Predictors of in-hospital length of stay among cardiac patients: A machine learning approach
پیش بینی کننده های مدت اقامت در بیمارستان در بیماران قلبی: رویکرد یادگیری ماشین-2019
Objective: The In-hospital length of stay (LOS) is expected to increase as cardiovascular diseases complexity increases and the population ages. This will affect healthcare systems especially with the current situation of decreased bed capacity and increasing costs. Therefore, accurately predicting LOS would have a positive impact on healthcare metrics. The aim of this study is to develop a machine learning-based model approach for predicting in-hospital LOS for cardiac patients. Design: Using electronic medical records, we retrospectively extracted all records of patients visits that were admitted under adult cardiology service. Admission diagnosis and primary treating physician were reviewed to verify selection criteria. A predictive machine learning-based model approach was applied to incorporate simple baseline health data at admission time to predict LOS. Patients were divided into three groups based on their LOS: short (b3 days), intermediate (3–5 days) and long (N5 days). Information gain algorithmwas utilized to select the most relevant attributes. Only attributes with information gain of more than zero were used in model building. Four different machine learning techniques were evaluated and their diagnostic accuracy measures were compared. Setting: The dataset of this study included adult patients who were admitted between 2008 and 2016 in King Abdulaziz Cardiac Center (KACC). The center is located in King Abdulaziz Medical City Complex in Riyadh, the capital of Saudi Arabia. Participants (dataset): A total of 16,414 consecutive inpatient visits for 12,769 unique patients (mean age of 58.8 ± 16 years of which 68.2% were males) between 2008 and 2016 were included. The study cohort had a high prevalence of cardiovascular risk factors (hypertension 56%, diabetes 56%, dyslipidemia 52%, obesity 33% and smoking 24%). The most common admitting diagnosis was acute coronary syndrome (36%). Results: The variables with highest impact on the prediction of in-hospital LOS were on admission heart rate, on admission systolic and diastolic blood pressure, age and insurance status (eligibility). Using machine learning models; Random Forest (RF) model outperformed among all other models (sensitivity (0.80), accuracy (0.80), and AUROC (0.94)). Conclusion: We showed that machine learning methods provide accurate prediction of LOS for cardiac patients. This is can be used in clinical bed management and resources allocation.
Keywords: Cardiac science | In-hospital length of stay | Prediction model | Machine learning | Classification techniques
A cut-off value of third molar maturity index for indicating a minimum age of criminal responsibility: Older or younger than 16 years?
ارزش برش از شاخص بلوغ مولر سوم برای نشان دادن حداقل سن مسئولیت کیفری: مسن تر یا جوان تر از 16 سال؟-2019
Providing appropriate legal mechanisms, that evaluate the progression of development from the age of childhood innocence to maturity and full responsibility, considered one of the difficult areas of criminal justice policy. The minimum age of criminal responsibility (MACR) in children varies among countries and differs widely owing to history and culture. Due to rising and brutality of criminal offenses, particularly by juveniles, few countries have lowered the minimum age of criminal responsibility, and many have considered/considering to do the same. India is one such country in which is under the proposal of lowering the age of criminal responsibility to 16 years. As there is lack of useful age assessment methods, that can indicate whether if the individual in question is younger (< 16 years) or older than MACR (≥16 years), the present study was undertaken to derive a specific cut-off value of the third molar maturity index (I3M) for this purpose. The sample consisted of 1078 orthopantomograms (OPTs) from Andhra Pradesh, India, aged between 11 and 20 years (45.4% males and 54.6% females). The reproducibility of I3M was calculated by intra-class correlation coefficients, which showed an intra-rater and inter-rater agreement of 0.912 and 0.891, respectively. The sample was divided into training dataset (819 OPTs), to test I3M and gender as independent variables and MACR as a dependent variable by logistic regression analysis, and test dataset (259 OPTs). A receiver operating curve (ROC) analysis was performed to evaluate the specific cut-off value of I3M for predicting MACR status. A logistic regression analysis showed that gender was not statistically significant for predicting MACR status while ROC analysis indicated a cut-off value of I3M=0.293 as best for predicting MACR status. The performance of derived cut-off value was tested in a test data set. The sensitivity of the test was 90.6% and 90%, while specificity was 86% and 87.1% in males and females, respectively. The proportion of correctly classified individuals was 88.0% and 88.7% in males and females, respectively. The estimated Bayes post-test probability in males was 87.2% and while in females it was 88.3%. The results highlight the contribution of the derived cut-off value of I3M for discriminating individuals around MACR and should be evaluated in other populations.
Keywords: Dental age estimation | Minimum age of criminal responsibility | Third molar maturity index | Orthopantomograms | 16 years
تاثیر برنامه های آموزش بهداشت دهان و دندان بر اساس فناوری تابش پرتوهای فلوئوروسنت در نوجوانان ازبکستانی
سال انتشار: 2018 - تعداد صفحات فایل pdf انگلیسی: 6 - تعداد صفحات فایل doc فارسی: 16
هدف: هدف از ان مطالعه پاسخ به این پرسش است که آیا برنامه های آموزش رعایت بهداشت دهان و دندان با استفاده از بررسی کمی تابش فلوئورسنت روی وضعیت بهداشت دهان و دندان نوجوانان چیست؟
مواد و روش ها: 100 نوجوان 14 تا 16 ساله مدرسه ای در شهر تاشکند در این مطالعه مورد بررسی قرار گرفتند. آن ها به طور تصادفی به دو گروه تقسیم شدند: 1- گروه کنترل (آموزش های سنتی) و 2- گروه آزمایش (آموزش بر مبنای تابش پرتو) به شرکت کنندگان حاضر در گروه آزمایش روش های برداشت پلاک های دندانی به کمک تابش امواج فلوئوروسنت اضافه بر روش های سنتی آموزش داده شد. میزان کل پلاک دندانی جمع شده روی دندان های تمامی شرکت کنندگانی که پرسش نامه مرتبط با وضعیت بهداشت دهان و دندان خود را پر کرده بودند در کنار نگرش و رفتار آن ها طی این 8 هفته مورد بررسی قرار گرفت.
نتایج: از لحاظ آماری پیشرفت قابل توجهی در گروه آزمایش نسبت به گروه کنترل در شاخص پلاک دندانی دیده شد. (45/0 و 07/0 p < 05/0)
نتیجه گیری: این مطالعه نشان می دهد که برنامه های آموزش رعایت بهداست دهان و دندان بر اساس استفاده از فناوری تابش امواج فلوئورسنت می تواند در پیشرغت وضعیت بهداشت دهان و دندان نوجوانان در ازبکستان بسیار مفید باشد.
عبارات کلیدی: فناوری امواج فلوئوروسنت | دستگاه انتشار امواج فلوئورسانس | آموزش بهداشت دهان و دندان | نوجوانان | بهداشت دهان
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Helmet use and injuries in children’s bicycle crashes in the Gothenburg region
استفاده از کلاه ایمنی و جراحات در سقوط دوچرخه کودکان-2017
Aim: To investigate the use and protective effect of helmets in children injured in bicycle crashes and changes in injury patterns during a period of increased helmet use. Method: Injuries in 4246 children below 16 years of age, who attended an A&E ward after a bicycle crash in the Gothenburg region during 1993–2006, were analyzed. The injury severity was classified according to the Abbreviated Injury Scale. The occurrence of skull/brain injuries and facial injuries was analyzed for 3711 children with respect to injury severity, helmet use and demographic and crash-related factors. Changes in injury patterns during the period were analyzed for 4246 children with no regard to helmet use. The ratio of the number of subjects with head injuries to the number of subjects with extremity injuries of any severity and of at least moderate severity was used to estimate the protective effect of helmet at a population level. Results: Helmets were used by 40% of the injured children at the beginning of the period and by 80% at the end; much less frequently by teenagers, especially girls. The adjusted odds of serious or more severe skull/brain injuries and moderate or more severe facial injuries with a helmet were about one fourth of those without a helmet. The proportion of children with skull/brain injuries did not change significantly during the period. Serious or more severe skull/brain injuries were noted more often during the latter half of the period, most often in children without a helmet. The proportion of children with facial injuries decreased, and the proportion with injuries to the upper extremities increased, also for moderate and severe injuries. The ratio between the number of children with head injuries and the number with extremity injuries decreased for injuries of any severity and for moderate or more severe injuries. Conclusions: Bicycle helmets have an obvious protective effect against head injuries in children, regardless of the crash circumstances. Teenagers must be informed about the high risk of skull/brain injuries in bicycle crashes without a helmet. The increasing occurrence of injuries to the upper extremities needs attention.
Keywords: Bicycle accident | Children | Helmet | Injury severity | Upper extremity injury | Head injury
``Thinking before posting? Reducing cyber harassment on social networking sites through a reflective message
`` فکر می کنم قبل از ارسال؟ کاهش آزار و اذیت سایبری در سایت های شبکه های اجتماعی از طریق یک پیام بازتابنده-2017
To deal with cyber harassment amongst youth on social networking sites (SNS), interfaces automatically showing a reflective message when harassment is recognized could be integrated. Such message en courages users to reconsider and to eventually self-censor their post. This study examines whether reflective messages reduce harassment among adolescents on SNS. We conducted an experimental study to test the effect of three different types of reflective messages, as well as a mere time delay, on the change in intention to engage in harassment on SNS. Participants were 321 adolescents from 15 to 16 years old (59.1% was female). We measured their intention to harass prior and after exposure to a reflective message. Moreover, we tested whether certain groups (based on their gender, empathy trait and behavioral inhibition) are more susceptible to certain types of reflective messages. The results show that, for all three conditions, the intention decreased after being exposed to the message, as well as following only a time delay. Furthermore, in one condition a stronger effect was found for individuals with a higher sensitivity of the behavioral inhibition system.
Keywords: Cyber harassment | Social networking sites | Adolescents | Reflective interfaces | Experimental study
The role of online social network chatting for alcohol use in adolescence: Testing three peer-related pathways in a Swedish population-based sample
نقش شبکه اجتماعی آنلاین چت برای استفاده از الکل در نوجوانی : تست سه راه مرتبط با همتایان در یک نمونه سوئدی مبتنی بر جمعیت-2017
The aim of the study was to examine whether online social network chatting (OSNC) is related to any of three peer-related pathways to alcohol use among adolescents including a stress-exposure pathway, a peer status pathway and a social context pathway. A survey was distributed to a Swedish population based sample of 2439 boys and girls 15e16 years old enrolled in the 9th grade of primary school. In direct effects, moderating effects, and gender differences were analysed. The results exposed a robust positive association between OSNC and alcohol use, but also that OSNC accounted for one-fifth of the association between the peer status pathway and alcohol use. A positive association between the stress exposure pathway and alcohol use was found that was weaker among adolescents who scored high on OSNC whereas a positive association between the social context pathway and alcohol use also was found that was stronger among adolescents who scored high on OSNC. Consequently, OSNC may contribute differently to alcohol use depending on which peer-related pathway that the adolescent follows. The robust positive association between OSNC and alcohol use that remained when the three peer-related pathways were accounted for also indicates that this association is accounted for by other factors.
Keywords: Internet | Adolescence | Alcohol drinking | Cross-sectional studies
Characteristics of Firearm Brain Injury Survivors in the Traumatic Brain Injury Model Systems (TBIMS) National Database: A Comparison of Assault and Self-Inflicted Injury Survivors
ویژگی های بازماندگان آسیب مغزی آتشین در پایگاه ملی سیستم های مدل آسیب های مغزی ضرب دیده (TBIMS): مقایسه تجاوز و ضرب خود تحمیلی آسیب بازماندگان-2017
Objective: To characterize and compare subgroups of survivors with assault-related versus self-inflicted traumatic brain injuries (TBIs) via firearms at the time of inpatient rehabilitation and at 1-, 2-, and 5-year follow-up. Design: Secondary analysis of data from the Traumatic Brain Injury Model Systems National Database (TBIMS NDB), a multicenter, longitudinal cohort study. Setting: Retrospective analyses of a subset of individuals enrolled in the TBIMS NDB. Participants: Individuals 16 years and older (NZ399; 310 via assault, 89 via self-inflicted injury) with a primary diagnosis of TBI caused by firearm injury enrolled in the TBIMS NDB. Interventions: Not applicable. Main Outcome Measures: Disability Rating Scale, Glasgow Outcome ScaleeExtended, sociodemographic variables (sex, age, race, marital status), injury-related/acute care information (posttraumatic amnesia, loss of consciousness, time from injury to acute hospital discharge), and mental health variables (substance use history, psychiatric hospitalizations, suicide history, incarcerations). Results: Individuals who survived TBI secondary to a firearm injury differed by injury mechanism (assault vs self-inflicted) on critical demographic, injury-related/acute care, and mental health variables at inpatient rehabilitation and across long-term recovery. Groups differed in terms of geographic area, age, ethnicity, education, marital status, admission Glasgow Coma Scale score, and alcohol abuse, suicide attempts, and psychiatric hospitalizations at various time points. Conclusions: These findings have implications for prevention (eg, mental health programming and access to firearms in targeted areas) and for rehabilitation planning (eg, by incorporating training with coping strategies and implementation of addictions-related services) for firearm-related TBI, based on subtype of injury.
No place for negative emotions? The effects of message valence, communication channel, and social distance on users’ willingness to respond to SNS status updates
هیچ جایی برای احساسات منفی وجود ندارد؟ اثرات حسی پیام، کانال ارتباطی و فاصله اجتماعی بر تمایل کاربران به پاسخ دادن به به روز رسانی وضعیت SNS-2017
The present study contributes to the investigation of communicative norms and social support in Social Network Sites (SNSs). We suggest that a positivity bias restricts the availability of social support users receive from others via public responses to negative status updates. Moderated mediation analyses of the data of an online experiment (N ¼ 870, Mage ¼ 25.16 years, 64% female) show that users are less willing to comment on negative status updates than on positive ones. In contrast, users are more willing to respond to negative status updates with private messages. These effects are moderated by the strength of the relationship between sender and receiver of the status update and mediated by perceived message appropriateness and support urgency. The results suggest that SNS users canalize supportive reactions to negative experience of their close SNS friends through private modes of communication.
Keywords: Social network sites | Status updates | Positivity bias | Social support | Mobilization requests | Facebook
Issues in Supply Chain Management: Progress and potential
مسائلی در مدیریت زنجیره تامین: پیشرفت و پتانسیل-2016
In a 2000 article in Industrial Marketing Management, “Issues in Supply Chain Management,” Lambert and Cooper presented a framework for Supply Chain Management (SCM) as well as issues related to how it should be imple mented and directions for future research. The framework was comprised of eight cross-functional, cross-firm business processes that could be used as a new way to manage relationships with suppliers and customers. It was based on research conducted by a team of academic researchers working with a group of executives from non-competing firms that had been meeting regularly since 1992 with the objective of improving SCM theory and practice. The research has continued for the past 16 years and now covers a total of 25 years. In this paper, we review the progress that has been made in the development and implementation of the proposed SCM frame work since 2000 and identify opportunities for further research.
نسخه فارسی ادوات ارتباطی والدین: ساختار عاملی و ویژگی های روانشناسی
سال انتشار: 2015 - تعداد صفحات فایل pdf انگلیسی: 8 - تعداد صفحات فایل doc فارسی: 23
ادوات ارتباطی والدین( پی بی آی) واحدی جامع برای اندازه گیری روشهای فرزند داری ادراک شده تا 16سال اول آنها میباشد.زمانی که مطالعه دو بعد کلیدی والدین را مشخص نمود مطالعات بعدی آن دو و حتی ما بقی روشهای تربیت را بگونه ای متفاوت نشان داد.ما پی بی ای را به فارسی ترجمه و آن را در 340دبیرستان ایرانی اجرا کردیم.اعتبار پی بی ای فارسی توسط عامل تحلیلی اکتشافی مورد بررسی قرار گرفت در حالی که عامل تحلیلی تصدیق کننده برای شناسایی مناسب ترین مدل استفاده می شد.تحلیل پی بی ای فارسی یک مدل چهار عاملی را برای هردو شکل پدرانه و مادرانه را در نظر گرفت.پی بی ای فارسی ساختار عاملی استوار تربیتی در فرهنگ های غربی رابر اساس آزمون و خطا داراست.در چند عامل چند متغیره تفاوت های زیادی میان دختر و پسر ها نشان داد.پی بی ای واحدی قابل قبول و مناسب برای ادوات اتصال والدین و فرزند در نمونه های ایرانی میباشد. کلمات کلیدی: ساختار عاملی | پی بی ای | پارسی | ویژگی های روانسنجی | اطمینان پذیری | اعتبار
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