Simulation study on regionalization of esophagectomy using data of 27,576 patients with esophageal malignant tumor.

2019 ◽  
Vol 37 (4_suppl) ◽  
pp. 151-151
Author(s):  
Tatsuto Nishigori ◽  
Arata Takahashi ◽  
Nao Ichihara ◽  
Shigeru Tsunoda ◽  
Yasushi Toh ◽  
...  
Keyword(s):  
Malignant Tumor ◽  
Operative Mortality ◽  
Mortality Rates ◽  
Cancer Surgery ◽  
Minimum Volume ◽  
Clinical Database ◽  
Culture Of Evidence ◽  
Using Data ◽  
Almost All ◽  
Travel Distances

151 Background: The culture of evidence-based policy making in the field of cancer surgery is still at a developing stage. Although the volume-outcome relationship with esophagectomy has been recently recognized in Japan, there is no regionalization policy. This study was aimed to simulate regionalization of esophagectomy in Japan using data registered in a nationwide clinical database. Methods: The National Clinical Database (NCD) covers more than 95 per cent of all surgical procedures in Japan. The study used data of 27,476 patients with esophageal malignant tumor registered in the NCD as having undergone esophagectomy at 1040 hospitals between 2012 and 2016. The following four scenarios were tested; in scenario 1, 2, 3, and 4, a minimum volume standard was set as 2, 5, 10 and 15 cases per year. The risk-adjusted operative mortality rates after regionalization and travel distances according to patients’ place of residence were estimated for each scenario. Results: Current operative mortality rates according to hospital volume were < 2 cases: 4.8%, 2-4: 3.7%, 5-9: 2.4%, 10-14: 2.1%, and ≥15: 1.6%. In scenario 1 to 4, 598, 791, 896, and 939 hospitals, and 1,982, 4,740, 7,996, and 10,419 patients were affected by regionalization. The risk-adjusted operative mortality rates after regionalization in target patients were estimated to decrease to 2.7, 2.1, 1.8, and 1.7% in each scenario. The median travel distances after regionalization in metropolitan areas were calculated as 4 kilometer (km) in scenario 1 and 7 km in scenario 4. However, those in provincial cities and depopulated areas were 8 and 36 km in scenario 1, and 28 and 65 km in scenario 4. Conclusions: Regionalization of cancer surgery services could be simulated using the comprehensive clinical database covering almost all surgeries in the nation. The simulation showed that operative mortality rate could decrease to less than 2 % by regionalization but a minimum volume standard should be determined considering regional characteristics.

Impact of Socio-Economic Deprivation on Mortality Rates after Upper GI Cancer Surgery

Endoscopy ◽  
2006 ◽  
Vol 38 (11) ◽  
Author(s):  
Y Leigh ◽  
J Seagroatt ◽  
S Cole ◽  
M Goldacre ◽  
P McCulloch
Keyword(s):  
Mortality Rates ◽  
Cancer Surgery ◽  
Economic Deprivation ◽  
Upper Gi ◽  
Gi Cancer ◽  
Upper Gi Cancer

Accessibility and Intraurban Travel

1987 ◽  
Vol 19 (6) ◽  
pp. 735-748 ◽  
Author(s):  
S Hanson ◽  
M Schwab
Keyword(s):  
Travel Behavior ◽  
Activity Spaces ◽  
Household Travel Survey ◽  
Trip Frequency ◽  
Potential Activity ◽  
Using Data ◽  
Household Travel ◽  
Automobile Use ◽  
The Relationship ◽  
Travel Distances

This paper contains an examination of the fundamental assumption underlying the use of accessibility indicators: that an individual's travel behavior is related to his or her location vis-à-vis the distribution of potential activity sites. First, the conceptual and measurement issues surrounding accessibility and its relationship to travel are reviewed; then, an access measure for individuals is formulated. Using data from the Uppsala (Sweden) Household Travel Survey and controlling for sex, automobile availability, and employment status, the authors explore the relationship between both home- and work-based accessibility and five aspects of an individual's travel: mode use, trip frequencies and travel distances for discretionary purposes, trip complexity, travel in conjunction with the journey to work, and size of the activity space. From the results it can be seen that although all of these travel characteristics are related to accessibility to some degree, the travel–accessibility relationship is not as strong as deductive formulations have implied. High accessibility levels are associated with higher proportions of travel by nonmotorized means, lower levels of automobile use, reduced travel distances for certain discretionary trip purposes, and smaller individual activity spaces. Furthermore, the density of activity sites around the workplace affects the distances travelled by employed people for discretionary purposes. Overall, accessibility level has a greater impact on mode use and travel distance than it does on discretionary trip frequency. This result was unexpected in light of the strong trip frequency–accessibility relationship posited frequently in the literature.

Risk Analysis for Knowledge Sharing in Tax Payment

2016 ◽  
Vol 6 (1) ◽  
pp. 20-37
Author(s):  
Zahra Kazemi ◽  
Ahmad Jafari Samimi ◽  
Hamed Fazlollahtabar
Keyword(s):  
Knowledge Sharing ◽  
Tax Evasion ◽  
Developed Countries ◽  
Government Expenditures ◽  
Positive Effects ◽  
The People ◽  
Using Data ◽  
Tax Payments ◽  
Almost All ◽  
Tax Payers

One way to finance government expenditures is to collect taxes. Regarding to this financial source compared with other sources positive tax knowledge sharing amongst people or tax payers lead to effective investment. Unlike developing countries in developed countries - that taxes have little effects - almost all government expenditures is financed by taxes. One of the main challenges in the tax system is how to collect taxes due to tax evasion. The main reason is the uncertainty surrounding how government uses the taxes paid by the people. A major factor in the outbreak of the sense of failure to pay taxes, is the discussion and sharing the viewpoint of each other. If there is any positive tax effect prevalence of speech among people motivate them to pay more and if not, paying taxes is impaired. Therefore in order to avoid disorderliness in paying taxes that lead to a reduction in the development growth rate of investing taxes in industry and services sectors procedures should be designed so that taxes spread in speech with more quality. In this article five categories that people share their knowledge about them with each other, have been proposed. Defining risk structure and using data from surveying form the risk values of tax payment the results indicate that sharing tax knowledge amongst people have positive effects on tax payments.

Ranking and Rankability of Hospital Postoperative Mortality Rates in Colorectal Cancer Surgery

2014 ◽  
Vol 259 (5) ◽  
pp. 844-849 ◽  
Author(s):  
Daniel Henneman ◽  
Annelotte C. M. van Bommel ◽  
Alexander Snijders ◽  
Heleen S. Snijders ◽  
Rob A. E. M. Tollenaar ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Postoperative Mortality ◽  
Mortality Rates ◽  
Cancer Surgery ◽  
Colorectal Cancer Surgery

scholarly journals STATISTICAL STUDIES ON PROTEIN POLYMORPHISM IN NATURAL POPULATIONS II. GENE DIFFERENTIATION BETWEEN POPULATIONS

Genetics ◽  
1978 ◽  
Vol 88 (2) ◽  
pp. 367-390
Author(s):  
Ranajit Chakraborty ◽  
Paul A Fuerst ◽  
Masatoshi Nei
Keyword(s):  
Genetic Differentiation ◽  
Natural Populations ◽  
Drift Theory ◽  
Alternative Hypotheses ◽  
Mean And Variance ◽  
Statistical Studies ◽  
Different Populations ◽  
Using Data ◽  
Almost All ◽  
Good Agreement

ABSTRACT With the aim of testing the validity of the mutation-drift hypothesis, we examined the pattern of genetic differentiation between populations by using data from Drosophila, fishes, reptiles, and mammals. The observed relationship between genetic identity and correlation of heterozygosities of different populations or species was generally in good agreement with the theoretical expectations from the mutation-drift theory, when the variation in mutation rate among loci was taken into account. In some species of Drosophila, however, the correlation was unduly high. The relationship between the mean and variance of genetic distance was also in good agreement with the theoretical prediction in almost all organisms. We noted that both the distribution of heterozygosity within species and the pattern of genetic differentiation between species can be explained by the same set of genetic parameters in each group of organisms. Alternative hypotheses for explaining these observations are discussed.

scholarly journals Comparison of Mortality Rates in Different Categories of Pigs and Cattle during Transport for Slaughter

2007 ◽  
Vol 76 (8) ◽  
pp. S109-S116 ◽  
Author(s):  
M. Malena ◽  
E. Voslářová ◽  
A. Kozák ◽  
P. Bělobrádek ◽  
I. Bedáňová ◽  
...  
Keyword(s):  
Dairy Cows ◽  
Animal Welfare ◽  
Animal Species ◽  
Mortality Rates ◽  
Research Data ◽  
Individual Animal ◽  
Significant Difference ◽  
Related Stress ◽  
Travel Distances ◽  
Related Mortality

The death of animals during transport for slaughter is a major factor indicating the level of welfare in transported animals. However, research data that report the level of animal welfare as reflected in transport-related mortality rates of individual animal species and categories are missing. The present study focused on losses of pigs and cattle in the period from 1997 to 2006. Transport-related mortality rates were recorded by species and categories of animals and also for the following travel distances: up to 50 km, 51-100 km, 101-200 km, 201-300 km, and over 300 km. Rates differed according to species and category. The highest mortality rates were found in young sows, sows, and boars (0.2562%) followed by fattened pigs (0.1075%), excluded dairy cows (0.0396%), calves (0.0269%), and fattened cattle (0.0069%). Significant differences were found among mortality rates (p < 0.05). The lowest mortality rates occurred with shorter travel distances (< 50 km and 51-100 km) when compared to long travel distances (101-200 km, 201-300 km and > 300 km), with a significant difference (p < 0.05) between short and long travel distances being found in fattened pigs, fattened cattle and dairy cows. Mortality rates in animals during transport for slaughter show young sows, sows, and boars to be the most susceptible to transport-related stress, followed by fattened pigs, dairy cows, and calves, whereas the highest resistance was observed in fattened cattle.

scholarly journals Predicting heart ailment in patients with varying number of features using data mining techniques

2019 ◽  
Vol 8 (1) ◽  
pp. 56
Author(s):  
T R Stella Mary ◽  
Shoney Sebastian
Keyword(s):  
Data Mining ◽  
Heart Disease ◽  
Random Forest ◽  
Naive Bayes ◽  
Heart Diseases ◽  
Naïve Bayes ◽  
Bayes Classifier ◽  
Data Mining Techniques ◽  
Using Data ◽  
Almost All

<span>Data mining can be defined as a process of extracting unknown, verifiable and possibly helpful data from information. Among the various ailments, heart ailment is one of the primary reason behind death of individuals around the globe, hence in order to curb this, a detailed analysis is done using Data Mining. Many a times we limit ourselves with minimal attributes that are required to predict a patient with heart disease. By doing so we are missing on a lot of important attributes that are main causes for heart diseases. Hence, this research aims at considering almost all the important features affecting heart disease and performs the analysis step by step with minimal to maximum set of attributes using Data Mining techniques to predict heart ailments. The various classification methods used are Naïve Bayes classifier, Random Forest and Random Tree which are applied on three datasets with different number of attributes but with a common class label. From the analysis performed, it shows that there is a gradual increase in prediction accuracies with the increase in the attributes irrespective of the classifiers used and Naïve Bayes and Random Forest algorithms comparatively outperforms with these sets of data.</span>

Surgical outcomes for early-stage non-small cell lung cancer at facilities with stereotactic body radiation therapy programs.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. 8538-8538
Author(s):  
Yusef Syed ◽  
William A. Stokes ◽  
Onkar Khullar ◽  
Nikhil Sebastian ◽  
Manali Rupji ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Radiation Therapy ◽  
Stereotactic Body Radiation Therapy ◽  
Operative Mortality ◽  
Early Stage ◽  
Mortality Rates ◽  
Small Cell ◽  
Small Cell Lung ◽  
Early Stage Nsclc ◽  
Interaction Testing

8538 Background: Patients undergoing surgery for early-stage non-small cell lung cancer (NSCLC) may be at high-risk for post-operative mortality. Access to stereotactic body radiation therapy (SBRT) offers a less invasive alternative for this population that may facilitate more appropriate patient selection for surgery. Methods: An analysis of all patients with early-stage NSCLC reported to the National Cancer Database between 2004-2015 was performed. Post-operative mortality rates were derived using vital status data. Utilization of SBRT was defined by each facility’s SBRT Experience in years and SBRT-to-Surgery volume ratios, defined by quartiles. Multivariable logistic regression with backward elimination was used to test for independence of associations between exposures of interest and post-operative mortality. Interaction testing was performed to assess the statistical relationship of covariates found to have independent associations. Results: The study cohort consisted of 202,542 patients who underwent surgical resection of clinical stage T1-T2 NSCLC (AJCC 7th edition). The 90-day post-operative mortality rate declined significantly during the study period from 4.6% to 2.6% (p < 0.001). During this period, the proportion of facilities that utilized SBRT increased from 3.3% to 77.5% (p < 0.001) and the proportion of patients treated with SBRT increased significantly from 0.7% to 15.4% (p < 0.001). Lower 90-day post-operative mortality rates were observed at facilities with greater than six years of SBRT experience (OR 0.84, CI 0.76-0.94, p = 0.003) and SBRT-to-Surgery volume ratios above 17% (OR 0.85, CI 0.79-0.92, p < 0.001). Additional covariates associated with 90-day mortality included higher surgical volume, geographic region, year of diagnosis, age, sex, race, insurance status, facility type, Charlson-Deyo score, clinical T stage, histology, anatomic location, surgery type, and prior malignancy. Interaction testing between these covariates was negative, demonstrating that higher SBRT Experience and SBRT-to-Surgery volume ratios were independently associated with lower 90-day surgical mortality. Conclusions: Patients who underwent surgery for early-stage NSCLC at facilities with higher SBRT Experience and SBRT-to-Surgery volume ratios had lower rates of post-operative mortality. These findings suggest that the availability of SBRT may be a surrogate for a more comprehensive and safer approach to matching patients to surgery or SBRT. The observation of higher post-operative mortality rates at facilities without an SBRT program deserves further study.

Analysis of Rayleigh-wave multipath propagation at LASA

1970 ◽  
Vol 60 (5) ◽  
pp. 1701-1731 ◽  
Author(s):  
Jack Capon
Keyword(s):  
Rayleigh Waves ◽  
Multipath Propagation ◽  
Continental Margins ◽  
Period Range ◽  
Analysis Technique ◽  
High Resolution Analysis ◽  
Resolution Analysis ◽  
Propagation Paths ◽  
Using Data ◽  
Almost All

Abstract An investigation has been made of the multipath propagation of Rayleigh waves by using data obtained from the large aperture seismic array (LASA). The use of the LASA in conjunction with a high-resolution analysis technique provides a greater angular resolution and accuracy than was previously possible for the analysis of the multipath propagation. Measurements have been made of this phenomenon for the Rayleigh waves of 26 events distributed at various azimuths and distances from LASA. On the bas of these measurements reasonably good conjectures are made concerning the actual propagation paths for groups in the 20- to 40-sec period range. It is shown that in almost all cases these propagation paths can be associated with refractions and reflections at the continental margins.

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