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IVY-RF-Based Logistics Claims Risk Classification and Prediction 认领 引用
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作者 Shufeng Wang 《Journal of Electronic Research and Application》 2026年第2期1-14,共14页
With the rapid development of e-commerce,the scale and complexity of logistics operations continue to increase,and the claims risks caused by abnormal events such as cargo damage,delays,and loss during transportation ... With the rapid development of e-commerce,the scale and complexity of logistics operations continue to increase,and the claims risks caused by abnormal events such as cargo damage,delays,and loss during transportation are becoming increasingly prominent.The traditional claims processing model,primarily based on manual review,is no longer adequate for the high-frequency,large-scale business demands in terms of processing efficiency,decision consistency,and cost control.There is an urgent need to introduce intelligent methods to achieve accurate identification and hierarchical management of claims risks.Addressing the challenges of diverse feature dimensions,highly imbalanced category distribution,and difficulty in distinguishing different risk types in logistics claims data,this paper proposes a Random Forest Logistics Claims Risk Classification Model(IVY-RF)based on the IVY growth optimization algorithm.This method uses a random forest as the basic classifier,fully leveraging its advantages in nonlinear relationship modeling and feature interaction capture.It also introduces the IVY metaheuristic optimization algorithm to adaptively optimize the model’s key hyperparameters globally.Experimental results based on real-world logistics claims datasets demonstrate that the IVY-RF model significantly outperforms comparable models such as IVY-LightGBM and IVY-XGBoost in core evaluation metrics,including macro-average F1 score,weighted precision,and weighted recall,achieving a better performance balance between the majority and minority high-risk categories.The findings indicate that the proposed IVYRF model exhibits significant advantages in prediction accuracy,stability,and engineering feasibility,providing reliable technical support for logistics companies to conduct intelligent identification and refined management of claims risks. 展开更多
关键词 Logistics claims Anomaly detection XGBoost Random forest Ivy optimization algorithm
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Asymptotic Estimates for the Ruin Probability of a Multidimensional Delay-Claim Risk Model with Dependent Claims 认领 引用
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作者 Yuchen Sun Weipeng Sun 《Communications in Mathematical Research》 CSCD 2026年第1期36-56,共21页
This paper studies a multidimensional delay-claim risk model in which an insurance company operates$d(d≥2) lines of business exposed to a common renewal counting process.Each catastrophic event simultaneously produce... This paper studies a multidimensional delay-claim risk model in which an insurance company operates$d(d≥2) lines of business exposed to a common renewal counting process.Each catastrophic event simultaneously produces main and delayed claims across all business lines,where the delayed claims are settled after random delay periods.The surplus process incorporates a geometric Lévy price process to describe investment returns.Assuming that the main and delayed claims follow subexponential distributions and satisfy a conditional linear dependence structure,we derive asymptotic estimates for the finite-time ruin probability.The obtained results extend existing findings on delay-claim models to the multidimensional framework and contribute to a deeper understanding of ruin behavior under dependence and heavy-tailed risks. 展开更多
关键词 Asymptotics multidimensional risk model dependence structure delayed claim subexponential class
Analysis of Claims in the Uganda Construction Industry 认领 引用
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作者 Alinaitwe Henry 《Journal of Civil Engineering and Architecture》 2025年第1期36-43,共8页
The increasing cost of infrastructure development risks stifling national investment plans.Many projects in Uganda have suffered because of the frequency and magnitude of claims made by parties involved especially the... The increasing cost of infrastructure development risks stifling national investment plans.Many projects in Uganda have suffered because of the frequency and magnitude of claims made by parties involved especially the contractors.As a result,the construction industry is plagued with claims which quite often lead to adversarial relationships.The major grounds for claims were identified through studying the contract documents where claims had been made.Increase in scope;change orders;errors in contract documents;inclement weather;inflation;delay in possessing the site;and change in the tax policy were the most prevalent grounds for making claims.Problems identified in claiming process include delays in getting approval;information on claims not reliable;hostility from the parties involved;pricing of claims;delays in effecting payment when approved;and overzealous contract interpretation leading to misunderstanding and delays Using a survey on project managers for 64 contractors and their corresponding clients or their representatives,the major ways in which it can be reduced were identified as being thoroughness during the design phase;providing for inflation;proper planning of works;using prequalified contractors;and proper documentation of records.Clients have a big role to play in reducing claims. 展开更多
关键词 Claims construction causes disputes
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Professional construction of forensic medicine and insurance perso nal injury claims under the background of the new normal 认领 引用
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作者 Li Mengying 《Journal of Humanities and Nature》 2025年第1期2-11,共10页
Objective:With the continuous changes in social production,the consumption th inking of the masses obviously cannot keep up with the speed of social developmen t,and insurance disputes are increasingly emerging.Among ... Objective:With the continuous changes in social production,the consumption th inking of the masses obviously cannot keep up with the speed of social developmen t,and insurance disputes are increasingly emerging.Among them,the shortcomings of personal injury claims are not prominent,and the theoretical knowledge is not co mplete.In order to improve the quality of professional talents and reduce claims dis putes,the feasibility of integrating forensic medicine into personal injury claims is ex plored.Methods:The professional attributes,subject attributes,knowledge system an d employment data of forensic medicine are analyzed and compared with the actual work of personal injury claims.Main results:Forensic medicine has its uniqueness i n on-site investigation,injury-disease relationship analysis,and resolution of doubts.I t is irreplaceable by other subjects.The subject attributes are consistent with the pe rsonal injury claims major,and personal injury claims itself has basic medical courses,so it is easier to accept forensic medicine.Conclusion:Under the current social bac kground,through the study of the forensic medicine system in the personal injury cl aims major,it has positive practical significance for its professional construction and talent training. 展开更多
关键词 insurance education personal injury claims forensic medicine
Identification of cancer patients using claims data from health insurance systems: A real-world comparative study 认领 引用 被引量:7
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作者 Hongrui Tian Ruiping Xu +7 位作者 Fenglei Li Chuanhai Guo Lixin Zhang Zhen Liu Mengfei Liu Yaqi Pan Zhonghu He Yang Ke 《Chinese Journal of Cancer Research》 SCIE CAS CSCD 2019年第4期699-706,共8页
Objective: To evaluate the accuracy of identifying cancer patients by use of medical claims data in a health insurance system in China, and provide the basis for establishing the claims-based cancer surveillance syste... Objective: To evaluate the accuracy of identifying cancer patients by use of medical claims data in a health insurance system in China, and provide the basis for establishing the claims-based cancer surveillance system in China.Methods: We chose Hua County, Henan Province as the study site, and randomly selected 300 and 1,200 qualified inpatient electronic medical records(EMRs) as well as the New Rural Cooperative Medical Scheme(NCMS) claims records for cancer patients in Hua County People’s Hospital(HCPH) and Anyang Cancer Hospital(ACH) in 2017. Diagnostic information for NCMS claims was evaluated on an individual level, and sensitivity and positive predictive value(PPV) were calculated taking the EMRs as the gold standard.Results: The sensitivity of NCMS was 95.2%(93.8%-96.3%) and 92.0%(88.3%-94.8%) in ACH and HCPH,respectively. The PPV of the NCMS was 97.8%(96.7%-98.5%) in ACH and 89.0%(84.9%-92.3%) in HCPH.Overall, the weighted and combined sensitivity and PPV of NCMS in Hua County was 93.1% and 92.1%,respectively. Significantly higher sensitivity and PPV in identifying patients with common cancers than noncommon cancers were detected in HCPH and ACH separately(P<0.01).Conclusions: Identification of cancer patients by use of the NCMS is accurate on individual level, and it is therefore feasible to conduct claims-based cancer surveillance in areas not covered by cancer registries in China. 展开更多
关键词 NCMS claims data cancer surveillance sensitivity positive predictive value
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ON THE RUIN FUNCTIONS FOR A CORRELATED AGGREGATE CLAIMS MODEL WITH POISSON AND ERLANG RISK PROCESSES 认领 引用 被引量:12
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作者 刘艳 杨文权 胡亦钧 《Acta Mathematica Scientia》 SCIE 2006年第2期321-330,共10页
This article considers a risk model as in Yuen et al. (2002). Under this model the two claim number processes are correlated. Claim occurrence of both classes relate to Poisson and Erlang processes. The formulae is ... This article considers a risk model as in Yuen et al. (2002). Under this model the two claim number processes are correlated. Claim occurrence of both classes relate to Poisson and Erlang processes. The formulae is derived for the distribution of the surplus immediately before ruin, for the distribution of the surplus immediately after ruin and the joint distribution of the surplus immediately before and after ruin. The asymptotic property of these ruin functions is also investigated. 展开更多
关键词 Correlated aggregate claims Poisson process Erlang process ruin functions
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Disease trends after Helicobacter pylori eradication based on Japanese nationwide claims and the health check-up database 认领 引用 被引量:2
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作者 Kazuhiro Mizukami Kentaro Sugano +1 位作者 Tomomi Takeshima Kazunari Murakami 《World Journal of Gastroenterology》 SCIE CAS 2023年第4期692-705,共14页
BACKGROUND Helicobacter pylori(H.pylori)infection is a risk factor for many diseases,including peptic ulcer disease and gastric cancer.While H.pylori eradication therapy can prevent these diseases,potentially unfavora... BACKGROUND Helicobacter pylori(H.pylori)infection is a risk factor for many diseases,including peptic ulcer disease and gastric cancer.While H.pylori eradication therapy can prevent these diseases,potentially unfavorable effects of eradication therapy have also been reported in some diseases,such as gastroesophageal reflux disease(GERD),Barrett’s esophagus(BE),inflammatory bowel disease(IBD),allergic diseases,and metabolic diseases.Consequently,both positive and negative impacts should be considered when assessing the effects of H.pylori eradication therapy.AIM To compare the incidence of these diseases before and after H.pylori eradication and to comprehensively assess its effects.METHODS This retrospective cohort study used a Japanese nationwide health claims database(April 2009-March 2020),developed by the Japanese Ministry of Health,Labour and Welfare.The database contained almost all health insurance claims data issued in Japan,and specific health check-up data for individuals who took the check-ups.Descriptive statistics were used for the analyses.Patients who received primary eradication therapy were defined as those prescribed medication for H.pylori eradication.New diagnoses,defined as incidence of upper gastrointestinal diseases and IBD,and prevalence of allergic diseases were compared before and after eradication.The incidence and prevalence of each disease were also compared between the 3-year period before eradication(from the 4th to the 2nd year prior to the year of eradication)and the 3-year period after eradication(from the 1st to the 3rd year after the year of eradication)based on the age category and calendar year and month.Changes in body mass index and proportion of patients with metabolic syndrome(MS)were examined before and after eradication.RESULTS We identified 5219731 patients who received primary eradication therapy.The 65-69 years age group had the greatest number of patients in both sexes.There was no significant increase in the incidence of GERD after eradication when considering the effects of aging and reporting period.However,the incidence of BE was higher in the 3-year period after eradication than in the 3-year period before eradication for all age categories(0.02%-0.10%vs<0.01%-0.05%).The incidence of IBD and prevalence of allergic disease were also higher after eradication.In contrast,the incidence of gastric and duodenal ulcers and gastritis was reduced after eradication.In patients with at least one entry of health check-up data(1701111 patients),the percentage of patients with MS showed a slight increase following eradication(11.0%in the year of eradication and 12.2%after 5 years).CONCLUSION The results suggest that H.pylori eradication therapy reduces peptic ulcers and gastritis;however,it is associated with increased incidence of several other chronic diseases. 展开更多
关键词 Administrative claims Healthcare Allergy Eradication therapy Gastroesophageal reflux disease Helicobacter pylori Inflammatory bowel disease
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Real-world treatment patterns of gastrointestinal neuroendocrine tumors:A claims database analysis 认领 引用 被引量:1
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作者 Al B Benson III Michael S Broder +3 位作者 Beilei Cai Eunice Chang Maureen P Neary Elya Papoyan 《World Journal of Gastroenterology》 SCIE CAS 2017年第33期6128-6136,共9页
AIM To describe real-world treatment patterns of gastrointestinal neuroendocrine tumors(GI NET).METHODS In this retrospective cohort study,we used 2009-2014 data from 2 United States commercial claims databases to exa... AIM To describe real-world treatment patterns of gastrointestinal neuroendocrine tumors(GI NET).METHODS In this retrospective cohort study,we used 2009-2014 data from 2 United States commercial claims databases to examine newly pharmacologically treated patients using tabular and graphical techniques.Treatments included somatostatin analogues(SSA),cytotoxic chemotherapy(CC),targeted therapy(TT),interferon(IF)and combinations.We identified patients at least 18 years of age,with≥1 inpatient or≥2 outpatient claims for GI NET who initiated pharmacologic treatment from 7/1/09-6/30/14.A 6 mo clean period prior to first treatment ensured patients were newly treated.Patients were followed until end of enrollment or the study end date,whichever was first.RESULTS We identified 2258 newly treated GI NET patients:mean(SD)age was 55.6 years(SD=9.7),47.2%of the patients were between 55 and 64 years,and 48.8%were female.All regions of the United States were represented.59.6%started first-line therapy with SSA monotherapy(964 with octreotide LAR,380 with octreotide SA,and 1 with lanreotide),33.3%CC,3.6%TT,and 0.5%IF.The remainder received combinations.Mean follow up was 576 d.Overall mean first-line therapy duration was 361 d(449 d for SSA,215 for CC,267 for TT).58.9%of patients had no pharmacological treatment beyond first line.The most common secondline was combination therapy with SSA.In graphical pattern analysis,there was no clear pattern visible after first line therapy.CONCLUSION In this study,60%of patients initiated treatment with SSA alone or in combination.The relatively long time to discontinuation suggests possible sustained effectiveness and tolerability. 展开更多
关键词 Gastrointestinal neuroendocrine tumors Treatment patterns Insurance claims Somatostatin analogue Targeted therapy Chemotherapy
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Asymptotics of discounted aggregate claims for renewal risk model with risky investment 认领 引用
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作者 JIANG Tao 《Applied Mathematics(A Journal of Chinese Universities)》 SCIE 2010年第2期209-216,共8页
Under the assumption that the claim size is subexponentially distributed and the insurance surplus is totally invested in risky asset,a simple asymptotic relation of tail probability of discounted aggregate claims for... Under the assumption that the claim size is subexponentially distributed and the insurance surplus is totally invested in risky asset,a simple asymptotic relation of tail probability of discounted aggregate claims for renewal risk model within finite horizon is obtained.The result extends the corresponding conclusions of related references. 展开更多
关键词 Discounted aggregate claims ruin probability within finite horizon renewal risk model risky investment subexponential class.
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Climate Change and Heavy Rainfall-Related Water Damage Insurance Claims and Losses in Ontario, Canada 认领 引用 被引量:3
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作者 Chad Shouquan Cheng Qian Li +1 位作者 Guilong Li Heather Auld 《Journal of Water Resource and Protection》 CAS 2012年第2期49-62,共14页
The objective of this paper was to project possible impacts of climate change on heavy rainfall-related water damage insurance claims and incurred losses for four selected cites (Kitchener-Waterloo, London, Ottawa, an... The objective of this paper was to project possible impacts of climate change on heavy rainfall-related water damage insurance claims and incurred losses for four selected cites (Kitchener-Waterloo, London, Ottawa, and Toronto) located at Ontario, Canada. To achieve this goal, the future climate change scenarios and rainfall simulations, at local scale, were needed. A statistical downscaling method was used to downscale five global climate model (GCM) scenarios to selected weather stations. The downscaled meteorological variables included surface and upper-air hourly temperature, dew point, west-east and south-north winds, air pressure, and total cloud cover. These variables are necessary to project future daily rainfall quantities using within-weather-type rainfall simulation models. A model result verification process has been built into the whole exercise, including rainfall simulation modeling and the development of downscaling transfer functions. The results of the verification, based on historical observations of the outcome variables simulated by the models, showed a very good agreement. To effectively evaluate heavy rainfall-related water damage insurance claims and incurred losses, a rainfall index was developed considering rainfall intensity and duration. The index was evaluated to link with insurance data as to determination of a critical threshold of the rainfall index for triggering high numbers of rainfall-related water damage insurance claims and incurred losses. The relationship between rainfall index and insurance data was used with future rainfall simulations to project changes in future heavy rainfall-related sewer flood risks in terms of water damage insurance claims and incurred losses. The modeled results showed that, averaged over the five GCM scenarios and across the study area, both the monthly total number of rainfall-related water damage claims and incurred losses could increase by about 13%, 20% and 30% for the periods 2016-2035, 2046-2065, and 2081-2100, respectively (from the four-city seasonal average of 12 ± 1.7 thousand claims and $88 ± $21 million during April-September 1992-2002). Within the context of this study, increases in the future number of insurance claims and incurred losses in the study area are driven by only increases in future heavy rainfall events. 展开更多
关键词 Climate Change Statistical Downscaling Rainfall-Related Flooding Risks Water Damage Insurance Claims Canada
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The Study of Construction Claims for International Project under FIDIC Conditions of Contract 认领 引用
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作者 焦清杰 《海外英语》 2012年第15期281-283,288,共3页
Claims over contracts in the building,engineering and construction industry are become common issues in business today.The text aims at presenting the key concepts of construction claim,and construction claim manageme... Claims over contracts in the building,engineering and construction industry are become common issues in business today.The text aims at presenting the key concepts of construction claim,and construction claim management,focusing on the common classifica tion.In addition,it introduces some measures trying to prevent the event of claim.The result from the text can help the contractors im prove their weaknesses and maintain their strengths of their claim management process.Meanwhile,it also gives some measures for owner to prevent the contractor's claim. 展开更多
关键词 FIDIC Conditions of Contract Claims additional cos
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Herbs and management of hypertension:Claims,criticism,and challenges 认领 引用 被引量:1
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作者 Oluwakemi Elizabeth ADEOLA Oluwaseyi Abiodun AKPOR +2 位作者 Oghenerobor Benjamin AKPOR Modupe Motunrayo ADAMOLEKUN Olusola Bolaji ADEWALE 《Journal of Integrative Nursing》 2023年第3期216-222,共7页
Hypertension(HTN)is one of the most common chronic diseases affecting over 30%of the adult population globally,with a growing incidence rate.This article aims to identify the commonly used herbs for HTN treatment and ... Hypertension(HTN)is one of the most common chronic diseases affecting over 30%of the adult population globally,with a growing incidence rate.This article aims to identify the commonly used herbs for HTN treatment and examine their claims,criticisms,and challenges.It further aims to provide useful recommendations regarding the use of herbs for HTN treatment.HTN complications,such as coronary heart disease,stroke,peripheral vascular disease,vision impairment,and renal failure can result in morbidity and mortality.The high cost of conventional medications,which sometimes may not even be available or easily accessible with their unfavorable side effects as well as taking more than one pill per day,has led hypertensive patients,particularly those in rural areas,to explore alternative treatments such as herbal therapies.It is crucial to determine the different modes of action,doses,safety,and efficacy of herbal remedies used in combination with conventional medications to improve treatment adherence and enhance patient outcomes. 展开更多
关键词 Challenges claims criticism herbs hypertension
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EXPECTED PRESENT VALUE OF TOTAL DIVIDENDS IN THE COMPOUND BINOMIAL MODEL WITH DELAYED CLAIMS AND RANDOM INCOME 认领 引用 被引量:8
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作者 周杰明 莫晓云 +1 位作者 欧辉 杨向群 《Acta Mathematica Scientia》 SCIE CSCD 2013年第6期1639-1651,共13页
In this paper, a compound binomial model with a constant dividend barrier and random income is considered. Two types of individual claims, main claims and by-claims, are defined, where every by-claim is induced by the... In this paper, a compound binomial model with a constant dividend barrier and random income is considered. Two types of individual claims, main claims and by-claims, are defined, where every by-claim is induced by the main claim and may be delayed for one time period with a certain probability. The premium income is assumed to another binomial process to capture the uncertainty of the customer's arrivals and payments. A system of difference equations with certain boundary conditions for the expected present value of total dividend payments prior to ruin is derived and solved. Explicit results are obtained when the claim sizes are Kn distributed or the claim size distributions have finite support. Numerical results are also provided to illustrate the impact of the delay of by-claims on the expected present value of dividends. 展开更多
关键词 compound binomial model main claim by-claim dividend random income
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The Domination for Evaluation of the Contingent Claims by Nonlinear Generator 认领 引用
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作者 何坤 闫理坦 胡良剑 《Journal of Donghua University(English Edition)》 EI CAS 2009年第3期290-292,共3页
In this paper,through applying the result of backward stochastic differential equations,it investigates a domination for pricing of the contingent claims by the use of nonlinear infinitesimal generator of process X. T... In this paper,through applying the result of backward stochastic differential equations,it investigates a domination for pricing of the contingent claims by the use of nonlinear infinitesimal generator of process X. This domination provides a guide for valuing the price of the position on the financial market. 展开更多
关键词 backward stochastic differential equations gevaluation contingent claims infinitesimal generator
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Shorebirds, Stakeholders, and Competing Claims to the Beach and Intertidal Habitat in Delaware Bay, New Jersey, USA 认领 引用 被引量:1
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作者 Joanna Burger Lawrence Niles 《Natural Science》 2017年第6期181-205,共25页
Birds have specific habitat needs as a function of their life cycle and reproductive stage. Migrant shorebirds that may fly from the Arctic to the southern tip of South America have foraging and habitat requirements a... Birds have specific habitat needs as a function of their life cycle and reproductive stage. Migrant shorebirds that may fly from the Arctic to the southern tip of South America have foraging and habitat requirements at sites where they stop to refuel before continuing their migration north or south. Throughout the world, shorebirds mainly forage on mudflats at low tide. Red knots (Calidris canutus rufa) are threatened in the United States and elsewhere, and it is critical to determine factors that might contribute to their decline. This paper uses Delaware Bay as a case study to examine shorebird (and red knot) use of the intertidal habitat, and competing claims to habitats they require during their northward migration, as well as some of the key stakeholders that play a role in protecting red knots. Shorebirds are drawn to Delaware Bay to feed on the eggs of Horseshoe Crabs (Limulus polyphemus) that are concentrated at the high tide. But they also feed on the intertidal mudflat. We examined intertidal habitat use on 17 beaches in an extensive study in 2015, and 5 key beaches in 2016. Most of the beaches were longitudinal, but four were more complex, and were used extensively for resting as well as foraging;numbers there were higher than on the longitudinal beaches. On foraging beaches, some shorebirds were present on over 85% of the intertidal censuses, and red knots were present on over 48% of the intertidal censuses. Average numbers of red knots on the longitudinal beaches varied from 0 to 354 ± 116 when any shorebirds were present, but averaged up to 1184 ± 634 when knots were present in 2015. Some beaches in 2015 had no knots (a beach with long-term aquaculture). Tide, intertidal location, and beach (name) determined the number of knots (and all shorebirds). Numbers decreased with distance from the mean high tide line. The average number of knots present in the intertidal mudflats two hours before or after low tide when knots were present (e.g. no censuses with zeros) was 2040 (=maximum flock size, in 2015). Major threats to red knots are from recreationists, overfishing of horseshoe crabs (reduction in egg prey base), and use of the intertidal by aquaculture. We discuss the role of stakeholders in conservation and protection of red knots. 展开更多
关键词 Assessment Aquaculture Monitoring Red Knot Shorebirds Intertidal Recreationists Horseshoe Crabs Competing Claims
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The Latest Status and Progress of Domestic and Foreign Regulations on Cosmetic Efficacy Claims 认领 引用
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作者 Li Yanan Jiang Ligang 《China Detergent & Cosmetics》 CAS 2021年第3期46-53,共8页
The supervision and administration of cosmetics and its two supporting documents related to efficacy,cosmetics classification rules and classification catalogue and evaluation standard of cosmetic efficacy claims,have... The supervision and administration of cosmetics and its two supporting documents related to efficacy,cosmetics classification rules and classification catalogue and evaluation standard of cosmetic efficacy claims,have been successively introduced and implemented,making China’s cosmetics industry officially enter the era of efficacy evaluation.In the time window when the new era is coming,the definitions of cosmetics in China and other countries are compared.The latest status and progress of regulations on cosmetic efficacy claims in China and other countries are summarized,and the standard methods or guidance of cosmetic efficacy evaluation at home and abroad are introduced.The enlightenment from the supervision systems of cosmetic efficacy in other cosmetic consumer markets around the world are discussed.In addition,the opportunities and challenges for cosmetic enterprises under the background of cosmetic law reform in China are also prospected. 展开更多
关键词 cosmetics efficacy claims laws and regulations China Europe and America standard methods evaluation guidelines
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Impact of relative contraindications on the use, benefits, and risks of anticoagulant prophylaxis in atrial fibrillation: analysis of a claims database 认领 引用
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作者 Maneesha Mehra Julia DiBello +1 位作者 Alan C. Fisher Roger M. Mills 《Open Journal of Internal Medicine》 2011年第3期60-67,共8页
Background: Many individuals with atrial fibrillation (AF) do not receive recommended anticoagulant prophylaxis for stroke prevention. The study investigators attempted to assess whether the presence of relative contr... Background: Many individuals with atrial fibrillation (AF) do not receive recommended anticoagulant prophylaxis for stroke prevention. The study investigators attempted to assess whether the presence of relative contraindications (RCIs) to anticoagulation with warfarin might contribute to this, and to assess the risks and benefits of prophylaxis in patients with RCIs. Methods: Study investigators identified patients with established non-valvular AF and flutter in a claims database. Operationally defined RCIs included, in order of clinical severity: (1) prior intracranial hemorrhage;(2) gastrointestinal bleeding or esophageal varices;(3) neurological disorder;and (4) dizziness. Nonfatal events were attributed to warfarin if patients had an appropriate claim in the previous month. Results: A total of 67,082 AF patients were eligible for analysis, including 50,485 (75.3%) in the prevalent cohort. Warfarin exposure during the study period was 68% in the prevalent cohort. At baseline, 50.5% of prevalent cohort patients had one or more RCIs. Patients with RCI had higher prevalence of stroke risk factors (congestive heart failure, hypertension, age ≥ 75 years, diabetes mellitus, and prior stroke or transient ischemic attack) compared to those without RCI. Patients with RCIs often received warfarin and had lower rates of ischemic stroke than those who did not. Conclusions: These results suggest that RCIs do not account for underutilization of anticoagulant prophylaxis in AF patients. Further, the benefitisk aspects of anticoagulation for stroke prophylaxis may be favorable for many patients with RCIs. 展开更多
关键词 RCI Anticoagulant Atrial Fibrillation Prophylaxis Stroke Claims Database
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Anesthesia Related Closed Claims and Litigations at the Detroit Medical Center: Analysis, Lessons Learned, and Conclusions 认领 引用
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作者 Kris Ferguson Jason Young +4 位作者 Peter Panagopoulos Philip Khoury George M. McKelvey Samir F. Fuleihan Walid A. Osta 《Open Journal of Anesthesiology》 2014年第4期88-98,共11页
The analysis of closed claims and litigations can provide an invaluable tool to improve patient safety by minimizing adverse anesthesia-related outcomes. Analysis of collective data describing such claims is integral ... The analysis of closed claims and litigations can provide an invaluable tool to improve patient safety by minimizing adverse anesthesia-related outcomes. Analysis of collective data describing such claims is integral to develop new guidelines aimed to reduce adverse anesthesia-related events. In this study, we give a descriptive analysis of anesthesia-related claims at the Detroit Medical Center, Detroit, MI, USA. The study analyzed different components in anesthesia-related closed claims and litigations such as medical, demographic and socio-economic factors. From 67,000 procedures in anesthesiology care provider, related cases claims were made in 0.057% (38/67,000) of all cases. The majority of claims involved procedures involving Caucasian females aged 51-55 years. The highest risk periods involved early shift times during Monday and Tuesday, particularly of procedures performed during August. About 33% of all cases in which death occurred involved patients who received an Obstetrics/Gynecology or an Orthopedic procedure under general anesthesia. The majority of closed claims and litigations cases were distributed between procedures treating nerves injuries and anoxic encephalopathy. The OR and PACU at urban hospitals had the highest claim rates. MD anesthesiologists constituted the lowest proportion of all anesthesia providers involved in closed claims incidents. The average compensation paid was predominately in the range of $200,000-$250,000. In addition to reporting anesthesia related factors involved in closed claims and litigations this study also includes a series of recommendations which may work as a framework for improving anesthesia practices. 展开更多
关键词 Anesthesia Closed Claims Complications Litigations Malpractice Negligence
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Faults and Claims about Thermal Environments in Relation to Energy Saving Measures in Smaller Office Buildings 认领 引用
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作者 Noriko Umemiya Taiji Obuchi Ryota Matsui 《Journal of Civil Engineering and Architecture》 2014年第4期413-424,共12页
Building equipment, energy-saving systems, and claims of inappropriate indoor thermal environments were analyzed in relation to the floor area using responses to a questionnaire survey of service managers of 157 build... Building equipment, energy-saving systems, and claims of inappropriate indoor thermal environments were analyzed in relation to the floor area using responses to a questionnaire survey of service managers of 157 buildings built in Osaka, Kyoto and Hyogo prefectures in Kinki area of Japan. Results show the following: (1) In smaller buildings (〈 5,000 m2), setting temperatures are higher in summer and lower in winter, effects of "uncomfortable radiation from windows" are greater, energy-saving systems decrease indoor thermal comfort, but claims of "hot" and "cold" are fewer; (2) Claims of "hot" and "cold" are unrelated to the setting temperature and whether the air-conditioning control system is central or local; (3) The adoption rates of mitigation of dress codes ("COOL-BIZ" and "WARM-BIZ") are higher than those of temperature mitigation of air conditioning. 展开更多
关键词 Smaller office buildings energy management energy saving measures COOL-BIZ user claims of hot and cold.
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Small Claims Court in Environmental Disputes Resolution to Support the Realization of Sustainable Development 认领 引用
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作者 Efa Laela Fakhriah 《Sociology Study》 2013年第8期588-595,共8页
An appropriate business dispute resolution will ensure that the parties involved would not have to spend too much time and cost to resolve their case. There are two ways to resolve business disputes, through litigatio... An appropriate business dispute resolution will ensure that the parties involved would not have to spend too much time and cost to resolve their case. There are two ways to resolve business disputes, through litigation and non-litigation process. The non-litigation process mainly depends upon the agreement of the parties involved and does not have a formally binding force upon them. Although the non-litigation process is more preferred in resolving business disputes, sometimes it does not completely resolve the issue. A specific business dispute resolution procedure such as the mechanism of small claims court (an informal court) is required. The objectives of the small claims court are to settle cases in prompt and cost-effective manner, and to avoid lengthy and complex formal legal procedures. Although it is still a part of the litigation process, the small claims court applies simplified procedures that are different from those of conventional civil cases. Nonetheless, the judgment of the small claims court has the same legally binding force as that of general court. The small claims court is situated in the District Court, but the examination of cases is different from general procedures and until now the mechanism has not been widely known in Indonesia. 展开更多
关键词 Small claims court dispute resolution
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