Displaying publications 1 - 20 of 37 in total

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  1. Aziz F, Arof H, Mokhtar N, Shah NM, Khairuddin ASM, Hanafi E, et al.
    PLoS One, 2018;13(8):e0202092.
    PMID: 30157219 DOI: 10.1371/journal.pone.0202092
    In this paper, an image-based waste collection scheduling involving a node with three waste bins is considered. First, the system locates the three bins and determines the waste level of each bin using four Laws Masks and a set of Support Vector Machine (SVM) classifiers. Next, a Hidden Markov Model (HMM) is used to decide on the number of days remaining before waste is collected from the node. This decision is based on the HMM's previous state and current observations. The HMM waste collection scheduling seeks to maximize the number of days between collection visits while preventing waste contamination due to late collection. The proposed system was trained using 100 training images and then tested on 100 test images. Each test image contains three bins that might be shifted, rotated, occluded or toppled over. The upright bins could be empty, partially full or full of garbage of various shapes and sizes. The method achieves bin detection, waste level classification and collection day scheduling rates of 100%, 99.8% and 100% respectively.
    Matched MeSH terms: Markov Chains
  2. Raouf MA, Hashim F, Liew JT, Alezabi KA
    PLoS One, 2020;15(8):e0237386.
    PMID: 32790697 DOI: 10.1371/journal.pone.0237386
    The IEEE 802.11ah standard relies on the conventional distributed coordination function (DCF) as a backoff selection method. The DCF is utilized in the contention-based period of the newly introduced medium access control (MAC) mechanism, namely restricted access window (RAW). Despite various advantages of RAW, DCF still utilizes the legacy binary exponential backoff (BEB) algorithm, which suffers from a crucial disadvantage of being prone to high probability of collisions with high number of contending stations. To mitigate this issue, this paper investigates the possibility of replacing the existing exponential sequence (i.e., as in BEB) with a better pseudorandom sequence of integers. In particular, a new backoff algorithm, namely Pseudorandom Sequence Contention Algorithm (PRSCA) is proposed to update the CW size and minimize the collision probability. In addition, the proposed PRSCA incorporates a different approach of CW freezing mechanism and backoff stage reset process. An analytical model is derived for the proposed PRSCA and presented through a discrete 2-D Markov chain model. Performance evaluation demonstrates the efficiency of the proposed PRSCA in reducing collision probability and improving saturation throughput, network throughput, and access delay performance.
    Matched MeSH terms: Markov Chains
  3. Camara M, Jamil NR, Abdullah AFB, Hashim RB, Aliyu AG
    Sci Total Environ, 2020 May 30;737:139800.
    PMID: 32526579 DOI: 10.1016/j.scitotenv.2020.139800
    The evaluation of the importance of having accurate and representative stations in a network for river water quality monitoring is always a matter of concern. The minimal budget and time demands of water quality monitoring programme may appear very attractive, especially when dealing with large-scale river watersheds. This article proposes an improved methodology for optimising water quality monitoring network for present and forthcoming monitoring of water quality under a case study of the Selangor River watershed in Malaysia, where different monitoring networks are being used by water management authorities. Knowing that the lack of financial resources in developing countries like Malaysia is one of the reasons for inadequate monitoring network density, to identify an optimised network for cost-efficiency benefits in this study, a geo-statistical technique coupled Kendall's W was first applied to analyse the performance of each monitoring station in the existing networks under the monitored water quality parameters. Second, the present and future changes in non-point pollution sources were simulated using the integrated Cellular Automata and Markov chain model (CA-Markov). Third, Station Potential Pollution Score (SPPS) determined based on Analytic Hierarchy Process (AHP) was used to weight each station under the changes of non-point pollution sources for 2015, 2024, and 2033 prior to prioritisation. Finally, according to the Kendall's W test on kriging results, the weights of non-point sources from the AHP evaluation and fuzzy membership functions, six most efficient sampling stations were identified to build a robust network for the present and future monitoring of water quality status in the Selangor River watershed. This study proposes a useful approach to the pertinent agencies and management authority concerned to establish appropriate methods for developing an efficient water quality monitoring network for tropical rivers.
    Matched MeSH terms: Markov Chains
  4. Ravi Kumar, P., Alex Goh, K.L., Ashutosh, K.S.
    MyJurnal
    Link analysis algorithms for Web search engines determine the importance and relevance of Web pages. Among the link analysis algorithms, PageRank is the state of the art ranking mechanism that is used in Google search engine today. The PageRank algorithm is modeled as the behavior of a randomized Web surfer; this model can be seen as Markov chain to predict the behavior of a system that travels from one state to another state considering only the current condition. However, this model has the dangling node or hanging node problem because these nodes cannot be presented in a Markov chain model. This paper focuses on the application of Markov chain on PageRank algorithm and discussed a few methods to handle the dangling node problem. The Experiment is done running on WEBSPAM-UK2007 to show the rank results of the dangling nodes.
    Matched MeSH terms: Markov Chains
  5. Lim KK, Yoon SY, Mohd Taib NA, Shabaruddin FH, Dahlui M, Woo YL, et al.
    Appl Health Econ Health Policy, 2018 06;16(3):395-406.
    PMID: 29572724 DOI: 10.1007/s40258-018-0384-8
    OBJECTIVE: Previous studies showed that offering BRCA mutation testing to population subgroups at high risk of harbouring the mutation may be cost effective, yet no evidence is available for low- or middle-income countries (LMIC) and in Asia. We estimated the cost effectiveness of BRCA mutation testing in early-stage breast cancer patients with high pre-test probability of harbouring the mutation in Malaysia, an LMIC in Asia.

    METHODS: We developed a decision analytic model to estimate the lifetime costs and quality-adjusted life-years (QALYs) accrued through BRCA mutation testing or routine clinical surveillance (RCS) for a hypothetical cohort of 1000 early-stage breast cancer patients aged 40 years. In the model, patients would decide whether to accept testing and to undertake risk-reducing mastectomy, oophorectomy, tamoxifen, combinations or neither. We calculated the incremental cost-effectiveness ratio (ICER) from the health system perspective. A series of sensitivity analyses were performed.

    RESULTS: In the base case, testing generated 11.2 QALYs over the lifetime and cost US$4815 per patient whereas RCS generated 11.1 QALYs and cost US$4574 per patient. The ICER of US$2725/QALY was below the cost-effective thresholds. The ICER was sensitive to the discounting of cost, cost of BRCA mutation testing and utility of being risk-free, but the ICERs remained below the thresholds. Probabilistic sensitivity analysis showed that at a threshold of US$9500/QALY, 99.9% of simulations favoured BRCA mutation testing over RCS.

    CONCLUSIONS: Offering BRCA mutation testing to early-stage breast cancer patients identified using a locally-validated risk-assessment tool may be cost effective compared to RCS in Malaysia.

    Matched MeSH terms: Markov Chains
  6. Phisalprapa P, Supakankunti S, Charatcharoenwitthaya P, Apisarnthanarak P, Charoensak A, Washirasaksiri C, et al.
    Medicine (Baltimore), 2017 Apr;96(17):e6585.
    PMID: 28445256 DOI: 10.1097/MD.0000000000006585
    BACKGROUND: Nonalcoholic fatty liver disease (NAFLD) can be diagnosed early by noninvasive ultrasonography; however, the cost-effectiveness of ultrasonography screening with intensive weight reduction program in metabolic syndrome patients is not clear. This study aims to estimate economic and clinical outcomes of ultrasonography in Thailand.

    METHODS: Cost-effectiveness analysis used decision tree and Markov models to estimate lifetime costs and health benefits from societal perspective, based on a cohort of 509 metabolic syndrome patients in Thailand. Data were obtained from published literatures and Thai database. Results were reported as incremental cost-effectiveness ratios (ICERs) in 2014 US dollars (USD) per quality-adjusted life year (QALY) gained with discount rate of 3%. Sensitivity analyses were performed to assess the influence of parameter uncertainty on the results.

    RESULTS: The ICER of ultrasonography screening of 50-year-old metabolic syndrome patients with intensive weight reduction program was 958 USD/QALY gained when compared with no screening. The probability of being cost-effective was 67% using willingness-to-pay threshold in Thailand (4848 USD/QALY gained). Screening before 45 years was cost saving while screening at 45 to 64 years was cost-effective.

    CONCLUSIONS: For patients with metabolic syndromes, ultrasonography screening for NAFLD with intensive weight reduction program is a cost-effective program in Thailand. Study can be used as part of evidence-informed decision making.

    TRANSLATIONAL IMPACTS: Findings could contribute to changes of NAFLD diagnosis practice in settings where economic evidence is used as part of decision-making process. Furthermore, study design, model structure, and input parameters could also be used for future research addressing similar questions.

    Matched MeSH terms: Markov Chains
  7. Permsuwan U, Dilokthornsakul P, Thavorn K, Saokaew S, Chaiyakunapruk N
    J Med Econ, 2017 Feb;20(2):171-181.
    PMID: 27645706 DOI: 10.1080/13696998.2016.1238386
    OBJECTIVE: With a high prevalence of chronic kidney disease (CKD) in type 2 diabetes (T2DM) in Thailand, the appropriate treatment for the patients has become a major concern. This study aimed to evaluate long-term cost-effective of dipeptidyl peptidase-4 (DPP-4) inhibitor monothearpy vs sulfonylurea (SFU) monotherapy in people with T2DM and CKD.

    METHODS: A validated IMS CORE Diabetes Model was used to estimate the long-term costs and outcomes. The efficacy parameters were identified and synthesized using a systematic review and meta-analysis. Baseline characteristics and cost parameters were obtained from published studies and hospital databases in Thailand. Costs were expressed in 2014 US Dollars. Outcomes were presented as an incremental cost-effectiveness ratio (ICER). One-way and probabilistic sensitivity analyses were performed to estimate parameter uncertainty.

    RESULTS: From a societal perspective, treatment with DPP-4 inhibitors yielded more quality-adjusted life years (QALYs) (0.024) at a higher cost (>66,000 Thai baht (THB) or >1,829.27 USD) per person than SFU, resulting in the ICER of >2.7 million THB/QALY (>74,833.70 USD/QALY). The cost-effectiveness results were mainly driven by differences in HbA1c reduction, hypoglycemic events, and drug acquisition cost of DPP-4 inhibitors. At the ceiling ratio of 160,000 THB/QALY (4,434.59 USD/QALY), the probability that DPP-4 inhibitors are cost-effective compared to SFU was less than 10%.

    CONCLUSIONS: Compared to SFU, DPP-4 inhibitor monotherapy is not a cost-effective treatment for people with T2DM and CKD in Thailand.

    Matched MeSH terms: Markov Chains
  8. Chong HY, Mohamed Z, Tan LL, Wu DBC, Shabaruddin FH, Dahlui M, et al.
    Br J Dermatol, 2017 Oct;177(4):1102-1112.
    PMID: 28346659 DOI: 10.1111/bjd.15498
    BACKGROUND: A strong association has been documented between HLA-B*15:02 and carbamazepine-induced severe cutaneous adverse reactions (SCARs) in Asians. Human leucocyte antigen testing is potentially valuable in many countries to facilitate early recognition of patient susceptibility to SCARs.

    OBJECTIVES: To determine the cost-effectiveness of universal HLA-B*15:02 screening in preventing carbamazepine-induced Stevens-Johnson syndrome/toxic epidermal necrolysis in an ethnically diverse Malaysian population.

    METHODS: A hybrid model of a decision tree and Markov model was developed to evaluate three strategies for treating newly diagnosed epilepsy among adults: (i) carbamazepine initiation without HLA-B*15:02 screening (current practice); (ii) universal HLA-B*15:02 screening prior to carbamazepine initiation; and (iii) alternative treatment [sodium valproate (VPA)] prescribing without HLA-B*15:02 screening. Base-case analysis and sensitivity analyses were performed over a lifetime time horizon. Incremental cost-effectiveness ratios were calculated.

    RESULTS: Both universal HLA-B*15:02 screening and VPA prescribing were dominated by current practice. Compared with current practice, universal HLA-B*15:02 screening resulted in a loss of 0·0255 quality-adjusted life years (QALYs) at an additional cost of 707 U.S. dollars (USD); VPA prescribing resulted in a loss of 0·2622 QALYs at an additional cost of USD 4127, owing to estimated differences in antiepileptic treatment efficacy.

    CONCLUSIONS: Universal HLA-B*15:02 screening is unlikely to be a cost-effective intervention in Malaysia. However, with the emergence of an ethnically diverse population in many other countries, this may render HLA-B*15:02 screening a viable intervention when an increasing proportion of the population is at risk and an equally effective yet safer antiepileptic drug is available.

    Matched MeSH terms: Markov Chains
  9. Gandola AE, Dainelli L, Zimmermann D, Dahlui M, Detzel P
    Nutrients, 2019 May 30;11(6).
    PMID: 31151244 DOI: 10.3390/nu11061235
    This study evaluated the cost-effectiveness of the consumption of a milk powder product fortified with potassium (+1050.28 mg/day) and phytosterols (+1200 mg/day) to lower systolic blood pressure and low-density lipoprotein cholesterol, respectively, and, therefore, the risk of myocardial infarction (MI) and stroke among the 35-75-year-old population in Malaysia. A Markov model was created against a do-nothing option, from a governmental perspective, and with a time horizon of 40 years. Different data sources, encompassing clinical studies, practice guidelines, grey literature, and statistical yearbooks, were used. Sensitivity analyses were performed to evaluate the impact of uncertainty on the base case estimates. With an incremental cost-effectiveness ratio equal to international dollars (int$) 22,518.03 per quality-adjusted life-years gained, the intervention can be classified as very cost-effective. If adopted nationwide, it would help prevent at least 13,400 MIs, 30,500 strokes, and more than 10,600 and 17,100 MI- and stroke-related deaths. The discounted cost savings generated for the health care system by those who consume the fortified milk powder would amount to int$8.1 per person, corresponding to 0.7% of the total yearly health expenditure per capita. Sensitivity analyses confirmed the robustness of the results. Together with other preventive interventions, the consumption of milk powder fortified with potassium and phytosterols represents a cost-effective strategy to attenuate the rapid increase in cardiovascular burden in Malaysia.
    Matched MeSH terms: Markov Chains
  10. Farrukh Mukhamedov
    MyJurnal
    In the present paper we provide a construction of Quantum Markov chain on a Cayley tree. Moreover, we give a concrete example of such chains, which is shift invariant and has the clustering property
    Matched MeSH terms: Markov Chains
  11. Yen FY, Chong KM, Ha LM
    PLoS One, 2013;8(6):e65440.
    PMID: 23755231 DOI: 10.1371/journal.pone.0065440
    This paper proposes three synthetic-type control charts to monitor the mean time-between-events of a homogenous Poisson process. The first proposed chart combines an Erlang (cumulative time between events, Tr ) chart and a conforming run length (CRL) chart, denoted as Synth-Tr chart. The second proposed chart combines an exponential (or T) chart and a group conforming run length (GCRL) chart, denoted as GR-T chart. The third proposed chart combines an Erlang chart and a GCRL chart, denoted as GR-Tr chart. By using a Markov chain approach, the zero- and steady-state average number of observations to signal (ANOS) of the proposed charts are obtained, in order to evaluate the performance of the three charts. The optimal design of the proposed charts is shown in this paper. The proposed charts are superior to the existing T chart, Tr chart, and Synth-T chart. As compared to the EWMA-T chart, the GR-T chart performs better in detecting large shifts, in terms of the zero- and steady-state performances. The zero-state Synth-T4 and GR-Tr (r = 3 or 4) charts outperform the EWMA-T chart for all shifts, whereas the Synth-Tr (r = 2 or 3) and GR-T 2 charts perform better for moderate to large shifts. For the steady-state process, the Synth-Tr and GR-Tr charts are more efficient than the EWMA-T chart in detecting small to moderate shifts.
    Matched MeSH terms: Markov Chains*
  12. de Vries B, Narayan R, McGeechan K, Santiagu S, Vairavan R, Burke M, et al.
    Acta Obstet Gynecol Scand, 2018 Jun;97(6):668-676.
    PMID: 29450884 DOI: 10.1111/aogs.13310
    INTRODUCTION: Cesarean section rates continue to increase globally. Prediction of intrapartum cesarean section could lead to preventive measures. Our aim was to assess the association between sonographically measured cervical length at 37 weeks of gestation and cesarean section among women planning a vaginal birth. The population was women with a low-risk pregnancy or with gestational diabetes.

    MATERIAL AND METHODS: This was a prospective cohort study conducted in a tertiary referral hospital in Sydney, Australia. In all, 212 women with a low-risk pregnancy or with gestational diabetes were recruited including 158 nulliparous and 54 parous women. Maternal demographic, clinical and ultrasound characteristics were collected at 37 weeks of gestation. Semi-Bayesian logistic regression and Markov chain Monte Carlo simulation were used to assess the relation between cervical length and cesarean section in labor.

    RESULTS: Rates of cesarean section were 5% (2/55) for cervical length ≤20 mm, 17% (17/101) for cervical length 20-32 mm, and 27% (13/56) for cervical length >32 mm. These rates were 4, 22 and 33%, respectively, in nulliparous women. In the semi-Bayesian analysis, the odds ratio for cesarean section was 6.2 (95% confidence interval 2.2-43) for cervical length 20-32 mm and 10 (95% confidence interval 4.8-74) for cervical length >32 mm compared with the lowest quartile of cervical length, after adjusting for maternal age, parity, height, prepregnancy body mass index, gestational diabetes, induction of labor, neonatal sex and birthweight centile.

    CONCLUSIONS: Cervical length at 37 weeks of gestation is associated with intrapartum cesarean section.

    Matched MeSH terms: Markov Chains
  13. Lertjanyakun V, Chaiyakunapruk N, Kunisawa S, Imanaka Y
    Pharmacoeconomics, 2018 09;36(9):1113-1124.
    PMID: 29707743 DOI: 10.1007/s40273-018-0660-3
    BACKGROUND: Exemestane (EXE), exemestane + everolimus (EXE + EVE), toremifene (TOR), and fulvestrant (FUL) are second-line endocrine therapies for postmenopausal hormone receptor-positive (HR +)/human epidermal growth factor receptor 2-negative (HER2 -) metastatic breast cancer (mBC) in Japan. Although the efficacy of these therapies has been shown in recent studies, cost-effectiveness has not yet been determined in Japan.

    OBJECTIVE: This study aimed to examine the cost-effectiveness of second-line endocrine therapies for the treatment of postmenopausal women with HR + and HER2 - mBC.

    METHODS: A Markov model was developed to analyze the cost-effectiveness of the therapies over a 15-year time horizon from a public healthcare payer's perspective. The efficacy and utility parameters were determined via a systematic search of the literature. Direct medical care costs were used. A discount rate of 2% was applied for costs and outcomes. Subgroup analysis was performed for non-visceral metastasis. A series of sensitivity analyses, including probabilistic sensitivity analysis (PSA) and threshold analysis were performed.

    RESULTS: Base-case analyses estimated incremental cost-effectiveness ratios (ICERs) of 3 million and 6 million Japanese yen (JPY)/quality-adjusted life year (QALY) gained for TOR and FUL 500 mg relative to EXE, respectively. FUL 250 mg and EXE + EVE were dominated. The overall survival (OS) highly influenced the ICER. With a willingness-to-pay (WTP) threshold of 5 million JPY/QALY, the probability of TOR being cost-effective was the highest. Subgroup analysis in non-visceral metastasis revealed 0.4 and 10% reduction in ICER from the base-case results of FUL5 500 mg versus EXE and TOR versus EXE, respectively, while threshold analysis indicated EVE and FUL prices should be reduced 73 and 30%, respectively.

    CONCLUSION: As a second-line therapy for postmenopausal women with HR +/HER2 - mBC, TOR may be cost-effective relative to other alternatives and seems to be the most favorable choice, based on a WTP threshold of 5 million JPY/QALY. FUL 250 mg is expected to be as costly and effective as EXE. The cost-effectiveness of EXE + EVE and FUL 500 mg could be improved by a large price reduction. However, the results are highly sensitive to the hazard ratio of OS. Policy makers should carefully interpret and utilize these findings.

    Matched MeSH terms: Markov Chains
  14. Apenteng OO, Ismail NA
    PLoS One, 2015;10(7):e0131950.
    PMID: 26147199 DOI: 10.1371/journal.pone.0131950
    The spread of human immunodeficiency virus (HIV) infection and the resulting acquired immune deficiency syndrome (AIDS) is a major health concern in many parts of the world, and mathematical models are commonly applied to understand the spread of the HIV epidemic. To understand the spread of HIV and AIDS cases and their parameters in a given population, it is necessary to develop a theoretical framework that takes into account realistic factors. The current study used this framework to assess the interaction between individuals who developed AIDS after HIV infection and individuals who did not develop AIDS after HIV infection (pre-AIDS). We first investigated how probabilistic parameters affect the model in terms of the HIV and AIDS population over a period of time. We observed that there is a critical threshold parameter, R0, which determines the behavior of the model. If R0 ≤ 1, there is a unique disease-free equilibrium; if R0 < 1, the disease dies out; and if R0 > 1, the disease-free equilibrium is unstable. We also show how a Markov chain Monte Carlo (MCMC) approach could be used as a supplement to forecast the numbers of reported HIV and AIDS cases. An approach using a Monte Carlo analysis is illustrated to understand the impact of model-based predictions in light of uncertain parameters on the spread of HIV. Finally, to examine this framework and demonstrate how it works, a case study was performed of reported HIV and AIDS cases from an annual data set in Malaysia, and then we compared how these approaches complement each other. We conclude that HIV disease in Malaysia shows epidemic behavior, especially in the context of understanding and predicting emerging cases of HIV and AIDS.
    Matched MeSH terms: Markov Chains*
  15. Apenteng OO, Osei PP, Oduro B, Kwabla MP, Ismail NA
    Infect Dis Model, 2020;5:755-765.
    PMID: 33073067 DOI: 10.1016/j.idm.2020.09.009
    Malaysia is faced with a high HIV/AIDS burden that poses a public health threat. We constructed and applied a compartmental model to understand the spread and control of HIV/AIDS in Malaysia. A simple model for HIV and AIDS disease that incorporates condom and uncontaminated needle-syringes interventions and addresses the relative impact of given treatment therapy for infected HIV newborns on reducing HIV and AIDS incidence is presented. We demonstrated how treatment therapy for new-born babies and the use of condoms or uncontaminated needle-syringes impact the dynamics of HIV in Malaysia. The model was calibrated to HIV and AIDS incidence data from Malaysia from 1986 to 2011. The epidemiological parameters are estimated using Bayesian inference via Markov chain Monte Carlo simulation method. The reproduction number optimal for control of the HIV/AIDS disease obtained suggests that the disease-free equilibrium was unstable during the 25 years. However, the results indicated that the use of condoms and uncontaminated needle-syringes are pivotal intervention control strategies; a comprehensive adoption of the intervention may help stop the spread of HIV disease. Treatment therapy for newborn babies is also of high value; it reduces the epidemic peak. The combined effect of condom use or uncontaminated needle-syringe is more pronounced in controlling the spread of HIV/AIDS.
    Matched MeSH terms: Markov Chains
  16. Ting CM, Samdin SB, Salleh ShH, Omar MH, Kamarulafizam I
    PMID: 23367426 DOI: 10.1109/EMBC.2012.6347491
    This paper applies an expectation-maximization (EM) based Kalman smoother (KS) approach for single-trial event-related potential (ERP) estimation. Existing studies assume a Markov diffusion process for the dynamics of ERP parameters which is recursively estimated by optimal filtering approaches such as Kalman filter (KF). However, these studies only consider estimation of ERP state parameters while the model parameters are pre-specified using manual tuning, which is time-consuming for practical usage besides giving suboptimal estimates. We extend the KF approach by adding EM based maximum likelihood estimation of the model parameters to obtain more accurate ERP estimates automatically. We also introduce different model variants by allowing flexibility in the covariance structure of model noises. Optimal model selection is performed based on Akaike Information Criterion (AIC). The method is applied to estimation of chirp-evoked auditory brainstem responses (ABRs) for detection of wave V critical for assessment of hearing loss. Results shows that use of more complex covariances are better estimating inter-trial variability.
    Matched MeSH terms: Markov Chains
  17. Wu DB, Hussain S, Mak V, Lee KK
    Value Health, 2014 Nov;17(7):A382.
    PMID: 27200852 DOI: 10.1016/j.jval.2014.08.2625
    OBJECTIVES. Osteoporotic fractures are common in older adults and are often associated with high morbidity and mortality. As the incidence increases with age, it is natural that osteoporotic fractures have become a major health problem worldwide. Increasing number of patients with osteoporotic fracture will have a serious economic impact on the patient themselves and the society. The objective of this study is to study the cost-effectiveness of strontium ranelate compared to alendronate for patients with post-menopausal osteoporotic fractures in Malaysia.
    METHODS. A Markov model was developed to project clinical and economic benefits of strontium in a hypothetical cohort of patients (N=1,000) over a 5-year time horizon. This study was conducted from a payer perspective. Model parameters including transition probabilities and costs of treating fracture at various sites were Malaysia-specific. Drug costs were obtained from a public teaching hospital in Kuala Lumpur. Utilities were derived from previous literatures and efficacy data were derived from two pivotal trials, i. e. SOTI and TROPOS trials. Outcomes were presented as cost per quality-adjusted life year (QALY) gained. A discount rate of 3% was applied. Both 1-way and multivariate probabilistic sensitivity analyses were undertaken to evaluate robustness of results.
    RESULTS. Compared to alendronate, strontium could prevent 328 wrist, 192 hip, 7 vertebra and 115 multiple fractures respectively over 5 years, which was translated into 27.9 QALYs gained. Using strontium can lead to cost reduction of MYR1,416,595 (USD442,685), MYR478,257 (USD149,455), MYR22,784 (USD7,120) and MYR61,883 (USD113,088) due to reduced episodes of fractures at wrist/hip/vertebra/multiple sites respectively. The total reduction of direct medical costs of MYR2,279,519 (USD712,349) was larger than the extra drug cost, hence making strontium a cost-saving therapy.
    CONCLUSIONS. It was shown that strontium appeared to be more cost-effective compared to alendronate and hence should be recommended in the public sector in Malaysia.
    Matched MeSH terms: Markov Chains
  18. Yap KL, Chong YW, Liu W
    PLoS One, 2020;15(1):e0227982.
    PMID: 31978101 DOI: 10.1371/journal.pone.0227982
    The rapid increase in the usage of the mobile internet has led to a great expansion of cellular data networks in order to provide better quality of service. However, the cost to expand the cellular network is high. One of the solutions to provide affordable wireless connectivity is the deployment of a WiFi access point to offload users' data usage. Nevertheless, the frequent and inefficient handover process between the WiFi AP and cellular network, especially when the mobile device is on the go, may degrade the network performance. Mobile devices do not have the intelligence to select the optimal network to enhance the quality of service (QoS). This paper presents an enhanced handover mechanism using mobility prediction (eHMP) to assist mobile devices in the handover process so that users can experience seamless connectivity. eHMP is tested in two wireless architectures, homogeneous and heterogeneous networks. The network performance significantly improved when eHMP is used in a homogeneous network, where the network throughput increases by 106% and the rate of retransmission decreases by 85%. When eHMP is used in a heterogeneous network, the network throughput increases by 55% and the retransmission rate decreases by 75%. The findings presented in this paper reveal that mobility prediction coupled with the multipath protocol can improve the QoS for mobile devices. These results will contribute to a better understanding of how the network service provider can offload traffic to the WiFi network without experiencing performance degradation.
    Matched MeSH terms: Markov Chains
  19. Dawood F, Loo CK
    PLoS One, 2016;11(3):e0152003.
    PMID: 26998923 DOI: 10.1371/journal.pone.0152003
    Mirror neurons are visuo-motor neurons found in primates and thought to be significant for imitation learning. The proposition that mirror neurons result from associative learning while the neonate observes his own actions has received noteworthy empirical support. Self-exploration is regarded as a procedure by which infants become perceptually observant to their own body and engage in a perceptual communication with themselves. We assume that crude sense of self is the prerequisite for social interaction. However, the contribution of mirror neurons in encoding the perspective from which the motor acts of others are seen have not been addressed in relation to humanoid robots. In this paper we present a computational model for development of mirror neuron system for humanoid based on the hypothesis that infants acquire MNS by sensorimotor associative learning through self-exploration capable of sustaining early imitation skills. The purpose of our proposed model is to take into account the view-dependency of neurons as a probable outcome of the associative connectivity between motor and visual information. In our experiment, a humanoid robot stands in front of a mirror (represented through self-image using camera) in order to obtain the associative relationship between his own motor generated actions and his own visual body-image. In the learning process the network first forms mapping from each motor representation onto visual representation from the self-exploratory perspective. Afterwards, the representation of the motor commands is learned to be associated with all possible visual perspectives. The complete architecture was evaluated by simulation experiments performed on DARwIn-OP humanoid robot.
    Matched MeSH terms: Markov Chains
  20. Dawood F, Loo CK
    Int J Neural Syst, 2018 May;28(4):1750038.
    PMID: 29022403 DOI: 10.1142/S0129065717500381
    Imitation learning through self-exploration is essential in developing sensorimotor skills. Most developmental theories emphasize that social interactions, especially understanding of observed actions, could be first achieved through imitation, yet the discussion on the origin of primitive imitative abilities is often neglected, referring instead to the possibility of its innateness. This paper presents a developmental model of imitation learning based on the hypothesis that humanoid robot acquires imitative abilities as induced by sensorimotor associative learning through self-exploration. In designing such learning system, several key issues will be addressed: automatic segmentation of the observed actions into motion primitives using raw images acquired from the camera without requiring any kinematic model; incremental learning of spatio-temporal motion sequences to dynamically generates a topological structure in a self-stabilizing manner; organization of the learned data for easy and efficient retrieval using a dynamic associative memory; and utilizing segmented motion primitives to generate complex behavior by the combining these motion primitives. In our experiment, the self-posture is acquired through observing the image of its own body posture while performing the action in front of a mirror through body babbling. The complete architecture was evaluated by simulation and real robot experiments performed on DARwIn-OP humanoid robot.
    Matched MeSH terms: Markov Chains
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