scholarly journals The Relationship between Resource Utilization, Clinical Risk and Hospital Costs for Emergency Medical Admissions

2016 ◽  
Vol 15 (1) ◽  
pp. 7-12
Author(s):  
Seán Cournane ◽  
◽  
Declan Byrne ◽  
Deirdre O’Riordan ◽  
Brian Fitzgerald ◽  
...  
Keyword(s):  
Quantile Regression ◽  
Univariate Analysis ◽  
Hospital Costs ◽  
Resource Utilisation ◽  
Patient Acuity ◽  
Emergency Medical ◽  
Non Linear ◽  
Clinical Complexity ◽  
Clinical Risks ◽  
The Relationship

There has been little study of the relationship between resource utilisation, clinical risks and hospital costs in acute medicine with the question remaining as to whether current funding models reflect patient acuity. We examined the relationship between resource use for investigations/allied professional and patient episode costs in all emergency medical admissions admitted to our institution during 2008-2013. Univariate estimates were compared with a multivariate model adjusted for major cost predictors. Interestingly, the model adjusted cost estimates changed considerably when compared with univariate analysis. We used both linear and non-linear (quantile regression) methods due to the highly skewed nature of hospital costs. The data suggested that hospital episode costs were predictable and driven by objective measures of clinical complexity. The use of expensive investigations and healthcare professional time was secondary to the clinical acuity. Thus, cost was heavily weighted towards higher complexity, and lower resource utilisation associated with lower risk patient groups. However, the non-linear nature of the costings would caution against simple predictor models and non-linear techniques such as quantile regression may, as we have demonstrated, prove superior in defining the underlying relationships.

Analysis of Maximum Expiratory Flow Volume Curves Using Canonical Correlation Analysis

1985 ◽  
Vol 24 (02) ◽  
pp. 91-100 ◽  
Author(s):  
W. van Pelt ◽  
Ph. H. Quanjer ◽  
M. E. Wise ◽  
E. van der Burg ◽  
R. van der Lende
Keyword(s):  
Correlation Analysis ◽  
Canonical Correlation Analysis ◽  
Canonical Correlation ◽  
Flow Volume ◽  
Non Linear ◽  
Maximum Expiratory Flow ◽  
Expiratory Flow ◽  
Relationship Of ◽  
The Relationship ◽  
Age And Sex

SummaryAs part of a population study on chronic lung disease in the Netherlands, an investigation is made of the relationship of both age and sex with indices describing the maximum expiratory flow-volume (MEFV) curve. To determine the relationship, non-linear canonical correlation was used as realized in the computer program CANALS, a combination of ordinary canonical correlation analysis (CCA) and non-linear transformations of the variables. This method enhances the generality of the relationship to be found and has the advantage of showing the relative importance of categories or ranges within a variable with respect to that relationship. The above is exemplified by describing the relationship of age and sex with variables concerning respiratory symptoms and smoking habits. The analysis of age and sex with MEFV curve indices shows that non-linear canonical correlation analysis is an efficient tool in analysing size and shape of the MEFV curve and can be used to derive parameters concerning the whole curve.

Kaitan Akses Internet dan Penyelesaian Tugas Sekolah Berdasarkan Regresi Kuantil Menuju Masyarakat 5.0

2020 ◽  
Vol 3 (2) ◽  
pp. 342-350
Author(s):  
Suparna Parwodiwiyono
Keyword(s):  
Quantile Regression ◽  
Internet Use ◽  
Secondary Data ◽  
Internet Access ◽  
The Internet ◽  
School Work ◽  
Close Relationship ◽  
Use Of The Internet ◽  
Good Learning ◽  
The Relationship

Abstrak: Bagi generasi pasca milenial penggunaan internet sangat akrab tetapi dengan berbagai tujuan penggunaan. Penelitian ini ingin melihat keterkaitan penggunaan internet oleh penduduk yang sedang sekolah untuk kepentingan penyelesaian tugas sekolah di Indonesia untuk mendapatkan hasil belajar yang baik. Analisis berdasarkan data sekunder dari Survei Sosial Ekonomi Nasional tahun 2018. Hanya saja data yang didapatkan tidak simetris dengan adanya pencilan. Regresi kuantil digunakan untuk meminimumkan pengaruh dari pencilan yang ada. Penelitian mendapatkan hasil bahwa terdapat kaitan yang erat antara akses internet dari penduduk yang sedang sekolah dengan penyelesaian tugas sekolah.  Hasil regresi kuantil menunjukkan bahwa proporsi akses internet untuk penyelesaian tugas sekolah berbeda antar golongan proporsi penggunaan internet. Proporsi penggunaan internet yang tinggi akan digunakan untuk penyelesaian tugas sekolah yang lebih tinggi pula. Abstract: For the post millennial generation the use of the internet is very familiar but with various purposes of use. This study wants to look at the relationship between the use of the internet by residents who are currently in school for the sake of completing school work in Indonesia to get good learning outcomes. Analysis based on secondary data from the 2018 National Socio-Economic Survey. It's just that the data obtained is not symmetrical with outliers. Quantile regression is used to minimize the effect of outliers. The study found that there was a close relationship between internet access from residents who were in school and completion of school work. The quantile regression results show that the proportion of internet access for completing school work differs between groups of proportions of internet use. A high proportion of internet use will be used for completing higher school work.

scholarly journals $$ T\overline{T} $$-like flows in non-linear electrodynamic theories and S-duality

2021 ◽  
Vol 2021 (4) ◽  
Author(s):  
H. Babaei-Aghbolagh ◽  
Komeil Babaei Velni ◽  
Davood Mahdavian Yekta ◽  
H. Mohammadzadeh
Keyword(s):  
Type Theory ◽  
Free Action ◽  
Momentum Tensor ◽  
Flow Equation ◽  
Supersymmetric Model ◽  
Deformation Problem ◽  
Dimensional Spacetime ◽  
Non Linear ◽  
The Relationship ◽  
Simple Integration

Abstract We investigate the $$ T\overline{T} $$ T T ¯ -like flows for non-linear electrodynamic theories in D(=2n)-dimensional spacetime. Our analysis is restricted to the deformation problem of the classical free action by employing the proposed $$ T\overline{T} $$ T T ¯ operator from a simple integration technique. We show that this flow equation is compatible with $$ T\overline{T} $$ T T ¯ deformation of a scalar field theory in D = 2 and of a non-linear Born-Infeld type theory in D = 4 dimensions. However, our computation discloses that this kind of $$ T\overline{T} $$ T T ¯ flow in higher dimensions is essentially different from deformation that has been derived from the AdS/CFT interpretations. Indeed, the gravity that may be exist as a holographic dual theory of this kind of effective Born-Infeld action is not necessarily an AdS space. As an illustrative investigation in D = 4, we shall also show that our construction for the $$ T\overline{T} $$ T T ¯ operator preserves the original SL(2, ℝ) symmetry of a non-supersymmetric Born-Infeld theory, as well as $$ \mathcal{N} $$ N = 2 supersymmetric model. It is shown that the corresponding SL(2, ℝ) invariant action fixes the relationship between the $$ T\overline{T} $$ T T ¯ operator and quadratic form of the energy-momentum tensor in D = 4.

scholarly journals Correlation between fundus autofluorescence and visual function in patients with cone-rod dystrophy

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Satoru Kanda ◽  
Takumi Hara ◽  
Ryosuke Fujino ◽  
Keiko Azuma ◽  
Hirotsugu Soga ◽  
...  
Keyword(s):  
Visual Field ◽  
Significant Relationship ◽  
Fundus Autofluorescence ◽  
Univariate Analysis ◽  
Retrospective Chart Review ◽  
Mean Deviation ◽  
Wide Field ◽  
The Mean ◽  
The Relationship ◽  
Field Imaging

AbstractThis study aimed to investigate the relationship between autofluorescence (AF) signal measured with ultra-wide field imaging and visual functions in patients with cone-rod dystrophy (CORD). A retrospective chart review was performed for CORD patients. We performed the visual field test and fundus autofluorescence (FAF) measurement and visualized retinal structures with optical coherence tomography (OCT) on the same day. Using binarised FAF images, we identified a low FAF area ratio (LFAR: low FAF/30°). Relationships between age and logMAR visual acuity (VA), central retinal thickness (CRT), central choroidal thickness (CCT), mean deviation (MD) value, and LFAR were investigated. Thirty-seven eyes of 21 CORD patients (8 men and 13 women) were enrolled. The mean patient age was 49.8 years. LogMAR VA and MD were 0.52 ± 0.47 and − 17.91 ± 10.59 dB, respectively. There was a significant relationship between logMAR VA and MD (p = 0.001). LogMAR VA significantly correlated with CRT (p = 0.006) but not with other parameters. Conversely, univariate analysis suggested a significant relationship between MD and LFAR (p = 0.001). In the multivariate analysis, LFAR was significantly associated with MD (p = 0.002). In conclusion, it is useful to measure the low FAF area in patients with CORD. The AF measurement reflects the visual field deterioration but not VA in CORD.

scholarly journals Hypogonadism and liver fibrosis in HIV-infected patients

2021 ◽  
Author(s):  
E. Quiros-Roldan ◽  
T. Porcelli ◽  
L. C. Pezzaioli ◽  
M. Degli Antoni ◽  
S. Paghera ◽  
...  
Keyword(s):  
Liver Fibrosis ◽  
Univariate Analysis ◽  
Free Testosterone ◽  
Sex Hormone Binding Globulin ◽  
Total Testosterone ◽  
Cross Sectional ◽  
Pituitary Dysfunction ◽  
Consequent Reduction ◽  
Secondary Hypogonadism ◽  
The Relationship

Abstract Purpose Hypogonadism is frequent in HIV-infected men and might impact on metabolic and sexual health. Low testosterone results from either primary testicular damage, secondary hypothalamic-pituitary dysfunction, or from liver-derived sex-hormone-binding-globulin (SHBG) elevation, with consequent reduction of free testosterone. The relationship between liver fibrosis and hypogonadism in HIV-infected men is unknown. Aim of our study was to determine the prevalence and type of hypogonadism in a cohort of HIV-infected men and its relationship with liver fibrosis. Methods We performed a cross-sectional retrospective study including 107 HIV-infected men (median age 54 years) with hypogonadal symptoms. Based on total testosterone (TT), calculated free testosterone, and luteinizing hormone, five categories were identified: eugonadism, primary, secondary, normogonadotropic and compensated hypogonadism. Estimates of liver fibrosis were performed by aspartate aminotransferase (AST)-to-platelet ratio index (APRI) and Fibrosis-4 (FIB-4) scores. Results Hypogonadism was found in 32/107 patients (30.8%), with normogonadotropic (10/107, 9.3%) and compensated (17/107, 15.8%) being the most frequent forms. Patients with secondary/normogonadotropic hypogonadism had higher body mass index (BMI) (p < 0001). Patients with compensated hypogonadism had longer HIV infection duration (p = 0.031), higher APRI (p = 0.035) and FIB-4 scores (p = 0.008), and higher HCV co-infection. Univariate analysis showed a direct significant correlation between APRI and TT (p = 0.006) and SHBG (p = 0.002), and between FIB-4 and SHBG (p = 0.045). Multivariate analysis showed that SHBG was independently associated with both liver fibrosis scores. Conclusion Overt and compensated hypogonadism are frequently observed among HIV-infected men. Whereas obesity is related to secondary hypogonadism, high SHBG levels, related to liver fibrosis degree and HCV co-infection, are responsible for compensated forms.

scholarly journals Variables determining clinical complexity in hospitalized Internal Medicine patients: a workload analysis

2017 ◽  
Vol 11 (2) ◽  
pp. 202
Author(s):  
Valentina Tommasi ◽  
Alessandra Campolongo ◽  
Irene Caridi ◽  
Simone Gatti ◽  
Lorena Lagana ◽  
...  
Keyword(s):  
Internal Medicine ◽  
Rating Scale ◽  
Univariate Analysis ◽  
Index Patient ◽  
Clinical Severity ◽  
Optimal Care ◽  
Workload Analysis ◽  
High Type ◽  
Clinical Complexity ◽  
Comorbidity Index

The clinical complexity of Internal Medicine patients is a daily challenge for clinicians. Although clinical complexity cannot be directly measured, several scores describe the variability of clinical severity and comorbidity. The aim of this study was to analyze staff workload by assessing the nursing and medical complexity of patients admitted to an Internal Medicine ward. We included 40 consecutive inpatients [52.5% females, mean age 71.2 (18.2) years] classified according to the index of clinical complexity (ICC, type A: very high; type B: high; type C: moderate) and the cumulative illness rating scale (CIRS) severity and comorbidity index. Patient outcomes, hospitalization duration, tests performed, number of daily medications and time to perform standard nursing tasks were analysed across groups. Mean duration of hospitalization was 15.6 (10.1) days; in-hospital mortality was 15%. Mean CIRS severity index (SI) was 1.03 (0.31) and median CIRS comorbidity index (CI) was 2 (range 1-5). Significant differences were observed among ICC groups in time spent performing specific tasks [univariate analysis of variance F(2.37)=17.26, P&lt;0.001]. No significant differences were found between the three groups for mean CIRS-SI [F(2.37)=3.033, P=0.060] and median CIRS-CI [Kruskal Wallis test: c<sup>2</sup>(2)= 1.672, P=0.433]. Clinical complexity and caring complexity were not correlated in our sample of Internal Medicine inpatients. Optimal care of Internal Medicine patients must take into account their complexity in both the medical and nursing aspects.

scholarly journals The relationship between maximal expiratory pressure values and critical outcomes in mechanically ventilated patients: a post hoc analysis of an observational study

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Yann Combret ◽  
Guillaume Prieur ◽  
Roger Hilfiker ◽  
Francis-Edouard Gravier ◽  
Pauline Smondack ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Observational Study ◽  
Univariate Analysis ◽  
Premature Death ◽  
Extubation Failure ◽  
Short Term ◽  
Expiratory Muscle ◽  
Maximal Expiratory Pressure ◽  
The Impact ◽  
The Relationship

Abstract Background Little interest has been paid to expiratory muscle strength, and the impact of expiratory muscle weakness on critical outcomes is not known. Very few studies assessed the relationship between maximal expiratory pressure (MEP) and critical outcomes. The aim of this study was to investigate the relationship between MEP and critical outcomes. Methods This work was a secondary analysis of a prospective, observational study of adult patients who required mechanical ventilation for ≥ 24 h in an 18-bed ICU. MEP was assessed before extubation after a successful, spontaneous breathing trial. The relationships between MEP and extubation failure, and short-term (30 days) mortality, were investigated. Univariate logistic regressions were computed to investigate the relationship between MEP values and critical outcomes. Two multivariate analyses, with and without maximal inspiratory pressure (MIP), both adjusted using principal component analysis, were undertaken. Unadjusted and adjusted ROC curves were computed to compare the respective ability of MEP, MIP and the combination of both measures to discriminate patients with and without extubation failure or premature death. Results One hundred and twenty-four patients were included. Median age was 66 years (IQR 18) and median mechanical ventilation duration was 7 days (IQR 6). Extubation failure rate was 15% (18/124 patients) and the rate for 30-day mortality was 11% (14/124 patient). Higher MEP values were significantly associated with a lower risk of extubation failure in the univariate analysis [OR 0.96 95% CI (0.93–0.98)], but not with short-term mortality. MEP was independently linked with extubation failure when MIP was not included in the multivariate model, but not when it was included, despite limited collinearity between these variables. This study was not able to differentiate the respective abilities of MEP, MIP, and their combination to discriminate patients with extubation failure or premature death (adjusted AUC for the combination of MEP and MIP: 0.825 and 0.650 for extubation failure and premature death, respectively). Conclusions MEP is related to extubation failure. But, the results did not support its use as a substitute for MIP, since the relationship between MEP and critical outcomes was no longer significant when MIP was included. The use of MIP and MEP measurements combined did not reach higher discriminative capacities for critical outcomes that MEP or MIP alone. Trial Registration This study was retrospectively registered at https://clinicaltrials.gov/ct2/show/NCT02363231?cond=NCT02363231&draw=2&rank=1 (NCT02363231) in 13 February 2015

Anemia and dementia among the elderly: the São Paulo Ageing & Health Study

2011 ◽  
Vol 24 (1) ◽  
pp. 74-81 ◽  
Author(s):  
Itamar S. Santos ◽  
Márcia Scazufca ◽  
Paulo A. Lotufo ◽  
Paulo R. Menezes ◽  
Isabela M. Benseñor
Keyword(s):  
Low Income ◽  
Univariate Analysis ◽  
The Elderly ◽  
Sao Paulo ◽  
Health Study ◽  
São Paulo ◽  
Total Blood ◽  
Cross Sectional ◽  
The Relationship ◽  
Life Function

ABSTRACTBackground: Anemia and dementia are common diseases among the elderly, but conflicting data are available regarding an association between these two conditions. We analyzed data from the São Paulo Ageing & Health Study to address the relationship between anemia and dementia.Methods: This cross-sectional observational study included participants aged 65 years and older from a deprived area of the borough of Butantan, São Paulo, Brazil. Data about demographics, education, income, and cognitive and daily life function were collected, as well as blood samples. Anemia and dementia were defined according to WHO and DSM-IV criteria, respectively.Results: Of the 2267 subjects meeting the inclusion criteria, 2072 agreed to participate in the study; of whom 1948 had a valid total blood count and were included in the analysis. Anemia was diagnosed in 203 (10.2%) participants and dementia in 99 (5.1%). The frequency of anemia was higher in patients with dementia according to univariate analysis (odds ratio (OR) = 2.00, 95% confidence interval (CI) = 1.17–3.41, p = 0.01), but this association was not present after adjusting for age (OR = 1.33, 95% CI = 0.76–2.33, p = 0.32). Further multivariate adjustment did not change the results.Conclusion: Although anemia and dementia are frequent disorders in older people, we found their relationship to be mediated exclusively by aging in this low-income population from São Paulo.

Chloride Accumulation as a Homeostatic System: Negative Feedback Signals for Concentration and Turgor Maintenance Differ in a Glycophyte and a Halophyte

1980 ◽  
Vol 7 (3) ◽  
pp. 237 ◽  
Author(s):  
WJ Cram
Keyword(s):  
Negative Feedback ◽  
Turgor Maintenance ◽  
Non Linear ◽  
Steady Level ◽  
Homeostatic System ◽  
Chloride Accumulation ◽  
Relationship Of ◽  
The Relationship ◽  
Uptake Of Nutrients

Carrot tissue is taken as a representative glycophilic tissue. It accumulates K+, Cl- and total osmotica to a steady level after 10-15 days. This level of Cl- is nearly constant and is independent of external KCl concentration and of turgor. Cl- influx is also independent of turgor. It therefore appears that the Cl- accumulating system in carrot (and possibly in other glycophytes) can, under artificial conditions, act as a homeostat for intracellular C- concentration, and is not the basis of turgor maintenance. It is suggested that turgor might be maintained by controlled accumulation of K+ carboxylates in glycophytes. Beet tissue is taken as a representative halophilic tissue. It accumulates K+, Cl-, and total osmotica to a steady level after about 4 days. At this stage turgor is constant, due to differences in the levels of KCl accumulated. Cl- influx is stimulated by reducing turgor after a lag of 3-5 h. The relationship of Cl- influx to turgor is non-linear. It therefore appears that in beet (and possibly in other halophytes) turgor maintenance is based on the turgor-sensitive accumulation of Cl- salts. Cl- influx in beet is also affected by changes in intracellular Cl- concentration, as in carrot. It is suggested that this feedback relationship may primarily be part of a system for the controlled uptake of nutrients rather than of Cl- in both tissues.

Abstract TP201: The Relationship Between Chronic Kidney Diseases and the Presence of Cerebral Small Vessel Disease in Patients With Acute Ischemic Stroke

Stroke ◽  
2017 ◽  
Vol 48 (suppl_1) ◽  
Author(s):  
Kana Ueki ◽  
Asako Nakamura ◽  
Masahiro Yasaka ◽  
Takahiro Kuwashiro ◽  
Seiji Gotoh ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
White Matter ◽  
Acute Ischemic Stroke ◽  
White Matter Lesion ◽  
Kidney Diseases ◽  
Univariate Analysis ◽  
Small Vessel ◽  
Chronic Kidney Diseases ◽  
History Of ◽  
The Relationship

Introduction: Cerebral small vessel diseases (SVDs) i.e. white matter lesion and cerebral microbleeds (CMBs) are related to the patients with stroke more deeply than those without. In general population, in addition to age, hypertension, diabetes chronic kidney diseases (CKD) is well known to be related to SVDs, but it remains unclear in patients with stroke. We investigated the relationship between CKD and the presence of SVDs in patients with acute ischemic stroke. Methods: We enrolled 493 patients with acute ischemic stroke patients or transient ischemic attack patients (mean age 71; 60% male) who had undergone 1.5T MR imaging within a week of the index events from April 2013 to march 2015. We evaluated kidney function by estimated glomerular filtration rate (eGFR) with the modification of diet in Renal Disease. CKD was defined as an eGFR less than 60mil/min/1.73m 2 . CMBs were defined as focal areas of very low signal intensity smaller than 10mm. White matter lesion as Periventricular hyper intensity (PVH)>grade 2 and Deep and Subcortical White Matter Hyper intensity (DSWMH)> grade 2 were defied as advanced PVH and advanced DSWMH, respectively. We investigated relationship between CKD and CMBs, advanced PVH and advanced DSWMH using a logistic regression analysis. Results: We noted CMBs in 173 patients (35%), PVH in 81 (16%), and DSWMH in 151 (31%). An univariate analysis revealed that the age, CKD, history of stroke, and antiplatelet agents were associated with presence of CMBs, advanced PVH and severe DSWMH . The multivariate analysis revealed that CMBs, advanced PVH and advanced DSWMH were associated with age (CMBs: odds ratio(OR) ; 1.32 ; 95% confidence interval(CI), 1.10-1.60, p=0.004, advanced PVH : OR ; 3.00 ; 95% CI, 2.17-4.26, p<0.01, advanced DSWMH: OR ; 1.94; 95% CI, 1.56-2.45, p<0.01 ), history of stroke(CMBs : OR ; 2.01 ; 95% CI, 1.21-3.34, p=0.007, advanced PVH : OR ; 2.25 ; 95% CI, 1.18-4.27, p=0.01, advanced DSWMH: OR ; 1.78 ; 95% CI, 1.03-3.06, p=0.038). CKD was associated with CMBs (OR ; 1.62 ; 95% CI, 1.04-2.52, p=0.03), but PVH and DSWMH were not. Conclusions: It seems that age and history of stroke are related to CMBs, advanced PVH and advanced DSWMH, and that CKD is associates with CMBs but not with either advanced PVH or advanced DSWMH.

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