thomas

    2017-12-22

    The complexity of surgical interventions and the number of technologies involved are constantly rising. Hospital staff has to learn how to handle new medical devices efficiently. However, if medical device-related incidents occur, the patient treatment is delayed. Patient safety could therefore be supported by an optimized assistance system that helps improve the management of technical equipment by nonmedical hospital staff. We developed a system for the optimal monitoring of networked medical device activity and maintenance requirements, which works in conjunction with a vendor-independent integrated operating room and an accurate surgical intervention Time And Resource Management System. An integrated situation-dependent risk assessment system gives the medical engineers optimal awareness of the medical devices in the operating room. A qualitative and quantitative survey among ten medical engineers from three different hospitals was performed to evaluate the approach. A series of 25 questions was used to evaluate various aspects of our system as well as the system currently used. Moreover, the respondents were asked to perform five tasks related to system supervision and incident handling. Our system received a very positive feedback. The evaluation studies showed that the integration of information, the structured presentation of information, and the assistance modules provide valuable support to medical engineers. An automated operating room monitoring system with an integrated risk assessment and Time And Resource Management System module is a new way to assist the staff being outside of a vendor-independent integrated operating room, who are nevertheless involved in processes in the operating room.

  1. CHARACTERIZATION OF DATA VARIABILITY AND UNCERTAINTY: HEALTH EFFECTS ASSESSMENTS IN THE INTEGRATED RISK INFORMATION SYSTEM (IRIS)

    EPA Science Inventory

    In response to a Congressional directive contained in HR 106-379 regarding EPA's appropriations for FY2000, EPA has undertaken an evaluation of the characterization of data variability and uncertainty in its Integrated Risk Information System (IRIS) health effects information dat...

  2. Risk assessment techniques with applicability in marine engineering

    NASA Astrophysics Data System (ADS)

    Rudenko, E.; Panaitescu, F. V.; Panaitescu, M.

    2015-11-01

    Nowadays risk management is a carefully planned process. The task of risk management is organically woven into the general problem of increasing the efficiency of business. Passive attitude to risk and awareness of its existence are replaced by active management techniques. Risk assessment is one of the most important stages of risk management, since for risk management it is necessary first to analyze and evaluate risk. There are many definitions of this notion but in general case risk assessment refers to the systematic process of identifying the factors and types of risk and their quantitative assessment, i.e. risk analysis methodology combines mutually complementary quantitative and qualitative approaches. Purpose of the work: In this paper we will consider as risk assessment technique Fault Tree analysis (FTA). The objectives are: understand purpose of FTA, understand and apply rules of Boolean algebra, analyse a simple system using FTA, FTA advantages and disadvantages. Research and methodology: The main purpose is to help identify potential causes of system failures before the failures actually occur. We can evaluate the probability of the Top event.The steps of this analize are: the system's examination from Top to Down, the use of symbols to represent events, the use of mathematical tools for critical areas, the use of Fault tree logic diagrams to identify the cause of the Top event. Results: In the finally of study it will be obtained: critical areas, Fault tree logical diagrams and the probability of the Top event. These results can be used for the risk assessment analyses.

  3. The Effect of Balance Training by Tetraks Interactive Balance System on Balance and Fall Risk in Parkinson’s Patients: A Report of Four Cases

    PubMed Central

    BALCI, Nilay Çömük; TONGA, Eda; GÜLŞEN, Mustafa

    2013-01-01

    This pilot study aimed to investigate the effect of balance training by Tetraks Interactive Balance System (TIBS) on balance and fall risk in patients with mild to moderate Parkinson’s disease. Four patients with Parkinson’s disease between the ages of 56 and 70 years (61.25±6.70) were applied balance training for 3 weeks by TIBS. Sociodemographic features and physical properties of the subjects were recorded. Their motor performance was evaluated by the Unified Parkinson’s Disease Rating Scale (UPDRS), balance was measured using the Berg Balance Scale (BBS), Functional Reach Test (FRT), Timed Up and Go Test (TUG), and the Standing on One Leg Balance Test (SOL) and, their fall risks were evaluated by TIBS. Evaluations were performed twice, before and after treatment. Following training, Parkinson’s patients showed improvements in UPDRS, TUG, BBS, FRT, SOL and fall risk. Balance training by TIBS has positive effects on balance and decreases fall risk in Parkinson’s disease patients. PMID:28360557

  4. IRIS Toxicological Review of Tetrahydrofuran (THF) (External ...

    EPA Pesticide Factsheets

    EPA is conducting a peer review and public comment of the scientific basis supporting the human health hazard and dose-response assessment of tetrahydrofuran (THF) that when finalized will appear on the Integrated Risk Information System (IRIS) database. EPA is undertaking an Integrated Risk Information System (IRIS) health assessment for tetrahydrofuran. IRIS is an EPA database containing Agency scientific positions on potential adverse human health effects that may result from chronic (or lifetime) exposure to chemicals in the environment. IRIS contains chemical-specific summaries of qualitative and quantitative health information in support of two steps of the risk assessment paradigm, i.e., hazard identification and dose-response evaluation. IRIS assessments are used in combination with specific situational exposure assessment information to evaluate potential public health risk associated with environmental contaminants.

  5. Fiber glass exposure and human respiratory system cancer risk: lack of evidence persists since 2001 IARC re-evaluation.

    PubMed

    Marsh, Gary M; Buchanich, Jeanine M; Youk, Ada O

    2011-06-01

    To determine whether IARC's 2001 decision to downgrade the classification of insulation glass wool from Group 2B to Group 3 remains valid in light of epidemiological evidence reported after 2001. We performed a systematic review of epidemiological evidence regarding respiratory cancer risks in relation to man-made vitreous fiber (MMVF) exposure before and after the 2001 IARC re-evaluation with focus on glass wool exposure and respiratory system cancer. Since 2001, three new community-based, case-control studies, two detailed analyses of existing cohort studies and two reviews/meta-analyses were published. These studies revealed no consistent evidence of an increased respiratory system cancer risk in relation to glass wool exposure. From our evaluation of the epidemiological evidence published since 2001, we conclude that IARC's 2001 decision to downgrade insulation glass wool from Group 2B to Group 3 remains valid. Copyright © 2011 Elsevier Inc. All rights reserved.

  6. Feasibility of using the International Classification of Functioning, Disability and Health Core Set for evaluation of fall-related risk factors in acute rehabilitation settings.

    PubMed

    Huang, Shih W; Lin, Li F; Chou, Lin C; Wu, Mei J; Liao, Chun D; Liou, Tsan H

    2016-04-01

    Previously, we reported the use of an International Classification of Functioning (ICF) core set that can provide a holistic framework for evaluating the risk factors of falls; however, data on the feasibility of applying this core set are lacking. To investigate the feasibility of applying the fall-related ICF risk-factor core set in the case of patients in an acute-rehabilitation setting. A cross-sectional and descriptive correlational design. Acute-rehabilitation ward. A total of 273 patients who experienced fall at acute-rehabilitation ward. The data on falls were collected from the hospital's Nursing Information System (NIS) and the fall-reporting system (Adverse Event Reporting System, AERS) between 2010 and 2013. The relationship of both systems to the fall-related ICF core set was analyzed to assess the feasibility of their clinical application. We evaluated the feasibility of using the fall-related ICF risk-factor core set by using the frequency and the percentage of the fall patients in of the listed categories. The fall-related ICF risk-factor core set category b735 (muscle tone functions) exhibited a high feasibility (85.95%) for clinical application, and the category b730 (muscle power functions) covered 77.11% of the patients. The feasibility of application of the category d410 (change basic body position) was also high in the case of all fall patients (81.69%). In the acute-rehabilitation setting, the feasibility of application of the fall-related ICF risk-factor core set is high. The fall-related ICF risk-factor core set can help multidisciplinary teams develop fall-prevention strategies in acute rehabilitation wards.

  7. Risk assessment analysis of the future technical unit dedicated to the evaluation and treatment of motor disabilities.

    PubMed

    Grelier, S; Thetio, M; Quentin, V; Achache, V; Sanchez, N; Leroux, V; Durand, E; Pequignot, R

    2011-03-01

    The National Hospital of Saint Maurice (HNSM) for Physical Medicine and Rehabilitation aims at strengthening its position as a pivot rehabilitation and physical therapy center. The opening in 2011 of a new unit for the evaluation and treatment of motor disabilities meets this objective. This project includes several parts: clinical, financial, architectural, organizational, applied clinical research as well as dealing with medical equipments and information system. This study focuses on the risk assessment of this future technical unit. This study was conducted by a group of professionals working for the hospital. It started with the design of a functional model to better comprehend the system to be analyzed. Risk assessment consists in confronting this functional model to a list of dangers in order to determine the vulnerable areas of the system. Then the team designed some scenarios to identify the causes, securities barriers and consequences in order to rank the risks. The analysis targeted various dangers, e.g. political, strategic, financial, economical, marketing, clinical and operational. The team identified more than 70 risky scenarios. For 75% of them the criticality level was deemed initially tolerable and under control or unacceptable. The implementation of an action plan for reducing the level of risks before opening this technical unit brought the system down to an acceptable level at 66%. A year prior to opening this technical unit for the evaluation and treatment of motor disabilities, conducting this preliminary risk assessment, with its exhaustive and rigorous methodology, enabled the concerned professionals to work together around an action plan for reducing the risks. 2011 Elsevier Masson SAS. All rights reserved.

  8. Industrial machine systems risk assessment: a critical review of concepts and methods.

    PubMed

    Etherton, John R

    2007-02-01

    Reducing the risk of work-related death and injury to machine operators and maintenance personnel poses a continuing occupational safety challenge. The risk of injury from machinery in U.S. workplaces is high. Between 1992 and 2001, there were, on average, 520 fatalities per year involving machines and, on average, 3.8 cases per 10,000 workers of nonfatal caught-in-running-machine injuries involving lost workdays. A U.S. task group recently developed a technical reference guideline, ANSI B11 TR3, "A Guide to Estimate, Evaluate, & Reduce Risks Associated with Machine Tools," that is intended to bring machine tool risk assessment practice in the United States up to or above the level now required by the international standard, ISO 14121. The ANSI guideline emphasizes identifying tasks and hazards not previously considered, particularly those associated with maintenance; and it further emphasizes teamwork among line workers, engineers, and safety professionals. The value of this critical review of concepts and methods resides in (1) its linking current risk theory to machine system risk assessment and (2) its exploration of how various risk estimation tools translate into risk-informed decisions on industrial machine system design and use. The review was undertaken to set the stage for a field evaluation study on machine risk assessment among users of the ANSI B11 TR3 method.

  9. Evaluation of the WinROP system for identifying retinopathy of prematurity in Czech preterm infants.

    PubMed

    Timkovic, Juraj; Pokryvkova, Martina; Janurova, Katerina; Barinova, Denisa; Polackova, Renata; Masek, Petr

    2017-03-01

    Retinopathy of Prematurity (ROP) is a potentially serious condition that can afflict preterm infants. Timely and correct identification of individuals at risk of developing a serious form of ROP is therefore of paramount importance. WinROP is an online system for predicting ROP based on birth weight and weight increments. However, the results vary significantly for various populations. It has not been evaluated in the Czech population. This study evaluates the test characteristics (specificity, sensitivity, positive and negative predictive values) of the WinROP system in Czech preterm infants. Data on 445 prematurely born infants included in the ROP screening program at the University Hospital Ostrava, Czech Republic, were retrospectively entered into the WinROP system and the outcomes of the WinROP and regular screening were compared. All 24 infants who developed high-risk (Type 1 or Type 2) ROP were correctly identified by the system. The sensitivity and negative predictive values for this group were 100%. However, the specificity and positive predictive values were substantially lower, resulting in a large number of false positives. Extending the analysis to low risk ROP, the system did not provide such reliable results. The system is a valuable tool for identifying infants who are not likely to develop high-risk ROP and this could help to substantially reduce the number of preterm infants in need of regular ROP screening. It is not suitable for predicting the development of less serious forms of ROP which is however in accordance with the declared aims of the WinROP system.

  10. Benchmarking Global Food Safety Performances: The Era of Risk Intelligence.

    PubMed

    Valleé, Jean-Charles Le; Charlebois, Sylvain

    2015-10-01

    Food safety data segmentation and limitations hamper the world's ability to select, build up, monitor, and evaluate food safety performance. Currently, there is no metric that captures the entire food safety system, and performance data are not collected strategically on a global scale. Therefore, food safety benchmarking is essential not only to help monitor ongoing performance but also to inform continued food safety system design, adoption, and implementation toward more efficient and effective food safety preparedness, responsiveness, and accountability. This comparative study identifies and evaluates common elements among global food safety systems. It provides an overall world ranking of food safety performance for 17 Organisation for Economic Co-Operation and Development (OECD) countries, illustrated by 10 indicators organized across three food safety risk governance domains: risk assessment (chemical risks, microbial risks, and national reporting on food consumption), risk management (national food safety capacities, food recalls, food traceability, and radionuclides standards), and risk communication (allergenic risks, labeling, and public trust). Results show all countries have very high food safety standards, but Canada and Ireland, followed by France, earned excellent grades relative to their peers. However, any subsequent global ranking study should consider the development of survey instruments to gather adequate and comparable national evidence on food safety.

  11. Applicability of the Common Safety Method for Risk Evaluation and Assessment (CSM-RA) to the Space Domain

    NASA Astrophysics Data System (ADS)

    Moreira, Francisco; Silva, Nuno

    2016-08-01

    Safety systems require accident avoidance. This is covered by application standards, processes, techniques and tools that support the identification, analysis, elimination or reduction to an acceptable level of system risks and hazards. Ideally, a safety system should be free of hazards. However, both industry and academia have been struggling to ensure appropriate risk and hazard analysis, especially in what concerns completeness of the hazards, formalization, and timely analysis in order to influence the specifications and the implementation. Such analysis is also important when considering a change to an existing system. The Common Safety Method for Risk Evaluation and Assessment (CSM- RA) is a mandatory procedure whenever any significant change is proposed to the railway system in a European Member State. This paper provides insights on the fundamentals of CSM-RA based and complemented with Hazard Analysis. When and how to apply them, and the relation and similarities of these processes with industry standards and the system life cycles is highlighted. Finally, the paper shows how CSM-RA can be the basis of a change management process, guiding the identification and management of the hazards helping ensuring the similar safety level as the initial system. This paper will show how the CSM-RA principles can be used in other domains particularly for space system evolution.

  12. Human action quality evaluation based on fuzzy logic with application in underground coal mining.

    PubMed

    Ionica, Andreea; Leba, Monica

    2015-01-01

    The work system is defined by its components, their roles and the relationships between them. Any work system gravitates around the human resource and the interdependencies between human factor and the other components of it. Researches in this field agreed that the human factor and its actions are difficult to quantify and predict. The objective of this paper is to apply a method of human actions evaluation in order to estimate possible risks and prevent possible system faults, both at human factor level and at equipment level. In order to point out the importance of the human factor influence on all the elements of the working systems we propose a fuzzy logic based methodology for quality evaluation of human actions. This methodology has a multidisciplinary character, as it gathers ideas and methods from: quality management, ergonomics, work safety and artificial intelligence. The results presented refer to a work system with a high degree of specificity, namely, underground coal mining and are valuable for human resources risk evaluation pattern. The fuzzy logic evaluation of the human actions leads to early detection of possible dangerous evolutions of the work system and alarm the persons in charge.

  13. Research on Liquidity Risk Evaluation of Chinese A-Shares Market Based on Extension Theory

    NASA Astrophysics Data System (ADS)

    Bai-Qing, Sun; Peng-Xiang, Liu; Lin, Zhang; Yan-Ge, Li

    This research defines the liquidity risk of stock market in matter-element theory and affair-element theory, establishes the indicator system of the forewarning for liquidity risks,designs the model and the process of early warning using the extension set method, extension dependent function and the comprehensive evaluation model. And the paper studies empirically A-shares market through the data of 1A0001, which prove that the model can better describe liquidity risk of China’s A-share market. At last, it gives the corresponding policy recommendations.

  14. Risk of infective endocarditis in patients with systemic lupus erythematosus in Taiwan: a nationwide population-based study.

    PubMed

    Chang, Y S; Chang, C C; Chen, Y H; Chen, W S; Chen, J H

    2017-10-01

    Objectives Patients with systemic lupus erythematosus are considered vulnerable to infective endocarditis and prophylactic antibiotics are recommended before an invasive dental procedure. However, the evidence is insufficient. This nationwide population-based study evaluated the risk and related factors of infective endocarditis in systemic lupus erythematosus. Methods We identified 12,102 systemic lupus erythematosus patients from the National Health Insurance research-oriented database, and compared the incidence rate of infective endocarditis with that among 48,408 non-systemic lupus erythematosus controls. A Cox multivariable proportional hazards model was employed to evaluate the risk of infective endocarditis in the systemic lupus erythematosus cohort. Results After a mean follow-up of more than six years, the systemic lupus erythematosus cohort had a significantly higher incidence rate of infective endocarditis (42.58 vs 4.32 per 100,000 person-years, incidence rate ratio = 9.86, p < 0.001) than that of the control cohort. By contrast, the older systemic lupus erythematosus cohort had lower risk (adjusted hazard ratio 11.64) than that of the younger-than-60-years systemic lupus erythematosus cohort (adjusted hazard ratio 15.82). Cox multivariate proportional hazards analysis revealed heart disease (hazard ratio = 5.71, p < 0.001), chronic kidney disease (hazard ratio = 2.98, p = 0.034), receiving a dental procedure within 30 days (hazard ratio = 36.80, p < 0.001), and intravenous steroid therapy within 30 days (hazard ratio = 39.59, p < 0.001) were independent risk factors for infective endocarditis in systemic lupus erythematosus patients. Conclusions A higher risk of infective endocarditis was observed in systemic lupus erythematosus patients. Risk factors for infective endocarditis in the systemic lupus erythematosus cohort included heart disease, chronic kidney disease, steroid pulse therapy within 30 days, and a recent invasive dental procedure within 30 days.

  15. [Pregnancy in systemic autoimmune diseases: Myths, certainties and doubts].

    PubMed

    Danza, Álvaro; Ruiz-Irastorza, Guillermo; Khamashta, Munther

    2016-10-07

    Systemic autoimmune diseases especially affect young women during childbearing age. The aim of this review is to update systemic lupus erythematosus, antiphospholipid syndrome and systemic sclerosis management during pregnancy. These diseases present variable maternal and fetal risks. Studies show that an appropriate disease control and a reasonable remission period prior to pregnancy are associated with satisfactory obstetric outcomes. Antiphospholipid autoantibodies profile, anti-Ro/anti-La antibodies, pulmonary pressure and activity evaluation are crucial to assess the pregnancy risk. Monitoring requires a multidisciplinary team, serial analytic controls and Doppler ultrasound of maternal and fetal circulation. Evaluation of the activity of the disease is essential. Copyright © 2016 Elsevier España, S.L.U. All rights reserved.

  16. ADMS Evaluation Platform

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

    2018-01-23

    Deploying an ADMS or looking to optimize its value? NREL offers a low-cost, low-risk evaluation platform for assessing ADMS performance. The National Renewable Energy Laboratory (NREL) has developed a vendor-neutral advanced distribution management system (ADMS) evaluation platform and is expanding its capabilities. The platform uses actual grid-scale hardware, large-scale distribution system models, and advanced visualization to simulate realworld conditions for the most accurate ADMS evaluation and experimentation.

  17. Staging of intestinal- and diffuse-type gastric cancers with the OLGA and OLGIM staging systems.

    PubMed

    Cho, S-J; Choi, I J; Kook, M-C; Nam, B-H; Kim, C G; Lee, J Y; Ryu, K W; Kim, Y-W

    2013-11-01

    Operative link on gastritis assessment (OLGA) and Operative link on gastric intestinal metaplasia assessment (OLGIM) staging systems have been proposed for gastric cancer (GC) risk estimation. To validate the OLGA and OLGIM staging systems in a region with high risk of GC. This retrospective study included 474 GC patients and age- and sex-matched health screening control persons in a cancer centre hospital. We classified gastritis patterns according to the OLGA and OLGIM systems using the histological database that a pathologist prospectively evaluated using the updated Sydney system. GC risk according to the OLGA and OLGIM stages was evaluated using logistic regression analysis. More GC patients had OLGA stages III-IV (46.2%) than controls (26.6%, P < 0.001), particularly among patients with intestinal-type GCs (62.2%) compared with diffuse-type GCs (30.9%). OLGA stages III and IV were significantly associated with increased risk of GC [odds ratios (ORs), 2.09; P = 0.008 and 2.04; P = 0.014 respectively] in multivariate analysis. The association was more significant for intestinal-type (ORs, 4.76; P = 0.001 and 4.19; P = 0.002 respectively), but not diffuse-type GC. OLGIM stages from I to IV were significantly associated with increased risk of both intestinal-type (ORs, 3.64, 5.15, 7.89 and 13.20 respectively) and diffuse-type GC (ORs, 1.84, 2.59, 5.08 and 6.32 respectively) with a significantly increasing trend. As high OLGA and OLGIM stages are independent risk factors for gastric cancer, the staging systems may be useful for risk assessment in high-risk regions, especially for intestinal-type gastric cancer. © 2013 John Wiley & Sons Ltd.

  18. Adding Eyes: The Rise, Rewards, and Risks of Multi-Rater Teacher Observation Systems. Issue Brief

    ERIC Educational Resources Information Center

    White, Taylor

    2014-01-01

    New teacher evaluation systems have emerged as the cornerstone of the recent movement to improve public school teaching. Fueled by incentives from the federal government, state and local policymakers have sought to replace the often-cursory evaluation models of the past with more comprehensive ones. In contrast to past evaluations, which often…

  19. Risk measures for power failures in transmission systems

    NASA Astrophysics Data System (ADS)

    Cassidy, Alex; Feinstein, Zachary; Nehorai, Arye

    2016-11-01

    We present a novel framework for evaluating the risk of failures in power transmission systems. We use the concept of systemic risk measures from the financial mathematics literature with models of power system failures in order to quantify the risk of the entire power system for design and comparative purposes. The proposed risk measures provide the collection of capacity vectors for the components in the system that lead to acceptable outcomes. Keys to the formulation of our measures of risk are two elements: a model of system behavior that provides the (distribution of) outcomes based on component capacities and an acceptability criterion that determines whether a (random) outcome is acceptable from an aggregated point of view. We examine the effects of altering the line capacities on energy not served under a variety of networks, flow manipulation methods, load shedding schemes, and load profiles using Monte Carlo simulations. Our results provide a quantitative comparison of the performance of these schemes, measured by the required line capacity. These results provide more complete descriptions of the risks of power failures than the previous, one-dimensional metrics.

  20. Committee to evaluate Sandia`s risk expertise: Final report. Volume 1: Presentations

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

    Dudley, E.C.

    1998-05-01

    On July 1--2, 1997, Sandia National Laboratories hosted the External Committee to Evaluate Sandia`s Risk Expertise. Under the auspices of SIISRS (Sandia`s International Institute for Systematic Risk Studies), Sandia assembled a blue-ribbon panel of experts in the field of risk management to assess their risk programs labs-wide. Panelists were chosen not only for their own expertise, but also for their ability to add balance to the panel as a whole. Presentations were made to the committee on the risk activities at Sandia. In addition, a tour of Sandia`s research and development programs in support of the US Nuclear Regulatory Commissionmore » was arranged. The panel attended a poster session featuring eight presentations and demonstrations for selected projects. Overviews and viewgraphs from the presentations are included in Volume 1 of this report. Presentations are related to weapons, nuclear power plants, transportation systems, architectural surety, environmental programs, and information systems.« less

  1. Modelling the ability of source control measures to reduce inundation risk in a community-scale urban drainage system

    NASA Astrophysics Data System (ADS)

    Mei, Chao; Liu, Jiahong; Wang, Hao; Shao, Weiwei; Xia, Lin; Xiang, Chenyao; Zhou, Jinjun

    2018-06-01

    Urban inundation is a serious challenge that increasingly confronts the residents of many cities, as well as policymakers, in the context of rapid urbanization and climate change worldwide. In recent years, source control measures (SCMs) such as green roofs, permeable pavements, rain gardens, and vegetative swales have been implemented to address flood inundation in urban settings, and proven to be cost-effective and sustainable. In order to investigate the ability of SCMs on reducing inundation in a community-scale urban drainage system, a dynamic rainfall-runoff model of a community-scale urban drainage system was developed based on SWMM. SCMs implementing scenarios were modelled under six design rainstorm events with return period ranging from 2 to 100 years, and inundation risks of the drainage system were evaluated before and after the proposed implementation of SCMs, with a risk-evaluation method based on SWMM and analytic hierarchy process (AHP). Results show that, SCMs implementation resulting in significantly reduction of hydrological indexes that related to inundation risks, range of reduction rates of average flow, peak flow, and total flooded volume of the drainage system were 28.1-72.1, 19.0-69.2, and 33.9-56.0 %, respectively, under six rainfall events with return periods ranging from 2 to 100 years. Corresponding, the inundation risks of the drainage system were significantly reduced after SCMs implementation, the risk values falling below 0.2 when the rainfall return period was less than 10 years. Simulation results confirm the effectiveness of SCMs on mitigating inundation, and quantified the potential of SCMs on reducing inundation risks in the urban drainage system, which provided scientific references for implementing SCMs for inundation control of the study area.

  2. PILOT-SCALE EVALUATION OF AN INCINERABILITY RANKING SYSTEM FOR HAZARDOUS ORGANIC COMPOUNDS

    EPA Science Inventory

    The subject study was conducted to evaluate an incinerability ranking system developed by teh University of Dayton Research Institute under contract to the EPA Risk Reduction Engineering Laboratory. Fixtures of organic compounds were prepared and combined with a clay-based sorben...

  3. Development and validation of an automated delirium risk assessment system (Auto-DelRAS) implemented in the electronic health record system.

    PubMed

    Moon, Kyoung-Ja; Jin, Yinji; Jin, Taixian; Lee, Sun-Mi

    2018-01-01

    A key component of the delirium management is prevention and early detection. To develop an automated delirium risk assessment system (Auto-DelRAS) that automatically alerts health care providers of an intensive care unit (ICU) patient's delirium risk based only on data collected in an electronic health record (EHR) system, and to evaluate the clinical validity of this system. Cohort and system development designs were used. Medical and surgical ICUs in two university hospitals in Seoul, Korea. A total of 3284 patients for the development of Auto-DelRAS, 325 for external validation, 694 for validation after clinical applications. The 4211 data items were extracted from the EHR system and delirium was measured using CAM-ICU (Confusion Assessment Method for Intensive Care Unit). The potential predictors were selected and a logistic regression model was established to create a delirium risk scoring algorithm to construct the Auto-DelRAS. The Auto-DelRAS was evaluated at three months and one year after its application to clinical practice to establish the predictive validity of the system. Eleven predictors were finally included in the logistic regression model. The results of the Auto-DelRAS risk assessment were shown as high/moderate/low risk on a Kardex screen. The predictive validity, analyzed after the clinical application of Auto-DelRAS after one year, showed a sensitivity of 0.88, specificity of 0.72, positive predictive value of 0.53, negative predictive value of 0.94, and a Youden index of 0.59. A relatively high level of predictive validity was maintained with the Auto-DelRAS system, even one year after it was applied to clinical practice. Copyright © 2017. Published by Elsevier Ltd.

  4. Risk assessment of hazardous release in air due to the chemical production of "P. Karaminchev" company in the town of Rousse.

    PubMed

    Diankova, M

    1998-09-01

    A health risk evaluation of the lifetime population risk has been made, by using the US EPA's method of risk assessment. Several main steps have been conducted: --a hazard identification, by means of emission analysis and mathematical modeling of air concentration dispersion; a dose-response evaluation and exposure assessment, and finally--a risk characterization. The health risk evaluation was conducted, using lifetime reference concentrations and doses. As risk descriptors were applied: --the individual exposure coefficient (IEC), the hazard quotient (HQ) and the margin of exposure (MOE)--for system toxicants, and the excess lifetime cancer risk (ELCR)--for carcinogens. The method that was used provides an upperbound estimate, including all possible exposures. The results showed, that the emissions of hydrogen chloride, phthalates (DOF), nitrogen oxides and most of the organic solvents, released from this chemical plant, are not a source of lifetime chronic health risk for the population of any of the six evaluated residential areas of Rousse. The rest of the hazardous emissions cause a slightly increased lifetime health risk, which is entirely in the so called 'controlled risk zone' the risk descriptors vary from 1.00 to 5.00. A number of actions have been prescribed to the plant's government, most of which were realized in the short term.

  5. The German clinical risk management survey for hospitals: Implementation levels and areas for improvement in 2015.

    PubMed

    Manser, Tanja; Frings, Janina; Heuser, Gregory; Mc Dermott, Fiona

    2016-01-01

    Despite the growing recognition of the need to implement systematic approaches for managing the risks associated with healthcare, few studies have investigated the level of implementation for clinical risk management (CRM) at a national level. Therefore, this study aimed to assess the current level of CRM implementation in German hospitals and to explore differences across hospital types. From March to June 2015, persons responsible for CRM in 2,617 hospitals and rehabilitation clinics in Germany were invited to participate in a voluntary online survey assessing the level of implementation for various aspects of CRM: CRM strategy, structures and processes; risk assessment (risk identification, risk analysis, risk evaluation) with a focus on incident reporting systems; risk mitigation measures; and risk monitoring and reporting. 572 hospitals participated in the survey (response rate 22 %). Most of these hospitals had a formalised, binding CRM strategy (72 %). 66 % had a centralised and 34 % a decentralised CRM structure. We also found that, despite a broad range of risk assessment methods being applied, there was a lack of integration of risk information from different data sources. Hospitals also reported a high level of implementation of critical incident reporting systems with a strong preference for local (74 %) over transorganisational systems. This study provides relevant data to inform targeted interventions concerning CRM implementation at a national level and to consider the specific context of different types of hospitals more carefully in this process. The approach to CRM assessment illustrated in this article could be the basis of a system for monitoring CRM over time and, thus, for evaluating the impact of strategy decisions at the policy level on CRM development. Copyright © 2016. Published by Elsevier GmbH.

  6. Comprehensive managed care evaluation.

    PubMed

    Bushick, B

    1992-01-01

    To optimize the benefits of managed care delivery systems, employers must identify and reward those systems that are most efficient and effective. At the same time, their deeper involvement in system design and management exposes employers to greater potential liability. Employers thus need to better evaluate their managed care programs in order to enhance the benefits and minimize the risks.

  7. Investigations regarding the evaluation of specific intellectual property production risks within Quality Management System

    NASA Astrophysics Data System (ADS)

    Pakocs, R.; Lupulescu, N. B.

    2016-11-01

    This paper is a theoretical research concerning methods for risk assessment of specific intellectual property production risks that are identified in the product achievement stage within the Quality Management System. In order to realize this, we will start by identifying the specific intellectual property production risks and by proposing some new calculating formulas for minimalizing their negative effects. The theoretical model proposed assessment of specific intellectual property production risks, will be realized based on 3 hypothetical situations. This study intends to reduce the intellectual property risks identified in the production process of commercial societies that have an industrial profile.

  8. Spatially Explicit Landscape-Level Ecological Risks Induced by Land Use and Land Cover Change in a National Ecologically Representative Region in China.

    PubMed

    Gong, Jian; Yang, Jianxin; Tang, Wenwu

    2015-11-09

    Land use and land cover change is driven by multiple influential factors from environmental and social dimensions in a land system. Land use practices of human decision-makers modify the landscape of the land system, possibly leading to landscape fragmentation, biodiversity loss, or environmental pollution-severe environmental or ecological impacts. While landscape-level ecological risk assessment supports the evaluation of these impacts, investigations on how these ecological risks induced by land use practices change over space and time in response to alternative policy intervention remain inadequate. In this article, we conducted spatially explicit landscape ecological risk analysis in Ezhou City, China. Our study area is a national ecologically representative region experiencing drastic land use and land cover change, and is regulated by multiple policies represented by farmland protection, ecological conservation, and urban development. We employed landscape metrics to consider the influence of potential landscape-level disturbance for the evaluation of landscape ecological risks. Using spatiotemporal simulation, we designed scenarios to examine spatiotemporal patterns in landscape ecological risks in response to policy intervention. Our study demonstrated that spatially explicit landscape ecological risk analysis combined with simulation-driven scenario analysis is of particular importance for guiding the sustainable development of ecologically vulnerable land systems.

  9. Spatially Explicit Landscape-Level Ecological Risks Induced by Land Use and Land Cover Change in a National Ecologically Representative Region in China

    PubMed Central

    Gong, Jian; Yang, Jianxin; Tang, Wenwu

    2015-01-01

    Land use and land cover change is driven by multiple influential factors from environmental and social dimensions in a land system. Land use practices of human decision-makers modify the landscape of the land system, possibly leading to landscape fragmentation, biodiversity loss, or environmental pollution—severe environmental or ecological impacts. While landscape-level ecological risk assessment supports the evaluation of these impacts, investigations on how these ecological risks induced by land use practices change over space and time in response to alternative policy intervention remain inadequate. In this article, we conducted spatially explicit landscape ecological risk analysis in Ezhou City, China. Our study area is a national ecologically representative region experiencing drastic land use and land cover change, and is regulated by multiple policies represented by farmland protection, ecological conservation, and urban development. We employed landscape metrics to consider the influence of potential landscape-level disturbance for the evaluation of landscape ecological risks. Using spatiotemporal simulation, we designed scenarios to examine spatiotemporal patterns in landscape ecological risks in response to policy intervention. Our study demonstrated that spatially explicit landscape ecological risk analysis combined with simulation-driven scenario analysis is of particular importance for guiding the sustainable development of ecologically vulnerable land systems. PMID:26569270

  10. Managing health and safety risks: Implications for tailoring health and safety management system practices.

    PubMed

    Willmer, D R; Haas, E J

    2016-01-01

    As national and international health and safety management system (HSMS) standards are voluntarily accepted or regulated into practice, organizations are making an effort to modify and integrate strategic elements of a connected management system into their daily risk management practices. In high-risk industries such as mining, that effort takes on added importance. The mining industry has long recognized the importance of a more integrated approach to recognizing and responding to site-specific risks, encouraging the adoption of a risk-based management framework. Recently, the U.S. National Mining Association led the development of an industry-specific HSMS built on the strategic frameworks of ANSI: Z10, OHSAS 18001, The American Chemistry Council's Responsible Care, and ILO-OSH 2001. All of these standards provide strategic guidance and focus on how to incorporate a plan-do-check-act cycle into the identification, management and evaluation of worksite risks. This paper details an exploratory study into whether practices associated with executing a risk-based management framework are visible through the actions of an organization's site-level management of health and safety risks. The results of this study show ways that site-level leaders manage day-to-day risk at their operations that can be characterized according to practices associated with a risk-based management framework. Having tangible operational examples of day-to-day risk management can serve as a starting point for evaluating field-level risk assessment efforts and their alignment to overall company efforts at effective risk mitigation through a HSMS or other processes.

  11. Updated hazard rate equations for dual safeguard systems.

    PubMed

    Rothschild, Marc

    2007-04-11

    A previous paper by this author [M.J. Rothschild, Updated hazard rate equation for single safeguards, J. Hazard. Mater. 130 (1-2) (2006) 15-20] showed that commonly used analytical methods for quantifying failure rates overestimates the risk in some circumstances. This can lead the analyst to mistakenly believe that a given operation presents an unacceptable risk. For a single safeguard system, a formula was presented in that paper that accurately evaluates the risk over a wide range of conditions. This paper expands on that analysis by evaluating the failure rate for dual safeguard systems. The safeguards can be activated at the same time or at staggered times, and the safeguard may provide an indication whether it was successful upon a challenge, or its status may go undetected. These combinations were evaluated using a Monte Carlo simulation. Empirical formulas for evaluating the hazard rate were developed from this analysis. It is shown that having the safeguards activate at the same time while providing positive feedback of their individual actions is the most effective arrangement in reducing the hazard rate. The hazard rate can also be reduced by staggering the testing schedules of the safeguards.

  12. 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.

  13. An early warning system for groundwater pollution based on the assessment of groundwater pollution risks.

    NASA Astrophysics Data System (ADS)

    Zhang, Weihong.; Zhao, Yongsheng; Hong, Mei; Guo, Xiaodong

    2009-04-01

    Groundwater pollution usually is complex and concealed, remediation of which is difficult, high cost, time-consuming, and ineffective. An early warning system for groundwater pollution is needed that detects groundwater quality problems and gets the information necessary to make sound decisions before massive groundwater quality degradation occurs. Groundwater pollution early warning were performed by considering comprehensively the current groundwater quality, groundwater quality varying trend and groundwater pollution risk . The map of the basic quality of the groundwater was obtained by fuzzy comprehensive evaluation or BP neural network evaluation. Based on multi-annual groundwater monitoring datasets, Water quality state in sometime of the future was forecasted using time-sequenced analyzing methods. Water quality varying trend was analyzed by Spearman's rank correlative coefficient.The relative risk map of groundwater pollution was estimated through a procedure that identifies, cell by cell,the values of three factors, that is inherent vulnerability, load risk of pollution source and contamination hazard. DRASTIC method was used to assess inherent vulnerability of aquifer. Load risk of pollution source was analyzed based on the potential of contamination and pollution degree. Assessment index of load risk of pollution source which involves the variety of pollution source, quantity of contaminants, releasing potential of pollutants, and distance were determined. The load risks of all sources considered by GIS overlay technology. Early warning model of groundwater pollution combined with ComGIS technology organically, the regional groundwater pollution early-warning information system was developed, and applied it into Qiqiha'er groundwater early warning. It can be used to evaluate current water quality, to forecast water quality changing trend, and to analyze space-time influencing range of groundwater quality by natural process and human activities. Keywords: groundwater pollution, early warning, aquifer vulnerability, pollution load, pollution risk, ComGIS

  14. Risk with energy from conventional and nonconventional sources.

    PubMed

    Inhaber, H

    1979-02-23

    Risk to human health was compared for five conventional and six nonconventional energy systems. The entire cycle for producing energy was considered, not just part. The most important conclusion drawn is that the risk to human health from nonconventional sources can be as high as, or even higher than, that of conventional sources. This result is produced only when the risk per unit energy is considered, rather than the risk per solar panel or windmill. The risk from nonconventional energy sources derives from the large amount of material and labor needed, along with their backup and storage requirements. Risk evaluation is a relatively new discipline, and therefore the results presented here can be considered only a beginning. However, society should keep relative risk in mind when evaluating present and future energy sources.

  15. Medical-device risk management and public safety: using cost-benefit as a measurement of effectiveness

    NASA Astrophysics Data System (ADS)

    Hughes, Allen A.

    1994-12-01

    Public safety can be enhanced through the development of a comprehensive medical device risk management. This can be accomplished through case studies using a framework that incorporates cost-benefit analysis in the evaluation of risk management attributes. This paper presents a framework for evaluating the risk management system for regulatory Class III medical devices. The framework consists of the following sixteen attributes of a comprehensive medical device risk management system: fault/failure analysis, premarket testing/clinical trials, post-approval studies, manufacturer sponsored hospital studies, product labeling, establishment inspections, problem reporting program, mandatory hospital reporting, medical literature surveillance, device/patient registries, device performance monitoring, returned product analysis, autopsy program, emergency treatment funds/interim compensation, product liability, and alternative compensation mechanisms. Review of performance histories for several medical devices can reveal the value of information for many attributes, and also the inter-dependencies of the attributes in generating risk information flow. Such an information flow network is presented as a starting point for enhancing medical device risk management by focusing on attributes with high net benefit values and potential to spur information dissemination.

  16. Economic Evaluation of the Information Security Levels Achieved by Electric Energy Providers in North Arctic Region

    NASA Astrophysics Data System (ADS)

    Sushko, O. P.; Kaznin, A. A.; Babkin, A. V.; Bogdanov, D. A.

    2017-10-01

    The study we are conducting involves the analysis of information security levels achieved by energy providers operating in the North Arctic Region. We look into whether the energy providers’ current information security levels meet reliability standards and determine what further actions may be needed for upgrading information security in the context of the digital transformation that the world community is undergoing. When developing the information security systems for electric energy providers or selecting the protection means for them, we are governed by the fact that the assets to be protected are process technologies. While information security risk can be assessed using different methods, the evaluation of the economic damage from these risks appears to be a difficult task. The most probable and harmful risks we have identified when evaluating the electric energy providers’ information security will be used by us as variables. To provide the evaluation, it is necessary to calculate the costs relating to elimination of the risks identified. The final stage of the study will involve the development of an operation algorithm for the North Arctic Region’s energy provider’s business information protection security system - a set of information security services, and security software and hardware.

  17. Automated Pressure Injury Risk Assessment System Incorporated Into an Electronic Health Record System.

    PubMed

    Jin, Yinji; Jin, Taixian; Lee, Sun-Mi

    Pressure injury risk assessment is the first step toward preventing pressure injuries, but traditional assessment tools are time-consuming, resulting in work overload and fatigue for nurses. The objectives of the study were to build an automated pressure injury risk assessment system (Auto-PIRAS) that can assess pressure injury risk using data, without requiring nurses to collect or input additional data, and to evaluate the validity of this assessment tool. A retrospective case-control study and a system development study were conducted in a 1,355-bed university hospital in Seoul, South Korea. A total of 1,305 pressure injury patients and 5,220 nonpressure injury patients participated for the development of a risk scoring algorithm: 687 and 2,748 for the validation of the algorithm and 237 and 994 for validation after clinical implementation, respectively. A total of 4,211 pressure injury-related clinical variables were extracted from the electronic health record (EHR) systems to develop a risk scoring algorithm, which was validated and incorporated into the EHR. That program was further evaluated for predictive and concurrent validity. Auto-PIRAS, incorporated into the EHR system, assigned a risk assessment score of high, moderate, or low and displayed this on the Kardex nursing record screen. Risk scores were updated nightly according to 10 predetermined risk factors. The predictive validity measures of the algorithm validation stage were as follows: sensitivity = .87, specificity = .90, positive predictive value = .68, negative predictive value = .97, Youden index = .77, and the area under the receiver operating characteristic curve = .95. The predictive validity measures of the Braden Scale were as follows: sensitivity = .77, specificity = .93, positive predictive value = .72, negative predictive value = .95, Youden index = .70, and the area under the receiver operating characteristic curve = .85. The kappa of the Auto-PIRAS and Braden Scale risk classification result was .73. The predictive performance of the Auto-PIRAS was similar to Braden Scale assessments conducted by nurses. Auto-PIRAS is expected to be used as a system that assesses pressure injury risk automatically without additional data collection by nurses.

  18. Guidelines for developing NASA (National Aeronautics and Space Administration) ADP security risk management plans

    NASA Technical Reports Server (NTRS)

    Tompkins, F. G.

    1983-01-01

    This report presents guidance to NASA Computer security officials for developing ADP security risk management plans. The six components of the risk management process are identified and discussed. Guidance is presented on how to manage security risks that have been identified during a risk analysis performed at a data processing facility or during the security evaluation of an application system.

  19. NASA Collaborative Approach Mitigates Environmentally-Driven Obsolescence

    NASA Technical Reports Server (NTRS)

    Greene, Brian; Leeney, Bob; Richards, Joni

    2016-01-01

    National Aeronautics and Space Administration (NASA) missions, like Department of Defense (DoD) organizations, require the rigorous testing and qualification of critical materials. Obsolescence supply risks created by environmental requirements can affect the cost, schedule and performance of NASA missions and the resilience of critical infrastructure. The NASA Technology Evaluation for Environmental Risk Mitigation (TEERM) Principal Center helps to identify obsolescence supply risks driven by environmental requirements and works proactively with NASA Centers and Programs, the DoD, the European Space Agency (ESA) and other agencies and partners to identify and evaluate environmentally friendly alternatives. TEERM tracks environmental regulations, identifies the potential loss of material availability and works with NASA programs and Centers to evaluate potential impacts through a risk assessment approach. TEERM collaborative projects identify, demonstrate and evaluate commercially viable alternative technologies and materials. A major focus during the Space Shuttle Program was the need to replace ozone depleting substances that were used in spray foam and cleaning applications. The potential obsolescence of coatings containing hexavalent chromium and the risks associated with lead free solder were also of concern for the Space Shuttle and present ongoing risks to new programs such as the Space Launch System. One current project teams NASA and ESA in the evaluation and testing of individual coatings and coating systems as replacements for hexavalent chromium coatings in aerospace applications. The proactive, collaborative approach used by TEERM helps reduce the cost burden on any one team partner, reduces duplication of effort, and enhances the technical quality and overall applicability of the testing and analysis.

  20. An Introduction to the Mission Risk Diagnostic for Incident Management Capabilities (MRD-IMC)

    DTIC Science & Technology

    2014-05-01

    objectives. Analysts applying the MRD- IMC evaluate a set of systemic risk factors (called drivers) to aggregate decision-making data and provide decision...function is in position to achieve its mission and objective(s) [Alberts 2012]. To accomplish this goal, analysts applying the MRD- IMC evaluate a...005 | 3 evaluation of IM processes and capabilities. The MRD- IMC comprises the following three core tasks: 1. Identify the mission and objective(s

  1. Evaluation of the impacts of cooperative adaptive cruise control on reducing rear-end collision risks on freeways.

    PubMed

    Li, Ye; Wang, Hao; Wang, Wei; Xing, Lu; Liu, Shanwen; Wei, Xueyan

    2017-01-01

    Although plenty of studies have been conducted recently about the impacts of cooperative adaptive cruise control (CACC) system on traffic efficiency, there are few researches analyzing the safety effects of this advanced driving-assistant system. Thus, the primary objective of this study is to evaluate the impacts of the CACC system on reducing rear-end collision risks on freeways. The CACC model is firstly developed, which is based on the Intelligent Driver Model (IDM). Then, two surrogated safety measures, derived from the time-to-collision (TTC), denoting time exposed time-to-collision (TET) and time integrated time-to-collision (TIT), are introduced for quantifying the collision risks. And the safety effects are analyzed both theoretically and experimentally, by the linear stability analysis and simulations. The theoretical and simulation results conformably indicate that the CACC system brings dramatic benefits for reducing rear-end collision risks (TET and TIT are reduced more than 90%, respectively), when the desired time headway and time delay are set properly. The sensitivity analysis indicates there are few differences among different values of the threshold of TTC and the length of a CACC platoon. The results also show that the safety improvements weaken with the decrease of the penetration rates of CACC on the market and the increase of time delay between platoons. We also evaluate the traffic efficiency of the CACC system with different desired time headway. Copyright © 2016 Elsevier Ltd. All rights reserved.

  2. Comparative health and safety assessment of the SPS and alternative electrical generation systems

    NASA Astrophysics Data System (ADS)

    Habegger, L. J.; Gasper, J. R.; Brown, C. D.

    1980-07-01

    A comparative analysis of health and safety risks is presented for the Satellite Power System and five alternative baseload electrical generation systems: a low-Btu coal gasification system with an open-cycle gas turbine combined with a steam topping cycle; a light water fission reactor system without fuel reprocessing; a liquid metal fast breeder fission reactor system; a central station terrestrial photovoltaic system; and a first generation fusion system with magnetic confinement. For comparison, risk from a decentralized roof-top photovoltaic system with battery storage is also evaluated. Quantified estimates of public and occupational risks within ranges of uncertainty were developed for each phase of the energy system. The potential significance of related major health and safety issues that remain unquantitied are also discussed.

  3. Comparative health and safety assessment of the SPS and alternative electrical generation systems

    NASA Technical Reports Server (NTRS)

    Habegger, L. J.; Gasper, J. R.; Brown, C. D.

    1980-01-01

    A comparative analysis of health and safety risks is presented for the Satellite Power System and five alternative baseload electrical generation systems: a low-Btu coal gasification system with an open-cycle gas turbine combined with a steam topping cycle; a light water fission reactor system without fuel reprocessing; a liquid metal fast breeder fission reactor system; a central station terrestrial photovoltaic system; and a first generation fusion system with magnetic confinement. For comparison, risk from a decentralized roof-top photovoltaic system with battery storage is also evaluated. Quantified estimates of public and occupational risks within ranges of uncertainty were developed for each phase of the energy system. The potential significance of related major health and safety issues that remain unquantitied are also discussed.

  4. 75 FR 76982 - Integrated Risk Information System (IRIS); Announcement of Availability of Literature Searches...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-12-10

    ... quantitative and qualitative risk information on effects that may result from exposure to specific chemical...), Office of Research and Development, U.S. Environmental Protection Agency, Washington, DC 20460; telephone... human health assessment program that evaluates quantitative and qualitative risk information on effects...

  5. 77 FR 20817 - Integrated Risk Information System (IRIS); Announcement of Availability of Literature Searches...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-04-06

    ... quantitative and qualitative risk information on effects that may result from exposure to specific chemical... Deputy Director, National Center for Environmental Assessment, (mail code: 8601D), Office of Research and... program that evaluates quantitative and qualitative risk information on effects that may result from...

  6. 77 FR 41784 - Integrated Risk Information System (IRIS); Announcement of Availability of Literature Searches...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-07-16

    ... health assessment program that evaluates quantitative and qualitative risk information on effects that..., National Center for Environmental Assessment, (mail code: 8601P), Office of Research and Development, U.S... quantitative and qualitative risk information on effects that may result from exposure to specific chemical...

  7. Incidence of cervical human papillomavirus infection in systemic lupus erythematosus women.

    PubMed

    Mendoza-Pinto, C; García-Carrasco, M; Vallejo-Ruiz, V; Méndez-Martínez, S; Taboada-Cole, A; Etchegaray-Morales, I; Muñóz-Guarneros, M; Reyes-Leyva, J; López-Colombo, A

    2017-08-01

    Objectives Our objective was to study the incidence, persistence and clearance of human papillomavirus infection in systemic lupus erythematosus women and assess risk factors for persistence of human papillomavirus infection. Methods We carried out a prospective, observational cohort study of 127 systemic lupus erythematosus women. Patients were evaluated at baseline and at three years. Traditional and systemic lupus erythematosus women-related disease risk factors were collected. Gynaecological evaluations and cervical cytology screening were made. Human papillomavirus detection and genotyping were made by polymerase chain reaction and linear array. Results The cumulative prevalence of human papillomavirus infection increased from 22.8% at baseline to 33.8% at three years; p = < 0.001: 20.1% of patients experienced 43 incident infections. The risk of any human papillomavirus infection was 10.1 per 1000 patient-months. At three years, 47 (88.6%) prevalent infections were cleared. Independent risk factors associated with incident human papillomavirus infection included more lifetime sexual partners (odds ratio = 1.8, 95% confidence interval = 1.11-3.0) and cumulative cyclophosphamide dose (odds ratio = 3.9, 95% confidence interval = 1.2-12.8). Conclusions In systemic lupus erythematosus women, the cumulative prevalence of human papillomavirus infection, including high risk-human papillomavirus and multiple human papillomavirus infections, may increase over time. Most persistent infections were low risk-human papillomavirus. The number of lifetime sexual partners and the cumulative cyclophosphamide dose were independently associated with incident human papillomavirus infection.

  8. The construction of power grid operation index system considering the risk of maintenance

    NASA Astrophysics Data System (ADS)

    Tang, Jihong; Wang, Canlin; Jiang, Xinfan; Ye, Jianhui; Pan, Feilai

    2018-02-01

    In recent years, large-scale blackout occurred at home and abroad caused widespread concern about the operation of the grid in the world, and the maintenance risk is an important indicator of grid safety. The barrier operation of the circuit breaker exists in the process of overhaul of the power grid. The operation of the different barrier is of great significance to the change of the power flow, thus affecting the safe operation of the system. Most of the grid operating status evaluation index system did not consider the risk of maintenance, to this end, this paper from the security, economy, quality and cleanliness of the four angles, build the power grid operation index system considering the risk of maintenance.

  9. Children Placed at Risk for Learning and Behavioral Difficulties: Implementing a School-Wide System of Early Identification and Intervention.

    ERIC Educational Resources Information Center

    O'Shaughnessy, Tam E.; Lane, Kathleen L.; Gresham, Frank M.; Beebe-Frankenberger, Margaret E.

    2003-01-01

    This article describes a school-wide system of early identification and intervention for children recognized as being at risk for learning and behavior difficulties. Suggested guidelines for implementing such a program include: evaluating existing theory, knowledge, and practice; providing ongoing professional development; creating a school-wide…

  10. Evaluation of passenger health risk assessment of sustainable indoor air quality monitoring in metro systems based on a non-Gaussian dynamic sensor validation method.

    PubMed

    Kim, MinJeong; Liu, Hongbin; Kim, Jeong Tai; Yoo, ChangKyoo

    2014-08-15

    Sensor faults in metro systems provide incorrect information to indoor air quality (IAQ) ventilation systems, resulting in the miss-operation of ventilation systems and adverse effects on passenger health. In this study, a new sensor validation method is proposed to (1) detect, identify and repair sensor faults and (2) evaluate the influence of sensor reliability on passenger health risk. To address the dynamic non-Gaussianity problem of IAQ data, dynamic independent component analysis (DICA) is used. To detect and identify sensor faults, the DICA-based squared prediction error and sensor validity index are used, respectively. To restore the faults to normal measurements, a DICA-based iterative reconstruction algorithm is proposed. The comprehensive indoor air-quality index (CIAI) that evaluates the influence of the current IAQ on passenger health is then compared using the faulty and reconstructed IAQ data sets. Experimental results from a metro station showed that the DICA-based method can produce an improved IAQ level in the metro station and reduce passenger health risk since it more accurately validates sensor faults than do conventional methods. Copyright © 2014 Elsevier B.V. All rights reserved.

  11. USER'S GUIDE TO CLOSURE EVALUATION SYSTEM: CES BETA-TEST VERSION 1.0

    EPA Science Inventory

    The Closure Evaluation System (CES) is a decision support tool, developed by the U.S. EPA's Risk Reduction Engineering Laboratory, to assist reviewers and preparers of Resource Conservation and Recovery Act (RCRA) Part B permit applications. CES is designed to serve as a checklis...

  12. Evaluating Potential Exposures to Ecological Receptors Due to Transport of Hydrophobic Organic Contaminants in Subsurface Systems (Final Report)

    EPA Science Inventory

    EPA's Ecological Risk Assessment Support Center (ERASC) announced the release of the final report, Evaluating Potential Exposures to Ecological Receptors Due to Transport of Hydrophobic Organic Contaminants in Subsurface Systems. This technical paper recommends several ty...

  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. Analysis of space systems study for the space disposal of nuclear waste. Study report, volume 1: Executive summary

    NASA Technical Reports Server (NTRS)

    1981-01-01

    Space systems concepts were identified and defined and evaluated as to their performance, risks, and technical viability in order to select the most attractive approach for disposal of high level nuclear wastes in space. Major study areas discussed include: (1) mission and operations analysis; (2) waste payload systems; (3) flight support system; (4) launch site systems; (5) launch vehicle systems; (6) orbit transfer system; (7) space disposal destinations; and (8) systems integration and evaluation.

  15. Assessment of environmental risk for red mud storage facility in China: a case study in Shandong Province.

    PubMed

    Wen, Zhi-Chao; Ma, Shu-Hua; Zheng, Shi-Li; Zhang, Yi; Liang, Yan

    2016-06-01

    Red mud storage facility (RM-SF) pollution remains a serious problem in China mainly due to the RM's huge quantity, little recyclability, and high alkalinity. And, there is also a risk of dam failure because almost all RM-SFs are processed by damming. In order to address this challenge and improve the level of risk management, it is necessary to evaluate the environmental risk of RM-SFs systematically. So, this paper firstly designs a comprehensive evaluation index system with a three-level evaluation index in the terms of RM characteristics, RM-SF characteristics, ambient environment of RM-SF, the management of RM-SF, and the application aspect of RM by the analytic hierarchy process (AHP) method. Then, a case of RM-SF from a typical alumina production enterprise is studied according to this system, as is assisted by several experts from different fields when determining the weights of all indicators. The results show that the risk of selected RM-SF primarily depends on the former factors, that is, RM and RM-SF characteristics, while the contributions of the other factors are quite smaller.

  16. Evaluating the risk of water distribution system failure: A shared frailty model

    NASA Astrophysics Data System (ADS)

    Clark, Robert M.; Thurnau, Robert C.

    2011-12-01

    Condition assessment (CA) Modeling is drawing increasing interest as a technique that can assist in managing drinking water infrastructure. This paper develops a model based on the application of a Cox proportional hazard (PH)/shared frailty model and applies it to evaluating the risk of failure in drinking water networks using data from the Laramie Water Utility (located in Laramie, Wyoming, USA). Using the risk model a cost/ benefit analysis incorporating the inspection value method (IVM), is used to assist in making improved repair, replacement and rehabilitation decisions for selected drinking water distribution system pipes. A separate model is developed to predict failures in prestressed concrete cylinder pipe (PCCP). Various currently available inspection technologies are presented and discussed.

  17. Time-Tagged Risk/Reliability Assessment Program for Development and Operation of Space System

    NASA Astrophysics Data System (ADS)

    Kubota, Yuki; Takegahara, Haruki; Aoyagi, Junichiro

    We have investigated a new method of risk/reliability assessment for development and operation of space system. It is difficult to evaluate risk of spacecraft, because of long time operation, maintenance free and difficulty of test under the ground condition. Conventional methods are FMECA, FTA, ETA and miscellaneous. These are not enough to assess chronological anomaly and there is a problem to share information during R&D. A new method of risk and reliability assessment, T-TRAP (Time-tagged Risk/Reliability Assessment Program) is proposed as a management tool for the development and operation of space system. T-TRAP consisting of time-resolved Fault Tree and Criticality Analyses, upon occurrence of anomaly in the system, facilitates the responsible personnel to quickly identify the failure cause and decide corrective actions. This paper describes T-TRAP method and its availability.

  18. Coastal risk forecast system

    NASA Astrophysics Data System (ADS)

    Sabino, André; Poseiro, Pedro; Rodrigues, Armanda; Reis, Maria Teresa; Fortes, Conceição J.; Reis, Rui; Araújo, João

    2018-03-01

    The run-up and overtopping by sea waves are two of the main processes that threaten coastal structures, leading to flooding, destruction of both property and the environment, and harm to people. To build early warning systems, the consequences and associated risks in the affected areas must be evaluated. It is also important to understand how these two types of spatial information integrate with sensor data sources and the risk assessment methodology. This paper describes the relationship between consequences and risk maps, their role in risk management and how the HIDRALERTA system integrates both aspects in its risk methodology. It describes a case study for Praia da Vitória Port, Terceira Island, Azores, Portugal, showing that the main innovations in this system are twofold: it represents the overtopping flow and consequent flooding, which are critical for coastal and port areas protected by maritime structures, and it works also as a risk assessment tool, extremely important for long-term planning and decision-making. Moreover, the implementation of the system considers possible known variability issues, enabling changes in its behaviour as needs arise. This system has the potential to become a useful tool for the management of coastal and port areas, due to its capacity to effectively issue warnings and assess risks.

  19. Coastal risk forecast system

    NASA Astrophysics Data System (ADS)

    Sabino, André; Poseiro, Pedro; Rodrigues, Armanda; Reis, Maria Teresa; Fortes, Conceição J.; Reis, Rui; Araújo, João

    2018-04-01

    The run-up and overtopping by sea waves are two of the main processes that threaten coastal structures, leading to flooding, destruction of both property and the environment, and harm to people. To build early warning systems, the consequences and associated risks in the affected areas must be evaluated. It is also important to understand how these two types of spatial information integrate with sensor data sources and the risk assessment methodology. This paper describes the relationship between consequences and risk maps, their role in risk management and how the HIDRALERTA system integrates both aspects in its risk methodology. It describes a case study for Praia da Vitória Port, Terceira Island, Azores, Portugal, showing that the main innovations in this system are twofold: it represents the overtopping flow and consequent flooding, which are critical for coastal and port areas protected by maritime structures, and it works also as a risk assessment tool, extremely important for long-term planning and decision-making. Moreover, the implementation of the system considers possible known variability issues, enabling changes in its behaviour as needs arise. This system has the potential to become a useful tool for the management of coastal and port areas, due to its capacity to effectively issue warnings and assess risks.

  20. Estimation of physiologic ability and surgical stress (E-PASS) scoring system could provide preoperative advice on whether to undergo laparoscopic surgery for colorectal cancer patients with a high physiological risk

    PubMed Central

    Zhang, Ao; Liu, Tingting; Zheng, Kaiyuan; Liu, Ningbo; Huang, Fei; Li, Weidong; Liu, Tong; Fu, Weihua

    2017-01-01

    Abstract Laparoscopic colorectal surgery had been widely used for colorectal cancer patient and showed a favorable outcome on the postoperative morbidity rate. We attempted to evaluate physiological status of patients by mean of Estimation of physiologic ability and surgical stress (E-PASS) system and to analyze the difference variation of postoperative morbidity rate of open and laparoscopic colorectal cancer surgery in patients with different physiological status. In total 550 colorectal cancer patients who underwent surgery treatment were included. E-PASS and some conventional scoring systems were reviewed to examine their mortality prediction ability. The preoperative risk score (PRS) in the E-PASS system was used to evaluate the physiological status of patients. The difference of postoperative morbidity rate between open and laparoscopic colorectal cancer surgeries was analyzed respectively in patients with different physiological status. E-PASS had better prediction ability than other conventional scoring systems in colorectal cancer surgeries. Postoperative morbidities were developed in 143 patients. The parameters in the E-PASS system had positive correlations with postoperative morbidity. The overall postoperative morbidity rate of laparoscopic surgeries was lower than open surgeries (19.61% and 28.46%), but the postoperative morbidity rate of laparoscopic surgeries increased more significantly than in open surgery as PRS increased. When PRS was more than 0.7, the postoperative morbidity rate of laparoscopic surgeries would exceed the postoperative morbidity rate of open surgeries. The E-PASS system was capable to evaluate the physiological and surgical risk of colorectal cancer surgery. PRS could assist preoperative decision-making on the surgical method. Colorectal cancer patients who were assessed with a low physiological risk by PRS would be safe to undergo laparoscopic surgery. On the contrary, surgeons should make decisions prudently on the operation method for patient with a high physiological risk. PMID:28816959

  1. Evaluation of Additively Manufactured Metals for Use in Oxygen Systems Project

    NASA Technical Reports Server (NTRS)

    Tylka, Jonathan; Cooper, Ken; Peralta, Stephen; Wilcutt, Terrence; Hughitt, Brian; Generazio, Edward

    2016-01-01

    Space Launch System, Commercial Resupply, and Commercial Crew programs have published intent to use additively manufactured (AM) components in propulsion systems and are likely to include various life support systems in the future. Parts produced by these types of additive manufacturing techniques have not been fully evaluated for use in oxygen systems and the inherent risks have not been fully identified. Some areas of primary concern in the SLS process with respect to oxygen compatibility may be the porosity of the printed parts, fundamental differences in microstructure of an AM part as compared to traditional materials, or increased risk of shed metal particulate into an oxygen system. If an ignition were to occur the printed material could be more flammable than components manufactured from a traditional billet of raw material and/or present a significant hazards if not identified and rigorously studied in advance of implementation into an oxygen system.

  2. Prototype development of a web-based participative decision support platform in risk management

    NASA Astrophysics Data System (ADS)

    Aye, Zar Chi; Olyazadeh, Roya; Jaboyedoff, Michel; Derron, Marc-Henri

    2014-05-01

    This paper discusses the proposed background architecture and prototype development of an internet-based decision support system (DSS) in the field of natural hazards and risk management using open-source geospatial software and web technologies. It is based on a three-tier, client-server architecture with the support of boundless (opengeo) framework and its client side SDK application environment using customized gxp components and data utility classes. The main purpose of the system is to integrate the workflow of risk management systematically with the diverse involvement of stakeholders from different organizations dealing with natural hazards and risk for evaluation of management measures through the active online participation approach. It aims to develop an adaptive user friendly, web-based environment that allows the users to set up risk management strategies based on actual context and data by integrating web-GIS and DSS functionality associated with process flow and other visualization tools. Web-GIS interface has been integrated within the DSS to deliver maps and provide certain geo-processing capabilities on the web, which can be easily accessible and shared by different organizations located in case study sites of the project. This platform could be envisaged not only as a common web-based platform for the centralized sharing of data such as hazard maps, elements at risk maps and additional information but also to ensure an integrated platform of risk management where the users could upload data, analyze risk and identify possible alternative scenarios for risk reduction especially for floods and landslides, either quantitatively or qualitatively depending on the risk information provided by the stakeholders in case study regions. The level of involvement, access to and interaction with the provided functionality of the system varies depending on the roles and responsibilities of the stakeholders, for example, only the experts (planners, geological services, etc.) can have access to the alternative definition component to formulate the risk reduction measures. The development of such a participative platform would finally lead to an integrated risk management approach highlighting the needs to deal with involved experts and civil society in the decision-making process for evaluation of risk management measures through the active participation approach. The system will be applied and evaluated in four case study areas of the CHANGES project in Europe: Romania, North Eastern Italy, French Alps and Poland. However, the framework of the system is designed in a generic way so as to be applicable in other regions to achieve the high adaptability and flexibility of the system. The research has been undertaken as a part of the CHANGES project funded by the European Commission's 7th framework program.

  3. Development of a Safety Monitoring and Assurance System for chilled food products.

    PubMed

    Koutsoumanis, K; Taoukis, P S; Nychas, G J E

    2005-04-15

    The principles of a novel chill chain management policy, coded Safety Monitoring and Assurance System (SMAS) for the optimisation of the distribution of chilled food products within the chill chain are developed. In this system, a new approach based on actual risk evaluation at important points of the chill chain is used in order to promote products to the next stage of distribution. This evaluation based on product's time-temperature history, variation in product's characteristics (e.g. a(w), pH, etc.), and the use of predictive models for the growth of food pathogens, allows to give priority to products in such a way that risk at consumption time is minimized. The effectiveness of SMAS was evaluated against the First In First Out (FIFO) approach, the current method for food distribution, in a case study on the risk of listeriosis of cooked ham using the Monte Carlo simulation technique. Furthermore, the two approaches were compared for their effect on the quality of the products in terms of remaining shelf life at the time of consumption. The results showed that following the SMAS approach the risk of listerisosis is significantly lower while the spoiled products at the time of consumption are significantly reduced compared to FIFO approach.

  4. Breach Risk Magnitude: A Quantitative Measure of Database Security.

    PubMed

    Yasnoff, William A

    2016-01-01

    A quantitative methodology is described that provides objective evaluation of the potential for health record system breaches. It assumes that breach risk increases with the number of potential records that could be exposed, while it decreases when more authentication steps are required for access. The breach risk magnitude (BRM) is the maximum value for any system user of the common logarithm of the number of accessible database records divided by the number of authentication steps needed to achieve such access. For a one million record relational database, the BRM varies from 5.52 to 6 depending on authentication protocols. For an alternative data architecture designed specifically to increase security by separately storing and encrypting each patient record, the BRM ranges from 1.3 to 2.6. While the BRM only provides a limited quantitative assessment of breach risk, it may be useful to objectively evaluate the security implications of alternative database organization approaches.

  5. IRIS Toxicological Review of Ammonia Noncancer Inhalation ...

    EPA Pesticide Factsheets

    EPA has finalized the Integrated Risk Information System (IRIS) Assessment of Ammonia (Noncancer Inhalation). This assessment addresses the potential noncancer human health effects from long-term inhalation exposure to ammonia. Now final, this assessment will update the current toxicological information on ammonia posted in 1991. EPA’s program and regional offices may use this assessment to inform decisions to protect human health. EPA completed the Integrated Risk Information System (IRIS) health assessment for ammonia. IRIS is an EPA database containing Agency scientific positions on potential adverse human health effects that may result from chronic (or lifetime) exposure to chemicals in the environment. IRIS contains chemical-specific summaries of qualitative and quantitative health information in support of two steps of the risk assessment paradigm, i.e., hazard identification and dose-response evaluation. IRIS assessments are used in combination with specific situational exposure assessment information to evaluate potential public health risk associated with environmental contaminants.

  6. Incorporation of Personal Single Nucleotide Polymorphism (SNP) Data into a National Level Electronic Health Record for Disease Risk Assessment, Part 3: An Evaluation of SNP Incorporated National Health Information System of Turkey for Prostate Cancer

    PubMed Central

    Beyan, Timur

    2014-01-01

    Background A personalized medicine approach provides opportunities for predictive and preventive medicine. Using genomic, clinical, environmental, and behavioral data, the tracking and management of individual wellness is possible. A prolific way to carry this personalized approach into routine practices can be accomplished by integrating clinical interpretations of genomic variations into electronic medical records (EMRs)/electronic health records (EHRs). Today, various central EHR infrastructures have been constituted in many countries of the world, including Turkey. Objective As an initial attempt to develop a sophisticated infrastructure, we have concentrated on incorporating the personal single nucleotide polymorphism (SNP) data into the National Health Information System of Turkey (NHIS-T) for disease risk assessment, and evaluated the performance of various predictive models for prostate cancer cases. We present our work as a three part miniseries: (1) an overview of requirements, (2) the incorporation of SNP data into the NHIS-T, and (3) an evaluation of SNP data incorporated into the NHIS-T for prostate cancer. Methods In the third article of this miniseries, we have evaluated the proposed complementary capabilities (ie, knowledge base and end-user application) with real data. Before the evaluation phase, clinicogenomic associations about increased prostate cancer risk were extracted from knowledge sources, and published predictive genomic models assessing individual prostate cancer risk were collected. To evaluate complementary capabilities, we also gathered personal SNP data of four prostate cancer cases and fifteen controls. Using these data files, we compared various independent and model-based, prostate cancer risk assessment approaches. Results Through the extraction and selection processes of SNP-prostate cancer risk associations, we collected 209 independent associations for increased risk of prostate cancer from the studied knowledge sources. Also, we gathered six cumulative models and two probabilistic models. Cumulative models and assessment of independent associations did not have impressive results. There was one of the probabilistic, model-based interpretation that was successful compared to the others. In envirobehavioral and clinical evaluations, we found that some of the comorbidities, especially, would be useful to evaluate disease risk. Even though we had a very limited dataset, a comparison of performances of different disease models and their implementation with real data as use case scenarios helped us to gain deeper insight into the proposed architecture. Conclusions In order to benefit from genomic variation data, existing EHR/EMR systems must be constructed with the capability of tracking and monitoring all aspects of personal health status (genomic, clinical, environmental, etc) in 24/7 situations, and also with the capability of suggesting evidence-based recommendations. A national-level, accredited knowledge base is a top requirement for improved end-user systems interpreting these parameters. Finally, categorization using similar, individual characteristics (SNP patterns, exposure history, etc) may be an effective way to predict disease risks, but this approach needs to be concretized and supported with new studies. PMID:25600087

  7. Information and problem report usage in system saftey engineering division

    NASA Technical Reports Server (NTRS)

    Morrissey, Stephen J.

    1990-01-01

    Five basic problems or question areas are examined. They are as follows: (1) Evaluate adequacy of current problem/performance data base; (2) Evaluate methods of performing trend analysis; (3) Methods and sources of data for probabilistic risk assessment; and (4) How is risk assessment documentation upgraded and/or updated. The fifth problem was to provide recommendations for each of the above four areas.

  8. Construction risk assessment of deep foundation pit in metro station based on G-COWA method

    NASA Astrophysics Data System (ADS)

    You, Weibao; Wang, Jianbo; Zhang, Wei; Liu, Fangmeng; Yang, Diying

    2018-05-01

    In order to get an accurate understanding of the construction safety of deep foundation pit in metro station and reduce the probability and loss of risk occurrence, a risk assessment method based on G-COWA is proposed. Firstly, relying on the specific engineering examples and the construction characteristics of deep foundation pit, an evaluation index system based on the five factors of “human, management, technology, material and environment” is established. Secondly, the C-OWA operator is introduced to realize the evaluation index empowerment and weaken the negative influence of expert subjective preference. The gray cluster analysis and fuzzy comprehensive evaluation method are combined to construct the construction risk assessment model of deep foundation pit, which can effectively solve the uncertainties. Finally, the model is applied to the actual project of deep foundation pit of Qingdao Metro North Station, determine its construction risk rating is “medium”, evaluate the model is feasible and reasonable. And then corresponding control measures are put forward and useful reference are provided.

  9. Study on the evaluation index of active power reserve

    NASA Astrophysics Data System (ADS)

    Guo, Xiaorui; Liu, Jiantao; Wang, Ke; Min, Lu

    2018-01-01

    Based on the role of active reserve at different time scales, divides the evaluation dimension of active reserve. Analysis the calculation principle of traditional reliability index such as probability of system safety, lack of power shortage and electricity shortage expectancy, and studies the applicability of these indicators to evaluate the reserve capacity on different dimensions. Resolves the evaluation index of active reserve capacity from the dimensions of time dimension, spatial dimension, system state, risk degree and economy, then construct evaluation index of active reserve capacity.

  10. Systems Toxicology: The Future of Risk Assessment.

    PubMed

    Sauer, John Michael; Hartung, Thomas; Leist, Marcel; Knudsen, Thomas B; Hoeng, Julia; Hayes, A Wallace

    2015-01-01

    Risk assessment, in the context of public health, is the process of quantifying the probability of a harmful effect to individuals or populations from human activities. With increasing public health concern regarding the potential risks associated with chemical exposure, there is a need for more predictive and accurate approaches to risk assessment. Developing such an approach requires a mechanistic understanding of the process by which xenobiotic substances perturb biological systems and lead to toxicity. Supplementing the shortfalls of traditional risk assessment with mechanistic biological data has been widely discussed but not routinely implemented in the evaluation of chemical exposure. These mechanistic approaches to risk assessment have been generally referred to as systems toxicology. This Symposium Overview article summarizes 4 talks presented at the 35th Annual Meeting of the American College of Toxicology. © The Author(s) 2015.

  11. Comparative Risk Analysis for Metropolitan Solid Waste Management Systems

    NASA Astrophysics Data System (ADS)

    Chang, Ni-Bin; Wang, S. F.

    1996-01-01

    Conventional solid waste management planning usually focuses on economic optimization, in which the related environmental impacts or risks are rarely considered. The purpose of this paper is to illustrate the methodology of how optimization concepts and techniques can be applied to structure and solve risk management problems such that the impacts of air pollution, leachate, traffic congestion, and noise increments can be regulated in the iong-term planning of metropolitan solid waste management systems. Management alternatives are sequentially evaluated by adding several environmental risk control constraints stepwise in an attempt to improve the management strategies and reduce the risk impacts in the long run. Statistics associated with those risk control mechanisms are presented as well. Siting, routing, and financial decision making in such solid waste management systems can also be achieved with respect to various resource limitations and disposal requirements.

  12. [Cardiovascular risk by Framingham and SCORE in patients 40-65 years old].

    PubMed

    González, Carmen; Rodilla, Enrique; Costa, José A; Justicia, Jorge; Pascual, José M

    2006-04-15

    The aim of this study was to compare the clinical and treatment implications of 2 cardiovascular risk stratification systems in a population of patients 40-65 years old. 929 non diabetic patients (40-65 years old) (51% female) with no evidence of previous cardiovascular disease were included in the study. The risk of cardiovascular death was assessed with the charts of the Systematic Coronary Risk Evaluation (SCORE), and coronary risk by the Framingham function (National Cholesterol Education Program Expert Panel on Detection, Evaluation and Treatment of High Blood Cholesterol in Adults -NCEP-ATP-III-). Patients were considered of high risk if risk of cardiovascular death was >or= 5% and coronary risk was > 20%, respectively. 4.1% of patients were considered as high risk by SCORE and 2.5% by Framingham. Only 0.2% of females were classified as high risk with either system. 8.2% and 4.8% of male population were considered as high risk by SCORE and Framingham, respectively. There was a low level of concordance between both systems. Patients classified as high risk by SCORE but not by Framingham were older, smoke less and had a better lipid profile. According to European Guidelines 28% of male and 23% of female were candidates to hypolipemic treatment, that proportion was higher, 43% of males and 28% of females, by NCEP-ATP-III guidelines. In Spanish patients 40-65 years old, SCORE charts almost duplicate the number of high risk individuals compared to Framingham. although the number of patients candidates to hypolipemic treatment is lower with the European than ATP-III guidelines. Differences were more evident in male.

  13. Content and Usability Evaluation of Patient Oriented Drug-Drug Interaction Websites.

    PubMed

    Adam, Terrence J; Vang, Joseph

    Drug-Drug Interactions (DDI) are an important source of preventable adverse drug events and a common reason for hospitalization among patients on multiple drug therapy regimens. DDI information systems are important patient safety tools with the capacity to identify and warn health professionals of clinically significant DDI risk. While substantial research has been completed on DDI information systems in professional settings such as community, hospital, and independent pharmacies; there has been limited research on DDI systems offered through online websites directly for use by ambulatory patients. The focus of this project is to test patient oriented website capacity to correctly identify drug interactions among well established and clinically significant medication combinations and convey clinical risk data to patients. The patient education capability was assessed by evaluating website Information Capacity, Patient Usability and Readability. The study results indicate that the majority of websites identified which met the inclusion and exclusion criteria operated similarly, but vary in risk severity assessment and are not optimally patient oriented to effectively deliver risk information. The limited quality of information and complex medical term content complicate DDI risk data conveyance and the sites may not provide optimal information delivery to allow medication consumers to understand and manage their medication regimens.

  14. EVALUATION OF VADOSE ZONE AND SORUCE MODULES FOR MULTI-MEDIA, MULTI-PATHWAY, AND MULTI-RECEPTOR RISK ASSESSMENT USING LARGE-SOIL-COLUMN EXPERIMENTAL DATA

    EPA Science Inventory

    The United States Environmental Protection Agency (EPA) is developing a comprehensive environmental exposure and risk analysis software system for agency-wide application using the methodology of a Multi-media, Multi-pathway, Multi-receptor Risk Assessment (3MRA) model. This sof...

  15. EVALUATION OF VADOSE ZONE AND SOURCE MODELS FOR MULTI-MEDIA, MULTI-PATHWAY, MULTI-RECEPTOR RISK ASSESSMENT USING LARGE SOIL COLUMN EXPERIMENT DATA

    EPA Science Inventory

    The U.S. Environmental Protection Agency (EPA) is developing a comprehensive environmental exposure and risk analysis software system for agency-wide application using the methodology of a Multi-media, Multi-pathway, Multi-receptor Risk Assessment (3MRA) model. This software sys...

  16. Changing Forest Disturbance Regimes and Risk Perceptions in Homer, Alaska

    Treesearch

    Courtney G. F1int

    2007-01-01

    Forest disturbances caused by insects can lead to other disturbances, risks, and changes across landscapes. Evaluating the human dimensions of such disturbances furthers understanding of integrated changes in natural and social systems. This article examines the effects of changing forest disturbance regimes on local risk perceptions and attitudes in Homer, Alaska....

  17. FEES: design of a Fire Economics Evaluation System

    Treesearch

    Thomas J. Mills; Frederick W. Bratten

    1982-01-01

    The Fire Economics Evaluation System (FEES)--a simulation model--is being designed for long-term planning application by all public agencies with wildland fire management responsibilities. A fully operational version of FEES will be capable of estimating the economic efficiency, fire-induced changes in resource outputs, and risk characteristics of a range of fire...

  18. Evaluation of Small System Filtration Technologies for the Treatment of Color, Disinfection ByProducts and Microbiological Contaminants in Surface Water

    EPA Science Inventory

    The U.S. Environmental Protection Agency (EPA) National Risk Management Research Laboratory (NRMRL) evaluated various filtration systems at the EPA T&E Facility in Cincinnati, Ohio and at a field site in Ely, Minnesota (MN) in collaboration with the Minnesota Department of Health...

  19. Maternal social support and neighborhood income inequality as predictors of low birth weight and preterm birth outcome disparities: analysis of South Carolina Pregnancy Risk Assessment and Monitoring System survey, 2000-2003.

    PubMed

    Nkansah-Amankra, Stephen; Dhawain, Ashish; Hussey, James Robert; Luchok, Kathryn J

    2010-09-01

    Effects of income inequality on health and other social systems have been a subject of considerable debate, but only a few studies have used multilevel models to evaluate these relationships. The main objectives of the study were to (1) Evaluate the relationships among neighborhood income inequality, social support and birth outcomes (low birth weight, and preterm delivery) and (2) Assess variations in racial disparities in birth outcomes across neighborhood contexts of income distribution and maternal social support. We evaluated these relationships by using South Carolina Pregnancy Risk Assessment and Monitoring System (PRAMS) survey for 2000-2003 geocoded to 2000 US Census data for South Carolina. Multilevel analysis was used to simultaneously evaluate the association between income inequality (measured as Gini), maternal social relationships and birth outcomes (low birth weight and preterm delivery). The results showed residence in neighborhoods with medium levels of income inequality was independently associated with low birth weight (OR: 2.00; 95% CI 1.14-3.26), but not preterm birth; low social support was an independent risk for low birth weight or preterm births. The evidence suggests that non-Hispanic black mothers were at increased risks of low birth weight or preterm birth primarily due to greater exposures of neighborhood deprivations associated with low income and reduced social support and modified by unequal income distribution.

  20. Fault tree analysis for integrated and probabilistic risk analysis of drinking water systems.

    PubMed

    Lindhe, Andreas; Rosén, Lars; Norberg, Tommy; Bergstedt, Olof

    2009-04-01

    Drinking water systems are vulnerable and subject to a wide range of risks. To avoid sub-optimisation of risk-reduction options, risk analyses need to include the entire drinking water system, from source to tap. Such an integrated approach demands tools that are able to model interactions between different events. Fault tree analysis is a risk estimation tool with the ability to model interactions between events. Using fault tree analysis on an integrated level, a probabilistic risk analysis of a large drinking water system in Sweden was carried out. The primary aims of the study were: (1) to develop a method for integrated and probabilistic risk analysis of entire drinking water systems; and (2) to evaluate the applicability of Customer Minutes Lost (CML) as a measure of risk. The analysis included situations where no water is delivered to the consumer (quantity failure) and situations where water is delivered but does not comply with water quality standards (quality failure). Hard data as well as expert judgements were used to estimate probabilities of events and uncertainties in the estimates. The calculations were performed using Monte Carlo simulations. CML is shown to be a useful measure of risks associated with drinking water systems. The method presented provides information on risk levels, probabilities of failure, failure rates and downtimes of the system. This information is available for the entire system as well as its different sub-systems. Furthermore, the method enables comparison of the results with performance targets and acceptable levels of risk. The method thus facilitates integrated risk analysis and consequently helps decision-makers to minimise sub-optimisation of risk-reduction options.

  1. Federal Family Education Loan Information System. Weak Computer Controls Increase Risk of Unauthorized Access to Sensitive Data. Report to the Secretary of Education.

    ERIC Educational Resources Information Center

    General Accounting Office, Washington, DC. Accounting and Information Management Div.

    This report presents an evaluation of the general controls over the Federal Family Education Loan Program (FFELP) information system maintained and operated by a contractor for the U.S. Department of Education (ED), which administers FFELP. The evaluation found that ED's general controls over the FFELP information system did not adequately protect…

  2. a New Method for Fmeca Based on Fuzzy Theory and Expert System

    NASA Astrophysics Data System (ADS)

    Byeon, Yoong-Tae; Kim, Dong-Jin; Kim, Jin-O.

    2008-10-01

    Failure Mode Effects and Criticality Analysis (FMECA) is one of most widely used methods in modern engineering system to investigate potential failure modes and its severity upon the system. FMECA evaluates criticality and severity of each failure mode and visualize the risk level matrix putting those indices to column and row variable respectively. Generally, those indices are determined subjectively by experts and operators. However, this process has no choice but to include uncertainty. In this paper, a method for eliciting expert opinions considering its uncertainty is proposed to evaluate the criticality and severity. In addition, a fuzzy expert system is constructed in order to determine the crisp value of risk level for each failure mode. Finally, an illustrative example system is analyzed in the case study. The results are worth considering in deciding the proper policies for each component of the system.

  3. Ecological risk assessment of depleted uranium in the environment at Aberdeen Proving Ground

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

    Clements, W.H.; Kennedy, P.L.; Myers, O.B.

    1993-01-01

    A preliminary ecological risk assessment was conducted to evaluate the effects of depleted uranium (DU) in the Aberdeen Proving Ground (APG) ecosystem and its potential for human health effects. An ecological risk assessment of DU should include the processes of hazard identification, dose-response assessment, exposure assessment, and risk characterization. Ecological risk assessments also should explicitly examine risks incurred by nonhuman as well as human populations, because risk assessments based only on human health do not always protect other species. To begin to assess the potential ecological risk of DU release to the environment we modeled DU transport through the principalmore » components of the aquatic ecosystem at APG. We focused on the APG aquatic system because of the close proximity of the Chesapeake Bay and concerns about potential impacts on this ecosystem. Our objective in using a model to estimate environmental fate of DU is to ultimately reduce the uncertainty about predicted ecological risks due to DU from APG. The model functions to summarize information on the structure and functional properties of the APG aquatic system, to provide an exposure assessment by estimating the fate of DU in the environment, and to evaluate the sources of uncertainty about DU transport.« less

  4. Ecological risk assessment of depleted uranium in the environment at Aberdeen Proving Ground. Annual report, 1991

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

    Clements, W.H.; Kennedy, P.L.; Myers, O.B.

    1993-03-01

    A preliminary ecological risk assessment was conducted to evaluate the effects of depleted uranium (DU) in the Aberdeen Proving Ground (APG) ecosystem and its potential for human health effects. An ecological risk assessment of DU should include the processes of hazard identification, dose-response assessment, exposure assessment, and risk characterization. Ecological risk assessments also should explicitly examine risks incurred by nonhuman as well as human populations, because risk assessments based only on human health do not always protect other species. To begin to assess the potential ecological risk of DU release to the environment we modeled DU transport through the principalmore » components of the aquatic ecosystem at APG. We focused on the APG aquatic system because of the close proximity of the Chesapeake Bay and concerns about potential impacts on this ecosystem. Our objective in using a model to estimate environmental fate of DU is to ultimately reduce the uncertainty about predicted ecological risks due to DU from APG. The model functions to summarize information on the structure and functional properties of the APG aquatic system, to provide an exposure assessment by estimating the fate of DU in the environment, and to evaluate the sources of uncertainty about DU transport.« less

  5. A wildfire risk modeling system for evaluating landscape fuel treatment strategies

    Treesearch

    Alan Ager; Mark Finney; Andrew McMahan

    2006-01-01

    Despite a wealth of literature and models concerning wildfire risk, field units in Federal land management agencies lack a clear framework and operational tools to measure how risk might change from proposed fuel treatments. In an actuarial context, risk is defined as the expected value change from a fire, calculated as the product of (1) probability of a fire at a...

  6. Analysis of chats on French internet forums about drugs and pregnancy.

    PubMed

    Palosse-Cantaloube, Lucie; Lacroix, Isabelle; Rousseau, Vanessa; Bagheri, Haleh; Montastruc, Jean-Louis; Damase-Michel, Christine

    2014-12-01

    Some pregnant women use the internet to search for medical information. However, online information is not controlled. The objectives were to describe French online chats about drugs and pregnancy and evaluate the quality and reliability of information shared by internet users. This French descriptive study was performed in November 2012. In order to identify drugs and pregnancy-related forum websites, we used three French key words: forum, pregnancy and drug. We explored the first 10 websites from the search result. Diseases were described using the International Classification of Diseases and drugs classified with the Anatomical Therapeutic Chemical codes and the FDA risk classification. We selected 115 questions that were mainly posted by pregnant internet users in French forums. Drugs raising questions were mostly "nervous system," "anti-infective for systemic use" and "respiratory system" drugs. The risk during pregnancy for nearly half of these drugs had not been evaluated properly. Health professionals were only involved in 7% of the 214 answers. Internet users advised to take a drug in 21% of their answers. Thirty-four percent of those recommended drugs had not been well-evaluated or were potentially at risk during pregnancy. Finally, 12% of the answers could be at risk for pregnant woman. This study shows that information related to drugs and pregnancy in online chats could be at risk for pregnant women. Internet users must be aware that online forums are not reliable sources of information. Copyright © 2014 John Wiley & Sons, Ltd.

  7. Let the IRIS Bloom:Regrowing the integrated risk information system (IRIS) of the U.S. Environmental Protection Agency.

    PubMed

    Dourson, Michael L

    2018-05-03

    The Integrated Risk Information System (IRIS) of the U.S. Environmental Protection Agency (EPA) has an important role in protecting public health. Originally it provided a single database listing official risk values equally valid for all Agency offices, and was an important tool for risk assessment communication across EPA. Started in 1986, IRIS achieved full standing in 1990 when it listed 500 risk values, the effort of two senior EPA groups over 5 years of monthly face-to-face meetings, to assess combined risk data from multiple Agency offices. Those groups were disbanded in 1995, and the lack of continuing face-to-face meetings meant that IRIS became no longer EPA's comprehensive database of risk values or their latest evaluations. As a remedy, a work group of the Agency's senior scientists should be re-established to evaluate new risks and to update older ones. Risk values to be reviewed would come from the same EPA offices now developing such information on their own. Still, this senior group would have the final authority on posting a risk value in IRIS, independently of individual EPA offices. This approach could also lay the groundwork for an all-government IRIS database, especially needed as more government Agencies, industries and non-governmental organizations are addressing evolving risk characterizations. Copyright © 2018. Published by Elsevier Inc.

  8. Controls on the Environmental Fate of Compounds Controlled by Coupled Hydrologic and Reactive Processes

    NASA Astrophysics Data System (ADS)

    Hixson, J.; Ward, A. S.; McConville, M.; Remucal, C.

    2017-12-01

    Current understanding of how compounds interact with hydrologic processes or reactive processes have been well established. However, the environmental fate for compounds that interact with hydrologic AND reactive processes is not well known, yet critical in evaluating environmental risk. Evaluations of risk are often simplified to homogenize processes in space and time and to assess processes independently of one another. However, we know spatial heterogeneity and time-variable reactivities complicate predictions of environmental transport and fate, and is further complicated by the interaction of these processes, limiting our ability to accurately predict risk. Compounds that interact with both systems, such as photolytic compounds, require that both components are fully understood in order to predict transport and fate. Release of photolytic compounds occurs through both unintentional releases and intentional loadings. Evaluating risks associated with unintentional releases and implementing best management practices for intentional releases requires an in-depth understanding of the sensitivity of photolytic compounds to external controls. Lampricides, such as 3-trifluoromethyl-4-nitrophenol (TFM), are broadly applied in the Great Lakes system to control the population of invasive sea lamprey. Over-dosing can yield fish kills and other detrimental impacts. Still, planning accounts for time of passage and dilution, but not the interaction of the physical and chemical systems (i.e., storage in the hyporheic zone and time-variable decay rates). In this study, we model a series of TFM applications to test the efficacy of dosing as a function of system characteristics. Overall, our results demonstrate the complexity associated with photo-sensitive compounds through stream-hyporheic systems, and highlight the need to better understand how physical and chemical systems interact to control transport and fate in the environment.

  9. Relative risk analysis of the use of radiation-emitting medical devices: A preliminary application

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

    Jones, E.D.

    This report describes the development of a risk analysis approach for evaluating the use of radiation-emitting medial devices. This effort was performed by Lawrence Livermore National Laboratory for the US Nuclear Regulatory Commission (NRC). The assessment approach has bee applied to understand the risks in using the Gamma Knife, a gamma irradiation therapy device. This effort represents an initial step to evaluate the potential role of risk analysis for developing regulations and quality assurance requirements in the use of nuclear medical devices. The risk approach identifies and assesses the most likely risk contributors and their relative importance for the medicalmore » system. The approach uses expert screening techniques and relative risk profiling to incorporate the type, quality, and quantity of data available and to present results in an easily understood form.« less

  10. The role of the anterior cingulate cortex in women's sexual decision making.

    PubMed

    Rupp, Heather A; James, Thomas W; Ketterson, Ellen D; Sengelaub, Dale R; Janssen, Erick; Heiman, Julia R

    2009-01-02

    Women's sexual decision making is a complex process balancing the potential rewards of conception and pleasure against the risks of possible low paternal care or sexually transmitted infection. Although neural processes underlying social decision making are suggested to overlap with those involved in economic decision making, the neural systems associated with women's sexual decision making are unknown. Using fMRI, we measured the brain activation of 12 women while they viewed photos of men's faces. Face stimuli were accompanied by information regarding each man's potential risk as a sexual partner, indicated by a written description of the man's number of previous sexual partners and frequency of condom use. Participants were asked to evaluate how likely they would be to have sex with the man depicted. Women reported that they would be more likely to have sex with low compared to high risk men. Stimuli depicting low risk men also elicited stronger activation in the anterior cingulate cortex (ACC), midbrain, and intraparietal sulcus, possibly reflecting an influence of sexual risk on women's attraction, arousal, and attention during their sexual decision making. Activation in the ACC was positively correlated with women's subjective evaluations of sex likelihood and response times during their evaluations of high, but not low risk men. These findings provide evidence that neural systems involved in sexual decision making in women overlap with those described previously to underlie nonsexual decision making.

  11. Risk Modeling of Interdependent Complex Systems of Systems: Theory and Practice.

    PubMed

    Haimes, Yacov Y

    2018-01-01

    The emergence of the complexity characterizing our systems of systems (SoS) requires a reevaluation of the way we model, assess, manage, communicate, and analyze the risk thereto. Current models for risk analysis of emergent complex SoS are insufficient because too often they rely on the same risk functions and models used for single systems. These models commonly fail to incorporate the complexity derived from the networks of interdependencies and interconnectedness (I-I) characterizing SoS. There is a need to reevaluate currently practiced risk analysis to respond to this reality by examining, and thus comprehending, what makes emergent SoS complex. The key to evaluating the risk to SoS lies in understanding the genesis of characterizing I-I of systems manifested through shared states and other essential entities within and among the systems that constitute SoS. The term "essential entities" includes shared decisions, resources, functions, policies, decisionmakers, stakeholders, organizational setups, and others. This undertaking can be accomplished by building on state-space theory, which is fundamental to systems engineering and process control. This article presents a theoretical and analytical framework for modeling the risk to SoS with two case studies performed with the MITRE Corporation and demonstrates the pivotal contributions made by shared states and other essential entities to modeling and analysis of the risk to complex SoS. A third case study highlights the multifarious representations of SoS, which require harmonizing the risk analysis process currently applied to single systems when applied to complex SoS. © 2017 Society for Risk Analysis.

  12. Risk analysis based CWR track buckling safety evaluations

    DOT National Transportation Integrated Search

    2001-01-01

    As part of the Federal Railroad Administrations (FRA) track systems research program, the US DOTS Volpe Center is conducting analytic and experimental investigations to evaluate track lateral strength and stability limits for improved safety an...

  13. Development of a prototype system for statewide asthma surveillance.

    PubMed

    Deprez, Ronald D; Asdigian, Nancy L; Oliver, L Christine; Anderson, Norman; Caldwell, Edgar; Baggott, Lee Ann

    2002-12-01

    We developed and evaluated a statewide and community-level asthma surveillance system. Databases and measures included a community prevalence survey, hospital admissions data, emergency department/outpatient clinic visit records, and a physician survey of diagnosis and treatment practices. We evaluated the system in 5 Maine communities varying in population and income. Asthma hospitalizations were high in the rural/low-socioeconomic-status communities studied, although diagnosed asthma was low. Males were more likely than females to experience asthma symptoms, although they were less likely to have been diagnosed with asthma or to have used hospital-based asthma care. Databases were useful for estimating asthma burden and identifying service needs as well as high-risk groups. They were less useful in estimating severity or in identifying environmental risks.

  14. Consideration of Base Rates within Universal Screening for Behavioral and Emotional Risk: A Novel Procedural Framework

    ERIC Educational Resources Information Center

    Kilgus, Stephen P.; Eklund, Katie R.

    2016-01-01

    Universal screening for behavioral and emotional risk represents an important component of multitiered systems of support, being a means by which schools identify at-risk students and evaluate the effectiveness of Tier 1 programming. Despite its importance, many schools have not adopted universal screening procedures, instead relying upon more…

  15. Smarten

    NASA Astrophysics Data System (ADS)

    Metcalfe, C.; Bennett, E.; Chappell, M.; Steevens, J.; Depledge, M.; Goss, G.; Goudey, S.; Kaczmar, S.; O'Brien, N.; Picado, A.; Ramadan, A. B.

    Traditional risk assessment procedures are inadequate for predicting the ecological risks associated with the release of nanomaterials (NM) into the environment. The root of the problem lies in an inadequate application of solid phase chemical principles (e.g. particle size, shape, functionality) for the risk assessment of NMs. Thus, the "solubility" paradigm used to evaluate the risks associated with other classes of contaminants must be replaced by a "dispersivity" paradigm for evaluating the risks associated with NM. The pace of development of NM will exceed the capacity to conduct adequate risk assessments using current methods and approaches. Each NM product will be available in a variety of size classes and with different surface functionalizations; probably requiring multiple risk assessments for each NM. The "SMARTEN" approach to risk assessment involves having risk assessors play a more proactive role in evaluating all aspects of the NM life cycle and in making decisions to develop lower risk NM products. Improved problem formulation could come from considering the chemical, physical and biological properties of NMs. New effects assessment techniques are needed to evaluate cellular binding and uptake potential, such as biological assays for binding to macromolecules or organelles, phagocytic activity, and active/passive uptake processes. Tests should be developed to evaluate biological effects with multiple species across a range of trophic levels. Despite our best efforts to assess the risks associated with NM, previous experience indicates that some NM products will enter the environment and cause biological effects. Therefore, risk assessors should support programs for reconnaissance and surveillance to detect the impacts of NM before irreversible damage occurs. New analytical tools are needed for surveillance, including sensors for detecting NMs, passive sampling systems, and improved methods for separation and characterization of NMs in environmental matrices, as well as biomarker techniques to evaluate exposure to NMs. Risk assessors should use this information to refine data quality, determine future risk assessment objectives and to communicate interim conclusions to a wide group of stakeholders.1

  16. Societal Risk Evaluation Scheme (SRES): Scenario-Based Multi-Criteria Evaluation of Synthetic Biology Applications

    PubMed Central

    2017-01-01

    Synthetic biology (SB) applies engineering principles to biology for the construction of novel biological systems designed for useful purposes. From an oversight perspective, SB products come with significant uncertainty. Yet there is a need to anticipate and prepare for SB applications before deployment. This study develops a Societal Risk Evaluation Scheme (SRES) in order to advance methods for anticipatory governance of emerging technologies such as SB. The SRES is based upon societal risk factors that were identified as important through a policy Delphi study. These factors range from those associated with traditional risk assessment, such as health and environmental consequences, to broader features of risk such as those associated with reversibility, manageability, anticipated levels of public concern, and uncertainty. A multi-disciplinary panel with diverse perspectives and affiliations assessed four case studies of SB using the SRES. Rankings of the SRES components are compared within and across the case studies. From these comparisons, we found levels of controllability and familiarity associated with the cases to be important for overall SRES rankings. From a theoretical standpoint, this study illustrates the applicability of the psychometric paradigm to evaluating SB cases. In addition, our paper describes how the SRES can be incorporated into anticipatory governance models as a screening tool to prioritize research, information collection, and dialogue in the face of the limited capacity of governance systems. To our knowledge, this is the first study to elicit data on specific cases of SB with the goal of developing theory and tools for risk governance. PMID:28052080

  17. Risk factors for implant failure: a retrospective study in an educational institution using GEE analyses.

    PubMed

    Borba, Marcelo; Deluiz, Daniel; Lourenço, Eduardo José Veras; Oliveira, Luciano; Tannure, Patrícia Nivoloni

    2017-08-21

    This study aimed to evaluate dental implant outcomes and to identify risk factors associated with implant failure over 12 years via dental records of patients attending an educational institution. Dental records of 202 patients receiving 774 dental implants from 2002 to 2014 were analyzed by adopting a more reliable statistical method to evaluate risk factors with patients as the unit [generalized estimating equation (GEE)]. Information regarding patient age at implantation, sex, use of tobacco, and history of systemic diseases was collected. Information about implant location in the arch region and implant length, diameter, and placement in a grafted area was evaluated after 2 years under load. Systemic and local risk factors for early and late implant failure were studied. A total of 18 patients experienced 25 implant failures, resulting in an overall survival rate of 96.8% (2.84% and 0.38% early and late implant failures, respectively). The patient-based survival rate was 91.8%. GEE univariate and multivariate analyses revealed that a significant risk factor for implant failure was the maxillary implant (p = 0.006 and p = 0.014, respectively). Bone grafting appeared to be a risk factor for implant failure (p = 0.054). According to GEE analyses, maxillary implants had significantly worse outcomes in this population and were considered to be a risk factor for implant failure. Our results suggested that implants placed in a bone augmentation area had a tendency to fail.

  18. RiskChanges Spatial Decision Support system for the analysis of changing multi-hazard risk

    NASA Astrophysics Data System (ADS)

    van Westen, Cees; Zhang, Kaixi; Bakker, Wim; Andrejchenko, Vera; Berlin, Julian; Olyazadeh, Roya; Cristal, Irina

    2015-04-01

    Within the framework of the EU FP7 Marie Curie Project CHANGES and the EU FP7 Copernicus project INCREO a spatial decision support system was developed with the aim to analyse the effect of risk reduction planning alternatives on reducing the risk now and in the future, and support decision makers in selecting the best alternatives. Central to the SDSS are the stakeholders. The envisaged users of the system are organizations involved in planning of risk reduction measures, and that have staff capable of visualizing and analyzing spatial data at a municipal scale. The SDSS should be able to function in different countries with different legal frameworks and with organizations with different mandates. These could be subdivided into Civil protection organization with the mandate to design disaster response plans, Expert organizations with the mandate to design structural risk reduction measures (e.g. dams, dikes, check-dams etc), and planning organizations with the mandate to make land development plans. The SDSS can be used in different ways: analyzing the current level of risk, analyzing the best alternatives for risk reduction, the evaluation of the consequences of possible future scenarios to the risk levels, and the evaluation how different risk reduction alternatives will lead to risk reduction under different future scenarios. The SDSS is developed based on open source software and following open standards, for code as well as for data formats and service interfaces. Code development was based upon open source software as well. The architecture of the system is modular. The various parts of the system are loosely coupled, extensible, using standards for interoperability, flexible and web-based. The Spatial Decision Support System is composed of a number of integrated components. The Risk Assessment component allows to carry out spatial risk analysis, with different degrees of complexity, ranging from simple exposure (overlay of hazard and assets maps) to quantitative analysis (using different hazard types, temporal scenarios and vulnerability curves) resulting into risk curves. The platform does not include a component to calculate hazard maps, and existing hazard maps are used as input data for the risk component. The second component of the SDSS is a risk reduction planning component, which forms the core of the platform. This component includes the definition of risk reduction alternatives (related to disaster response planning, risk reduction measures and spatial planning) and links back to the risk assessment module to calculate the new level of risk if the measure is implemented, and a cost-benefit (or cost-effectiveness/ Spatial Multi Criteria Evaluation) component to compare the alternatives and make decision on the optimal one. The third component of the SDSS is a temporal scenario component, which allows to define future scenarios in terms of climate change, land use change and population change, and the time periods for which these scenarios will be made. The component doesn't generate these scenarios but uses input maps for the effect of the scenarios on the hazard and assets maps. The last component is a communication and visualization component, which can compare scenarios and alternatives, not only in the form of maps, but also in other forms (risk curves, tables, graphs)

  19. A scheme to scientifically and accurately assess cadmium pollution of river sediments, through consideration of bioavailability when assessing ecological risk.

    PubMed

    Song, Zhixin; Tang, Wenzhong; Shan, Baoqing

    2017-10-01

    Evaluating heavy metal pollution status and ecological risk in river sediments is a complex task, requiring consideration of contaminant pollution levels, as well as effects of biological processes within the river system. There are currently no simple or low-cost approaches to heavy metal assessment in river sediments. Here, we introduce a system of assessment for pollution status of heavy metals in river sediments, using measurements of Cd in the Shaocun River sediments as a case study. This system can be used to identify high-risk zones of the river that should be given more attention. First, we evaluated the pollution status of Cd in the river sediments based on their total Cd content, and calculated a risk assessment, using local geochemical background values at various sites along the river. Using both acetic acid and ethylenediaminetetraacetic acid to extracted the fractions of Cd in sediments, and used DGT to evaluate the bioavailability of Cd. Thus, DGT provided a measure of potentially bioavailable concentrations of Cd concentrations in the sediments. Last, we measured Cd contents in plant tissue collected at the same site to compare with our other measures. A Pearson's correlation analysis showed that Cd-Plant correlated significantly with Cd-HAc, (r = 0.788, P < 0.01), Cd-EDTA (r = 0.925, P < 0.01), Cd-DGT (r = 0.976, P < 0.01), and Cd-Total (r = 0.635, P < 0.05). We demonstrate that this system of assessment is a useful means of assessing heavy metal pollution status and ecological risk in river sediments. Copyright © 2017 Elsevier Ltd. All rights reserved.

  20. Wild Fire Risk Map in the Eastern Steppe of Mongolia Using Spatial Multi-Criteria Analysis

    NASA Astrophysics Data System (ADS)

    Nasanbat, Elbegjargal; Lkhamjav, Ochirkhuyag

    2016-06-01

    Grassland fire is a cause of major disturbance to ecosystems and economies throughout the world. This paper investigated to identify risk zone of wildfire distributions on the Eastern Steppe of Mongolia. The study selected variables for wildfire risk assessment using a combination of data collection, including Social Economic, Climate, Geographic Information Systems, Remotely sensed imagery, and statistical yearbook information. Moreover, an evaluation of the result is used field validation data and assessment. The data evaluation resulted divided by main three group factors Environmental, Social Economic factor, Climate factor and Fire information factor into eleven input variables, which were classified into five categories by risk levels important criteria and ranks. All of the explanatory variables were integrated into spatial a model and used to estimate the wildfire risk index. Within the index, five categories were created, based on spatial statistics, to adequately assess respective fire risk: very high risk, high risk, moderate risk, low and very low. Approximately more than half, 68 percent of the study area was predicted accuracy to good within the very high, high risk and moderate risk zones. The percentages of actual fires in each fire risk zone were as follows: very high risk, 42 percent; high risk, 26 percent; moderate risk, 13 percent; low risk, 8 percent; and very low risk, 11 percent. The main overall accuracy to correct prediction from the model was 62 percent. The model and results could be support in spatial decision making support system processes and in preventative wildfire management strategies. Also it could be help to improve ecological and biodiversity conservation management.

  1. Flight Projects Office Information Systems Testbed (FIST)

    NASA Technical Reports Server (NTRS)

    Liggett, Patricia

    1991-01-01

    Viewgraphs on the Flight Projects Office Information Systems Testbed (FIST) are presented. The goal is to perform technology evaluation and prototyping of information systems to support SFOC and JPL flight projects in order to reduce risk in the development of operational data systems for such projects.

  2. Integration of second cancer risk calculations in a radiotherapy treatment planning system

    NASA Astrophysics Data System (ADS)

    Hartmann, M.; Schneider, U.

    2014-03-01

    Second cancer risk in patients, in particular in children, who were treated with radiotherapy is an important side effect. It should be minimized by selecting an appropriate treatment plan for the patient. The objectives of this study were to integrate a risk model for radiation induced cancer into a treatment planning system which allows to judge different treatment plans with regard to second cancer induction and to quantify the potential reduction in predicted risk. A model for radiation induced cancer including fractionation effects which is valid for doses in the radiotherapy range was integrated into a treatment planning system. From the three-dimensional (3D) dose distribution the 3D-risk equivalent dose (RED) was calculated on an organ specific basis. In addition to RED further risk coefficients like OED (organ equivalent dose), EAR (excess absolute risk) and LAR (lifetime attributable risk) are computed. A risk model for radiation induced cancer was successfully integrated in a treatment planning system. Several risk coefficients can be viewed and used to obtain critical situations were a plan can be optimised. Risk-volume-histograms and organ specific risks were calculated for different treatment plans and were used in combination with NTCP estimates for plan evaluation. It is concluded that the integration of second cancer risk estimates in a commercial treatment planning system is feasible. It can be used in addition to NTCP modelling for optimising treatment plans which result in the lowest possible second cancer risk for a patient.

  3. A Review on Methods of Risk Adjustment and their Use in Integrated Healthcare Systems

    PubMed Central

    Juhnke, Christin; Bethge, Susanne

    2016-01-01

    Introduction: Effective risk adjustment is an aspect that is more and more given weight on the background of competitive health insurance systems and vital healthcare systems. The objective of this review was to obtain an overview of existing models of risk adjustment as well as on crucial weights in risk adjustment. Moreover, the predictive performance of selected methods in international healthcare systems should be analysed. Theory and methods: A comprehensive, systematic literature review on methods of risk adjustment was conducted in terms of an encompassing, interdisciplinary examination of the related disciplines. Results: In general, several distinctions can be made: in terms of risk horizons, in terms of risk factors or in terms of the combination of indicators included. Within these, another differentiation by three levels seems reasonable: methods based on mortality risks, methods based on morbidity risks as well as those based on information on (self-reported) health status. Conclusions and discussion: After the final examination of different methods of risk adjustment it was shown that the methodology used to adjust risks varies. The models differ greatly in terms of their included morbidity indicators. The findings of this review can be used in the evaluation of integrated healthcare delivery systems and can be integrated into quality- and patient-oriented reimbursement of care providers in the design of healthcare contracts. PMID:28316544

  4. Risk Scan: A Review of Risk Assessment Capability and Maturity within the Canadian Safety and Security Program

    DTIC Science & Technology

    2014-06-01

    SCADA / ICS Cyber Test Lab initiated in 2013 Psychosocial – academic research exists,; opportunity for sharing and developing impact assessment...ecosystems and species at risk), accidents / system failure (rail; pipelines ; ferries CSSP strategy for the North Focus on regional l(and local) problem...Guidance; business planning; environmental scan; proposal evaluation; and performance measurement Program Risk Management – Guidelines for project

  5. Information security risk management for computerized health information systems in hospitals: a case study of Iran.

    PubMed

    Zarei, Javad; Sadoughi, Farahnaz

    2016-01-01

    In recent years, hospitals in Iran - similar to those in other countries - have experienced growing use of computerized health information systems (CHISs), which play a significant role in the operations of hospitals. But, the major challenge of CHIS use is information security. This study attempts to evaluate CHIS information security risk management at hospitals of Iran. This applied study is a descriptive and cross-sectional research that has been conducted in 2015. The data were collected from 551 hospitals of Iran. Based on literature review, experts' opinion, and observations at five hospitals, our intensive questionnaire was designed to assess security risk management for CHISs at the concerned hospitals, which was then sent to all hospitals in Iran by the Ministry of Health. Sixty-nine percent of the studied hospitals pursue information security policies and procedures in conformity with Iran Hospitals Accreditation Standards. At some hospitals, risk identification, risk evaluation, and risk estimation, as well as risk treatment, are unstructured without any specified approach or methodology. There is no significant structured approach to risk management at the studied hospitals. Information security risk management is not followed by Iran's hospitals and their information security policies. This problem can cause a large number of challenges for their CHIS security in future. Therefore, Iran's Ministry of Health should develop practical policies to improve information security risk management in the hospitals of Iran.

  6. Performance and economic risk evaluation of dispersed solar thermal power systems by Monte Carlo simulation

    NASA Technical Reports Server (NTRS)

    Manvi, R.; Fujita, T.

    1978-01-01

    A preliminary comparative evaluation of dispersed solar thermal power plants utilizing advanced technologies available in 1985-2000 time frame is under way at JPL. The solar power plants of 50 KWe to 10 MWe size are equipped with two axis tracking parabolic dish concentrator systems operating at temperatures in excess of 1000 F. The energy conversion schemes under consideration include advanced steam, open and closed cycle gas turbines, stirling, and combined cycle. The energy storage systems include advanced batteries, liquid metal, and chemical. This paper outlines a simple methodology for a probabilistic assessment of such systems. Sources of uncertainty in the development of advanced systems are identified, and a computer Monte Carlo simulation is exercised to permit an analysis of the tradeoffs of the risk of failure versus the potential for large gains. Frequency distribution of energy cost for several alternatives are presented.

  7. ECOSYSTEM RESTORATION RESEARCH THROUGH THE NATIONAL RISK MANAGEMENT RESEARCH LABORATORY (NRMRL)

    EPA Science Inventory

    The Ecosystem Restoration Research Program underway through ORD's National Risk Management Research Laboratory (NRMRL) has the long-term goal of providing watershed managers with "..state-of-the-science field-evaluated tools, technical guidance, and decision-support systems for s...

  8. Importance Of Quality Control in Reducing System Risk, a Lesson Learned From The Shuttle and a Recommendation for Future Launch Vehicles

    NASA Technical Reports Server (NTRS)

    Safie, Fayssal M.; Messer, Bradley P.

    2006-01-01

    This paper presents lessons learned from the Space Shuttle return to flight experience and the importance of these lessons learned in the development of new the NASA Crew Launch Vehicle (CLV). Specifically, the paper discusses the relationship between process control and system risk, and the importance of process control in improving space vehicle flight safety. It uses the External Tank (ET) Thermal Protection System (TPS) experience and lessons learned from the redesign and process enhancement activities performed in preparation for Return to Flight after the Columbia accident. The paper also, discusses in some details, the Probabilistic engineering physics based risk assessment performed by the Shuttle program to evaluate the impact of TPS failure on system risk and the application of the methodology to the CLV.

  9. Reframing climate change assessments around risk: recommendations for the US National Climate Assessment

    DOE PAGES

    Weaver, C. P.; Moss, Richard H.; Ebi, Kristie L.; ...

    2017-07-21

    Climate change is a risk management challenge for society, with uncertain but potentially severe outcomes affecting natural and human systems, across generations. Managing climate-related risks will be more difficult without a base of knowledge and practice aimed at identifying and evaluating specific risks, and their likelihood and consequences, as well as potential actions to promote resilience in the face of these risks. Here, we suggest three improvements to the process of conducting climate change assessments to better characterize risk and inform risk management actions.

  10. Reframing climate change assessments around risk: recommendations for the US National Climate Assessment

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

    Weaver, C. P.; Moss, Richard H.; Ebi, Kristie L.

    Climate change is a risk management challenge for society, with uncertain but potentially severe outcomes affecting natural and human systems, across generations. Managing climate-related risks will be more difficult without a base of knowledge and practice aimed at identifying and evaluating specific risks, and their likelihood and consequences, as well as potential actions to promote resilience in the face of these risks. Here, we suggest three improvements to the process of conducting climate change assessments to better characterize risk and inform risk management actions.

  11. Personnel reliability impact on petrochemical facilities monitoring system's failure skipping probability

    NASA Astrophysics Data System (ADS)

    Kostyukov, V. N.; Naumenko, A. P.

    2017-08-01

    The paper dwells upon urgent issues of evaluating impact of actions conducted by complex technological systems operators on their safe operation considering application of condition monitoring systems for elements and sub-systems of petrochemical production facilities. The main task for the research is to distinguish factors and criteria of monitoring system properties description, which would allow to evaluate impact of errors made by personnel on operation of real-time condition monitoring and diagnostic systems for machinery of petrochemical facilities, and find and objective criteria for monitoring system class, considering a human factor. On the basis of real-time condition monitoring concepts of sudden failure skipping risk, static and dynamic error, monitoring systems, one may solve a task of evaluation of impact that personnel's qualification has on monitoring system operation in terms of error in personnel or operators' actions while receiving information from monitoring systems and operating a technological system. Operator is considered as a part of the technological system. Although, personnel's behavior is usually a combination of the following parameters: input signal - information perceiving, reaction - decision making, response - decision implementing. Based on several researches on behavior of nuclear powers station operators in USA, Italy and other countries, as well as on researches conducted by Russian scientists, required data on operator's reliability were selected for analysis of operator's behavior at technological facilities diagnostics and monitoring systems. The calculations revealed that for the monitoring system selected as an example, the failure skipping risk for the set values of static (less than 0.01) and dynamic (less than 0.001) errors considering all related factors of data on reliability of information perception, decision-making, and reaction fulfilled is 0.037, in case when all the facilities and error probability are under control - not more than 0.027. In case when only pump and compressor units are under control, the failure skipping risk is not more than 0.022, when the probability of error in operator's action is not more than 0.011. The work output shows that on the basis of the researches results an assessment of operators' reliability can be made in terms of almost any kind of production, but considering only technological capabilities, since operators' psychological and general training considerable vary in different production industries. Using latest technologies of engineering psychology and design of data support systems, situation assessment systems, decision-making and responding system, as well as achievement in condition monitoring in various production industries one can evaluate hazardous condition skipping risk probability considering static, dynamic errors and human factor.

  12. Research on Comprehensive Evaluation Method for Heating Project Based on Analytic Hierarchy Processing

    NASA Astrophysics Data System (ADS)

    Han, Shenchao; Yang, Yanchun; Liu, Yude; Zhang, Peng; Li, Siwei

    2018-01-01

    It is effective to reduce haze in winter by changing the distributed heat supply system. Thus, the studies on comprehensive index system and scientific evaluation method of distributed heat supply project are essential. Firstly, research the influence factors of heating modes, and an index system with multiple dimension including economic, environmental, risk and flexibility was built and all indexes were quantified. Secondly, a comprehensive evaluation method based on AHP was put forward to analyze the proposed multiple and comprehensive index system. Lastly, the case study suggested that supplying heat with electricity has great advantage and promotional value. The comprehensive index system of distributed heating supply project and evaluation method in this paper can evaluate distributed heat supply project effectively and provide scientific support for choosing the distributed heating project.

  13. [Economic effects of integrated RIS-PACS solution in the university environment].

    PubMed

    Kröger, M; Nissen-Meyer, S; Wetekam, V; Reiser, M

    1999-04-01

    The goal of the current article is to demonstrate how qualitative and monetary effects resulting from an integrated RIS/PACS installation can be evaluated. First of all, the system concept of a RIS/PACS solution for a university hospital is defined and described. Based on this example, a generic method for the evaluation of qualitative and monetary effects as well as associated risks is depicted and demonstrated. To this end, qualitative analyses, investment calculations and risk analysis are employed. The sample analysis of a RIS/PACS solution specially designed for a university hospital demonstrates positive qualitative and monetary effects of the system. Under ideal conditions the payoff time of the investments is reached after 4 years of an assumed 8 years effective life of the system. Furthermore, under conservative assumptions, the risk analysis shows a probability of 0% for realising a negative net present value at the end of the payoff time period. It should be pointed out that the positive result of this sample analysis will not necessarily apply to other clinics or hospitals. However, the same methods may be used for the individual evaluation of the qualitative and monetary effects of a RIS/PACS installation in any clinic.

  14. The evaluation of acute physiology and chronic health evaluation II score, poisoning severity score, sequential organ failure assessment score combine with lactate to assess the prognosis of the patients with acute organophosphate pesticide poisoning.

    PubMed

    Yuan, Shaoxin; Gao, Yusong; Ji, Wenqing; Song, Junshuai; Mei, Xue

    2018-05-01

    The aim of this study was to assess the ability of acute physiology and chronic health evaluation II (APACHE II) score, poisoning severity score (PSS) as well as sequential organ failure assessment (SOFA) score combining with lactate (Lac) to predict mortality in the Emergency Department (ED) patients who were poisoned with organophosphate.A retrospective review of 59 stands-compliant patients was carried out. Receiver operating characteristic (ROC) curves were constructed based on the APACHE II score, PSS, SOFA score with or without Lac, respectively, and the areas under the ROC curve (AUCs) were determined to assess predictive value. According to SOFA-Lac (a combination of SOFA and Lac) classification standard, acute organophosphate pesticide poisoning (AOPP) patients were divided into low-risk and high-risk groups. Then mortality rates were compared between risk levels.Between survivors and non-survivors, there were significant differences in the APACHE II score, PSS, SOFA score, and Lac (all P < .05). The AUCs of the APACHE II score, PSS, and SOFA score were 0.876, 0.811, and 0.837, respectively. However, after combining with Lac, the AUCs were 0.922, 0.878, and 0.956, respectively. According to SOFA-Lac, the mortality of high-risk group was significantly higher than low-risk group (P < .05) and the patients of the non-survival group were all at high risk.These data suggest the APACHE II score, PSS, SOFA score can all predict the prognosis of AOPP patients. For its simplicity and objectivity, the SOFA score is a superior predictor. Lac significantly improved the predictive abilities of the 3 scoring systems, especially for the SOFA score. The SOFA-Lac system effectively distinguished the high-risk group from the low-risk group. Therefore, the SOFA-Lac system is significantly better at predicting mortality in AOPP patients.

  15. Evaluation of Historical and Projected Agricultural Climate Risk Over the Continental US

    NASA Astrophysics Data System (ADS)

    Zhu, X.; Troy, T. J.; Devineni, N.

    2016-12-01

    Food demands are rising due to an increasing population with changing food preferences, which places pressure on agricultural systems. In addition, in the past decade climate extremes have highlighted the vulnerability of our agricultural production to climate variability. Quantitative analyses in the climate-agriculture research field have been performed in many studies. However, climate risk still remains difficult to evaluate at large scales yet shows great potential of help us better understand historical climate change impacts and evaluate the future risk given climate projections. In this study, we developed a framework to evaluate climate risk quantitatively by applying statistical methods such as Bayesian regression, distribution fitting, and Monte Carlo simulation. We applied the framework over different climate regions in the continental US both historically and for modeled climate projections. The relative importance of any major growing season climate index, such as maximum dry period or heavy precipitation, was evaluated to determine what climate indices play a role in affecting crop yields. The statistical modeling framework was applied using county yields, with irrigated and rainfed yields separated to evaluate the different risk. This framework provides estimates of the climate risk facing agricultural production in the near-term that account for the full uncertainty of climate occurrences, range of crop response, and spatial correlation in climate. In particular, the method provides robust estimates of importance of irrigation in mitigating agricultural climate risk. The results of this study can contribute to decision making about crop choice and water use in an uncertain climate.

  16. Risk analysis based CWR track buckling safety evaluations

    DOT National Transportation Integrated Search

    1999-12-01

    As part of the Federal Railroad Administration's (FRA) track systems research program, the US DOT'S Volpe Center is conducting analytic and experimental investigations to evaluate track lateral strength and stability limits for improved safety and pe...

  17. Weighted Fuzzy Risk Priority Number Evaluation of Turbine and Compressor Blades Considering Failure Mode Correlations

    NASA Astrophysics Data System (ADS)

    Gan, Luping; Li, Yan-Feng; Zhu, Shun-Peng; Yang, Yuan-Jian; Huang, Hong-Zhong

    2014-06-01

    Failure mode, effects and criticality analysis (FMECA) and Fault tree analysis (FTA) are powerful tools to evaluate reliability of systems. Although single failure mode issue can be efficiently addressed by traditional FMECA, multiple failure modes and component correlations in complex systems cannot be effectively evaluated. In addition, correlated variables and parameters are often assumed to be precisely known in quantitative analysis. In fact, due to the lack of information, epistemic uncertainty commonly exists in engineering design. To solve these problems, the advantages of FMECA, FTA, fuzzy theory, and Copula theory are integrated into a unified hybrid method called fuzzy probability weighted geometric mean (FPWGM) risk priority number (RPN) method. The epistemic uncertainty of risk variables and parameters are characterized by fuzzy number to obtain fuzzy weighted geometric mean (FWGM) RPN for single failure mode. Multiple failure modes are connected using minimum cut sets (MCS), and Boolean logic is used to combine fuzzy risk priority number (FRPN) of each MCS. Moreover, Copula theory is applied to analyze the correlation of multiple failure modes in order to derive the failure probabilities of each MCS. Compared to the case where dependency among multiple failure modes is not considered, the Copula modeling approach eliminates the error of reliability analysis. Furthermore, for purpose of quantitative analysis, probabilities importance weight from failure probabilities are assigned to FWGM RPN to reassess the risk priority, which generalize the definition of probability weight and FRPN, resulting in a more accurate estimation than that of the traditional models. Finally, a basic fatigue analysis case drawn from turbine and compressor blades in aeroengine is used to demonstrate the effectiveness and robustness of the presented method. The result provides some important insights on fatigue reliability analysis and risk priority assessment of structural system under failure correlations.

  18. 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.

  19. A feasibility study of cell phone and landline phone interviews for monitoring of risk and protection factors for chronic diseases in Brazil.

    PubMed

    Moura, Erly Catarina; Claro, Rafael Moreira; Bernal, Regina; Ribeiro, Juliano; Malta, Deborah Carvalho; Morais Neto, Otaliba

    2011-02-01

    The study objective was to evaluate the feasibility of interviews by cell phone as a complement to interviews by landline to estimate risk and protection factors for chronic non-communicable diseases. Adult cell phone users were evaluated by random digit dialing. Questions asked were: age, sex, education, race, marital status, ownership of landline and cell phones, health condition, weight and height, medical diagnosis of hypertension and diabetes, physical activity, diet, binge drinking and smoking. The estimates were calculated using post-stratification weights. The cell phone interview system showed a reduced capacity to reach elderly and low educated populations. The estimates of the risk and protection factors for chronic non-communicable diseases in cell phone interviews were equal to the estimates obtained by landline phone. Eligibility, success and refusal rates using the cell phone system were lower than those of the landline system, but loss and cost were much higher, suggesting it is unsatisfactory as a complementary method in such a context.

  20. Composite power system well-being analysis

    NASA Astrophysics Data System (ADS)

    Aboreshaid, Saleh Abdulrahman Saleh

    The evaluation of composite system reliability is extremely complex as it is necessary to include detailed modeling of both generation and transmission facilities and their auxiliary elements. The most significant quantitative indices in composite power system adequacy evaluation are those which relate to load curtailment. Many utilities have difficulty in interpreting the expected load curtailment indices as the existing models are based on adequacy analysis and in many cases do not consider realistic operating conditions in the system under study. This thesis presents a security based approach which alleviates this difficulty and provides the ability to evaluate the well-being of customer load points and the overall composite generation and transmission power system. Acceptable deterministic criteria are included in the probabilistic evaluation of the composite system reliability indices to monitor load point well-being. The degree of load point well-being is quantified in terms of the healthy and marginal state indices in addition to the traditional risk indices. The individual well-being indices of the different system load points are aggregated to produce system indices. This thesis presents new models and techniques to quantify the well-being of composite generation and, direct and alternating current transmission systems. Security constraints are basically the operating limits which must be satisfied for normal system operation. These constraints depend mainly on the purpose behind the study. The constraints which govern the practical operation of a power system are divided, in this thesis, into three sets namely, steady-state, voltage stability and transient stability constraints. The inclusion of an appropriate transient stability constraint will lead to a more accurate appraisal of the overall power system well-being. This thesis illustrates the utilization of a bisection method in the analytical evaluation of the critical clearing time which forms the basis of most existing stability assessments. The effect of employing high-speed-simultaneous or adaptive reclosing schemes is presented in this thesis. An effective and fast technique to incorporate voltage stability considerations in composite generation and transmission system reliability evaluation is also presented. The proposed technique can be easily incorporated in an existing composite power system reliability program using voltage stability constraints that are constructed for individual load points based on a relatively simple risk index. It is believed that the concepts, procedures and indices presented in this thesis will provide useful tools for power system designers, planners and operators and assist them to perform composite system well-being analysis in addition to traditional risk assessment.

  1. A risk analysis for production processes with disposable bioreactors.

    PubMed

    Merseburger, Tobias; Pahl, Ina; Müller, Daniel; Tanner, Markus

    2014-01-01

    : Quality management systems are, as a rule, tightly defined systems that conserve existing processes and therefore guarantee compliance with quality standards. But maintaining quality also includes introducing new enhanced production methods and making use of the latest findings of bioscience. The advances in biotechnology and single-use manufacturing methods for producing new drugs especially impose new challenges on quality management, as quality standards have not yet been set. New methods to ensure patient safety have to be established, as it is insufficient to rely only on current rules. A concept of qualification, validation, and manufacturing procedures based on risk management needs to be established and realized in pharmaceutical production. The chapter starts with an introduction to the regulatory background of the manufacture of medicinal products. It then continues with key methods of risk management. Hazards associated with the production of medicinal products with single-use equipment are described with a focus on bioreactors, storage containers, and connecting devices. The hazards are subsequently evaluated and criteria for risk evaluation are presented. This chapter concludes with aspects of industrial application of quality risk management.

  2. Risk assessment of supply chain for pharmaceutical excipients with AHP-fuzzy comprehensive evaluation.

    PubMed

    Li, Maozhong; Du, Yunai; Wang, Qiyue; Sun, Chunmeng; Ling, Xiang; Yu, Boyang; Tu, Jiasheng; Xiong, Yerong

    2016-01-01

    As the essential components in formulations, pharmaceutical excipients directly affect the safety, efficacy, and stability of drugs. Recently, safety incidents of pharmaceutical excipients posing seriously threats to the patients highlight the necessity of controlling the potential risks. Hence, it is indispensable for the industry to establish an effective risk assessment system of supply chain. In this study, an AHP-fuzzy comprehensive evaluation model was developed based on the analytic hierarchy process and fuzzy mathematical theory, which quantitatively assessed the risks of supply chain. Taking polysorbate 80 as the example for model analysis, it was concluded that polysorbate 80 for injection use is a high-risk ingredient in the supply chain compared to that for oral use to achieve safety application in clinic, thus measures should be taken to control and minimize those risks.

  3. Risk assessment of supply chain for pharmaceutical excipients with AHP-fuzzy comprehensive evaluation.

    PubMed

    Li, Maozhong; Du, Yunai; Wang, Qiyue; Sun, Chunmeng; Ling, Xiang; Yu, Boyang; Tu, Jiasheng; Xiong, Yerong

    2016-04-01

    As the essential components in formulations, pharmaceutical excipients directly affect the safety, efficacy, and stability of drugs. Recently, safety incidents of pharmaceutical excipients posing seriously threats to the patients highlight the necessity of controlling the potential risks. Hence, it is indispensable for the industry to establish an effective risk assessment system of supply chain. In this study, an AHP-fuzzy comprehensive evaluation model was developed based on the analytic hierarchy process and fuzzy mathematical theory, which quantitatively assessed the risks of supply chain. Taking polysorbate 80 as the example for model analysis, it was concluded that polysorbate 80 for injection use is a high-risk ingredient in the supply chain compared to that for oral use to achieve safety application in clinic, thus measures should be taken to control and minimize those risks.

  4. Using linked data to evaluate collisions with fixed objects in Pennsylvania : Crash Outcome Data Evaluation System (CODES) linked data demonstration project

    DOT National Transportation Integrated Search

    1998-10-01

    This report uses police-reported motor vehicle crash data linked to Emergency Medical Services data and hospital discharge data to evaluate the relative risk of injury posed by specific roadside objects in Pennsylvania. The report focuses primarily o...

  5. Underwriting: a key to healthy capitation agreements.

    PubMed

    Dameron, T H; Fessler, J C

    1996-09-01

    In some markets, healthcare providers in integrated delivery systems have been assuming full-risk capitated contracts. Some of these contracts have been profitable, but others have produced inconsistent financial results. These results may reflect inadequate underwriting practices. For providers and HMO insurers to establish financially successful capitation agreements, they must develop and audit an underwriting process to evaluate the health risk of the population entering the managed care system.

  6. A new era of prospective real-world safety evaluation primary report of XIENCE V USA (XIENCE V Everolimus Eluting Coronary Stent System condition-of-approval post-market study).

    PubMed

    Krucoff, Mitchell W; Rutledge, David R; Gruberg, Luis; Jonnavithula, Lalitha; Katopodis, John N; Lombardi, William; Mao, Vivian W; Sharma, Samin K; Simonton, Charles A; Tamboli, Hoshedar P; Wang, Jin; Wilburn, Olivia; Zhao, Weiying; Sudhir, Krishnankutty; Hermiller, James B

    2011-12-01

    The XIENCE V USA (XIENCE V Everolimus Eluting Coronary Stent System Condition-of-Approval Post-Market study) sought to: 1) evaluate the safety of everolimus-eluting coronary stent systems (EECSS) in a contemporary cohort of real-world subjects; and 2) prospectively test the quality of event reporting with analysis of matched patients from the randomized SPIRIT IV (Clinical Evaluation of the XIENCE V Everolimus Eluting Coronary Stent System in the Treatment of Subjects With de Novo Native Coronary Artery Lesions) trial. Randomized trials have demonstrated the safety and efficacy of EECSS in selected "standard-risk" patients. The XIENCE V USA trial was a prospective, multicenter, single-arm study in unselected patients. The primary endpoint was Academic Research Consortium (ARC)-defined definite and probable stent thrombosis (ST); the co-primary endpoint was the composite of cardiac death and myocardial infarction at 1 year. Secondary analyses included: 1) stratification by standard-risk and extended-risk cohorts; and 2) late ST after dual antiplatelet therapy interruption. Of 5,054 participants (1,875 standard-risk; 3,179 extended-risk), 4,958 (98.1%) reached 1-year follow-up. The rate of ARC-defined definite and probable ST was 0.84% (95% confidence interval [CI]: 0.60% to 1.14%) in the overall population and 0.33% (95% CI: 0.12% to 10.72%) and 1.14% (95% CI: 0.80% to 11.58%) in the standard-risk and extended-risk cohorts, respectively. No late ST was observed after dual antiplatelet therapy interruption in either cohort after 6 months. The composite rate of cardiac death and ARC-defined myocardial infarction was 6.5% (95% CI: 5.79% to 17.17%) in the overall population, 3.8% (95% CI: 2.98% to 14.78%) in the standard-risk cohort, and 8.0% (95% CI: 7.09% to 19.02%) in the extended-risk cohort. This study comprehensively reports ST rates for EECSS in a contemporary real-world population. The absence of ST after dual antiplatelet therapy interruption beyond 6 months in standard-risk and high-risk patients is notable. Consistent safety outcomes between matched standard-risk cohorts from the XIENCE V USA study and the SPIRIT IV randomized trial suggest that this study affords a reliable benchmark for understanding the safety of EECSS in the context of real-world clinical practice. (XIENCE V Everolimus Eluting Coronary Stent System [EECSS] USA Post-Approval Study; NCT00676520). Copyright © 2011 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

  7. [Contribution of remote sensing to malaria control].

    PubMed

    Machault, V; Pages, F; Rogier, C

    2009-04-01

    Despite national and international efforts, malaria remains a major public health problem and the fight to control the disease is confronted by numerous hurdles. Study of space and time dynamics of malaria is necessary as a basis for making appropriate decision and prioritizing intervention including in areas where field data are rare and sanitary information systems are inadequate. Evaluation of malarial risk should also help anticipate the risk of epidemics as a basis for early warning systems. Since 1960-70 civilian satellites launched for earth observation have been providing information for the measuring or evaluating geo-climatic and anthropogenic factors related to malaria transmission and burden. Remotely sensed data gathered for several civilian or military studies have allowed setup of entomological, parasitological, and epidemiological risk models and maps for rural and urban areas. Mapping of human populations at risk has also benefited from remotely sensing. The results of the published studies show that remote sensing is a suitable tool for optimizing planning, efficacy and efficiency of malaria control.

  8. Infection, Alveolar Osteitis, and Adverse Effects Using Metronidazole in Healthy Patients Undergoing Third Molar Surgery: A Meta-analysis.

    PubMed

    Isiordia-Espinoza, Mario Alberto; Aragon-Martinez, Othoniel H; Bollogna-Molina, Ronell E; Alonso-Castro, Ángel J

    2018-06-01

    The aim of this systematic review and meta-analysis was to evaluate the risk of surgical infection, alveolar osteitis, and adverse effects using systemic metronidazole in comparison with placebo in healthy patients undergoing third molar surgery. The eligible reports were identified from diverse science sources. Clinical trials meeting the inclusion and exclusion criteria and an acceptable Oxford Quality Score were included in this study. The evaluation of risk was done using the Risk Reduction Calculator and Review Manager 5.3., from the Cochrane Library. A significant risk reduction was assumed when the upper limit of the 95% confidence intervals was <1 and the lower limit did not cross zero (negative number) alongside a p value of <0.05 for the overall test. Data of 667 patients from five clinical trials were used for the assessment of risk. Our analysis showed no reduction of the risk of infection or dry socket in patients receiving metronidazole compared to whom took placebo. Meanwhile, the adverse effects did not exhibit a difference between the studied groups. The routine use of systemic metronidazole to prevent surgical site infection and/or dry socket in healthy patients undergoing third molar surgery is not recommended.

  9. Evaluation of Human Reliability in Selected Activities in the Railway Industry

    NASA Astrophysics Data System (ADS)

    Sujová, Erika; Čierna, Helena; Molenda, Michał

    2016-09-01

    The article focuses on evaluation of human reliability in the human - machine system in the railway industry. Based on a survey of a train dispatcher and of selected activities, we have identified risk factors affecting the dispatcher`s work and the evaluated risk level of their influence on the reliability and safety of preformed activities. The research took place at the authors` work place between 2012-2013. A survey method was used. With its help, authors were able to identify selected work activities of train dispatcher's risk factors that affect his/her work and the evaluated seriousness of its influence on the reliability and safety of performed activities. Amongst the most important finding fall expressions of unclear and complicated internal regulations and work processes, a feeling of being overworked, fear for one's safety at small, insufficiently protected stations.

  10. A decision support system for drinking water production integrating health risks assessment.

    PubMed

    Delpla, Ianis; Monteith, Donald T; Freeman, Chris; Haftka, Joris; Hermens, Joop; Jones, Timothy G; Baurès, Estelle; Jung, Aude-Valérie; Thomas, Olivier

    2014-07-18

    The issue of drinking water quality compliance in small and medium scale water services is of paramount importance in relation to the 98/83/CE European Drinking Water Directive (DWD). Additionally, concerns are being expressed over the implementation of the DWD with respect to possible impacts on water quality from forecast changes in European climate with global warming and further anticipated reductions in north European acid emissions. Consequently, we have developed a decision support system (DSS) named ARTEM-WQ (AwaReness Tool for the Evaluation and Mitigation of drinking Water Quality issues resulting from environmental changes) to support decision making by small and medium plant operators and other water stakeholders. ARTEM-WQ is based on a sequential risk analysis approach that includes consideration of catchment characteristics, climatic conditions and treatment operations. It provides a holistic evaluation of the water system, while also assessing human health risks of organic contaminants potentially present in treated waters (steroids, pharmaceuticals, pesticides, bisphenol-a, polychlorobiphenyls, polycyclic aromatic hydrocarbons, petrochemical hydrocarbons and disinfection by-products; n = 109). Moreover, the system provides recommendations for improvement while supporting decision making in its widest context. The tool has been tested on various European catchments and shows a promising potential to inform water managers of risks and appropriate mitigative actions. Further improvements should include toxicological knowledge advancement, environmental background pollutant concentrations and the assessment of the impact of distribution systems on water quality variation.

  11. Evaluating Effects of Marine Energy Devices on the Marine Environment - A Risk-Based and In-Water Testing Approach

    NASA Astrophysics Data System (ADS)

    Harker-Klimes, G.; Copping, A. E.

    2016-02-01

    The portfolio of emerging renewables includes generating power from offshore winds, tides, waves, and ocean currents, as well as seawater temperature and salinity differentials. These new systems are collectively known as marine renewable energy (MRE). MRE development worldwide is in the early stages of design, deployment, and commercialization. A major barrier to bringing these systems into commercial use is the need to overcome uncertainties in environmental effects that slow siting and permitting of devices. Using a risk-based approach, this paper will discuss pathways for evaluating potential effects of tidal turbines and wave energy converters (WECs) on marine animals, habitats, and ecosystem processes. Using basic biological principles and knowledge of specific MRE technologies, the Environmental Risk Evaluation System has been used to narrow pertinent risks from devices, enabling laboratory and field studies to focus on the most important interactions. These interactions, include: potential collisions and behavioral disturbances of marine mammals, fish and other organisms; effects of underwater sound on animal communication and navigation; changes in sediment transport, benthic habitats, and water quality constituents; and effects of electromagnetic fields on animals. It is then necessary to apply these findings to the projects themselves. Another uncertainty is how to measure these key interactions in high-energy locations where MRE deployment is desirable. Consequently, new systems are being developed: instrumentation, innovative platforms for deployment, and new management strategies for collecting and analyzing very large data streams. Inherent in this development pathway is the need to test, deploy, and calibrate these monitoring systems. The Triton initiative is designed to enable this development, and has initiated testing of devices in Washington State to move the MRE industry forward while protecting marine animals, habitats and processes.

  12. The Auckland Cataract Study: Assessing Preoperative Risk Stratification Systems for Phacoemulsification Surgery in a Teaching Hospital.

    PubMed

    Kim, Bia Z; Patel, Dipika V; Sherwin, Trevor; McGhee, Charles N J

    2016-11-01

    To evaluate 2 preoperative risk stratification systems for assessing the risk of complications in phacoemulsification cataract surgery, performed by residents, fellows, and attending physicians in a public teaching hospital. Cohort study. One observer assessed the clinical data of 500 consecutive cases, prior to phacoemulsification cataract surgery performed between April and June 2015 at Greenlane Clinical Centre, Auckland, New Zealand. Preoperatively 2 risk scores were calculated for each case using the Muhtaseb and Buckinghamshire risk stratification systems. Complications, intraoperative and postoperative, and visual outcomes were analyzed in relation to these risk scores. Intraoperative complication rates increased with higher risk scores using the Muhtaseb or Buckinghamshire stratification system (P = .001 and P = .003, respectively, n = 500). The odds ratios for residents and fellows were not significantly different from attending physicians after case-mix adjustment according to risk scores (P > .05). Postoperative complication rates increased with higher Buckinghamshire risk scores but not with Muhtaseb scores (P = .014 and P = .094, respectively, n = 476). Postoperative corrected-distance visual acuity was poorer with higher risk scores (P < .001 for both, n = 476). This study confirms that the risk of intraoperative complications increases with higher preoperative risk scores. Furthermore, higher risk scores correlate with poorer postoperative visual acuity and the Buckinghamshire risk score also correlates with postoperative complications. Therefore, preoperative assessment using such risk stratification systems could assist individual informed consent, preoperative surgical planning, safe allocation of cases to trainees, and more meaningful analyses of outcomes for individual surgeons and institutions. Copyright © 2016 Elsevier Inc. All rights reserved.

  13. Risk Costs for New Dams: Economic Analysis and Effects of Monitoring

    NASA Astrophysics Data System (ADS)

    Paté-Cornell, M. Elisabeth; Tagaras, George

    1986-01-01

    This paper presents new developments and illustrations of the introduction of risk and costs in cost-benefit analysis for new dams. The emphasis is on a method of evaluation of the risk costs based on the structure of the local economy. Costs to agricultural property as well as residential, commercial, industrial, and public property are studied in detail. Of particular interest is the case of sequential dam failure and the evaluation of the risk costs attributable to a new dam upstream from an existing one. Three real cases are presented as illustrations of the method: the Auburn Dam, the Dickey-Lincoln School Project, and the Teton Dam, which failed in 1976. This last case provides a calibration tool for the estimation of loss ratios. For these three projects, the risk-modified benefit-cost ratios are computed to assess the effect of the risk on the economic performance of the project. The role of a warning system provided by systematic monitoring of the dam is analyzed: by reducing the risk costs, the warning system attenuates their effect on the benefit-cost ratio. The precursors, however, can be missed or misinterpreted: monitoring does not guarantee that the risks to human life can be reduced to zero. This study shows, in particular, that it is critical to consider the risk costs in the decision to build a new dam when the flood area is large and densely populated.

  14. Realization of a service for the long-term risk assessment of diabetes-related complications.

    PubMed

    Lagani, Vincenzo; Chiarugi, Franco; Manousos, Dimitris; Verma, Vivek; Fursse, Joanna; Marias, Kostas; Tsamardinos, Ioannis

    2015-07-01

    We present a computerized system for the assessment of the long-term risk of developing diabetes-related complications. The core of the system consists of a set of predictive models, developed through a data-mining/machine-learning approach, which are able to evaluate individual patient profiles and provide personalized risk assessments. Missing data is a common issue in (electronic) patient records, thus the models are paired with a module for the intelligent management of missing information. The system has been deployed and made publicly available as Web service, and it has been fully integrated within the diabetes-management platform developed by the European project REACTION. Preliminary usability tests showed that the clinicians judged the models useful for risk assessment and for communicating the risk to the patient. Furthermore, the system performs as well as the United Kingdom Prospective Diabetes Study (UKPDS) Risk Engine when both systems are tested on an independent cohort of UK diabetes patients. Our work provides a working example of risk-stratification tool that is (a) specific for diabetes patients, (b) able to handle several different diabetes related complications, (c) performing as well as the widely known UKPDS Risk Engine on an external validation cohort. Copyright © 2015 Elsevier Inc. All rights reserved.

  15. A surety engineering framework to reduce cognitive systems risks.

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

    Caudell, Thomas P.; Peercy, David Eugene; Caldera, Eva O.

    Cognitive science research investigates the advancement of human cognition and neuroscience capabilities. Addressing risks associated with these advancements can counter potential program failures, legal and ethical issues, constraints to scientific research, and product vulnerabilities. Survey results, focus group discussions, cognitive science experts, and surety researchers concur technical risks exist that could impact cognitive science research in areas such as medicine, privacy, human enhancement, law and policy, military applications, and national security (SAND2006-6895). This SAND report documents a surety engineering framework and a process for identifying cognitive system technical, ethical, legal and societal risks and applying appropriate surety methods to reducemore » such risks. The framework consists of several models: Specification, Design, Evaluation, Risk, and Maturity. Two detailed case studies are included to illustrate the use of the process and framework. Several Appendices provide detailed information on existing cognitive system architectures; ethical, legal, and societal risk research; surety methods and technologies; and educing information research with a case study vignette. The process and framework provide a model for how cognitive systems research and full-scale product development can apply surety engineering to reduce perceived and actual risks.« less

  16. A human tissue-based functional assay platform to evaluate the immune function impact of small molecule inhibitors that target the immune system.

    PubMed

    St Pierre, Cristina; Guo, Jane; Shin, John D; Engstrom, Laura W; Lee, Hyun-Hee; Herbert, Alan; Surdi, Laura; Baker, James; Salmon, Michael; Shah, Sanjiv; Ellis, J Michael; Houshyar, Hani; Crackower, Michael A; Kleinschek, Melanie A; Jones, Dallas C; Hicks, Alexandra; Zaller, Dennis M; Alves, Stephen E; Ramadas, Ravisankar A

    2017-01-01

    While the immune system is essential for the maintenance of the homeostasis, health and survival of humans, aberrant immune responses can lead to chronic inflammatory and autoimmune disorders. Pharmacological modulation of drug targets in the immune system to ameliorate disease also carry a risk of immunosuppression that could lead to adverse outcomes. Therefore, it is important to understand the 'immune fingerprint' of novel therapeutics as they relate to current and, clinically used immunological therapies to better understand their potential therapeutic benefit as well as immunosuppressive ability that might lead to adverse events such as infection risks and cancer. Since the mechanistic investigation of pharmacological modulators in a drug discovery setting is largely compound- and mechanism-centric but not comprehensive in terms of immune system impact, we developed a human tissue based functional assay platform to evaluate the impact of pharmacological modulators on a range of innate and adaptive immune functions. Here, we demonstrate that it is possible to generate a qualitative and quantitative immune system impact of pharmacological modulators, which might help better understand and predict the benefit-risk profiles of these compounds in the treatment of immune disorders.

  17. Necessity and Effect of Combating Legionella pneumophila in Municipal Shower Systems

    PubMed Central

    Wiik, Ragnhild; Krøvel, Anne Vatland

    2014-01-01

    The objective was to obtain research-based, holistic knowledge about necessity and effect of practiced measures against L. pneumophila in municipal shower systems in Stavanger, Norway. The effects of hot water treatment and membrane-filtering were investigated and compared to no intervention at all. The studies were done under real-world conditions. Additionally, a surveillance pilot study of municipal showers in Stavanger was performed. The validity of high total plate count (TPC) as an indication of L. pneumophila was evaluated. A simplified method, named “dripping method”, for detection and quantification of L. pneumophila was developed. The sensitivity of the dripping method is 5 colony-forming units of L. pneumophila/ml. The transference of L. pneumophila from shower water to aerosols was studied. Interviews and observational studies among the stakeholders were done in order to identify patterns of communication and behavior in a Legionella risk perspective. No substantial effects of the measures against L. pneumophila were demonstrated, except for a distally placed membrane filter. No significant positive correlation between TPC and L. pneumophila concentrations were found. L. pneumophila serogroup 2–14 was demonstrated in 21% of the 29 buildings tested in the surveillance pilot. Relatively few cells of L. pneumophila were transferred from shower water to aerosols. Anxiety appeared as the major driving force in the risk governance of Legionella. In conclusion, the risk of acquiring Legionnaires' disease from municipal shower systems is evaluated as low and uncertain. By eliminating ineffective approaches, targeted Legionella risk governance can be practiced. Risk management by surveillance is evaluated as appropriate. PMID:25490721

  18. Environmental Risk Assessment System for Phosphogypsum Tailing Dams

    PubMed Central

    Sun, Xin; Tang, Xiaolong; Yi, Honghong; Li, Kai; Zhou, Lianbi; Xu, Xianmang

    2013-01-01

    This paper may be of particular interest to the readers as it provides a new environmental risk assessment system for phosphogypsum tailing dams. In this paper, we studied the phosphogypsum tailing dams which include characteristics of the pollution source, environmental risk characteristics and evaluation requirements to identify the applicable environmental risk assessment methods. Two analytical methods, that is, the analytic hierarchy process (AHP) and fuzzy logic, were used to handle the complexity of the environmental and nonquantitative data. Using our assessment method, different risk factors can be ranked according to their contributions to the environmental risk, thereby allowing the calculation of their relative priorities during decision making. Thus, environmental decision-makers can use this approach to develop alternative management strategies for proposed, ongoing, and completed PG tailing dams. PMID:24382947

  19. Environmental risk assessment system for phosphogypsum tailing dams.

    PubMed

    Sun, Xin; Ning, Ping; Tang, Xiaolong; Yi, Honghong; Li, Kai; Zhou, Lianbi; Xu, Xianmang

    2013-01-01

    This paper may be of particular interest to the readers as it provides a new environmental risk assessment system for phosphogypsum tailing dams. In this paper, we studied the phosphogypsum tailing dams which include characteristics of the pollution source, environmental risk characteristics and evaluation requirements to identify the applicable environmental risk assessment methods. Two analytical methods, that is, the analytic hierarchy process (AHP) and fuzzy logic, were used to handle the complexity of the environmental and nonquantitative data. Using our assessment method, different risk factors can be ranked according to their contributions to the environmental risk, thereby allowing the calculation of their relative priorities during decision making. Thus, environmental decision-makers can use this approach to develop alternative management strategies for proposed, ongoing, and completed PG tailing dams.

  20. Tsunami risk zoning in south-central Chile

    NASA Astrophysics Data System (ADS)

    Lagos, M.

    2010-12-01

    The recent 2010 Chilean tsunami revealed the need to optimize methodologies for assessing the risk of disaster. In this context, modern techniques and criteria for the evaluation of the tsunami phenomenon were applied in the coastal zone of south-central Chile as a specific methodology for the zoning of tsunami risk. This methodology allows the identification and validation of a scenario of tsunami hazard; the spatialization of factors that have an impact on the risk; and the zoning of the tsunami risk. For the hazard evaluation, different scenarios were modeled by means of numerical simulation techniques, selecting and validating the results that better fit with the observed tsunami data. Hydrodynamic parameters of the inundation as well as physical and socioeconomic vulnerability aspects were considered for the spatialization of the factors that affect the tsunami risk. The tsunami risk zoning was integrated into a Geographic Information System (GIS) by means of multicriteria evaluation (MCE). The results of the tsunami risk zoning show that the local characteristics and their location, together with the concentration of poverty levels, establish spatial differentiated risk levels. This information builds the basis for future applied studies in land use planning that tend to minimize the risk levels associated to the tsunami hazard. This research is supported by Fondecyt 11090210.

  1. [Establishment and application effect of fall prevention and control information system in elderly community].

    PubMed

    Zhao, Ting; Pi, Hong-Ying; Ku, Hong-An; Pan, Li; Gong, Zhu-Yun

    2018-02-08

    To investigate establishing, applying and evaluating the fall prevention and control information system in elderly community. Relying on internet technology and informatization means, the fall comprehensive prevention and control strategy of elderly was guided into online from offline. The fall prevention and control information system which was a collection of risk assessment, remote education and feedback was established. One hundred and twenty-six elderly (over 60 years old) in community were screened in this study and 84 high-risk elders who were involved in the remote continuous comprehensive intervention were screened out. Intervening measures included distributing propaganda album, making mission slides and video used to play with the interpretation remotely. Then fall related situation before and after intervention was analyzed and the effectiveness of system evaluated. After remote intervention, the fall incidence of high-risk group decreased from 21.43% to 4.76%( P <0.01). The body balance and gait stability improved clearly( P <0. 01). The rate of taking proper prevention and control behavior significantly improved( P <0.01). They believed in themselves not to fall down with more confidence when taking complex behaviors( P <0.01). The security of environment at home significantly enhanced( P <0. 01). Fall prevention and control information system in elderly community was innovative and convenient. The system could roundly assess the status related to fall and accurately screen out high-risk group. The system could implement the remote continuous comprehensive intervention so that the incident of fall was decrease. In conclusion, the system is stable and effective, can be further popularization and application as a successful pilot.

  2. 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.

  3. Cost-Effectiveness of Staphylococcus aureus Decolonization Strategies in High-Risk Total Joint Arthroplasty Patients.

    PubMed

    Williams, Devin M; Miller, Andy O; Henry, Michael W; Westrich, Geoffrey H; Ghomrawi, Hassan M K

    2017-09-01

    The risk of prosthetic joint infection increases with Staphylococcus aureus colonization. The cost-effectiveness of decolonization is controversial. We evaluated cost-effectiveness decolonization protocols in high-risk arthroplasty patients. An analytical model evaluated risk under 3 protocols: 4 swabs, 2 swabs, and nasal swab alone. These were compared to no-screening and universal decolonization strategies. Cost-effectiveness was evaluated from the hospital, patient, and societal perspective. Under base case conditions, universal decolonization and 4-swab strategies were most effective. The 2-swab and universal decolonization strategy were most cost-effective from patient and societal perspectives. From the hospital perspective, universal decolonization was the dominant strategy (much less costly and more effective). S aureus decolonization may be cost-effective for reducing prosthetic joint infections in high-risk patients. These results may have important implications for treatment of patients and for cost containment in a bundled payment system. Copyright © 2017 Elsevier Inc. All rights reserved.

  4. [Helicobacter pylori gastritis: assessment of OLGA and OLGIM staging systems].

    PubMed

    Ben Slama, Sana; Ben Ghachem, Dorra; Dhaoui, Amen; Jomni, Mohamed Taieb; Dougui, Mohamed Hédi; Bellil, Khadija

    2016-01-01

    Helicobacter pylori (H pylori) gastritis presents a risk of cancer related to atrophy and intestinal metaplasia. Two recent classifications OLGA (Operative Link on Gastritis Assessment) and OLGIM (Operative Link on Gastritic Intestinal Metaplasia assessment) have been proposed to identify high-risk forms (stages III and IV). The aim of this study is to evaluate the OLGA and OLGIM staging systems in H pylori gastritis. A descriptive study of 100 cases of chronic H pylori gastritis was performed. The revaluation of Sydney System parameters of atrophy and intestinal metaplasia, of gastric antrum and corpus, allowed identifying respectively the stages of OLGA and OLGIM systems. The progressive risk of our H pylori gastritis was 6% according to OLGA staging and 7% according to OLGIM staging. Significant correlation was revealed between age and OLGA staging. High-risk gastritis according to OLGIM staging was significantly associated with moderate to severe atrophy. High-risk forms according to OLGA staging were associated in 80% of the cases to intestinal metaplasia. OLGA and OLGIM systems showed a highly significant positive correlation between them with a mismatch at 5% for H pylori gastritis. The OLGA and OLGIM staging systems in addition to Sydney System, allow selection of high risk forms of chronic gastritis requiring accurate observation.

  5. 75 FR 77645 - Disease, Disability, and Injury Prevention and Control Special Emphasis Panel (SEP): Pregnancy...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-12-13

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Disease Control and Prevention Disease, Disability, and Injury Prevention and Control Special Emphasis Panel (SEP): Pregnancy Risk Assessment... initial review, discussion, and evaluation of ``Pregnancy Risk Assessment Monitoring System (PRAMS), DP11...

  6. Proactive assessment of accident risk to improve safety on a system of freeways.

    DOT National Transportation Integrated Search

    2012-05-01

    This report describes the development and evaluation of real-time crash risk-assessment models for four freeway corridors: U.S. Route 101 NB (northbound) and SB (southbound) and Interstate 880 NB and SB. Crash data for these freeway segments for the ...

  7. The Basics of Risk Assessment to Protect Human Health and the Environment

    EPA Science Inventory

    Risk assessment is the evaluation to determine the chance of harmful effects to human health or ecological systems resulting from exposure to an environmental stressor. A stressor is any physical, chemical, or biological entity that can induce an adverse response. Stressors may a...

  8. Evaluating visual system toxicity in relation to human risk assessments in the 21st century

    EPA Science Inventory

    Abstract for an invited presentation to a symposium entitled "Physiological assessment of sensory toxicity and the role in human risk assessment in the 21st century", for the Joint Meeting of the Neurotoxicity Society and International Neurotoxicology Association, May 2...

  9. Systematic screening of common wastewater-marking pharmaceuticals in urban aquatic environments: implications for environmental risk control.

    PubMed

    Zhou, Haidong; Zhang, Qingjun; Wang, Xuelian; Zhang, Qianqian; Ma, Lixin; Zhan, Yong

    2014-01-01

    In this report, we refer to pharmaceuticals that are widespread in the urban aquatic environment and that mainly originate from wastewater treatment plants or non-point source sewage as "wastewater-marking pharmaceuticals" (WWMPs). To some extent, they reflect the condition or trend of water contamination and also contribute to aquatic environmental risk assessment. The method reported here for screening typical WWMPs was proposed based on academic concerns about them and their concentrations present in the urban aquatic environment, as well as their properties of accumulation, persistence, eco-toxicity and related environmental risks caused by them. The screening system consisted of an initial screening system and a further screening system. In the former, pharmaceuticals were categorised into different evaluation levels, and in the latter, each pharmaceutical was given a normalised final evaluation score, which was the sum of every score for its properties of accumulation, persistence, eco-toxicity and environmental risk in the aquatic environment. The system was applied to 126 pharmaceuticals frequently detected in the aquatic environment. In the initial screening procedure, five pharmaceuticals were classified into the "high" category, 16 pharmaceuticals into the "medium" category, 15 pharmaceuticals into the "low" category and 90 pharmaceuticals into the "very low" category. Subsequently, further screening were conducted on 36 pharmaceuticals considered as being of "high", "medium" and "low" categories in the former system. We identified 7 pharmaceuticals with final evaluation scores of 1-10, 10 pharmaceuticals with scores of 11-15, 15 pharmaceuticals with scores from 16 to 20 and 4 pharmaceuticals with scores above 21. The results showed that this screening system could contribute to the effective selection of target WWMPs, which would be important for spatial-temporal dynamics, transference and pollution control of pharmaceuticals in the urban aquatic environment. However, there remains a number of pharmaceutical parameters with measured data gaps, such as organic carbon adsorption coefficients and bioconcentration factors, which, if filled, would improve the accuracy of the screening system.

  10. Adaptive Flood Risk Management Under Climate Change Uncertainty Using Real Options and Optimization.

    PubMed

    Woodward, Michelle; Kapelan, Zoran; Gouldby, Ben

    2014-01-01

    It is well recognized that adaptive and flexible flood risk strategies are required to account for future uncertainties. Development of such strategies is, however, a challenge. Climate change alone is a significant complication, but, in addition, complexities exist trying to identify the most appropriate set of mitigation measures, or interventions. There are a range of economic and environmental performance measures that require consideration, and the spatial and temporal aspects of evaluating the performance of these is complex. All these elements pose severe difficulties to decisionmakers. This article describes a decision support methodology that has the capability to assess the most appropriate set of interventions to make in a flood system and the opportune time to make these interventions, given the future uncertainties. The flood risk strategies have been explicitly designed to allow for flexible adaptive measures by capturing the concepts of real options and multiobjective optimization to evaluate potential flood risk management opportunities. A state-of-the-art flood risk analysis tool is employed to evaluate the risk associated to each strategy over future points in time and a multiobjective genetic algorithm is utilized to search for the optimal adaptive strategies. The modeling system has been applied to a reach on the Thames Estuary (London, England), and initial results show the inclusion of flexibility is advantageous, while the outputs provide decisionmakers with supplementary knowledge that previously has not been considered. © 2013 HR Wallingford Ltd.

  11. Joint System Prognostics For Increased Efficiency And Risk Mitigation In Advanced Nuclear Reactor Instrumentation and Control

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

    Donald D. Dudenhoeffer; Tuan Q. Tran; Ronald L. Boring

    2006-08-01

    The science of prognostics is analogous to a doctor who, based on a set of symptoms and patient tests, assesses a probable cause, the risk to the patient, and a course of action for recovery. While traditional prognostics research has focused on the aspect of hydraulic and mechanical systems and associated failures, this project will take a joint view in focusing not only on the digital I&C aspect of reliability and risk, but also on the risks associated with the human element. Model development will not only include an approximation of the control system physical degradation but also on humanmore » performance degradation. Thus the goal of the prognostic system is to evaluate control room operation; to identify and potentially take action when performance degradation reduces plant efficiency, reliability or safety.« less

  12. One approach for evaluating the Distributed Computing Design System (DCDS)

    NASA Technical Reports Server (NTRS)

    Ellis, J. T.

    1985-01-01

    The Distributed Computer Design System (DCDS) provides an integrated environment to support the life cycle of developing real-time distributed computing systems. The primary focus of DCDS is to significantly increase system reliability and software development productivity, and to minimize schedule and cost risk. DCDS consists of integrated methodologies, languages, and tools to support the life cycle of developing distributed software and systems. Smooth and well-defined transistions from phase to phase, language to language, and tool to tool provide a unique and unified environment. An approach to evaluating DCDS highlights its benefits.

  13. The effect of control and display lag on unmanned air system internal pilot manual landing performance

    NASA Astrophysics Data System (ADS)

    Lloyd, Marshall Everett

    An important characteristic of UASs is lag because it can become a considerable challenge to successful human-in-the-loop control. As such, UASs are designed and configured to minimize system lag, though this can increase acquisition and operation costs considerably. In an effort to cut costs, an organization may choose to accept greater risk and deploy a UAS with high system lag. Before this risk can be responsibly accepted, it must be quantified. While many studies have examined system lag, very few have been able to quantify the risk that various levels of lag pose to an internally piloted, manually landed UAS. This study attempted to do so by evaluating pilot landing performance in a simulator with 0 ms, 240 ms, and 1000 ms of additional lag. Various measures were used, including a novel coding technique. Results indicated that 1000 ms of lag was unsafe by all measures. They also indicate that 240 ms of lag degrades performance, but participants were able to successfully land the simulated aircraft. This study showed the utility of using several measures to evaluate the effect of lag on landing performance and it helped demonstrate that while 1000 ms poses a high risk, 240 ms of lag may be a much more manageable risk. Future research suggested by this research includes: investigating lag between 240 ms and 1000 ms, introducing different weather phenomena, developing system lag training techniques for operators, and investigating the effect of aides such as predictive displays and autopilot-assisted recovery.

  14. A Tissue Systems Pathology Test Detects Abnormalities Associated with Prevalent High-Grade Dysplasia and Esophageal Cancer in Barrett's Esophagus.

    PubMed

    Critchley-Thorne, Rebecca J; Davison, Jon M; Prichard, Jeffrey W; Reese, Lia M; Zhang, Yi; Repa, Kathleen; Li, Jinhong; Diehl, David L; Jhala, Nirag C; Ginsberg, Gregory G; DeMarshall, Maureen; Foxwell, Tyler; Jobe, Blair A; Zaidi, Ali H; Duits, Lucas C; Bergman, Jacques J G H M; Rustgi, Anil; Falk, Gary W

    2017-02-01

    There is a need for improved tools to detect high-grade dysplasia (HGD) and esophageal adenocarcinoma (EAC) in patients with Barrett's esophagus. In previous work, we demonstrated that a 3-tier classifier predicted risk of incident progression in Barrett's esophagus. Our aim was to determine whether this risk classifier could detect a field effect in nondysplastic (ND), indefinite for dysplasia (IND), or low-grade dysplasia (LGD) biopsies from Barrett's esophagus patients with prevalent HGD/EAC. We performed a multi-institutional case-control study to evaluate a previously developed risk classifier that is based upon quantitative image features derived from 9 biomarkers and morphology, and predicts risk for HGD/EAC in Barrett's esophagus patients. The risk classifier was evaluated in ND, IND, and LGD biopsies from Barrett's esophagus patients diagnosed with HGD/EAC on repeat endoscopy (prevalent cases, n = 30, median time to HGD/EAC diagnosis 140.5 days) and nonprogressors (controls, n = 145, median HGD/EAC-free surveillance time 2,015 days). The risk classifier stratified prevalent cases and non-progressor patients into low-, intermediate-, and high-risk classes [OR, 46.0; 95% confidence interval, 14.86-169 (high-risk vs. low-risk); P < 0.0001]. The classifier also provided independent prognostic information that outperformed the subspecialist and generalist diagnosis. A tissue systems pathology test better predicts prevalent HGD/EAC in Barrett's esophagus patients than pathologic variables. The results indicate that molecular and cellular changes associated with malignant transformation in Barrett's esophagus may be detectable as a field effect using the test. A tissue systems pathology test may provide an objective method to facilitate earlier identification of Barrett's esophagus patients requiring therapeutic intervention. Cancer Epidemiol Biomarkers Prev; 26(2); 240-8. ©2016 AACR. ©2016 American Association for Cancer Research.

  15. A Guide to the Application of Probability Risk Assessment Methodology and Hazard Risk Frequency Criteria as a Hazard Control for the Use of the Mobile Servicing System on the International Space Station

    NASA Astrophysics Data System (ADS)

    D'silva, Oneil; Kerrison, Roger

    2013-09-01

    A key feature for the increased utilization of space robotics is to automate Extra-Vehicular manned space activities and thus significantly reduce the potential for catastrophic hazards while simultaneously minimizing the overall costs associated with manned space. The principal scope of the paper is to evaluate the use of industry standard accepted Probability risk/safety assessment (PRA/PSA) methodologies and Hazard Risk frequency Criteria as a hazard control. This paper illustrates the applicability of combining the selected Probability risk assessment methodology and hazard risk frequency criteria, in order to apply the necessary safety controls that allow for the increased use of the Mobile Servicing system (MSS) robotic system on the International Space Station. This document will consider factors such as component failure rate reliability, software reliability, and periods of operation and dormancy, fault tree analyses and their effects on the probability risk assessments. The paper concludes with suggestions for the incorporation of existing industry Risk/Safety plans to create an applicable safety process for future activities/programs

  16. Prospective Validation of ATA and ETA Sonographic Pattern Risk of Thyroid Nodules Selected for FNAC.

    PubMed

    Maino, Fabio; Forleo, Raffaella; Martinelli, Martina; Fralassi, Noemi; Barbato, Filomena; Pilli, Tania; Capezzone, Marco; Brilli, Lucia; Ciuoli, Cristina; Di Cairano, Giovanni; Nigi, Laura; Pacini, Furio; Castagna, Maria Grazia

    2018-06-01

    Recently, the American Thyroid Association (ATA) and the European Thyroid Association (ETA) have proposed that thyroid ultrasound (US) should be used to stratify the risk of malignancy in thyroid nodules and to aid decision-making about whether fine-needle aspiration cytology (FNAC) is indicated. To validate and to compare the ATA and ETA US risk stratification systems of thyroid nodules in a prospective series of thyroid nodules submitted to FNAC. We prospectively evaluated 432 thyroid nodules selected for FNAC from 340 patients. Cytology reports were based on the five categories according to the criteria of the British Thyroid Association. The proportion of Thy2 nodules decreased significantly, whereas the proportion of Thy4/Thy5 nodules significantly increased with increasing US risk class (P < 0.0001). The ability to identify benign and malignant nodules was similar between ATA and ETA systems. According to ATA and ETA US risk stratification systems, 23.7% and 56.0% nodules did not meet the criteria for FNAC, respectively. Considering only categories at lower risk of malignancy, the cumulative malignancy rate in these nodules was 1.2% for ATA and 1.7% for ETA US risk stratification systems. ETA and ATA US risk stratification systems provide effective malignancy risk stratification for thyroid nodules. In clinical practice, using this approach, we should be able to reduce the number of unnecessary FNAC without losing clinically relevant thyroid cancer.

  17. Risk to Water Security on Small Islands

    NASA Astrophysics Data System (ADS)

    Holding, S. T.; Allen, D. M.

    2013-12-01

    The majority of fresh water available on small islands is shallow groundwater that forms a freshwater lens. Freshwater lenses are generally limited in extent and as such are vulnerable to many stressors that impact water security. These include stressors related to climate change, such as sea level rise, as well as those related to human impacts, such as contamination. Traditionally, water security assessments have focussed on indicators that provide a snapshot of the current condition. However, recent work suggests that in order to effectively manage the water system, it is also important to consider uncertain future impacts to the system by evaluating how different stressors might impact water security. In this study, a framework for assessing risk to water security was developed and tested on Andros Island in The Bahamas. The assessment comprises two main components that characterise the water system: numerical modelling studies and a hazard survey. A baseline numerical model of the freshwater lens throughout Andros Island was developed to simulate the morphology of the freshwater lens and estimate the freshwater resources currently available. The model was prepared using SEAWAT, a density-dependent flow and solute transport code. Various stressors were simulated in the model to evaluate the response of the freshwater lens to predicted future shifts in climate patterns, sea level rise, and changes in water use. A hazard survey was also conducted on the island to collect information related to the storage of contaminants, sanitation infrastructure, waste disposal practices and groundwater abstraction rates. The results of the survey form a geo-spatial database of the location and associated hazards to the freshwater lens. The resulting risk framework provides a ranking of overall risk to water security based on information from the numerical modelling and hazard survey. The risk framework is implemented in a Geographic Information System (GIS) and provides a map of the risk to water security throughout Andros Island. It evaluates risk to water security for current and future scenarios and will enable water resource managers to effectively adapt to future impacts on water security.

  18. Validation of Preoperative Risk Grouping of the Selection of Patients Most Likely to Benefit From Neoadjuvant Chemotherapy Before Radical Cystectomy.

    PubMed

    Moschini, Marco; Soria, Francesco; Klatte, Tobias; Wirth, Gregory J; Özsoy, Mehmet; Gust, Killian; Briganti, Alberto; Roupret, Morgan; Susani, Martin; Haitel, Andrea; Shariat, Shahrokh F

    2017-04-01

    The aim of this study was to validate the value of preoperative patient characteristics in prognosticating survival after radical cystectomy (RC) to guide treatment decisions regarding neoadjuvant systemic treatment. We evaluated a single cohort of 449 consecutive patients treated with RC for bladder cancer. Patients treated with neoadjuvant therapy were excluded from the study cohort (n = 24). Patients were stratified based on preoperative characteristics into 2 risk groups. The high-risk group included patients harboring clinically non-organ-confined disease (≥ cT3), hydroureteronephrosis, lymphovascular invasion, or variant histology (micropapillary, neuroendocrine, sarcomatoid, or plasmacytoid variants on transurethral resection). The low-risk group included patients with cT2 disease without any of the aforementioned features. Survival expectancies after surgery were evaluated using competing risk and Kaplan-Meier analyses. We identified 153 (44.6%) low-risk and 190 (55.4%) high-risk patients. The majority of high-risk patients had only 1 high-risk feature (n = 111; 58.4%); the most common high-risk feature was preoperative hydroureteronephrosis (n = 107; 56.3%). The majority of low-risk patients were upstaged at time of RC (n = 118; 70.6%), whereas a pathologic downstage occurred only in 27 high-risk patients (14.2%). Cancer-specific mortality-free rates at 5 years after RC were 77.4% versus 64.4% for low-risk versus high-risk patients, respectively. We confirm that preoperative risk features can stratify patients with muscle-invasive bladder cancer into differential risk groups regarding survival. Decision-making regarding neoadjuvant systemic therapy administration is likely to be improved by integrating clinical stage, lymphovascular invasion, variant histology, and hydroureteronephrosis. Copyright © 2016 Elsevier Inc. All rights reserved.

  19. Evaluating the Risks of School Dropout amongst Children in the Care of the French Child Protection System: An Exploratory Study

    ERIC Educational Resources Information Center

    Derivois, Daniel; Guillier-Pasut, Nathalie; Karray, Amira; Cénat, Jude-Mary; Brolles, Lisbeth; Matsuhara, Hanae

    2015-01-01

    The aim of this pilot study is to identify the best way of preventing and assessing the livelihood and risk of school dropout amongst children entrusted to the care of the French child protection system in the Département of Rhone. The sample comprised 91 children and adolescents aged 4- to 17-years-old, of whom 45 were girls. The data were…

  20. [Assessment of cardiovascular risk in population groups. Comparison of Score system and Framingham in hypertensive patients].

    PubMed

    Cosín Aguilar, J; Hernándiz Martínez, A; Rodríguez Padial, L; Zamorano Gómez, J L; Arístegui Urrestarazu, R; Armada Peláez, B; Aguilar Llopis, A; Masramon Morell, X

    2006-04-01

    Calculation of cardiovascular risk in populations allows for developing and assessing of intervention programs and adapting health resources. While the Framingham System has been used in the past, a group of European researchers have proposed a different method called the Score project. The purpose of this paper is to compare the value of both methods for assessing cardiovascular risk. In 6,775 evaluable hypertensive patients distributed over the 17 Spanish autonomous communities (ACs), the 10-year risk of experiencing a coronary event (CR) was calculated using the Framingham equation, while risk of coronary death (RCD) and vascular death (RVD) was calculated using the Score project system, both at baseline and after one year of blood pressure control with amlodipine at the required dose. A comparison was made of the capacity to detect risk differences by both methods between populations with known different risks, and in the same population as a result of blood pressure control. Both the Score and the Framingham systems detected the significant decrease in both CR and RCD or RVD at one year of application of the CORONARIA study protocol. Risk decrease measured by any of the two methods was significant (p < 0.05) overall, by genders, and by ACs. However, the Score System, unlike the Framingham system, could not detect the reported differences in the mortality risk for coronary and vascular disease between the ACs of the North and the South-East parts of Spain.

  1. Undiagnosed light chain systemic amyloidosis: does it matter to anesthesiologists? -a case report-

    PubMed Central

    Kim, Gwan Ho; Lee, Woo Kyung; Na, Se Hee

    2013-01-01

    Light chain systemic amyloidosis is rare but may accompany laryngeal or pulmonary involvement, which may increase the risk in airway management. We present a case of a patient planned for resection of cervical epidural mass. The patient had face and neck ecchymoses and purpuras with an unknown cause. Mask ventilation and intubation were successful, but the operation was cancelled to evaluate bleeding from facial skin lesions. A diagnosis of light chain systemic amyloidosis prompted evaluation of involvement of other organs and treatment. This case shows the importance of preoperative evaluation and careful airway management in patients with systemic amyloidosis. PMID:24363850

  2. [Screening of malnutrition risk versus indicators of nutritional status and systemic inflammatory response in newly diagnosed lung cancer patients].

    PubMed

    Illa, P; Tomíšková, M; Skřičková, J

    2014-01-01

    Most lung cancers are already advanced at the time of dia-gnosis. In these patients, a frequent symptom is protein energy malnutrition, often diagnosed prior to oncological treatment. Malnutrition results in poor tolerance of treatment and increased morbidity and mortality. Nutritional Risk Screening (NRS) 2002 adapted for oncological patients was used to assess the risk of undernutrition in a group of 188 lung cancer patients. The risk was evaluated on a 6- point scale according to common signs of nutritional status and tumor and its treatment risk factors. A score of 3 and more (called "nutritional risk") means a significant risk of malnutrition. Furthermore, pretreatment nutritional characteristics were evaluated in patients (including the value of BMI) and laboratory values indicating malnutrition/ acute phase response (albumin/ C reactive protein - CRP). Acceptable NRS score was found in 50.6%, while in 45.3% was suggested into risk of malnutrition ("nutritional risk"). Only 6.6% of our patients had a BMI less than 20 kg/ m2. Significant differences in albumin and CRP values in various categories of NRS were confirmed. Initial signs of cancer malnutrition may be overlooked in patients who fall within or above the range of BMI for adequate weight, although these patients may be at significant risk of malnutrition. The indicators of nutritional status and systemic inflammatory responses were significantly associated with resulting values NRS score.

  3. Information security risk management for computerized health information systems in hospitals: a case study of Iran

    PubMed Central

    Zarei, Javad; Sadoughi, Farahnaz

    2016-01-01

    Background In recent years, hospitals in Iran – similar to those in other countries – have experienced growing use of computerized health information systems (CHISs), which play a significant role in the operations of hospitals. But, the major challenge of CHIS use is information security. This study attempts to evaluate CHIS information security risk management at hospitals of Iran. Materials and methods This applied study is a descriptive and cross-sectional research that has been conducted in 2015. The data were collected from 551 hospitals of Iran. Based on literature review, experts’ opinion, and observations at five hospitals, our intensive questionnaire was designed to assess security risk management for CHISs at the concerned hospitals, which was then sent to all hospitals in Iran by the Ministry of Health. Results Sixty-nine percent of the studied hospitals pursue information security policies and procedures in conformity with Iran Hospitals Accreditation Standards. At some hospitals, risk identification, risk evaluation, and risk estimation, as well as risk treatment, are unstructured without any specified approach or methodology. There is no significant structured approach to risk management at the studied hospitals. Conclusion Information security risk management is not followed by Iran’s hospitals and their information security policies. This problem can cause a large number of challenges for their CHIS security in future. Therefore, Iran’s Ministry of Health should develop practical policies to improve information security risk management in the hospitals of Iran. PMID:27313481

  4. Evaluation of Environmental Risk Due to Metro System Construction in Jinan, China

    PubMed Central

    Wang, Guo-Fu; Lyu, Hai-Min; Lu, Lin-Hai; Li, Gang; Arulrajah, Arul

    2017-01-01

    Jinan is a famous spring city in China. Construction of underground metro system may block groundwater seepage, inducing the depletion risk of springs. This paper presents an assessment of the risk due to metro line construction to groundwater in Jinan City using Analytic Hierarchy Process (AHP) and Geographic International System (GIS). Based on the characteristics of hydrogeology and engineering geology, the assessment model is established from the perspectives of surface index and underground index. The assessment results show that the high and very high risk levels of surface index exceed 98% in the north region; and high and very high risk levels of underground index exceed 56% in urban center and southern region. The assessment result also shows that about 14% of the urban area belongs to very high risk level; regions of high risk are 20% in urban area, 9% in Changqing County and 43% in Pingyin County. In the high risk region, metro lines R1 to R3, which are under construction, and metro lines L1 to L5, which are planned, have very high and high risk. Therefore, risk control measures are proposed to protect the groundwater seepage path to spring. PMID:28946709

  5. Evaluation of Environmental Risk Due to Metro System Construction in Jinan, China.

    PubMed

    Wang, Guo-Fu; Lyu, Hai-Min; Shen, Jack Shuilong; Lu, Lin-Hai; Li, Gang; Arulrajah, Arul

    2017-09-25

    Jinan is a famous spring city in China. Construction of underground metro system may block groundwater seepage, inducing the depletion risk of springs. This paper presents an assessment of the risk due to metro line construction to groundwater in Jinan City using Analytic Hierarchy Process (AHP) and Geographic International System (GIS). Based on the characteristics of hydrogeology and engineering geology, the assessment model is established from the perspectives of surface index and underground index. The assessment results show that the high and very high risk levels of surface index exceed 98% in the north region; and high and very high risk levels of underground index exceed 56% in urban center and southern region. The assessment result also shows that about 14% of the urban area belongs to very high risk level; regions of high risk are 20% in urban area, 9% in Changqing County and 43% in Pingyin County. In the high risk region, metro lines R1 to R3, which are under construction, and metro lines L1 to L5, which are planned, have very high and high risk. Therefore, risk control measures are proposed to protect the groundwater seepage path to spring.

  6. A Spike Cocktail Approach to Improve Microbial Performance ...

    EPA Pesticide Factsheets

    Water reuse, via either centralized treatment of traditional wastewater or decentralized treatment and on-site reuse, is becoming an increasingly important element of sustainable water management. Despite advances in waterborne pathogen detection methods, low and highly variable pathogen levels limit their utility for routine evaluation of health risks in water reuse systems. Therefore, there is a need to improve our understanding of the linkage between pathogens and more readily measured process indicators during treatment. This paper describes an approach for constructing spiking experiments to relate the behavior of viral, bacterial, and protozoan pathogens with relevant process indicators. General issues are reviewed, and the spiking protocol is applied as a case study example to improve microbial performance monitoring and health risk evaluation in a water reuse system. This approach provides a foundation for the development of novel approaches to improve real or near-real time performance monitoring of water recycling systems. This manuscrupt details an approach for developing "spike cocktail", a mixture of microorganisms that can be used to evaluate the performance of engineered and natural systems.

  7. Study protocol for evaluating the implementation and effectiveness of an emergency department longitudinal patient monitoring system using a mixed-methods approach.

    PubMed

    Ward, Marie; McAuliffe, Eilish; Wakai, Abel; Geary, Una; Browne, John; Deasy, Conor; Schull, Michael; Boland, Fiona; McDaid, Fiona; Coughlan, Eoin; O'Sullivan, Ronan

    2017-01-23

    Early detection of patient deterioration is a key element of patient safety as it allows timely clinical intervention and potential rescue, thus reducing the risks of serious patient safety incidents. Longitudinal patient monitoring systems have been widely recommended for use to detect clinical deterioration. However, there is conflicting evidence on whether they improve patient outcomes. This may in part be related to variation in the rigour with which they are implemented and evaluated. This study aims to evaluate the implementation and effectiveness of a longitudinal patient monitoring system designed for adult patients in the unique environment of the Emergency Department (ED). A novel participatory action research (PAR) approach is taken where socio-technical systems (STS) theory and analysis informs the implementation through the improvement methodology of 'Plan Do Study Act' (PDSA) cycles. We hypothesise that conducting an STS analysis of the ED before beginning the PDSA cycles will provide for a much richer understanding of the current situation and possible challenges to implementing the ED-specific longitudinal patient monitoring system. This methodology will enable both a process and an outcome evaluation of implementing the ED-specific longitudinal patient monitoring system. Process evaluations can help distinguish between interventions that have inherent faults and those that are badly executed. Over 1.2 million patients attend EDs annually in Ireland; the successful implementation of an ED-specific longitudinal patient monitoring system has the potential to affect the care of a significant number of such patients. To the best of our knowledge, this is the first study combining PAR, STS and multiple PDSA cycles to evaluate the implementation of an ED-specific longitudinal patient monitoring system and to determine (through process and outcome evaluation) whether this system can significantly improve patient outcomes by early detection and appropriate intervention for patients at risk of clinical deterioration.

  8. [Risk assessment comparison of biomechanical overloading of the musculoskeletal system: 10 years' applied experience].

    PubMed

    Sala, Emma; Bonfiglioli, Roberta; Fostinellil, Jacopo; Tomasi, Cesare; Graziosi, Francesca; Violante, Francesco S; Apostoli, Pietro

    2014-01-01

    Risk assessment for upper extremity work related muscoloskeletal disorders by applying six methods of ergonomic: a ten years experience. The objective of this research was to verify and validate the multiple step method suggested by SIMLII guidelines and to compare results obtained by use of these methods: Washington State Standard, OCRA, HAL, RULA, OREGE and STRAIN INDEX. 598 workstations for a total of 1800 analysis by different methods were considered, by adopting the following multiple step procedure: prelinminary evaluation by Washington State method and OCRA checklist in all the working stations, RULA or HAL as first level evaluation, OREGE or SI as second level evaluation. The preliminary evaluation resulted negative (risk absent) in the 75% of examined work stations and by using checklist OCRA optimal-acceptable condition was found in 58% by HAL in 92% of analysis, by RULA in 100%, by OREGE in 64%; by SI in 70% of examined working positions. We observed similar evaluation of strain among methods and main differences have been observed in posture and frequency assessment. The preliminary evaluation by State of Washington method appears to be an adequate instrument for identify the working condition at risk. All the adopted methods were in a good agreement in two estreme situations: high risk or absent risk, expecially in absent risk conditions. Level of accordance varied on the basis of their rationale and of the role of their different components so SIML indications about the critical use of biouzechanical methods and about the possible use of more than one of them (considering working chlaracteristics) have been confirmed.

  9. A Dynamic Risk Model for Evaluation of Space Shuttle Abort Scenarios

    NASA Technical Reports Server (NTRS)

    Henderson, Edward M.; Maggio, Gaspare; Elrada, Hassan A.; Yazdpour, Sabrina J.

    2003-01-01

    The Space Shuttle is an advanced manned launch system with a respectable history of service and a demonstrated level of safety. Recent studies have shown that the Space Shuttle has a relatively low probability of having a failure that is instantaneously catastrophic during nominal flight as compared with many US and international launch systems. However, since the Space Shuttle is a manned. system, a number of mission abort contingencies exist to primarily ensure the safety of the crew during off-nominal situations and to attempt to maintain the integrity of the Orbiter. As the Space Shuttle ascends to orbit it transverses various intact abort regions evaluated and planned before the flight to ensure that the Space Shuttle Orbiter, along with its crew, may be returned intact either to the original launch site, a transoceanic landing site, or returned from a substandard orbit. An intact abort may be initiated due to a number of system failures but the highest likelihood and most challenging abort scenarios are initiated by a premature shutdown of a Space Shuttle Main Engine (SSME). The potential consequences of such a shutdown vary as a function of a number of mission parameters but all of them may be related to mission time for a specific mission profile. This paper focuses on the Dynamic Abort Risk Evaluation (DARE) model process, applications, and its capability to evaluate the risk of Loss Of Vehicle (LOV) due to the complex systems interactions that occur during Space Shuttle intact abort scenarios. In addition, the paper will examine which of the Space Shuttle subsystems are critical to ensuring a successful return of the Space Shuttle Orbiter and crew from such a situation.

  10. Evaluation of air-displacement plethysmography for body composition assessment in preterm infants

    USDA-ARS?s Scientific Manuscript database

    Adiposity may contribute to the future risk of disease. The aim of this study was to evaluate the accuracy and reliability of an air-displacement plethysmography (ADP) system to estimate percentage fat mass (%FM) in preterm infants and to evaluate interdevice reliability in infants. A total of 70 pr...

  11. Risk-benefit analysis and public policy: a bibliography

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

    Clark, E.M.; Van Horn, A.J.

    1976-11-01

    Risk-benefit analysis has been implicitly practiced whenever decision-makers are confronted with decisions involving risks to life, health, or to the environment. Various methodologies have been developed to evaluate relevant criteria and to aid in assessing the impacts of alternative projects. Among these have been cost-benefit analysis, which has been widely used for project evaluation. However, in many cases it has been difficult to assign dollar costs to those criteria involving risks and benefits which are not now assigned explicit monetary values in our economic system. Hence, risk-benefit analysis has evolved to become more than merely an extension of cost-benefit analysis,more » and many methods have been applied to examine the trade-offs between risks and benefits. In addition, new scientific and statistical techniques have been developed for assessing current and future risks. The 950 references included in this bibliography are meant to suggest the breadth of those methodologies which have been applied to decisions involving risk.« less

  12. Contract Design: Risk Management and Evaluation.

    PubMed

    Mühlbacher, Axel C; Amelung, Volker E; Juhnke, Christin

    2018-01-12

    Effective risk adjustment is an aspect that is more and more given weight on the background of competitive health insurance systems and vital healthcare systems. The risk structure of the providers plays a vital role in Pay for Performance. A prerequisite for optimal incentive-based service models is a (partial) dependence of the agent's returns on the provider's gain level. Integrated care systems as well as accountable care organisations (ACOs) in the US and similar concepts in other countries are advocated as an effective method of improving the performance of healthcare systems. These systems outline a payment and care delivery model that intends to tie provider reimbursements to predefined quality metrics. By this the total costs of care shall be reduced. Little is known about the contractual design and the main challenges of delegating "accountability" to these new kinds of organisations and/or contracts. The costs of market utilisation are highly relevant for the conception of healthcare contracts; furthermore information asymmetries and contract-specific investments are an obstacle to the efficient operation of ACOs. A comprehensive literature review on methods of designing contracts in Integrated Care was conducted. The research question in this article focuses on how reimbursement strategies, evaluation of measures and methods of risk adjustment can best be integrated in healthcare contracting. Each integrated care contract includes challenges for both payers and providers without having sufficient empirical data on both sides. These challenges are clinical, administrative or financial nature. Risk adjusted contracts ensure that the reimbursement roughly matches the true costs resulting from the morbidity of a population. If reimbursement of care provider corresponds to the actual expenses for an individual/population the problem of risk selection is greatly reduced. The currently used methods of risk adjustment have widely differing model and forecast accuracy. For this reason, it is necessary to clearly regulate the method of risk adjustment in the integrated care contract. The series of three articles on contract design has shown that coordination and motivation problems in designing healthcare contracts cannot be solved at no-costs. Moreover, it became clear, that complete contracts in healthcare are unrealistic and that contracts do always include certain uncertainties. These are based on the risk of random, and no contracting party can control these risks completely. It is also not possible to fully integrate these risks in the contract or to eliminate these risks by the parties.

  13. Evaluating probabilistic dengue risk forecasts from a prototype early warning system for Brazil.

    PubMed

    Lowe, Rachel; Coelho, Caio As; Barcellos, Christovam; Carvalho, Marilia Sá; Catão, Rafael De Castro; Coelho, Giovanini E; Ramalho, Walter Massa; Bailey, Trevor C; Stephenson, David B; Rodó, Xavier

    2016-02-24

    Recently, a prototype dengue early warning system was developed to produce probabilistic forecasts of dengue risk three months ahead of the 2014 World Cup in Brazil. Here, we evaluate the categorical dengue forecasts across all microregions in Brazil, using dengue cases reported in June 2014 to validate the model. We also compare the forecast model framework to a null model, based on seasonal averages of previously observed dengue incidence. When considering the ability of the two models to predict high dengue risk across Brazil, the forecast model produced more hits and fewer missed events than the null model, with a hit rate of 57% for the forecast model compared to 33% for the null model. This early warning model framework may be useful to public health services, not only ahead of mass gatherings, but also before the peak dengue season each year, to control potentially explosive dengue epidemics.

  14. Clearing margin system in the futures markets—Applying the value-at-risk model to Taiwanese data

    NASA Astrophysics Data System (ADS)

    Chiu, Chien-Liang; Chiang, Shu-Mei; Hung, Jui-Cheng; Chen, Yu-Lung

    2006-07-01

    This article sets out to investigate if the TAIFEX has adequate clearing margin adjustment system via unconditional coverage, conditional coverage test and mean relative scaled bias to assess the performance of three value-at-risk (VaR) models (i.e., the TAIFEX, RiskMetrics and GARCH-t). For the same model, original and absolute returns are compared to explore which can accurately capture the true risk. For the same return, daily and tiered adjustment methods are examined to evaluate which corresponds to risk best. The results indicate that the clearing margin adjustment of the TAIFEX cannot reflect true risks. The adjustment rules, including the use of absolute return and tiered adjustment of the clearing margin, have distorted VaR-based margin requirements. Besides, the results suggest that the TAIFEX should use original return to compute VaR and daily adjustment system to set clearing margin. This approach would improve the funds operation efficiency and the liquidity of the futures markets.

  15. Method for Assessing the Integrated Risk of Soil Pollution in Industrial and Mining Gathering Areas

    PubMed Central

    Guan, Yang; Shao, Chaofeng; Gu, Qingbao; Ju, Meiting; Zhang, Qian

    2015-01-01

    Industrial and mining activities are recognized as major sources of soil pollution. This study proposes an index system for evaluating the inherent risk level of polluting factories and introduces an integrated risk assessment method based on human health risk. As a case study, the health risk, polluting factories and integrated risks were analyzed in a typical industrial and mining gathering area in China, namely, Binhai New Area. The spatial distribution of the risk level was determined using a Geographic Information System. The results confirmed the following: (1) Human health risk in the study area is moderate to extreme, with heavy metals posing the greatest threat; (2) Polluting factories pose a moderate to extreme inherent risk in the study area. Such factories are concentrated in industrial and urban areas, but are irregularly distributed and also occupy agricultural land, showing a lack of proper planning and management; (3) The integrated risks of soil are moderate to high in the study area. PMID:26580644

  16. 76 FR 5379 - Disease, Disability, and Injury Prevention and Control Special Emphasis Panel (SEP): Pregnancy...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-01-31

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Disease Control and Prevention Disease, Disability, and Injury Prevention and Control Special Emphasis Panel (SEP): Pregnancy Risk Assessment..., discussion, and evaluation of ``Pregnancy Risk Assessment Monitoring System (PRAMS), DP11-001 Panels A, B...

  17. A REGIONAL APPROACH TO ECOLOGICAL RISK ASSESSMENTS FOR PESTICIDE REGISTRATION

    EPA Science Inventory

    Currently, most ecological risk assessments for EPA pesticide registration are evaluated at the national scale using a predetermined list of test species (OPPTS 850.4225 and 8504250) as a model system with little regard to where and how the product will ultimately be used. The a...

  18. Assessing Peer Entry and Play in Preschoolers at Risk for Maladjustment

    ERIC Educational Resources Information Center

    Brotman, Laurie Miller; Gouley, Kathleen Kiely; Chesir-Teran, Daniel

    2005-01-01

    This study evaluated the psychometric properties of an observational rating system for assessing preschoolers' peer entry and play skills: Observed Peer Play in Unfamiliar Settings (OPPUS). Participants were 84 preschoolers at risk for psychopathology. Reliability and concurrent validity are reported. The 30-min paradigm yielded reliable indexes…

  19. Concepts for risk-based surveillance in the field of veterinary medicine and veterinary public health: Review of current approaches

    PubMed Central

    Stärk, Katharina DC; Regula, Gertraud; Hernandez, Jorge; Knopf, Lea; Fuchs, Klemens; Morris, Roger S; Davies, Peter

    2006-01-01

    Background Emerging animal and zoonotic diseases and increasing international trade have resulted in an increased demand for veterinary surveillance systems. However, human and financial resources available to support government veterinary services are becoming more and more limited in many countries world-wide. Intuitively, issues that present higher risks merit higher priority for surveillance resources as investments will yield higher benefit-cost ratios. The rapid rate of acceptance of this core concept of risk-based surveillance has outpaced the development of its theoretical and practical bases. Discussion The principal objectives of risk-based veterinary surveillance are to identify surveillance needs to protect the health of livestock and consumers, to set priorities, and to allocate resources effectively and efficiently. An important goal is to achieve a higher benefit-cost ratio with existing or reduced resources. We propose to define risk-based surveillance systems as those that apply risk assessment methods in different steps of traditional surveillance design for early detection and management of diseases or hazards. In risk-based designs, public health, economic and trade consequences of diseases play an important role in selection of diseases or hazards. Furthermore, certain strata of the population of interest have a higher probability to be sampled for detection of diseases or hazards. Evaluation of risk-based surveillance systems shall prove that the efficacy of risk-based systems is equal or higher than traditional systems; however, the efficiency (benefit-cost ratio) shall be higher in risk-based surveillance systems. Summary Risk-based surveillance considerations are useful to support both strategic and operational decision making. This article highlights applications of risk-based surveillance systems in the veterinary field including food safety. Examples are provided for risk-based hazard selection, risk-based selection of sampling strata as well as sample size calculation based on risk considerations. PMID:16507106

  20. Modifying Evaluations and Decisions in Risky Situations.

    PubMed

    Maldonado, Antonio; Serra, Sara; Catena, Andrés; Cándido, Antonio; Megías, Alberto

    2016-09-20

    The main aim of this research was to investigate the decision making process in risky situations. We studied how different types of feedback on risky driving behaviors modulate risk evaluation and risk-taking. For a set of risky traffic situations, participants had to make evaluative judgments (judge the situation as risky or not) and urgent decisions (brake or not). In Experiment 1, participants received feedback with and without negative emotional content when they made risky behaviors. In Experiment 2 we investigated the independent effects of feedback and negative emotional stimuli. The results showed three important findings: First, urgent decisions were faster [F(1, 92) = 6.76, p = .01] and more cautious [F(1, 92) = 17.16, p < .001] than evaluative judgments. These results suggest that evaluative judgments of risk and actual risk-taking may not always coincide, and that they seem to be controlled by two different processing systems as proposed by dual process theories. Second, feedback made participants' responses even faster [F(1, 111) = 71.53, p < .001], allowing greater risk sensitivity [F(1, 111) = 22.12, p < .001] and skewing towards more cautious responses [F(1, 111) = 14.09, p < .001]. Finally, emotional stimuli had an effect only when they were presented as feedback. The results of this research increase our understanding of the processes involved in risky driving behavior and suggest efficient ways to control risk taking through the use of feedback.

  1. Risk Group Systems for Penile Cancer Management: A Study of 203 Patients With Invasive Squamous Cell Carcinoma.

    PubMed

    Chaux, Alcides

    2015-10-01

    To evaluate the accuracy of previously published risk group systems for predicting inguinal nodal metastases in patients with penile carcinoma. Two hundred three cases of invasive penile squamous cell carcinomas (SCC) were stratified using the following systems: Solsona et al (J Urol 2001;165:1509), Hungerhuber et al (Urology 2006;68:621), and the system proposed by the European Association of Urology (EAU; Eur Urol 2004;46:1). Receiver operating characteristic (ROC) analysis was carried out to compare accuracy in predicting final nodal status and cancer-related death. Most of cases were pT2/pT3 high-grade tumors with a small percentage of low-grade pT1 carcinomas. The metastatic rates for the Solsona et al, EAU, and Hungerhuber et al systems in the high-risk category were 15 of 73 (21%), 16 of 103 (16%), and 10 of 35 (29%) in patients with clinically negative inguinal lymph nodes and 52 of 75 (69%), 55 of 93 (59%), and 34 of 47 (72%) in patients with palpable inguinal lymph nodes, respectively. Performance by ROC analysis showed a low accuracy for all stratification systems although the Solsona et al and the Hungerhuber et al systems performed better than the EAU system. Patients in intermediate-risk categories and with clinically palpable inguinal lymph nodes were more likely to have nodal metastasis than patients with clinically negative lymph nodes in the same category. These stratification systems may be useful for patients with low-grade superficial tumors and less accurate for evaluating patients with high-grade locally advanced penile carcinomas. These data may be useful for therapeutic planning of patients with penile SCC. Copyright © 2015 Elsevier Inc. All rights reserved.

  2. Geographic Mapping as a Tool for Identifying Communities at High Risk for Fires.

    PubMed

    Fahey, Erin; Lehna, Carlee; Hanchette, Carol; Coty, Mary-Beth

    2016-01-01

    The purpose of this study was to evaluate whether the sample of older adults in a home fire safety (HFS) study captured participants living in the areas at highest risk for fire occurrence. The secondary aim was to identify high risk areas to focus future HFS interventions. Geographic information systems software was used to identify census tracts where study participants resided. Census data for these tracts were compared with participant data based on seven risk factors (ie, age greater than 65 years, nonwhite race, below high school education, low socioeconomic status, rented housing, year home built, home value) previously identified in a fire risk model. The distribution of participants and census tracts among risk categories determined how well higher risk census tracts were sampled. Of the 46 census tracts where the HFS intervention was implemented, 78% (n = 36) were identified as high or severe risk according to the fire risk model. Study participants' means for median annual family income (P < .0001) and median home value (P < .0001) were significantly lower than the census tract means (n = 46), indicating participants were at higher risk of fire occurrence. Of the 92 census tracts identified as high or severe risk in the entire county, the study intervention was implemented in 39% (n = 36), indicating 56 census tracts as potential areas for future HFS interventions. The Geographic information system-based fire risk model is an underutilized but important tool for practice that allows community agencies to develop, plan, and evaluate their outreach efforts and ensure the most effective use of scarce resources.

  3. A unified framework for evaluating the risk of re-identification of text de-identification tools.

    PubMed

    Scaiano, Martin; Middleton, Grant; Arbuckle, Luk; Kolhatkar, Varada; Peyton, Liam; Dowling, Moira; Gipson, Debbie S; El Emam, Khaled

    2016-10-01

    It has become regular practice to de-identify unstructured medical text for use in research using automatic methods, the goal of which is to remove patient identifying information to minimize re-identification risk. The metrics commonly used to determine if these systems are performing well do not accurately reflect the risk of a patient being re-identified. We therefore developed a framework for measuring the risk of re-identification associated with textual data releases. We apply the proposed evaluation framework to a data set from the University of Michigan Medical School. Our risk assessment results are then compared with those that would be obtained using a typical contemporary micro-average evaluation of recall in order to illustrate the difference between the proposed evaluation framework and the current baseline method. We demonstrate how this framework compares against common measures of the re-identification risk associated with an automated text de-identification process. For the probability of re-identification using our evaluation framework we obtained a mean value for direct identifiers of 0.0074 and a mean value for quasi-identifiers of 0.0022. The 95% confidence interval for these estimates were below the relevant thresholds. The threshold for direct identifier risk was based on previously used approaches in the literature. The threshold for quasi-identifiers was determined based on the context of the data release following commonly used de-identification criteria for structured data. Our framework attempts to correct for poorly distributed evaluation corpora, accounts for the data release context, and avoids the often optimistic assumptions that are made using the more traditional evaluation approach. It therefore provides a more realistic estimate of the true probability of re-identification. This framework should be used as a basis for computing re-identification risk in order to more realistically evaluate future text de-identification tools. Copyright © 2016 The Authors. Published by Elsevier Inc. All rights reserved.

  4. Effectiveness of nursing management information systems: a systematic review.

    PubMed

    Choi, Mona; Yang, You Lee; Lee, Sun-Mi

    2014-10-01

    The purpose of this study was to review evaluation studies of nursing management information systems (NMISs) and their outcome measures to examine system effectiveness. For the systematic review, a literature search of the PubMed, CINAHL, Embase, and Cochrane Library databases was conducted to retrieve original articles published between 1970 and 2014. Medical Subject Headings (MeSH) terms included informatics, medical informatics, nursing informatics, medical informatics application, and management information systems for information systems and evaluation studies and nursing evaluation research for evaluation research. Additionally, manag(*) and admin(*), and nurs(*) were combined. Title, abstract, and full-text reviews were completed by two reviewers. And then, year, author, type of management system, study purpose, study design, data source, system users, study subjects, and outcomes were extracted from the selected articles. The quality and risk of bias of the studies that were finally selected were assessed with the Risk of Bias Assessment Tool for Non-randomized Studies (RoBANS) criteria. Out of the 2,257 retrieved articles, a total of six articles were selected. These included two scheduling programs, two nursing cost-related programs, and two patient care management programs. For the outcome measurements, usefulness, time saving, satisfaction, cost, attitude, usability, data quality/completeness/accuracy, and personnel work patterns were included. User satisfaction, time saving, and usefulness mostly showed positive findings. The study results suggest that NMISs were effective in time saving and useful in nursing care. Because there was a lack of quality in the reviewed studies, well-designed research, such as randomized controlled trials, should be conducted to more objectively evaluate the effectiveness of NMISs.

  5. Evaluation of Roadmap to Achieve Energy Delivery Systems Cybersecurity

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

    Chavez, Adrian R.

    The Department of Energy/Office of Electricity Delivery and Energy Reliability (DOE/OE) Cybersecurity for Energy Delivery Systems (CEDS) program is currently evaluating the Roadmap to Achieve Energy Delivery Systems Cybersecurity document that sets a vision and outlines a set of milestones. The milestones are divided into five strategic focus areas that include: 1. Build a Culture of Security; 2. Assess and Monitor Risk; 3. Develop and Implement New Protective Measures to Reduce Risk; 4. Manage Incidents; and 5. Sustain Security Improvements. The most current version of the roadmap was last updated in September of 2016. Sandia National Laboratories (SNL) has beenmore » tasked with revisiting the roadmap to update the current state of energy delivery systems cybersecurity protections. SNL is currently working with previous and current partners to provide feedback on which of the roadmap milestones have been met and to identify any preexisting or new gaps that are not addressed by the roadmap. The specific focus areas SNL was asked to evaluate are: 1. Develop and Implement New Protective Measures to Reduce Risk and 2. Sustain Security Improvements. SNL has formed an Industry Advisory Board (IAB) to assist in answering these questions. The IAB consists of previous partners on past CEDS funded efforts as well as new collaborators that have unique insights into the current state of cybersecurity within energy delivery systems. The IAB includes asset owners, utilities and vendors of control systems. SNL will continue to maintain regular communications with the IAB to provide various perspectives on potential future updates to further improve the breadth of cybersecurity coverage of the roadmap.« less

  6. An integrated comprehensive occupational surveillance system for health care workers.

    PubMed

    Dement, John M; Pompeii, Lisa A; Østbye, Truls; Epling, Carol; Lipscomb, Hester J; James, Tamara; Jacobs, Michael J; Jackson, George; Thomann, Wayne

    2004-06-01

    Workers in the health care industry may be exposed to a variety of work-related stressors including infectious, chemical, and physical agents; ergonomic hazards; psychological hazards; and workplace violence. Many of these hazards lack surveillance systems to evaluate exposures and health outcomes. The development and implementation of a comprehensive surveillance system within the Duke University Health System (DUHS) that tracks occupational exposures and stressors as well as injuries and illnesses among a defined population of health care workers (HCWs) is presented. Human resources job and work location data were used to define the DUHS population at risk. Outcomes and exposure data from existing occupational health and safety programs, health promotion programs, and employee health insurance claims, were linked with human resources data and de-identified to create the Duke Health and Safety Surveillance System (DHSSS). The surveillance system is described and four examples are presented demonstrating how the system has successfully been used to study consequences of work-related stress, hearing conservation program evaluation, risk factors for back pain and inflammation, and exposures to blood and body fluids (BBF). Utilization of existing data, often collected for other purposes, can be successfully integrated and used for occupational health surveillance monitoring of HCWs. Use of the DHSSS for etiologic studies, benchmarking, and intervention program evaluation are discussed. Copyright 2004 Wiley-Liss, Inc.

  7. Our trial to develop a risk assessment tool for CO2 geological storage (GERAS-CO2GS)

    NASA Astrophysics Data System (ADS)

    Tanaka, A.; Sakamoto, Y.; Komai, T.

    2012-12-01

    We will introduce our researches about to develop a risk assessment tool named 'GERAS-CO2GS' (Geo-environmental Risk Assessment System, CO2 Geological Storage Risk Assessment System) for 'Carbon Dioxide Geological Storage (Geological CCS)'. It aims to facilitate understanding of size of impact of risks related with upper migration of injected CO2. For gaining public recognition about feasibility of Geological CCS, quantitative estimation of risks is essential, to let public knows the level of the risk: whether it is negligible or not. Generally, in preliminary hazard analysis procedure, potential hazards could be identified within Geological CCS's various facilities such as: reservoir, cap rock, upper layers, CO2 injection well, CO2 injection plant and CO2 transport facilities. Among them, hazard of leakage of injected C02 is crucial, because it is the clue to estimate risks around a specific injection plan in terms of safety, environmental protection effect and economy. Our risk assessment tool named GERAS-CO2GS evaluates volume and rate of retention and leakage of injected CO2 in relation with fractures and/or faults, and then it estimates impact of seepages on the surface of the earth. GERAS-CO2GS has four major processing segments: (a) calculation of CO2 retention and leakage volume and rate, (b) data processing of CO2 dispersion on the surface and ambient air, (c) risk data definition and (d) evaluation of risk. Concerning to the injection site, we defined a model, which is consisted from an injection well and a geological strata model: which involves a reservoir, a cap rock, an upper layer, faults, seabed, sea, the surface of the earth and the surface of the sea. For retention rate of each element of CO2 injection site model, we use results of our experimental and numerical studies on CO2 migration within reservoirs and faults with specific lithological conditions. For given CO2 injection rate, GERAS-CO2GS calculates CO2 retention and leakage of each segment of injection site model. It also evaluates dispersion of CO2 on the surface of the earth and ambient air, and displays evaluated risk level on Goole earth contour of risk levels with color classification. As regard with numerical estimation of CO2's surface dispersion, we use ADMER 2.5 (Atmospheric Dispersion Model for Exposure and Risk Assessment, AIST), which assesses ambient dispersion of materials using real observed atmospheric data such as wind direction and temperatures by meteorological observatory. As far as our simulations, it is obvious that cause of Lake Nyos type accident is owes its maar topography of the lake and the volume and duration of the CO2 outburst (about 1 km3). It's unlikely to cause similar happenings in geological CCS site, because there are significant difference amount of CO2 and topography. At this moment, GERAS-CO2GS is prototype system. We are going to extend GERAS-CO2GS functions and evaluate risks of further risk scenarios. Concerning to the route of seabed to sea and the surface of the sea, we hope to implement outer research findings into our logics. In the course of further research, we are going to develop GERAS-CO2GS will be able to estimate broader risks, and to contribute to the efforts for legislations and standards of CO2 Geological storage.

  8. Measurement and Internalization of Systemic Risk in a Global Banking Network

    NASA Astrophysics Data System (ADS)

    Feng, Xiaobing; Hu, Haibo

    2013-12-01

    The negative externalities from an individual bank failure to the whole system can be huge. One of the key purposes of bank regulation is to internalize the social costs of potential bank failures via capital charges. This study proposes a method to evaluate and allocate the systemic risk to different countries/regions using a Susceptible-Infected-Removable (SIR) type of epidemic spreading model and the Shapley value (SV) in game theory. The paper also explores features of a constructed bank network using real globe-wide banking data.

  9. Safe disposal of cytotoxic waste: an evaluation of an air-tight system.

    PubMed

    Craig, Gemma; Wadey, Charlotte

    2017-09-07

    A 3-month evaluation was undertaken at the Kent Oncology Centre's chemotherapy day unit (CDU) to trial an air-tight sealing disposal system for cytotoxic waste management. Research has identified the potential risk to staff who handle waste products that are hazardous to health. Staff safety was a driving force behind a trial of a new way of working. This article provides an overview of the evaluation of the Pactosafe system in one clinical area, examining reviews by oncology healthcare workers, the practicalities in the clinical setting, training, cost effectiveness and the environmental benefits.

  10. Oil taxation and risks

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

    Rodriguez-Padilla, V.

    1992-01-01

    The relationship between the taxation system and the division of risks between the host country governments and the international companies is discussed. The analysis underscores the effect of taxation on the geological and political risks. These two cases are evaluated in two West-African oil-producing countries. It emerges from this that too heavy and regressive taxes greatly increase the risks supported by the two partners. The progressive character of the taxation is a necessary but not a sufficient condition for the reduction of public and private risks. A taxation burden well-balanced among small and large deposits is the best way tomore » reduce the risk due to taxation. The oil-producing countries of this region had made great advances in developing neutral taxation systems but in most cases they must progress further. 15 refs., 3 figs., 1 tab.« less

  11. Time/frequency systems.

    DOT National Transportation Integrated Search

    1971-06-01

    The report summarizes the work performed at DOT/TSC on the Time/Frequency ATC System study project. Principal emphasis in this report is given to the evaluation and analysis of the technological risk areas. A survey and description of proposed T/F sy...

  12. Investigation of the use and feasibility of speed warning systems.

    DOT National Transportation Integrated Search

    2014-05-01

    This report summarizes a feasibility evaluation of a speed monitoring system that provided speed warning feedback to drivers enrolled in a voluntary program, with particular emphasis on at-risk drivers, especially chronic speeders. This project inclu...

  13. Decision Making and Risk Evaluation Frameworks for Extreme Space Weather Events

    NASA Astrophysics Data System (ADS)

    Uritskaya, O.; Robinson, R. M.; Pulkkinen, A. A.

    2017-12-01

    Extreme Space Weather events (ESWE) are in the spotlight nowadays because they can produce a significant impact not only due to their intensity and broad geographical scope, but also because of the widespread levels and the multiple sectors of the economy that could be involved. In the task of evaluation of the ESWE consequences, the most problematic and vulnerable aspect is the determination and calculation of the probability of statistically infrequent events and the subsequent assessment of the economic risks. In this work, we conduct a detailed analysis of the available frameworks of the general Decision-Making Theory in the presence of uncertainty, in the context of their applicability for the numerical estimation of the risks and losses associated with ESWE. The results of our study demonstrate that, unlike the Multiple-criteria decision analysis or Minimax approach to modeling of the possible scenarios for the ESWE effects, which prevail in the literature, the most suitable concept is the Games Against Nature (GAN). It enables an evaluation of every economically relevant aspect of space weather conditions and obtain more detailed results. Choosing the appropriate methods for solving GAN models, i.e. determining the most optimal strategy with a given level of uncertainty, requires estimating the conditional probabilities of Space Weather events for each outcome of possible scenarios of this natural disaster. Due to the specifics of complex natural and economic systems, with which we are dealing in this case, this problem remains unsolved, mainly because of inevitable loss of information at every stage of the decision-making process. The analysis is illustrated by deregulated electricity markets of the USA and Canada, whose power grid systems are known to be perceptive to ESWE. The GAN model is more appropriate in identifying potential risks in economic systems. The proposed approach, when applied to the existing database of Space Weather observations and numerical simulations, can provide more accurate forecasts of possible losses and allow for a more precise evaluation of the potential risks of the consequences of the ESWE for the vulnerable industries, such as electric power distribution systems, which have been shown to experience some of the most significant losses caused by ESWE.

  14. General principles of institutional risks influence on pension systems

    NASA Astrophysics Data System (ADS)

    Nepp, A. N.; Shilkov, A. A.; Sheveleva, A. Y.; Mamedbakov, M. R.

    2016-12-01

    This paper examines the tools used to study the influence of institutional factors on investment returns. The research object are the tools used in the evaluation of institutional risks in the pension system, in particular, the correlation model of factors impacting on the `anti-director' index, econometric estimates combining the different determinants of savings, the model of endogenous institutional change, etc. Research work focusing on issues of institutional factors affecting pension systems (authored by La Porta, Guiso, Gianetti, El-Mekkaouide Freitas, Neyapti B., and others) is reviewed. The model is examined in terms of the impact of institutional risks on pension systems, especially with regard to the funded part. The study identified the following factors that affect financial institutions, including pension institutions: management quality, regulation quality, rule of law, political stability, and corruption control.

  15. FDA-iRISK--a comparative risk assessment system for evaluating and ranking food-hazard pairs: case studies on microbial hazards.

    PubMed

    Chen, Yuhuan; Dennis, Sherri B; Hartnett, Emma; Paoli, Greg; Pouillot, Régis; Ruthman, Todd; Wilson, Margaret

    2013-03-01

    Stakeholders in the system of food safety, in particular federal agencies, need evidence-based, transparent, and rigorous approaches to estimate and compare the risk of foodborne illness from microbial and chemical hazards and the public health impact of interventions. FDA-iRISK (referred to here as iRISK), a Web-based quantitative risk assessment system, was developed to meet this need. The modeling tool enables users to assess, compare, and rank the risks posed by multiple food-hazard pairs at all stages of the food supply system, from primary production, through manufacturing and processing, to retail distribution and, ultimately, to the consumer. Using standard data entry templates, built-in mathematical functions, and Monte Carlo simulation techniques, iRISK integrates data and assumptions from seven components: the food, the hazard, the population of consumers, process models describing the introduction and fate of the hazard up to the point of consumption, consumption patterns, dose-response curves, and health effects. Beyond risk ranking, iRISK enables users to estimate and compare the impact of interventions and control measures on public health risk. iRISK provides estimates of the impact of proposed interventions in various ways, including changes in the mean risk of illness and burden of disease metrics, such as losses in disability-adjusted life years. Case studies for Listeria monocytogenes and Salmonella were developed to demonstrate the application of iRISK for the estimation of risks and the impact of interventions for microbial hazards. iRISK was made available to the public at http://irisk.foodrisk.org in October 2012.

  16. Evaluation of HDL-modulating interventions for cardiovascular risk reduction using a systems pharmacology approach[S

    PubMed Central

    Gadkar, Kapil; Lu, James; Sahasranaman, Srikumar; Davis, John; Mazer, Norman A.; Ramanujan, Saroja

    2016-01-01

    The recent failures of cholesteryl ester transport protein inhibitor drugs to decrease CVD risk, despite raising HDL cholesterol (HDL-C) levels, suggest that pharmacologic increases in HDL-C may not always reflect elevations in reverse cholesterol transport (RCT), the process by which HDL is believed to exert its beneficial effects. HDL-modulating therapies can affect HDL properties beyond total HDL-C, including particle numbers, size, and composition, and may contribute differently to RCT and CVD risk. The lack of validated easily measurable pharmacodynamic markers to link drug effects to RCT, and ultimately to CVD risk, complicates target and compound selection and evaluation. In this work, we use a systems pharmacology model to contextualize the roles of different HDL targets in cholesterol metabolism and provide quantitative links between HDL-related measurements and the associated changes in RCT rate to support target and compound evaluation in drug development. By quantifying the amount of cholesterol removed from the periphery over the short-term, our simulations show the potential for infused HDL to treat acute CVD. For the primary prevention of CVD, our analysis suggests that the induction of ApoA-I synthesis may be a more viable approach, due to the long-term increase in RCT rate. PMID:26522778

  17. Evaluation of HDL-modulating interventions for cardiovascular risk reduction using a systems pharmacology approach.

    PubMed

    Gadkar, Kapil; Lu, James; Sahasranaman, Srikumar; Davis, John; Mazer, Norman A; Ramanujan, Saroja

    2016-01-01

    The recent failures of cholesteryl ester transport protein inhibitor drugs to decrease CVD risk, despite raising HDL cholesterol (HDL-C) levels, suggest that pharmacologic increases in HDL-C may not always reflect elevations in reverse cholesterol transport (RCT), the process by which HDL is believed to exert its beneficial effects. HDL-modulating therapies can affect HDL properties beyond total HDL-C, including particle numbers, size, and composition, and may contribute differently to RCT and CVD risk. The lack of validated easily measurable pharmacodynamic markers to link drug effects to RCT, and ultimately to CVD risk, complicates target and compound selection and evaluation. In this work, we use a systems pharmacology model to contextualize the roles of different HDL targets in cholesterol metabolism and provide quantitative links between HDL-related measurements and the associated changes in RCT rate to support target and compound evaluation in drug development. By quantifying the amount of cholesterol removed from the periphery over the short-term, our simulations show the potential for infused HDL to treat acute CVD. For the primary prevention of CVD, our analysis suggests that the induction of ApoA-I synthesis may be a more viable approach, due to the long-term increase in RCT rate. Copyright © 2016 by the American Society for Biochemistry and Molecular Biology, Inc.

  18. Impact of Chronic Glucocorticoid Treatment on Cardiovascular Risk Profile in Patients with Systemic Lupus Erythematosus.

    PubMed

    Moya, Fernando Briceño; Pineda Galindo, Luis Francisco; García de la Peña, Maximiliano

    2016-01-01

    Systemic lupus erythematosus is highly associated with premature atherosclerosis and cardiovascular events. The origin of this subclinical atherosclerosis has been attributed mainly to the inflammatory nature of the disease. To assess the effect of long-term use of glucocorticoids on cardiovascular risk in patients with systemic lupus erythematosus. We conducted a registry-based retrospective cohort study. We determined 2 periods: (1) Time 0, that is, time of diagnosis and (2) time 1, that is, when the study was finalized. At both times, the cardiovascular risk was evaluated using the Framingham scale and their scores were compared. Afterward, the change magnitude between the 2 times was evaluated and associated with the cumulative glucocorticoids dose. One hundred one patients were included. The mean ± SD age was 26.5 ± 5 years. Length of disease evolution was of 7.8 ± 4.9 years. There was an 8-point increase in the Framingham score, from -8.1 ± 4 to 0.8 ± 7; P < 0.0001. The correlation between the magnitude of the increase in Framingham score and their corresponding cumulative dose showed a coefficient of 0.88; P < 0.001. The glucocorticoids are a primary factor that influences cardiovascular risk. There is a directly proportional relationship between the cumulative glucocorticoid dose and the increase in cardiovascular risk.

  19. Evaluation of Sensor Technology to Detect Fall Risk and Prevent Falls in Acute Care.

    PubMed

    Potter, Patricia; Allen, Kelly; Costantinou, Eileen; Klinkenberg, William Dean; Malen, Jill; Norris, Traci; O'Connor, Elizabeth; Roney, Wilhemina; Tymkew, Heidi Hahn; Wolf, Laurie

    2017-08-01

    Sensor technology that dynamically identifies hospitalized patients' fall risk and detects and alerts nurses of high-risk patients' early exits out of bed has potential for reducing fall rates and preventing patient harm. During Phase 1 (August 2014-January 2015) of a previously reported performance improvement project, an innovative depth sensor was evaluated on two inpatient medical units to study fall characteristics. In Phase 2 (April 2015-January 2016), a combined depth and bed sensor system designed to assign patient fall probability, detect patient bed exits, and subsequently prevent falls was evaluated. Fall detection depth sensors remained in place on two medicine units; bed sensors used to detect patient bed exits were added on only one of the medicine units. Fall rates and fall with injury rates were evaluated on both units. During Phase 2, the designated evaluation unit had 14 falls, for a fall rate of 2.22 per 1,000 patient-days-a 54.1% reduction compared with the Phase 1 fall rate. The difference in rates from Phase 1 to Phase 2 was statistically significant (z = 2.20; p = 0.0297). The comparison medicine unit had 30 falls-a fall rate of 4.69 per 1,000 patient-days, representing a 57.9% increase as compared with Phase 1. A fall detection sensor system affords a level of surveillance that standard fall alert systems do not have. Fall prevention remains a complex issue, but sensor technology is a viable fall prevention option. Copyright © 2017 The Joint Commission. Published by Elsevier Inc. All rights reserved.

  20. [Evaluation of a training system for middle ear surgery with optoelectric detection].

    PubMed

    Strauss, G; Bahrami, N; Pössneck, A; Strauss, M; Dietz, A; Korb, W; Lüth, T; Haase, R; Moeckel, H; Grunert, R

    2009-10-01

    This work presents a new training concept for surgery of the temporal bone. It is based on a model of gypsum plastic with optoelectric detection of risk structures. A prototypical evaluation is given. The training models are based on high-resolution computed tomographic data of a human skull. The resulting data set was printed by a three-dimensional (3D) printer. A 3D phantom is created from gypsum powder and a bonding agent. Risks structures are the facial nerve, semicircular canal, cochlea, ossicular chain, sigmoid sinus, dura, and internal carotid artery. An electrically conductive metal (Wood's metal) and a fiber-optic cable were used as detection materials for the risk structures. For evaluating the training system, a study was done with eight inexperienced and eight experienced ear surgeons. They were asked to perform temporal bone surgery using two identical training models (group A). In group B, the same surgeons underwent surgical training with human cadavers. In the case of injuries, the number, point in time, degree (facial nerve), and injured structure were documented during the training on the model. In addition, the total time needed was noted. The training systems could be used in all cases. Evaluation of the anatomic accuracy of the models showed results that were between 49.5% and 90% agreement with the anatomic origin. Error detection was evaluated with values between 79% and 100% agreement with the perception of an experienced surgeon. The operating setting was estimated to be better than the previous"gold standard." The possibility of completely replacing the previous training method, which uses cadavers, with the examined training model was affirmed. This study shows that the examined system fulfills the conditions for a new training concept for temporal bone surgery. The system connects the preliminary work with printed and sintered models with the possibilities of microsystem engineering. In addition, the model's digital database permits a complete virtual representation of the model with appropriate further applications ("look behind the wall," virtual endoscopy).

  1. Development and evaluation of an automated fall risk assessment system.

    PubMed

    Lee, Ju Young; Jin, Yinji; Piao, Jinshi; Lee, Sun-Mi

    2016-04-01

    Fall risk assessment is the first step toward prevention, and a risk assessment tool with high validity should be used. This study aimed to develop and validate an automated fall risk assessment system (Auto-FallRAS) to assess fall risks based on electronic medical records (EMRs) without additional data collected or entered by nurses. This study was conducted in a 1335-bed university hospital in Seoul, South Korea. The Auto-FallRAS was developed using 4211 fall-related clinical data extracted from EMRs. Participants included fall patients and non-fall patients (868 and 3472 for the development study; 752 and 3008 for the validation study; and 58 and 232 for validation after clinical application, respectively). The system was evaluated for predictive validity and concurrent validity. The final 10 predictors were included in the logistic regression model for the risk-scoring algorithm. The results of the Auto-FallRAS were shown as high/moderate/low risk on the EMR screen. The predictive validity analyzed after clinical application of the Auto-FallRAS was as follows: sensitivity = 0.95, NPV = 0.97 and Youden index = 0.44. The validity of the Morse Fall Scale assessed by nurses was as follows: sensitivity = 0.68, NPV = 0.88 and Youden index = 0.28. This study found that the Auto-FallRAS results were better than were the nurses' predictions. The advantage of the Auto-FallRAS is that it automatically analyzes information and shows patients' fall risk assessment results without requiring additional time from nurses. © The Author 2016. Published by Oxford University Press in association with the International Society for Quality in Health Care; all rights reserved.

  2. Evaluation of the DAVROS (Development And Validation of Risk-adjusted Outcomes for Systems of emergency care) risk-adjustment model as a quality indicator for healthcare

    PubMed Central

    Wilson, Richard; Goodacre, Steve W; Klingbajl, Marcin; Kelly, Anne-Maree; Rainer, Tim; Coats, Tim; Holloway, Vikki; Townend, Will; Crane, Steve

    2014-01-01

    Background and objective Risk-adjusted mortality rates can be used as a quality indicator if it is assumed that the discrepancy between predicted and actual mortality can be attributed to the quality of healthcare (ie, the model has attributional validity). The Development And Validation of Risk-adjusted Outcomes for Systems of emergency care (DAVROS) model predicts 7-day mortality in emergency medical admissions. We aimed to test this assumption by evaluating the attributional validity of the DAVROS risk-adjustment model. Methods We selected cases that had the greatest discrepancy between observed mortality and predicted probability of mortality from seven hospitals involved in validation of the DAVROS risk-adjustment model. Reviewers at each hospital assessed hospital records to determine whether the discrepancy between predicted and actual mortality could be explained by the healthcare provided. Results We received 232/280 (83%) completed review forms relating to 179 unexpected deaths and 53 unexpected survivors. The healthcare system was judged to have potentially contributed to 10/179 (8%) of the unexpected deaths and 26/53 (49%) of the unexpected survivors. Failure of the model to appropriately predict risk was judged to be responsible for 135/179 (75%) of the unexpected deaths and 2/53 (4%) of the unexpected survivors. Some 10/53 (19%) of the unexpected survivors died within a few months of the 7-day period of model prediction. Conclusions We found little evidence that deaths occurring in patients with a low predicted mortality from risk-adjustment could be attributed to the quality of healthcare provided. PMID:23605036

  3. New research on bioregenerative air/water purification systems

    NASA Technical Reports Server (NTRS)

    Johnson, Anne H.; Ellender, R. D.; Watkins, Paul J.

    1991-01-01

    For the past several years, air and water purification systems have been developed and used. This technology is based on the combined activities of plants and microorganisms as they function in a natural environment. More recently, researchers have begun to address the problems associated with indoor air pollution. Various common houseplants are currently being evaluated for their abilities to reduce concentrations of volatile organic compounds (VOCS) such as formaldehyde and benzene. With development of the Space Exploration Initiative, missions will increase in duration, and problems with resupply necessitates implementation of regenerative technology. Aspects of bioregenerative technology have been included in a habitat known as the BioHome. The ultimate goal is to use this technology in conjunction with physicochemical systems for air and water purification within closed systems. This study continued the risk assessment of bioregenerative technology with emphasis on biological hazards. In an effort to evaluate the risk for human infection, analyses were directed at enumeration of fecal streptococci and enteric viruses with the BioHome waste water treatment system.

  4. Review of Aircraft Crash Databases and Evaluation of the Probability of Aircraft Crashes on to a MAGLEV Guide-way: Technical Report

    DOT National Transportation Integrated Search

    1991-12-09

    The System Safety & Security Division at The Volpe National Transportation System Center (VNTSC), Cambridge, MA is participating in an overall risk assessment study on the safety of High Speed Magnetic Levitation Transportation Systems ("MagLev"). Tr...

  5. Environmental and social risk evaluation of overseas investment under the China-Pakistan Economic Corridor.

    PubMed

    Zhang, Ruilian; Andam, Francis; Shi, Guoqing

    2017-06-01

    Along with the further implementation of the "One Belt, One Road" initiative and the promotion of the China-Pakistan Economic Corridor (CPEC), the construction of the CPEC will likely face challenges owing to differences between China and Pakistan in politics, economics, culture, religion, language, customs, environmental management systems, environmental protection laws, social management systems, and social management regulations. To address potential environmental and social risks associated with Chinese enterprises as they invest in the CPEC region, this paper examines previous studies addressing topics such as the environmental and social safeguards of international institutions and Pakistan's domestic environmental and social management requirements. We then systematically identify the environmental and social risk factors involved in CPEC construction, which cover risks regarding water, air, soil, noise, biodiversity, politics, economics, culture, technology, and individuals. By establishing and calculating these risks and using a multi-fuzzy comprehensive evaluation model, we found that noise and individual risks belong to a medium risk category, while others belong to a higher risk category. In view of these risks, the Chinese government must create a friendly and peaceful environment for Chinese enterprises to invest in the CPEC region, and Chinese enterprises must adopt a development strategy of strength and capacity building and establish enterprises capable of addressing environmental and social issues during the investment process. All stakeholders must understand that if no determined and diligent steps are taken, CPEC construction might be doomed for failure from the start.

  6. Flood vulnerability evaluation in complex urban areas

    NASA Astrophysics Data System (ADS)

    Giosa, L.; Pascale, S.; Sdao, F.; Sole, A.; Cantisani, A.

    2009-04-01

    This paper deals the conception, the development and the subsequent validation of an integrated numerical model for the assessment of systemic vulnerability in complex and urbanized areas, subject to flood risk. The proposed methodology is based on the application of the concept of "systemic vulnerability", the model is a mathematician-decisional model action to estimate the vulnerability of complex a territorial system during a flood event. The model uses a group of "pressure pointers" in order to define, qualitatively and quantitatively, the influence exercised on the territorial system from factors like as those physicists, social, economic, etc.. The model evaluates the exposure to the flood risk of the elements that belong to a system. The proposed model, which is based on the studies of Tamura et al., 2000; Minciardi et al., 2004; Pascale et al., 2008; considers the vulnerability not as a characteristic of a particular element at risk, but as a peculiarity of a complex territorial system, in which the different elements are reciprocally linked in a functional way. The proposed model points out the elements with the major functional lost and that make the whole system critical. This characteristic makes the proposed model able to support a correct territorial planning and a suitable management of the emergency following natural disasters such as floods. The proposed approach was tested on the study area in the city of Potenza, southern Italy.

  7. Validation of the Apnea Risk Evaluation System (ARES) Device Against Laboratory Polysomnography in Pregnant Women at Risk for Obstructive Sleep Apnea Syndrome

    PubMed Central

    Sharkey, Katherine M.; Waters, Kelly; Millman, Richard P.; Moore, Robin; Martin, Susan M.; Bourjeily, Ghada

    2014-01-01

    Study Objective: To assess the validity of using the Apnea Risk Evaluation System (ARES) Unicorder for detecting obstructive sleep apnea (OSA) in pregnant women. Methods: Sixteen pregnant women, mean age (SD) = 29.8 (5.4) years, average gestational age (SD) = 28.6 (6.3) weeks, mean body mass index (SD) = 44.7 (6.9) kg/m2 with signs and symptoms of OSA wore the ARES Unicorder during one night of laboratory polysomnography (PSG). PSG was scored according to AASM 2007 criteria, and PSG AHI and RDI were compared to the ARES 1%, 3%, and 4% AHIs calculated with the ARES propriety software. Results: Median PSG AHI and PSG RDI were 3.1 and 10.3 events/h of sleep, respectively. Six women had a PSG AHI ≥ 5 events/h of sleep and 11 had a PSG RDI ≥ 5 events/h of sleep. PSG AHI and RDI were strongly correlated with the ARES AHI measures. When compared with polysomnographic diagnosis of OSA, the ARES 3% algorithm provided the best balance between sensitivity (1.0 for PSG AHI, 0.91 for PSG RDI) and specificity (0.5 for PSG AHI, 0.8 for PSG RDI) for detecting sleep disordered breathing in our sample. Conclusions: The ARES Unicorder demonstrated reasonable consistency with PSG for diagnosing OSA in this small, heterogeneous sample of obese pregnant women. Citation: Sharkey KM, Waters K, Millman RP, Moore R, Martin SM, Bourjeily G. Validation of the Apnea Risk Evaluation System (ARES) device against laboratory polysomnography in pregnant women at risk for obstructive sleep apnea syndrome. J Clin Sleep Med 2014;10(5):497-502. PMID:24910550

  8. Development and Justification of a Risk Evaluation Matrix To Guide Chemical Testing Necessary To Select and Qualify Plastic Components Used in Production Systems for Pharmaceutical Products.

    PubMed

    Jenke, Dennis

    2015-01-01

    An accelerating trend in the pharmaceutical industry is the use of plastic components in systems used to produce an active pharmaceutical ingredient or a finished drug product. If the active pharmaceutical ingredient, the finished drug product, or any solution used to generate them (for example, a process stream such as media, buffers, eluents, and the like) is contacted by a plastic component at any time during the production process, substances leached from the component may accumulate in the active pharmaceutical ingredient or finished drug product, affecting its safety and/or efficacy. In this article the author develops and justifies a semi-quantitative risk evaluation matrix that is used to determine the amount and rigor of component testing necessary and appropriate to establish that the component is chemically suitable for its intended use. By considering key properties of the component, the contact medium, the contact conditions, and the active pharmaceutical ingredient's or finished drug product's clinical conditions of use, use of the risk evaluation matrix produces a risk score whose magnitude reflects the accumulated risk that the component will interact with the contact solution to such an extent that component-related extractables will accumulate in the active pharmaceutical ingredient or finished drug product as leachables at levels sufficiently high to adversely affect user safety. The magnitude of the risk score establishes the amount and rigor of the testing that is required to select and qualify the component, and such testing is broadly grouped into three categories: baseline assessment, general testing, and full testing (extractables profiling). Production suites used to generate pharmaceuticals can include plastic components. It is possible that substances in the components could leach into manufacturing solutions and accumulate in the pharmaceutical product. In this article the author develops and justifies a semi-quantitative risk evaluation matrix that can be used to determine the amount and rigor of component testing that may be necessary and appropriate to establish that the component is suitable for its intended use. Use of the risk evaluation matrix allows a user of a component to determine the type and amount of testing that should be performed to establish the patient safety risk associated with using that component in order to manufacture an active pharmaceutical ingredient or a finished drug product. © PDA, Inc. 2015.

  9. A Decision Support System for Drinking Water Production Integrating Health Risks Assessment

    PubMed Central

    Delpla, Ianis; Monteith, Donald T.; Freeman, Chris; Haftka, Joris; Hermens, Joop; Jones, Timothy G.; Baurès, Estelle; Jung, Aude-Valérie; Thomas, Olivier

    2014-01-01

    The issue of drinking water quality compliance in small and medium scale water services is of paramount importance in relation to the 98/83/CE European Drinking Water Directive (DWD). Additionally, concerns are being expressed over the implementation of the DWD with respect to possible impacts on water quality from forecast changes in European climate with global warming and further anticipated reductions in north European acid emissions. Consequently, we have developed a decision support system (DSS) named ARTEM-WQ (AwaReness Tool for the Evaluation and Mitigation of drinking Water Quality issues resulting from environmental changes) to support decision making by small and medium plant operators and other water stakeholders. ARTEM-WQ is based on a sequential risk analysis approach that includes consideration of catchment characteristics, climatic conditions and treatment operations. It provides a holistic evaluation of the water system, while also assessing human health risks of organic contaminants potentially present in treated waters (steroids, pharmaceuticals, pesticides, bisphenol-a, polychlorobiphenyls, polycyclic aromatic hydrocarbons, petrochemical hydrocarbons and disinfection by-products; n = 109). Moreover, the system provides recommendations for improvement while supporting decision making in its widest context. The tool has been tested on various European catchments and shows a promising potential to inform water managers of risks and appropriate mitigative actions. Further improvements should include toxicological knowledge advancement, environmental background pollutant concentrations and the assessment of the impact of distribution systems on water quality variation. PMID:25046634

  10. Study on quantitative risk assessment model of the third party damage for natural gas pipelines based on fuzzy comprehensive assessment

    NASA Astrophysics Data System (ADS)

    Qiu, Zeyang; Liang, Wei; Wang, Xue; Lin, Yang; Zhang, Meng

    2017-05-01

    As an important part of national energy supply system, transmission pipelines for natural gas are possible to cause serious environmental pollution, life and property loss in case of accident. The third party damage is one of the most significant causes for natural gas pipeline system accidents, and it is very important to establish an effective quantitative risk assessment model of the third party damage for reducing the number of gas pipelines operation accidents. Against the third party damage accident has the characteristics such as diversity, complexity and uncertainty, this paper establishes a quantitative risk assessment model of the third party damage based on Analytic Hierarchy Process (AHP) and Fuzzy Comprehensive Evaluation (FCE). Firstly, risk sources of third party damage should be identified exactly, and the weight of factors could be determined via improved AHP, finally the importance of each factor is calculated by fuzzy comprehensive evaluation model. The results show that the quantitative risk assessment model is suitable for the third party damage of natural gas pipelines and improvement measures could be put forward to avoid accidents based on the importance of each factor.

  11. Aid decision algorithms to estimate the risk in congenital heart surgery.

    PubMed

    Ruiz-Fernández, Daniel; Monsalve Torra, Ana; Soriano-Payá, Antonio; Marín-Alonso, Oscar; Triana Palencia, Eddy

    2016-04-01

    In this paper, we have tested the suitability of using different artificial intelligence-based algorithms for decision support when classifying the risk of congenital heart surgery. In this sense, classification of those surgical risks provides enormous benefits as the a priori estimation of surgical outcomes depending on either the type of disease or the type of repair, and other elements that influence the final result. This preventive estimation may help to avoid future complications, or even death. We have evaluated four machine learning algorithms to achieve our objective: multilayer perceptron, self-organizing map, radial basis function networks and decision trees. The architectures implemented have the aim of classifying among three types of surgical risk: low complexity, medium complexity and high complexity. Accuracy outcomes achieved range between 80% and 99%, being the multilayer perceptron method the one that offered a higher hit ratio. According to the results, it is feasible to develop a clinical decision support system using the evaluated algorithms. Such system would help cardiology specialists, paediatricians and surgeons to forecast the level of risk related to a congenital heart disease surgery. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  12. Development and Implementation of a Design Metric for Systems Containing Long-Term Fluid Loops

    NASA Technical Reports Server (NTRS)

    Steele, John W.

    2016-01-01

    John Steele, a chemist and technical fellow from United Technologies Corporation, provided a water quality module to assist engineers and scientists with a metric tool to evaluate risks associated with the design of space systems with fluid loops. This design metric is a methodical, quantitative, lessons-learned based means to evaluate the robustness of a long-term fluid loop system design. The tool was developed by a cross-section of engineering disciplines who had decades of experience and problem resolution.

  13. Browns Ferry Nuclear Plant: variation in test intervals for high-pressure coolant injection (HPCI) system

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

    Christie, R.F.; Stetkar, J.W.

    1985-01-01

    The change in availability of the high-pressure coolant injection system (HPCIS) due to a change in pump and valve test interval from monthly to quarterly was analyzed. This analysis started by using the HPCIS base line evaluation produced as part of the Browns Ferry Nuclear Plant (BFN) Probabilistic Risk Assessment (PRA). The base line evaluation showed that the dominant contributors to the unavailability of the HPCI system are hardware failures and the resultant downtime for unscheduled maintenance.

  14. Beating the Odds (BTO) Program: A Comprehensive Support System for Teachers and Families of At-Risk Students.

    ERIC Educational Resources Information Center

    Opuni, Kwame A.; And Others

    This paper evaluates the effectiveness of the Beating the Odds (BTO) program of the Houston (Texas) schools in the 1990-91 school year, the third and final year of Phase I of the program. The BTO program provided training workshops for teachers of at-risk students and direct counseling and social service support for at-risk students in a selected…

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

    Thurman, J.

    Can operating companies cost-effectively manage environmental risks, meet compliance requirements and attain financial and market-oriented goals? Yes, if top management fully supports incorporating environmental-risk issues into the corporate management system. Using evaluation tools such as risk assessment and environmental audits, operators can fully define their environment condition and risk level. Working these results, HPI companies can take action to reduce the probability of environmental accidents and mitigate adverse event effects. Adopting this top-down, proactive outlook, organizations can evade environmental catastrophes, avoid negative public image and prevent ruined reputations.

  16. Neck circumference as a predictor of metabolic syndrome, insulin resistance and low-grade systemic inflammation in children: the ACFIES study.

    PubMed

    Gomez-Arbelaez, Diego; Camacho, Paul Anthony; Cohen, Daniel Dylan; Saavedra-Cortes, Sandra; Lopez-Lopez, Cristina; Lopez-Jaramillo, Patricio

    2016-03-08

    The current study aims to evaluate the association between neck circumference (NC) and several cardio-metabolic risk factors, to compare it with well-established anthropometric indices, and to determine the cut-off point value of NC for predicting children at increased risk of metabolic syndrome, insulin resistance and low-grade systemic inflammation. A total of 669 school children, aged 8-14, were recruited. Demographic, clinical, anthropometric and biochemical data from all patients were collected. Correlations between cardio-metabolic risk factors and NC and other anthropometric variables were evaluated using the Spearman's correlation coefficient. Multiple linear regression analysis was applied to further examine these associations. We then determined by receiver operating characteristic (ROC) analyses the optimal cut-off for NC for identifying children with elevated cardio-metabolic risk. NC was positively associated with fasting plasma glucose and triglycerides (p = 0.001 for all), and systolic and diastolic blood pressure, C-reactive protein, insulin and HOMA-IR (p < 0.001 for all), and negatively with HDL-C (p = 0.001). Whereas, other anthropometric indices were associated with fewer risk factors. NC could be used as clinically relevant and easy to implement indicator of cardio-metabolic risk in children.

  17. An improved approach for flight readiness certification: Methodology for failure risk assessment and application examples. Volume 2: Software documentation

    NASA Technical Reports Server (NTRS)

    Moore, N. R.; Ebbeler, D. H.; Newlin, L. E.; Sutharshana, S.; Creager, M.

    1992-01-01

    An improved methodology for quantitatively evaluating failure risk of spaceflight systems to assess flight readiness and identify risk control measures is presented. This methodology, called Probabilistic Failure Assessment (PFA), combines operating experience from tests and flights with engineering analysis to estimate failure risk. The PFA methodology is of particular value when information on which to base an assessment of failure risk, including test experience and knowledge of parameters used in engineering analyses of failure phenomena, is expensive or difficult to acquire. The PFA methodology is a prescribed statistical structure in which engineering analysis models that characterize failure phenomena are used conjointly with uncertainties about analysis parameters and/or modeling accuracy to estimate failure probability distributions for specific failure modes, These distributions can then be modified, by means of statistical procedures of the PFA methodology, to reflect any test or flight experience. Conventional engineering analysis models currently employed for design of failure prediction are used in this methodology. The PFA methodology is described and examples of its application are presented. Conventional approaches to failure risk evaluation for spaceflight systems are discussed, and the rationale for the approach taken in the PFA methodology is presented. The statistical methods, engineering models, and computer software used in fatigue failure mode applications are thoroughly documented.

  18. An improved approach for flight readiness certification: Methodology for failure risk assessment and application examples, volume 1

    NASA Technical Reports Server (NTRS)

    Moore, N. R.; Ebbeler, D. H.; Newlin, L. E.; Sutharshana, S.; Creager, M.

    1992-01-01

    An improved methodology for quantitatively evaluating failure risk of spaceflight systems to assess flight readiness and identify risk control measures is presented. This methodology, called Probabilistic Failure Assessment (PFA), combines operating experience from tests and flights with engineering analysis to estimate failure risk. The PFA methodology is of particular value when information on which to base an assessment of failure risk, including test experience and knowledge of parameters used in engineering analyses of failure phenomena, is expensive or difficult to acquire. The PFA methodology is a prescribed statistical structure in which engineering analysis models that characterize failure phenomena are used conjointly with uncertainties about analysis parameters and/or modeling accuracy to estimate failure probability distributions for specific failure modes. These distributions can then be modified, by means of statistical procedures of the PFA methodology, to reflect any test or flight experience. Conventional engineering analysis models currently employed for design of failure prediction are used in this methodology. The PFA methodology is described and examples of its application are presented. Conventional approaches to failure risk evaluation for spaceflight systems are discussed, and the rationale for the approach taken in the PFA methodology is presented. The statistical methods, engineering models, and computer software used in fatigue failure mode applications are thoroughly documented.

  19. Phthalates and Cumulative Risk Assessment (NAS Final ...

    EPA Pesticide Factsheets

    On December 18, 2008, the National Academy of Sciences' National Research Council released a final report, requested and sponsored by the EPA, entitled Phthalates and Cumulative Risk Assessment: The Task Ahead. Risk assessment has become a dominant public policy tool for making choices, based on limited resources, to protect public health and the environment. It has been instrumental to the mission of the U.S. Environmental Protection Agency (EPA) as well as other federal agencies in evaluating public health concerns, informing regulatory and technological decisions, prioritizing research needs and funding, and in developing approaches for cost-benefit analysis. People are exposed to a variety of chemicals throughout their daily lives. To protect public health, regulators use risk assessments to examine the effects of chemical exposures. This book provides guidance for assessing the risk of phthalates, chemicals found in many consumer products that have been shown to affect the development of the male reproductive system of laboratory animals. Because people are exposed to multiple phthalates and other chemicals that affect male reproductive development, a cumulative risk assessment should be conducted that evaluates the combined effects of exposure to all these chemicals. The book suggests an approach for cumulative risk assessment that can serve as a model for evaluating the health risks of other types of chemicals.

  20. Risk Assessment and Hierarchical Risk Management of Enterprises in Chemical Industrial Parks Based on Catastrophe Theory

    PubMed Central

    Chen, Yu; Song, Guobao; Yang, Fenglin; Zhang, Shushen; Zhang, Yun; Liu, Zhenyu

    2012-01-01

    According to risk systems theory and the characteristics of the chemical industry, an index system was established for risk assessment of enterprises in chemical industrial parks (CIPs) based on the inherent risk of the source, effectiveness of the prevention and control mechanism, and vulnerability of the receptor. A comprehensive risk assessment method based on catastrophe theory was then proposed and used to analyze the risk levels of ten major chemical enterprises in the Songmu Island CIP, China. According to the principle of equal distribution function, the chemical enterprise risk level was divided into the following five levels: 1.0 (very safe), 0.8 (safe), 0.6 (generally recognized as safe, GRAS), 0.4 (unsafe), 0.2 (very unsafe). The results revealed five enterprises (50%) with an unsafe risk level, and another five enterprises (50%) at the generally recognized as safe risk level. This method solves the multi-objective evaluation and decision-making problem. Additionally, this method involves simple calculations and provides an effective technique for risk assessment and hierarchical risk management of enterprises in CIPs. PMID:23208298

  1. COMPUTERIZED ASSESSMENT OF HUMAN NEUROTOXICITY: SENSITIVITY TO NITROUS OXIDE EXPOSURE

    EPA Science Inventory

    The authors recently developed a flexible, portable, computer based neurobehavioral evaluation system (NES) to standardize data collection in epidemiologic field studies of individuals at risk for neurobehavioral toxicity. The current study was performed to examine the system's s...

  2. 75 FR 77645 - Disease, Disability, and Injury Prevention and Control Special Emphasis Panel (SEP): Pregnancy...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-12-13

    ... Monitoring System (PRAMS), DP11-001 Panel D, Initial Review In accordance with Section 10(a)(2) of the... initial review, discussion, and evaluation of ``Pregnancy Risk Assessment Monitoring System (PRAMS), DP11...

  3. 75 FR 77645 - Disease, Disability, and Injury Prevention and Control Special Emphasis Panel (SEP): Pregnancy...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-12-13

    ... Monitoring System (PRAMS), DP11-001 Panel F, Initial Review In accordance with Section 10(a)(2) of the... initial review, discussion, and evaluation of ``Pregnancy Risk Assessment Monitoring System (PRAMS), DP11...

  4. Subject-enabled analytics model on measurement statistics in health risk expert system for public health informatics.

    PubMed

    Chung, Chi-Jung; Kuo, Yu-Chen; Hsieh, Yun-Yu; Li, Tsai-Chung; Lin, Cheng-Chieh; Liang, Wen-Miin; Liao, Li-Na; Li, Chia-Ing; Lin, Hsueh-Chun

    2017-11-01

    This study applied open source technology to establish a subject-enabled analytics model that can enhance measurement statistics of case studies with the public health data in cloud computing. The infrastructure of the proposed model comprises three domains: 1) the health measurement data warehouse (HMDW) for the case study repository, 2) the self-developed modules of online health risk information statistics (HRIStat) for cloud computing, and 3) the prototype of a Web-based process automation system in statistics (PASIS) for the health risk assessment of case studies with subject-enabled evaluation. The system design employed freeware including Java applications, MySQL, and R packages to drive a health risk expert system (HRES). In the design, the HRIStat modules enforce the typical analytics methods for biomedical statistics, and the PASIS interfaces enable process automation of the HRES for cloud computing. The Web-based model supports both modes, step-by-step analysis and auto-computing process, respectively for preliminary evaluation and real time computation. The proposed model was evaluated by computing prior researches in relation to the epidemiological measurement of diseases that were caused by either heavy metal exposures in the environment or clinical complications in hospital. The simulation validity was approved by the commercial statistics software. The model was installed in a stand-alone computer and in a cloud-server workstation to verify computing performance for a data amount of more than 230K sets. Both setups reached efficiency of about 10 5 sets per second. The Web-based PASIS interface can be used for cloud computing, and the HRIStat module can be flexibly expanded with advanced subjects for measurement statistics. The analytics procedure of the HRES prototype is capable of providing assessment criteria prior to estimating the potential risk to public health. Copyright © 2017 Elsevier B.V. All rights reserved.

  5. Development of the Connecticut Airway Risk Evaluation (CARE) system to improve handoff communication in pediatric patients with tracheotomy.

    PubMed

    Lawrason Hughes, Amy; Murray, Nicole; Valdez, Tulio A; Kelly, Raeanne; Kavanagh, Katherine

    2014-01-01

    National attention has focused on the importance of handoffs in medicine. Our practice during airway patient handoffs is to communicate a patient-specific emergency plan for airway reestablishment; patients who are not intubatable by standard means are at higher risk for failure. There is currently no standard classification system describing airway risk in tracheotomized patients. To introduce and assess the interrater reliability of a simple airway risk classification system, the Connecticut Airway Risk Evaluation (CARE) system. We created a novel classification system, the CARE system, based on ease of intubation and the need for ventilation: group 1, easily intubatable; group 2, intubatable with special equipment and/or maneuvers; group 3, not intubatable. A "v" was appended to any group number to indicate the need for mechanical ventilation. We performed a retrospective medical chart review of patients aged 0 to 18 years who were undergoing tracheotomy at our tertiary care pediatric hospital between January 2000 and April 2011. INTERVENTIONS Each patient's medical history, including airway disease and means of intubation, was reviewed by 4 raters. Patient airways were separately rated as CARE groups 1, 2, or 3, each group with or without a v appended, as appropriate, based on the available information. After the patients were assigned to an airway group by each of the 4 raters, the interrater reliability was calculated to determine the ease of use of the rating system. We identified complete data for 155 of 169 patients (92%), resulting in a total of 620 ratings. Based on the patient's ease of intubation, raters categorized tracheotomized patients into group 1 (70%, 432 of 620); group 2 (25%, 157 of 620); or group 3 (5%, 29 of 620), each with a v appended if appropriate. The interrater reliability was κ = 0.95. We propose an airway risk classification system for tracheotomized patients, CARE, that has high interrater reliability and is easy to use and interpret. As medical providers and national organizations place more focus on improvements in interprovider communication, the creation of an airway handoff tool is integral to improving patient safety and airway management strategies following tracheotomy complications.

  6. Evaluation of the DIBELS (Sixth Edition) Diagnostic System for the Selection of Native and Proficient English Speakers at Risk of Reading Difficulties

    ERIC Educational Resources Information Center

    Smolkowski, Keith; Cummings, Kelli D.

    2016-01-01

    This comprehensive evaluation of the Dynamic Indicators of Basic Early Literacy Skills Sixth Edition (DIBELS6) set of measures gives a practical illustration of signal detection methods, the methods used to determine the value of screening and diagnostic systems, and offers an updated set of cut scores (decision thresholds). Data were drawn from a…

  7. Obstetric profile of pregnant adolescents in a public hospital: risk at beginning of labor, at delivery, postpartum, and in puerperium1

    PubMed Central

    Martínez, Hugo Tapia; Silva, Marta Angélica Iossi; Cabrera, Iñiga Pérez; Mendoza, Araceli Jiménez

    2015-01-01

    Objective: describe the obstetric profile of adolescents at beginning of labor, at delivery, postpartum, and in puerperium. Method: Cross-sectional descriptive study with 85 pregnant adolescents, selected by convenience, referred by health centers to a public hospital in Mexico City. Risks were evaluated before, during and after delivery and in puerperium, and measured respectively with the "Previgenes" that compose the Reproductive and Perinatal Risk Assessment System. Results: socioeconomic status, occupation and education level had influence on the emotionality of adolescents in relation to labor, whose obstetric risk was low for 55%, medium for 35%, and high for 10%. Risk in labor was low for 55%, medium for 18%, and high for 27%. Risk postpartum was low for 50%, medium for 25%, and high for 25%. In puerperium, most adolescents (90%) had low risk. Conclusion: most adolescents had low risk in the stages evaluated. The study contributed to identify strategies to approach risk considering the vulnerability inherent in this type of population and favored the conduct of appropriate interventions for the respective needs. PMID:26487132

  8. Obstetric profile of pregnant adolescents in a public hospital: risk at beginning of labor, at delivery, postpartum, and in puerperium.

    PubMed

    Martínez, Hugo Tapia; Silva, Marta Angélica Iossi; Cabrera, Iñiga Pérez; Mendoza, Araceli Jiménez

    2015-01-01

    describe the obstetric profile of adolescents at beginning of labor, at delivery, postpartum, and in puerperium. Cross-sectional descriptive study with 85 pregnant adolescents, selected by convenience, referred by health centers to a public hospital in Mexico City. Risks were evaluated before, during and after delivery and in puerperium, and measured respectively with the "Previgenes" that compose the Reproductive and Perinatal Risk Assessment System. socioeconomic status, occupation and education level had influence on the emotionality of adolescents in relation to labor, whose obstetric risk was low for 55%, medium for 35%, and high for 10%. Risk in labor was low for 55%, medium for 18%, and high for 27%. Risk postpartum was low for 50%, medium for 25%, and high for 25%. In puerperium, most adolescents (90%) had low risk. most adolescents had low risk in the stages evaluated. The study contributed to identify strategies to approach risk considering the vulnerability inherent in this type of population and favored the conduct of appropriate interventions for the respective needs.

  9. Bayesian Inference for NASA Probabilistic Risk and Reliability Analysis

    NASA Technical Reports Server (NTRS)

    Dezfuli, Homayoon; Kelly, Dana; Smith, Curtis; Vedros, Kurt; Galyean, William

    2009-01-01

    This document, Bayesian Inference for NASA Probabilistic Risk and Reliability Analysis, is intended to provide guidelines for the collection and evaluation of risk and reliability-related data. It is aimed at scientists and engineers familiar with risk and reliability methods and provides a hands-on approach to the investigation and application of a variety of risk and reliability data assessment methods, tools, and techniques. This document provides both: A broad perspective on data analysis collection and evaluation issues. A narrow focus on the methods to implement a comprehensive information repository. The topics addressed herein cover the fundamentals of how data and information are to be used in risk and reliability analysis models and their potential role in decision making. Understanding these topics is essential to attaining a risk informed decision making environment that is being sought by NASA requirements and procedures such as 8000.4 (Agency Risk Management Procedural Requirements), NPR 8705.05 (Probabilistic Risk Assessment Procedures for NASA Programs and Projects), and the System Safety requirements of NPR 8715.3 (NASA General Safety Program Requirements).

  10. Neurobehavioral and Neurophysiological Assessment of Healthy and "At-Risk" Full-Term Infants.

    ERIC Educational Resources Information Center

    Eldredge, Lynnette; Salamy, Alan

    1988-01-01

    Study evaluates the functioning of the central nervous system (CNS) of 15 neonates born at-risk for neurological sequelae and 15 healthy controls. CNS information was generated through the use of two measures: (1) the Neurological and Adaptive Capacity Score (NACS) and the auditory brainstem response (ABR). (Author/RWB)

  11. Youth Justice in England and Wales: A Risky Business

    ERIC Educational Resources Information Center

    Paylor, Ian

    2011-01-01

    Risk factor research dominates explanatory models of youth offending and "evidence-based" policy and practice with young people in the youth justice system in England and Wales. Asset is the product of these actuarial ideas and has put the risk factor prevention paradigm into practice. This article evaluates the impact that an actuarial…

  12. 48 CFR 215.404-71-3 - Contract type risk and working capital adjustment.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... provisions for performance-based payments, do not compute a working capital adjustment. (d) Evaluation... working capital adjustment. 215.404-71-3 Section 215.404-71-3 Federal Acquisition Regulations System... CONTRACTING BY NEGOTIATION Contract Pricing 215.404-71-3 Contract type risk and working capital adjustment. (a...

  13. Antenatal Ultrasound and Risk of Autism Spectrum Disorders

    ERIC Educational Resources Information Center

    Grether, Judith K.; Li, Sherian Xu; Yoshida, Cathleen K.; Croen, Lisa A.

    2010-01-01

    We evaluated antenatal ultrasound (U/S) exposure as a risk factor for autism spectrum disorders (ASD), comparing affected singleton children and control children born 1995-1999 and enrolled in the Kaiser Permanente health care system. Among children with ASD (n = 362) and controls (n = 393), 13% had no antenatal exposure to U/S examinations;…

  14. Implementing system-wide risk stratification approaches: A review of critical success and failure factors.

    PubMed

    Huckel Schneider, Carmen; Gillespie, James A; Wilson, Andrew

    2017-05-01

    Risk stratification has become a widely used tool for linking people identified at risk of health deterioration to the most appropriate evidence-based care. This article systematically reviews recent literature to determine key factors that have been identified as critical enablers and/or barriers to successful implementation of risk stratification tools at a system level. A systematic search found 23 articles and four promising protocols for inclusion in the review, covering the use to 20 different risk stratification tools. These articles reported on only a small fraction of the risk stratification tools used in health systems; suggesting that while the development and statistical validation of risk stratification algorithms is widely reported, there has been little published evaluation of how they are implemented in real-world settings. Controlled studies provided some evidence that the use of risk stratification tools in combination with a care management plan offer patient benefits and that the use of a risk stratification tool to determine components of a care management plan may contribute to reductions in hospital readmissions, patient satisfaction and improved patient outcomes. Studies with the strongest focus on implementation used qualitative and case study methods. Among these, the literature converged on four key areas of implementation that were found to be critical for overcoming barriers to success: the engagement of clinicians and safeguarding equity, both of which address barriers of acceptance; the health system context to address administrative, political and system design barriers; and data management and integration to address logistical barriers.

  15. Expanding pedestrian injury risk to the body region level: how to model passive safety systems in pedestrian injury risk functions.

    PubMed

    Niebuhr, Tobias; Junge, Mirko; Achmus, Stefanie

    2015-01-01

    Assessment of the effectiveness of advanced driver assistance systems (ADAS) plays a crucial role in accident research. A common way to evaluate the effectiveness of new systems is to determine the potentials for injury severity reduction. Because injury risk functions describe the probability of an injury of a given severity conditional on a technical accident severity (closing speed, delta V, barrier equivalent speed, etc.), they are predestined for such evaluations. Recent work has stated an approach on how to model the pedestrian injury risk in pedestrian-to-passenger car accidents as a family of functions. This approach gave explicit and easily interpretable formulae for the injury risk conditional on the closing speed of the car. These results are extended to injury risk functions for pedestrian body regions. Starting with a double-checked German In-depth Accident Study (GIDAS) pedestrian-to-car accident data set (N = 444) and a functional-anatomical definition of the body regions, investigations on the influence of specific body regions on the overall injury severity will be presented. As the measure of injury severity, the ISSx, a rescaled version of the well-known Injury Severity Score (ISS), was used. Though traditional ISS is computed by summation of the squares of the 3 most severe injured body regions, ISSx is computed by the summation of the exponentials of the Abbreviated Injury Scale (AIS) severities of the 3 most severely injured body regions. The exponentials used are scaled to fit the ISS range of values between 0 and 75. Three body regions (head/face/neck, thorax, hip/legs) clearly dominated abdominal and upper extremity injuries; that is, the latter 2 body regions had no influence at all on the overall injury risk over the range of technical accident severities. Thus, the ISSx is well described by use of the injury codes from the same body regions for any pedestrian injury severity. As a mathematical consequence, the ISSx becomes explicitly decomposable into the 3 body regions and so are the risk functions as body region-specific risk functions. The risk functions for each body region are stated explicitly for different injury severity levels and compared to the real-world accident data. The body region-specific risk functions can then be used to model the effect of improved passive safety systems. These modified body region-specific injury risk functions are aggregated to a new pedestrian injury risk function. Passive safety systems can therefore be modeled in injury risk functions for the first time. A short example on how the results can be used for assessing the effectiveness of new driver assistance systems concludes the article.

  16. Historical Relationship Between Performance Assessment for Radioactive Waste Disposal and Other Types of Risk Assessment in the United States

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

    RECHARD,ROBERT P.

    This paper describes the evolution of the process for assessing the hazards of a geologic disposal system for radioactive waste and, similarly, nuclear power reactors, and the relationship of this process with other assessments of risk, particularly assessments of hazards from manufactured carcinogenic chemicals during use and disposal. This perspective reviews the common history of scientific concepts for risk assessment developed to the 1950s. Computational tools and techniques developed in the late 1950s and early 1960s to analyze the reliability of nuclear weapon delivery systems were adopted in the early 1970s for probabilistic risk assessment of nuclear power reactors, amore » technology for which behavior was unknown. In turn, these analyses became an important foundation for performance assessment of nuclear waste disposal in the late 1970s. The evaluation of risk to human health and the environment from chemical hazards is built upon methods for assessing the dose response of radionuclides in the 1950s. Despite a shared background, however, societal events, often in the form of legislation, have affected the development path for risk assessment for human health, producing dissimilarities between these risk assessments and those for nuclear facilities. An important difference is the regulator's interest in accounting for uncertainty and the tools used to evaluate it.« less

  17. Human errors and measurement uncertainty

    NASA Astrophysics Data System (ADS)

    Kuselman, Ilya; Pennecchi, Francesca

    2015-04-01

    Evaluating the residual risk of human errors in a measurement and testing laboratory, remaining after the error reduction by the laboratory quality system, and quantifying the consequences of this risk for the quality of the measurement/test results are discussed based on expert judgments and Monte Carlo simulations. A procedure for evaluation of the contribution of the residual risk to the measurement uncertainty budget is proposed. Examples are provided using earlier published sets of expert judgments on human errors in pH measurement of groundwater, elemental analysis of geological samples by inductively coupled plasma mass spectrometry, and multi-residue analysis of pesticides in fruits and vegetables. The human error contribution to the measurement uncertainty budget in the examples was not negligible, yet also not dominant. This was assessed as a good risk management result.

  18. A risk-based framework to assess long-term effects of policy and water supply changes on water resources systems

    NASA Astrophysics Data System (ADS)

    Hassanzadeh, Elmira; Elshorbagy, Amin; Wheater, Howard; Gober, Patricia

    2015-04-01

    Climate uncertainty can affect water resources availability and management decisions. Sustainable water resources management therefore requires evaluation of policy and management decisions under a wide range of possible future water supply conditions. This study proposes a risk-based framework to integrate water supply uncertainty into a forward-looking decision making context. To apply this framework, a stochastic reconstruction scheme is used to generate a large ensemble of flow series. For the Rocky Mountain basins considered here, two key characteristics of the annual hydrograph are its annual flow volume and the timing of the seasonal flood peak. These are perturbed to represent natural randomness and potential changes due to future climate. 30-year series of perturbed flows are used as input to the SWAMP model - an integrated water resources model that simulates regional water supply-demand system and estimates economic productivity of water and other sustainability indicators, including system vulnerability and resilience. The simulation results are used to construct 2D-maps of net revenue of a particular water sector; e.g., hydropower, or for all sectors combined. Each map cell represents a risk scenario of net revenue based on a particular annual flow volume, timing of the peak flow, and 200 stochastic realizations of flow series. This framework is demonstrated for a water resources system in the Saskatchewan River Basin (SaskRB) in Saskatchewan, Canada. Critical historical drought sequences, derived from tree-ring reconstructions of several hundred years of annual river flows, are used to evaluate the system's performance (net revenue risk) under extremely low flow conditions and also to locate them on the previously produced 2D risk maps. This simulation and analysis framework is repeated under various reservoir operation strategies (e.g., maximizing flood protection or maximizing water supply security); development proposals, such as irrigation expansion; and change in energy prices. Such risk-based analysis demonstrates relative reduction/increase of risk associated with management and policy decisions and allow decision makers to explore the relative importance of policy versus natural water supply change in a water resources system.

  19. Effect of balance training on postural balance control and risk of fall in children with diplegic cerebral palsy.

    PubMed

    El-Shamy, Shamekh Mohamed; Abd El Kafy, Ehab Mohamed

    2014-01-01

    The purpose of this study was to evaluate the effects of balance training on postural control and fall risk in children with diplegic cerebral palsy. Thirty spastic diplegic cerebral palsied children (10-12 years) were included in this study. Children were randomly assigned into two equal-sized groups: control and study groups. Participants in both groups received a traditional physical therapy exercise program. The study group additionally received balance training on the Biodex balance system. Treatment was provided 30 min/d, 3 d/week for 3 successive months. To evaluate the limit of stability and fall risk, participated children received baseline and post-treatment assessments using the Biodex balance system. Overall directional control, total time to complete the test, overall stability index of the fall risk test and total score of the pediatric balance scale were measured. Children in both groups showed significant improvements in the mean values of all measured variables post-treatment (p < 0.05). The results also showed significantly better improvement in the measured parameters for the study group, as compared to the control group (p < 0.05). Balance training on Biodex system is a useful tool that can be used in improving postural balance control in children with diplegic cerebral palsy.

  20. Bioconcentration of gaseous organic chemicals in plant leaves: Comparison of experimental data with model predictions

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

    Polder, M.D.; Hulzebos, E.M.; Jager, D.T.

    1998-01-01

    This literature study is performed to support the implementation of two models in a risk assessment system for the evaluation of chemicals and their risk for human health and the environment. One of the exposure pathways for humans and cattle is the uptake of chemicals by plants. In this risk assessment system the transfer of gaseous organic substances from air to plants modeled by Riederer is included. A similar model with a more refined approach, including dilution by growth, is proposed by Trapp and Matthies, which was implemented in the European version of this risk assessment system (EUSES). In thismore » study both models are evaluated by comparison with experimental data on leaf/air partition coefficients found in the literature. For herbaceous plants both models give good estimations for the leaf/air partition coefficient up to 10{sup 7}, with deviations for most substances within a factor of five. For the azalea and spruce group the fit between experimental BCF values and the calculated model values is less adequate. For substances for which Riederer estimates a leaf/air partition coefficient above 10{sup 7}, the approach of Trapp and Matthies seems more adequate; however, few data were available.« less

  1. Risk control and the minimum significant risk

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

    Seiler, F.A.; Alvarez, J.L.

    1996-06-01

    Risk management implies that the risk manager can, by his actions, exercise at least a modicum of control over the risk in question. In the terminology of control theory, a management action is a control signal imposed as feedback on the system to bring about a desired change in the state of the system. In the terminology of risk management, an action is taken to bring a predicted risk to lower values. Even if it is assumed that the management action taken is 100% effective and that the projected risk reduction is infinitely well known, there is a lower limitmore » to the desired effects that can be achieved. It is based on the fact that all risks, such as the incidence of cancer, exhibit a degree of variability due to a number of extraneous factors such as age at exposure, sex, location, and some lifestyle parameters such as smoking or the consumption of alcohol. If the control signal is much smaller than the variability of the risk, the signal is lost in the noise and control is lost. This defines a minimum controllable risk based on the variability of the risk over the population considered. This quantity is the counterpart of the minimum significant risk which is defined by the uncertainties of the risk model. Both the minimum controllable risk and the minimum significant risk are evaluated for radiation carcinogenesis and are shown to be of the same order of magnitude. For a realistic management action, the assumptions of perfectly effective action and perfect model prediction made above have to be dropped, resulting in an effective minimum controllable risk which is determined by both risk limits. Any action below that effective limit is futile, but it is also unethical due to the ethical requirement of doing more good than harm. Finally, some implications of the effective minimum controllable risk on the use of the ALARA principle and on the evaluation of remedial action goals are presented.« less

  2. WE-B-BRC-01: Current Methodologies in Risk Assessment

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

    Rath, F.

    Prospective quality management techniques, long used by engineering and industry, have become a growing aspect of efforts to improve quality management and safety in healthcare. These techniques are of particular interest to medical physics as scope and complexity of clinical practice continue to grow, thus making the prescriptive methods we have used harder to apply and potentially less effective for our interconnected and highly complex healthcare enterprise, especially in imaging and radiation oncology. An essential part of most prospective methods is the need to assess the various risks associated with problems, failures, errors, and design flaws in our systems. Wemore » therefore begin with an overview of risk assessment methodologies used in healthcare and industry and discuss their strengths and weaknesses. The rationale for use of process mapping, failure modes and effects analysis (FMEA) and fault tree analysis (FTA) by TG-100 will be described, as well as suggestions for the way forward. This is followed by discussion of radiation oncology specific risk assessment strategies and issues, including the TG-100 effort to evaluate IMRT and other ways to think about risk in the context of radiotherapy. Incident learning systems, local as well as the ASTRO/AAPM ROILS system, can also be useful in the risk assessment process. Finally, risk in the context of medical imaging will be discussed. Radiation (and other) safety considerations, as well as lack of quality and certainty all contribute to the potential risks associated with suboptimal imaging. The goal of this session is to summarize a wide variety of risk analysis methods and issues to give the medical physicist access to tools which can better define risks (and their importance) which we work to mitigate with both prescriptive and prospective risk-based quality management methods. Learning Objectives: Description of risk assessment methodologies used in healthcare and industry Discussion of radiation oncology-specific risk assessment strategies and issues Evaluation of risk in the context of medical imaging and image quality E. Samei: Research grants from Siemens and GE.« less

  3. WE-B-BRC-03: Risk in the Context of Medical Imaging

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

    Samei, E.

    Prospective quality management techniques, long used by engineering and industry, have become a growing aspect of efforts to improve quality management and safety in healthcare. These techniques are of particular interest to medical physics as scope and complexity of clinical practice continue to grow, thus making the prescriptive methods we have used harder to apply and potentially less effective for our interconnected and highly complex healthcare enterprise, especially in imaging and radiation oncology. An essential part of most prospective methods is the need to assess the various risks associated with problems, failures, errors, and design flaws in our systems. Wemore » therefore begin with an overview of risk assessment methodologies used in healthcare and industry and discuss their strengths and weaknesses. The rationale for use of process mapping, failure modes and effects analysis (FMEA) and fault tree analysis (FTA) by TG-100 will be described, as well as suggestions for the way forward. This is followed by discussion of radiation oncology specific risk assessment strategies and issues, including the TG-100 effort to evaluate IMRT and other ways to think about risk in the context of radiotherapy. Incident learning systems, local as well as the ASTRO/AAPM ROILS system, can also be useful in the risk assessment process. Finally, risk in the context of medical imaging will be discussed. Radiation (and other) safety considerations, as well as lack of quality and certainty all contribute to the potential risks associated with suboptimal imaging. The goal of this session is to summarize a wide variety of risk analysis methods and issues to give the medical physicist access to tools which can better define risks (and their importance) which we work to mitigate with both prescriptive and prospective risk-based quality management methods. Learning Objectives: Description of risk assessment methodologies used in healthcare and industry Discussion of radiation oncology-specific risk assessment strategies and issues Evaluation of risk in the context of medical imaging and image quality E. Samei: Research grants from Siemens and GE.« less

  4. WE-B-BRC-00: Concepts in Risk-Based Assessment

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

    NONE

    Prospective quality management techniques, long used by engineering and industry, have become a growing aspect of efforts to improve quality management and safety in healthcare. These techniques are of particular interest to medical physics as scope and complexity of clinical practice continue to grow, thus making the prescriptive methods we have used harder to apply and potentially less effective for our interconnected and highly complex healthcare enterprise, especially in imaging and radiation oncology. An essential part of most prospective methods is the need to assess the various risks associated with problems, failures, errors, and design flaws in our systems. Wemore » therefore begin with an overview of risk assessment methodologies used in healthcare and industry and discuss their strengths and weaknesses. The rationale for use of process mapping, failure modes and effects analysis (FMEA) and fault tree analysis (FTA) by TG-100 will be described, as well as suggestions for the way forward. This is followed by discussion of radiation oncology specific risk assessment strategies and issues, including the TG-100 effort to evaluate IMRT and other ways to think about risk in the context of radiotherapy. Incident learning systems, local as well as the ASTRO/AAPM ROILS system, can also be useful in the risk assessment process. Finally, risk in the context of medical imaging will be discussed. Radiation (and other) safety considerations, as well as lack of quality and certainty all contribute to the potential risks associated with suboptimal imaging. The goal of this session is to summarize a wide variety of risk analysis methods and issues to give the medical physicist access to tools which can better define risks (and their importance) which we work to mitigate with both prescriptive and prospective risk-based quality management methods. Learning Objectives: Description of risk assessment methodologies used in healthcare and industry Discussion of radiation oncology-specific risk assessment strategies and issues Evaluation of risk in the context of medical imaging and image quality E. Samei: Research grants from Siemens and GE.« less

  5. WE-B-BRC-02: Risk Analysis and Incident Learning

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

    Fraass, B.

    Prospective quality management techniques, long used by engineering and industry, have become a growing aspect of efforts to improve quality management and safety in healthcare. These techniques are of particular interest to medical physics as scope and complexity of clinical practice continue to grow, thus making the prescriptive methods we have used harder to apply and potentially less effective for our interconnected and highly complex healthcare enterprise, especially in imaging and radiation oncology. An essential part of most prospective methods is the need to assess the various risks associated with problems, failures, errors, and design flaws in our systems. Wemore » therefore begin with an overview of risk assessment methodologies used in healthcare and industry and discuss their strengths and weaknesses. The rationale for use of process mapping, failure modes and effects analysis (FMEA) and fault tree analysis (FTA) by TG-100 will be described, as well as suggestions for the way forward. This is followed by discussion of radiation oncology specific risk assessment strategies and issues, including the TG-100 effort to evaluate IMRT and other ways to think about risk in the context of radiotherapy. Incident learning systems, local as well as the ASTRO/AAPM ROILS system, can also be useful in the risk assessment process. Finally, risk in the context of medical imaging will be discussed. Radiation (and other) safety considerations, as well as lack of quality and certainty all contribute to the potential risks associated with suboptimal imaging. The goal of this session is to summarize a wide variety of risk analysis methods and issues to give the medical physicist access to tools which can better define risks (and their importance) which we work to mitigate with both prescriptive and prospective risk-based quality management methods. Learning Objectives: Description of risk assessment methodologies used in healthcare and industry Discussion of radiation oncology-specific risk assessment strategies and issues Evaluation of risk in the context of medical imaging and image quality E. Samei: Research grants from Siemens and GE.« less

  6. Evaluation with stabilometric platform of balance disorders in osteoporosis patients. A proposal for a diagnostic protocol.

    PubMed

    Cultrera, Pina; Pratelli, Elisa; Petrai, Veronica; Postiglione, Marco; Zambelan, Giulia; Pasquetti, Pietro

    2010-05-01

    Osteoporosis is a systemic disease with reduced bone mass and qualitative alterations of the bone, associated to increased risk of fracture. Pathogenesis of osteoporosis fractures is multifactorial. Main risk factor is falls (except for vertebral fragility fractures which occurs often in absence of trauma). Aging by itself produces physiological changes: muscular hypotrophy with asthenia, deficit of visus and hearing together with associated pathologies and multi-drug therapies. In osteoporosis patients with vertebral fractures posture change occurs which reduces balance. After clinical postural evaluation it is possible to carry out instrumental evaluation of posture with computerized methods such as stabilometry, baropodometry, dynanometry and gait analysis. Examination carried out with use of stabilometric computerized platform allows stabilometric (body sway assessment) as well as posturometric examination (center of pressure assessment during quiet standing). Fundamental parameters obtained are: position of the body center of gravity, area and shape of sway density curve and velocity variables. Protocol of evaluation includes assessment of examination in standard condition and in condition of temporary sensorial deprivation (to investigate the influence of various afferent systems on the maintenance of posture and balance). Accurate evaluation of postural control in osteoporosis patients constitutes a fundamental tool in fracture risk evaluation due to fall and in identification and correction of modifiable factors responsible for balance defect. This approach, together with adequate drug therapy, may lead to significant reduction of fractures in osteoporosis patients with subsequent reduction of hospitalization and residual consequent disabilities.

  7. A new scoring system (DAIGA) for predicting bleeding complications in atrial fibrillation patients after drug-eluting stent implantation with triple antithrombotic therapy.

    PubMed

    Kobayashi, Norihiro; Yamawaki, Masahiro; Nakano, Masatsugu; Hirano, Keisuke; Araki, Motoharu; Takimura, Hideyuki; Sakamoto, Yasunari; Mori, Shinsuke; Tsutsumi, Masakazu; Ito, Yoshiaki

    2016-11-15

    No scoring system for evaluating the bleeding risk of atrial fibrillation (AF) patients after drug-eluting stent (DES) implantation with triple antithrombotic therapy (TAT) is available. We aimed to develop a new scoring system for predicting bleeding complications in AF patients after DES implantation with TAT. Between April 2007 and April 2014, 227 AF patients undergoing DES implantation with TAT were enrolled. Bleeding incidence defined as Bleeding Academic Research Consortium criteria≥2 was investigated and predictors of bleeding complications were evaluated using multivariate analysis. Bleeding complications occurred in 58 patients (25.6%) during follow-up. Multivariate analysis revealed dual antiplatelet therapy (DAPT) continuation (OR 3.33, P=0.01), age>75 (OR 2.14, P=0.037), international normalized ratio>2.2 (OR 5.82, P<0.001), gastrointestinal ulcer history (OR 3.06, P=0.037), and anemia (OR 2.15, P=0.042) as predictors of major bleeding complications. A score was created using the weighted points proportional to the beta regression coefficient of each variable. The DAIGA score showed better predictive ability for bleeding complications than the HAS-BLED score (AUC: 0.79 vs. 0.62, P=0.0003). Bleeding incidence was well stratified: 17.8% in low-risk (scores 0-1), 55.5% in moderate-risk (2-3), and 83.0% in high-risk (4-7) patients (P<0.001). This scoring system is useful for predicting bleeding complications and risk stratification of AF patients after DES implantation with TAT. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  8. 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.

  9. Socioeconomic indicators of heat-related health risk supplemented with remotely sensed data

    PubMed Central

    Johnson, Daniel P; Wilson, Jeffrey S; Luber, George C

    2009-01-01

    Background Extreme heat events are the number one cause of weather-related fatalities in the United States. The current system of alert for extreme heat events does not take into account intra-urban spatial variation in risk. The purpose of this study is to evaluate a potential method to improve spatial delineation of risk from extreme heat events in urban environments by integrating sociodemographic risk factors with estimates of land surface temperature derived from thermal remote sensing data. Results Comparison of logistic regression models indicates that supplementing known sociodemographic risk factors with remote sensing estimates of land surface temperature improves the delineation of intra-urban variations in risk from extreme heat events. Conclusion Thermal remote sensing data can be utilized to improve understanding of intra-urban variations in risk from extreme heat. The refinement of current risk assessment systems could increase the likelihood of survival during extreme heat events and assist emergency personnel in the delivery of vital resources during such disasters. PMID:19835578

  10. Applying usability heuristics to radiotherapy systems.

    PubMed

    Chan, Alvita J; Islam, Mohammad K; Rosewall, Tara; Jaffray, David A; Easty, Anthony C; Cafazzo, Joseph A

    2012-01-01

    Heuristic evaluations have been used to evaluate safety of medical devices by identifying and assessing usability issues. Since radiotherapy treatment delivery systems often consist of multiple complex user-interfaces, a heuristic evaluation was conducted to assess the potential safety issues of such a system. A heuristic evaluation was conducted to evaluate the treatment delivery system at Princess Margaret Hospital (Toronto, Canada). Two independent evaluators identified usability issues with the user-interfaces and rated the severity of each issue. The evaluators identified 75 usability issues in total. Eighteen of them were rated as high severity, indicating the potential to have a major impact on patient safety. A majority of issues were found on the record and verify system, and many were associated with the patient setup process. While the hospital has processes in place to ensure patient safety, recommendations were developed to further mitigate the risks of potential consequences. Heuristic evaluation is an efficient and inexpensive method that can be successfully applied to radiotherapy delivery systems to identify usability issues and improve patient safety. Although this study was conducted only at one site, the findings may have broad implications for the design of these systems. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

  11. Evaluating Predictive Models of Software Quality

    NASA Astrophysics Data System (ADS)

    Ciaschini, V.; Canaparo, M.; Ronchieri, E.; Salomoni, D.

    2014-06-01

    Applications from High Energy Physics scientific community are constantly growing and implemented by a large number of developers. This implies a strong churn on the code and an associated risk of faults, which is unavoidable as long as the software undergoes active evolution. However, the necessities of production systems run counter to this. Stability and predictability are of paramount importance; in addition, a short turn-around time for the defect discovery-correction-deployment cycle is required. A way to reconcile these opposite foci is to use a software quality model to obtain an approximation of the risk before releasing a program to only deliver software with a risk lower than an agreed threshold. In this article we evaluated two quality predictive models to identify the operational risk and the quality of some software products. We applied these models to the development history of several EMI packages with intent to discover the risk factor of each product and compare it with its real history. We attempted to determine if the models reasonably maps reality for the applications under evaluation, and finally we concluded suggesting directions for further studies.

  12. Effects and Risk Evaluation of Oil Spillage in the Sea Areas of Changxing Island

    PubMed Central

    Wang, Hanxi; Xu, Jianling; Zhao, Wenkui; Zhang, Jiquan

    2014-01-01

    This paper evaluated the oil spillage risk in the waters near the island of Changxing in Dalian (China) based on the established risk assessment index. Four wind regimes (windless, northerly wind, westerly wind and southerly wind) were selected as weather conditions for the dynamic prediction of oil drift. If an oil spill occurs near the Koumen (a place near the island of Changxing), the forecast and evaluation are conducted based on a three-dimensional mathematical model of oil spillage, and the results obtained show the scope of the affected area when winds from various directions are applied. The oil spillage would, under various conditions, flow into the northern and western sea area of Changxing Island Bay, namely the Dalian harbor seal National Nature Reserve, and create adverse effects on the marine ecological environment. The rationality of combining the established oil spillage risk comprehensive index system with model prediction is further confirmed. Finally, preventive measures and quick fixes are presented in the case of accidental oil spillages. The most effective method to reduce environment risk is to adopt reasonable preventive measures and quick fixes. PMID:25153473

  13. A threshold-free summary index of prediction accuracy for censored time to event data.

    PubMed

    Yuan, Yan; Zhou, Qian M; Li, Bingying; Cai, Hengrui; Chow, Eric J; Armstrong, Gregory T

    2018-05-10

    Prediction performance of a risk scoring system needs to be carefully assessed before its adoption in clinical practice. Clinical preventive care often uses risk scores to screen asymptomatic population. The primary clinical interest is to predict the risk of having an event by a prespecified future time t 0 . Accuracy measures such as positive predictive values have been recommended for evaluating the predictive performance. However, for commonly used continuous or ordinal risk score systems, these measures require a subjective cutoff threshold value that dichotomizes the risk scores. The need for a cutoff value created barriers for practitioners and researchers. In this paper, we propose a threshold-free summary index of positive predictive values that accommodates time-dependent event status and competing risks. We develop a nonparametric estimator and provide an inference procedure for comparing this summary measure between 2 risk scores for censored time to event data. We conduct a simulation study to examine the finite-sample performance of the proposed estimation and inference procedures. Lastly, we illustrate the use of this measure on a real data example, comparing 2 risk score systems for predicting heart failure in childhood cancer survivors. Copyright © 2018 John Wiley & Sons, Ltd.

  14. Assessing reservoir operations risk under climate change

    USGS Publications Warehouse

    Brekke, L.D.; Maurer, E.P.; Anderson, J.D.; Dettinger, M.D.; Townsley, E.S.; Harrison, A.; Pruitt, T.

    2009-01-01

    Risk-based planning offers a robust way to identify strategies that permit adaptive water resources management under climate change. This paper presents a flexible methodology for conducting climate change risk assessments involving reservoir operations. Decision makers can apply this methodology to their systems by selecting future periods and risk metrics relevant to their planning questions and by collectively evaluating system impacts relative to an ensemble of climate projection scenarios (weighted or not). This paper shows multiple applications of this methodology in a case study involving California's Central Valley Project and State Water Project systems. Multiple applications were conducted to show how choices made in conducting the risk assessment, choices known as analytical design decisions, can affect assessed risk. Specifically, risk was reanalyzed for every choice combination of two design decisions: (1) whether to assume climate change will influence flood-control constraints on water supply operations (and how), and (2) whether to weight climate change scenarios (and how). Results show that assessed risk would motivate different planning pathways depending on decision-maker attitudes toward risk (e.g., risk neutral versus risk averse). Results also show that assessed risk at a given risk attitude is sensitive to the analytical design choices listed above, with the choice of whether to adjust flood-control rules under climate change having considerably more influence than the choice on whether to weight climate scenarios. Copyright 2009 by the American Geophysical Union.

  15. Falling Down on the Job: Evaluation and Treatment of Fall Risk Among Older Adults With Upper Extremity Fragility Fractures.

    PubMed

    McDonough, Christine M; Colla, Carrie H; Carmichael, Donald; Tosteson, Anna N A; Tosteson, Tor D; Bell, John-Erik; Cantu, Robert V; Lurie, Jonathan D; Bynum, Julie P W

    2017-03-01

    Clinical practice guidelines recommend fall risk assessment and intervention for older adults who sustain a fall-related injury to prevent future injury and mobility decline. The aim of this study was to describe how often Medicare beneficiaries with upper extremity fracture receive evaluation and treatment for fall risk. Observational cohort. Participants were fee-for-service beneficiaries age 66 to 99 treated as outpatients for proximal humerus or distal radius/ulna ("wrist") fragility fractures. -Participants were studied using Carrier and Outpatient Hospital files. The proportion of patients evaluated or treated for fall risk up to 6 months after proximal humerus or wrist fracture from 2007-2009 was examined based on evaluation, treatment, and diagnosis codes. Time to evaluation and number of treatment sessions were calculated. Logistic regression was used to analyze patient characteristics that predicted receiving evaluation or treatment. Narrow (gait training) and broad (gait training or therapeutic exercise) definitions of service were used. There were 309,947 beneficiaries who sustained proximal humerus (32%) or wrist fracture (68%); 10.7% received evaluation or treatment for fall risk or gait issues (humerus: 14.2%; wrist: 9.0%). Using the broader definition, the percentage increased to 18.5% (humerus: 23.4%; wrist: 16.3%). Factors associated with higher likelihood of services after fracture were: evaluation or treatment for falls or gait prior to fracture, more comorbidities, prior nursing home stay, older age, humerus fracture (vs wrist), female sex, and white race. Claims analysis may underestimate physician and physical therapist fall assessments, but it is not likely to qualitatively change the results. A small proportion of older adults with upper extremity fracture received fall risk assessment and treatment. Providers and health systems must advance efforts to provide timely evidence-based management of fall risk in this population. © 2017 American Physical Therapy Association

  16. Falling Down on the Job: Evaluation and Treatment of Fall Risk Among Older Adults With Upper Extremity Fragility Fractures

    PubMed Central

    Colla, Carrie H.; Carmichael, Donald; Tosteson, Anna N. A.; Tosteson, Tor D.; Bell, John-Erik; Cantu, Robert V.; Lurie, Jonathan D.; Bynum, Julie P. W.

    2017-01-01

    Abstract Background: Clinical practice guidelines recommend fall risk assessment and intervention for older adults who sustain a fall-related injury to prevent future injury and mobility decline. Objective: The aim of this study was to describe how often Medicare beneficiaries with upper extremity fracture receive evaluation and treatment for fall risk. Design: Observational cohort. Methods: Participants were fee-for-service beneficiaries age 66 to 99 treated as outpatients for proximal humerus or distal radius/ulna (“wrist”) fragility fractures. -Participants were studied using Carrier and Outpatient Hospital files. The proportion of patients evaluated or treated for fall risk up to 6 months after proximal humerus or wrist fracture from 2007–2009 was examined based on evaluation, treatment, and diagnosis codes. Time to evaluation and number of treatment sessions were calculated. Logistic regression was used to analyze patient characteristics that predicted receiving evaluation or treatment. Narrow (gait training) and broad (gait training or therapeutic exercise) definitions of service were used. Results: There were 309,947 beneficiaries who sustained proximal humerus (32%) or wrist fracture (68%); 10.7% received evaluation or treatment for fall risk or gait issues (humerus: 14.2%; wrist: 9.0%). Using the broader definition, the percentage increased to 18.5% (humerus: 23.4%; wrist: 16.3%). Factors associated with higher likelihood of services after fracture were: evaluation or treatment for falls or gait prior to fracture, more comorbidities, prior nursing home stay, older age, humerus fracture (vs wrist), female sex, and white race. Limitations: Claims analysis may underestimate physician and physical therapist fall assessments, but it is not likely to qualitatively change the results. Conclusions: A small proportion of older adults with upper extremity fracture received fall risk assessment and treatment. Providers and health systems must advance efforts to provide timely evidence-based management of fall risk in this population. PMID:28340130

  17. Consumers’ intention to use health recommendation systems to receive personalized nutrition advice

    PubMed Central

    2013-01-01

    Background Sophisticated recommendation systems are used more and more in the health sector to assist consumers in healthy decision making. In this study we investigate consumers' evaluation of hypothetical health recommendation systems that provide personalized nutrition advice. We examine consumers' intention to use such a health recommendation system as a function of options related to the underlying system (e.g. the type of company that generates the advice) as well as intermediaries (e.g. general practitioner) that might assist in using the system. We further explore if the effect of both the system and intermediaries on intention to use a health recommendation system are mediated by consumers' perceived effort, privacy risk, usefulness and enjoyment. Methods 204 respondents from a consumer panel in the Netherlands participated. The data were collected by means of a questionnaire. Each respondent evaluated three hypothetical health recommendation systems on validated multi-scale measures of effort, privacy risk, usefulness, enjoyment and intention to use the system. To test the hypothesized relationships we used regression analyses. Results We find evidence that the options related to the underlying system as well as the intermediaries involved influence consumers' intention to use such a health recommendation system and that these effects are mediated by perceptions of effort, privacy risk, usefulness and enjoyment. Also, we find that consumers value usefulness of a system more and enjoyment less when a general practitioner advices them to use a health recommendation system than if they use it out of their own curiosity. Conclusions We developed and tested a model of consumers' intention to use a health recommendation system. We found that intermediaries play an important role in how consumers evaluate such a system over and above options of the underlying system that is used to generate the recommendation. Also, health-related information services seem to rely on endorsement by the medical sector. This has considerable implications for the distribution as well as the communication channels of health recommendation systems which may be quite difficult to put into practice outside traditional health service channels. PMID:23557363

  18. Consumers' intention to use health recommendation systems to receive personalized nutrition advice.

    PubMed

    Wendel, Sonja; Dellaert, Benedict G C; Ronteltap, Amber; van Trijp, Hans C M

    2013-04-04

    Sophisticated recommendation systems are used more and more in the health sector to assist consumers in healthy decision making. In this study we investigate consumers' evaluation of hypothetical health recommendation systems that provide personalized nutrition advice. We examine consumers' intention to use such a health recommendation system as a function of options related to the underlying system (e.g. the type of company that generates the advice) as well as intermediaries (e.g. general practitioner) that might assist in using the system. We further explore if the effect of both the system and intermediaries on intention to use a health recommendation system are mediated by consumers' perceived effort, privacy risk, usefulness and enjoyment. 204 respondents from a consumer panel in the Netherlands participated. The data were collected by means of a questionnaire. Each respondent evaluated three hypothetical health recommendation systems on validated multi-scale measures of effort, privacy risk, usefulness, enjoyment and intention to use the system. To test the hypothesized relationships we used regression analyses. We find evidence that the options related to the underlying system as well as the intermediaries involved influence consumers' intention to use such a health recommendation system and that these effects are mediated by perceptions of effort, privacy risk, usefulness and enjoyment. Also, we find that consumers value usefulness of a system more and enjoyment less when a general practitioner advices them to use a health recommendation system than if they use it out of their own curiosity. We developed and tested a model of consumers' intention to use a health recommendation system. We found that intermediaries play an important role in how consumers evaluate such a system over and above options of the underlying system that is used to generate the recommendation. Also, health-related information services seem to rely on endorsement by the medical sector. This has considerable implications for the distribution as well as the communication channels of health recommendation systems which may be quite difficult to put into practice outside traditional health service channels.

  19. Probability and Confidence Trade-Space (PACT) Evaluation: Accounting for Uncertainty in Sparing Assessments

    NASA Technical Reports Server (NTRS)

    Anderson, Leif; Box, Neil; Carter-Journet, Katrina; DiFilippo, Denise; Harrington, Sean; Jackson, David; Lutomski, Michael

    2012-01-01

    Purpose of presentation: (1) Status update on the developing methodology to revise sub-system sparing targets. (2) To describe how to incorporate uncertainty into spare assessments and why it is important to do so (3) Demonstrate hardware risk postures through PACT evaluation

  20. [Materials and articles intended to come into contact with food: evaluation of the rapid alert system for food and feed (RASFF) 2008-2010].

    PubMed

    Baiguini, Alessandro; Colletta, Stefano; Rebella, Valentina

    2011-01-01

    For some time, packaging materials and articles intended to come into contact with food are included in the system of controls, early warnings and risk communication provided by the European Commission (EU) regulation 178/2002. Data analysis of the EU rapid alert system for food allows one to define a specific risk profile and to establish an effective plan for official control of materials intended to come into contact with food. In the 2008-2010 period the rapid alert system has ratified alert notifications, mostly related to plastic materials of Chinese origin.

  1. Police transport versus ground EMS: A trauma system-level evaluation of prehospital care policies and their effect on clinical outcomes.

    PubMed

    Wandling, Michael W; Nathens, Avery B; Shapiro, Michael B; Haut, Elliott R

    2016-11-01

    Rapid transport to definitive care ("scoop and run") versus field stabilization in trauma remains a topic of debate and has resulted in variability in prehospital policy. We aimed to identify trauma systems frequently using a true "scoop and run" police transport approach and to compare mortality rates between police and ground emergency medical services (EMS) transport. Using the National Trauma Databank (NTDB), we identified adult gunshot and stab wound patients presenting to Level 1 or 2 trauma centers from 2010 to 2012. Hospitals were grouped into their respective cities and regional trauma systems. Patients directly transported by police or ground EMS to trauma centers in the 100 most populous US trauma systems were included. Frequency of police transport was evaluated, identifying trauma systems with high utilization. Mortality rates and risk-adjusted odds ratio for mortality for police versus EMS transport were derived. Of 88,564 total patients, 86,097 (97.2%) were transported by EMS and 2,467 (2.8%) by police. Unadjusted mortality was 17.7% for police transport and 11.6% for ground EMS. After risk adjustment, patients transported by police were no more likely to die than those transported by EMS (OR = 1.00, 95% CI: 0.69-1.45). Among all police transports, 87.8% occurred in three locations (Philadelphia, Sacramento, and Detroit). Within these trauma systems, unadjusted mortality was 19.9% for police transport and 13.5% for ground EMS. Risk-adjusted mortality was no different (OR = 1.01, 95% CI: 0.68-1.50). Using trauma system-level analyses, patients with penetrating injuries in urban trauma systems were found to have similar mortality for police and EMS transport. The majority of prehospital police transport in penetrating trauma occurs in three trauma systems. These cities represent ideal sites for additional system-level evaluation of prehospital transport policies. Prognostic/epidemiologic study, level III.

  2. Research on big data risk assessment of major transformer defects and faults fusing power grid, equipment and environment based on SVM

    NASA Astrophysics Data System (ADS)

    Guo, Lijuan; Yan, Haijun; Gao, Wensheng; Chen, Yun; Hao, Yongqi

    2018-01-01

    With the development of power big data, considering the wider power system data, the appropriate large data analysis method can be used to mine the potential law and value of power big data. On the basis of considering all kinds of monitoring data and defects and fault records of main transformer, the paper integrates the power grid, equipment as well as environment data and uses SVM as the main algorithm to evaluate the risk of the main transformer. It gets and compares the evaluation results under different modes, and proves that the risk assessment algorithms and schemes have certain effectiveness. This paper provides a new idea for data fusion of smart grid, and provides a reference for further big data evaluation of power grid equipment.

  3. Forecast and virtual weather driven plant disease risk modeling system

    USDA-ARS?s Scientific Manuscript database

    We describe a system in use and development that leverages public weather station data, several spatialized weather forecast types, leaf wetness estimation, generic plant disease models, and online statistical evaluation. Convergent technological developments in all these areas allow, with funding f...

  4. INTERGENERATIONAL SEX AS A RISK FACTOR FOR HIV AMONG YOUNG MEN WHO HAVE SEX WITH MEN: A SCOPING REVIEW

    PubMed Central

    Anema, Aranka; Marshall, Brandon D.L.; Stevenson, Benjamin; Gurm, Jasmine; Montaner, Gabriela; Small, Will; Roth, Eric A.; Lima, Viviane D.; Montaner, Julio S.G.; Moore, David; Hogg, Robert S.

    2015-01-01

    An emerging body of evidence suggests that intergenerational sexual partnerships may increase risk of HIV acquisition among young men who have sex with men (YMSM). However, no studies have comprehensively evaluated literature in this area. We applied a scoping review methodology to explore the relationships between age mixing, HIV risk behavior, and HIV seroconversion among YMSM. This study identified several individual, micro-, and meso-system factors influencing HIV risk among YMSM in the context of intergenerational relationships: childhood maltreatment, coming of age and sexual identity, and substance use (individual-level factors); family and social support, partner characteristics, intimate partner violence, connectedness to gay community (micro-system factors); and race/ethnicity, economic disparity, and use of the Internet (meso-system factors). These thematic groups can be used to frame future research on the role of age-discrepant relationships on HIV risk among YMSM, and to enhance public health HIV education and prevention strategies targeting this vulnerable population. PMID:24272070

  5. Intergenerational sex as a risk factor for HIV among young men who have sex with men: a scoping review.

    PubMed

    Anema, Aranka; Marshall, Brandon D L; Stevenson, Benjamin; Gurm, Jasmine; Montaner, Gabriela; Small, Will; Roth, Eric A; Lima, Viviane D; Montaner, Julio S G; Moore, David; Hogg, Robert S

    2013-12-01

    An emerging body of evidence suggests that intergenerational sexual partnerships may increase risk of HIV acquisition among young men who have sex with men (YMSM). However, no studies have comprehensively evaluated literature in this area. We applied a scoping review methodology to explore the relationships between age mixing, HIV risk behavior, and HIV seroconversion among YMSM. This study identified several individual, micro-, and meso-system factors influencing HIV risk among YMSM in the context of intergenerational relationships: childhood maltreatment, coming of age and sexual identity, and substance use (individual-level factors); family and social support, partner characteristics, intimate partner violence, connectedness to gay community (micro-system factors); and race/ethnicity, economic disparity, and use of the Internet (meso-system factors). These thematic groups can be used to frame future research on the role of age-discrepant relationships on HIV risk among YMSM, and to enhance public health HIV education and prevention strategies targeting this vulnerable population.

  6. Toxicological Risks During Human Space Exploration

    NASA Technical Reports Server (NTRS)

    James, John T.; Limero, T. F.; Lam, C. W.; Billica, Roger (Technical Monitor)

    2000-01-01

    The goal of toxicological risk assessment of human space flight is to identify and quantify significant risks to astronaut health from air pollution inside the vehicle or habitat, and to develop a strategy for control of those risks. The approach to completing a toxicological risk assessment involves data and experience on the frequency and severity of toxicological incidents that have occurred during space flight. Control of these incidents depends on being able to understand their cause from in-flight and ground-based analysis of air samples, crew reports of air quality, and known failures in containment of toxic chemicals. Toxicological risk assessment in exploration missions must be based on an evaluation of the unique toxic hazards presented by the habitat location. For example, lunar and Martian dust must be toxicologically evaluated to determine the appropriate control measures for exploration missions. Experience with near-earth flights has shown that the toxic products from fires present the highest risk to crew health from air pollution. Systems and payload leaks also present a significant hazard. The health risk from toxicity associated with materials offgassing or accumulation of human metabolites is generally well controlled. Early tests of lunar and Martian dust simulants have shown that each posses the potential to cause fibrosis in the lung in a murine model. Toxicological risks from air pollutants in space habitats originate from many sources. A number of risks have been identified through near-earth operations; however, the evaluation of additional new risks present during exploration missions will be a challenge.

  7. SCRL-Model for Human Space Flight Operations Enterprise Supply Chain

    NASA Technical Reports Server (NTRS)

    Tucker, Brian; Paxton, Joseph

    2010-01-01

    This paper will present a Supply Chain Readiness Level (SCRL) model that can be used to evaluate and configure adaptable and sustainable program and mission supply chains at an enterprise level. It will also show that using SCRL in conjunction with Technology Readiness Levels (TRLs), Manufacturing Readiness Levels (MRLs) and National Aeronautics Space Administrations (NASA s) Project Lifecycle Process will provide a more complete means of developing and evaluating a robust sustainable supply chain that encompasses the entire product, system and mission lifecycle. In addition, it will be shown that by implementing the SCRL model, NASA can additionally define supplier requirements to enable effective supply chain management (SCM). Developing and evaluating overall supply chain readiness for any product, system and mission lifecycle is critical for mission success. Readiness levels are presently being used to evaluate the maturity of technology and manufacturing capability during development and deployment phases of products and systems. For example, TRLs are used to support the assessment of the maturity of a particular technology and compare maturity of different types of technologies. MRLs are designed to assess the maturity and risk of a given technology from a manufacturing perspective. In addition, when these measurement systems are used collectively they can offer a more comprehensive view of the maturity of the system. While some aspects of the supply chain and supply chain planning are considered in these familiar metric systems, certain characteristics of an effective supply chain, when evaluated in more detail, will provide an improved insight into the readiness and risk throughout the supply chain. Therefore, a system that concentrates particularly on supply chain attributes is required to better assess enterprise supply chain readiness.

  8. Effectiveness of Nursing Management Information Systems: A Systematic Review

    PubMed Central

    Choi, Mona; Yang, You Lee

    2014-01-01

    Objectives The purpose of this study was to review evaluation studies of nursing management information systems (NMISs) and their outcome measures to examine system effectiveness. Methods For the systematic review, a literature search of the PubMed, CINAHL, Embase, and Cochrane Library databases was conducted to retrieve original articles published between 1970 and 2014. Medical Subject Headings (MeSH) terms included informatics, medical informatics, nursing informatics, medical informatics application, and management information systems for information systems and evaluation studies and nursing evaluation research for evaluation research. Additionally, manag* and admin*, and nurs* were combined. Title, abstract, and full-text reviews were completed by two reviewers. And then, year, author, type of management system, study purpose, study design, data source, system users, study subjects, and outcomes were extracted from the selected articles. The quality and risk of bias of the studies that were finally selected were assessed with the Risk of Bias Assessment Tool for Non-randomized Studies (RoBANS) criteria. Results Out of the 2,257 retrieved articles, a total of six articles were selected. These included two scheduling programs, two nursing cost-related programs, and two patient care management programs. For the outcome measurements, usefulness, time saving, satisfaction, cost, attitude, usability, data quality/completeness/accuracy, and personnel work patterns were included. User satisfaction, time saving, and usefulness mostly showed positive findings. Conclusions The study results suggest that NMISs were effective in time saving and useful in nursing care. Because there was a lack of quality in the reviewed studies, well-designed research, such as randomized controlled trials, should be conducted to more objectively evaluate the effectiveness of NMISs. PMID:25405060

  9. Application of a hazard and operability study method to hazard evaluation of a chemical unit of the power station.

    PubMed

    Habibi, E; Zare, M; Barkhordari, A; Mirmohammadi, Sj; Halvani, Ghh

    2008-12-28

    The aim of this study was to identify the hazards, evaluate their risk factors and determine the measure for promotion of the process and reduction of accidents in the chemical unit of the power station. In this case and qualitative study, HAZOP technique was used to recognize the hazards and problems of operations on the chemical section at power station. Totally, 126 deviations were documented with various causes and consequences. Ranking and evaluation of identified risks indicate that the majority of deviations were categorized as "acceptable" and less than half of that were "unacceptable". The highest calculated risk level (1B) related to both the interruption of acid entry to the discharge pumps and an increased density of the acid. About 27% of the deviations had the lowest risk level (4B). The identification of hazards by HAZOP indicates that it could, systemically, assess and criticize the process of consumption or production of acid and alkali in the chemical unit of power plant.

  10. Tradeoffs in the Design of Health Plan Payment Systems: Fit, Power and Balance

    PubMed Central

    Geruso, Michael; McGuire, Thomas G.

    2016-01-01

    In many markets, including the new U.S. Marketplaces, health insurance plans are paid by risk-adjusted capitation, sometimes combined with reinsurance and other payment mechanisms. This paper proposes a framework for evaluating the de facto insurer incentives embedded in these complex payment systems. We discuss fit, power and balance, each of which addresses a distinct market failure in health insurance. We implement empirical metrics of fit, power, and balance in a study of Marketplace payment systems. Using data similar to that used to develop the Marketplace risk adjustment scheme, we quantify tradeoffs among the three classes of incentives. We show that an essential tradeoff arises between the goals of limiting costs and limiting cream skimming because risk adjustment, which is aimed at discouraging cream-skimming, weakens cost control incentives in practice. A simple reinsurance system scores better on our measures of fit, power and balance than the risk adjustment scheme in use in the Marketplaces. PMID:26922122

  11. Tradeoffs in the design of health plan payment systems: Fit, power and balance.

    PubMed

    Geruso, Michael; McGuire, Thomas G

    2016-05-01

    In many markets, including the new U.S. Marketplaces, health insurance plans are paid by risk-adjusted capitation, sometimes combined with reinsurance and other payment mechanisms. This paper proposes a framework for evaluating the de facto insurer incentives embedded in these complex payment systems. We discuss fit, power and balance, each of which addresses a distinct market failure in health insurance. We implement empirical metrics of fit, power, and balance in a study of Marketplace payment systems. Using data similar to that used to develop the Marketplace risk adjustment scheme, we quantify tradeoffs among the three classes of incentives. We show that an essential tradeoff arises between the goals of limiting costs and limiting cream skimming because risk adjustment, which is aimed at discouraging cream-skimming, weakens cost control incentives in practice. A simple reinsurance system scores better on our measures of fit, power and balance than the risk adjustment scheme in use in the Marketplaces. Copyright © 2016 Elsevier B.V. All rights reserved.

  12. A Methodology for Making Early Comparative Architecture Performance Evaluations

    ERIC Educational Resources Information Center

    Doyle, Gerald S.

    2010-01-01

    Complex and expensive systems' development suffers from a lack of method for making good system-architecture-selection decisions early in the development process. Failure to make a good system-architecture-selection decision increases the risk that a development effort will not meet cost, performance and schedule goals. This research provides a…

  13. 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.

  14. Cost-benefit analysis of biopsy methods for suspicious mammographic lesions; discussion 994-5.

    PubMed

    Fahy, B N; Bold, R J; Schneider, P D; Khatri, V; Goodnight, J E

    2001-09-01

    Stereotactic core biopsy (SCB) is more cost-effective than needle-localized biopsy (NLB) for evaluation and treatment of mammographic lesions. A computer-generated mathematical model was developed based on clinical outcome modeling to estimate costs accrued during evaluation and treatment of suspicious mammographic lesions. Total costs were determined for evaluation and subsequent treatment of cancer when either SCB or NLB was used as the initial biopsy method. Cost was estimated by the cumulative work relative value units accrued. The risk of malignancy based on the Breast Imaging Reporting Data System (BIRADS) score and mammographic suspicion of ductal carcinoma in situ were varied to simulate common clinical scenarios. Total cost accumulated during evaluation and subsequent surgical therapy (if required). Evaluation of BIRADS 5 lesions (highly suggestive, risk of malignancy = 90%) resulted in equivalent relative value units for both techniques (SCB, 15.54; NLB, 15.47). Evaluation of lesions highly suspicious for ductal carcinoma in situ yielded similar total treatment relative value units (SCB, 11.49; NLB, 10.17). Only for evaluation of BIRADS 4 lesions (suspicious abnormality, risk of malignancy = 34%) was SCB more cost-effective than NLB (SCB, 7.65 vs. NLB, 15.66). No difference in cost-benefit was found when lesions highly suggestive of malignancy (BIRADS 5) or those suspicious for ductal carcinoma in situ were evaluated initially with SCB vs. NLB, thereby disproving the hypothesis. Only for intermediate-risk lesions (BIRADS 4) did initial evaluation with SCB yield a greater cost savings than with NLB.

  15. A Spike Cocktail Approach to Improve Microbial Performance Monitoring for Water Reuse.

    PubMed

    Zimmerman, Brian D; Korajkic, Asja; Brinkman, Nichole E; Grimm, Ann C; Ashbolt, Nicholas J; Garland, Jay L

      Water reuse, via either centralized treatment of traditional wastewater or decentralized treatment and on-site reuse, is becoming an increasingly important element of sustainable water management. Despite advances in waterborne pathogen detection methods, low and highly variable pathogen levels limit their utility for routine evaluation of health risks in water reuse systems. Therefore, there is a need to improve our understanding of the linkage between pathogens and more readily measured process indicators during treatment. This paper describes an approach for constructing spiking experiments to relate the behavior of viral, bacterial, and protozoan pathogens with relevant process indicators. General issues are reviewed, and the spiking protocol is applied as a case study example to improve microbial performance monitoring and health risk evaluation in a water reuse system. This approach provides a foundation for the development of novel approaches to improve real or near-real time performance monitoring of water recycling systems.

  16. Assessment and uncertainty analysis of groundwater risk.

    PubMed

    Li, Fawen; Zhu, Jingzhao; Deng, Xiyuan; Zhao, Yong; Li, Shaofei

    2018-01-01

    Groundwater with relatively stable quantity and quality is commonly used by human being. However, as the over-mining of groundwater, problems such as groundwater funnel, land subsidence and salt water intrusion have emerged. In order to avoid further deterioration of hydrogeological problems in over-mining regions, it is necessary to conduct the assessment of groundwater risk. In this paper, risks of shallow and deep groundwater in the water intake area of the South-to-North Water Transfer Project in Tianjin, China, were evaluated. Firstly, two sets of four-level evaluation index system were constructed based on the different characteristics of shallow and deep groundwater. Secondly, based on the normalized factor values and the synthetic weights, the risk values of shallow and deep groundwater were calculated. Lastly, the uncertainty of groundwater risk assessment was analyzed by indicator kriging method. The results meet the decision maker's demand for risk information, and overcome previous risk assessment results expressed in the form of deterministic point estimations, which ignore the uncertainty of risk assessment. Copyright © 2017 Elsevier Inc. All rights reserved.

  17. The role of noninvasive cardiovascular testing, applied clinical nutrition and nutritional supplements in the prevention and treatment of coronary heart disease.

    PubMed

    Houston, Mark

    2018-03-01

    Numerous clinical trials suggest that we have reached a limit in our ability to decrease the incidence of coronary heart disease (CHD) and cardiovascular disease (CVD) utilizing the traditional diagnostic evaluation, prevention and treatment strategies for the top five cardiovascular risk factors of hypertension, diabetes mellitus, dyslipidemia, obesity and smoking. About 80% of heart disease (heart attacks, angina, coronary heart disease and congestive heart failure) can be prevented by optimal nutrition, optimal exercise, optimal weight and body composition, mild alcohol intake and avoiding smoking. Statistics show that approximately 50% of patients continue to have CHD or myocardial infarction (MI) despite presently defined 'normal' levels of the five risk factors listed above. This is often referred to as the 'CHD gap'. Novel and more accurate definitions and evaluations of these top five risk factors are required, such as 24 h ambulatory blood pressure (ABM) results, advanced lipid profiles, redefined fasting and 2 h dysglycemia parameters, a focus on visceral obesity and body composition and the effects of adipokines on cardiovascular risk. There are numerous traumatic insults from the environment that damage the cardiovascular system but there are only three finite vascular endothelial responses, which are inflammation, oxidative stress and immune vascular dysfunction. In addition, the concept of translational cardiovascular medicine is mandatory in order to correlate the myriad of CHD risk factors to the presence or absence of functional or structural damage to the vascular system, preclinical and clinical CHD. This can be accomplished by utilizing advanced and updated CV risk scoring systems, new and redefined CV risk factors and biomarkers, micronutrient testing, cardiovascular genetics, nutrigenomics, metabolomics, genetic expression testing and noninvasive cardiovascular testing.

  18. The role of noninvasive cardiovascular testing, applied clinical nutrition and nutritional supplements in the prevention and treatment of coronary heart disease

    PubMed Central

    Houston, Mark

    2018-01-01

    Numerous clinical trials suggest that we have reached a limit in our ability to decrease the incidence of coronary heart disease (CHD) and cardiovascular disease (CVD) utilizing the traditional diagnostic evaluation, prevention and treatment strategies for the top five cardiovascular risk factors of hypertension, diabetes mellitus, dyslipidemia, obesity and smoking. About 80% of heart disease (heart attacks, angina, coronary heart disease and congestive heart failure) can be prevented by optimal nutrition, optimal exercise, optimal weight and body composition, mild alcohol intake and avoiding smoking. Statistics show that approximately 50% of patients continue to have CHD or myocardial infarction (MI) despite presently defined ‘normal’ levels of the five risk factors listed above. This is often referred to as the ‘CHD gap’. Novel and more accurate definitions and evaluations of these top five risk factors are required, such as 24 h ambulatory blood pressure (ABM) results, advanced lipid profiles, redefined fasting and 2 h dysglycemia parameters, a focus on visceral obesity and body composition and the effects of adipokines on cardiovascular risk. There are numerous traumatic insults from the environment that damage the cardiovascular system but there are only three finite vascular endothelial responses, which are inflammation, oxidative stress and immune vascular dysfunction. In addition, the concept of translational cardiovascular medicine is mandatory in order to correlate the myriad of CHD risk factors to the presence or absence of functional or structural damage to the vascular system, preclinical and clinical CHD. This can be accomplished by utilizing advanced and updated CV risk scoring systems, new and redefined CV risk factors and biomarkers, micronutrient testing, cardiovascular genetics, nutrigenomics, metabolomics, genetic expression testing and noninvasive cardiovascular testing. PMID:29316855

  19. 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.

  20. Development of evaluation metod of flood risk in Tokyo metropolitan area

    NASA Astrophysics Data System (ADS)

    Hirano, J.; Dairaku, K.

    2012-12-01

    Flood is one of the most significant natural hazards in Japan. In particular, the Tokyo metropolitan area has been affected by several large flood disasters. Investigating potential flood risk in Tokyo metropolitan area is important for development of climate change adaptation strategy. We aim to develop a method for evaluating flood risk in Tokyo Metropolitan area by considering effect of historical land use and land cover change, socio-economic change, and climatic change. Ministry of land, infrastructure, transport and tourism in Japan published "Statistics of flood", which contains data for flood causes, number of damaged houses, area of wetted surface, and total amount of damage for each flood at small municipal level. Based on these flood data, we constructed a flood database system for Tokyo metropolitan area for the period from 1961 to 2008 by using ArcGIS software.Based on these flood data , we created flood risk curve, representing the relation ship between damage and exceedbability of flood for the period 1976-2008. Based on the flood risk cruve, we aim to evaluate potential flood risk in the Tokyo metropolitan area and clarify the cause of regional difference in flood risk at Tokyo metropolitan area by considering effect of socio-economic change and climate change

  1. Review of existing experimental approaches for the clinical evaluation of the benefits of plant food supplements on cardiovascular function.

    PubMed

    Meoni, Paolo; Restani, Patrizia; Mancama, Dalu T

    2013-06-01

    We conducted a survey of the National Centre for Biotechnology Information (NCBI) PubMed database to identify methods most commonly used for the evaluation of the effect of plant food supplements on the cardiovascular system and their relevance to the regulatory status of these products. Particularly, our search strategy was aimed at the selection of studies concerning the clinical evaluation of the beneficial effects of the most commonly studied plant food supplements acting on the cardiovascular system. Following the screening of 3839 papers for inclusion criteria, 48 published reports were retained for this review. Most studies included in this review used a double blind controlled design, and evaluated the effect of plant food supplements on individuals affected by a disease of the cardiovascular system. The majority of the studies were found to be of low methodological quality on the Jadad scale, mainly because of inadequate reporting of adverse events and of patient withdrawals. In comparison, measures used for the evaluation of benefits included mostly cardiovascular risk factors as recommended in international guidelines and in accordance with principles laid down for the evaluation of health claims in food. The risk factors most frequently evaluated belonged to the category of "lipid function and levels", "heart function" and "blood pressure". For the absolute majority of the studies, the study period did not exceed one month. This review highlights critical factors to be considered in the design of studies evaluating the health effects of plant food supplements on the cardiovascular system. Between others, the inclusion of healthy individuals, better reporting and description of the characteristics of the product used could improve the quality and relevance of these studies.

  2. Performance Monitoring: Evaluating an Organic Carbon-Limestone PRB for Treatment of Heavy Metals and Acidity

    EPA Science Inventory

    Since 2004, researchers from the U.S. EPA National Risk Management Research Laboratory (NRMRL) have annually evaluated performance of an organic carbon-limestone permeable reactive barrier (PRB) system installed in 2003 by EPA Region 6 at the Delatte Metals Superfund site in Ponc...

  3. Contract Design: Risk Management and Evaluation

    PubMed Central

    Amelung, Volker E.; Juhnke, Christin

    2018-01-01

    Introduction: Effective risk adjustment is an aspect that is more and more given weight on the background of competitive health insurance systems and vital healthcare systems. The risk structure of the providers plays a vital role in Pay for Performance. A prerequisite for optimal incentive-based service models is a (partial) dependence of the agent’s returns on the provider’s gain level. Integrated care systems as well as accountable care organisations (ACOs) in the US and similar concepts in other countries are advocated as an effective method of improving the performance of healthcare systems. These systems outline a payment and care delivery model that intends to tie provider reimbursements to predefined quality metrics. By this the total costs of care shall be reduced. Methods: Little is known about the contractual design and the main challenges of delegating “accountability” to these new kinds of organisations and/or contracts. The costs of market utilisation are highly relevant for the conception of healthcare contracts; furthermore information asymmetries and contract-specific investments are an obstacle to the efficient operation of ACOs. A comprehensive literature review on methods of designing contracts in Integrated Care was conducted. The research question in this article focuses on how reimbursement strategies, evaluation of measures and methods of risk adjustment can best be integrated in healthcare contracting. Results: Each integrated care contract includes challenges for both payers and providers without having sufficient empirical data on both sides. These challenges are clinical, administrative or financial nature. Risk adjusted contracts ensure that the reimbursement roughly matches the true costs resulting from the morbidity of a population. If reimbursement of care provider corresponds to the actual expenses for an individual/population the problem of risk selection is greatly reduced. The currently used methods of risk adjustment have widely differing model and forecast accuracy. For this reason, it is necessary to clearly regulate the method of risk adjustment in the integrated care contract. Conclusions and discussion: The series of three articles on contract design has shown that coordination and motivation problems in designing healthcare contracts cannot be solved at no-costs. Moreover, it became clear, that complete contracts in healthcare are unrealistic and that contracts do always include certain uncertainties. These are based on the risk of random, and no contracting party can control these risks completely. It is also not possible to fully integrate these risks in the contract or to eliminate these risks by the parties. PMID:29632454

  4. Evaluation of Carrying Capacity Land-Based Layout to Mitigate Flood Risk (Case Study in Tempuran Floodplain, Ponorogo Regency) Novia Lusiana1 Bambang Rahadi2 Tunggul Sutanhaji3 1Environmental and Natural Resources Management Graduate Program University of Brawijaya, Malang, Indonesia 23Laboratory of Environment and Natural Resources Engineering, Department of Agricultural Engineering, Faculty of Agricultural Technology, University of Brawijaya, Malang, Indonesia Email : novialusiana@rocketmail.com, jbrahadi@ub.ac.id, tunggulsutanhaji@yahoo.com

    NASA Astrophysics Data System (ADS)

    Lusiana, N.

    2013-12-01

    Abstract Floods haves frequently hit Indonesia and have had greater negative impacts. In Javaboth the area affected by flooding and the amount of damage caused by floods have increased. At least, five factors, affect the flooding in Indonesia, including rainfall, reduced retention capacity of the watershed, erroneous design of river channel development, silting-up of the river, and erroneous regional layout. The level of the disastrous risks can be evaluated based on the extent of the threat and susceptibility of a region. One methode for risk assessment is Geographical Information System (GIS)-based mapping. Objectives of this research are: 1) evaluating current flood risk in susceptible areas, 2) applying supported land-based layout as effort to mitigate floodrisk, and 3) evaluating floodrisk for the period 2031 in the Tempuran floodplain of Ponorogo Regency. Result show that the area categorized as high risk covers 104. 6 ha (1. 2%), moderate risk covers 2512. 9 ha (28. 4%), low risk covers 3140. 8 ha (35. 5%), and the lowest risk covers 3096. 1 (34. 9%). Using Regional Layout Design for the years 2011 - 2031, the high risk area covers 67. 9 ha (0.8%), moderate risk covers 3033 ha (34. 3%), low risk covers 2770. 8 ha (31, 3%), and the lowest risk covers 2982. 6 ha (34%). Based on supported land suitability, the high-risk areais only 2. 9 ha (0.1%), moderate risk covers of 426. 1 ha (4. 8%), low risk covers 4207. 4 ha (47. 5%), and the lowest risk covers 4218 ha (47. 6%). Flood risk can be mitigated by applying supported land-based layout as shown by the reduced high-risk area, and the fact that > 90% of the areas are categorized as low or lowest risk of disaster. Keywords : Carrying Capacity, Land Capacity, Flood Risk

  5. Performance of Cleared Blood Glucose Monitors.

    PubMed

    Klonoff, David C; Prahalad, Priya

    2015-07-01

    Cleared blood glucose monitor (BGM) systems do not always perform as accurately for users as they did to become cleared. We performed a literature review of recent publications between 2010 and 2014 that present data about the frequency of inaccurate performance using ISO 15197 2003 and ISO 15197 2013 as target standards. We performed an additional literature review of publications that present data about the clinical and economic risks of inaccurate BGMs for making treatment decisions or calibrating continuous glucose monitors (CGMs). We found 11 publications describing performance of 98 unique BGM systems. 53 of these 98 (54%) systems met ISO 15197 2003 and 31 of the 98 (32%) tested systems met ISO 15197 2013 analytical accuracy standards in all studies in which they were evaluated. Of the tested systems, 33 were identified by us as FDA-cleared. Among these FDA-cleared BGM systems, 24 out of 32 (75%) met ISO 15197 2003 and 15 out of 31 (48.3%) met ISO 15197 2013 in all studies in which they were evaluated. Among the non-FDA-cleared BGM systems, 29 of 65 (45%) met ISO 15197 2003 and 15 out of 65 (23%) met ISO 15197 2013 in all studies in which they were evaluated. It is more likely that an FDA-cleared BGM system, compared to a non-FDA-cleared BGM system, will perform according to ISO 15197 2003 (χ(2) = 6.2, df = 3, P = 0.04) and ISO 15197 2013 (χ(2) = 11.4, df = 3, P = 0.003). We identified 7 articles about clinical risks and 3 articles about economic risks of inaccurate BGMs. We conclude that a significant proportion of cleared BGMs do not perform at the level for which they were cleared or according to international standards of accuracy. Such poor performance leads to adverse clinical and economic consequences. © 2015 Diabetes Technology Society.

  6. Biomechanical considerations for abdominal loading by seat belt pretensioners.

    PubMed

    Rouhana, Stephen W; El-Jawahri, Raed E; Laituri, Tony R

    2010-11-01

    While seat belts are the most effective safety technology in vehicles today, there are continual efforts in the industry to improve their ability to reduce the risk of injury. In this paper, seat belt pretensioners and current trends towards more powerful systems were reviewed and analyzed. These more powerful systems may be, among other things, systems that develop higher belt forces, systems that remove slack from belt webbing at higher retraction speeds, or both. The analysis started with validation of the Ford Human Body Finite Element Model for use in evaluation of abdominal belt loading by pretensioners. The model was then used to show that those studies, done with lap-only belts, can be used to establish injury metrics for tests done with lap-shoulder belts. Then, previously-performed PMHS studies were used to develop AIS 2+ and AIS 3+ injury risk curves for abdominal interaction with seat belts via logistic regression and reliability analysis with interval censoring. Finally, some considerations were developed for a possible laboratory test to evaluate higher-powered pretensioners.

  7. The application of seismic risk-benefit analysis to land use planning in Taipei City.

    PubMed

    Hung, Hung-Chih; Chen, Liang-Chun

    2007-09-01

    In the developing countries of Asia local authorities rarely use risk analysis instruments as a decision-making support mechanism during planning and development procedures. The main purpose of this paper is to provide a methodology to enable planners to undertake such analyses. We illustrate a case study of seismic risk-benefit analysis for the city of Taipei, Taiwan, using available land use maps and surveys as well as a new tool developed by the National Science Council in Taiwan--the HAZ-Taiwan earthquake loss estimation system. We use three hypothetical earthquakes to estimate casualties and total and annualised direct economic losses, and to show their spatial distribution. We also characterise the distribution of vulnerability over the study area using cluster analysis. A risk-benefit ratio is calculated to express the levels of seismic risk attached to alternative land use plans. This paper suggests ways to perform earthquake risk evaluations and the authors intend to assist city planners to evaluate the appropriateness of their planning decisions.

  8. Indoor air quality investigation and health risk assessment at correctional institutions.

    PubMed

    Ofungwu, Joseph

    2005-04-01

    A comprehensive indoor air-quality (IAQ) investigation was conducted at a state correctional facility in New Jersey, USA with a lengthy history of IAQ problems. The IAQ investigation comprised preliminary indoor air screening using direct readout instrumentation, indoor air/surface wipe sampling and laboratory analysis, as well as a heating, ventilation, and air-conditioning system evaluation, and a building envelope survey. In addition to air sampling, a human health risk assessment was performed to evaluate the potential for exposure to site-related air contaminants with respect to the inmate and worker populations. The risk assessment results for the prison facility indicated the potential for significant health risks for the inmate population, possibly reflecting the effects of their confinement and extended exposure to indoor air contaminants, as compared to the prison guard and worker population. Based on the results of the risk assessment, several mitigation measures are recommended to minimize prison population health risks and improve indoor air quality at prison facilities.

  9. An exposure-based, ecology-driven framework for selection of indicator species for insecticide risk assessment

    USDA-ARS?s Scientific Manuscript database

    In the current “tiered” paradigm for evaluating risks of insecticidal products, one of the first decisions that must be made is the selection of indicator species to be used in toxicity assays. However, as yet, no formal system has been developed to determine whether proposed indicator species are r...

  10. Vocational Education in Prisons: An Investment for Yesterday's At-Risk Youth. Evaluation Report.

    ERIC Educational Resources Information Center

    Texas State Council on Vocational Education, Austin.

    The provision of secondary vocational education to adult offenders in the Texas state prison system was assessed. Discussions held with inmates established that most adult inmates are former at-risk youths who eventually dropped out of high school and who have low self-esteem and poor morale because of their frustrating educational experiences.…

  11. Assessing the importance of agricultural management practices to reduce the ecological risk of pesticides

    USDA-ARS?s Scientific Manuscript database

    The use of pesticides in agriculture, their potential to be transported beyond the intended target, and their possible risk to human and environmental health has been of public concern for many years. We utilized 5 years of field data from 3 vegetable production systems to evaluate the ability of ag...

  12. Contribution of European research to risk analysis.

    PubMed

    Boenke, A

    2001-12-01

    The European Commission's, Quality of Life Research Programme, Key Action 1-Health, Food & Nutrition is mission-oriented and aims, amongst other things, at providing a healthy, safe and high-quality food supply leading to reinforced consumer confidence in the safety, of European food. Its objectives also include the enhancing of the competitiveness of the European food supply. Key Action 1 is currently supporting a number of different types of European collaborative projects in the area of risk analysis. The objectives of these projects range from the development and validation of prevention strategies including the reduction of consumers risks; development and validation of new modelling approaches, harmonization of risk assessment principles methodologies and terminology; standardization of methods and systems used for the safety evaluation of transgenic food; providing of tools for the evaluation of human viral contamination of shellfish and quality control; new methodologies for assessing the potential of unintended effects of genetically modified (genetically modified) foods; development of a risk assessment model for Cryptosporidium parvum related to the food and water industries, to the development of a communication platform for genetically modified organism, producers, retailers, regulatory authorities and consumer groups to improve safety assessment procedures, risk management strategies and risk communication; development and validation of new methods for safety testing of transgenic food; evaluation of the safety and efficacy of iron supplementation in pregnant women, evaluation of the potential cancer-preventing activity of pro- and pre-biotic ('synbiotic') combinations in human volunteers. An overview of these projects is presented here.

  13. Decentralized domestic wastewater systems in developing countries: the case study of Harare (Zimbabwe)

    NASA Astrophysics Data System (ADS)

    Chirisa, Innocent; Bandauko, Elmond; Matamanda, Abraham; Mandisvika, Gladys

    2017-06-01

    Until recently there has been little, if any, concern over revamping let alone improving wastewater management system in Zimbabwe's urban areas given the dominance and institutionalised water-borne system. Yet, the current constraints in this system and the immensity of urbanisation in the country begs and compels planners, engineers and systems thinkers to rethink what best can work as a sustainable wastewater system. With particular reference to the ever-expanding Harare metropolitan region, this article provides an evaluative analysis on the potentiality, risks and strategies that can be adopted by Harare and its satellites in addressing the problems of the conventional wastewater management system. The suggested framework of operation is a decentralised domestic wastewater collection and treatment system which however has its own multifarious risks. Using systems dynamics conceptualisation of the potentiality, opportunities, risks and strategies, the paper seeks to model the path and outcomes of this decentralised domestic wastewater collection and treatment system and also suggests a number of policy measures and strategies that the city of Harare and its satellites can adopt.

  14. Comparison Of Intake Gate Closure Methods At Lower Granite, Little Goose, Lower Monumental, And Mcnary Dams Using Risk-Based Analysis

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

    Gore, Bryan F.; Blackburn, Tyrone R.; Heasler, Patrick G.

    2001-01-19

    The objective of this report is to compare the benefits and costs of modifications proposed for intake gate closure systems at four hydroelectric stations on the Lower Snake and Upper Columbia Rivers in the Walla Walla District that are unable to meet the COE 10-minute closure rule due to the installation of fish screens. The primary benefit of the proposed modifications is to reduce the risk of damage to the station and environs when emergency intake gate closure is required. Consequently, this report presents the results and methodology of an extensive risk analysis performed to assess the reliability of powerhousemore » systems and the costs and timing of potential damages resulting from events requiring emergency intake gate closure. As part of this analysis, the level of protection provided by the nitrogen emergency closure system was also evaluated. The nitrogen system was the basis for the original recommendation to partially disable the intake gate systems. The risk analysis quantifies this protection level.« less

  15. Performance evaluation of inpatient service in Beijing: a horizontal comparison with risk adjustment based on Diagnosis Related Groups.

    PubMed

    Jian, Weiyan; Huang, Yinmin; Hu, Mu; Zhang, Xiumei

    2009-04-30

    The medical performance evaluation, which provides a basis for rational decision-making, is an important part of medical service research. Current progress with health services reform in China is far from satisfactory, without sufficient regulation. To achieve better progress, an effective tool for evaluating medical performance needs to be established. In view of this, this study attempted to develop such a tool appropriate for the Chinese context. Data was collected from the front pages of medical records (FPMR) of all large general public hospitals (21 hospitals) in the third and fourth quarter of 2007. Locally developed Diagnosis Related Groups (DRGs) were introduced as a tool for risk adjustment and performance evaluation indicators were established: Charge Efficiency Index (CEI), Time Efficiency Index (TEI) and inpatient mortality of low-risk group cases (IMLRG), to reflect respectively work efficiency and medical service quality. Using these indicators, the inpatient services' performance was horizontally compared among hospitals. Case-mix Index (CMI) was used to adjust efficiency indices and then produce adjusted CEI (aCEI) and adjusted TEI (aTEI). Poisson distribution analysis was used to test the statistical significance of the IMLRG differences between different hospitals. Using the aCEI, aTEI and IMLRG scores for the 21 hospitals, Hospital A and C had relatively good overall performance because their medical charges were lower, LOS shorter and IMLRG smaller. The performance of Hospital P and Q was the worst due to their relatively high charge level, long LOS and high IMLRG. Various performance problems also existed in the other hospitals. It is possible to develop an accurate and easy to run performance evaluation system using Case-Mix as the tool for risk adjustment, choosing indicators close to consumers and managers, and utilizing routine report forms as the basic information source. To keep such a system running effectively, it is necessary to improve the reliability of clinical information and the risk-adjustment ability of Case-Mix.

  16. [Health-based risk adjustment. Effects and side effects].

    PubMed

    Jahn, R; Schillo, S; Wasem, J

    2012-05-01

    Numerous health systems have introduced competition between health plans while banning risk-rated premiums. Risk adjustment for health plans is introduced to reduce incentives for risk selection and to create incentives for health plans to permanently invest in care for the chronically ill. According to the international health economics state of the art, risk adjustment in the German social health insurance system has used information on health status (measured by diagnoses and drug prescriptions) on top of demographic information since 2009. In non-competitive health care systems similar mechanisms are sometimes established, e.g. to achieve an equitable distribution of resources between regions. An evaluation of the first year of health-based risk adjustment demonstrates a superior performance in comparison to the old, demographic risk adjustment. The old risk adjustment formula (without ex post high-cost pooling) showed R(2) of 5.8%, CPM of 10.4% and MAPE of 2,226 €, in contrast to the new health status-based risk adjustment formula (without cash benefit for sick allowance) which reaches R(2) 20.2%, CPM 22.5% and MAPE 1,817 €. However, to make competition between health plans functional for improvement of quality and efficiency of health care, health plans must be granted additional instruments to act as prudent buyers of health care.

  17. Multi-factor evaluation indicator method for the risk assessment of atmospheric and oceanic hazard group due to the attack of tropical cyclones

    NASA Astrophysics Data System (ADS)

    Qi, Peng; Du, Mei

    2018-06-01

    China's southeast coastal areas frequently suffer from storm surge due to the attack of tropical cyclones (TCs) every year. Hazards induced by TCs are complex, such as strong wind, huge waves, storm surge, heavy rain, floods, and so on. The atmospheric and oceanic hazards cause serious disasters and substantial economic losses. This paper, from the perspective of hazard group, sets up a multi-factor evaluation method for the risk assessment of TC hazards using historical extreme data of concerned atmospheric and oceanic elements. Based on the natural hazard dynamic process, the multi-factor indicator system is composed of nine natural hazard factors representing intensity and frequency, respectively. Contributing to the indicator system, in order of importance, are maximum wind speed by TCs, attack frequency of TCs, maximum surge height, maximum wave height, frequency of gusts ≥ Scale 8, rainstorm intensity, maximum tidal range, rainstorm frequency, then sea-level rising rate. The first four factors are the most important, whose weights exceed 10% in the indicator system. With normalization processing, all the single-hazard factors are superposed by multiplying their weights to generate a superposed TC hazard. The multi-factor evaluation indicator method was applied to the risk assessment of typhoon-induced atmospheric and oceanic hazard group in typhoon-prone southeast coastal cities of China.

  18. Preparation of a flood-risk environmental index: case study of eight townships in Changhua County, Taiwan.

    PubMed

    Peng, Szu-Hsien

    2018-02-26

    To evaluate flood-prone areas, correlation analysis of flooding factors for the quantitative evaluation of hazard degree was determined to assist in further disaster prevention management. This study used flood-prone areas in 35 villages over eight townships (Changhua, Huatan, Yuanlin, Xiushui, Puyan, Hemei, Dacun, and Erlin) in Changhua County as research samples. Linear combination was used to evaluate flood-prone environmental indices, and an expert questionnaire was designed by using the analytic hierarchy process and the Delphi method to determine the weights of factors. These factors were then used to calculate the eigenvector of a pairwise comparison matrix to obtain the weights for the risk assessment criteria. Through collection of disaster cases, with particular focus on specifically protected areas where flooding has occurred or is likely to occur, public adaptation and response capabilities were evaluated by using an interview questionnaire that contains the items of perceived disaster risk, resource acquisition capability, adaptation capability, and environment understanding and disaster prevention education. Overlays in a geographic information system were used to analyze the flood-risk degree in villages and to construct a distribution map that contains flood-prone environment indices. The results can assist local governments in understanding the risk degree of various administrative areas to aid them in developing effective mitigation plans.

  19. Evaluating the effectiveness of risk minimisation measures: the application of a conceptual framework to Danish real-world dabigatran data.

    PubMed

    Nyeland, Martin Erik; Laursen, Mona Vestergaard; Callréus, Torbjörn

    2017-06-01

    For both marketing authorization holders and regulatory authorities, evaluating the effectiveness of risk minimization measures is now an integral part of pharmacovigilance in the European Union. The overall aim of activities in this area is to assess the performance of risk minimization measures implemented in order to ensure a positive benefit-risk balance in patients treated with a medicinal product. Following a review of the relevant literature, we developed a conceptual framework consisting of four domains (data, knowledge, behaviour and outcomes) intended for the evaluation of risk minimization measures put into practice in the Danish health-care system. For the implementation of the framework, four classes of monitoring variables can be named and defined: patient descriptors, performance-related indicators of knowledge, behaviour and outcomes. We reviewed the features of the framework when applied to historical, real-world data following the introduction of dabigatran in Denmark for the prophylactic treatment of patients with non-valvular atrial fibrillation. The application of the framework provided useful graphical displays and an opportunity for a statistical evaluation (interrupted time series analysis) of a regulatory intervention. © 2017 Commonwealth of Australia. Pharmacoepidemiology & Drug Safety © 2017 John Wiley & Sons, Ltd. © 2017 Commonwealth of Australia. Pharmacoepidemiology & Drug Safety © 2017 John Wiley & Sons, Ltd.

  20. Multicriteria Decision Framework for Cybersecurity Risk Assessment and Management.

    PubMed

    Ganin, Alexander A; Quach, Phuoc; Panwar, Mahesh; Collier, Zachary A; Keisler, Jeffrey M; Marchese, Dayton; Linkov, Igor

    2017-09-05

    Risk assessors and managers face many difficult challenges related to novel cyber systems. Among these challenges are the constantly changing nature of cyber systems caused by technical advances, their distribution across the physical, information, and sociocognitive domains, and the complex network structures often including thousands of nodes. Here, we review probabilistic and risk-based decision-making techniques applied to cyber systems and conclude that existing approaches typically do not address all components of the risk assessment triplet (threat, vulnerability, consequence) and lack the ability to integrate across multiple domains of cyber systems to provide guidance for enhancing cybersecurity. We present a decision-analysis-based approach that quantifies threat, vulnerability, and consequences through a set of criteria designed to assess the overall utility of cybersecurity management alternatives. The proposed framework bridges the gap between risk assessment and risk management, allowing an analyst to ensure a structured and transparent process of selecting risk management alternatives. The use of this technique is illustrated for a hypothetical, but realistic, case study exemplifying the process of evaluating and ranking five cybersecurity enhancement strategies. The approach presented does not necessarily eliminate biases and subjectivity necessary for selecting countermeasures, but provides justifiable methods for selecting risk management actions consistent with stakeholder and decisionmaker values and technical data. Published 2017. This article is a U.S. Government work and is in the public domain in the U.S.A.

  1. Integration and Assessment of Component Health Prognostics in Supervisory Control Systems

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

    Ramuhalli, Pradeep; Bonebrake, Christopher A.; Dib, Gerges

    Enhanced risk monitors (ERMs) for active components in advanced reactor concepts use predictive estimates of component failure to update, in real time, predictive safety and economic risk metrics. These metrics have been shown to be capable of use in optimizing maintenance scheduling and managing plant maintenance costs. Integrating this information with plant supervisory control systems increases the potential for making control decisions that utilize real-time information on component conditions. Such decision making would limit the possibility of plant operations that increase the likelihood of degrading the functionality of one or more components while maintaining the overall functionality of the plant.more » ERM uses sensor data for providing real-time information about equipment condition for deriving risk monitors. This information is used to estimate the remaining useful life and probability of failure of these components. By combining this information with plant probabilistic risk assessment models, predictive estimates of risk posed by continued plant operation in the presence of detected degradation may be estimated. In this paper, we describe this methodology in greater detail, and discuss its integration with a prototypic software-based plant supervisory control platform. In order to integrate these two technologies and evaluate the integrated system, software to simulate the sensor data was developed, prognostic models for feedwater valves were developed, and several use cases defined. The full paper will describe these use cases, and the results of the initial evaluation.« less

  2. Evaluating probabilistic dengue risk forecasts from a prototype early warning system for Brazil

    PubMed Central

    Lowe, Rachel; Coelho, Caio AS; Barcellos, Christovam; Carvalho, Marilia Sá; Catão, Rafael De Castro; Coelho, Giovanini E; Ramalho, Walter Massa; Bailey, Trevor C; Stephenson, David B; Rodó, Xavier

    2016-01-01

    Recently, a prototype dengue early warning system was developed to produce probabilistic forecasts of dengue risk three months ahead of the 2014 World Cup in Brazil. Here, we evaluate the categorical dengue forecasts across all microregions in Brazil, using dengue cases reported in June 2014 to validate the model. We also compare the forecast model framework to a null model, based on seasonal averages of previously observed dengue incidence. When considering the ability of the two models to predict high dengue risk across Brazil, the forecast model produced more hits and fewer missed events than the null model, with a hit rate of 57% for the forecast model compared to 33% for the null model. This early warning model framework may be useful to public health services, not only ahead of mass gatherings, but also before the peak dengue season each year, to control potentially explosive dengue epidemics. DOI: http://dx.doi.org/10.7554/eLife.11285.001 PMID:26910315

  3. The development of a streamlined, coordinated and sustainable evaluation methodology for a diverse chronic disease management program.

    PubMed

    Berlowitz, David J; Graco, Marnie

    2010-05-01

    The Northern Alliance Hospital Admission Risk Program-Chronic Disease Management comprises 13 services delivering care to those with chronic disease and older people with complex care needs, who are frequent hospital users. To develop and implement a system-wide approach to the evaluation of this existing program. The Northern Clinical Research Centre audited all existing, routinely collected administrative data within the program and then met with each service to develop service specific outcome measures. The evaluators then developed and implemented a system-wide evaluation approach to measure performance in terms of: client profile; access and entry; service efficiency; client outcomes; and hospital demand. Data are collected electronically and more than 80% are derived from existing, administrative datasets, minimising staff and client burden. Additional data include client outcomes and a health related quality of life measure. The preliminary twelve month data suggest that clients have the equivalent of 'fair' or 'poor' self-reported health status (n = 862) and the average health utility scores are significantly (P < 0.05) worse than population control data. These analyses reveal, for the first time, that the Northern Alliance Hospital Admission Risk Program-Chronic Disease Management program is targeting appropriate clients. This methodology will enable many prospective assessments to be performed including; client outcome evaluation, service model comparisons, and cost-utility analyses. This evaluation approach demonstrates the feasibility of a highly coordinated 'whole of system' evaluation. Such an approach may ultimately contribute to the development of evidence-based policy.

  4. Cyclic subway networks are less risky in metropolises

    NASA Astrophysics Data System (ADS)

    Xiao, Ying; Zhang, Hai-Tao; Xu, Bowen; Zhu, Tao; Chen, Guanrong; Chen, Duxin

    2018-02-01

    Subways are crucial in modern transportation systems of metropolises. To quantitatively evaluate the potential risks of subway networks suffered from natural disasters or deliberate attacks, real data from seven Chinese subway systems are collected and their population distributions and anti-risk capabilities are analyzed. Counterintuitively, it is found that transfer stations with large numbers of connections are not the most crucial, but the stations and lines with large betweenness centrality are essential, if subway networks are being attacked. It is also found that cycles reduce such correlations due to the existence of alternative paths. To simulate the data-based observations, a network model is proposed to characterize the dynamics of subway systems under various intensities of attacks on stations and lines. This study sheds some light onto risk assessment of subway networks in metropolitan cities.

  5. Risk Factors for Postoperative Respiratory Mortality and Morbidity in Patients Undergoing Coronary Artery Bypass Grafting

    PubMed Central

    Rajaei, Samira; Dabbagh, Ali

    2012-01-01

    ABSTRACT Nowadays, coronary artery bypass grafting (CABG) is considered to be one of the most common surgical procedures. This procedure has been the main topic in many clinical research studies, which have assessed the effect of the procedure on patients’ outcomes. Like other surgical procedures, this procedure is also accompanied by a number of unwanted complications, including those of the respiratory system. Since the respiratory system plays an integral role in defining the clinical outcome of patients, improvements in studies that can assess and predict clinical outcomes of the respiratory system, assume greater importance. There are a number of predictive models which can assess patients in the preoperative period and introduce a number of risk factors, which could be considered as prognostic factors for patients undergoing CABG. The respiratory system is among the clinical systems that are assessed in many prediction scoring systems. This review assesses the main studies which have evaluated the possible risk factors for postoperative respiratory mortality and morbidity, in patients undergoing CABG. PMID:24223339

  6. An improved approach for flight readiness certification: Methodology for failure risk assessment and application examples. Volume 3: Structure and listing of programs

    NASA Technical Reports Server (NTRS)

    Moore, N. R.; Ebbeler, D. H.; Newlin, L. E.; Sutharshana, S.; Creager, M.

    1992-01-01

    An improved methodology for quantitatively evaluating failure risk of spaceflight systems to assess flight readiness and identify risk control measures is presented. This methodology, called Probabilistic Failure Assessment (PFA), combines operating experience from tests and flights with engineering analysis to estimate failure risk. The PFA methodology is of particular value when information on which to base an assessment of failure risk, including test experience and knowledge of parameters used in engineering analyses of failure phenomena, is expensive or difficult to acquire. The PFA methodology is a prescribed statistical structure in which engineering analysis models that characterize failure phenomena are used conjointly with uncertainties about analysis parameters and/or modeling accuracy to estimate failure probability distributions for specific failure modes. These distributions can then be modified, by means of statistical procedures of the PFA methodology, to reflect any test or flight experience. Conventional engineering analysis models currently employed for design of failure prediction are used in this methodology. The PFA methodology is described and examples of its application are presented. Conventional approaches to failure risk evaluation for spaceflight systems are discussed, and the rationale for the approach taken in the PFA methodology is presented. The statistical methods, engineering models, and computer software used in fatigue failure mode applications are thoroughly documented.

  7. Overweight and obesity prevalence among Cree youth of Eeyou Istchee according to three body mass index classification systems.

    PubMed

    St-Jean, Audray; Meziou, Salma; Ayotte, Pierre; Lucas, Michel

    2017-11-22

    Little is known about the suitability of three commonly used body mass index (BMI) classification systems for Indigenous youth. We estimated overweight and obesity prevalence among Cree youth of Eeyou Istchee according to three BMI classification systems, assessed the level of agreement between them, and evaluated their accuracy through body fat and cardiometabolic risk factors. Data on 288 youth (aged 8-17 years) were collected. Overweight and obesity prevalence were estimated with Centers for Disease Control and Prevention (CDC), International Obesity Task Force (IOTF) and World Health Organization (WHO) criteria. Agreement was measured with weighted kappa (κw). Associations with body fat and cardiometabolic risk factors were evaluated by analysis of variance. Obesity prevalence was 42.7% with IOTF, 47.2% with CDC, and 49.3% with WHO criteria. Agreement was almost perfect between IOTF and CDC (κw = 0.93), IOTF and WHO (κw = 0.91), and WHO and CDC (κw = 0.94). Means of body fat and cardiometabolic risk factors were significantly higher (P trend  < 0.001) from normal weight to obesity, regardless of the system used. Youth considered overweight by IOTF but obese by CDC or WHO exhibited less severe clinical obesity. IOTF seems to be more accurate in identifying obesity in Cree youth.

  8. A scoring system for ascertainment of incident stroke; the Risk Index Score (RISc).

    PubMed

    Kass-Hout, T A; Moyé, L A; Smith, M A; Morgenstern, L B

    2006-01-01

    The main objective of this study was to develop and validate a computer-based statistical algorithm that could be translated into a simple scoring system in order to ascertain incident stroke cases using hospital admission medical records data. The Risk Index Score (RISc) algorithm was developed using data collected prospectively by the Brain Attack Surveillance in Corpus Christi (BASIC) project, 2000. The validity of RISc was evaluated by estimating the concordance of scoring system stroke ascertainment to stroke ascertainment by physician and/or abstractor review of hospital admission records. RISc was developed on 1718 randomly selected patients (training set) and then statistically validated on an independent sample of 858 patients (validation set). A multivariable logistic model was used to develop RISc and subsequently evaluated by goodness-of-fit and receiver operating characteristic (ROC) analyses. The higher the value of RISc, the higher the patient's risk of potential stroke. The study showed RISc was well calibrated and discriminated those who had potential stroke from those that did not on initial screening. In this study we developed and validated a rapid, easy, efficient, and accurate method to ascertain incident stroke cases from routine hospital admission records for epidemiologic investigations. Validation of this scoring system was achieved statistically; however, clinical validation in a community hospital setting is warranted.

  9. Assessment and Control of Spacecraft Charging Risks on the International Space Station

    NASA Technical Reports Server (NTRS)

    Koontz, Steve; Valentine, Mark; Keeping, Thomas; Edeen, Marybeth; Spetch, William; Dalton, Penni

    2004-01-01

    The International Space Station (ISS) operates in the F2 region of Earth's ionosphere, orbiting at altitudes ranging from 350 to 450 km at an inclination of 51.6 degrees. The relatively dense, cool F2 ionospheric plasma suppresses surface charging processes much of the time, and the flux of relativistic electrons is low enough to preclude deep dielectric charging processes. The most important spacecraft charging processes in the ISS orbital environment are: 1) ISS electrical power system interactions with the F2 plasma, 2) magnetic induction processes resulting from flight through the geomagnetic field and, 3) charging processes that result from interaction with auroral electrons at high latitude. Recently, the continuing review and evaluation of putative ISS charging hazards required by the ISS Program Office revealed that ISS charging could produce an electrical shock hazard to the ISS crew during extravehicular activity (EVA). ISS charging risks are being evaluated in an ongoing measurement and analysis campaign. The results of ISS charging measurements are combined with a recently developed model of ISS charging (the Plasma Interaction Model) and an exhaustive analysis of historical ionospheric variability data (ISS Ionospheric Specification) to evaluate ISS charging risks using Probabilistic Risk Assessment (PRA) methods. The PRA combines estimates of the frequency of occurrence and severity of the charging hazards with estimates of the reliability of various hazard controls systems, as required by NASA s safety and risk management programs, to enable design and selection of a hazard control approach that minimizes overall programmatic and personnel risk. The PRA provides a quantitative methodology for incorporating the results of the ISS charging measurement and analysis campaigns into the necessary hazard reports, EVA procedures, and ISS flight rules required for operating ISS in a safe and productive manner.

  10. A near real time scenario at regional scale for the hydrogeological risk

    NASA Astrophysics Data System (ADS)

    Ponziani, F.; Stelluti, M.; Zauri, R.; Berni, N.; Brocca, L.; Moramarco, T.; Salciarini, D.; Tamagnini, C.

    2012-04-01

    The early warning systems dedicated to landslides and floods represent the Umbria Region Civil Protection Service new generation tools for hydraulic and hydrogeological risk reduction. Following past analyses performed by the Functional Centre (part of the civil protection service dedicated to the monitoring and the evaluation of natural hazards) on the relationship between saturated soil conditions and rainfall thresholds, we have developed an automated early warning system for the landslide risk, called LANDWARN, which generates daily and 72h forecast risk matrix with a dense mesh of 100 x 100m, throughout the region. The system is based on: (a) the 20 days -observed and 72h -predicted rainfall, provided by the local meteorological network and the Local scale Meteorological Model COSMO ME, (b) the assessment of the saturation of soils by: daily extraction of ASCAT satellite data, data from a network of 16 TDR sensors, and a water balance model (developed by the Research Institute for Geo-Hydrological Protection, CNR, Perugia, Italy) that allows for the prediction of a saturation index for each point of the analysis grid up to a window of 72 h, (c) a Web-GIS platform that combines the data grids of calculated hazard indicators with layers of landslide susceptibility and vulnerability of the territory, in order to produce dynamic risk scenarios. The system is still under development and it's implemented at different scales: the entire region, and a set of known high-risk landslides in Umbria. The system is monitored and regularly reviewed through the back analysis of landslide reports for which the activation date is available. Up to now, the development of the system involves: a) the improvement of the reliability assessment of the condition of soil saturation, a key parameter which is used to dynamically adjust the values of rainfall thresholds used for the declaration of levels of landslide hazard. For this purpose, a procedure was created for the ASCAT satellite data daily download, used for the derivation of a soil water content index (SWI): these data are compared with instrumental ones from the TDR stations and the results of the water balance model that evaluates the contributions of water infiltration, percolation, evapotranspiration, etc. using physically based parameters obtained through a long process of characterization of soil and rock types, for each grid point; b) The assessment of the contribution due to the melting of the snow; c) the physically based - coupling model slope stability analysis, GIS-based, developed by the Department of Civil and Environmental Engineering, University of Perugia, with the aim to introduce also the actual mechanical and physical characteristics of slopes in the analysis. As result of the system, is the daily creation of near real-time and 24, 48, 72h forecast risk scenarios, that, under the intention of the Department of Civil Protection Service, will be used by the Functional Centre for the institutional tasks of hydrogeological risk evaluation and management, but also by local Administrations involved in the monitoring and assessment of landslide risk, in order to receive feedback on the effectiveness of the scenarios produced.

  11. Amoeba-related health risk in drinking water systems: could monitoring of amoebae be a complementary approach to current quality control strategies?

    PubMed

    Codony, Francesc; Pérez, Leonardo Martín; Adrados, Bárbara; Agustí, Gemma; Fittipaldi, Mariana; Morató, Jordi

    2012-01-01

    Culture-based methods for fecal indicator microorganisms are the standard protocol to assess potential health risk from drinking water systems. However, these traditional fecal indicators are inappropriate surrogates for disinfection-resistant fecal pathogens and the indigenous pathogens that grow in drinking water systems. There is now a range of molecular-based methods, such as quantitative PCR, which allow detection of a variety of pathogens and alternative indicators. Hence, in addition to targeting total Escherichia coli (i.e., dead and alive) for the detection of fecal pollution, various amoebae may be suitable to indicate the potential presence of pathogenic amoeba-resisting microorganisms, such as Legionellae. Therefore, monitoring amoeba levels by quantitative PCR could be a useful tool for directly and indirectly evaluating health risk and could also be a complementary approach to current microbial quality control strategies for drinking water systems.

  12. Implanting inequality: empirical evidence of social and ethical risks of implantable radio-frequency identification (RFID) devices.

    PubMed

    Monahan, Torin; Fisher, Jill A

    2010-10-01

    The aim of this study was to assess empirically the social and ethical risks associated with implantable radio-frequency identification (RFID) devices. Qualitative research included observational studies in twenty-three U.S. hospitals that have implemented new patient identification systems and eighty semi-structured interviews about the social and ethical implications of new patient identification systems, including RFID implants. The study identified three primary social and ethical risks associated with RFID implants: (i) unfair prioritization of patients based on their participation in the system, (ii) diminished trust of patients by care providers, and (iii) endangerment of patients who misunderstand the capabilities of the systems. RFID implants may aggravate inequalities in access to care without any clear health benefits. This research underscores the importance of critically evaluating new healthcare technologies from the perspective of both normative ethics and empirical ethics.

  13. Integrating human and ecological risk assessment: application to the cyanobacterial harmful algal bloom problem.

    PubMed

    Orme-Zavaleta, Jennifer; Munns, Wayne R

    2008-01-01

    Environmental and public health policy continues to evolve in response to new and complex social, economic and environmental drivers. Globalization and centralization of commerce, evolving patterns of land use (e.g., urbanization, deforestation), and technological advances in such areas as manufacturing and development of genetically modified foods have created new and complex classes of stressors and risks (e.g., climate change, emergent and opportunist disease, sprawl, genomic change). In recognition of these changes, environmental risk assessment and its use are changing from stressor-endpoint specific assessments used in command and control types of decisions to an integrated approach for application in community-based decisions. As a result, the process of risk assessment and supporting risk analyses are evolving to characterize the human-environment relationship. Integrating risk paradigms combine the process of risk estimation for humans, biota, and natural resources into one assessment to improve the information used in environmental decisions (Suter et al. 2003b). A benefit to this approach includes a broader, system-wide evaluation that considers the interacting effects of stressors on humans and the environment, as well the interactions between these entities. To improve our understanding of the linkages within complex systems, risk assessors will need to rely on a suite of techniques for conducting rigorous analyses characterizing the exposure and effects relationships between stressors and biological receptors. Many of the analytical techniques routinely employed are narrowly focused and unable to address the complexities of an integrated assessment. In this paper, we describe an approach to integrated risk assessment, and discuss qualitative community modeling and Probabilistic Relational Modeling techniques that address these limitations and evaluate their potential for use in an integrated risk assessment of cyanobacteria.

  14. Approaches for grouping of pesticides into cumulative assessment groups for risk assessment of pesticide residues in food.

    PubMed

    Colnot, Thomas; Dekant, Wolfgang

    2017-02-01

    The European Food Safety Authority (EFSA) is developing approaches to cumulative risk assessment of pesticides by assigning individual pesticides to cumulative assessment groups (CAGs). For assignment to CAGs, EFSA recommended to rely on adverse effects on the specific target system. Contractors to EFSA have proposed to allocate individual pesticides into CAGs relying on NOAELs for effects on target organs. This manuscript evaluates the assignments by applying EFSAs criteria to the CAGs "Toxicity to the nervous system" and "Toxicity to the thyroid hormone system (gland or hormones)". Assignment to the CAG "Toxicity to the nervous system" based, for example, on neurochemical effects like choline esterase inhibition is well supported, whereas assignment to the CAG "Toxicity to the thyroid hormone system (gland or hormones)" has been based in the examined case studies on non-reproducible effects seen in single studies or on observations that are not adverse. Therefore, a more detailed effects evaluation is required to assign a pesticide to a CAG for a target organ where many confounders regarding effects are present. Relative potency factors in cumulative risk assessment should be based on benchmark doses from studies in one species with identical study design and human relevance of effects on specific target organs should be analyzed to define minimal margins of exposure. Copyright © 2016 The Authors. Published by Elsevier Inc. All rights reserved.

  15. Development of NASA's Accident Precursor Analysis Process Through Application on the Space Shuttle Orbiter

    NASA Technical Reports Server (NTRS)

    Maggio, Gaspare; Groen, Frank; Hamlin, Teri; Youngblood, Robert

    2010-01-01

    Accident Precursor Analysis (APA) serves as the bridge between existing risk modeling activities, which are often based on historical or generic failure statistics, and system anomalies, which provide crucial information about the failure mechanisms that are actually operative in the system. APA docs more than simply track experience: it systematically evaluates experience, looking for under-appreciated risks that may warrant changes to design or operational practice. This paper presents the pilot application of the NASA APA process to Space Shuttle Orbiter systems. In this effort, the working sessions conducted at Johnson Space Center (JSC) piloted the APA process developed by Information Systems Laboratories (ISL) over the last two years under the auspices of NASA's Office of Safety & Mission Assurance, with the assistance of the Safety & Mission Assurance (S&MA) Shuttle & Exploration Analysis Branch. This process is built around facilitated working sessions involving diverse system experts. One important aspect of this particular APA process is its focus on understanding the physical mechanism responsible for an operational anomaly, followed by evaluation of the risk significance of the observed anomaly as well as consideration of generalizations of the underlying mechanism to other contexts. Model completeness will probably always be an issue, but this process tries to leverage operating experience to the extent possible in order to address completeness issues before a catastrophe occurs.

  16. 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.

  17. ePORT, NASA's Computer Database Program for System Safety Risk Management Oversight (Electronic Project Online Risk Tool)

    NASA Technical Reports Server (NTRS)

    Johnson, Paul W.

    2008-01-01

    ePORT (electronic Project Online Risk Tool) provides a systematic approach to using an electronic database program to manage a program/project risk management processes. This presentation will briefly cover the standard risk management procedures, then thoroughly cover NASA's Risk Management tool called ePORT. This electronic Project Online Risk Tool (ePORT) is a web-based risk management program that provides a common framework to capture and manage risks, independent of a programs/projects size and budget. It is used to thoroughly cover the risk management paradigm providing standardized evaluation criterion for common management reporting, ePORT improves Product Line, Center and Corporate Management insight, simplifies program/project manager reporting, and maintains an archive of data for historical reference.

  18. Operating health analysis of electric power systems

    NASA Astrophysics Data System (ADS)

    Fotuhi-Firuzabad, Mahmud

    The required level of operating reserve to be maintained by an electric power system can be determined using both deterministic and probabilistic techniques. Despite the obvious disadvantages of deterministic approaches there is still considerable reluctance to apply probabilistic techniques due to the difficulty of interpreting a single numerical risk index and the lack of sufficient information provided by a single index. A practical way to overcome difficulties is to embed deterministic considerations in the probabilistic indices in order to monitor the system well-being. The system well-being can be designated as healthy, marginal and at risk. The concept of system well-being is examined and extended in this thesis to cover the overall area of operating reserve assessment. Operating reserve evaluation involves the two distinctly different aspects of unit commitment and the dispatch of the committed units. Unit commitment health analysis involves the determination of which unit should be committed to satisfy the operating criteria. The concepts developed for unit commitment health, margin and risk are extended in this thesis to evaluate the response well-being of a generating system. A procedure is presented to determine the optimum dispatch of the committed units to satisfy the response criteria. The impact on the response wellbeing being of variations in the margin time, required regulating margin and load forecast uncertainty are illustrated. The effects on the response well-being of rapid start units, interruptible loads and postponable outages are also illustrated. System well-being is, in general, greatly improved by interconnection with other power systems. The well-being concepts are extended to evaluate the spinning reserve requirements in interconnected systems. The interconnected system unit commitment problem is decomposed into two subproblems in which unit scheduling is performed in each isolated system followed by interconnected system evaluation. A procedure is illustrated to determine the well-being indices of the overall interconnected system. Under normal operating conditions, the system may also be able to carry a limited amount of interruptible load on top of its firm load without violating the operating criterion. An energy based approach is presented to determine the optimum interruptible load carrying capability in both the isolated and interconnected systems. Composite system spinning reserve assessment and composite system well-being are also examined in this research work. The impacts on the composite well-being of operating reserve considerations such as stand-by units, interruptible loads and the physical locations of these resources are illustrated. It is expected that the well-being framework and the concepts developed in this research work will prove extremely useful in the new competitive utility environment.

  19. Use of mechanistic simulations as a quantitative risk-ranking tool within the quality by design framework.

    PubMed

    Stocker, Elena; Toschkoff, Gregor; Sacher, Stephan; Khinast, Johannes G

    2014-11-20

    The purpose of this study is to evaluate the use of computer simulations for generating quantitative knowledge as a basis for risk ranking and mechanistic process understanding, as required by ICH Q9 on quality risk management systems. In this specific publication, the main focus is the demonstration of a risk assessment workflow, including a computer simulation for the generation of mechanistic understanding of active tablet coating in a pan coater. Process parameter screening studies are statistically planned under consideration of impacts on a potentially critical quality attribute, i.e., coating mass uniformity. Based on computer simulation data the process failure mode and effects analysis of the risk factors is performed. This results in a quantitative criticality assessment of process parameters and the risk priority evaluation of failure modes. The factor for a quantitative reassessment of the criticality and risk priority is the coefficient of variation, which represents the coating mass uniformity. The major conclusion drawn from this work is a successful demonstration of the integration of computer simulation in the risk management workflow leading to an objective and quantitative risk assessment. Copyright © 2014. Published by Elsevier B.V.

  20. Need for, and financial feasibility of, satellite-aided land mobile communications

    NASA Technical Reports Server (NTRS)

    Castruccio, P. A.; Marantz, C. S.; Freibaum, J.

    1982-01-01

    Questions regarding the role of a mobile-satellite system in augmenting the terrestrial communications system are considered, and a market assessment study is discussed. Aspects of an investment analysis are examined, taking into account a three phase financial study of four postulated land Mobile Satellite Service (LMSS) systems, project profitability evaluation methods, risk analysis methods, financial projections, potential investor acceptance standards, and a risk analysis. It is concluded that a satellite augmented terrestrial mobile service appears to be economically and technically superior to a service depending exclusively on terrestrial systems. The interest in the Mobile Satellite Service is found to be worldwide, and the ground equipment market is potentially large.

  1. Musculoskeletal system pain and related factors in mothers of children with cerebral palsy.

    PubMed

    Terzi, Rabia; Tan, Gülten

    2016-01-01

    The aim of the present study was to identify prevalence of musculoskeletal system diseases and related factors among mothers of children with cerebral palsy. Eighty-five mothers of children with cerebral palsy were included as the treatment group, and 42 mothers of healthy children were included as the control group. Sociodemographic characteristics of all subjects were recorded. Musculoskeletal system pain was evaluated by the standardized Nordic Musculoskeletal Questionnaire, and level of depression was evaluated according to Beck's Depression Scale. Musculoskeletal system pain and depression scores of the treatment group were significantly higher than those of the control group. Most frequently reported by mothers in the treatment group was low back pain (44.7%). In multiple regression analysis, number of children, age, and functional level of the child with cerebral palsy, as well as depression level of the mother were identified as independent risk factors for musculoskeletal system pain. Mothers of children with cerebral palsy are at higher risk for musculoskeletal system pain and depression. Prevalence of musculoskeletal system pain in these mothers, especially those with older children who have lower functional statuses, should be kept in mind.

  2. Using a quantitative risk register to promote learning from a patient safety reporting system.

    PubMed

    Mansfield, James G; Caplan, Robert A; Campos, John S; Dreis, David F; Furman, Cathie

    2015-02-01

    Patient safety reporting systems are now used in most health care delivery organizations. These systems, such as the one in use at Virginia Mason (Seattle) since 2002, can provide valuable reports of risk and harm from the front lines of patient care. In response to the challenge of how to quantify and prioritize safety opportunities, a risk register system was developed and implemented. Basic risk register concepts were refined to provide a systematic way to understand risks reported by staff. The risk register uses a comprehensive taxonomy of patient risk and algorithmically assigns each patient safety report to 1 of 27 risk categories in three major domains (Evaluation, Treatment, and Critical Interactions). For each category, a composite score was calculated on the basis of event rate, harm, and cost. The composite scores were used to identify the "top five" risk categories, and patient safety reports in these categories were analyzed in greater depth to find recurrent patterns of risk and associated opportunities for improvement. The top five categories of risk were easy to identify and had distinctive "profiles" of rate, harm, and cost. The ability to categorize and rank risks across multiple dimensions yielded insights not previously available. These results were shared with leadership and served as input for planning quality and safety initiatives. This approach provided actionable input for the strategic planning process, while at the same time strengthening the Virginia Mason culture of safety. The quantitative patient safety risk register serves as one solution to the challenge of extracting valuable safety lessons from large numbers of incident reports and could profitably be adopted by other organizations.

  3. Influence of socioeconomic status on trauma center performance evaluations in a Canadian trauma system.

    PubMed

    Moore, Lynne; Turgeon, Alexis F; Sirois, Marie-Josée; Murat, Valérie; Lavoie, André

    2011-09-01

    Trauma center performance evaluations generally include adjustment for injury severity, age, and comorbidity. However, disparities across trauma centers may be due to other differences in source populations that are not accounted for, such as socioeconomic status (SES). We aimed to evaluate whether SES influences trauma center performance evaluations in an inclusive trauma system with universal access to health care. The study was based on data collected between 1999 and 2006 in a Canadian trauma system. Patient SES was quantified using an ecologic index of social and material deprivation. Performance evaluations were based on mortality adjusted using the Trauma Risk Adjustment Model. Agreement between performance results with and without additional adjustment for SES was evaluated with correlation coefficients. The study sample comprised a total of 71,784 patients from 48 trauma centers, including 3,828 deaths within 30 days (4.5%) and 5,549 deaths within 6 months (7.7%). The proportion of patients in the highest quintile of social and material deprivation varied from 3% to 43% and from 11% to 90% across hospitals, respectively. The correlation between performance results with or without adjustment for SES was almost perfect (r = 0.997; 95% CI 0.995-0.998) and the same hospital outliers were identified. We observed an important variation in SES across trauma centers but no change in risk-adjusted mortality estimates when SES was added to adjustment models. Results suggest that after adjustment for injury severity, age, comorbidity, and transfer status, disparities in SES across trauma center source populations do not influence trauma center performance evaluations in a system offering universal health coverage. Copyright © 2011 American College of Surgeons. Published by Elsevier Inc. All rights reserved.

  4. Retrospective Evaluation of Safety, Efficacy and Risk Factors for Pneumothorax in Simultaneous Localizations of Multiple Pulmonary Nodules Using Hook Wire System.

    PubMed

    Zhong, Yan; Xu, Xiao-Quan; Pan, Xiang-Long; Zhang, Wei; Xu, Hai; Yuan, Mei; Kong, Ling-Yan; Pu, Xue-Hui; Chen, Liang; Yu, Tong-Fu

    2017-09-01

    To evaluate the safety and efficacy of the hook wire system in the simultaneous localizations for multiple pulmonary nodules (PNs) before video-assisted thoracoscopic surgery (VATS), and to clarify the risk factors for pneumothorax associated with the localization procedure. Between January 2010 and February 2016, 67 patients (147 nodules, Group A) underwent simultaneous localizations for multiple PNs using a hook wire system. The demographic, localization procedure-related information and the occurrence rate of pneumothorax were assessed and compared with a control group (349 patients, 349 nodules, Group B). Multivariate logistic regression analyses were used to determine the risk factors for pneumothorax during the localization procedure. All the 147 nodules were successfully localized. Four (2.7%) hook wires dislodged before VATS procedure, but all these four lesions were successfully resected according to the insertion route of hook wire. Pathological diagnoses were acquired for all 147 nodules. Compared with Group B, Group A demonstrated significantly longer procedure time (p < 0.001) and higher occurrence rate of pneumothorax (p = 0.019). Multivariate logistic regression analysis indicated that position change during localization procedure (OR 2.675, p = 0.021) and the nodules located in the ipsilateral lung (OR 9.404, p < 0.001) were independent risk factors for pneumothorax. Simultaneous localizations for multiple PNs using a hook wire system before VATS procedure were safe and effective. Compared with localization for single PN, simultaneous localizations for multiple PNs were prone to the occurrence of pneumothorax. Position change during localization procedure and the nodules located in the ipsilateral lung were independent risk factors for pneumothorax.

  5. Evaluation of biologic occupational risk control practices: quality indicators development and validation.

    PubMed

    Takahashi, Renata Ferreira; Gryschek, Anna Luíza F P L; Izumi Nichiata, Lúcia Yasuko; Lacerda, Rúbia Aparecida; Ciosak, Suely Itsuko; Gir, Elucir; Padoveze, Maria Clara

    2010-05-01

    There is growing demand for the adoption of qualification systems for health care practices. This study is aimed at describing the development and validation of indicators for evaluation of biologic occupational risk control programs. The study involved 3 stages: (1) setting up a research team, (2) development of indicators, and (3) validation of the indicators by a team of specialists recruited to validate each attribute of the developed indicators. The content validation method was used for the validation, and a psychometric scale was developed for the specialists' assessment. A consensus technique was used, and every attribute that obtained a Content Validity Index of at least 0.75 was approved. Eight indicators were developed for the evaluation of the biologic occupational risk prevention program, with emphasis on accidents caused by sharp instruments and occupational tuberculosis prevention. The indicators included evaluation of the structure, process, and results at the prevention and biologic risk control levels. The majority of indicators achieved a favorable consensus regarding all validated attributes. The developed indicators were considered validated, and the method used for construction and validation proved to be effective. Copyright (c) 2010 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Mosby, Inc. All rights reserved.

  6. Evaluation of Ecotoxicological Risks Related to the Discharge of Combined Sewer Overflows (CSOs) in a Periurban River

    PubMed Central

    Angerville, Ruth; Perrodin, Yves; Bazin, Christine; Emmanuel, Evens

    2013-01-01

    Discharges of Combined Sewer Overflows (CSOs) into periurban rivers present risks for the concerned aquatic ecosystems. In this work, a specific ecotoxicological risk assessment methodology has been developed as management tool to municipalities equipped with CSOs. This methodology comprises a detailed description of the spatio-temporal system involved, the choice of ecological targets to be preserved, and carrying out bioassays adapted to each compartment of the river receiving CSOs. Once formulated, this methodology was applied to a river flowing through the outskirts of the city of Lyon in France. The results obtained for the scenario studied showed a moderate risk for organisms of the water column and a major risk for organisms of the benthic and hyporheic zones of the river. The methodology enabled identifying the critical points of the spatio-temporal systems studied, and then making proposals for improving the management of CSOs. PMID:23812025

  7. Principles of Pharmacology and Toxicology Also Govern Effects of Chemicals on the Endocrine System.

    PubMed

    Autrup, Herman; Barile, Frank A; Blaauboer, Bas J; Degen, Gisela H; Dekant, Wolfgang; Dietrich, Daniel; Domingo, Jose L; Gori, Gio Batta; Greim, Helmuth; Hengstler, Jan G; Kacew, Sam; Marquardt, Hans; Pelkonen, Olavi; Savolainen, Kai; Vermeulen, Nico P

    2015-07-01

    The present debate on chemicals with Hormonal activity, often termed 'endocrine disruptors', is highly controversial and includes challenges of the present paradigms used in toxicology and in hazard identification and risk characterization. In our opinion, chemicals with hormonal activity can be subjected to the well-evaluated health risk characterization approach used for many years including adverse outcome pathways. Many of the points arguing for a specific approach for risk characterization of chemicals with hormonal activity are based on highly speculative conclusions. These conclusions are not well supported when evaluating the available information. © The Author 2015. Published by Oxford University Press on behalf of the Society of Toxicology. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

  8. DNT DATA CALL-IN FOR ORGANO PHOSPHATES

    EPA Science Inventory

    Product: Developmental neurotoxicity (DNT) and age-comparative cholinesterase data. Activity: Individual pesticide hazard characterizations and risk assessments, including FQPA factor determinations. The need for evaluation of nervous system development follow...

  9. A framework and case studies for evaluation of enzyme ontogeny in children's health risk evaluation.

    PubMed

    Ginsberg, Gary; Vulimiri, Suryanarayana V; Lin, Yu-Sheng; Kancherla, Jayaram; Foos, Brenda; Sonawane, Babasaheb

    2017-01-01

    Knowledge of the ontogeny of Phase I and Phase II metabolizing enzymes may be used to inform children's vulnerability based upon likely differences in internal dose from xenobiotic exposure. This might provide a qualitative assessment of toxicokinetic (TK) variability and uncertainty pertinent to early lifestages and help scope a more quantitative physiologically based toxicokinetic (PBTK) assessment. Although much is known regarding the ontogeny of metabolizing systems, this is not commonly utilized in scoping and problem formulation stage of human health risk evaluation. A framework is proposed for introducing this information into problem formulation which combines data on enzyme ontogeny and chemical-specific TK to explore potential child/adult differences in internal dose and whether such metabolic differences may be important factors in risk evaluation. The framework is illustrated with five case study chemicals, including some which are data rich and provide proof of concept, while others are data poor. Case studies for toluene and chlorpyrifos indicate potentially important child/adult TK differences while scoping for acetaminophen suggests enzyme ontogeny is unlikely to increase early-life risks. Scoping for trichloroethylene and aromatic amines indicates numerous ways that enzyme ontogeny may affect internal dose which necessitates further evaluation. PBTK modeling is a critical and feasible next step to further evaluate child-adult differences in internal dose for a number of these chemicals.

  10. Risk assessing study for Bio-CCS technology

    NASA Astrophysics Data System (ADS)

    Tanaka, A.; Sakamoto, Y.; Kano, Y.; Higashino, H.; Suzumura, M.; Tosha, T.; Nakao, S.; Komai, T.

    2013-12-01

    We have started a new R&D project titled 'Energy resources creation by geo-microbes and CCS'. It is new concept of a technology which cultivate methanogenic geo-microbes in reservoirs of geological CCS conditions to produce methane gas effectively and safely. As one of feasibility studies, we are evaluating risks around its new Bio-CCS technology. Our consideration involves risk scenarios about Bio-CCS in geological strata, marine environment, surface facilities, ambient air and injection sites. To cover risk scenarios in these areas, we are carrying out a sub-project with five sub-themes. Four sub-themes out of five are researches for identifying risk scenarios: A) Underground strata and injection well, B) Ambient air, C) Surface facilities and D) Seabed. We are developing risk assessment tool,named GERAS-CO2GS (Geo-environmental Risk Assessment System,CO2 Geological Storage Risk Assessment System. We are going to combine identified risk scenarios into GERAS-CO2GS accordingly. It is expected that new GERAS-CO2GS will contribute to risk assessment and management for not only Bio-CCS but also individual injection sites, and facilitate under standing of risks among legislators and concerned peoples around injection site.

  11. Evaluation of the cost-effectiveness of bovine brucellosis surveillance in a disease-free country using stochastic scenario tree modelling.

    PubMed

    Hénaux, Viviane; Calavas, Didier

    2017-01-01

    Surveillance systems of exotic infectious diseases aim to ensure transparency about the country-specific animal disease situation (i.e. demonstrate disease freedom) and to identify any introductions. In a context of decreasing resources, evaluation of surveillance efficiency is essential to help stakeholders make relevant decisions about prioritization of measures and funding allocation. This study evaluated the efficiency (sensitivity related to cost) of the French bovine brucellosis surveillance system using stochastic scenario tree models. Cattle herds were categorized into three risk groups based on the annual number of purchases, given that trading is considered as the main route of brucellosis introduction in cattle herds. The sensitivity in detecting the disease and the costs of the current surveillance system, which includes clinical (abortion) surveillance, programmed serological testing and introduction controls, were compared to those of 19 alternative surveillance scenarios. Surveillance costs included veterinary fees and laboratory analyses. The sensitivity over a year of the current surveillance system was predicted to be 91±7% at a design prevalence of 0.01% for a total cost of 14.9±1.8 million €. Several alternative surveillance scenarios, based on clinical surveillance and random or risk-based serological screening in a sample (20%) of the population, were predicted to be at least as sensitive but for a lower cost. Such changes would reduce whole surveillance costs by 20 to 61% annually, and the costs for farmers only would be decreased from about 12.0 million € presently to 5.3-9.0 million € (i.e. 25-56% decrease). Besides, fostering the evolution of the surveillance system in one of these directions would be in agreement with the European regulations and farmers perceptions on brucellosis risk and surveillance.

  12. Evaluation of the cost-effectiveness of bovine brucellosis surveillance in a disease-free country using stochastic scenario tree modelling

    PubMed Central

    Calavas, Didier

    2017-01-01

    Surveillance systems of exotic infectious diseases aim to ensure transparency about the country-specific animal disease situation (i.e. demonstrate disease freedom) and to identify any introductions. In a context of decreasing resources, evaluation of surveillance efficiency is essential to help stakeholders make relevant decisions about prioritization of measures and funding allocation. This study evaluated the efficiency (sensitivity related to cost) of the French bovine brucellosis surveillance system using stochastic scenario tree models. Cattle herds were categorized into three risk groups based on the annual number of purchases, given that trading is considered as the main route of brucellosis introduction in cattle herds. The sensitivity in detecting the disease and the costs of the current surveillance system, which includes clinical (abortion) surveillance, programmed serological testing and introduction controls, were compared to those of 19 alternative surveillance scenarios. Surveillance costs included veterinary fees and laboratory analyses. The sensitivity over a year of the current surveillance system was predicted to be 91±7% at a design prevalence of 0.01% for a total cost of 14.9±1.8 million €. Several alternative surveillance scenarios, based on clinical surveillance and random or risk-based serological screening in a sample (20%) of the population, were predicted to be at least as sensitive but for a lower cost. Such changes would reduce whole surveillance costs by 20 to 61% annually, and the costs for farmers only would be decreased from about 12.0 million € presently to 5.3–9.0 million € (i.e. 25–56% decrease). Besides, fostering the evolution of the surveillance system in one of these directions would be in agreement with the European regulations and farmers perceptions on brucellosis risk and surveillance. PMID:28859107

  13. Evaluation of performance of footwear and flooring systems in combination with personnel using voltage probability analysis

    NASA Astrophysics Data System (ADS)

    Smallwood, Jeremy; Swenson, David E.

    2011-06-01

    Evaluation of electrostatic performance of footwear and flooring in combination is necessary in applications such as electrostatic discharge (ESD) control in electronics manufacture, evaluation of equipment for avoidance of factory process electrostatic ignition risks and avoidance of electrostatic shocks to personnel in working environments. Typical standards use a walking test in which the voltage produced on a subject is evaluated by identification and measurement of the magnitude of the 5 highest "peaks" and "valleys" of the recorded voltage waveform. This method does not lend itself to effective analysis of the risk that the voltage will exceed a hazard threshold. This paper shows the advantages of voltage probability analysis and recommends that the method is adopted for use in future standards.

  14. Evaluation of an Innovative Post-Arrest Diversion Program: 12-Month Recidivism Analysis

    ERIC Educational Resources Information Center

    Dembo, Richard; Walters, Wansley; Wareham, Jennifer; Burgos, Catherimarty; Schmeidler, James; Hoge, Robert; Underwood, Lee

    2008-01-01

    We report the results of an evaluation study of a diversion program, operated by the Miami-Dade County Juvenile Assessment Center in Florida. The Post-Arrest Diversion (PAD) program represents an innovative approach to treatment and intervention within the juvenile justice system that utilizes standardized psychosocial risks and needs assessment…

  15. 78 FR 15931 - Sunshine Act Meeting; Request for Comments on Draft Evaluation of Recommended Practice on Fatigue...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-03-13

    ... Evaluation of Recommended Practice on Fatigue Risk Management Systems for Personnel in the Refining and... and Health Administration: 2001-05-I-DE-1 (Process Safety Management coverage of atmospheric storage tanks); 2005-04-I-TX-9 (Process Safety Management requirement for organizational management of change...

  16. Advanced Booster Composite Case/Polybenzimidazole Nitrile Butadiene Rubber Insulation Development

    NASA Technical Reports Server (NTRS)

    Gentz, Steve; Taylor, Robert; Nettles, Mindy

    2015-01-01

    The NASA Engineering and Safety Center (NESC) was requested to examine processing sensitivities (e.g., cure temperature control/variance, debonds, density variations) of polybenzimidazole nitrile butadiene rubber (PBI-NBR) insulation, case fiber, and resin systems and to evaluate nondestructive evaluation (NDE) and damage tolerance methods/models required to support human-rated composite motor cases. The proposed use of composite motor cases in Blocks IA and II was expected to increase performance capability through optimizing operating pressure and increasing propellant mass fraction. This assessment was to support the evaluation of risk reduction for large booster component development/fabrication, NDE of low mass-to-strength ratio material structures, and solid booster propellant formulation as requested in the Space Launch System NASA Research Announcement for Advanced Booster Engineering Demonstration and/or Risk Reduction. Composite case materials and high-energy propellants represent an enabling capability in the Agency's ability to provide affordable, high-performing advanced booster concepts. The NESC team was requested to provide an assessment of co- and multiple-cure processing of composite case and PBI-NBR insulation materials and evaluation of high-energy propellant formulations.

  17. Chronic Obstructive Pulmonary Disease and Health-Related Quality of Life in the 2009 Texas Behavioral Risk Factor Survey

    ERIC Educational Resources Information Center

    Jackson, Bradford E.; Suzuki, Sumihiro; Coultas, David; Singh, Karan P.; Bae, Sejong

    2013-01-01

    Introduction: Individuals with chronic obstructive pulmonary disease (COPD) experience irreversible airflow obstruction, dyspnea, coughing, and fatigue. One of the goals of treating individuals with COPD is to improve their quality of life. The aim of this research was to evaluate the 2009 Texas Behavioral Risk Factor Surveillance System (BRFSS)…

  18. Structural reliability assessment capability in NESSUS

    NASA Technical Reports Server (NTRS)

    Millwater, H.; Wu, Y.-T.

    1992-01-01

    The principal capabilities of NESSUS (Numerical Evaluation of Stochastic Structures Under Stress), an advanced computer code developed for probabilistic structural response analysis, are reviewed, and its structural reliability assessed. The code combines flexible structural modeling tools with advanced probabilistic algorithms in order to compute probabilistic structural response and resistance, component reliability and risk, and system reliability and risk. An illustrative numerical example is presented.

  19. Structural reliability assessment capability in NESSUS

    NASA Astrophysics Data System (ADS)

    Millwater, H.; Wu, Y.-T.

    1992-07-01

    The principal capabilities of NESSUS (Numerical Evaluation of Stochastic Structures Under Stress), an advanced computer code developed for probabilistic structural response analysis, are reviewed, and its structural reliability assessed. The code combines flexible structural modeling tools with advanced probabilistic algorithms in order to compute probabilistic structural response and resistance, component reliability and risk, and system reliability and risk. An illustrative numerical example is presented.

  20. Outcome and prognostic factors in critically ill patients with systemic lupus erythematosus: a retrospective study.

    PubMed

    Hsu, Chia-Lin; Chen, Kuan-Yu; Yeh, Pu-Sheng; Hsu, Yeong-Long; Chang, Hou-Tai; Shau, Wen-Yi; Yu, Chia-Li; Yang, Pan-Chyr

    2005-06-01

    Systemic lupus erythematosus (SLE) is an archetypal autoimmune disease, involving multiple organ systems with varying course and prognosis. However, there is a paucity of clinical data regarding prognostic factors in SLE patients admitted to the intensive care unit (ICU). From January 1992 to December 2000, all patients admitted to the ICU with a diagnosis of SLE were included. Patients were excluded if the diagnosis of SLE was established at or after ICU admission. A multivariate logistic regression model was applied using Acute Physiology and Chronic Health Evaluation II scores and variables that were at least moderately associated (P < 0.2) with survival in the univariate analysis. A total of 51 patients meeting the criteria were included. The mortality rate was 47%. The most common cause of admission was pneumonia with acute respiratory distress syndrome. Multivariate logistic regression analysis showed that intracranial haemorrhage occurring while the patient was in the ICU (relative risk = 18.68), complicating gastrointestinal bleeding (relative risk = 6.97) and concurrent septic shock (relative risk = 77.06) were associated with greater risk of dying, whereas causes of ICU admission and Acute Physiology and Chronic Health Evaluation II score were not significantly associated with death. The mortality rate in critically ill SLE patients was high. Gastrointestinal bleeding, intracranial haemorrhage and septic shock were significant prognostic factors in SLE patients admitted to the ICU.

  1. [Multicriteria evaluation of environmental risk exposure using a geographic information system in Argentina].

    PubMed

    Pietri, Diana De; Dietrich, Patricia; Mayo, Patricia; Carcagno, Alejandro

    2011-10-01

    Develop a spatial model that includes environmental factors posing a health hazard, for application in the Matanza-Riachuelo River Basin (MRB) in Argentina. Multicriteria evaluation procedures were used with geographic information systems to obtain territorial zoning based on the degree of suitability for residence. Variables that characterize the habitability of housing and potential sources of basin pollution were geographically referenced. Health information was taken from the Risk Factor Survey (RFS) to measure the relative risk of living in unsuitable areas (exposed population) compared with suitable areas (unexposed population). Sixty percent of the MRB area is in suitable condition, a situation that affects 40% of residents. The rest of the population lives in unsuitable territory, and 6% live in the basin's most unsuitable conditions. Environmental conditions that are detrimental to health in the unsuitable areas became evident during the interviews through three of the pathologies considered: diarrheal diseases, respiratory diseases, and cancer. A regional analysis that provides valid information to support decisionmaking was obtained. Considering the basin as a unit of analysis allowed the use of a single protocol to undertake comprehensive measurement of the magnitude of risk and, thus, set priorities.

  2. Application and Evaluation of Control Modes for Risk-Based Engine Performance Enhancements

    NASA Technical Reports Server (NTRS)

    Liu, Yuan; Litt, Jonathan S.; Sowers, T. Shane; Owen, A. Karl (Compiler); Guo, Ten-Huei

    2014-01-01

    The engine control system for civil transport aircraft imposes operational limits on the propulsion system to ensure compliance with safety standards. However, during certain emergency situations, aircraft survivability may benefit from engine performance beyond its normal limits despite the increased risk of failure. Accordingly, control modes were developed to improve the maximum thrust output and responsiveness of a generic high-bypass turbofan engine. The algorithms were designed such that the enhanced performance would always constitute an elevation in failure risk to a consistent predefined likelihood. This paper presents an application of these risk-based control modes to a combined engine/aircraft model. Through computer and piloted simulation tests, the aim is to present a notional implementation of these modes, evaluate their effects on a generic airframe, and demonstrate their usefulness during emergency flight situations. Results show that minimal control effort is required to compensate for the changes in flight dynamics due to control mode activation. The benefits gained from enhanced engine performance for various runway incursion scenarios are investigated. Finally, the control modes are shown to protect against potential instabilities during propulsion-only flight where all aircraft control surfaces are inoperable.

  3. Application and Evaluation of Control Modes for Risk-Based Engine Performance Enhancements

    NASA Technical Reports Server (NTRS)

    Liu, Yuan; Litt, Jonathan S.; Sowers, T. Shane; Owen, A. Karl; Guo, Ten-Huei

    2015-01-01

    The engine control system for civil transport aircraft imposes operational limits on the propulsion system to ensure compliance with safety standards. However, during certain emergency situations, aircraft survivability may benefit from engine performance beyond its normal limits despite the increased risk of failure. Accordingly, control modes were developed to improve the maximum thrust output and responsiveness of a generic high-bypass turbofan engine. The algorithms were designed such that the enhanced performance would always constitute an elevation in failure risk to a consistent predefined likelihood. This paper presents an application of these risk-based control modes to a combined engine/aircraft model. Through computer and piloted simulation tests, the aim is to present a notional implementation of these modes, evaluate their effects on a generic airframe, and demonstrate their usefulness during emergency flight situations. Results show that minimal control effort is required to compensate for the changes in flight dynamics due to control mode activation. The benefits gained from enhanced engine performance for various runway incursion scenarios are investigated. Finally, the control modes are shown to protect against potential instabilities during propulsion-only flight where all aircraft control surfaces are inoperable.

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

    Hattemer-Frey, H.A.; Brandt, E.J.; Travis, C.C.

    Commercial genetic engineering is advancing into areas that require the small-scale introduction of genetically engineered microorganisms (GEMs) to better quantify variables that affect microorganism distribution and survival and to document potential long-term consequences. A recombinant DNA marker system, the lacZY marker, developed by the Monsanto Agricultural Co., enables the distribution and fate of marked fluorescent pseudomonad organisms to be monitored under actual field conditions. Critical evaluation of GEMs under field conditions is imperative if plant-beneficial effects are to be correlated with organism release. This paper evaluates the effectiveness of this marker system and its ability to facilitate the assessment ofmore » risks associated with deliberate environmental introductions of genetically engineered microorganisms. Results of prerelease contained growth chamber and field experiments demonstrated that: (1) the scientific risk assessment methodology adopted by Monsanto and approved by the U.S. Environmental Protection Agency was appropriate and comprehensive; (2) the deliberate introduction of a GEM did not pose unacceptable or unforeseen risks to human health or the environment; (3) the lacZY marker is an effective environmental tracking tool; and (4) regulatory oversight should reflect the expected risk and not be excessively burdensome for all GEMs.« less

  5. Neural mechanisms underlying urgent and evaluative behaviors: An fMRI study on the interaction of automatic and controlled processes.

    PubMed

    Megías, Alberto; Navas, Juan Francisco; Petrova, Dafina; Cándido, Antonio; Maldonado, Antonio; Garcia-Retamero, Rocio; Catena, Andrés

    2015-08-01

    Dual-process theories have dominated the study of risk perception and risk-taking over the last two decades. However, there is a lack of objective brain-level evidence supporting the two systems of processing in every-day risky behavior. To address this issue, we propose the dissociation between evaluative and urgent behaviors as evidence of dual processing in risky driving situations. Our findings show a dissociation of evaluative and urgent behavior both at the behavioral and neural level. fMRI data showed an increase of activation in areas implicated in motor programming, emotional processing, and visuomotor integration in urgent behavior compared to evaluative behavior. These results support a more automatic processing of risk in urgent tasks, relying mainly on heuristics and experiential appraisal. The urgent task, which is characterized by strong time pressure and the possibility for negative consequences among others factors, creates a suitable context for the experiential-affective system to guide the decision-making process. Moreover, we observed greater frontal activation in the urgent task, suggesting the participation of cognitive control in safe behaviors. The findings of this research are relevant for the study of the neural mechanisms underlying dual process models in risky perception and decision-making, especially because of their proximity to everyday activities. © 2015 Wiley Periodicals, Inc.

  6. Reliability and cost evaluation of small isolated power systems containing photovoltaic and wind energy

    NASA Astrophysics Data System (ADS)

    Karki, Rajesh

    Renewable energy application in electric power systems is growing rapidly worldwide due to enhanced public concerns for adverse environmental impacts and escalation in energy costs associated with the use of conventional energy sources. Photovoltaics and wind energy sources are being increasingly recognized as cost effective generation sources. A comprehensive evaluation of reliability and cost is required to analyze the actual benefits of utilizing these energy sources. The reliability aspects of utilizing renewable energy sources have largely been ignored in the past due the relatively insignificant contribution of these sources in major power systems, and consequently due to the lack of appropriate techniques. Renewable energy sources have the potential to play a significant role in the electrical energy requirements of small isolated power systems which are primarily supplied by costly diesel fuel. A relatively high renewable energy penetration can significantly reduce the system fuel costs but can also have considerable impact on the system reliability. Small isolated systems routinely plan their generating facilities using deterministic adequacy methods that cannot incorporate the highly erratic behavior of renewable energy sources. The utilization of a single probabilistic risk index has not been generally accepted in small isolated system evaluation despite its utilization in most large power utilities. Deterministic and probabilistic techniques are combined in this thesis using a system well-being approach to provide useful adequacy indices for small isolated systems that include renewable energy. This thesis presents an evaluation model for small isolated systems containing renewable energy sources by integrating simulation models that generate appropriate atmospheric data, evaluate chronological renewable power outputs and combine total available energy and load to provide useful system indices. A software tool SIPSREL+ has been developed which generates risk, well-being and energy based indices to provide realistic cost/reliability measures of utilizing renewable energy. The concepts presented and the examples illustrated in this thesis will help system planners to decide on appropriate installation sites, the types and mix of different energy generating sources, the optimum operating policies, and the optimum generation expansion plans required to meet increasing load demands in small isolated power systems containing photovoltaic and wind energy sources.

  7. Things That Go "Bump": in the Virtual Night.

    ERIC Educational Resources Information Center

    Fore, Julie A.

    1997-01-01

    Introduces concepts of server security and includes articles and sidebars of firsthand accounts of consequences of not devoting enough time to security measures. Outlines the following factors to consider when evaluating a server's risk potential: confidentiality/reproducibility of the data; complexity of the system; backup system and hardware…

  8. Implementing an Inpatient Social Early Warning System for Child Maltreatment

    ERIC Educational Resources Information Center

    Atabaki, Armita; Heddaeus, Daniela; Metzner, Franka; Schulz, Holger; Siefert, Sonke; Pawils, Silke

    2013-01-01

    Objectives: The current article describes the process evaluation of a social early warning system (SEWS) for the prevention of child maltreatment in the federal state of Hamburg. This prevention initiative targets expectant mothers and their partners including an initial screening of risk factors for child maltreatment, a subsequent structured…

  9. 77 FR 40863 - Privacy Act of 1974; System of Records

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-07-11

    ... DEPARTMENT OF DEFENSE Office of the Secretary [Docket ID: DOD-2012-OS-0085] Privacy Act of 1974... Register Liaison Officer, Department of Defense. QNRO-31 System name: Software Security Risk Evaluations... the Department of Defense; DoDD 5240.2, DoD Counterintelligence (CI); DoDI 5240.8, Security...

  10. Deep learning in breast cancer risk assessment: evaluation of fine-tuned convolutional neural networks on a clinical dataset of FFDMs

    NASA Astrophysics Data System (ADS)

    Li, Hui; Mendel, Kayla R.; Lee, John H.; Lan, Li; Giger, Maryellen L.

    2018-02-01

    We evaluated the potential of deep learning in the assessment of breast cancer risk using convolutional neural networks (CNNs) fine-tuned on full-field digital mammographic (FFDM) images. This study included 456 clinical FFDM cases from two high-risk datasets: BRCA1/2 gene-mutation carriers (53 cases) and unilateral cancer patients (75 cases), and a low-risk dataset as the control group (328 cases). All FFDM images (12-bit quantization and 100 micron pixel) were acquired with a GE Senographe 2000D system and were retrospectively collected under an IRB-approved, HIPAA-compliant protocol. Regions of interest of 256x256 pixels were selected from the central breast region behind the nipple in the craniocaudal projection. VGG19 pre-trained on the ImageNet dataset was used to classify the images either as high-risk or as low-risk subjects. The last fully-connected layer of pre-trained VGG19 was fine-tuned on FFDM images for breast cancer risk assessment. Performance was evaluated using the area under the receiver operating characteristic (ROC) curve (AUC) in the task of distinguishing between high-risk and low-risk subjects. AUC values of 0.84 (SE=0.05) and 0.72 (SE=0.06) were obtained in the task of distinguishing between the BRCA1/2 gene-mutation carriers and low-risk women and between unilateral cancer patients and low-risk women, respectively. Deep learning with CNNs appears to be able to extract parenchymal characteristics directly from FFDMs which are relevant to the task of distinguishing between cancer risk populations, and therefore has potential to aid clinicians in assessing mammographic parenchymal patterns for cancer risk assessment.

  11. Global computer-assisted appraisal of osteoporosis risk in Asian women: an innovative study.

    PubMed

    Chang, Shu F; Hong, Chin M; Yang, Rong S

    2011-05-01

    To develop a computer-assisted appraisal system of osteoporosis that can predict osteoporosis health risk in community-dwelling women and to use it in an empirical analysis of the risk in Asian women. As the literature indicates, health risk assessment tools are generally applied in clinical practice for patient diagnosis. However, few studies have explored how to assist community-dwelling women to understand the risk of osteoporosis without invasive data. A longitudinal, evidence-based study. The first stage of this study is to establish a system that combines expertise in nursing, medicine and information technology. This part includes information from random samples (n = 700), including data on bone mineral density, osteoporosis risk factors, knowledge, beliefs and behaviour, which are used as the health risk appraisal system database. The second stage is to apply an empirical study. The relative risks of osteoporosis of the participants (n = 300) were determined with the system. The participants that were classified as at-risk were randomly grouped into experimental and control groups. Each group was treated using different nursing intervention methods. The sensitivity and specificity of the analytical tools was 75%. In empirical study, analysis results indicate that the prevalence of osteoporosis was 14.0%. Data indicate that strategic application of multiple nursing interventions can promote osteoporosis prevention knowledge in high-risk women and enhance the effectiveness of preventive action. The system can also provide people in remote areas or with insufficient medical resources a simple and effective means of managing health risk and implement the idea of self-evaluation and self-caring among community-dwelling women at home to achieve the final goal of early detection and early treatment of osteoporosis. This study developed a useful approach for providing Asia women with a reliable, valid, convenient and economical self-health management model. Health care professionals can explore the use of advanced information systems and nursing interventions to increase the effectiveness of osteoporosis prevention programmes for women. © 2011 Blackwell Publishing Ltd.

  12. A System of Systems (SoS) Approach to Sustainable Energy Planning

    NASA Astrophysics Data System (ADS)

    Madani, Kaveh; Hadian, Saeed

    2015-04-01

    The general policy of mandating fossil fuel replacement with "green" energies may not be as effective and environmental-friendly as perceived, due to the secondary impacts of renewable energies on different natural resources. An integrated systems analysis framework is essential to developing sustainable energy supply systems with minimal unintended impacts on valuable natural resources such as water, climate, and ecosystem. This presentation discusses how a system of systems (SoS) framework can be developed to quantitatively evaluate the desirability of different energy supply alternatives with respect to different sustainability criteria under uncertainty. Relative Aggregate Footprint (RAF) scores of a range of renewable and nonrenewable energy alternatives are determined using their performance values under four sustainability criteria, namely carbon footprint, water footprint, land footprint, and cost of energy production. Our results suggest that despite their lower emissions, some renewable energy sources are less promising than non-renewable energy sources from a SoS perspective that considers the trade-offs between carbon footprint of energies and their effects on water, ecosystem, and economic resources. A new framework based on the Modern Portfolio Theory (MPT) is also proposed for analyzing the overall sustainability of different energy mixes for different risk of return levels with respect to the trade-offs involved. It is discussed how the proposed finance-based sustainability evaluation method can help policy makers maximize the energy portfolio's expected sustainability for a given amount of portfolio risk, or equivalently minimize risk for a given level of expected sustainability level, by revising the energy mix.

  13. European solvent industry group generic exposure scenario risk and exposure tool

    PubMed Central

    Zaleski, Rosemary T; Qian, Hua; Zelenka, Michael P; George-Ares, Anita; Money, Chris

    2014-01-01

    The European Solvents Industry Group (ESIG) Generic Exposure Scenario (GES) Risk and Exposure Tool (EGRET) was developed to facilitate the safety evaluation of consumer uses of solvents, as required by the European Union Registration, Evaluation and Authorization of Chemicals (REACH) Regulation. This exposure-based risk assessment tool provides estimates of both exposure and risk characterization ratios for consumer uses. It builds upon the consumer portion of the European Center for Ecotoxicology and Toxicology of Chemicals (ECETOC) Targeted Risk Assessment (TRA) tool by implementing refinements described in ECETOC TR107. Technical enhancements included the use of additional data to refine scenario defaults and the ability to include additional parameters in exposure calculations. Scenarios were also added to cover all frequently encountered consumer uses of solvents. The TRA tool structure was modified to automatically determine conditions necessary for safe use. EGRET reports results using specific standard phrases in a format consistent with REACH exposure scenario guidance, in order that the outputs can be readily assimilated within safety data sheets and similar information technology systems. Evaluation of tool predictions for a range of commonly encountered consumer uses of solvents found it provides reasonable yet still conservative exposure estimates. PMID:23361440

  14. Determination of Radioactive Risks Associated with the Operation of a Nuclear Plant; EVALUATION DES RISQUES RADIOACTIFS LIES AU FONTIONNEMENT D'UNE INSTALLATION NUCLEAIRE

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

    Laie, J.M.; Doury, A.

    1960-01-01

    Numerous problems which are posed by the evaluation of the radioactive risks linked to the working of a nuclear plant are new problems that have not yet been satisfactorily solved. In these conditions this study must be considered only as a preliminary approach whose essential aims include development and synthesis of the existing data and rapid determination of conservative and usable orders of greatness for the security factors, both for normal working and in the case of an accident. The most probable typical accidents are reviewed together with the nature of the resulting risks and the principal factors on whichmore » these risks depend. Among these factors, one of the most important is atmospheric diffusion, which is studied in some detail using the analytic model by Sutton. A logical graphical presentation is made, increasing ths flexibility in the use of the results and presenting the responsible authorities with a flexible, practical, and rapid means of evaluating the risks involved starting from a sufficiently general system of initial and simultaneously valid conditions (types of accident, atmospheric conditions). (auth)« less

  15. European solvent industry group generic exposure scenario risk and exposure tool.

    PubMed

    Zaleski, Rosemary T; Qian, Hua; Zelenka, Michael P; George-Ares, Anita; Money, Chris

    2014-01-01

    The European Solvents Industry Group (ESIG) Generic Exposure Scenario (GES) Risk and Exposure Tool (EGRET) was developed to facilitate the safety evaluation of consumer uses of solvents, as required by the European Union Registration, Evaluation and Authorization of Chemicals (REACH) Regulation. This exposure-based risk assessment tool provides estimates of both exposure and risk characterization ratios for consumer uses. It builds upon the consumer portion of the European Center for Ecotoxicology and Toxicology of Chemicals (ECETOC) Targeted Risk Assessment (TRA) tool by implementing refinements described in ECETOC TR107. Technical enhancements included the use of additional data to refine scenario defaults and the ability to include additional parameters in exposure calculations. Scenarios were also added to cover all frequently encountered consumer uses of solvents. The TRA tool structure was modified to automatically determine conditions necessary for safe use. EGRET reports results using specific standard phrases in a format consistent with REACH exposure scenario guidance, in order that the outputs can be readily assimilated within safety data sheets and similar information technology systems. Evaluation of tool predictions for a range of commonly encountered consumer uses of solvents found it provides reasonable yet still conservative exposure estimates.

  16. Addressing Risk Assessment for Patient Safety in Hospitals through Information Extraction in Medical Reports

    NASA Astrophysics Data System (ADS)

    Proux, Denys; Segond, Frédérique; Gerbier, Solweig; Metzger, Marie Hélène

    Hospital Acquired Infections (HAI) is a real burden for doctors and risk surveillance experts. The impact on patients' health and related healthcare cost is very significant and a major concern even for rich countries. Furthermore required data to evaluate the threat is generally not available to experts and that prevents from fast reaction. However, recent advances in Computational Intelligence Techniques such as Information Extraction, Risk Patterns Detection in documents and Decision Support Systems allow now to address this problem.

  17. Final Environmental Assessment of the Joint Air-to-Surface Stand-Off Missile (JASSM) Development and Evaluation Testing, White Sands Missile Range, New Mexico

    DTIC Science & Technology

    2001-12-01

    Explosive Test Site Program Definition and Risk Reduction Permissible Exposure Limit Program Executive Office Propellants, Explosives, and...each test vehicle is flown in the captive mode and critical systems are functioned to further remove risk of failure due to the flight environment...of other inferior missiles would require a larger number of missiles, at increased procurement costs and risk to aircraft and crew, in order to

  18. Evaluation systems for clinical governance development: a comparative study.

    PubMed

    Hooshmand, Elaheh; Tourani, Sogand; Ravaghi, Hamid; Ebrahimipour, Hossein

    2014-01-01

    Lack of scientific and confirmed researches and expert knowledge about evaluation systems for clinical governance development in Iran have made studies on different evaluation systems for clinical governance development a necessity. These studies must provide applied strategies to design criteria of implementing clinical governance for hospital's accreditation. This is a descriptive and comparative study on development of clinical governance models all over the world. Data have been gathered by reviewing related articles. Models have been studied in comprehensive review method. The evaluated models of clinical governance development were Australian, NHS, SPOCK and OPTIGOV. The final aspects extracted from these models were Responsiveness, Policies and Strategies, Organizational Structure, Allocating Resources, Education and Occupational Development, Performance Evaluation, External Evaluation, Patient Oriented Approach, Risk Management, Personnel's Participation, Information Technology, Human Resources, Research and Development, Evidence Based Medicine, Clinical Audit, Health Technology Assessment and Quality. These results are applicable for completing the present criteria which evaluating clinical governance application and provide practical framework to evaluate country's hospital on the basis of clinical governance elements.

  19. Evaluating the Cost, Safety, and Proliferation Risks of Small Floating Nuclear Reactors.

    PubMed

    Ford, Michael J; Abdulla, Ahmed; Morgan, M Granger

    2017-11-01

    It is hard to see how our energy system can be decarbonized if the world abandons nuclear power, but equally hard to introduce the technology in nonnuclear energy states. This is especially true in countries with limited technical, institutional, and regulatory capabilities, where safety and proliferation concerns are acute. Given the need to achieve serious emissions mitigation by mid-century, and the multidecadal effort required to develop robust nuclear governance institutions, we must look to other models that might facilitate nuclear plant deployment while mitigating the technology's risks. One such deployment paradigm is the build-own-operate-return model. Because returning small land-based reactors containing spent fuel is infeasible, we evaluate the cost, safety, and proliferation risks of a system in which small modular reactors are manufactured in a factory, and then deployed to a customer nation on a floating platform. This floating small modular reactor would be owned and operated by a single entity and returned unopened to the developed state for refueling. We developed a decision model that allows for a comparison of floating and land-based alternatives considering key International Atomic Energy Agency plant-siting criteria. Abandoning onsite refueling is beneficial, and floating reactors built in a central facility can potentially reduce the risk of cost overruns and the consequences of accidents. However, if the floating platform must be built to military-grade specifications, then the cost would be much higher than a land-based system. The analysis tool presented is flexible, and can assist planners in determining the scope of risks and uncertainty associated with different deployment options. © 2017 Society for Risk Analysis.

  20. CXCL4 in undifferentiated connective tissue disease at risk for systemic sclerosis (SSc) (previously referred to as very early SSc).

    PubMed

    Valentini, Gabriele; Riccardi, Antonella; Vettori, Serena; Irace, Rosaria; Iudici, Michele; Tolone, Salvatore; Docimo, Ludovico; Bocchino, Marialuisa; Sanduzzi, Alessandro; Cozzolino, Domenico

    2017-08-01

    The aim of the study was to evaluate CXCL4 levels in undifferentiated connective tissue disease at risk for SSc (UCTD-SSc-risk) and confirm its increase and investigate its prognostic value. Serum CXCL4 levels were measured in 45 patients and 24 controls. CXCL4 was significantly higher in UCTD-SSc-risk patients than in controls. It resulted higher in patients with a shorter disease duration and in those lacking capillaroscopic alterations. We confirm that CXCL4 levels are increased in UCTD-risk-SSc patients. Further studies are needed to investigate the role of CXCL4 assessment in UCTD-risk-SSc.

  1. The application of risk management in sport.

    PubMed

    Fuller, Colin; Drawer, Scott

    2004-01-01

    The process of risk management can be implemented as part of a best practice management system within the sport and leisure sector. The process enables risk factors that might lead to injuries to be identified and the levels of risk associated with activities to be estimated and evaluated. This information can be utilised proactively by sports governing bodies and participants to identify preventive and therapeutic interventions in order to reduce the frequency of occurrence and/or severity of injuries within their sports. The acceptability of risk within specific sports, however, is dependent on the perceptions of the participants involved. Copyright 2004 Adis Data Information BV

  2. Manned Versus Unmanned Risk and Complexity Considerations for Future Midsized X-Planes

    NASA Technical Reports Server (NTRS)

    Lechniak, Jason A.; Melton, John E.

    2017-01-01

    The objective of this work was to identify and estimate complexity and risks associated with the development and testing of new low-cost medium-scale X-plane aircraft primarily focused on air transport operations. Piloting modes that were evaluated for this task were manned, remotely piloted, and unmanned flight research programs. This analysis was conducted early in the data collection period for X-plane concept vehicles before preliminary designs were complete. Over 50 different aircraft and system topics were used to evaluate the three piloting control modes. Expert group evaluations from a diverse set of pilots, engineers, and other experts at Aeronautics Research Mission Directorate centers within the National Aeronautics and Space Administration provided qualitative reasoning on the many issues surrounding the decisions regarding piloting modes. The group evaluations were numerically rated to evaluate each topic quantitatively and were used to provide independent criteria for vehicle complexity and risk. An Edwards Air Force Base instruction document was identified that emerged as a source of the effects found in our qualitative and quantitative data. The study showed that a manned aircraft was the best choice to align with test activities for transport aircraft flight research from a low-complexity and low-risk perspective. The study concluded that a manned aircraft option would minimize the risk and complexity to improve flight-test efficiency and bound the cost of the flight-test portion of the program. Several key findings and discriminators between the three modes are discussed in detail.

  3. Evaluation of an inpatient fall risk screening tool to identify the most critical fall risk factors in inpatients.

    PubMed

    Hou, Wen-Hsuan; Kang, Chun-Mei; Ho, Mu-Hsing; Kuo, Jessie Ming-Chuan; Chen, Hsiao-Lien; Chang, Wen-Yin

    2017-03-01

    To evaluate the accuracy of the inpatient fall risk screening tool and to identify the most critical fall risk factors in inpatients. Variations exist in several screening tools applied in acute care hospitals for examining risk factors for falls and identifying high-risk inpatients. Secondary data analysis. A subset of inpatient data for the period from June 2011-June 2014 was extracted from the nursing information system and adverse event reporting system of an 818-bed teaching medical centre in Taipei. Data were analysed using descriptive statistics, receiver operating characteristic curve analysis and logistic regression analysis. During the study period, 205 fallers and 37,232 nonfallers were identified. The results revealed that the inpatient fall risk screening tool (cut-off point of ≥3) had a low sensitivity level (60%), satisfactory specificity (87%), a positive predictive value of 2·0% and a negative predictive value of 99%. The receiver operating characteristic curve analysis revealed an area under the curve of 0·805 (sensitivity, 71·8%; specificity, 78%). To increase the sensitivity values, the Youden index suggests at least 1·5 points to be the most suitable cut-off point for the inpatient fall risk screening tool. Multivariate logistic regression analysis revealed a considerably increased fall risk in patients with impaired balance and impaired elimination. The fall risk factor was also significantly associated with days of hospital stay and with admission to surgical wards. The findings can raise awareness about the two most critical risk factors for falls among future clinical nurses and other healthcare professionals and thus facilitate the development of fall prevention interventions. This study highlights the needs for redefining the cut-off points of the inpatient fall risk screening tool to effectively identify inpatients at a high risk of falls. Furthermore, inpatients with impaired balance and impaired elimination should be closely monitored by nurses to prevent falling during hospitalisations. © 2016 John Wiley & Sons Ltd.

  4. Interdependencies and Risks at the Nexus of Energy, Water, and Land Systems

    NASA Astrophysics Data System (ADS)

    Geernaert, G. L.

    2016-12-01

    During recent years, the federal agencies have rallied around efforts to understand and predict the interdependencies involving various combinations of energy infrastructure and supply, water supply and quality, and land use that combines agriculture and food production. The US Department of Energy has, in particular, focused on the energy-water nexus, with specific goals to understand the degree of interdependence that leads to multi-sector risk and, in the worst case, the precursors that can lead to cascading failure. Determining thresholds for system interdependence, evaluating the impact of drought on systems, and planning for robust mitigation options to avert future risks, are among DOE's highest research priorities. In this presentation, the DOE program plan and its rationale will be described; and the DOE plan will be placed in context of broader efforts across the federal government.

  5. The PRESSCA operational early warning system for landslide forecasting: the 11-12 November 2013 rainfall event in Central Italy.

    NASA Astrophysics Data System (ADS)

    Ciabatta, Luca; Brocca, Luca; Ponziani, Francesco; Berni, Nicola; Stelluti, Marco; Moramarco, Tommaso

    2014-05-01

    The Umbria Region, located in Central Italy, is one of the most landslide risk prone area in Italy, almost yearly affected by landslides events at different spatial scales. For early warning procedures aimed at the assessment of the hydrogeological risk, the rainfall thresholds represent the main tool for the Italian Civil Protection System. As shown in previous studies, soil moisture plays a key-role in landslides triggering. In fact, acting on the pore water pressure, soil moisture influences the rainfall amount needed for activating a landslide. In this work, an operational physically-based early warning system, named PRESSCA, that takes into account soil moisture for the definition of rainfall thresholds is presented. Specifically, the soil moisture conditions are evaluated in PRESSCA by using a distributed soil water balance model that is recently coupled with near real-time satellite soil moisture product obtained from ASCAT (Advanced SCATterometer) and from in-situ monitoring data. The integration of three different sources of soil moisture information allows to estimate the most accurate possible soil moisture condition. Then, both observed and forecasted rainfall data are compared with the soil moisture-based thresholds in order to obtain risk indicators over a grid of ~ 5 km. These indicators are then used for the daily hydrogeological risk evaluation and management by the Civil Protection regional service, through the sharing/delivering of near real-time landslide risk scenarios (also through an open source web platform: www.cfumbria.it). On the 11th-12th November, 2013, Umbria Region was hit by an exceptional rainfall event with up to 430mm/72hours that resulted in significant economic damages, but fortunately no casualties among the population. In this study, the results during the rainfall event of PRESSCA system are described, by underlining the model capability to reproduce, two days in advance, landslide risk scenarios in good spatial and temporal agreement with the occurred actual conditions. High-resolution risk scenarios (100mx100m), obtained by coupling PRESSCA forecasts with susceptibility and vulnerability layers, are also produced. The results show good relationship between the PRESSCA forecast and the reported landslides to the Civil Protection Service during the rainfall event, confirming the system robustness. The good forecasts of PRESSCA system have surely contributed to start well in advance the Civil Protection operations (alerting local authorities and population).

  6. Lymphohaematopoietic system cancer incidence in an urban area near a coke oven plant: an ecological investigation

    PubMed Central

    Parodi, S; Vercelli, M; Stella, A; Stagnaro, E; Valerio, F

    2003-01-01

    Aims: To evaluate the incidence risk of lymphohaematopoietic cancers for the 1986–94 period in Cornigliano, a district of Genoa (Italy), where a coke oven is located a few hundred metres from the residential area. Methods: The whole of Genoa and one of its 25 districts (Rivarolo) were selected as controls. The trend of risk around the coke oven was evaluated via Stone's method, while the geographic pattern of such risks across the Cornigliano district was evaluated by computing full Bayes estimates of standardised incidence ratio (FBE-SIR). Results: In males, elevated relative risks (RR) were observed for all lymphohaematopoietic cancers (RR 1.7 v Rivarolo and 1.6 v Genoa), for NHL (RR 2.4 v Rivarolo and 1.7 v Genoa), and for leukaemia (RR 2.4 v Rivarolo and 1.9 v Genoa). In females, statistically non-significant RR were observed. In males no excess of risk was found close to the coke oven. In females, a rising risk for NHL was observed approaching the plant, although statistical significance was not reached, while the risk for leukaemia was not evaluable due to the small number of cases. Analysis of the geographic pattern of risk suggested the presence of a cluster of NHL in both sexes in the eastern part of the district, where a foundry had been operational until the early 1980s. A cluster of leukaemia cases was observed in males in a northern part of the area, where no major sources of benzene seemed to be present. Conclusions: The estimated risks seem to be slightly or not at all related to the distance from the coke oven. The statistically significant higher risks observed in males for NHL and leukaemia, and the clusters of leukaemia in males and of NHL in both sexes deserve further investigations in order to trace the exposures associated with such risks. PMID:12598665

  7. Joint Aspiration (Arthrocentesis)

    MedlinePlus

    ... arthritis, or JRA), systemic lupus erythematosus (SLE), and Lyme disease. Joint aspiration is diagnostic but it also can ... topic for: Parents Kids Teens Evaluate Your Child's Lyme Disease Risk Living With Lupus Bones, Muscles, and Joints ...

  8. The reliability-quality relationship for quality systems and quality risk management.

    PubMed

    Claycamp, H Gregg; Rahaman, Faiad; Urban, Jason M

    2012-01-01

    Engineering reliability typically refers to the probability that a system, or any of its components, will perform a required function for a stated period of time and under specified operating conditions. As such, reliability is inextricably linked with time-dependent quality concepts, such as maintaining a state of control and predicting the chances of losses from failures for quality risk management. Two popular current good manufacturing practice (cGMP) and quality risk management tools, failure mode and effects analysis (FMEA) and root cause analysis (RCA) are examples of engineering reliability evaluations that link reliability with quality and risk. Current concepts in pharmaceutical quality and quality management systems call for more predictive systems for maintaining quality; yet, the current pharmaceutical manufacturing literature and guidelines are curiously silent on engineering quality. This commentary discusses the meaning of engineering reliability while linking the concept to quality systems and quality risk management. The essay also discusses the difference between engineering reliability and statistical (assay) reliability. The assurance of quality in a pharmaceutical product is no longer measured only "after the fact" of manufacturing. Rather, concepts of quality systems and quality risk management call for designing quality assurance into all stages of the pharmaceutical product life cycle. Interestingly, most assays for quality are essentially static and inform product quality over the life cycle only by being repeated over time. Engineering process reliability is the fundamental concept that is meant to anticipate quality failures over the life cycle of the product. Reliability is a well-developed theory and practice for other types of manufactured products and manufacturing processes. Thus, it is well known to be an appropriate index of manufactured product quality. This essay discusses the meaning of reliability and its linkages with quality systems and quality risk management.

  9. A genetic fuzzy system for unstable angina risk assessment.

    PubMed

    Dong, Wei; Huang, Zhengxing; Ji, Lei; Duan, Huilong

    2014-02-18

    Unstable Angina (UA) is widely accepted as a critical phase of coronary heart disease with patients exhibiting widely varying risks. Early risk assessment of UA is at the center of the management program, which allows physicians to categorize patients according to the clinical characteristics and stratification of risk and different prognosis. Although many prognostic models have been widely used for UA risk assessment in clinical practice, a number of studies have highlighted possible shortcomings. One serious drawback is that existing models lack the ability to deal with the intrinsic uncertainty about the variables utilized. In order to help physicians refine knowledge for the stratification of UA risk with respect to vagueness in information, this paper develops an intelligent system combining genetic algorithm and fuzzy association rule mining. In detail, it models the input information's vagueness through fuzzy sets, and then applies a genetic fuzzy system on the acquired fuzzy sets to extract the fuzzy rule set for the problem of UA risk assessment. The proposed system is evaluated using a real data-set collected from the cardiology department of a Chinese hospital, which consists of 54 patient cases. 9 numerical patient features and 17 categorical patient features that appear in the data-set are selected in the experiments. The proposed system made the same decisions as the physician in 46 (out of a total of 54) tested cases (85.2%). By comparing the results that are obtained through the proposed system with those resulting from the physician's decision, it has been found that the developed model is highly reflective of reality. The proposed system could be used for educational purposes, and with further improvements, could assist and guide young physicians in their daily work.

  10. First Evaluation of a Contingency Management Intervention Addressing Adolescent Substance Use and Sexual Risk Behaviors: Risk Reduction Therapy for Adolescents.

    PubMed

    Letourneau, Elizabeth J; McCart, Michael R; Sheidow, Ashli J; Mauro, Pia M

    2017-01-01

    There is a need for interventions that comprehensively address youth substance use disorders (SUD) and sexual risk behaviors. Risk Reduction Therapy for Adolescents (RRTA) adapts a validated family-focused intervention for youth SUD to include sexual risk reduction components in a single intervention. In this first evaluation of RRTA, drug court involved youth were randomly assigned to RRTA (N=45) or usual services (US; N=60) and followed through 12-months post-baseline. RRTA included weekly cognitive behavior therapy and behavior management training and contingency-contracting with a point earning system managed by caregivers targeting drug use and sexual risk antecedents. Longitudinal models estimated within-group change and between-group differences through 6- and 12-month follow-up on outcomes for substance use, sexual risk behaviors, and protective HIV behaviors. Robust effects of the intervention were not detected under conditions of the study that included potent background interventions by the juvenile drug court. Considerations about future development and testing of sexual risk reduction therapy for youth are discussed, including the potential role of contingency management in future interventions. Copyright © 2016 Elsevier Inc. All rights reserved.

  11. First Evaluation of a Contingency Management Intervention Addressing Adolescent Substance Use and Sexual Risk Behaviors: Risk Reduction Therapy for Adolescents

    PubMed Central

    Letourneau, Elizabeth J.; McCart, Michael R.; Sheidow, Ashli J.; Mauro, Pia M.

    2016-01-01

    There is a need for interventions that comprehensively address youth substance use disorders (SUD) and sexual risk behaviors. Risk Reduction Therapy for Adolescents (RRTA) adapts a validated family-focused intervention for youth SUD to include sexual risk reduction components in a single intervention. In this first evaluation of RRTA, drug court involved youth were randomly assigned to RRTA (N = 45) or usual services (US; N = 60) and followed through 12-months post-baseline. RRTA included weekly cognitive behavior therapy and behavior management training and contingency-contracting with a point earning system managed by caregivers targeting drug use and sexual risk antecedents. Longitudinal models estimated within-group change and between-group differences through 6- and 12-month follow-up on outcomes for substance use, sexual risk behaviors, and protective HIV behaviors. Robust effects of the intervention were not detected under conditions of the study that included potent background interventions by the juvenile drug court. Considerations about future development and testing of sexual risk reduction therapy for youth are discussed, including the potential role of contingency management in future interventions. PMID:27629581

  12. Health Risk Assessment of Ambient Air Concentrations of Benzene, Toluene and Xylene (BTX) in Service Station Environments

    PubMed Central

    Edokpolo, Benjamin; Yu, Qiming Jimmy; Connell, Des

    2014-01-01

    A comprehensive evaluation of the adverse health effects of human exposures to BTX from service station emissions was carried out using BTX exposure data from the scientific literature. The data was grouped into different scenarios based on activity, location and occupation and plotted as Cumulative Probability Distributions (CPD) plots. Health risk was evaluated for each scenario using the Hazard Quotient (HQ) at 50% (CEXP50) and 95% (CEXP95) exposure levels. HQ50 and HQ95 > 1 were obtained with benzene in the scenario for service station attendants and mechanics repairing petrol dispensing pumps indicating a possible health risk. The risk was minimized for service stations using vapour recovery systems which greatly reduced the benzene exposure levels. HQ50 and HQ95 < 1 were obtained for all other scenarios with benzene suggesting minimal risk for most of the exposed population. However, HQ50 and HQ95 < 1 was also found with toluene and xylene for all scenarios, suggesting minimal health risk. The lifetime excess Cancer Risk (CR) and Overall Risk Probability for cancer on exposure to benzene was calculated for all Scenarios and this was higher amongst service station attendants than any other scenario. PMID:24945191

  13. Earthquake Hazard Mitigation Using a Systems Analysis Approach to Risk Assessment

    NASA Astrophysics Data System (ADS)

    Legg, M.; Eguchi, R. T.

    2015-12-01

    The earthquake hazard mitigation goal is to reduce losses due to severe natural events. The first step is to conduct a Seismic Risk Assessment consisting of 1) hazard estimation, 2) vulnerability analysis, 3) exposure compilation. Seismic hazards include ground deformation, shaking, and inundation. The hazard estimation may be probabilistic or deterministic. Probabilistic Seismic Hazard Assessment (PSHA) is generally applied to site-specific Risk assessments, but may involve large areas as in a National Seismic Hazard Mapping program. Deterministic hazard assessments are needed for geographically distributed exposure such as lifelines (infrastructure), but may be important for large communities. Vulnerability evaluation includes quantification of fragility for construction or components including personnel. Exposure represents the existing or planned construction, facilities, infrastructure, and population in the affected area. Risk (expected loss) is the product of the quantified hazard, vulnerability (damage algorithm), and exposure which may be used to prepare emergency response plans, retrofit existing construction, or use community planning to avoid hazards. The risk estimate provides data needed to acquire earthquake insurance to assist with effective recovery following a severe event. Earthquake Scenarios used in Deterministic Risk Assessments provide detailed information on where hazards may be most severe, what system components are most susceptible to failure, and to evaluate the combined effects of a severe earthquake to the whole system or community. Casualties (injuries and death) have been the primary factor in defining building codes for seismic-resistant construction. Economic losses may be equally significant factors that can influence proactive hazard mitigation. Large urban earthquakes may produce catastrophic losses due to a cascading of effects often missed in PSHA. Economic collapse may ensue if damaged workplaces, disruption of utilities, and resultant loss of income produces widespread default on payments. With increased computational power and more complete inventories of exposure, Monte Carlo methods may provide more accurate estimation of severe losses and the opportunity to increase resilience of vulnerable systems and communities.

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

    KIRKBRIDE, R.A.

    The Tank Waste Remediation System Operation and Utilization Plan updates the operating scenario and plans for the delivery of feed to BNFL Inc., retrieval of waste from single-shell tanks, and the overall process flowsheets for Phases I and II of the privatization of the Tank Waste Remediation System. The plans and flowsheets are updated with the most recent tank-by-tank inventory and sludge washing data. Sensitivity cases were run to evaluate the impact or benefits of proposed changes to the BNFL Inc. contract and to evaluate a risk-based SST retrieval strategy.

  15. Conscious worst case definition for risk assessment, part I: a knowledge mapping approach for defining most critical risk factors in integrative risk management of chemicals and nanomaterials.

    PubMed

    Sørensen, Peter B; Thomsen, Marianne; Assmuth, Timo; Grieger, Khara D; Baun, Anders

    2010-08-15

    This paper helps bridge the gap between scientists and other stakeholders in the areas of human and environmental risk management of chemicals and engineered nanomaterials. This connection is needed due to the evolution of stakeholder awareness and scientific progress related to human and environmental health which involves complex methodological demands on risk management. At the same time, the available scientific knowledge is also becoming more scattered across multiple scientific disciplines. Hence, the understanding of potentially risky situations is increasingly multifaceted, which again challenges risk assessors in terms of giving the 'right' relative priority to the multitude of contributing risk factors. A critical issue is therefore to develop procedures that can identify and evaluate worst case risk conditions which may be input to risk level predictions. Therefore, this paper suggests a conceptual modelling procedure that is able to define appropriate worst case conditions in complex risk management. The result of the analysis is an assembly of system models, denoted the Worst Case Definition (WCD) model, to set up and evaluate the conditions of multi-dimensional risk identification and risk quantification. The model can help optimize risk assessment planning by initial screening level analyses and guiding quantitative assessment in relation to knowledge needs for better decision support concerning environmental and human health protection or risk reduction. The WCD model facilitates the evaluation of fundamental uncertainty using knowledge mapping principles and techniques in a way that can improve a complete uncertainty analysis. Ultimately, the WCD is applicable for describing risk contributing factors in relation to many different types of risk management problems since it transparently and effectively handles assumptions and definitions and allows the integration of different forms of knowledge, thereby supporting the inclusion of multifaceted risk components in cumulative risk management. Copyright 2009 Elsevier B.V. All rights reserved.

  16. Delineating risk zones and evaluation of shelter centres for flood disaster management along the Pahang River Basin, Malaysia

    PubMed Central

    Isahak, Anizan; Siwar, Chamhuri; Ismail, Shaharuddin M.; Hanafi, Zulkifli; Zainuddin, Mohd S.

    2018-01-01

    Shelter centres are important locations to safeguard people from helpless situations and are an integral part of disaster risk reduction (DRR), particularly for flood DRR. The establishment of shelter centres, and their design based on scientific assessment, is crucial. Yet, they are very much related to the geographic location, socio-economic conditions and the livelihoods of the affected communities. However, many parts of the developing world are still lagging behind in ensuring such scientific design. Considering the flood disaster in 2014 that affected the residents living along the Pahang River Basin, in this study we delineate the communities at risk and evaluate the existing shelter centres to determine how they reduce people’s vulnerability to the risks associated with rural and urban landscapes. We used spatial analysis tools to delineate risk zones and to evaluate existing evacuation systems. A flood disaster risk map was produced to determine which communities are living with risks. Subsequently, the distribution of shelter centres examined whether they are able to support people living at the flood risk zones. These centres were also evaluated using a set of international guidelines for effective disaster shelters. This reveals that the number of shelter centres is not adequate. The designation and designing of shelter centres are not being done scientifically. The maps produced here have a lot of potential to support disaster management decisions, in particular site selection and the prioritisation of centres. The study concludes with a set of guidelines and recommendations for structural and non-structural measures, such as alternative livelihoods and the potential of ecotourism, which may improve the resilience among flood-affected communities; and the decision-making process for the overall flood DRR initiatives.

  17. Likelihood ratio-based integrated personal risk assessment of type 2 diabetes.

    PubMed

    Sato, Noriko; Htun, Nay Chi; Daimon, Makoto; Tamiya, Gen; Kato, Takeo; Kubota, Isao; Ueno, Yoshiyuki; Yamashita, Hidetoshi; Fukao, Akira; Kayama, Takamasa; Muramatsu, Masaaki

    2014-01-01

    To facilitate personalized health care for multifactorial diseases, risks of genetic and clinical/environmental factors should be assessed together for each individual in an integrated fashion. This approach is possible with the likelihood ratio (LR)-based risk assessment system, as this system can incorporate manifold tests. We examined the usefulness of this system for assessing type 2 diabetes (T2D). Our system employed 29 genetic susceptibility variants, body mass index (BMI), and hypertension as risk factors whose LRs can be estimated from openly available T2D association data for the Japanese population. The pretest probability was set at a sex- and age-appropriate population average of diabetes prevalence. The classification performance of our LR-based risk assessment was compared to that of a non-invasive screening test for diabetes called TOPICS (with score based on age, sex, family history, smoking, BMI, and hypertension) using receiver operating characteristic analysis with a community cohort (n = 1263). The area under the receiver operating characteristic curve (AUC) for the LR-based assessment and TOPICS was 0.707 (95% CI 0.665-0.750) and 0.719 (0.675-0.762), respectively. These AUCs were much higher than that of a genetic risk score constructed using the same genetic susceptibility variants, 0.624 (0.574-0.674). The use of ethnically matched LRs is necessary for proper personal risk assessment. In conclusion, although LR-based integrated risk assessment for T2D still requires additional tests that evaluate other factors, such as risks involved in missing heritability, our results indicate the potential usability of LR-based assessment system and stress the importance of stratified epidemiological investigations in personalized medicine.

  18. When bad things happen: adverse event reporting and disclosure as patient safety and risk management tools in the neonatal intensive care unit.

    PubMed

    Donn, Steven M; McDonnell, William M

    2012-01-01

    The Institute of Medicine has recommended a change in culture from "name and blame" to patient safety. This will require system redesign to identify and address errors, establish performance standards, and set safety expectations. This approach, however, is at odds with the present medical malpractice (tort) system. The current system is outcomes-based, meaning that health care providers and institutions are often sued despite providing appropriate care. Nevertheless, the focus should remain to provide the safest patient care. Effective peer review may be hindered by the present tort system. Reporting of medical errors is a key piece of peer review and education, and both anonymous reporting and confidential reporting of errors have potential disadvantages. Diagnostic and treatment errors continue to be the leading sources of allegations of malpractice in pediatrics, and the neonatal intensive care unit is uniquely vulnerable. Most errors result from systems failures rather than human error. Risk management can be an effective process to identify, evaluate, and address problems that may injure patients, lead to malpractice claims, and result in financial losses. Risk management identifies risk or potential risk, calculates the probability of an adverse event arising from a risk, estimates the impact of the adverse event, and attempts to control the risk. Implementation of a successful risk management program requires a positive attitude, sufficient knowledge base, and a commitment to improvement. Transparency in the disclosure of medical errors and a strategy of prospective risk management in dealing with medical errors may result in a substantial reduction in medical malpractice lawsuits, lower litigation costs, and a more safety-conscious environment. Thieme Medical Publishers, Inc.

  19. Visualization of risk of radiogenic second cancer in the organs and tissues of the human body.

    PubMed

    Zhang, Rui; Mirkovic, Dragan; Newhauser, Wayne D

    2015-04-28

    Radiogenic second cancer is a common late effect in long term cancer survivors. Currently there are few methods or tools available to visually evaluate the spatial distribution of risks of radiogenic late effects in the human body. We developed a risk visualization method and demonstrated it for radiogenic second cancers in tissues and organs of one patient treated with photon volumetric modulated arc therapy and one patient treated with proton craniospinal irradiation. Treatment plans were generated using radiotherapy treatment planning systems (TPS) and dose information was obtained from TPS. Linear non-threshold risk coefficients for organs at risk of second cancer incidence were taken from the Biological Effects of Ionization Radiation VII report. Alternative risk models including linear exponential model and linear plateau model were also examined. The predicted absolute lifetime risk distributions were visualized together with images of the patient anatomy. The risk distributions of second cancer for the two patients were visually presented. The risk distributions varied with tissue, dose, dose-risk model used, and the risk distribution could be similar to or very different from the dose distribution. Our method provides a convenient way to directly visualize and evaluate the risks of radiogenic second cancer in organs and tissues of the human body. In the future, visual assessment of risk distribution could be an influential determinant for treatment plan scoring.

  20. Based on Fuzzy Comprehensive Evaluation Method The Investment Risk Assessment of Chinese Enterprises in The Countries Along “The Belt and Road”

    NASA Astrophysics Data System (ADS)

    Chen, Yanyu; Chai, Huaqi; Huang, Yimiao

    2018-01-01

    “Belt and Road Forum for International Cooperation” held in Beijing in May this year. once again, “The Belt and Road” strategic initiative to the world, causing the world’s enthusiastic response. The core of the “One Belt, One Road” strategy initiative is to promote infrastructure construction and interconnection, dock national policies and development strategies, deepen pragmatic cooperation, promote coordinated and coordinated development and achieve common prosperity. With the “The Belt and Road” strategy in-depth, Chinese enterprises will go abroad, in the countries along the country to invest in more and more examples, accompanied by the increasing risk. Analysis of the failure of investment cases, we can easily find that this is the majority of enterprises overseas investment in the lack of careful assessment of risk and risk of foreign investment risk management has a great relationship. In this paper, the risk factors are used to identify the risk factors table, and the fuzzy comprehensive evaluation method is used to estimate the comprehensive risk value of many uncertain factors that cannot be determined by the overseas investment. The risk assessment system is constructed to help Chinese enterprises to follow the " Investment to avoid risks, improve the success rate.

  1. Assessing the potential of economic instruments for managing drought risk at river basin scale

    NASA Astrophysics Data System (ADS)

    Pulido-Velazquez, M.; Lopez-Nicolas, A.; Macian-Sorribes, H.

    2015-12-01

    Economic instruments work as incentives to adapt individual decisions to collectively agreed goals. Different types of economic instruments have been applied to manage water resources, such as water-related taxes and charges (water pricing, environmental taxes, etc.), subsidies, markets or voluntary agreements. Hydroeconomic models (HEM) provide useful insight on optimal strategies for coping with droughts by simultaneously analysing engineering, hydrology and economics of water resources management. We use HEMs for evaluating the potential of economic instruments on managing drought risk at river basin scale, considering three criteria for assessing drought risk: reliability, resilience and vulnerability. HEMs allow to calculate water scarcity costs as the economic losses due to water deliveries below the target demands, which can be used as a vulnerability descriptor of drought risk. Two generic hydroeconomic DSS tools, SIMGAMS and OPTIGAMS ( both programmed in GAMS) have been developed to evaluate water scarcity cost at river basin scale based on simulation and optimization approaches. The simulation tool SIMGAMS allocates water according to the system priorities and operating rules, and evaluate the scarcity costs using economic demand functions. The optimization tool allocates water resources for maximizing net benefits (minimizing total water scarcity plus operating cost of water use). SIMGAS allows to simulate incentive water pricing policies based on water availability in the system (scarcity pricing), while OPTIGAMS is used to simulate the effect of ideal water markets by economic optimization. These tools have been applied to the Jucar river system (Spain), highly regulated and with high share of water use for crop irrigation (greater than 80%), where water scarcity, irregular hydrology and groundwater overdraft cause droughts to have significant economic, social and environmental consequences. An econometric model was first used to explain the variation of the production value of irrigated agriculture during droughts, assessing revenue responses to varying crop prices and water availability. Hydroeconomic approaches were then used to show the potential of economic instruments in setting incentives for a more efficient management of water resources systems.

  2. Immunoglobulin M monoclonal gammopathies of undetermined significance and indolent Waldenstrom's macroglobulinemia recognize the same determinants of evolution into symptomatic lymphoid disorders: proposal for a common prognostic scoring system.

    PubMed

    Baldini, Luca; Goldaniga, Maria; Guffanti, Andrea; Broglia, Chiara; Cortelazzo, Sergio; Rossi, Andrea; Morra, Enrica; Colombi, Mariangela; Callea, Vincenzo; Pogliani, Enrico; Ilariucci, Fiorella; Luminari, Stefano; Morel, Pierre; Merlini, Giampaolo; Gobbi, Paolo

    2005-07-20

    To evaluate the clinicohematologic variables at diagnosis that are prognostically related to neoplastic progression in patients with immunoglobulin M (IgM) monoclonal gammopathies of undetermined significance (MGUS), and indolent Waldenström's macroglobulinemia (IWM), and propose a scoring system to identify subsets of patients at different risk. We evaluated 217 patients with IgM MGUS and 201 with IWM (male-female ratio, 131:86 and 117:84; mean age, 63.7 and 63.6 years, respectively) diagnosed on the basis of serum monoclonal component (MC) levels and bone marrow lymphoplasmacytic infiltration degree. The variables selected by univariate analyses were multivariately investigated; on the basis of their individual relative hazards, a scoring system was devised to identify subsets of patients at different risk of evolution. After a median follow-up of 56.1 and 60.2 months, 15 of 217 MGUS and 45 of 201 IWM patients, respectively, required chemotherapy for symptomatic WM (13 and 36), non-Hodgkin's lymphoma (2 and 6) and amyloidosis (0 and 3). The median time to evolution (TTE) was not reached for MGUS and was 141.5 months for IWM. The variables adversely related to evolution were qualitatively the same in both groups: MC levels, Hb concentrations and sex. A scoring system based on these parameters identified three risk groups with highly significant differences in TTE in both groups (P < .0001). MGUS and IWM identify disease entities with different propensities for symptomatic neoplastic evolution. As both have the same prognostic determinants of progression, we propose a practical scoring system that, identifying different risks of malignant evolution, may allow an individualized clinical approach.

  3. Systems Biology and Biomarkers of Early Effects for Occupational Exposure Limit Setting

    PubMed Central

    DeBord, D. Gayle; Burgoon, Lyle; Edwards, Stephen W.; Haber, Lynne T.; Kanitz, M. Helen; Kuempel, Eileen; Thomas, Russell S.; Yucesoy, Berran

    2015-01-01

    In a recent National Research Council document, new strategies for risk assessment were described to enable more accurate and quicker assessments.( 1 ) This report suggested that evaluating individual responses through increased use of bio-monitoring could improve dose-response estimations. Identi-fication of specific biomarkers may be useful for diagnostics or risk prediction as they have the potential to improve exposure assessments. This paper discusses systems biology, biomarkers of effect, and computational toxicology approaches and their relevance to the occupational exposure limit setting process. The systems biology approach evaluates the integration of biological processes and how disruption of these processes by chemicals or other hazards affects disease outcomes. This type of approach could provide information used in delineating the mode of action of the response or toxicity, and may be useful to define the low adverse and no adverse effect levels. Biomarkers of effect are changes measured in biological systems and are considered to be preclinical in nature. Advances in computational methods and experimental -omics methods that allow the simultaneous measurement of families of macromolecules such as DNA, RNA, and proteins in a single analysis have made these systems approaches feasible for broad application. The utility of the information for risk assessments from -omics approaches has shown promise and can provide information on mode of action and dose-response relationships. As these techniques evolve, estimation of internal dose and response biomarkers will be a critical test of these new technologies for application in risk assessment strategies. While proof of concept studies have been conducted that provide evidence of their value, challenges with standardization and harmonization still need to be overcome before these methods are used routinely. PMID:26132979

  4. Consensus report on the future of animal-free systemic toxicity testing.

    PubMed

    Leist, Marcel; Hasiwa, Nina; Rovida, Costanza; Daneshian, Mardas; Basketter, David; Kimber, Ian; Clewell, Harvey; Gocht, Tilman; Goldberg, Alan; Busquet, Francois; Rossi, Anna-Maria; Schwarz, Michael; Stephens, Martin; Taalman, Rob; Knudsen, Thomas B; McKim, James; Harris, Georgina; Pamies, David; Hartung, Thomas

    2014-01-01

    Since March 2013, animal use for cosmetics testing for the European market has been banned. This requires a renewed view on risk assessment in this field. However, in other fields as well, traditional animal experimentation does not always satisfy requirements in safety testing, as the need for human-relevant information is ever increasing. A general strategy for animal-free test approaches was outlined by the US National Research Council`s vision document for Toxicity Testing in the 21st Century in 2007. It is now possible to provide a more defined roadmap on how to implement this vision for the four principal areas of systemic toxicity evaluation: repeat dose organ toxicity, carcinogenicity, reproductive toxicity and allergy induction (skin sensitization), as well as for the evaluation of toxicant metabolism (toxicokinetics) (Fig. 1). CAAT-Europe assembled experts from Europe, America and Asia to design a scientific roadmap for future risk assessment approaches and the outcome was then further discussed and refined in two consensus meetings with over 200 stakeholders. The key recommendations include: focusing on improving existing methods rather than favoring de novo design; combining hazard testing with toxicokinetics predictions; developing integrated test strategies; incorporating new high content endpoints to classical assays; evolving test validation procedures; promoting collaboration and data-sharing of different industrial sectors; integrating new disciplines, such as systems biology and high throughput screening; and involving regulators early on in the test development process. A focus on data quality, combined with increased attention to the scientific background of a test method, will be important drivers. Information from each test system should be mapped along adverse outcome pathways. Finally, quantitative information on all factors and key events will be fed into systems biology models that allow a probabilistic risk assessment with flexible adaptation to exposure scenarios and individual risk factors.

  5. Systems Biology and Biomarkers of Early Effects for Occupational Exposure Limit Setting.

    PubMed

    DeBord, D Gayle; Burgoon, Lyle; Edwards, Stephen W; Haber, Lynne T; Kanitz, M Helen; Kuempel, Eileen; Thomas, Russell S; Yucesoy, Berran

    2015-01-01

    In a recent National Research Council document, new strategies for risk assessment were described to enable more accurate and quicker assessments. This report suggested that evaluating individual responses through increased use of bio-monitoring could improve dose-response estimations. Identification of specific biomarkers may be useful for diagnostics or risk prediction as they have the potential to improve exposure assessments. This paper discusses systems biology, biomarkers of effect, and computational toxicology approaches and their relevance to the occupational exposure limit setting process. The systems biology approach evaluates the integration of biological processes and how disruption of these processes by chemicals or other hazards affects disease outcomes. This type of approach could provide information used in delineating the mode of action of the response or toxicity, and may be useful to define the low adverse and no adverse effect levels. Biomarkers of effect are changes measured in biological systems and are considered to be preclinical in nature. Advances in computational methods and experimental -omics methods that allow the simultaneous measurement of families of macromolecules such as DNA, RNA, and proteins in a single analysis have made these systems approaches feasible for broad application. The utility of the information for risk assessments from -omics approaches has shown promise and can provide information on mode of action and dose-response relationships. As these techniques evolve, estimation of internal dose and response biomarkers will be a critical test of these new technologies for application in risk assessment strategies. While proof of concept studies have been conducted that provide evidence of their value, challenges with standardization and harmonization still need to be overcome before these methods are used routinely.

  6. Nursing process decision support system for urology ward.

    PubMed

    Hao, Angelica Te-Hui; Wu, Lee-Pin; Kumar, Ajit; Jian, Wen-Shan; Huang, Li-Fang; Kao, Ching-Chiu; Hsu, Chien-Yeh

    2013-07-01

    We developed a nursing process decision support system (NPDSS) based on three clinical pathways, including benign prostatic hypertrophy, inguinal hernia, and urinary tract stone. NPDSS included six major nursing diagnoses - acute pain, impaired urinary elimination, impaired skin integrity, anxiety, infection risk, and risk of falling. This paper aims to describe the design, development and validation process of the NPDSS. We deployed the Delphi method to reach consensus for decision support rules of NPDSS. A team of nine-member expert nurses from a medical center in Taiwan was involved in Delphi method. The Cronbach's α method was used for examining the reliability of the questionnaire used in the Delphi method. The Visual Basic 6.0 as front-end and Microsoft Access 2003 as back-end was used to develop the system. A team of six nursing experts was asked to evaluate the usability of the developed systems. A 5-point Likert scale questionnaire was used for the evaluation. The sensitivity and specificity of NPDSS were validated using 150 nursing chart. The study showed a consistency between the diagnoses of the developed system (NPDSS) and the nursing charts. The sensitivities of the nursing diagnoses including acute pain, impaired urinary elimination, risk of infection, and risk of falling were 96.9%, 98.1%, 94.9%, and 89.9% respectively; and the specificities were 88%, 49.5%, 62%, and 88% respectively. We did not calculate the sensitivity and specificity of impaired skin integrity and anxiety due to non-availability of enough sample size. NPDSS can help nurses in decision making of nursing diagnoses. Besides, it can help them to generate nursing diagnoses based on patient-specific data, individualized care plans, and implementation within their usual nursing workflow. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  7. Impact of graft composition on the systemic inflammatory response after an elective repair of an abdominal aortic aneurysm

    PubMed Central

    Baek, Jong Kwan; Kwon, Hyunwook; Ko, Gi-Young; Kim, Min Joo; Han, Youngjin; Chung, Young Soo; Park, Hojong; Kwon, Tae-Won

    2015-01-01

    Purpose The present study aimed to evaluate the risk factors and the role of graft material in the development of an acute phase systemic inflammatory response, and the clinical outcome in patients who undergo endovascular aneurysm repair (EVAR) or open surgical repair (OSR) of an abdominal aortic aneurysm (AAA). Methods We retrospectively evaluated the risk factors and the role of graft material in an increased risk of developing systemic inflammatory response syndrome (SIRS), and the clinical outcome in patients who underwent EVAR or OSR of an AAA. Results A total of 308 consecutive patients who underwent AAA repair were included; 178 received EVAR and 130 received OSR. There was no significant difference in the incidence of SIRS between EVAR patients and OSR patients. Regardless of treatment modality, SIRS was observed more frequently in patients treated with woven polyester grafts. Postoperative hospitalization was significantly prolonged in patients that experienced SIRS. In multivariate analyses, the initial white blood cell count (P = 0.001) and the use of woven polyester grafts (P = 0.005) were significantly associated with an increased risk of developing SIRS in patients who underwent EVAR. By contrast, the use of woven polyester grafts was the only factor associated with an increased risk of developing SIRS in patients who underwent OSR, although this was not statistically significant (P = 0.052). Conclusion The current study shows that the graft composition plays a primordial role in the development of SIRS, and it leads to prolonged hospitalization in both EVAR and OSR patients. PMID:25553321

  8. China's soil and groundwater management challenges: Lessons from the UK's experience and opportunities for China.

    PubMed

    Coulon, Frédéric; Jones, Kevin; Li, Hong; Hu, Qing; Gao, Jingyang; Li, Fasheng; Chen, Mengfang; Zhu, Yong-Guan; Liu, Rongxia; Liu, Ming; Canning, Kate; Harries, Nicola; Bardos, Paul; Nathanail, Paul; Sweeney, Rob; Middleton, David; Charnley, Maggie; Randall, Jeremy; Richell, Martin; Howard, Trevor; Martin, Ian; Spooner, Simon; Weeks, Jason; Cave, Mark; Yu, Fang; Zhang, Fang; Jiang, Ying; Longhurst, Phil; Prpich, George; Bewley, Richard; Abra, Jonathan; Pollard, Simon

    2016-05-01

    There are a number of specific opportunities for UK and China to work together on contaminated land management issues as China lacks comprehensive and systematic planning for sustainable risk based land management, encompassing both contaminated soil and groundwater and recycling and reuse of soil. It also lacks comprehensive risk assessment systems, structures to support risk management decision making, processes for verification of remediation outcome, systems for record keeping and preservation and integration of contamination issues into land use planning, along with procedures for ensuring effective health and safety considerations during remediation projects, and effective evaluation of costs versus benefits and overall sustainability. A consequence of the absence of these overarching frameworks has been that remediation takes place on an ad hoc basis. At a specific site management level, China lacks capabilities in site investigation and consequent risk assessment systems, in particular related to conceptual modelling and risk evaluation. There is also a lack of shared experience of practical deployment of remediation technologies in China, analogous to the situation before the establishment of the independent, non-profit organisation CL:AIRE (Contaminated Land: Applications In Real Environments) in 1999 in the UK. Many local technology developments are at lab-scale or pilot-scale stage without being widely put into use. Therefore, a shared endeavour is needed to promote the development of technically and scientifically sound land management as well as soil and human health protection to improve the sustainability of the rapid urbanisation in China. Copyright © 2016 Elsevier Ltd. All rights reserved.

  9. Process monitoring in intensive care with the use of cumulative expected minus observed mortality and risk-adjusted P charts.

    PubMed

    Cockings, Jerome G L; Cook, David A; Iqbal, Rehana K

    2006-02-01

    A health care system is a complex adaptive system. The effect of a single intervention, incorporated into a complex clinical environment, may be different from that expected. A national database such as the Intensive Care National Audit & Research Centre (ICNARC) Case Mix Programme in the UK represents a centralised monitoring, surveillance and reporting system for retrospective quality and comparative audit. This can be supplemented with real-time process monitoring at a local level for continuous process improvement, allowing early detection of the impact of both unplanned and deliberately imposed changes in the clinical environment. Demographic and UK Acute Physiology and Chronic Health Evaluation II (APACHE II) data were prospectively collected on all patients admitted to a UK regional hospital between 1 January 2003 and 30 June 2004 in accordance with the ICNARC Case Mix Programme. We present a cumulative expected minus observed (E-O) plot and the risk-adjusted p chart as methods of continuous process monitoring. We describe the construction and interpretation of these charts and show how they can be used to detect planned or unplanned organisational process changes affecting mortality outcomes. Five hundred and eighty-nine adult patients were included. The overall death rate was 0.78 of predicted. Calibration showed excess survival in ranges above 30% risk of death. The E-O plot confirmed a survival above that predicted. Small transient variations were seen in the slope that could represent random effects, or real but transient changes in the quality of care. The risk-adjusted p chart showed several observations below the 2 SD control limits of the expected mortality rate. These plots provide rapid analysis of risk-adjusted performance suitable for local application and interpretation. The E-O chart provided rapid easily visible feedback of changes in risk-adjusted mortality, while the risk-adjusted p chart allowed statistical evaluation. Local analysis of risk-adjusted mortality data with an E-O plot and a risk-adjusted p chart is feasible and allows the rapid detection of changes in risk-adjusted outcome of intensive care patients. This complements the centralised national database, which is more archival and comparative in nature.

  10. Opinions of Nurses About the Evaluation of Risk of Falling Among Inpatients.

    PubMed

    Atay, Selma; Vurur, Sevda; Erdugan, Necla

    Patient falls and fall-related injuries are an important problem for patients, relatives, caregivers, and the health system at large. This study aims to identify opinions of nurses about the risk of falling among patients staying in hospitals. This study uses a qualitative descriptive design and employs a semistructured interview method to identify the opinions and experiences of nurses about patient falls. This study evaluated the opinions of a total of 12 staff nurses. It was found that nurses consider patients in the postoperative period to be most prone to falls. They think that most falls take place during transfers and that the medical diagnosis of the patient plays a crucial role in fall incidents. The most important problem associated with patient falls was symptoms of traumatic brain injury. According to the participating nurses, the risk of fall for every patient should be evaluated upon admission. Measures that the nurses take against patient falls include raising the bed's side rails and securing the bed brakes. The findings of this research suggest that in-service training programs about the evaluation of the risk of falling should be organized for nurses. Guidelines should be developed for patients with different levels of risk of falling. It is suggested that nurses should be in charge of training patients who are conscious, their relatives, and caregiver personnel. The training of nurses and caregivers helps to prevent the falls of inpatients.

  11. Risk evaluation and mitigation strategies: a focus on belatacept.

    PubMed

    Sam, Teena; Gabardi, Steven; Tichy, Eric M

    2013-03-01

    To review the elements and components of the risk evaluation and mitigation strategies (REMS) for the costimulation blocker belatacept and associated implications for health care providers working with transplant recipients. The MEDLINE and EMBASE databases (January 1990 to March 2012) were searched by using risk evaluation and mitigation strategies, REMS, belatacept, and organ transplant as search terms (individual organs were also searched). Retrieved articles were supplemented with analysis of information obtained from the Federal Register, the Food and Drug Administration, and the manufacturer of belatacept. REMS are risk-management strategies implemented to ensure that a product's benefits outweigh its known safety risks. Although belatacept offers a novel strategy in maintenance immunosuppression and was associated with superior renal function compared with cyclosporine in phase 2 and 3 trials, belatacept is also associated with increased risk of posttransplant lymphoproliferative disorder and central nervous system infections. The Food and Drug Administration required development of a REMS program as part of belatacept's approval process to ensure safe and appropriate use of the medication and optimization of its risk-benefit profile. Elements of the belatacept REMS include a medication guide that must be dispensed with each infusion and a communication plan. In the management of a complex population of patients, it is essential that those who care for transplant recipients, and patients, recognize the implications of potential and known risks of belatacept. The REMS program aims to facilitate careful selection and education of patients and vigilant monitoring.

  12. Assessing the risks of trace elements in environmental materials under selected greenhouse vegetable production systems of China.

    PubMed

    Chen, Yong; Huang, Biao; Hu, Wenyou; Weindorf, David C; Liu, Xiaoxiao; Niedermann, Silvana

    2014-02-01

    The risk assessment of trace elements of different environmental media in conventional and organic greenhouse vegetable production systems (CGVPS and OGVPS) can reveal the influence of different farming philosophy on the trace element accumulations and their effects on human health. These provide important basic data for the environmental protection and human health. This paper presents trace element accumulation characteristics of different land uses; reveals the difference of soil trace element accumulation both with and without consideration of background levels; compares the trace element uptake by main vegetables; and assesses the trace element risks of soils, vegetables, waters and agricultural inputs, using two selected greenhouse vegetable systems in Nanjing, China as examples. Results showed that greenhouse vegetable fields contained significant accumulations of Zn in CGVPS relative to rice-wheat rotation fields, open vegetable fields, and geochemical background levels, and this was the case for organic matter in OGVPS. The comparative analysis of the soil medium in two systems with consideration of geochemical background levels and evaluation of the geo-accumulation pollution index achieved a more reasonable comparison and accurate assessment relative to the direct comparison analysis and the evaluation of the Nemerow pollution index, respectively. According to the Chinese food safety standards and the value of the target hazard quotient or hazard index, trace element contents of vegetables were safe for local residents in both systems. However, the spatial distribution of the estimated hazard index for producers still presented certain specific hotspots which may cause potential risk for human health in CGVPS. The water was mainly influenced by nitrogen, especially for CGVPS, while the potential risk of Cd and Cu pollution came from sediments in OGVPS. The main inputs for trace elements were fertilizers which were relatively safe based on relevant standards; but excess application caused trace element accumulations in the environmental media. Copyright © 2013 Elsevier B.V. All rights reserved.

  13. Natural Attenuation of Hexavalent Chromium in Groundwater and Soils

    EPA Pesticide Factsheets

    Concerns about the impact of chromium on human health and the environment require an evaluation of the potential risk of chromium entering the groundwater flow system and being transported beyond compliance boundaries.

  14. Premise to Implement a Grading System to Evaluate the Sanitary Level in Food Service Establishments in Milan, Italy

    PubMed Central

    Razzini, Katia

    2015-01-01

    The regulatory framework of the official controls on food safety, the criteria and methods from the planning of interventions in the field of official control to the management of information flows, and the standards described in the operation manual of the local competent authorities drafted by the Lombardy Region (2011) were evaluated. A questionnaire consisting of n. 10 questions with multiple answers draft in partnership with EPAM (the Association of Provincial Public Retail and catering businesses in Milan) to n. 107 Food service establishments of Milan shows that 92% of managers approve the introduction of a grading system. The regulatory framework is planned to support the implementation of risk assignment, unfortunately the attribution of risk category of retail and catering businesses is still different among regions. PMID:27800403

  15. [Pay attention to the human health risk of drinking low mineral water].

    PubMed

    Shu, Weiqun

    2015-10-01

    The consumption of low mineral drinking water has been increasing around the world with the shortage of water resources and the development of advanced water treatment technologies. Evidences from systematic document reviews, ecological epidemiological observations, and experimental drinking water intervention studies indicate that lack of minerals in drinking water may cause direct or indirect harm to human health, among which, the associations of magnesium in water with cardiovascular disease, as well as calcium in water with osteoporosis, are well proved by sufficient evidence. This article points out that it is urgent to pay more attention to the issues about establishment of health risk evaluation system on susceptible consuming population, establishment of lab evaluation system on water quality and health effect for non-traditional drinking water, and program of safety mineralization for demineralized or desalinated water and so on.

  16. Interaction of Physical and Chemical Processes Controlling the Environmental Fate and Transport of Lampricides Through Stream-Hyporheic Systems

    NASA Astrophysics Data System (ADS)

    Hixson, J.; Ward, A. S.; Schmadel, N.; McConville, M.; Remucal, C.

    2016-12-01

    The transport and fate of contaminants of emerging concern through the environment is complicated by the heterogeneity of natural systems and the unique reaction pathways of individual compounds. Our current evaluation of risk is often simplified to controls assumed to be homogeneous in space and time. However, we know spatial heterogeneity and time-variable reaction rates complicate predictions of environmental transport and fate, and therefore risk. These complications are the result of the interactions between the physical and chemical systems and the time-variable equilibrium that exists between the two. Compounds that interact with both systems, such as photolytic compounds, require that both components are fully understood in order to predict transport and fate. Release of photolytic compounds occurs through both unintentional releases and intentional loadings. Evaluating risks associated with unintentional releases and implementing best management practices for intentional releases requires an in-depth understanding of the sensitivity of photolytic compounds to external controls. Lampricides, such as 3-trifluoromethyl-4-nitrophenol (TFM), are broadly applied in the Great Lakes system to control the population of invasive sea lamprey. Over-dosing can yield fish kills and other detrimental impacts. Still, planning accounts for time of passage and dilution, but not the interaction of the physical and chemical systems (i.e., storage in the hyporheic zone and time-variable decay rates). In this study, we model a series of TFM applications to test the efficacy of dosing as a function of system characteristics. Overall, our results demonstrate the complexity associated with photo-sensitive compounds through stream-hyporheic systems, and highlight the need to better understand how physical and chemical systems interact to control transport and fate in the environment.

  17. [How the information system can contribute to the implementation of a risk management program in a hospital?].

    PubMed

    Staccini, P; Quaranta, J F; Staccini-Myx, A; Veyres, P; Jambou, P

    2003-09-01

    Nowadays, information system is recognised as one of the key points of the management strategy. An information system is regarded conceptualised as a mean to link 3 aspects of a firm (structure, organisation rules and staff). Its design and implementation have to meet the objectives of medical and economical evaluation, especially risk management objectives. In order to identify, analyse, reduce and prevent the occurrence of adverse events, and also to measure the efficacy and efficiency of the production of care services, the design of information systems should be based on a process analysis in order to describe and classify all the working practices within the hospital. According to various methodologies (usually top-down analysis), each process can be divided into activities. Each activity (especially each care activity) can be described according to its potential risks and expected results. For care professionals performing a task, the access to official or internal guidelines and the adverse events reporting forms has also to be defined. Putting together all the elements of such a process analysis will contribute to integrate, into daily practice, the management of risks, supported by the information system.

  18. Detecting GNSS spoofing attacks using INS coupling

    NASA Astrophysics Data System (ADS)

    Tanil, Cagatay

    Vulnerability of Global Navigation Satellite Systems (GNSS) users to signal spoofing is a critical threat to positioning integrity, especially in aviation applications, where the consequences are potentially catastrophic. In response, this research describes and evaluates a new approach to directly detect spoofing using integrated Inertial Navigation Systems (INS) and fault detection concepts based on integrity monitoring. The monitors developed here can be implemented into positioning systems using INS/GNSS integration via 1) tightly-coupled, 2) loosely-coupled, and 3) uncoupled schemes. New evaluation methods enable the statistical computation of integrity risk resulting from a worst-case spoofing attack - without needing to simulate an unmanageably large number of individual aircraft approaches. Integrity risk is an absolute measure of safety and a well-established metric in aircraft navigation. A novel closed-form solution to the worst-case time sequence of GNSS signals is derived to maximize the integrity risk for each monitor and used in the covariance analyses. This methodology tests the performance of the monitors against the most sophisticated spoofers, capable of tracking the aircraft position - for example, by means of remote tracking or onboard sensing. Another contribution is a comprehensive closed-loop model that encapsulates the vehicle and compensator (estimator and controller) dynamics. A sensitivity analysis uses this model to quantify the leveraging impact of the vehicle's dynamic responses (e.g., to wind gusts, or to autopilot's acceleration commands) on the monitor's detection capability. The performance of the monitors is evaluated for two safety-critical terminal area navigation applications: 1) autonomous shipboard landing and 2) Boeing 747 (B747) landing assisted with Ground Based Augmentation Systems (GBAS). It is demonstrated that for both systems, the monitors are capable of meeting the most stringent precision approach and landing integrity requirements of the International Civil Aviation Organization (ICAO). The statistical evaluation methods developed here can be used as a baseline procedure in the Federal Aviation Administration's (FAA) certification of spoof-free navigation systems. The final contribution is an investigation of INS sensor quality on detection performance. This determines the minimum sensor requirements to perform standalone GNSS positioning in general en route applications with guaranteed spoofing detection integrity.

  19. Warning systems in risk management.

    PubMed

    Paté-Cornell, M E

    1986-06-01

    A method is presented here that allows probabilistic evaluation and optimization of warning systems, and comparison of their performance and cost-effectiveness with those of other means of risk management. The model includes an assessment of the signals, and of human response, given the memory that people have kept of the quality of previous alerts. The trade-off between the rate of false alerts and the length of the lead time is studied to account for the long-term effects of "crying wolf" and the effectiveness of emergency actions. An explicit formulation of the system's benefits, including inputs from a signal model, a response model, and a consequence model, is given to allow optimization of the warning threshold and of the system's sensitivity.

  20. Additively Manufactured Metals in Oxygen Systems Project

    NASA Technical Reports Server (NTRS)

    Tylka, Jonathan

    2015-01-01

    Metals produced by additive manufacturing methods, such as Powder Bed Fusion Technology, are now mature enough to be considered for qualification in human spaceflight oxygen systems. The mechanical properties of metals produced through AM processes are being systematically studied. However, it is unknown whether AM metals in oxygen applications may present an increased risk of flammability or ignition as compared to wrought metals of the same metallurgical composition due to increased porosity. Per NASA-STD-6001B materials to be used in oxygen system applications shall be based on flammability and combustion test data, followed by a flammability assessment. Without systematic flammability and ignition testing in oxygen there is no credible method for NASA to accurately evaluate the risk of using AM metals in oxygen systems.

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