Search results for: relative survival analysis
Commenced in January 2007
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Paper Count: 29167

Search results for: relative survival analysis

28627 Phenological and Molecular Genetic Diversity Analysis among Saudi durum Wheat Landraces

Authors: Naser B. Almari, Salem S. Alghamdi, Muhammad Afzal, Mohamed Helmy El Shal

Abstract:

Wheat landraces are a rich genetic resource for boosting agronomic qualities in breeding programs while also providing diversity and unique adaptation to local environmental conditions. These genotypes have grown increasingly important in the face of recent climate change challenges. This research aimed to look at the genetic diversity of Saudi Durum wheat landraces using morpho-phenological and molecular data. The principal components analysis (PCA) analysis recorded 78.47 % variance and 1.064 eigenvalues for the first six PCs of the total, respectively. The significant characters contributed more to the diversity are the length of owns at the tip relative to the length of the ear, culm: glaucosity of the neck, flag leaf: glaucosity of the sheath, flag leaf: anthocyanin coloration of auricles, plant: frequency of plants with recurved flag leaves, ear: length, and ear: shape in profile in the PC1. The significant wheat genotypes contributed more in the PC1 (8, 14, 497, 650, 569, 590, 594, 598, 600, 601, and 604). The cluster analysis recorded an 85.42 cophenetic correlation among the 22 wheat genotypes and grouped the genotypes into two main groups. Group, I contain 8 genotypes, however, the 2nd group contains 12 wheat genotypes, while two genotypes (13 and 497) are standing alone in the dendrogram and unable to make a group with any one of the genotypes. The second group was subdivided into two subgroups. The genotypes (14, 602, and 600) were present in the second sub-group. The genotypes were grouped into two main groups. The first group contains 17 genotypes, while the second group contains 3 (8, 977, and 594) wheat genotypes. The genotype (602) was standing alone and unable to make a group with any wheat genotype. The genotypes 650 and 13 also stand alone in the first group. Using the Mantel test, the data recorded a significant (R2 = 0.0006) correlation (phenotypic and genetic) among 22 wheat durum genotypes.

Keywords: durum wheat, PCA, cluster analysis, SRAP, genetic diversity

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28626 Ethanol Chlorobenzene Dosimetr Usage for Measuring Dose of the Intraoperative Linear Electron Accelerator System

Authors: Mojtaba Barzegar, Alireza Shirazi, Saied Rabi Mahdavi

Abstract:

Intraoperative radiation therapy (IORT) is an innovative treatment modality that the delivery of a large single dose of radiation to the tumor bed during the surgery. The radiotherapy success depends on the absorbed dose delivered to the tumor. The achievement better accuracy in patient treatment depends upon the measured dose by standard dosimeter such as ionization chamber, but because of the high density of electric charge/pulse produced by the accelerator in the ionization chamber volume, the standard correction factor for ion recombination Ksat calculated with the classic two-voltage method is overestimated so the use of dose/pulse independent dosimeters such as chemical Fricke and ethanol chlorobenzene (ECB) dosimeters have been suggested. Dose measurement is usually calculated and calibrated in the Zmax. Ksat calculated by comparison of ion chamber response and ECB dosimeter at each applicator degree, size, and dose. The relative output factors for IORT applicators have been calculated and compared with experimentally determined values and the results simulated by Monte Carlo software. The absorbed doses have been calculated and measured with statistical uncertainties less than 0.7% and 2.5% consecutively. The relative differences between calculated and measured OF’s were up to 2.5%, for major OF’s the agreement was better. In these conditions, together with the relative absorbed dose calculations, the OF’s could be considered as an indication that the IORT electron beams have been well simulated. These investigations demonstrate the utility of the full Monte Carlo simulation of accelerator head with ECB dosimeter allow us to obtain detailed information of clinical IORT beams.

Keywords: intra operative radiotherapy, ethanol chlorobenzene, ksat, output factor, monte carlo simulation

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28625 Complex Dynamics of a Four Species Food-Web Model: An Analysis through Beddington-Deangelis Functional Response in the Presence of Additional Food

Authors: Surbhi Rani, Sunita Gakkhar

Abstract:

The four-dimensional food web system consisting of two prey species for a generalist middle predator and a top predator is proposed and investigated. The middle predator is predating both the prey species with a modified Holling type-II functional response. The food web model is found to be well-posed, bounded, and dissipative. The proposed model's essential dynamical features are studied in terms of local stability. The four species' survival is explored, and persistence conditions are established. The numerical simulations reveal the persistence in the form of a chaotic attractor or stable focus. The conclusion is that providing additional food to the middle predator may help to control the food chain's chaos.

Keywords: predator-prey model, existence of equilibrium points, local stability, chaos, numerical simulations

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28624 Desire as Psychological Case against Nihilism and a Clear Mechanism as Evidence for Moral Realism

Authors: Paul Pistone

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Nihilism claims that there are no actual intrinsic goods. Desire, however, directly contradicts this claim. To desire, something is more than to be motivated to bring about the desired ends. It is more than to take pleasure in it, seeming that one has obtained her desired end. Desire is, further, more than believing that something is good. Desire is the perception that something is good for the self. In this paper, it is argued that desire is an agent-relative value seeming. This implies that there are intrinsic values. It will be argued that: (1) there are intrinsic values related to life and flourishing, (2) that it is metaphysically impossible that there are no intrinsic values, (3) that desire is our psychological mechanism which enables us to perceive a state of affairs or event as an agent-relative good, and (4) while we can be wrong about the large scale object of desire (i.e., the instrumental desire) we cannot be wrong about what is at the root of our desire (i.e., the intrinsic desire). The method of this paper will be to examine the claims of nihilism and moral realism in recent literature, present a case for moral realism, discuss a few theories of desire, connect moral realism to an evaluative perceptual model of desire, and conclude that not only is this the best theory of desire but that this psychological faculty offers a clear counterexample to nihilism.

Keywords: desire, moral realism, nihilism, perception

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28623 Digital Reconstruction of Museum's Statue Using 3D Scanner for Cultural Preservation in Indonesia

Authors: Ahmad Zaini, F. Muhammad Reza Hadafi, Surya Sumpeno, Muhtadin, Mochamad Hariadi

Abstract:

The lack of information about museum’s collection reduces the number of visits of museum. Museum’s revitalization is an urgent activity to increase the number of visits. The research's roadmap is building a web-based application that visualizes museum in the virtual form including museum's statue reconstruction in the form of 3D. This paper describes implementation of three-dimensional model reconstruction method based on light-strip pattern on the museum statue using 3D scanner. Noise removal, alignment, meshing and refinement model's processes is implemented to get a better 3D object reconstruction. Model’s texture derives from surface texture mapping between object's images with reconstructed 3D model. Accuracy test of dimension of the model is measured by calculating relative error of virtual model dimension compared against the original object. The result is realistic three-dimensional model textured with relative error around 4.3% to 5.8%.

Keywords: 3D reconstruction, light pattern structure, texture mapping, museum

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28622 Analytical Method for Seismic Analysis of Shaft-Tunnel Junction under Longitudinal Excitations

Authors: Jinghua Zhang

Abstract:

Shaft-tunnel junction is a typical case of the structural nonuniformity in underground structures. The shaft and the tunnel possess greatly different structural features. Even under uniform excitations, they tend to behave discrepantly. Studies on shaft-tunnel junctions are mainly performed numerically. Shaking table tests are also conducted. Although many numerical and experimental data are obtained, an analytical solution still has great merits of gaining more insights into the shaft-tunnel problem. This paper will try to remedy the situation. Since the seismic responses of shaft-tunnel junctions are very related to directions of the excitations, they are studied in two scenarios: the longitudinal-excitation scenario and the transverse-excitation scenario. The former scenario will be addressed in this paper. Given that responses of the tunnel are highly dependent on the shaft, the analytical solutions would be developed firstly for the vertical shaft. Then, the seismic responses of the tunnel would be discussed. Since vertical shafts bear a resemblance to rigid caissons, the solution proposed in this paper is derived by introducing terms of shaft-tunnel and soil-tunnel interactions into equations originally developed for rigid caissons. The validity of the solution is examined by a validation model computed by finite element method. The mutual influence between the shaft and the tunnel is introduced. The soil-structure interactions are discussed parametrically based on the proposed equations. The shaft-tunnel relative displacement and the soil-tunnel relative stiffness are found to be the most important parameters affecting the magnitudes and distributions of the internal forces of the tunnel. A hinge-joint at the shaft-tunnel junction could significantly reduce the degree of stress concentration compared with a rigid joint.

Keywords: analytical solution, longitudinal excitation, numerical validation , shaft-tunnel junction

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28621 Frailty Models for Modeling Heterogeneity: Simulation Study and Application to Quebec Pension Plan

Authors: Souad Romdhane, Lotfi Belkacem

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When referring to actuarial analysis of lifetime, only models accounting for observable risk factors have been developed. Within this context, Cox proportional hazards model (CPH model) is commonly used to assess the effects of observable covariates as gender, age, smoking habits, on the hazard rates. These covariates may fail to fully account for the true lifetime interval. This may be due to the existence of another random variable (frailty) that is still being ignored. The aim of this paper is to examine the shared frailty issue in the Cox proportional hazard model by including two different parametric forms of frailty into the hazard function. Four estimated methods are used to fit them. The performance of the parameter estimates is assessed and compared between the classical Cox model and these frailty models through a real-life data set from the Quebec Pension Plan and then using a more general simulation study. This performance is investigated in terms of the bias of point estimates and their empirical standard errors in both fixed and random effect parts. Both the simulation and the real dataset studies showed differences between classical Cox model and shared frailty model.

Keywords: life insurance-pension plan, survival analysis, risk factors, cox proportional hazards model, multivariate failure-time data, shared frailty, simulations study

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28620 Investigating Undrained Behavior of Noor Sand Using Triaxial Compression Test

Authors: Hossein Motaghedi, Siavash Salamatpoor, Abbas Mokhtari

Abstract:

Noor costal city which is located in Mazandaran province, Iran, regularly visited by many tourists. Accordingly, many tall building and heavy structures are going to be constructed over this coastal area. This region is overlaid by poorly graded clean sand and because of high water level, is susceptible to liquefaction. In this study, undrained triaxial tests under isotropic consolidation were conducted on the reconstituted samples of Noor sand, which underlies a densely populated, seismic region of southern bank of Caspian Sea. When the strain level is large enough, soil samples under shearing tend to be in a state of continuous deformation under constant shear and normal stresses. There exists a correlation between the void ratio and mean effective principal stress, which is referred to as the ultimate steady state line (USSL). Soil behavior can be achieved by expressing the state of effective confining stress and defining the location of this point relative to the steady state line. Therefore, one can say that sand behavior not only is dependent to relative density but also a description of stress state has to be defined. The current study tries to investigate behavior of this sand under different conditions such as confining effective stress and relative density using undrained monotonic triaxial compression tests. As expected, the analyzed results show that the sand behavior varies from dilative to contractive state while initial isotropic effective stress increases. Therefore, confining effective stress level will directly affect the overall behavior of sand. The observed behavior obtained from the conducted tests is then compared with some previously tested sands including Yamuna, Ganga, and Toyoura.

Keywords: noor sand, liquefaction, undrained test, steady state

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28619 Optimal Pricing Based on Real Estate Demand Data

Authors: Vanessa Kummer, Maik Meusel

Abstract:

Real estate demand estimates are typically derived from transaction data. However, in regions with excess demand, transactions are driven by supply and therefore do not indicate what people are actually looking for. To estimate the demand for housing in Switzerland, search subscriptions from all important Swiss real estate platforms are used. These data do, however, suffer from missing information—for example, many users do not specify how many rooms they would like or what price they would be willing to pay. In economic analyses, it is often the case that only complete data is used. Usually, however, the proportion of complete data is rather small which leads to most information being neglected. Also, the data might have a strong distortion if it is complete. In addition, the reason that data is missing might itself also contain information, which is however ignored with that approach. An interesting issue is, therefore, if for economic analyses such as the one at hand, there is an added value by using the whole data set with the imputed missing values compared to using the usually small percentage of complete data (baseline). Also, it is interesting to see how different algorithms affect that result. The imputation of the missing data is done using unsupervised learning. Out of the numerous unsupervised learning approaches, the most common ones, such as clustering, principal component analysis, or neural networks techniques are applied. By training the model iteratively on the imputed data and, thereby, including the information of all data into the model, the distortion of the first training set—the complete data—vanishes. In a next step, the performances of the algorithms are measured. This is done by randomly creating missing values in subsets of the data, estimating those values with the relevant algorithms and several parameter combinations, and comparing the estimates to the actual data. After having found the optimal parameter set for each algorithm, the missing values are being imputed. Using the resulting data sets, the next step is to estimate the willingness to pay for real estate. This is done by fitting price distributions for real estate properties with certain characteristics, such as the region or the number of rooms. Based on these distributions, survival functions are computed to obtain the functional relationship between characteristics and selling probabilities. Comparing the survival functions shows that estimates which are based on imputed data sets do not differ significantly from each other; however, the demand estimate that is derived from the baseline data does. This indicates that the baseline data set does not include all available information and is therefore not representative for the entire sample. Also, demand estimates derived from the whole data set are much more accurate than the baseline estimation. Thus, in order to obtain optimal results, it is important to make use of all available data, even though it involves additional procedures such as data imputation.

Keywords: demand estimate, missing-data imputation, real estate, unsupervised learning

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28618 Targeting Glucocorticoid Receptor Eliminate Dormant Chemoresistant Cancer Stem Cells in Glioblastoma

Authors: Aoxue Yang, Weili Tian, Haikun Liu

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Brain tumor stem cells (BTSCs) are resistant to therapy and give rise to recurrent tumors. These rare and elusive cells are likely to disseminate during cancer progression, and some may enter dormancy, remaining viable but not increasing. The identification of dormant BTSCs is thus necessary to design effective therapies for glioblastoma (GBM) patients. Glucocorticoids (GCs) are used to treat GBM-associated edema. However, glucocorticoids participate in the physiological response to psychosocial stress, linked to poor cancer prognosis. This raises concern that glucocorticoids affect the tumor and BTSCs. Identifying markers specifically expressed by brain tumor stem cells (BTSCs) may enable specific therapies that spare their regular tissue-resident counterparts. By ribosome profiling analysis, we have identified that glycerol-3-phosphate dehydrogenase 1 (GPD1) is expressed by dormant BTSCs but not by NSCs. Through different stress-induced experiments in vitro, we found that only dexamethasone (DEXA) can significantly increase the expression of GPD1 in NSCs. Adversely, mifepristone (MIFE) which is classified as glucocorticoid receptors antagonists, could decrease GPD1 protein level and weaken the proliferation and stemness in BTSCs. Furthermore, DEXA can induce GPD1 expression in tumor-bearing mice brains and shorten animal survival, whereas MIFE has a distinct adverse effect that prolonged mice lifespan. Knocking out GR in NSC can block the upregulation of GPD1 inducing by DEXA, and we find the specific sequences on GPD1 promotor combined with GR, thus improving the efficiency of GPD1 transcription from CHIP-Seq. Moreover, GR and GPD1 are highly co-stained on GBM sections obtained from patients and mice. All these findings confirmed that GR could regulate GPD1 and loss of GPD1 Impairs Multiple Pathways Important for BTSCs Maintenance GPD1 is also a critical enzyme regulating glycolysis and lipid synthesis. We observed that DEXA and MIFE could change the metabolic profiles of BTSCs by regulating GPD1 to shift the transition of cell dormancy. Our transcriptome and lipidomics analysis demonstrated that cell cycle signaling and phosphoglycerides synthesis pathways contributed a lot to the inhibition of GPD1 caused by MIFE. In conclusion, our findings raise concern that treatment of GBM with GCs may compromise the efficacy of chemotherapy and contribute to BTSC dormancy. Inhibition of GR can dramatically reduce GPD1 and extend the survival duration of GBM-bearing mice. The molecular link between GPD1 and GR may give us an attractive therapeutic target for glioblastoma.

Keywords: cancer stem cell, dormancy, glioblastoma, glycerol-3-phosphate dehydrogenase 1, glucocorticoid receptor, dexamethasone, RNA-sequencing, phosphoglycerides

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28617 Characteristics Influencing Response of a Base Isolated Building

Authors: Ounis Hadj Mohamed, Ounis Abdelhafid

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In order to illustrate the effect of damping on the response of a base-isolated building, a parametric study is led, taking into account the progressive variation of the damping ratio (10% to 30%) under different types of seismic excitations (near and far field). A time history analysis is used to determine the response of the structure in terms of relative displacement and understory drift at various levels of the building. Thus, the results show that the efficiency of the isolator increases with the assumed damping ratio, provided that this latter is less or equal to 20%. Beyond this value, the isolator becomes less convenient. Furthermore, a strong deviation of energy capacity by the LRB (Lead Rubber Bearing) system is recorded.

Keywords: damping, base isolation, LRB, seismic excitation, hysteresis

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28616 Consolidated Predictive Model of the Natural History of Breast Cancer Considering Primary Tumor and Secondary Distant Metastases Growth

Authors: Ella Tyuryumina, Alexey Neznanov

Abstract:

This study is an attempt to obtain reliable data on the natural history of breast cancer growth. We analyze the opportunities for using classical mathematical models (exponential and logistic tumor growth models, Gompertz and von Bertalanffy tumor growth models) to try to describe growth of the primary tumor and the secondary distant metastases of human breast cancer. The research aim is to improve predicting accuracy of breast cancer progression using an original mathematical model referred to CoMPaS and corresponding software. We are interested in: 1) modelling the whole natural history of the primary tumor and the secondary distant metastases; 2) developing adequate and precise CoMPaS which reflects relations between the primary tumor and the secondary distant metastases; 3) analyzing the CoMPaS scope of application; 4) implementing the model as a software tool. The foundation of the CoMPaS is the exponential tumor growth model, which is described by determinate nonlinear and linear equations. The CoMPaS corresponds to TNM classification. It allows to calculate different growth periods of the primary tumor and the secondary distant metastases: 1) ‘non-visible period’ for the primary tumor; 2) ‘non-visible period’ for the secondary distant metastases; 3) ‘visible period’ for the secondary distant metastases. The CoMPaS is validated on clinical data of 10-years and 15-years survival depending on the tumor stage and diameter of the primary tumor. The new predictive tool: 1) is a solid foundation to develop future studies of breast cancer growth models; 2) does not require any expensive diagnostic tests; 3) is the first predictor which makes forecast using only current patient data, the others are based on the additional statistical data. The CoMPaS model and predictive software: a) fit to clinical trials data; b) detect different growth periods of the primary tumor and the secondary distant metastases; c) make forecast of the period of the secondary distant metastases appearance; d) have higher average prediction accuracy than the other tools; e) can improve forecasts on survival of breast cancer and facilitate optimization of diagnostic tests. The following are calculated by CoMPaS: the number of doublings for ‘non-visible’ and ‘visible’ growth period of the secondary distant metastases; tumor volume doubling time (days) for ‘non-visible’ and ‘visible’ growth period of the secondary distant metastases. The CoMPaS enables, for the first time, to predict ‘whole natural history’ of the primary tumor and the secondary distant metastases growth on each stage (pT1, pT2, pT3, pT4) relying only on the primary tumor sizes. Summarizing: a) CoMPaS describes correctly the primary tumor growth of IA, IIA, IIB, IIIB (T1-4N0M0) stages without metastases in lymph nodes (N0); b) facilitates the understanding of the appearance period and inception of the secondary distant metastases.

Keywords: breast cancer, exponential growth model, mathematical model, metastases in lymph nodes, primary tumor, survival

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28615 Objectifying Media and Preadolescents' Media Internalization: A Developmental Perspective

Authors: Ann Rousseau, Steven Eggermont

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The current study sought to explain pre-adolescents’ differential susceptibility to the internalization of mediated appearance ideals, using a three-wave panel survey of preadolescent girls and boys (N = 973, Mage = 11.14). Based on the premises of objectification theory and sexual script theory, we proposed a double role for pubertal timing and cross-sex interactions in preadolescents’ media internalization. More specifically, we expected pubertal timing and cross-sex interactions to (a) trigger higher levels of media internalization, directly and indirectly via body surveillance, and (b) positively moderate the relationship between objectifying media exposure and girls’ and boys’ media internalization. A first cross-lagged model tested whether the pubertal timing and cross-sex interactions could trigger preadolescents media internalization and body surveillance. Structural equation analysis indicated that pubertal timing (Wave1) positively predicted body surveillance and media internalization (both Wave3). Cross-sex involvement (Wave1) was positively linked to media internalization (Wave2), but body surveillance (Wave2) was not associated with cross-sex interactions. Results also showed a reciprocal interaction between media internalization (Wave 2 and 3) and body surveillance (Wave2 and 3). Multiple group analysis showed that the observed relationships did not vary by gender. A second moderated moderation model examined whether (a) the relationship between objectifying media exposure (television and magazines, both Wave1) and media internalization (Wave3) depended on pubertal timing (Wave1), and (b) the two-way interaction between objectifying media exposure (Wave1) and pubertal timing (Wave1) varied depending on cross-sex interactions (Wave1). Results revealed that cross-sex interactions functioned as a buffer against media internalization. For preadolescents who had fewer cross-sex interactions, early puberty (relative to peers) positively moderated the relationship between magazine exposure and the internalization of mediated appearance ideals. No significant relationships were found for television. Again, no gender difference could be observed. The present study suggests a double role for pubertal timing and cross-sex interactions in preadolescents media internalization, and indicate that early developers with few cross-sex experiences are particularly vulnerable for media internalization. Additionally, the current findings suggest that there is relative gender equity in magazines’ ability to cultivate media internalization among preadolescents.

Keywords: cross-sex interactions, media effects, objectification theory, pubertal timing

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28614 Management of Renal Malignancies with IVC Thrombus: Our Experience

Authors: Sujeet Poudyal

Abstract:

Introduction: Renal cell carcinoma is the most common malignancy associated with Inferior vena cava (IVC) thrombosis. Radical nephrectomy with tumor thrombectomy provides durable cancer-free survival. Other renal malignancies like Wilms’ tumors are also associated with IVC thrombus. We describe our experience with the management of renal malignancies associated with IVC thrombus. Methods: This prospective study included 28 patients undergoing surgery for renal malignancies associated with IVC thrombus from February 2017 to March 2023. Demographics of patients, types of renal malignancy, level of IVC thrombus, intraoperative details, need for venovenous bypass, cardiopulmonary bypass and postoperative outcomes were all documented. Results: Out of a total of 28 patients, 24 patients had clear cell Renal Cell Carcinoma,1 had renal osteosarcoma and 3 patients had Wilms tumor. The levels. of thrombus were II in eight, III in seven, and IV in six patients. The mean age of RCC was 62.81±10.2 years, renal osteosarcoma was 26 years and Wilms tumor was 23 years. There was a need for venovenous bypass in four patients and cardiopulmonary bypass in four patients, and the Postoperative period was uneventful in most cases except for two mortalities, one in Level III due to pneumonia and one in Level IV due to sepsis. All cases followed up till now have no local recurrence and metastasis except one case of RCC with Level IV IVC thrombus, which presented with paraaortic nodal recurrence and is currently managed with sunitinib. Conclusion: The complexity in the management of renal malignancy with IVC thrombus increases with the level of IVC thrombus. As radical nephrectomy with tumor thrombectomy provides durable cancer-free survival in most cases, the surgery should be undertaken in an expert and experienced setup with a strong cardiovascular backup to minimize morbidity and mortality associated with the procedure.

Keywords: renal malignancy, IVC thrombus, radical nephrectomy with tumor thrombectomy, renal cell carcinoma

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28613 Impact of Tryptic Limited Hydrolysis on Bambara Protein-Gum Arabic Soluble Complexes Formation

Authors: Abiola A. Ojesanmi, Eric O. Amonsou

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The formation of soluble complexes is usually within a narrow pH range characterized by weak interactions. Moreover, the rigid conformation of globular proteins restricts the number of charged groups capable of interacting with polysaccharides, thereby limiting food applications. Hence, this study investigated the impact of tryptic-limited hydrolysis on the formation of Bambara protein-gum arabic soluble complexes formation. The electrostatic interactions were monitored through turbidimetry analysis. The Bambara protein hydrolysates at a specified degree of hydrolysis, and DHs (2, 5, and 7.5) were characterized using size exclusion chromatography, zeta potential, surface hydrophobicity, and intrinsic fluorescence. The stability of the complexes was investigated using differential scanning calorimetry and rheometry. The limited tryptic hydrolysis significantly widened the pH range of the formation of soluble complexes, with DH 5 having a wider range (pH 7.0 - 4.3) compared to DH 2 and DH 7.5, while there was no notable difference in the optimum complexation pH of the insoluble complexes. Larger peptides (140, 118 kDa) were detected in DH 2 relative to 144, 70, and 61 kDa in DH 5, which were larger than 140, 118, 48, and 32 kDa in DH 7. 5. An increase in net negative charge (- 30 Mv for DH 7.5) and a slight shift in the net neutrality (from pH 4.9 to 4.3) of the hydrolysates were observed which consequently impacted the electrostatic interaction with gum arabic. There was exposure of the hydrophobic amino acids up to 4-fold in comparison with the isolate and a red shift in maximum fluorescence wavelength in DH dependent manner following the hydrolysis. The denaturation temperature of the soluble complex from the hydrolysates shifted to higher values, having DH 5 with the maximum temperature (94.24 °C). A highly interconnected gel-like soluble complex network was formed having DH 5 with a better structure relative to DH 2 and 7.5. The study showed the use of limited tryptic hydrolysis at DH 5 as an effective approach to modify Bambara protein and provided a more stable and wider pH range of formation for soluble complex, thereby enhancing the food application.

Keywords: Bambara groundnut, gum arabic, interaction, soluble complex

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28612 Structural Design and Environmental Analysis of Oyster Mushroom Cultivation House in Korea

Authors: Lee Sunghyoun, Yu Byeongkee, Kim Hyuckjoo, Yun Namkyu, Jung Jongcheon

Abstract:

Most of the recent on-sale oyster mushrooms are raised in a oyster mushroom house, in which the necessary adjustment of growing condition is feasible. The rationale for such artificial growing is the impossibility of successive cultivation in the case of a natural cultivation due to external weather conditions. A oyster mushroom house adopts an equipment called growing bed, laying one growing bed upon another in a multi-column fashion, growing and developing the mushrooms on the respective equipments. The indispensable environment management factors of mushroom cultivation are temperature, humidity, and CO2; on which an appropriate regulation of the three requisites is a necessitated condition for the sake of the total output’s increase. However, due to the multiple layers of growing bed’s disturbance on air circulation, a oyster mushroom house’s internal environmental uniformity meets with considerable instability. This research presents a technology which assures the facilitation of environment regulation over all the internal space of a oyster mushroom house, irrespective of its location. The research staff reinforced the oyster mushroom house’s insulation in order to minimize the external environment’s influence on the oyster mushroom house’s internal environment and installed circulation fan to improve the oyster mushroom house’s interior environmental uniformity. Also, the humidifier nozzle’s position was set to prevent dew condensation when humidifying. As a result, a highly sophisticated management over all the oyster mushroom house‘s internal space was realized with the temperature of 0.2~1.3℃, and the relative humidity of 2~7% at the cultivating stage of mushroom’s growth. Therefore, to maximize oyster mushroom house‘s internal environmental uniformity, it can be concluded that consideration of various factors such as insulation reinforcement, decision on the humidifier nozzle’s location, disposition of circulation fan’s installation and the direction of wind discharge is needed.

Keywords: mushroom growing facility, environmental uniformity, temperature, relative humidity, CO2 concentration

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28611 The Role of Transport Investment and Enhanced Railway Accessibility in Regional Efficiency Improvement in Saudi Arabia: Data Envelopment Analysis

Authors: Saleh Alotaibi, Mohammed Quddus, Craig Morton, Jobair Bin Alam

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This paper explores the role of large-scale investment in transport sectors and the impact of increased railway accessibility on the efficiency of the regional economic productivity in the Kingdom of Saudi Arabia (KSA). There are considerable differences among the KSA regions in terms of their levels of investment and productivity due to their geographical scale and location, which in turn greatly affect their relative efficiency. The study used a non-parametric linear programming technique - Data Envelopment Analysis (DEA) - to measure the regional efficiency change over time and determine the drivers of inefficiency and their scope of improvement. In addition, Window DEA analysis is carried out to compare the efficiency performance change for various time periods. Malmquist index (MI) is also analyzed to identify the sources of productivity change between two subsequent years. The analysis involves spatial and temporal panel data collected from 1999 to 2018 for the 13 regions of the country. Outcomes reveal that transport investment and improved railway accessibility, in general, have significantly contributed to regional economic development. Moreover, the endowment of the new railway stations has spill-over effects. The DEA Window analysis confirmed the dynamic improvement in the average regional efficiency over the study periods. MI showed that the technical efficiency change was the main source of regional productivity improvement. However, there is evidence of investment allocation discrepancy among regions which could limit the achievement of development goals in the long term. These relevant findings will assist the Saudi government in developing better strategic decisions for future transport investments and their allocation at the regional level.

Keywords: data envelopment analysis, transport investment, railway accessibility, efficiency

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28610 A Horn Antenna Loaded with FSS of Crossed Dipoles

Authors: Ibrahim Mostafa El-Mongy, Abdelmegid Allam

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In this article analysis and investigation of the effect of loading a horn antenna with frequency selective surface (FSS) of crossed dipoles of finite size is presented. It is fabricated on Rogers RO4350 (lossy) of relative permittivity 3.33, thickness 1.524 mm and loss tangent 0.004. Basically it is applied for filtering and minimizing the interference and noise in the desired band. The filtration is carried out using a finite FSS of crossed dipoles of overall dimensions 98x58 mm2. The filtration is shown by limiting the transmission bandwidth from 4 GHz (8–12 GHz) to 0.25 GHz (10.75–11 GHz). It is simulated using CST MWS and measured using network analyzer. There is a good agreement between the simulated and measured results.

Keywords: antenna, filtenna, frequency selective surface (FSS), horn

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28609 Applications of Multi-Path Futures Analyses for Homeland Security Assessments

Authors: John Hardy

Abstract:

A range of future-oriented intelligence techniques is commonly used by states to assess their national security and develop strategies to detect and manage threats, to develop and sustain capabilities, and to recover from attacks and disasters. Although homeland security organizations use future's intelligence tools to generate scenarios and simulations which inform their planning, there have been relatively few studies of the methods available or their applications for homeland security purposes. This study presents an assessment of one category of strategic intelligence techniques, termed Multi-Path Futures Analyses (MPFA), and how it can be applied to three distinct tasks for the purpose of analyzing homeland security issues. Within this study, MPFA are categorized as a suite of analytic techniques which can include effects-based operations principles, general morphological analysis, multi-path mapping, and multi-criteria decision analysis techniques. These techniques generate multiple pathways to potential futures and thereby generate insight into the relative influence of individual drivers of change, the desirability of particular combinations of pathways, and the kinds of capabilities which may be required to influence or mitigate certain outcomes. The study assessed eighteen uses of MPFA for homeland security purposes and found that there are five key applications of MPFA which add significant value to analysis. The first application is generating measures of success and associated progress indicators for strategic planning. The second application is identifying homeland security vulnerabilities and relationships between individual drivers of vulnerability which may amplify or dampen their effects. The third application is selecting appropriate resources and methods of action to influence individual drivers. The fourth application is prioritizing and optimizing path selection preferences and decisions. The fifth application is informing capability development and procurement decisions to build and sustain homeland security organizations. Each of these applications provides a unique perspective of a homeland security issue by comparing a range of potential future outcomes at a set number of intervals and by contrasting the relative resource requirements, opportunity costs, and effectiveness measures of alternative courses of action. These findings indicate that MPFA enhances analysts’ ability to generate tangible measures of success, identify vulnerabilities, select effective courses of action, prioritize future pathway preferences, and contribute to ongoing capability development in homeland security assessments.

Keywords: homeland security, intelligence, national security, operational design, strategic intelligence, strategic planning

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28608 Potentiometric Determination of Moxifloxacin in Some Pharmaceutical Formulation Using PVC Membrane Sensors

Authors: M. M. Hefnawy, A. M. A. Homoda, M. A. Abounassif, A. M. Alanazia, A. Al-Majed, Gamal A. E. Mostafa

Abstract:

PVC membrane sensors using different approach e.g. ion-pair, ionophore, and Schiff-base has been used as testing membrane sensor. Analytical applications of membrane sensors for direct measurement of variety of different ions in complex biological and environmental sample are reported. The most important step of such PVC membrane sensor is the sensing active material. The potentiometric sensors have some outstanding advantages including simple design, operation, wide linear dynamic range, relative fast response time, and rotational selectivity. The analytical applications of these techniques to pharmaceutical compounds in dosage forms are also discussed. The construction and electrochemical response characteristics of Poly (vinyl chloride) membrane sensors for moxifloxacin HCl (MOX) are described. The sensing membranes incorporate ion association complexes of moxifloxacin cation and sodium tetraphenyl borate (NaTPB) (sensor 1), phosphomolybdic acid (PMA) (sensor 2) or phosphotungstic acid (PTA) (sensor 3) as electroactive materials. The sensors display a fast, stable and near-Nernstian response over a relative wide moxifloxacin concentration range (1 ×10-2-4.0×10-6, 1 × 10-2-5.0×10-6, 1 × 10-2-5.0×10-6 M), with detection limits of 3×10-6, 4×10-6 and 4.0×10-6 M for sensor 1, 2 and 3, respectively over a pH range of 6.0-9.0. The sensors show good discrimination of moxifloxacin from several inorganic and organic compounds. The direct determination of 400 µg/ml of moxifloxacin show an average recovery of 98.5, 99.1 and 98.6 % and a mean relative standard deviation of 1.8, 1.6 and 1.8% for sensors 1, 2, and 3 respectively. The proposed sensors have been applied for direct determination of moxifloxacin in some pharmaceutical preparations. The results obtained by determination of moxifloxacin in tablets using the proposed sensors are comparable favorably with those obtained using the US Pharmacopeia method. The sensors have been used as indicator electrodes for potentiometric titration of moxifloxacin.

Keywords: potentiometry, PVC, membrane sensors, ion-pair, ionophore, schiff-base, moxifloxacin HCl, sodium tetraphenyl borate, phosphomolybdic acid, phosphotungstic acid

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28607 Sensitivity Analysis of Prestressed Post-Tensioned I-Girder and Deck System

Authors: Tahsin A. H. Nishat, Raquib Ahsan

Abstract:

Sensitivity analysis of design parameters of the optimization procedure can become a significant factor while designing any structural system. The objectives of the study are to analyze the sensitivity of deck slab thickness parameter obtained from both the conventional and optimum design methodology of pre-stressed post-tensioned I-girder and deck system and to compare the relative significance of slab thickness. For analysis on conventional method, the values of 14 design parameters obtained by the conventional iterative method of design of a real-life I-girder bridge project have been considered. On the other side for analysis on optimization method, cost optimization of this system has been done using global optimization methodology 'Evolutionary Operation (EVOP)'. The problem, by which optimum values of 14 design parameters have been obtained, contains 14 explicit constraints and 46 implicit constraints. For both types of design parameters, sensitivity analysis has been conducted on deck slab thickness parameter which can become too sensitive for the obtained optimum solution. Deviations of slab thickness on both the upper and lower side of its optimum value have been considered reflecting its realistic possible ranges of variations during construction. In this procedure, the remaining parameters have been kept unchanged. For small deviations from the optimum value, compliance with the explicit and implicit constraints has been examined. Variations in the cost have also been estimated. It is obtained that without violating any constraint deck slab thickness obtained by the conventional method can be increased up to 25 mm whereas slab thickness obtained by cost optimization can be increased only up to 0.3 mm. The obtained result suggests that slab thickness becomes less sensitive in case of conventional method of design. Therefore, for realistic design purpose sensitivity should be conducted for any of the design procedure of girder and deck system.

Keywords: sensitivity analysis, optimum design, evolutionary operations, PC I-girder, deck system

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28606 MAGE-A3 and PRAME Gene Expression and EGFR Mutation Status in Non-Small-Cell Lung Cancer

Authors: Renata Checiches, Thierry Coche, Nicolas F. Delahaye, Albert Linder, Fernando Ulloa Montoya, Olivier Gruselle, Karen Langfeld, An de Creus, Bart Spiessens, Vincent G. Brichard, Jamila Louahed, Frédéric F. Lehmann

Abstract:

Background: The RNA-expression levels of cancer-testis antigens MAGE A3 and PRAME were determined in resected tissue from patients with primary non-small-cell lung cancer (NSCLC) and related to clinical outcome. EGFR, KRAS and BRAF mutation status was determined in a subset to investigate associations with MAGE A3 and PRAME expression. Methods: We conducted a single-centre, uncontrolled, retrospective study of 1260 tissue-bank samples from stage IA-III resected NSCLC. The prognostic value of antigen expression (qRT-PCR) was determined by hazard-ratio and Kaplan-Meier curves. Results: Thirty-seven percent (314/844) of tumours expressed MAGE-A3, 66% (723/1092) expressed PRAME and 31% (239/839) expressed both. Respective frequencies in squamous-cell tumours and adenocarcinomas were 43%/30% for MAGE A3 and 80%/44% for PRAME. No correlation with stage, tumour size or patient age was found. Overall, no prognostic value was identified for either antigen. A trend to poorer overall survival was associated with MAGE-A3 in stage IIIB and with PRAME in stage IB. EGFR and KRAS mutations were found in 10.1% (28/311) and 33.8% (97/311) of tumours, respectively. EGFR (but not KRAS) mutation status was negatively associated with PRAME expression. Conclusion: No clear prognostic value for either PRAME or MAGE A3 was observed in the overall population, although some observed trends may warrant further investigation.

Keywords: MAGE A3, PRAME, cancer-testis gene, NSCLC, survival, EGFR

Procedia PDF Downloads 357
28605 Tailoring Piezoelectricity of PVDF Fibers with Voltage Polarity and Humidity in Electrospinning

Authors: Piotr K. Szewczyk, Arkadiusz Gradys, Sungkyun Kim, Luana Persano, Mateusz M. Marzec, Oleksander Kryshtal, Andrzej Bernasik, Sohini Kar-Narayan, Pawel Sajkiewicz, Urszula Stachewicz

Abstract:

Piezoelectric polymers have received great attention in smart textiles, wearables, and flexible electronics. Their potential applications range from devices that could operate without traditional power sources, through self-powering sensors, up to implantable biosensors. Semi-crystalline PVDF is often proposed as the main candidate for industrial-scale applications as it exhibits exceptional energy harvesting efficiency compared to other polymers combined with high mechanical strength and thermal stability. Plenty of approaches have been proposed for obtaining PVDF rich in the desired β-phase with electric polling, thermal annealing, and mechanical stretching being the most prevalent. Electrospinning is a highly tunable technique that provides a one-step process of obtaining highly piezoelectric PVDF fibers without the need for post-treatment. In this study, voltage polarity and relative humidity influence on electrospun PVDF, fibers were investigated with the main focus on piezoelectric β-phase contents and piezoelectric performance. Morphology and internal structure of fibers were investigated using scanning (SEM) and transmission electron microscopy techniques (TEM). Fourier Transform Infrared Spectroscopy (FITR), wide-angle X-ray scattering (WAXS) and differential scanning calorimetry (DSC) were used to characterize the phase composition of electrospun PVDF. Additionally, surface chemistry was verified with X-ray photoelectron spectroscopy (XPS). Piezoelectric performance of individual electrospun PVDF fibers was measured using piezoresponse force microscopy (PFM), and the power output from meshes was analyzed via custom-built equipment. To prepare the solution for electrospinning, PVDF pellets were dissolved in dimethylacetamide and acetone solution in a 1:1 ratio to achieve a 24% solution. Fibers were electrospun with a constant voltage of +/-15kV applied to the stainless steel nozzle with the inner diameter of 0.8mm. The flow rate was kept constant at 6mlh⁻¹. The electrospinning of PVDF was performed at T = 25°C and relative humidity of 30 and 60% for PVDF30+/- and PVDF60+/- samples respectively in the environmental chamber. The SEM and TEM analysis of fibers produced at a lower relative humidity of 30% (PVDF30+/-) showed a smooth surface in opposition to fibers obtained at 60% relative humidity (PVDF60+/-), which had wrinkled surface and additionally internal voids. XPS results confirmed lower fluorine content at the surface of PVDF- fibers obtained by electrospinning with negative voltage polarity comparing to the PVDF+ obtained with positive voltage polarity. Changes in surface composition measured with XPS were found to influence the piezoelectric performance of obtained fibers what was further confirmed by PFM as well as by custom-built fiber-based piezoelectric generator. For PVDF60+/- samples humidity led to an increase of β-phase contents in PVDF fibers as confirmed by FTIR, WAXS, and DSC measurements, which showed almost two times higher concentrations of β-phase. A combination of negative voltage polarity with high relative humidity led to fibers with the highest β-phase contents and the best piezoelectric performance of all investigated samples. This study outlines the possibility to produce electrospun PVDF fibers with tunable piezoelectric performance in a one-step electrospinning process by controlling relative humidity and voltage polarity conditions. Acknowledgment: This research was conducted within the funding from m the Sonata Bis 5 project granted by National Science Centre, No 2015/18/E/ST5/00230, and supported by the infrastructure at International Centre of Electron Microscopy for Materials Science (IC-EM) at AGH University of Science and Technology. The PFM measurements were supported by an STSM Grant from COST Action CA17107.

Keywords: crystallinity, electrospinning, PVDF, voltage polarity

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28604 The impact of Breast Cancer Polymorphism on Breast Cancer

Authors: Roudabeh Vakil Monfared, Farhad Mashayekhi

Abstract:

Breast cancer is the most common malignancy type among women with about 1 million new cases each year. The immune system plays an important role in the breast cancer development. OX40L (also known as TNFSF4), a membrane protein, which is a member of the tumor necrosis factor super family binds to its receptor OX40 and this co-stimulation has a crucial role in T-cell proliferation, survival and cytokine release. Due to the importance of the T-cells in anti-tumor activities of OX40L we studied the association of rs3850641 (T→C) polymorphism of OX40L gene with breast cancer. The study included 123 women with breast cancer and 126 healthy volunteers with no signs of cancer. Genomic DNA was extracted from blood leucocytes. Genotype and allele frequencies were determined in patients and control cases with the method of polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) and the analysis was performed by Med Calc. The prevalence of genotype frequencies of TT, CT and CC were 60.9%, 30.08% and 8.9 % in patients with breast cancer and 74.6 %, 18.25 % and 7.14 % in healthy volunteers while the T and C allelic frequency was 76.01% and 23.98 % in patients and 83.73% and 16.26% in healthy controls. Respectively Statistical analysis has shown no significant difference from the comparison of either genotype (P=0.06). According to these results, the rs3850641 SNP has no association with the susceptibility of breast cancer in a population in northern Iran. However, further studies in larger populations including other genetic and environmental factors are required to achieve conclusion.

Keywords: OX40L, gene, polymorphism, breast cancer

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28603 Hierarchy and Weight of Influence Factors on Labor Productivity in the Construction Industry of the Nepal

Authors: Shraddha Palikhe, Sunkuk Kim

Abstract:

The construction industry is the most labor intensive in Nepal. It is obvious that construction is a major sector and any productivity enhancement activity in this sector will have a positive impact in the overall improvement of the national economy. Previous studies have stated that Nepal has poor labor productivity among other south Asian countries. Though considerable research has been done on productivity factors in other countries, no study has addressed labor productivity issues in Nepal. Therefore, the main objective of this study is to identify and hierarchy the influence factors for poor labor productivity. In this study, a questionnaire approach is chosen as a method of the survey from thirty experts involved in the construction industry, such as Architects, Civil Engineers, Project Engineers and Site Engineers. A survey was conducted in Nepal, to identify the major factors impacting construction labor productivity. Analytic Hierarchy Process (AHP) analysis method was used to understand the underlying relationships among the factors, categorized into five groups, namely (1) Labor-management group; (2) Material management group; (3) Human labor group; (4) Technological group and (5) External group and was divided into 33 subfactors. AHP was used to establish the relative importance of the criteria. The AHP makes pairwise comparisons of relative importance between hierarchy elements grouped by labor productivity decision criteria. Respondents were asked to answer based on their experience of construction works. On the basis of the respondent’s response, weight of all the factors were calculated and ranked it. The AHP results were tabulated based on weight and ranking of influence factors. AHP model consists of five main criteria and 33 sub-criteria. Among five main criteria, the scenario assigns a weight of highest influential factor i.e. 26.15% to human labor group followed by 23.01% to technological group, 22.97% to labor management group, 17.61% material management group and 10.25% to external group. While in 33 sub-criteria, the most influential factor for poor productivity in Nepal are lack of monetary incentive (20.53%) for human labor group, unsafe working condition (17.55%) for technological group, lack of leadership (18.43%) for labor management group, unavailability of tools at site (25.03%) for material management group and strikes (35.01%) for external group. The results show that AHP model associated criteria are helpful to predict the current situation of labor productivity. It is essential to consider these influence factors to improve the labor productivity in the construction industry of Nepal.

Keywords: construction, hierarchical analysis, influence factors, labor productivity

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28602 Political Corruption in an Authoritarian Regime: a Story from the Kingdom of Morocco

Authors: Noureddine Radouai

Abstract:

Corruption is an endemic phenomenon in many countries around the globe. Morocco, as an authoritarian regime, relies on corruption for monarchy survival. I analyze the Makhzen structure and methods that it follows to exchange corruption for political loyalty. The abuse of power in Morocco is sponsored by the monarch itself as it is its way to remain its importance in the regime.

Keywords: corruption, Clientelism, authoritarian regime, Morocco

Procedia PDF Downloads 118
28601 Modal Analysis of a Cantilever Beam Using an Inexpensive Smartphone Camera: Motion Magnification Technique

Authors: Hasan Hassoun, Jaafar Hallal, Denis Duhamel, Mohammad Hammoud, Ali Hage Diab

Abstract:

This paper aims to prove the accuracy of an inexpensive smartphone camera as a non-contact vibration sensor to recover the vibration modes of a vibrating structure such as a cantilever beam. A video of a vibrating beam is filmed using a smartphone camera and then processed by the motion magnification technique. Based on this method, the first two natural frequencies and their associated mode shapes are estimated experimentally and compared to the analytical ones. Results show a relative error of less than 4% between the experimental and analytical approaches for the first two natural frequencies of the beam. Also, for the first two-mode shapes, a Modal Assurance Criterion (MAC) value of above 0.9 between the two approaches is obtained. This slight error between the different techniques ensures the viability of a cheap smartphone camera as a non-contact vibration sensor, particularly for structures vibrating at relatively low natural frequencies.

Keywords: modal analysis, motion magnification, smartphone camera, structural vibration, vibration modes

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28600 The Role of Information and Communication Technology in Achieving Competitive Advantage

Authors: Malki Fatima Zahra Nadia, Kellal Chaimaa, Brahimi Houria

Abstract:

The world has undergone a big dramatic transformations as a result of the liberalization of the economy. Which lead to intensity of competition between economic institutions under the slogan “ Survival of the fittest”.in the line with these changes, it is imperative for Organizations to adopt the philosophy of applying ICT in the era of globalization in order to survive and sustain in the local and international markets.and even the Algerian economic institutions are concerned in what witnessed by the international institutions,especially after Algeria adopted the policy of trade openness.And from this point, it was the start of the study, that aims at identifying the role of ICT in achieving competitive advantage in the economic institutions according to an analytical study of Mobilis Telecom in Algeria city, and then the analysis of the results by SPSS edition 24.To sum up, i have come to the conclusion that ICT has effectively contributed to the achievement of competitive advantage, and that the value of organizations today lies in the extent to which they use ICT’s which make it gain speed, efficiency, and the quality of its operations especially in the competitive competition.

Keywords: ICT, company, competitive advantage, competitive strategie

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28599 Qualitative and Quantitative Methods in Multidisciplinary Fields Collection Development

Authors: Hui Wang

Abstract:

Traditional collection building approaches are limited in breadth and scope and are not necessarily suitable for multidisciplinary fields development in the institutes of the Chinese Academy of Sciences. The increasing of multidisciplinary fields researches require a viable approach to collection development in these libraries. This study uses qualitative and quantitative analysis to assess collection. The quantitative analysis consists of three levels of evaluation, which including realistic demand, potential demand and trend demand analysis. For one institute, three samples were separately selected from the object institute, more than one international top institutes in highly relative research fields and future research hotspots. Each sample contains an appropriate number of papers published in recent five years. Several keywords and the organization names were reasonably combined to search in commercial databases and the institutional repositories. The publishing information and citations in the bibliographies of these papers were selected to build the dataset. One weighted evaluation model and citation analysis were used to calculate the demand intensity index of every journal and book. Principal Investigator selector and database traffic provide a qualitative evidence to describe the demand frequency. The demand intensity, demand frequency and academic committee recommendations were comprehensively considered to recommend collection development. The collection gaps or weaknesses were ascertained by comparing the current collection and the recommend collection. This approach was applied in more than 80 institutes’ libraries in Chinese Academy of Sciences in the past three years. The evaluation results provided an important evidence for collections building in the second year. The latest user survey results showed that the updated collection’s capacity to support research in a multidisciplinary subject area have increased significantly.

Keywords: citation analysis, collection assessment, collection development, quantitative analysis

Procedia PDF Downloads 191
28598 Palliative Performance Scale Differences between Patients Referred by Specialized Cancer Center and General Hospitals to the Palliative Care Center in Kuwait

Authors: Khalid Al Saleh, Najlaa AlSayed

Abstract:

Background: Palliative care is changing from just ‘end of life care’ to care delivered earlier in the disease course. Metanalysis showed that Palliative Performance Scale (PPS) is associated with increased length of survival. The Palliative Care Center (PCC) in Kuwait is the only stand-alone center in Eastern Mediterranean Region with a capacity of 92 beds. We compared clinical characteristics between patients referred from the Specialized Cancer Center and general hospitals in Kuwait to PCC. Method: A cross Sectional survey was conducted since the opening of PCC in January 2011 to June 2013. Patients’ data on demographics, type of the cancer, PPS score and referring hospital were collected and analyzed. Results: Total number of the patients was 142. Mean age was 61.05±14.79 years, 66 patients (47.1%) were males and 74 (52.9%) were females. The most common cancers in males were lung (n=18, 27.3%) followed by head and neck cancers (n=8, 12.1%) and brain tumors (n=7, 10.6%) while in females, the most common cancers were breast cancer (n=12, 16.7%) followed by ovarian cancer (n=10, 13.9%) and Cancer Colon (n=8, 11.1%). Patients with PPS score 30% were 27.9% (n=39), 40% in 40.7% (n=57), and 50% in 17.1% (n=24) respectively. Patients referred from the Specialized Cancer Center had significantly higher portion of patients with PPS score > 30% (73.4%, n=94), compared to patients coming from general hospitals (33.3%, n=4), P value= 0.007. Conclusion: There is significant difference in PPS scores between patients referred from the Specialized Cancer Center compared to patients referred from general hospitals. We encourage that all cancer patients should be treated in Specialized Cancer Centers and earlier involvement of Palliative Care Centers to achieve better survival. Training workshops are needed for health care professionals working in general hospitals to raise awareness about earlier referral of patients to palliative care services.

Keywords: palliative care, kuwait, performance scale differences, pps score, specialized hospitals

Procedia PDF Downloads 277