Search results for: stem cell fate decision
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 8053

Search results for: stem cell fate decision

1753 Status of Participative Governance Practices in Higher Education: Implications for Stakeholders' Transformative Role-Assumption

Authors: Endalew Fufa Kufi

Abstract:

The research investigated the role of stakeholders such as students, teachers and administrators in the practices of good governance in higher education by looking into the special contributions of top-officials, teachers and students in ensuring workable ties and productive interchanges in Adama Science and Technology University. Attention was given to participation, fairness and exemplariness as key indicators of good governance. The target university was chosen for its familiarity for the researcher to get dependable data, access to respondent and management of the processing of data. Descriptive survey design was used for the purpose of describing concerned roles the stakeholders in the university governance in order to reflect on the nature of participation of the practices. Centres of the research were administration where supportive groups such as central administrators and underlying service-givers had parts and academia where teachers and students were target. Generally, 60 teachers, 40 students and 15 administrative officers were referents. Data were collected in the form of self-report through open-ended questionnaires. The findings indicated that, while vertical interchanges in terms of academic and administrative routines were had normal flow on top-down basis, planned practices of stakeholders in decision-making and reasonably communicating roles and changes in decisions with top-officials were not efficiently practiced. Moreover, the practices of good modelling were not witnessed to have existed to the fullest extent. Rather, existence of a very wide gap between the academic and administrative staffs was witnessed as was reflected the case between teachers and students. The implication was such that for shortage in participative atmosphere and weaning of fairness in governance, routine practices have been there as the vicious circles of governance.

Keywords: governance, participative, stakeholders, transformative, role-assumption

Procedia PDF Downloads 381
1752 Correlation of Hematological Indices with Fasting Blood Glucose Level and Anthropometric Measurements in Geriatric Diabetes Mellitus Subjects in Lagos State University Teaching Hospital, Ikeja, Lagos, Nigeria

Authors: Dada. O.Akinola, Uche. I. Ebele, Bamiro .A.Rafatu, Akinbami A. Akinsegun, Dada O. Adeyemi, Adeyemi. O. Ibukun, Okunowo O.Bolanle, Abdulateef O. Kareem, Ibrahim.N. Ismaila, Dosu Rihanat

Abstract:

Background: Hyperglycaemia alters qualitatively and quantitatively all the full blood count parameters. The alterations among other factors are responsible for the macrovascular and microvascular complications associated with diabetes mellitus (DM). This study is aimed at correlating haematological parameters in DM subjects with their fasting blood glucose (FBG) and anthropometric parameters. Materials and Methods: This was a cross-sectional study of participants attending DM clinic of Lagos State University Teaching Hospital (LASUTH), Ikeja. The study recruited one hundred and two (102) DM subjects and one hundred (100) non-DM controls. Venous blood samples were collected for full blood count (FBC) assay while FBG was done, structured questionnaires were administered, and anthropometric measurements of all participants were done. Data were analyzed with Statistical Package for Social Science (SPSS) version 23. P was set at ≤0.05. Results: The mean age of DM patients was 64.32± 11.31 years. Using a haemoglobin concentration cut-off of 11g/dl, 39.2%, and 13% DM and control participants respectively had values lower than 11g/dl. A total of 22.5% and 3% of DM and controls respectively gave a history of previous blood transfusion.White blood cells count and platelet count means were (6.12±1.60 and 5.30±7.52,p=0.59) and (213.31±73.58 and 228.91±73.21,p = 0.26) *109/L in DM subjects and controls respectively. FBG and all the anthropometric data in DM subjects were significantly higher than in controls. Conclusions: The prevalence of anaemia in DM subjects was three times higher than in controls. The white blood cell count was higher but not statistically significant in DM compared with controls. But platelet count was higher but not statistically significant in controls compared with DM subjects.

Keywords: haematological profile, diabetes mellitus, anthropometric data, fasting blood glucose

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1751 The Role of Polyphenolic Compounds in the Alpha Amylase and Alpha Glucosidase Inhibitory Potentials of Extracts from the Leaves of Acalypha godseffiana from Eastern Nigeria: An in-vitro Study

Authors: A. K. Asekunowo, A O. T. Asafa, O. O. Okoh, O. T. Asekun, O. B. Familoni

Abstract:

Background: Acalypha godseffiana is an important plant used both as an ornamental and herbs; its leaves are employed in management of diseases such as diabetics in Eastern Nigeria. Aim: The correlations of the polyphenolic compounds in the hypoglycemic potential of different extracts of leaves of A. godseffiana and their safety profile on cell lines were investigated. Materials and Methods: The phytochemical compositions and antioxidants potentials were determined using adopted methods. An in vitro approach was employed in determining the hypoglycemic potentials of the extracts on α-amylase and α-glucosidase. The Line weaver-Burke plot was used to evaluate the mechanisms of Inhibition mechanisms of the enzymes. Results and Conclusions: Antioxidants results revealed that total antioxidant capacity (TAC) of the acetone extract (IC50: 0.34 mg/mL) showed better activity compared to the standards (silymarine 0.52 mg/mL; gallic acid 0.51 mg/mL). In-vitro hypoglycemic activity of the extracts confirmed that acetone extract demonstrated strong and mild inhibitory potential against α-amylase and α-glucosidase respectively. The observed activity was concentration-dependent with IC50 values of 2.33 and 0.13 mg/mL. The observed hypoglycemic and anti-oxidant potentials of acetone extract A. godseffiana correlate to its high polyphenolic contents which include phenols (133.20 mg gallic acid g-1), flavonoid (350.60 mg quercetin g-1) and tannins (264.67 mg catechin g-1). The mechanisms of action exhibited by acetone extract of A. godseffiana were mixed non-competitive and uncompetitive; which can be attributed to its inhibitory properties on α-amylase and α-glucosidase respectively. This effect would cause reduction in the rate at which starch hydrolyse, boost palliated glucose levels; hence, making acetone extract of A. godseffiana a potential anti-hypoglycemic alternative.

Keywords: Acalypha godeseffiana, acetone extract, anti-hypoglycemia, antioxidant, phytochemicals

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1750 Clustering for Detection of the Population at Risk of Anticholinergic Medication

Authors: A. Shirazibeheshti, T. Radwan, A. Ettefaghian, G. Wilson, C. Luca, Farbod Khanizadeh

Abstract:

Anticholinergic medication has been associated with events such as falls, delirium, and cognitive impairment in older patients. To further assess this, anticholinergic burden scores have been developed to quantify risk. A risk model based on clustering was deployed in a healthcare management system to cluster patients into multiple risk groups according to anticholinergic burden scores of multiple medicines prescribed to patients to facilitate clinical decision-making. To do so, anticholinergic burden scores of drugs were extracted from the literature, which categorizes the risk on a scale of 1 to 3. Given the patients’ prescription data on the healthcare database, a weighted anticholinergic risk score was derived per patient based on the prescription of multiple anticholinergic drugs. This study was conducted on over 300,000 records of patients currently registered with a major regional UK-based healthcare provider. The weighted risk scores were used as inputs to an unsupervised learning algorithm (mean-shift clustering) that groups patients into clusters that represent different levels of anticholinergic risk. To further evaluate the performance of the model, any association between the average risk score within each group and other factors such as socioeconomic status (i.e., Index of Multiple Deprivation) and an index of health and disability were investigated. The clustering identifies a group of 15 patients at the highest risk from multiple anticholinergic medication. Our findings also show that this group of patients is located within more deprived areas of London compared to the population of other risk groups. Furthermore, the prescription of anticholinergic medicines is more skewed to female than male patients, indicating that females are more at risk from this kind of multiple medications. The risk may be monitored and controlled in well artificial intelligence-equipped healthcare management systems.

Keywords: anticholinergic medicines, clustering, deprivation, socioeconomic status

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1749 Fresh Amnion Membrane Grafting for the Regeneration of Skin in Full Thickness Burn in Newborn - Case Report

Authors: Priyanka Yadav, Umesh Bnasal, Yashvinder Kumar

Abstract:

The placenta is an important structure that provides oxygen and nutrients to the growing fetus in utero. It is usually thrown away after birth, but it has a therapeutic role in the regeneration of tissue. It is covered by the amniotic membrane, which can be easily separated into the amnion layer and the chorion layer—the amnion layer act as a biofilm for the healing of burn wound and non-healing ulcers. The freshly collected membrane has stem cells, cytokines, growth factors, and anti-inflammatory properties, which act as a biofilm for the healing of wounds. It functions as a barrier and prevents heat and water loss and also protects from bacterial contamination, thus supporting the healing process. The application of Amnion membranes has been successfully used for wound and reconstructive purposes for decades. It is a very cheap and easy process and has shown superior results to allograft and xenograft. However, there are very few case reports of amnion membrane grafting in newborns; we intend to highlight its therapeutic importance in burn injuries in newborns. We present a case of 9 days old male neonate who presented to the neonatal unit of Maulana Azad Medical College with a complaint of fluid-filled blisters and burns wound on the body for six days. He was born outside the hospital at 38 weeks of gestation to a 24-year-old primigravida mother by vaginal delivery. The presentation was cephalic and the amniotic fluid was clear. His birth weight was 2800 gm and APGAR scores were 7 and 8 at 1 and 5 minutes, respectively. His anthropometry was appropriate for gestational age. He developed respiratory distress after birth requiring oxygen support by nasal prongs for three days. On the day of life three, he developed blisters on his body, starting from than face then over the back and perineal region. At a presentation on the day of life nine, he had blisters and necrotic wound on the right side of the face, back, right shoulder and genitalia, affecting 60% of body surface area with full-thickness loss of skin. He was started on intravenous antibiotics and fluid therapy. Pus culture grew Pseudomonas aeuroginosa, for which culture-specific antibiotics were started. Plastic surgery reference was taken and regular wound dressing was done with antiseptics. He had a storming course during the hospital stay. On the day of life 35 when the baby was hemodynamically stable, amnion membrane grafting was done on the wound site; for the grafting, fresh amnion membrane was removed under sterile conditions from the placenta obtained by caesarean section. It was then transported to the plastic surgery unit in half an hour in a sterile fluid where the graft was applied over the infant’s wound. The amnion membrane grafting was done twice in two weeks for covering the whole wound area. After successful uptake of amnion membrane, skin from the thigh region was autografted over the whole wound area by Meek technique in a single setting. The uptake of autograft was excellent and most of the areas were healed. In some areas, there was patchy regeneration of skin so dressing was continued. The infant was discharged after three months of hospital stay and was later followed up in the plastic surgery unit of the hospital.

Keywords: amnion membrane grafting, autograft, meek technique, newborn, regeneration of skin

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1748 A Folk Theorem with Public Randomization Device in Repeated Prisoner’s Dilemma under Costly Observation

Authors: Yoshifumi Hino

Abstract:

An infinitely repeated prisoner’s dilemma is a typical model that represents teamwork situation. If both players choose costly actions and contribute to the team, then both players are better off. However, each player has an incentive to choose a selfish action. We analyze the game under costly observation. Each player can observe the action of the opponent only when he pays an observation cost in that period. In reality, teamwork situations are often costly observation. Members of some teams sometimes work in distinct rooms, areas, or countries. In those cases, they have to spend their time and money to see other team members if they want to observe it. The costly observation assumption makes the cooperation difficult substantially because the equilibrium must satisfy the incentives not only on the action but also on the observational decision. Especially, it is the most difficult to cooperate each other when the stage-game is prisoner's dilemma because players have to communicate through only two actions. We examine whether or not players can cooperate each other in prisoner’s dilemma under costly observation. Specifically, we check whether symmetric Pareto efficient payoff vectors in repeated prisoner’s dilemma can be approximated by sequential equilibria or not (efficiency result). We show the efficiency result without any randomization device under certain circumstances. It means that players can cooperate with each other without any randomization device even if the observation is costly. Next, we assume that public randomization device is available, and then we show that any feasible and individual rational payoffs in prisoner’s dilemma can be approximated by sequential equilibria under a specific situation (folk theorem). It implies that players can achieve asymmetric teamwork like leadership situation when public randomization device is available.

Keywords: cost observation, efficiency, folk theorem, prisoner's dilemma, private monitoring, repeated games.

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1747 Investigation into the Phytochemistry and Biological Activities of Medicinal Plants Used in Algerian Folk Medicine: Potential Use in Human Medicine

Authors: Djebbar Atmani, Dina Kilani, Tristan Richard

Abstract:

Medicinal plants are an important source for the discovery of potential new substances for use in medicine and food. Pistacia lentiscus, Fraxinus angustifolia and Clematis flammula, plants growing in the Mediterranean basin, are widely used in traditional medicine. Therefore, the present study was designed to investigate their antioxidant, anti-inflammatory, antidiabetic, anti-mutagenic/genotoxic and neuroprotective potential and identification of active compounds using appropriate methodology. Plant extracts and fractions exhibited high scavenging capacity against known radicals, enhanced superoxide dismutase and catalase activitiesand restored blood glucose levels, in vivo, to normal values, in agreement with the in vitro enzymatic inhibition data, through inhibition of amylase and glucosidase activities. Administration of Pistacia lentiscus extracts significantly decreased carrageenan-induced mice paw oedema and reduced effectively IL-1β levels in cell culture, whereas Fraxinus angustifolia extracts showed good healing capacity against wounds when applied topically on rabbits. Pistacia lentiscus and Fraxinus angustifolia extracts showed good neuro-protection and restored cognitive functions in mice, while Clematis flammula extracts showed potent anti-ulcerogenic activity associated to a promising anti-mutagenic/genotoxic activity. HPLC-MS and NMR analyses allowed the identification and structural elucidation of several known and new anthocyanins, flavonols and flavanols. Therefore, Pistacia lentiscus, Fraxinus angustifolia and Clematis flammulacould be used in palliative treatments against inflammatory conditions and diabetes complications, as well as against deterioration of cognitive functions.

Keywords: pistacia lentiscus, clematis flammula, fraxinus angustifolia, phenolic compounds, biological activity

Procedia PDF Downloads 55
1746 Infrastructure Sharing Synergies: Optimal Capacity Oversizing and Pricing

Authors: Robin Molinier

Abstract:

Industrial symbiosis (I.S) deals with both substitution synergies (exchange of waste materials, fatal energy and utilities as resources for production) and infrastructure/service sharing synergies. The latter is based on the intensification of use of an asset and thus requires to balance capital costs increments with snowball effects (network externalities) for its implementation. Initial investors must specify ex-ante arrangements (cost sharing and pricing schedule) to commit toward investments in capacities and transactions. Our model investigate the decision of 2 actors trying to choose cooperatively a level of infrastructure capacity oversizing to set a plug-and-play offer to a potential entrant whose capacity requirement is randomly distributed while satisficing their own requirements. Capacity cost exhibits sub-additive property so that there is room for profitable overcapacity setting in the first period. The entrant’s willingness-to-pay for the access to the infrastructure is dependent upon its standalone cost and the capacity gap that it must complete in case the available capacity is insufficient ex-post (the complement cost). Since initial capacity choices are driven by ex-ante (expected) yield extractible from the entrant we derive the expected complement cost function which helps us defining the investors’ objective function. We first show that this curve is decreasing and convex in the capacity increments and that it is shaped by the distribution function of the potential entrant’s requirements. We then derive the general form of solutions and solve the model for uniform and triangular distributions. Depending on requirements volumes and cost assumptions different equilibria occurs. We finally analyze the effect of a per-unit subsidy a public actor would apply to foster such sharing synergies.

Keywords: capacity, cooperation, industrial symbiosis, pricing

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1745 Application of Neutron Activation Analysis Technique for the Analysis of Soil Samples from Farmlands of Yebrage Hawariat, East Gojjam, Ethiopia

Authors: Yihunie Hibstie Asres, Manny Mathuthu

Abstract:

Farmers may not be conscious for their farmland’s nutrients, soil organic matter, water and air because they simply concerned only for their labor availability and soil fertility losses. The composition and proportion of these components greatly influence soil physical properties, including texture, structure, and porosity, the fraction of pore space in a soil. The soil of this farmland must be able to supply adequate amount of plant nutrients, in forms which can be absorbed by the crop, within its lifespan. Deficiencies or imbalances in the supply of any of essential elements can compromise growth, affecting root development, cell division, crop quality, crop yield and resistance to disease and drought. This study was conducted to fill this knowledge gap in order to develop economically vital and environmentally accepted nutrient management strategies for the use of soils in agricultural lands. The objective of this study is to assess the elemental contents and concentration of soil samples collected from farmlands of ‘Yebrage’ using Neutron Activation Analysis (NAA) techniques regardless of oxidation state, chemical form or physical locations. NAA is used to determine the elemental composition and concentrations present in a soil. The macro/micronutrient and organic matter deficiencies have been verified in agricultural soils through increased use of soil testing and plant analysis. The challenge for agriculture over the coming decades will meet the world’s increasing demands for food in a sustainable way. Current issues and future challenges point out that as long as agriculture remains a soil-based industry, major decreases in productivity likely to be attained ensuring that plants do not have adequate and balanced supply of nutrients.

Keywords: NAA, Yebrage, Chemoga, macro/micronutrient

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1744 A Parking Demand Forecasting Method for Making Parking Policy in the Center of Kabul City

Authors: Roien Qiam, Shoshi Mizokami

Abstract:

Parking demand in the Central Business District (CBD) has enlarged with the increase of the number of private vehicles due to rapid economic growth, lack of an efficient public transport and traffic management system. This has resulted in low mobility, poor accessibility, serious congestion, high rates of traffic accident fatalities and injuries and air pollution, mainly because people have to drive slowly around to find a vacant spot. With parking pricing and enforcement policy, considerable advancement could be found, and on-street parking spaces could be managed efficiently and effectively. To evaluate parking demand and making parking policy, it is required to understand the current parking condition and driver’s behavior, understand how drivers choose their parking type and location as well as their behavior toward finding a vacant parking spot under parking charges and search times. This study illustrates the result from an observational, revealed and stated preference surveys and experiment. Attained data shows that there is a gap between supply and demand in parking and it has maximized. For the modeling of the parking decision, a choice model was constructed based on discrete choice modeling theory and multinomial logit model estimated by using SP survey data; the model represents the choice of an alternative among different alternatives which are priced on-street, off-street, and illegal parking. Individuals choose a parking type based on their preference concerning parking charges, searching times, access times and waiting times. The parking assignment model was obtained directly from behavioral model and is used in parking simulation. The study concludes with an evaluation of parking policy.

Keywords: CBD, parking demand forecast, parking policy, parking choice model

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1743 Ata-Manobo Tribe as Stakeholders in the Making of School Improvement Plan: Basis for Policy Recommendation

Authors: Diobein C. Flores

Abstract:

The populace in Municipality of Talaingod is composed of Ata-Manobo. The said lumads enrich their culture, orientation and self because the place is a hive of their tribe. In lieu, the study would analyze the participation of the Ata-Manobo in the making of school improvement plan (SIP). Thus, it recommends alternative policy options that would help strengthen their involvement. The school stakeholders-Ata Manobo representatives from students, parent-teacher association, alumni, basic sector, municipal/barangay government unit, civic/social organizations and other government various agencies are the key participants in this study. The research used descriptive design. The responses of the representatives were analyzed through the criteria involved in employing Rational Model. The technical dimension, administrative, political acceptability and economic are the criteria in revealing decision. The policy alternative option 3- recommends to formulate policy for the purpose of capacitating stakeholders or governing council members in the making of SIP was pointed out as the most preferred option. This could strengthen the participation among Ata-Manobo as stakeholders in planning. Hence, the formulation alternative policy- capacitating stakeholders in the crafting of school improvement plan is recommended. The suggested initiative would assist the Department of Education in forging consensus across neighborhoods during the making of SIP. The appropriation of the definite budget to be used during the conduct of capability building activities is also suggested. Training-workshops are identified as possible intervention to ensure that the stakeholders are equipped with necessary knowledge and skills needed in the making of SIP. Indeed, the equal opportunities for all stakeholders regardless of their life circumstances must be noted. With the belief, people must be empowered to take advantage and spearhead progress in the making of SIP.

Keywords: Ata-Manobo Tribe, stakeholders, school improvement plan, Municipality of Talaingod, Philippines

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1742 Structural and Functional Characterization of the Transcriptional Regulator Rv1176 of Mycobacterium tuberculosis H37Rv

Authors: Vikash Yadav, Ashish Arora

Abstract:

Microorganisms have self-defense mechanisms to protect themselves from toxic environments. Phenolic acid decarboxylase(pad) is responsible for the defense against toxicity caused by phenolic acids, converting them into less toxic vinyl derivatives. The transcription of the pad gene is regulated by a negative transcription factor, phenolic acid decarboxylase regulators (PadR), in a substrate-inducible manner. The PadR family members share the conserved DNA-binding features and interact with the operator DNA using a winged helix-turn-helix (wHTH) motif, which contains a three-helix motif and a β-stranded wing. The members of this family function as transcriptional regulators that are involved in various cellular survival processes, such as toxin production, detoxification, multidrug resistance, antibiotic biosynthesis, and carbon catabolism. Rv1176 of Mycobacterium tuberculosis H37Rv has been assigned to the PadR family protein that remains to be structurally and functionally uncharacterized. To reveal the structural mechanism by which Rv1176 could regulates effector-responsive transcription, several experiments were performed, including Electrophoretic Mobility Shift Assay (EMSA) for DNA protein interaction, differential scanning calorimetry (DSC) and Differential Scanning Fluorimetry (DSF) for temperature and ligand-dependent protein stability, Circular Dichroism (CD) spectroscopy for secondary structure analysis. Further, to evaluate the functional role of Rv1176, the intracellular survival of recombinant M. smegmatis was examined in murine macrophage cell line J774A.1 and different stressed conditions like oxidative, pH, and nutritive stress. All these studies demonstrated that Rv1176 could behave as a transcription regulator and its expression in recombinant M. smegmatis increases intracellular survival.

Keywords: EMSA, Mycobacterium tuberculosis, PadR family protein, transcriptional regulator

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1741 Identification of Analogues to EGCG for the Inhibition of HPV E7: A Fundamental Insights through Structural Dynamics Study

Authors: Murali Aarthy, Sanjeev Kumar Singh

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High risk human papillomaviruses are highly associated with the carcinoma of the cervix and the other genital tumors. Cervical cancer develops through the multistep process in which increasingly severe premalignant dysplastic lesions called cervical intraepithelial neoplastic progress to invasive cancer. The oncoprotein E7 of human papillomavirus expressed in the lower epithelial layers drives the cells into S-phase creating an environment conducive for viral genome replication and cell proliferation. The replication of the virus occurs in the terminally differentiating epithelium and requires the activation of cellular DNA replication proteins. To date, no suitable drug molecule is available to treat HPV infection whereas identification of potential drug targets and development of novel anti-HPV chemotherapies with unique mode of actions are expected. Hence, our present study aimed to identify the potential inhibitors analogous to EGCG, a green tea molecule which is considered to be safe to use for mammalian systems. A 3D similarity search on the natural small molecule library from natural product database using EGCG identified 11 potential hits based on their similarity score. The structure based docking strategies were implemented in the potential hits and the key interacting residues of protein with compounds were identified through simulation studies and binding free energy calculations. The conformational changes between the apoprotein and the complex were analyzed with the simulation and the results demonstrated that the dynamical and structural effects observed in the protein were induced by the compounds and indicated the dominance to the oncoprotein. Overall, our study provides the basis for the structural insights of the identified potential hits and EGCG and hence, the analogous compounds identified can be potent inhibitors against the HPV 16 E7 oncoprotein.

Keywords: EGCG, oncoprotein, molecular dynamics simulation, analogues

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1740 The Emergence of Smart Growth in Developed and Developing Countries and Its Possible Application in Kabul City, Afghanistan

Authors: Bashir Ahmad Amiri, Nsenda Lukumwena

Abstract:

The global trend indicates that more and more people live and will continue to live in urban areas. Today cities are expanding both in physical size and number due to the rapid population growth along with sprawl development, which caused the cities to expand beyond the growth boundary and exerting intense pressure on environmental resources specially farmlands to accommodate new housing and urban facilities. Also noticeable is the increase in urban decay along with the increase of slum dwellers present another challenge that most cities in developed and developing countries have to deal with. Today urban practitioners, researchers, planners, and decision-makers are seeking for alternative development and growth management policies to house the rising urban population and also cure the urban decay and slum issues turn to Smart Growth to achieve their goals. Many cities across the globe have adopted smart growth as an alternative growth management tool to deal with patterns and forms of development and to cure the rising urban and environmental problems. The method used in this study is a literature analysis method through reviewing various resources to highlight the potential benefits of Smart Growth in both developed and developing countries and analyze, to what extent it can be a strategic alternative for Afghanistan’s cities, especially the capital city. Hence a comparative analysis is carried on three countries, namely the USA, China, and India to identify the potential benefits of smart growth likely to serve as an achievable broad base for recommendations in different urban contexts.

Keywords: growth management, housing, Kabul city, smart growth, urban-expansion

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1739 Evidence Theory Enabled Quickest Change Detection Using Big Time-Series Data from Internet of Things

Authors: Hossein Jafari, Xiangfang Li, Lijun Qian, Alexander Aved, Timothy Kroecker

Abstract:

Traditionally in sensor networks and recently in the Internet of Things, numerous heterogeneous sensors are deployed in distributed manner to monitor a phenomenon that often can be model by an underlying stochastic process. The big time-series data collected by the sensors must be analyzed to detect change in the stochastic process as quickly as possible with tolerable false alarm rate. However, sensors may have different accuracy and sensitivity range, and they decay along time. As a result, the big time-series data collected by the sensors will contain uncertainties and sometimes they are conflicting. In this study, we present a framework to take advantage of Evidence Theory (a.k.a. Dempster-Shafer and Dezert-Smarandache Theories) capabilities of representing and managing uncertainty and conflict to fast change detection and effectively deal with complementary hypotheses. Specifically, Kullback-Leibler divergence is used as the similarity metric to calculate the distances between the estimated current distribution with the pre- and post-change distributions. Then mass functions are calculated and related combination rules are applied to combine the mass values among all sensors. Furthermore, we applied the method to estimate the minimum number of sensors needed to combine, so computational efficiency could be improved. Cumulative sum test is then applied on the ratio of pignistic probability to detect and declare the change for decision making purpose. Simulation results using both synthetic data and real data from experimental setup demonstrate the effectiveness of the presented schemes.

Keywords: CUSUM, evidence theory, kl divergence, quickest change detection, time series data

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1738 Accessibility Assessment of School Facilities Using Geospatial Technologies: A Case Study of District Sheikhupura

Authors: Hira Jabbar

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Education is vital for inclusive growth of an economy and a critical contributor for investment in human capital. Like other developing countries, Pakistan is facing enormous challenges regarding the provision of public facilities, improper infrastructure planning, accelerating rate of population and poor accessibility. The influence of the rapid advancement and innovations in GIS and RS techniques have proved to be a useful tool for better planning and decision making to encounter these challenges. Therefore present study incorporates GIS and RS techniques to investigate the spatial distribution of school facilities, identifies settlements with served and unserved population, finds potential areas for new schools based on population and develops an accessibility index to evaluate the higher accessibility for schools. For this purpose high-resolution worldview imagery was used to develop road network, settlements and school facilities and to generate school accessibility for each level. Landsat 8 imagery was utilized to extract built-up area by applying pre and post-processing models and Landscan 2015 was used to analyze population statistics. Service area analysis was performed using network analyst extension in ArcGIS 10.3v and results were evaluated for served and underserved areas and population. An accessibility tool was used to evaluate a set of potential destinations to determine which is the most accessible with the given population distribution. Findings of the study may contribute to facilitating the town planners and education authorities for understanding the existing patterns of school facilities. It is concluded that GIS and remote sensing can be effectively used in urban transport and facility planning.

Keywords: accessibility, geographic information system, landscan, worldview

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1737 Application and Limitation of Heavy Metal Pollution Indicators in Coastal Environment of Pakistan

Authors: Noor Us Saher

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Oceans and Marine areas have a great importance, mainly regarding food resources, fishery products and reliance of livelihood. Aquatic pollution is common due to the incorporation of various chemicals mainly entering from urbanization, industrial and commercial facilities, such as oil and chemical spills. Many hazardous wastes and industrial effluents contaminate the nearby areas and initiate to affect the marine environment. These contaminated conditions may become worse in those aquatic environments situated besides the world’s largest cities, which are hubs of various commercial activities. Heavy metal contamination is one of the most important predicaments for marine environments and during past decades this problem has intensified due to an increase in urbanization and industrialization. Coastal regions of Pakistan are facing severe threats from various organic and inorganic pollutants, especially the estuarine and coastal areas of Karachi city, the most populated and industrialized city situated along the coastline. Metal contamination causes severe toxicity in biota resulting the degradation of Marine environments and depletion of fishery resources and sustainability. There are several abiotic (air, water and sediment) and biotic (fauna and flora) indicators that indicate metal contamination. However, all these indicators have certain limitations and complexities, which delay their implementation for rehabilitation and conservation in the marine environment. The inadequate evidences have presented on this significant topic till the time and this study discussed metal pollution and its consequences along the marine environment of Pakistan. This study further helps in identification of possible hazards for the ecological system and allied resources for management strategies and decision making for sustainable approaches.

Keywords: coastal and estuarine environment, heavy metals pollution, pollution indicators, Pakistan

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1736 COVID_ICU_BERT: A Fine-Tuned Language Model for COVID-19 Intensive Care Unit Clinical Notes

Authors: Shahad Nagoor, Lucy Hederman, Kevin Koidl, Annalina Caputo

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Doctors’ notes reflect their impressions, attitudes, clinical sense, and opinions about patients’ conditions and progress, and other information that is essential for doctors’ daily clinical decisions. Despite their value, clinical notes are insufficiently researched within the language processing community. Automatically extracting information from unstructured text data is known to be a difficult task as opposed to dealing with structured information such as vital physiological signs, images, and laboratory results. The aim of this research is to investigate how Natural Language Processing (NLP) techniques and machine learning techniques applied to clinician notes can assist in doctors’ decision-making in Intensive Care Unit (ICU) for coronavirus disease 2019 (COVID-19) patients. The hypothesis is that clinical outcomes like survival or mortality can be useful in influencing the judgement of clinical sentiment in ICU clinical notes. This paper introduces two contributions: first, we introduce COVID_ICU_BERT, a fine-tuned version of clinical transformer models that can reliably predict clinical sentiment for notes of COVID patients in the ICU. We train the model on clinical notes for COVID-19 patients, a type of notes that were not previously seen by clinicalBERT, and Bio_Discharge_Summary_BERT. The model, which was based on clinicalBERT achieves higher predictive accuracy (Acc 93.33%, AUC 0.98, and precision 0.96 ). Second, we perform data augmentation using clinical contextual word embedding that is based on a pre-trained clinical model to balance the samples in each class in the data (survived vs. deceased patients). Data augmentation improves the accuracy of prediction slightly (Acc 96.67%, AUC 0.98, and precision 0.92 ).

Keywords: BERT fine-tuning, clinical sentiment, COVID-19, data augmentation

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1735 Prevalence of Down Syndrome: A Single-Center Study in Bandung, Indonesia

Authors: Bremmy Laksono, Riksa Parikrama, Nur A. Rosyada, Willyanti Soewondo, Dadang S. H. Effendi, Eriska Rianti, Arlette S. Setiawan, Ine Sasmita, Risti S. Primanti, Erna Kurnikasari, Yunia Sribudiani

Abstract:

Down syndrome (DS) is a chromosomal abnormality characterised by complete 21 chromosome trisomy (classical or non-disjunction), or partial 21 chromosome trisomy (mosaicism), or chromosome rearrangement involving chromosome 21 (translocation). This study was carried out to describe the frequency of DS patients in a research institution in the city of Bandung, Indonesia. This descriptive study also provides a picture of the residential location and surrounding area of their dwellings. This study involved people with DS in various age whose chromosome were evaluated by conventional karyotyping method and FISH. Data were collected from 60 patients with DS from a total 150 patients during the period of September 2015 to August 2016 who were referred to Cell Culture and Cytogenetics Laboratory, Faculty of Medicine Universitas Padjadjaran, Indonesia. Results showed that the most common type of DS was non-disjunction (93%), followed by mosaicism (5%), no patient with translocation DS (0%), and a very rare type of tetrasomy 21 (2%). There were 39 males (65%) and 21 females (35%) of DS patient. Most of them live in suburban area beyond Bandung city (55%) while the rest live inside urban area of Bandung city (45%). They live mostly in dense area of greater Bandung area (65%) and only a few live in mid-density area (25%) and the least live in sparse populated area (10%). Their houses are mostly located in residential estate area (55%), nearby industrial area (37%), and around agricultural area (8%). Based on the study, it could be concluded that non-disjunction DS is the most common type. DS patients referred to the laboratory mostly came from dense residential zone in suburban area outside Bandung city. The low number of DS patients referred to the laboratory for chromosome analysis was the highlight to improve health service for people with genetic disorder. This study offered several information regarding area of DS patients’ residence and the condition of neighbourhood in Bandung city where they live as well.

Keywords: chromosome, descriptive, Down syndrome, prevalence

Procedia PDF Downloads 259
1734 Evaluation System of Spatial Potential Under Bridges in High Density Urban Areas of Chongqing Municipality and Applied Research on Suitability

Authors: Xvelian Qin

Abstract:

Urban "organic renewal" based on the development of existing resources in high-density urban areas has become the mainstream of urban development in the new era. As an important stock resource of public space in high-density urban areas, promoting its value remodeling is an effective way to alleviate the shortage of public space resources. However, due to the lack of evaluation links in the process of underpass space renewal, a large number of underpass space resources have been left idle, facing the problems of low space conversion efficiency, lack of accuracy in development decision-making, and low adaptability of functional positioning to citizens' needs. Therefore, it is of great practical significance to construct the evaluation system of under-bridge space renewal potential and explore the renewal mode. In this paper, some of the under-bridge spaces in the main urban area of Chongqing are selected as the research object. Through the questionnaire interviews with the users of the built excellent space under the bridge, three types of six levels and twenty-two potential evaluation indexes of "objective demand factor, construction feasibility factor and construction suitability factor" are selected, including six levels of land resources, infrastructure, accessibility, safety, space quality and ecological environment. The analytical hierarchy process and expert scoring method are used to determine the index weight, construct the potential evaluation system of the space under the bridge in high-density urban areas of Chongqing, and explore the direction of renewal and utilization of its suitability.

Keywords: space under bridge, potential evaluation, high density urban area, updated using

Procedia PDF Downloads 61
1733 A Challenge to Acquire Serious Victims’ Locations during Acute Period of Giant Disasters

Authors: Keiko Shimazu, Yasuhiro Maida, Tetsuya Sugata, Daisuke Tamakoshi, Kenji Makabe, Haruki Suzuki

Abstract:

In this paper, we report how to acquire serious victims’ locations in the Acute Stage of Large-scale Disasters, in an Emergency Information Network System designed by us. The background of our concept is based on the Great East Japan Earthquake occurred on March 11th, 2011. Through many experiences of national crises caused by earthquakes and tsunamis, we have established advanced communication systems and advanced disaster medical response systems. However, Japan was devastated by huge tsunamis swept a vast area of Tohoku causing a complete breakdown of all the infrastructures including telecommunications. Therefore, we noticed that we need interdisciplinary collaboration between science of disaster medicine, regional administrative sociology, satellite communication technology and systems engineering experts. Communication of emergency information was limited causing a serious delay in the initial rescue and medical operation. For the emergency rescue and medical operations, the most important thing is to identify the number of casualties, their locations and status and to dispatch doctors and rescue workers from multiple organizations. In the case of the Tohoku earthquake, the dispatching mechanism and/or decision support system did not exist to allocate the appropriate number of doctors and locate disaster victims. Even though the doctors and rescue workers from multiple government organizations have their own dedicated communication system, the systems are not interoperable.

Keywords: crisis management, disaster mitigation, messing, MGRS, military grid reference system, satellite communication system

Procedia PDF Downloads 227
1732 I Look Powerful So You Will Yield to Me: The Effects of Embodied Power and the Perception of Power on Conflict Management

Authors: Fai-Ho E. Choi, Wing-Tung Au

Abstract:

This study investigated the effects of embodiment on conflict management. As shown in the research literature, the physiological (i.e. bodily postures) can affect the emotional and cognitive proceedings of human beings, but little has been shown on whether such effects would have ramifications in decision-making related to other individuals. In this study, conflict is defined as when two parties have seemingly incompatible goals, and the two have to deal with each other in order to maximize one’s own gain. In a matched-gender experiment, university undergraduate students were randomly assigned to either the high power condition or the low power condition, with participants in each condition instructed to perform a fix set of bodily postures that would either embody them with a high sense of power or a low sense of power. One high-power participant would pair up with a low-power participant to engage in an integrative bargaining task and a dictator game. Participants also filled out a pre-trial questionnaire and a post-trial questionnaire measuring general sense of power, self-esteem and self-efficacy. Personality was controlled for. Results are expected to support our hypotheses that people who are embodied with power will be more unyielding in a conflict management situation, and that people who are dealing with another person embodied with power will be more yielding in a conflict management situation. As conflicts arise frequently both within and between organizations, a better understanding of how human beings function in conflicts is important. This study should provide evidence that bodily postures can influence the perceived sense of power of the parties involved and hence influence the conflict outcomes. Future research needs to be conducted to investigate further how people perceive themselves and how they perceive their opponents in conflicts, such that we can come up with a behavioral theory of conflict management.

Keywords: conflict management, embodiment, negotiation, perception

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1731 Effects of Different Processing Methods of Typha Grass on Feed Intake Milk Yield/Composition and Blood Parameters of Diry Cows

Authors: Alhaji Musa Abdullahi, Usman Abdullahi, Adamu Lawan, Aminu Maidala

Abstract:

Abstract 16 healthy lactating cows will be randomly selected for the trial and will be randomly divided in to 4 groups with 4 cows in each. They will be kept under similar management condition (conventional management system). Animals of relatively same weight and age will be used. After 11days for adaptation, feed intake and performance of the experimental animals will be determine. Milk sample will be collected at each milking in the morning and afternoon to determine; Milk yield, Milk fat percentage, Solid not fat percentage, Total solid percentage of milk. Cows dung will be observe to determine; Score 1 very loose watery stool, Score 2 semi solid with undigested raw material, Score 3 semi solid with less undigested raw material, Score 4 solid with very less undigested raw material, Score 5 good dung no undigested raw material. At the end of the experiment, blood samples will be analyzed for full blood counts and differentials {White Blood Cells (WBC), Red Blood Cells (RBC), Hemoglobin (Hb), Packed Cell Volume (PCV), Mean Corpuscular Volume (MCV), Mean Corpuscular Hemoglobin (MCH), Mean Corpuscular Hemoglobin Concentration (MCHC), Platelets (PLT), Lymphocytes (LYM), Basophils, Eosinophils and Monocytes Proportion (MXD) and Neutrophils (NEUT)} using automated hematology analyzer. Serum samples will be analyzed for heat shock transcription factors, heat shock proteins and hormones (Serum glucocorticoid, prolactin and cortisol). Moreover, biochemical analysis will also be conducted to check for Total protein (TP), Albumen (ALB), Globulin (GBL), Total cholesterol (TCH), glucose (G), sodium (Na+), potassium (K+), chloride (Cl-) and pH. Keywords: Lactating cows, milk composition, dung score and blood parameters.

Keywords: Lactating cows , Milk yield , Dung score , Blood parameters

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1730 Motivating Factors and Prospects for Rural Community Involvement in Entrepreneurship: Evidence from Mantanani Island, Sabah, Malaysia

Authors: F. Fabeil Noor, Roslinah Mahmud, Janice L. H. Nga, Rasid Mail

Abstract:

In Malaysia, particularly in Sabah, the government has been promoting entrepreneurship among rural people to encourage them to earn their living by making good use of the diverse natural resources and local cultures of Sabah. Nevertheless, despite the government’s aim to encourage more local community in rural area to involve in entrepreneurship, the involvement of community in entrepreneurial activity is still low. It is crucial to identify the factors stimulate (or prevent) the involvement of rural community in Sabah in entrepreneurial activity. Therefore, this study tries to investigate the personal and contextual factors that may have impact on decision to start a business among the local community in Mantanani Island. In addition, this study also aims to identify the perceived benefits they receive from entrepreneurial activity. A structured face-to-face interview was conducted with 61 local communities in Mantanani Island. Data analysis revealed that passion, personal skills and self-confidence are the significant internal factors to entrepreneurial activity, whereas access to finance, labour and infrastructure are the significant external factors that are found to influence entrepreneurship. In terms of perceived rewards they received from taking up small business, it was found that respondents are predominantly agreed that entrepreneurship offers financial benefit than non-financial. In addition, this study also offers several suggestions for entrepreneurship development in Mantanani Island and it is hoped that this study may help the related agency to develop effective support policies in order to encourage more people in rural area to involve in entrepreneurship.

Keywords: entrepreneurship, motivation, perceived rewards, rural community

Procedia PDF Downloads 244
1729 Investigating the Feasibility of Promoting Safety in Civil Projects by BIM System Using Fuzzy Logic

Authors: Mohammad Reza Zamanian

Abstract:

The construction industry has always been recognized as one of the most dangerous available industries, and the statistics of accidents and injuries resulting from it say that the safety category needs more attention and the arrival of up-to-date technologies in this field. Building information modeling (BIM) is one of the relatively new and applicable technologies in Iran, that the necessity of using it is increasingly evident. The main purposes of this research are to evaluate the feasibility of using this technology in the safety sector of construction projects and to evaluate the effectiveness and operationality of its various applications in this sector. These applications were collected and categorized after reviewing past studies and researches then a questionnaire based on Delphi method criteria was presented to 30 experts who were thoroughly familiar with modeling software and safety guidelines. After receiving and exporting the answers to SPSS software, the validity and reliability of the questionnaire were assessed to evaluate the measuring tools. Fuzzy logic is a good way to analyze data because of its flexibility in dealing with ambiguity and uncertainty issues, and the implementation of the Delphi method in the fuzzy environment overcomes the uncertainties in decision making. Therefore, this method was used for data analysis, and the results indicate the usefulness and effectiveness of BIM in projects and improvement of safety status at different stages of construction. Finally, the applications and the sections discussed were ranked in order of priority for efficiency and effectiveness. Safety planning is considered as the most influential part of the safety of BIM among the four sectors discussed, and planning for the installation of protective fences and barriers to prevent falls and site layout planning with a safety approach based on a 3D model are the most important applications of BIM among the 18 applications to improve the safety of construction projects.

Keywords: building information modeling, safety of construction projects, Delphi method, fuzzy logic

Procedia PDF Downloads 150
1728 Detection of Bcl2 Polymorphism in Patient with Hepatocellular carcinoma

Authors: Mohamed Abdel-Hamid, Olfat Gamil Shaker, Doha El-Sayed Ellakwa, Eman Fathy Abdel-Maksoud

Abstract:

Introduction: Despite advances in the knowledge of the molecular virology of hepatitis C virus (HCV), the mechanisms of hepatocellular injury in HCV infection are not completely understood. Hepatitis C viral infection (HCV) influences the susceptibility to apoptosis. This could lead to insufficient antiviral immune response and persistent viral infection. Aim of this study: was to examine whether BCL-2 gene polymorphism at codon 43 (+127G/A or Ala43Thr) has an impact on development of hepatocellular carcinoma caused by chronic hepatitis C Egyptian patients. Subjects and Methods: The study included three groups; group 1: composing of 30 patients with hepatocellular carcinoma (HCC), group 2 composing of 30 patients with HCV, group 3 composing of 30 healthy subjects matching the same age and socioeconomic status were taken as a control group. Gene polymorphism of BCL2 (Ala43Thr) were evaluated by PCR-RFLP technique and measured for all patients and controls. Results: The summed 43Thr genotype was more frequent and statistically significant in HCC patients as compared to control group. This genotype of BCL2 gene may inhibit the programmed cell death which leads to disturbance in tissue and cells homeostasis and reduction in immune regulation. This result leads to viral replication and HCV persistence. Moreover, virus produces variety of mechanisms to block genes participated in apoptosis. This mechanism proves that HCV patients who have 43Thr genotype are more susceptible to HCC. Conclusion: The data suggest for the first time that the BCL2 polymorphism is associated with the susceptibility to HCC in Egyptian populations and might be used as molecular markers for evaluating HCC risk. This study clearly demonstrated that Chronic HCV exhibit a deregulation of apoptosis with the disease progression. This provides an insight into the pathogenesis of chronic HCV infection, and may contribute to the therapy.

Keywords: BCL2 gene, Hepatitis C Virus, Hepatocellular carcinoma, sensitivity, specificity, apoptosis

Procedia PDF Downloads 493
1727 Examining the Adoption Rate of the Japanese Method of Food Samples in the International Market

Authors: Marwa Abdulsalam, Osamu Suzuki, Wirawan Dony Dahana

Abstract:

One of the remarkable and unique industries in Japan is the food samples industry which can be noticed in most of the restaurants located around Japan. However, the market is getting saturated, which has pushed Japanese food sample manufacturers to start exploring new international markets. Most of the markets they explored were in the East Asian region, such as China or Korea. In this research, we examine the feasibility and the potential adoption rate of food samples in the international market outside the East Asian region. The main focus of this study is on the Saudi Arabian market. Nonetheless, since Saudi Arabia is a big market, the study results could possibly be applied to the international market as well. The study has conducted a quantitative survey to test the potential of the food samples industry in Saudi Arabia especially in 4 major cities: Jeddah, Mecca, Riyadh, and Dammam. The survey also tests the willingness to purchase, the average price point that the consumer is willing to pay for food samples, and the factors that drive restaurant owners to adopt the food samples system. The study created a correlation analysis between different factors, such as the geographic factor and the size of the restaurant factor, to examine the effect of different aspects on the purchasing decision. The study has found that the Japanese food samples system is predicted to adapt successfully in the Saudi Arabian market and in the international market alike due to the high importance of the food culture and the existence of the communication challenges that the food samples can solve. Additionally, the market survey stated in this study indicated that 83% of the restaurants’ managers are willing to adopt this system in their restaurants.

Keywords: food samples, innovative marketing, international market, marketing method

Procedia PDF Downloads 91
1726 Predicting Emerging Agricultural Investment Opportunities: The Potential of Structural Evolution Index

Authors: Kwaku Damoah

Abstract:

The agricultural sector is characterized by continuous transformation, driven by factors such as demographic shifts, evolving consumer preferences, climate change, and migration trends. This dynamic environment presents complex challenges for key stakeholders including farmers, governments, and investors, who must navigate these changes to achieve optimal investment returns. To effectively predict market trends and uncover promising investment opportunities, a systematic, data-driven approach is essential. This paper introduces the Structural Evolution Index (SEI), a machine learning-based methodology. SEI is specifically designed to analyse long-term trends and forecast the potential of emerging agricultural products for investment. Versatile in application, it evaluates various agricultural metrics such as production, yield, trade, land use, and consumption, providing a comprehensive view of the evolution within agricultural markets. By harnessing data from the UN Food and Agricultural Organisation (FAOSTAT), this study demonstrates the SEI's capabilities through Comparative Exploratory Analysis and evaluation of international trade in agricultural products, focusing on Malaysia and Singapore. The SEI methodology reveals intricate patterns and transitions within the agricultural sector, enabling stakeholders to strategically identify and capitalize on emerging markets. This predictive framework is a powerful tool for decision-makers, offering crucial insights that help anticipate market shifts and align investments with anticipated returns.

Keywords: agricultural investment, algorithm, comparative exploratory analytics, machine learning, market trends, predictive analytics, structural evolution index

Procedia PDF Downloads 47
1725 Harmful Algal Blooming Micro-Algae in Kenya’s Coastal Waters

Authors: Nancy Awuor Oduor, Nils Moosdorf

Abstract:

Harmful Algal Blooms (HABs) are a threat to coastal water quality, marine biodiversity, and human health. The attention on HABs and associated phycotoxins is still very low in tropical coastal developing countries despite the high dependence of local communities on coastal and marine resources for food and livelihoods and the growing evidence of the global increase in HABs frequency, toxicity, and geographical expansion. Lack of HABs monitoring thus creates a high risk of exposure due to uncertainty. This study assessed the spatial and temporal variability and effects of potential HAB-forming species in Kenya’s coastal waters. The preliminary results from 463 sampled collected over a series of 10 coastal surveys conducted over 267 Km of Kenya’s coastline between August 2021 and July 2022 revealed the presence of 87 potential algal blooming species belonging to 47 genera dominated by species capable of producing toxins, causing physical harm and high biomass at 41, 31 and 21 % respectively. The taxonomic composition was also dominated by dinoflagellates at 47%, followed by diatoms, cyanobacteria, and silicoflagellates at 39, 12, and 2%, respectively. About 92 % of the toxin-producing species were established in the creek waters. However, there were no significant variations established in species richness between the dry and wet seasons. Paralytic Shellfish Poisoning (PSP) toxin-producing dinoflagellates Alexandrium spp., Aphanizomenon spp., Gonyaulax spp., Gymnodinium spp., and Brachydinium capitatum, and Amnesic Shellfish Poisoning (ASP) Toxin producing diatoms Amphora spp., Nitzschia spp. and Pseudo-nitzschia spp. Frequented the area in low cell densities ranging between 5 and 1500 cells/L. However, no domoic acid (DA) and saxitoxins (SXTs) were detected during the July surveys. This does not mean that the toxins are absent in the area, and longer studies are recommended.

Keywords: harmful algal blooms, phycotoxins, saxitoxin, domoic acid, Kenya

Procedia PDF Downloads 45
1724 Local Availability Influences Choice of Radical Treatment for Prostate Cancer

Authors: Jemini Vyas, Oluwatobi Adeyoe, Jenny Branagan, Chandran Tanabalan, Aakash Pai

Abstract:

Introduction: Radical prostatectomy and radiotherapy are both viable options for the treatment of localised prostate cancer. Over the years medicine has evolved towards a patient-centred approach. Patient decision-making is not motivated by clinical outcomes alone. Geographical location and ease of access to treating clinician are contributory factors. With the development of robotic surgery, prostatectomy has been centralised into tertiary centres. This has impacted on the distances that patients and their families are expected to travel. Methods: A single centre retrospective study was undertaken over a five-year period. All patients with localised prostate cancer, undergoing radical radiotherapy or prostatectomy were collected pre-centralisation. This was compared to the total number undergoing these treatments post centralisation. Results: Pre-centralisation, both radiotherapy and prostatectomy groups had to travel a median of less than five miles for treatment. Post-centralisation of pelvic surgery, prostatectomy patients had to travel a median of more than 40 miles, whilst travel distance for the radiotherapy group was unchanged. In the post centralisation cohort, there was a 63% decline in the number of patients undergoing radical prostatectomy per month from a mean of 5.1 to 1.9. The radical radiotherapy group had a concurrent 41% increase in patient numbers with a mean increase from 13.3 to 18.8 patients per month. Conclusion: Choice of radical treatment in localised prostate cancer is based on multiple factors. This study infers that local availability can influence choice of radical treatment. It is imperative that efforts are made to maintain accessibility to all viable options for prostate cancer patients, so that patient choice is not compromised.

Keywords: prostate, prostatectomy, radiotherapy, centralisation

Procedia PDF Downloads 81