scholarly journals An Alternative Risk Assessment Model of Urban Waterlogging: A Case Study of Ningbo City

2021 ◽  
Vol 13 (2) ◽  
pp. 826
Author(s):  
Meiling Zhou ◽  
Xiuli Feng ◽  
Kaikai Liu ◽  
Chi Zhang ◽  
Lijian Xie ◽  
...  
Keyword(s):  
Risk Assessment ◽  
High Risk ◽  
Assessment Model ◽  
Risk Assessments ◽  
Risk Assessment Model ◽  
Risk Area ◽  
The North ◽  
Coastal Cities ◽  
Risk Areas ◽  
The City

Influenced by climate change, extreme weather events occur frequently, and bring huge impacts to urban areas, including urban waterlogging. Conducting risk assessments of urban waterlogging is a critical step to diagnose problems, improve infrastructure and achieve sustainable development facing extreme weathers. This study takes Ningbo, a typical coastal city in the Yangtze River Delta, as an example to conduct a risk assessment of urban waterlogging with high-resolution remote sensing images and high-precision digital elevation models to further analyze the spatial distribution characteristics of waterlogging risk. Results indicate that waterlogging risk in the city proper of Ningbo is mainly low risk, accounting for 36.9%. The higher-risk and medium-risk areas have the same proportions, accounting for 18.7%. They are followed by the lower-risk and high-risk areas, accounting for 15.5% and 9.6%, respectively. In terms of space, waterlogging risk in the city proper of Ningbo is high in the south and low in the north. The high-risk area is mainly located to the west of Jiangdong district and the middle of Haishu district. The low-risk area is mainly distributed in the north of Jiangbei district. These results are consistent with the historical situation of waterlogging in Ningbo, which prove the effectiveness of the risk assessment model and provide an important reference for the government to prevent and mitigate waterlogging. The optimized risk assessment model is also of importance for waterlogging risk assessments in coastal cities. Based on this model, the waterlogging risk of coastal cities can be quickly assessed, combining with local characteristics, which will help improve the city’s capability of responding to waterlogging disasters and reduce socio-economic loss.

scholarly journals On the Risk Assessment of Terrorist Attacks Coupled with Multi-Source Factors

2018 ◽  
Vol 7 (9) ◽  
pp. 354 ◽  
Author(s):  
Xun Zhang ◽  
Min Jin ◽  
Jingying Fu ◽  
Mengmeng Hao ◽  
Chongchong Yu ◽  
...  
Keyword(s):  
Risk Assessment ◽  
High Risk ◽  
Southeast Asia ◽  
The Philippines ◽  
Assessment Model ◽  
Terrorist Attacks ◽  
Recommendation Algorithm ◽  
Spatial Risk ◽  
Risk Areas ◽  
F Measure

Terrorism has wreaked havoc on today’s society and people. The discovery of the regularity of terrorist attacks is of great significance to the global counterterrorism strategy. In this study, we improve the traditional location recommendation algorithm coupled with multi-source factors and spatial characteristics. We used the data of terrorist attacks in Southeast Asia from 1970 to 2016, and comprehensively considered 17 influencing factors, including socioeconomic and natural resource factors. The improved recommendation algorithm is used to build a spatial risk assessment model of terrorist attacks, and the effectiveness is tested. The model trained in this study is tested with precision, recall, and F-Measure. The results show that, when the threshold is 0.4, the precision is as high as 88%, and the F-Measure is the highest. We assess the spatial risk of the terrorist attacks in Southeast Asia through experiments. It can be seen that the southernmost part of the Indochina peninsula and the Philippines are high-risk areas and that the medium-risk and high-risk areas are mainly distributed in the coastal areas. Therefore, future anti-terrorism measures should pay more attention to these areas.

A Validated Risk Model for Prediction of Early Readmission in Patients with Hepatic Encephalopathy

2018 ◽  
Vol 17 (5) ◽  
pp. 0-10
Author(s):  
Andrew J. Kruger ◽  
Fasika Aberra ◽  
Sylvester M. Black ◽  
Alice Hinton ◽  
James Hanje ◽  
...  
Keyword(s):  
Risk Assessment ◽  
Hepatic Encephalopathy ◽  
High Risk ◽  
Risk Model ◽  
Cox Regression ◽  
Low Risk ◽  
Assessment Model ◽  
Risk Assessment Model ◽  
Early Readmission ◽  
The Impact

Introduction and aim. Hepatic encephalopathy (HE) is a common complication in cirrhotics and is associated with an increased healthcare burden. Our aim was to study independent predictors of 30-day readmission and develop a readmission risk model in patients with HE. Secondary aims included studying readmission rates, cost, and the impact of readmission on mortality. Material and methods. We utilized the 2013 Nationwide Readmission Database (NRD) for hospitalized patients with HE. A risk assessment model based on index hospitalization variables for predicting 30-day readmission was developed using multivariate logistic regression and validated with the 2014 NRD. Patients were stratified into Low Risk and High Risk groups. Cox regression models were fit to identify predictors of calendar-year mortality. Results. Of 24,473 cirrhosis patients hospitalized with HE, 32.4% were readmitted within 30-days. Predictors of readmission included presence of ascites (OR: 1.19; 95% CI: 1.06-1.33), receiving paracentesis (OR: 1.43; 95% CI: 1.26-1.62) and acute kidney injury (OR: 1.11; 95% CI: 1.00-1.22). Our validated model stratified patients into Low Risk and High Risk of 30-day readmissions (29% and 40%, respectively). The cost of the first readmission was higher than index admission in the 30-day readmission cohort ($14,198 vs. $10,386; p-value < 0.001). Thirty-day readmission was the strongest predictor of calendar-year mortality (HR: 4.03; 95% CI: 3.49-4.65). Conclusions. Nearly one-third of patients with HE were readmitted within 30-days, and early readmission adversely impacted healthcare utilization and calendar-year mortality. With our proposed simple risk assessment model, patients at high risk for early readmissions can be identified to potentially avert poor outcomes.

External validation of the IMPROVE Bleeding Risk Assessment Model in medical patients

2016 ◽  
Vol 116 (09) ◽  
pp. 530-536 ◽  
Author(s):  
David J. Rosenberg ◽  
Anne Press ◽  
Joanna Fishbein ◽  
Martin Lesser ◽  
Lauren McCullagh ◽  
...  
Keyword(s):  
Risk Assessment ◽  
High Risk ◽  
High Risk Patient ◽  
Assessment Model ◽  
Risk Assessment Model ◽  
Validation Sample ◽  
Medical Patients ◽  
Medically Ill ◽  
Major Bleed ◽  
Hospitalised Patients

SummaryThe IMPROVE Bleed Risk Assessment Model (RAM) remains the only bleed RAM in hospitalised medical patients using 11 clinical and laboratory factors. The aim of our study was to externally validate the IMPROVE Bleed RAM. A retrospective chart review was conducted between October 1, 2012 and July 31, 2014. We applied the point scoring system to compute risk scores for each patient in the validation sample. We then dichotomised the patients into those with a score <7 (low risk) vs ≥ 7 (high risk), as outlined in the original study, and compared the rates of any bleed, non-major bleed, and major bleed. Among the 12,082 subjects, there was an overall 2.6 % rate of any bleed within 14 days of admission. There was a 2.12 % rate of any bleed in those patients with a score of < 7 and a 4.68 % rate in those with a score ≥ 7 [Odds Ratio (OR) 2.3 (95 % CI=1.8–2.9), p<0.0001]. MB rates were 1.5 % in the patients with a score of < 7 and 3.2 % in the patients with a score of ≥ 7, [OR 2.2 (95 % CI=1.6–2.9), p<0.0001]. The ROC curve was 0.63 for the validation sample. This study represents the largest externally validated Bleed RAM in a hospitalised medically ill patient population. A cut-off point score of 7 or above was able to identify a high-risk patient group for MB and any bleed. The IMPROVE Bleed RAM has the potential to allow for more tailored approaches to thromboprophylaxis in medically ill hospitalised patients.Supplementary Material to this article is available online at www.thrombosis-online.com.

scholarly journals Ocupação em Área de Risco de Deslizamentos no Córrego do Jenipapo, Recife, Pernambuco (Occupation area at risk of landslides in Córrego do Jenipapo, Recife, Pernambuco)

2012 ◽  
Vol 5 (3) ◽  
pp. 524
Author(s):  
Josafá Henrique Gomes ◽  
Thiago Luiz do Vale Silva ◽  
Elidiane Ribeiro Guerra ◽  
Daniel Targa Dias Anastacio
Keyword(s):  
At Risk ◽  
Urban Planning ◽  
Area At Risk ◽  
Risk Area ◽  
The North ◽  
The People ◽  
Risk Areas ◽  
The Hill ◽  
The City

A ocupação e a organização do espaço aconteceram de forma desigual, onde as camadas menos favorecidas da população terminou sendo excluída das áreas mais nobres da cidade, terminando por se fixar em áreas desvalorizadas imobiliariamente, ocupando entre outros lugares, os morros ou encostas, cuja instabilidade geológica é caracterizada pelo predomínio de escorregamentos ou deslizamentos de massa, o que gera grandes problemas para a população que nelas habitam. Na cidade do Recife, as áreas de risco, que se caracterizam como locais vulneráveis ao deslizamento de massa se encontram, principalmente, na zona norte. Assim, no intuito de conhecer melhor esses espaços e verificar o que tem sido feito para a mitigação do problema, foi escolhido para a realização do presente trabalho o bairro do Córrego do Jenipapo, o qual se localiza nessa região problemática e apresenta em toda sua extensão relevo com características que propicia a ocorrência desse fenômeno. Portanto, tem como objetivo caracterizar o Córrego do Jenipapo, localizá-lo entre os principais bairros que apresenta áreas de risco na Cidade do Recife e apontar as principais ações adotadas pela prefeitura a fim de evitar acidentes.Palavras-chave: ocupação de morro; área de risco; deslizamento de encostas; planejamento urbano. Occupation Area at Risk of Landslides in Córrego do Jenipapo, Recife, Pernambuco ABSTRACTThe occupation of space and organization occurred unevenly, where the disadvantaged sections of the population ended up being excluded from the finest areas of the city, eventually settling in areas undervalued, ranking among other places, the hills and slopes, whose geological instability is characterized by the predominance of landslides or mudslides mass, which creates major problems for the people who inhabit them. In the city of Recife, the risk areas, which are characterized as places vulnerable to sliding mass are mainly in the north. Thus, in order to better understand these areas and see what has been done to mitigate the problem, was chosen for the present work the neighborhood of Jenipapo Stream, which is located in this region and presents problems in all its extension relief with features that facilitates the occurrence of this phenomenon. Therefore, aims to characterize the Stream Jenipapo, locate it among the top districts that presents risk areas in the city of Recife and point out the main actions taken by the city to avoid accidents.Keywords: occupation of the hill; risk area, landslides, urban planning.

scholarly journals The Application of Gail Model to Predict the Risk of Developing Breast Cancer among Jordanian Women

2020 ◽  
Vol 2020 ◽  
pp. 1-6
Author(s):  
Hikmat Abdel-Razeq ◽  
Luna Zaru ◽  
Ahmed Badheeb ◽  
Shadi Hijjawi
Keyword(s):  
Breast Cancer ◽  
Risk Assessment ◽  
High Risk ◽  
Risk Score ◽  
Assessment Model ◽  
Risk Assessment Model ◽  
Breast Cancer Patients ◽  
Gail Model ◽  
History Of ◽  
The Mean

Background and Objectives. Breast cancer has been the most common cancer affecting women in Jordan. In the process of implementing breast cancer prevention and early detection programs, individualized risk assessment can add to the cost-effectiveness of such interventions. Gail model is a widely used tool to stratify patients into different risk categories. However, concerns about its applicability across different ethnic groups do exist. In this study, we report our experience with the application of a modified version of this model among Jordanian women. Methods. The Gail risk assessment model (RAM) was modified and used to calculate the 5-year and lifetime risk for breast cancer. Patients with known breast cancer were used to test this model. Medical records and hospital database were utilized to collect information on known risk factors. The mean calculated risk score for women tested was 0.65. This number, which corresponds to the Gail original score of 1.66, was used as a cutoff point to categorize patients as high risk. Results. A total of 1786 breast cancer patients with a mean age of 50 (range: 19–93) years were included. The modified version of the Gail RAM was applied on 1213 patients aged 35–59.9 years. The mean estimated risk for developing invasive breast cancer over the following five years was 0.54 (95% CI: 0.52, 0.56), and the lifetime risk was 3.42 (95% CI: 3.30, 3.53). Only 210 (17.3%) women had a risk score >0.65 and thus categorized as high risk. First-degree family history of breast cancer was identified among 120 (57.1%) patients in this high-risk group. Conclusions. Among a group of patients with an established diagnosis of breast cancer, a modified Gail risk assessment model would have been able to stratify only 17% into the high-risk category. The family history of breast cancer contributed the most to the risk score.

scholarly journals The HAS-RISC Score for Venous Thromboembolism (VTE) Risk Stratification in Newly Diagnosed Multiple Myeloma Patients Starting Immunomodulatory Drugs (IMID)

Blood ◽  
2018 ◽  
Vol 132 (Supplement 1) ◽  
pp. 144-144 ◽  
Author(s):  
Ang Li ◽  
Qian V. Wu ◽  
Greg Warnick ◽  
Neil A Zakai ◽  
Edward N. Libby ◽  
...  
Keyword(s):  
Risk Factors ◽  
Risk Assessment ◽  
High Risk ◽  
Research Funding ◽  
Risk Group ◽  
High Risk Group ◽  
Assessment Model ◽  
Risk Assessment Model ◽  
Newly Diagnosed ◽  
Very High

Abstract Introduction: Patients with newly diagnosed multiple myeloma (MM) have high risk of venous thromboembolism (VTE) when starting initial treatment that contains immunomodulatory drugs (IMID) such as lenalidomide or thalidomide. The National Comprehensive Cancer Network (NCCN) guideline recommends primary anticoagulant thromboprophylaxis for the high-risk patients. However, it is challenging to risk-stratify patients without a validated risk model. We have conducted a retrospective cohort study using the SEER-Medicare (Surveillance, Epidemiology, and End Results) database to derive a new VTE risk assessment model. Methods: We selected all patients 66 or older with newly diagnosed MM 2007 to 2013. Patients were included if they had a prescription of IMID within twelve months of diagnosis and complete enrollment for fee-for-service and prescription drug coverage. We ascertained baseline demographics and VTE risk factors from the current NCCN guideline using validated codes. The VTE outcome was defined as either one inpatient or two outpatient claims at least 30 days apart in combination with an anticoagulant prescription within 90 days. All patients were followed from the date of IMID initiation until first VTE occurrence or death and were censored for disenrollment from Medicare, discontinuation of IMID (after a grace period of 90 days), autologous transplantation, or the end of claims data (12/31/2014). Cause specific Cox regression models were used for time to VTE analysis. For variable selection, all risk factors with p-value <0.10 were considered candidates for inclusion in the final multivariable regression model. VTE history, recent surgery, and anticoagulant exposure were forced into the model, regardless of significance testing. Integer points were assigned according to the beta coefficients and subsequent risk groups were created. The model's discrimination was validated internally by the bias-corrected Harrell's c statistic and the 95% confidence interval was estimated from 200 bootstrap samples. Results: We identified 2397 MM patients on IMID that met the study criteria. The median time on IMID treatment was 116 days (IQR 28-279). The mean age of patients was 74, 49% were female, 80% were White, 13% were Black, 6.5% were Asian. Only 13% of patients had concurrent anticoagulant exposure (11% warfarin, 2% LMWH, 1% DOAC) with a median duration of 116 days (IQR 42-315 days). In the multivariable model built from candidate covariates, we identified history of VTE, recent surgery, cytotoxic (non-bortezomib) chemotherapy, higher dose dexamethasone, older age, and Black race, as important risk factors. Asian race and LMWH/DOAC use were associated with lower VTE risk (Table 1). We derived a risk assessment model that stratified patients into 2 prognostic risk groups (Table 1): 25% (n=581) in the very high-risk group (score 2 to 7), 75% (n=1816) in the standard-risk group (score -3 to 1). The incidence of VTE at 3 months and 6 months were 9.5% and 16.3% in the very high-risk group compared to 3.7% and 6.3% in the standard-risk group with a resulting hazard ratio of 2.73 (p<0.001) (Figure 1). The bias-corrected Harrell's c statistic for the product index was 0.63 (0.59-0.68). Conclusions: We have derived a VTE risk assessment model specifically for patients with MM starting IMID therapy. The HAS-RiSC score combines 7 clinical risk factors - History of VTE, Age 80+, Surgery within last 90 days, Race Black, race Asian, Steroid use, and Chemotherapy - into a simplified VTE risk assessment model that identifies a subgroup of patients at very high risk for VTE. External validation of this risk assessment model is currently in progress. Disclosures Garcia: Daiichi Sankyo: Research Funding; Incyte: Research Funding; Janssen: Consultancy, Research Funding; Pfizer: Consultancy; Retham Technologies LLC: Consultancy; Shingoi: Consultancy; Portola: Research Funding; Bristol Meyers Squibb: Consultancy; Boehringer Ingelheim: Consultancy. Lyman:Amgen: Other: Research support; Generex Biotechnology: Membership on an entity's Board of Directors or advisory committees; Halozyme; G1 Therapeutics; Coherus Biosciences: Consultancy.

scholarly journals Evaluating post-operative venous thromboembolism risk in urology patients using a validated risk assessment model

2021 ◽  
Vol 27 (1) ◽  
Author(s):  
Winston Paul René Padayachee ◽  
Mohamed Haffejee ◽  
Marietha Nel
Keyword(s):  
Risk Factors ◽  
Risk Assessment ◽  
Venous Thromboembolism ◽  
High Risk ◽  
Significant Risk ◽  
Assessment Model ◽  
Risk Category ◽  
Risk Assessment Model ◽  
Surgical Morbidity ◽  
Significant Difference

Abstract Background Venous thromboembolism (VTE) is an important cause of post-surgical morbidity and mortality. This study aimed to apply a validated risk assessment model to evaluate the risk of post-operative VTE in urology patients. Methods This prospective descriptive observational study used the Caprini risk assessment model to evaluate VTE risk in patients planned for elective urology surgery at a tertiary Johannesburg hospital from January to June 2020. Results Two hundred and twenty-six patients with a mean age of 52 years were evaluated for post-operative VTE risk. The population was generally overweight, with a mean BMI of 26.3 kg/m2. The mean Caprini score was 4.42, reflecting a population at high risk for post-operative VTE. There was no statistically significant difference between males and females in this regard. On average, participants had three risk factors for post-operative VTE. Fifteen per cent of all patients were at low risk for VTE, while 40.3% of participants were categorised as moderate risk. The category with the highest percentage of participants (44.7%) was the high-risk category (Caprini score ≥ 5). High-risk patients undergoing oncology surgery comprised 16.8% of the population, and these patients may require extended duration pharmacological thromboprophylaxis to prevent VTE. The most clinically significant risk factors for post-operative VTE included age, obesity, malignancy and HIV infection. Conclusion Venous thromboembolism may be difficult to diagnose, and clinicians may underestimate the risk for it to develop. Risk assessment models, such as the Caprini score, are objective and a practical tool to guide the application of thromboprophylaxis. The application of the Caprini RAM in the elective urological surgery population at Chris Hani Baragwanath Academic Hospital yields similar results to studies performed elsewhere on similar surgical populations. Further research is required to evaluate whether the actual incidence of VTE correlates with the risk assessment in this population. Clinician compliance with the use of RAMs as well as the corresponding recommendations for prophylaxis may need to be evaluated. A validated risk assessment model which accounts for procedure-specific risks in urology may be useful.

Impact of Venous Thromboembolism (VTE) Prophylaxis and Risk Stratification with the Caprini Model in Hospitalized Patients with Cancer

Blood ◽  
2012 ◽  
Vol 120 (21) ◽  
pp. 364-364
Author(s):  
Joshua M Ruch ◽  
Hsou M Hu ◽  
Vinita Bahl ◽  
Suman L. Sood
Keyword(s):  
Risk Assessment ◽  
High Risk ◽  
Conflicts Of Interest ◽  
Assessment Model ◽  
Risk Assessment Model ◽  
Medical Patients ◽  
Vte Prophylaxis ◽  
Patients With Cancer ◽  
Pharmacologic Prophylaxis ◽  
The Impact

Abstract Abstract 364 Introduction: VTE is a common complication in hospitalized medical patients and the role of pharmacologic anticoagulation prophylaxis is well-established. Patients with active malignancy are at higher risk for VTE during hospitalization. However, VTE prophylaxis is underutilized in these patients due to many real and perceived contraindications to prophylaxis. To aid clinicians in determining VTE risk and guide choice of prophylaxis, our institution adopted the Caprini risk assessment model (Ann Surg, 2010; 251[2]:344–50), based on clinical factors such as age, comorbidities, and recent surgery. Our primary objective was to assess adherence to recommended VTE prophylaxis in hospitalized medical patients with solid tumors, hematological malignancies, and bone marrow transplant (BMT) patients in comparison to general medical (GM) patients, and the impact of recommended prophylaxis use on VTE outcomes. Secondary objectives were to evaluate the distribution of Caprini risk scores and the utility of the Caprini risk assessment model for guiding prophylaxis in this population. Methods: Patients admitted to the hematology/oncology (HO; oncology, malignant hematology, and BMT) and GM inpatient services at the University of Michigan between July 1, 2009 to December 31, 2011 were included in the study. After IRB approval, patient information was extracted from the electronic medical record (EMR). A point-scoring method based on the Caprini risk assessment model was used to calculate VTE risk at admission. A score of 3–4 was high risk and ≥ 5 highest risk for VTE. Type of VTE prophylaxis and VTE rate were determined. Recommended prophylaxis was 5000 units TID SQ heparin, 30–40 mg SQ enoxaparin, or 2.5 mg SQ fondaparinux, ± sequential compression devices (SCDs). Pharmacological prophylaxis administration was verified in the EMR. VTE is defined as deep venous thrombosis (DVT) or pulmonary embolism (PE) occurring during hospitalization or within 90 days, confirmed by Doppler, CT or V/Q scan. Adherence was defined as the percentage of patients at high or highest risk for VTE with a length of stay ≥ 2 days who received guideline recommended prophylaxis within 2 days of admission. Patients with a contraindication to prophylaxis were excluded. A retrospective cohort study was performed. Chi-squared test was used to test differences in proportions and Cochran-Armitage test for trends. Results: 4300 patients were admitted to HO and 18,347 to GM services. Compared to GM patients (86.8%), the rate of adherence to recommended VTE prophylaxis was similar for oncology (87.6%), hematology (85.4%), and lower (45.6%) for BMT patients (p<0.0001). The overall VTE rate on HO services was 2.77%. Compared with 1.45% in GM, VTE rate was 3.02% in oncology (p=0.070), 2.01% in hematology (p=0.220), and 3.61% for BMT (p=0.001). Over half (51.3%) of VTE in HO patients occurred in patients who did not receive pharmacologic prophylaxis. In HO patients with a VTE, ordered prophylaxis included 16.0% combined pharmacological and SCD, 32.8% pharmacological alone, 32.8% SCD alone, and 18.5% none. Use of combined or pharmacologic prophylaxis alone was non-significantly increased in the non-VTE HO patients. By the Caprini risk assessment model, 33.3% of all patients on HO services were high and 62.2% highest risk, with less oncology (p=0.0001) and more BMT (p=0.0003) patients classified as high or highest risk. VTE rate in HO patients rose as Caprini risk score increased: score (n, % with VTE) 0–1 (23, 4.35%,); 2 (169, 0.59%); 3–4 (1434, 1.67%); 5–6 (1691, 2.90%); 7–8 (745, 3.76%); and 9 (238, 6.72%), p<0.0001 for trend. Conclusions: Adherence to recommended VTE prophylaxis was high in medical patients with cancer, resulting in low overall rates of VTE during and following discharge. The majority of patients with VTE did not receive recommended pharmacologic prophylaxis. Most VTE occurred in patients at highest risk (Caprini risk assessment score ≥ 5), with a trend to higher VTE rate as individual score increased. These data suggest that the individual Caprini score may provide more detailed VTE risk assessment and may help inform the need for prophylaxis despite perceived relative contraindications in this high risk cancer population. Further study is needed to understand the barriers to ordering VTE prophylaxis in this population and encourage increased prophylaxis use. Disclosures: No relevant conflicts of interest to declare.

A RISK ASSESSMENT MODEL FOR ONSITE SYSTEMS APPLIED TO THE CITY OF OTTAWA, CANADA

2013 ◽  
Author(s):  
C.B. Kinsley ◽  
D. Joy ◽  
A. Campbell ◽  
D. Feniak ◽  
D. Branson ◽  
...  
Keyword(s):  
Risk Assessment ◽  
Assessment Model ◽  
Risk Assessment Model ◽  
The City
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