Search results for: outcome estimation

Authors: Ahmad Zulfahmi Mohd Kamaruzaman, Mohd Ismail Ibrahim, Ariffin Marzuki Mokhtar, Maizun Mohd Zain, Saiful Nazri Satiman, Mohd Najib Majdi Yaacob

Abstract:

Background: Aftermath any patient safety incidents, the involved healthcare providers possibly sustained second victim-related distress (second victim distress and reduced their professional efficacy), with subsequent negative work-related outcomes or vice versa cultivating resilience. This study aimed to investigate the factors affecting negative work-related outcomes and resilience, with the triad of support; colleague, supervisor, and institutional support as the hypothetical mediators. Methods: This was a cross sectional study recruiting a total of 733 healthcare providers from three tertiary care in Kelantan, Malaysia. Three steps of hierarchical linear regression were developed for each outcome; negative work-related outcomes and resilience. Then, four multiple mediator models of support triad were analyzed. Results: Second victim distress, professional efficacy, and the support triad contributed significantly for each regression model. In the pathway of professional efficacy on each negative work-related outcomes and resilience, colleague support partially mediated the relationship. As for second victim distress on negative work related outcomes, colleague and supervisor support were the partial mediator, and on resilience; all support triad also produced a similar effect. Conclusion: Second victim distress, professional efficacy, and the support triad influenced the relationship with the negative work-related outcomes and resilience. Support triad as the mediators ameliorated the effect in between and explained the urgency of having good support for recovery post encountering patient safety incidents.

Keywords: second victims, patient safety incidents, hierarchical linear regression, mediation, support

Procedia PDF Downloads 101

Authors: Sang-Keun Moon, Hong-Rok Lim, Jin-O Kim

Abstract:

This paper presents a Power Quality (PQ) modeling and filtering processes for the distribution system disturbances using recognition learning methods. Typical PQ waveforms with mathematical applications and gathered field data are applied to the proposed models. The objective of this paper is analyzing PQ data with respect to monitoring, discriminating, and evaluating the waveform of power disturbances to ensure the system preventative system failure protections and complex system problem estimations. Examined signal filtering techniques are used for the field waveform noises and feature extractions. Using extraction and learning classification techniques, the efficiency was verified for the recognition of the PQ disturbances with focusing on interactive modeling methods in this paper. The waveform of selected 8 disturbances is modeled with randomized parameters of IEEE 1159 PQ ranges. The range, parameters, and weights are updated regarding field waveform obtained. Along with voltages, currents have same process to obtain the waveform features as the voltage apart from some of ratings and filters. Changing loads are causing the distortion in the voltage waveform due to the drawing of the different patterns of current variation. In the conclusion, PQ disturbances in the voltage and current waveforms indicate different types of patterns of variations and disturbance, and a modified technique based on the symmetrical components in time domain was proposed in this paper for the PQ disturbances detection and then classification. Our method is based on the fact that obtained waveforms from suggested trigger conditions contain potential information for abnormality detections. The extracted features are sequentially applied to estimation and recognition learning modules for further studies.

Keywords: power quality recognition, PQ modeling, waveform feature extraction, disturbance trigger condition, PQ signal filtering

Procedia PDF Downloads 181

Authors: Lican Guzmán, José Manuel Lattus, Mariana Cervetto, Mauricio Calderón

Abstract:

Today the estimation of effects produced by climate change in high Andean wetland environments is confronted by big challenges. This study provides a way to an analysis by remote sensing how some Ambiental aspects have evolved on the Maricunga salt flat in the last 30 years, divided into the summer and winter seasons, and if global warming is conditioning these changes. The first step to achieve this goal was the recompilation of geological, hydrological, and morphometric antecedents to ensure an adequate contextualization of its environmental parameters. After this, software processing and analysis of Landsat 5,7 and 8 satellite imagery was required to get the vegetation, water, surface temperature, and soil moisture indexes (NDVI, NDWI, LST, and SMI) in order to see how their spatial-temporal conditions have evolved in the area of study during recent decades. Results show a tendency of regular increase in surface temperature and disponibility of water during both seasons but with slight drought periods during summer. Soil moisture factor behaves as a constant during the dry season and with a tendency to increase during wintertime. Vegetation analysis shows an areal and quality increase of its surface sustained through time that is consistent with the increase of water supply and temperature in the basin mentioned before. Roughly, the effects of climate change can be described as positive for the Maricunga salt flat; however, the lack of exact correlation in dates of the imagery available to remote sensing analysis could be a factor for misleading in the interpretation of results.

Keywords: global warming, geology, SIG, Atacama Desert, Salar de Maricunga, environmental geology, NDVI, SMI, LST, NDWI, Landsat

Procedia PDF Downloads 76

Authors: Saheed Ahmad Rufai

Abstract:

The growing nature of insurgencies in their various forms in the Muslim world is now of great concern to both the leadership and the citizenry. The high sense of insecurity occasioned by the unpleasant experience has in fact attained an alarming rate in the estimation of both Muslims and non-Muslims alike. Consequently, the situation began to attract contributions from scholars and researchers in security-related fields of humanities and social sciences. However, there is little evidence of contribution to the discourse and the scholarship involved by scholars in the field of education. The purpose of this proposed study is to contribute an education dimension to the growing scholarship on the subject. The study which is situated in the broad scholarship of curriculum making and grounded in both the philosophical and sociological foundations of the curriculum, employs a combination of curriculum criticism and creative synthesis, as methods, in reconstructing Muslim schools’ educational blueprint. The significance of the proposed study lies in its potential to contribute a useful addition to the scholarship of curriculum construction in the context of the Muslim world. The significance also lies in its potential to offer an ameliorative proposal over unnecessary insurgency or militancy thereby paving the way for the enthronement of a regime characterized by peaceful, harmonious and tranquil co-existence among people of diverse orientations and ideological persuasions in the Muslim world. The study is restricted to only the first two stages of curriculum making namely the formulation of philosophy which concerns the articulation of objectives, aims, purposes, goals, and principles, as well as the second stage which covers the translation of such principles to an anti-insurgency secondary school curriculum for the Muslim world.

Keywords: education for conflict resolution, anti-insurgency curriculum principles, peace education, anti-terrorist curriculum framework, curriculum for Muslim secondary schools

Procedia PDF Downloads 214

Authors: Aynura Valiyeva, Basil John Thomas

Abstract:

Intra-firm communication is critical for building synergy amongst internal business units of a firm, where employees from various functional departments and ranks incorporate their decision-making, understanding of organizational objectives, as well as common norms and culture for better organizational effectiveness. This study builds on and assesses a framework of the causes and consequences of effective communication in business interactions between customer and supplier firms, and the path for efficient communication within a firm. The proposed study’s structural equation modeling (SEM) analysis based on 352 sample responses collected from firm representatives at different job positions ranging from marketing to logistics operations, reveals that, in the frame of reference of intra-organizational communication, organization characteristics and shared values, top management support and style of leadership, as well as information technology, are all significantly related to communication effectiveness. Furthermore, the frequency and variety of interactions enhance the outcome of communication, that improves a company’s performance. The results reveal that cultural factors are significantly related to communication effectiveness, as well as the shared beliefs and goals. In terms of organizational factors, leadership style, top management support and information technology are significant determinants of effective communication. Among the contextual factors, interaction frequency and diversity are found to be priority factors. This study also tests the relationship between supplier and supplier firm performance in the context of communication effectiveness, and finds that they are closely related, when trust and commitment is built between business partners. When firms do business in other multicultural contexts, language and shared values with destination country must be considered significant elements of communication process.

Keywords: business performance, intra-firm communication, inter-firm communication, structural equation modeling

Procedia PDF Downloads 92

Authors: D. Calogine, O. Chau, S. Dotti, O. Ramiarinjanahary, P. Rasoavonjy, F. Tovondahiniriko

Abstract:

Mafate is a natural circus in the north-western part of Reunion Island, without an electrical grid and road network. A micro-grid concept is being experimented in this area, composed of a photovoltaic production combined with electrochemical batteries, in order to meet the local population for self-consumption of electricity demands. This work develops a discrete model as well as a stochastic model in order to reach an optimal equilibrium between production and consumptions for a cluster of houses. The management of the energy power leads to a large linearized programming system, where the time interval of interest is 24 hours The experimental data are solar production, storage energy, and the parameters of the different electrical devices and batteries. The unknown variables to evaluate are the consumptions of the various electrical services, the energy drawn from and stored in the batteries, and the inhabitants’ planning wishes. The objective is to fit the solar production to the electrical consumption of the inhabitants, with an optimal use of the energies in the batteries by satisfying as widely as possible the users' planning requirements. In the discrete model, the different parameters and solutions of the linear programming system are deterministic scalars. Whereas in the stochastic approach, the data parameters and the linear programming solutions become random variables, then the distributions of which could be imposed or established by estimation from samples of real observations or from samples of optimal discrete equilibrium solutions.

Keywords: photovoltaic production, power consumption, battery storage resources, random variables, stochastic modeling, estimations of probability distributions, mixed integer linear programming, smart micro-grid, self-consumption of electricity.

Procedia PDF Downloads 104

Authors: Shilpa Kumari, Ramakumar Jayachandran

Abstract:

Machining of aluminium extrusion profiles in the automotive industry has gained much interest in the last decade, particularly due to the higher utilization of aluminum profiles and the weight reduction benefits it brings. Milling is the most common material removal process, where the rotary milling cutter is moved against a workpiece. The physical contact of the milling cutter to the workpiece increases the friction between them, thereby affecting the longevity of the milling tool and also the surface finish of the workpiece. To minimise this issue, the milling process uses cutting fluids or emulsions; however, the use of emulsion in the process has a negative impact on the environment ( such as consumption of water, oils and the used emulsion needs to be treated before disposal) and also on the personal ( may cause respiratory problems, exposure to microbial toxins generated by bacteria in the emulsions on prolonged use) working close to the process. Furthermore, the workpiece also needs to be cleaned after the milling process, which is not adding value to the process, and the cleaning also disperses mist of emulsion in the working environment. Hydro Extrusion is committed to improving the performance of sustainability from its operations, and with the negative impact of using emulsion in the milling process, a new innovative process- Dry Milling was developed to minimise the impact the cutting fluid brings. In this paper, the authors present one application of dry milling in the machining of tensile specimens in the laboratory. Dry milling is an innovative milling process without the use of any cooling/lubrication and has several advantages. Several million tensile tests are carried out in extrusion laboratories worldwide with the wet milling process. The machining of tensile specimens has a significant impact on the reliability of test results. The paper presents the results for different 6xxx alloys with different wall thicknesses of the specimens, which were machined by both dry and wet milling processes. For both different 6xxx alloys and different wall thicknesses, mechanical properties were similar for samples milled using dry and wet milling. Several tensile specimens were prepared using both dry and wet milling to compare the results, and the outcome showed the dry milling process does not affect the reliability of tensile test results.

Keywords: dry milling, tensile testing, wet milling, 6xxx alloy

Procedia PDF Downloads 194

Authors: Deepshikha Shukla, C. H. Solanki, Mayank Desai

Abstract:

In the last few years, it has been observed that earthquake is proving a threat to the scientist across the world. With a large number of earthquakes occurring in day to day life, the threat to life and property has increased manifolds which call for an urgent attention of all the researchers globally to carry out the research in the field of Earthquake Engineering. Any hazard related to the earthquake and seismicity is considered to be seismic hazards. The common forms of seismic hazards are Ground Shaking, Structure Damage, Structural Hazards, Liquefaction, Landslides, Tsunami to name a few. Among all the natural hazards, the most devastating and damaging is the earthquake as all other hazards are triggered only after the occurrence of an earthquake. In order to quantify and estimate the seismicity and seismic hazards, many methods and approaches have been proposed in the past few years. Such approaches are Mathematical, Conventional and Computational. Convex Set Theory, Empirical Green’s Function are some of the Mathematical Approaches whereas the Deterministic and Probabilistic Approaches are the Conventional Approach for the estimation of the seismic Hazards. Ground response and Ground Shaking of a particular area or region plays an important role in the damage caused due to the earthquake. In this paper, seismic study using Deterministic Approach and 1 D Ground Response Analysis has been carried out for Madhya Pradesh Tourism Office in Indore Region in Madhya Pradesh in Central India. Indore lies in the seismic zone III (IS: 1893, 2002) in the Seismic Zoning map of India. There are various faults and lineament in this area and Narmada Some Fault and Gavilgadh fault are the active sources of earthquake in the study area. Deepsoil v6.1.7 has been used to perform the 1 D Linear Ground Response Analysis for the study area. The Peak Ground Acceleration (PGA) of the city ranges from 0.1g to 0.56g.

Keywords: seismicity, seismic hazards, deterministic, probabilistic methods, ground response analysis

Procedia PDF Downloads 159

Authors: B. Vijay Antony Raj, Umarani Gunasekaran, R. Thiru Kumara Raja Vallaban

Abstract:

Fibrous autoclaved aerated concrete (FAAC) is concrete containing fibrous material in it which helps to increase its structural integrity when compared to that of convention autoclaved aerated concrete (CAAC). These short discrete fibers are uniformly distributed and randomly oriented, which enhances the bond strength within the aerated concrete matrix. Conventional red-clay bricks create larger impact to the environment due to red soil depletion and it also consumes large amount to time for construction. Whereas, AAC are larger in size, lighter in weight and it is environmentally friendly in nature and hence it is a viable replacement for red-clay bricks. Internal micro cracks and corner cracks are the only disadvantages of conventional autoclaved aerated concrete, to resolve this particular issue it is preferable to make use of fibers in it.These fibers are bonded together within the matrix and they induce the aerated concrete to withstand considerable stresses, especially during the post cracking stage. Hence, FAAC has the capability of enhancing the mechanical properties and energy absorption capacity of CAAC. In this research work, individual fibers like glass, nylon, polyester and polypropylene are used they generally reduce the brittle fracture of AAC.To study the fibre’s surface topography and composition, SEM analysis is performed and then to determine the composition of a specimen as a whole as well as the composition of individual components EDAX mapping is carried out and then an experimental approach was performed to determine the effect of hybrid (multiple) fibres at various dosage (0.5%, 1%, 1.5%) and curing temperature of 180-2000 C is maintained to determine the mechanical properties of autoclaved aerated concrete. As an analytical part, the outcome experimental results is compared with fuzzy logic using MATLAB.

Keywords: fiberous AAC, crack control, energy absorption, mechanical properies, SEM, EDAX, MATLAB

Procedia PDF Downloads 265

Authors: Tahar Tayachi, Ahlam Alrehaili

Abstract:

Purpose: The purpose of this paper is to investigate the relationship between the corporate board characteristics and the dividend policy among firms on the Saudi Stock Exchange. Design/Methodology/Approach: This paper uses a sample of 103 nonfinancial firms over a time period of 4 years from 2015 to 2018. To investigate how corporate governance mechanisms such as board independence, the board size, frequency of meetings, and free cash flow impact dividends, the study uses Logit and Tobit models. Findings: This paper finds that board size, board independence, and frequency of board meetings have no influence on a firm’s decision to pay dividends, while board size has a significantly positive impact on the levels of cash dividends paid to investors. This study also finds that the level of free cash flows has a positively significant influence on both the decision to pay dividends and the magnitude of dividend payouts. Research Limitations/Implications: This paper attempts to study the effectiveness of dividend policy among some firms on the Saudi Stock Exchange. Practical Implications: The findings reveal that board characteristics, which represent one of the crucial mechanisms of corporate governance, were found to be complementary to corporate laws and regulations imposed on the Saudi market in 2015. The findings also imply that capital market authorities should revise their corporate regulations and ensure that protection laws are adequate and strong enough to protect the interests of all shareholders. Originality/Value: This paper is among the few studies focusing on dividend policy in Saudi Arabia. Finally, these findings suggest that the improvements in corporate laws in Saudi Arabia led to such an outcome, and it has become prevalent in dividend policy decisions and behaviors of Saudi firms.

Keywords: agency theory, Tobit, corporate governance, dividend payout, Logit

Procedia PDF Downloads 194

Authors: Gustavo Naranjo Maroto, Dolores Fernandez Martinez

Abstract:

Context has always been essential to understand any reaction from every human being, and words, whether written or spoken, are definitely a powerful representative sample of human reaction. This study starts with an accurate breakdown of the context in which the current president of the US, Mr. Donald J. Trump is conveying his discourses in order to be able to judge them from a critical discourse analysis point of view. The present world’s scenario with a pandemic disease in form of Covid-19 that is threatening the world and certainly putting at risk the so called 'Welfare State', the role of the United States as the first superpower on earth nowadays, the very peculiar profile of President Trump not only as a politician but as a persona, and the fact of being on the verge of a very controversial presidential elections are without doubt a great and undeniable opportunity for the implementation of the critical discourse analysis methodology. Hence, this research will primarily analyze in detail some of the most interesting discourses delivered by Trump in different media since the very beginning of the outbreak of the coronavirus pandemic in the United States of America (February, 2020), sadly very often downplayed by President Trump, until the final result of the upcoming presidential election scheduled for Tuesday, November 3, 2020, where the political discourse has been dramatically downgraded to a very dangerous state, putting in jeopardy the fundamentals of the political fair play in terms of speech. Finally, the study will hopefully conclude with the final outcome of the data analyzed, allowing to picture how significant the context can be concerning linguistics on the one hand, in terms of shaping or altering the message that the issuer thought to convey in the first place, and on the other hand, generously assessing to what extend the recipients of the message are influenced by the message in terms of receptiveness.

Keywords: Covid-19, critical discourse analysis, Donald J. Trump, political discourse

Procedia PDF Downloads 125

Authors: Ali Raouli, Amin Chegenizadeh, Hamid Nikraz

Abstract:

The Perth metropolitan area and its surrounding regions have been expanding rapidly in recent decades and it is expected that this growth will continue in the years to come. With this rapid growth and the resulting increase in population, consideration should be given to strategic planning and modelling for the future expansion of Perth. The accurate estimation of projected traffic volumes has always been a major concern for the transport modelers and planners. Development of a reliable strategic transport model depends significantly on the inputs data into the model and the calibrated parameters of the model to reflect the existing situation. Trip distribution is the second step in four-step modelling (FSM) which is complex due to its behavioral nature. Gravity model is the most common method for trip distribution. The spatial separation between the Origin and Destination (OD) zones will be reflected in gravity model by applying deterrence functions which provide an opportunity to include people’s behavior in choosing their destinations based on distance, time and cost of their journeys. Deterrence functions play an important role for distribution of the trips within a study area and would simulate the trip distances and therefore should be calibrated for any particular strategic transport model to correctly reflect the trip behavior within the modelling area. This paper aims to review the most common deterrence functions and propose a calibrated deterrence function for work trips within the Perth Metropolitan Area based on the information obtained from the latest available Household data and Perth and Region Travel Survey (PARTS) data. As part of this study, a four-step transport model using EMME software has been developed for Perth Metropolitan Area to assist with the analysis and findings.

Keywords: deterrence function, four-step modelling, origin destination, transport model

Procedia PDF Downloads 163

Authors: Luc de Brabandere

Abstract:

Searchers in various disciplines have long tried to understand how a human being thinks. Most of them seem to agree that the brain works in two very different modes. For us, the first phase of thought imagines, diverges, and unlocks the field of possibilities. The second phase, judges converge and choose. But if we were to stop there, that would give the impression that thought is essentially an individual effort that seldom depends on context. This is, however, not the case. Whether we be a champion in creativity, so primarily in induction, or a master in logic where we are confronted with reality, the ideas we layout are indeed destined to be presented to third parties. They should therefore be exposed, defended, communicated, negotiated, or even sold. Regardless of the quality of the concepts we craft (creative thinking) and the interferences we build (logical thinking) we will take one day, or another, be confronted by people whose beliefs, opinions and ideas differ from ours (critical thinking). Logic and critique: The shared characteristics of logical and critical thoughts include a three-level structure of reasoning invented by the Greeks. For the first time in history, Aristotle tried to model thought deployable in three stages: the concept, the statement, and the reasoning. The three levels can be assessed according to different criteria. A concept is more or less useful, a statement is true or false, and reasoning is right or wrong. This three-level structure allows us to differentiate logic and critique, where the intention and words used are not the same. Logic only deals with the structure of reasoning and exhausts the problem. It regards premises as acquired and excludes the debate. Logic is in all certainty and pursues the truth. Critique is most probably searching for the plausible. Logic and creativity: Many known models present the brain as a two-stroke engine (divergence vs convergence, fast vs. slow, left-brain vs right-brain, Yin vs Yang, etc.). But that’s not the only thing. “Why didn’t we think of that before?” How often have we heard that sentence? A creative idea is the outcome of logic, but you can only understand it afterward! Through the use of exercises, we will witness how logic and creativity work together. A third theme is hidden behind the two main themes of the conference: logical thought, which the author can shed some light on.

Keywords: creativity, logic, critique, digital

Procedia PDF Downloads 85

Authors: Marine Hascoet, Valentina Giaconi, Ludivine Jamain

Abstract:

The aim of our study is to examine if the family socio-economic status (SES) has an influence on students’ academic achievement. We first make the hypothesis that the more their families have financial and social resources, the more students succeed at school. We second make the hypothesis that this family SES has also an impact on parents’ expectations about their children educational outcomes. Moreover, we want to study if that parents’ expectations play the role of mediator between parents’ socio-economic status and the student’ self-concept and academic outcome. We test this model with a longitudinal design thanks to the census-based assessment from the System of Measurement of the Quality of Education (SIMCE). The SIMCE tests aim to assess all the students attending to regular education in a defined level. The sample used in this study came from the SIMCE assessments done three times: in 4th, 8th and 11th grade during the years 2007, 2011 and 2014 respectively. It includes 156.619 students (75.084 boys and 81.535 girls) that had valid responses for the three years. The family socio-economic status was measured at the first assessment (in 4th grade). The parents’ educational expectations and the students’ self-concept were measured at the second assessment (in 8th grade). The achievement score was measured twice; once when children were in 4th grade and a second time when they were in 11th grade. To test our hypothesis, we have defined a structural equation model. We found that our model fit well the data (CFI = 0.96, TLI = 0.95, RMSEA = 0.05, SRMR = 0.05). Both family SES and prior achievements predict parents’ educational expectations and effect of SES is important in comparison to the other coefficients. These expectations predict students’ achievement three years later (with prior achievement controlled) but not their self-concept. Our model explains 51.9% of the achievement in the 11th grade. Our results confirm the importance of the parents’ expectations and the significant role of socio-economic status in students’ academic achievement in Chile.

Keywords: Chilean context, parent’s expectations, school achievement, self-concept, socio-economic status

Procedia PDF Downloads 138

Authors: Brian Kwok

Abstract:

Hong Kong is well-known for its name as "the Pearl of the Orient", due to its spectacular night-view with vast amount of decorative neon lights on the streets. Neon signs are first used as the pervasive media of communication for all kinds of commercial advertising, ranging from movie theatres to nightclubs and department stores, and later appropriated by artists as medium of artwork. As a well-established visual language, it displays texts in bilingual format due to British's colonial influence, which are sometimes arranged in an opposite reading order. Research on neon signs as a visual representation is rare but significant because they are part of people’s collective memories of the unique cityscapes which associate the shifting values of people's daily lives and culture identity. Nevertheless, with the current policy to remove abandoned neon signs, their total number dramatically declines recently. The Buildings Department found an estimation of 120,000 unauthorized signboards (including neon signs) in Hong Kong in 2013, and the removal of such is at a rate of estimated 1,600 per year since 2006. In other words, the vernacular cultural values and historical continuity of neon signs will gradually be vanished if no immediate action is taken in documenting them for the purpose of research and cultural preservation. Therefore, the Hong Kong Neon Signs Archive project was established in June of 2015, and over 100 neon signs are photo-documented so far. By content analysis, this project will explore the two components of neon signs – the use of visual languages and vernacular tacit knowledge of neon makers. It attempts to answer these questions about Hong Kong's neon signs: 'What are the ways in which visual representations are used to produce our cityscapes and streetscapes?'; 'What are the visual languages and conventions of usage in different business types?'; 'What the intact knowledge are applied when producing these visual forms of neon signs?'

Keywords: cityscapes, neon signs, tacit knowledge, visual representation

Procedia PDF Downloads 296

Authors: Rosario Carmona

Abstract:

This article aims to discuss the importance of indigenous people participation in climate change mitigation and adaptation. Specifically, it analyses different understandings of climate vulnerability among diverse actors involved in climate change policies in Chile: indigenous people, state officials, and academics. These data were collected through participant observation and interviews conducted during October 2017 and January 2019 in Chile. Following Karen O’Brien, there are two types of vulnerability, outcome vulnerability and contextual vulnerability. How vulnerability to climate change is understood determines the approach, which actors are involved and which knowledge is considered to address it. Because climate change is a very complex phenomenon, it is necessary to transform the institutions and their responses. To do so, it is fundamental to consider these two perspectives and different types of knowledge, particularly those of the most vulnerable, such as indigenous people. For centuries and thanks to a long coexistence with the environment, indigenous societies have elaborated coping strategies, and some of them are already adapting to climate change. Indigenous people from Chile are not an exception. But, indigenous people tend to be excluded from decision-making processes. And indigenous knowledge is frequently seen as subjective and arbitrary in relation to science. Nevertheless, last years indigenous knowledge has gained particular relevance in the academic world, and indigenous actors are getting prominence in international negotiations. There are some mechanisms that promote their participation (e.g., Cancun safeguards, World Bank operational policies, REDD+), which are not absent from difficulties. And since 2016 parties are working on a Local Communities and Indigenous Peoples Platform. This paper also explores the incidence of this process in Chile. Although there is progress in the participation of indigenous people, this participation responds to the operational policies of the funding agencies and not to a real commitment of the state with this sector. The State of Chile omits a review of the structure that promotes inequality and the exclusion of indigenous people. In this way, climate change policies could be configured as a new mechanism of coloniality that validates a single type of knowledge and leads to new territorial control strategies, which increases vulnerability.

Keywords: indigenous knowledge, climate change, vulnerability, Chile

Procedia PDF Downloads 121

Authors: Hengki Eko Putra, Dennish Ari Putro, Tri Wahyu Hadi, Edi Riawan, Junnaedhi Dewa Gede, Aditia Rojali, Fariza Dian Prasetyo, Yudhistira Satya Pribadi, Dita Fatria Andarini, Mila Khaerunisa, Raditya Hanung Prakoswa

Abstract:

Catastrophe risk management can only be done if we are able to calculate the exposed risks. Jakarta is an important city economically, socially, and politically and in the same time exposed to severe floods. On the other hand, flood risk calculation is still very limited in the area. This study has calculated the risk of flooding for Jakarta using 2-Dimensional Model ANUGA. 2-Dimensional model ANUGA and 1-Dimensional Model HEC-RAS are used to calculate the risk of flooding from 13 major rivers in Jakarta. ANUGA can simulate physical and dynamical processes between the streamflow against river geometry and land cover to produce a 1-meter resolution inundation map. The value of streamflow as an input for the model obtained from hydrological analysis on rainfall data using hydrologic model HEC-HMS. The probabilistic streamflow derived from probabilistic rainfall using statistical distribution Log-Pearson III, Normal and Gumbel, through compatibility test using Chi Square and Smirnov-Kolmogorov. Flood event on 2007 is used as a comparison to evaluate the accuracy of model output. Property damage estimations were calculated based on flood depth for 1, 5, 10, 25, 50, and 100 years return period against housing value data from the BPS-Statistics Indonesia, Centre for Research and Development of Housing and Settlements, Ministry of Public Work Indonesia. The vulnerability factor was derived from flood insurance claim. Jakarta's flood loss estimation for the return period of 1, 5, 10, 25, 50, and 100 years, respectively are Rp 1.30 t; Rp 16.18 t; Rp 16.85 t; Rp 21.21 t; Rp 24.32 t; and Rp 24.67 t of the total value of building Rp 434.43 t.

Keywords: 2D hydrodynamic model, ANUGA, flood, flood modeling

Procedia PDF Downloads 270

Authors: K. S. Zaytsev, Y. R. Nartsissov

Abstract:

Glycine is one of the key inhibitory neurotransmitters in Central nervous system (CNS) meanwhile glycinergic transmission is highly dependable on its appropriate reuptake from synaptic cleft. Glycine transporters (GlyT) of types 1 and 2 are the enzymes providing glycine transport back to neuronal and glial cells along with Na⁺ and Cl⁻ co-transport. The distribution and stoichiometry of GlyT1 and GlyT2 differ in details, and GlyT2 is more interesting for the research as it reuptakes glycine to neuron cells, whereas GlyT1 is located in glial cells. In the process of GlyT2 activity, the translocation of the amino acid is accompanied with binding of both one chloride and three sodium ions consequently (two sodium ions for GlyT1). In the present study, we developed a computer simulator of GlyT2 and GlyT1 activity based on known experimental data for quantitative estimation of membrane glycine transport. The trait of a single protein functioning was described using the probability approach where each enzyme state was considered separately. Created scheme of transporter functioning realized as a consequence of elemental steps allowed to take into account each event of substrate association and dissociation. Computer experiments using up-to-date kinetic parameters allowed receiving the number of translocated glycine molecules, Na⁺ and Cl⁻ ions per time period. Flexibility of developed software makes it possible to evaluate glycine reuptake pattern in time under different internal characteristics of enzyme conformational transitions. We investigated the behavior of the system in a wide range of equilibrium constant (from 0.2 to 100), which is not determined experimentally. The significant influence of equilibrium constant in the range from 0.2 to 10 on the glycine transfer process is shown. The environmental conditions such as ion and glycine concentrations are decisive if the values of the constant are outside the specified range.

Keywords: glycine, inhibitory neurotransmitters, probability approach, single protein functioning

Procedia PDF Downloads 110

Authors: Marah El-Beeli, Abdullah Balkhair, Zakaryia Al Muharmi, Samir Al Adawi, Mansoor Al-Jabri, Abdullah Al Rawahi, Hazaa Al Yahyae, Eman Al Balushi, Yahya M. Al-Farsi

Abstract:

The health care service and the anticancer chemotherapeutics has changed the natural history of cancer into manageable chronic disease and improve the cancer patient’s lifestyle and increase the survival time. Despite that, still, infection is the major dilemma opposing the cancer patient either because of the clinical presentation of the cancer type and impaired immune system or as a consequence of anticancer therapy. This study has been conducted to1) track changes in the epidemiology of hospital-acquired bloodstream infections among patients with malignancies in the last five years. 2) To explore the causative pathogens and 3) the outcome of HA-BSIs in patients with a different types of malignancies. An ampi-directional study (retrospective and prospective follow up) of patients with malignancies admitted at Sultan Qaboos University hospital (570-bed tertiary hospital) during the study period (from January 2015 to December 2019). The cumulative frequency and prevalence rates of HA-BSIs by patients and isolates were calculated. In addition, the cumulative frequency of participants with single versus mixed infections and types of causative micro-organisms of HA-BSIs were obtained. A total of 1246 event of HA-BSIs has occurred during the study period. Nearly the third (30.25%) of the HA-BSI events was identified among 288 patients with malignancies. About 20% of cases were mixed infections (more than one isolate). Staphylococcus spp were the predominant isolated pathogen (24.7%), followed by Klebsiella spp (15.8%), Escherichia spp (13%), and Pseudomonas spp (9.3%). About half (51%) of cases died in the same year, and (64%) of the deaths occur within two weeks after the infection. According to the observations, no changes in the trends of epidemiology, causative pathogens, morbidity, and mortality rates in the last five years.

Keywords: epidemiology, haematological malignancies, hospital acquired bloodstream infections, solid malignancies

Procedia PDF Downloads 147

Authors: Jonathan J. Burson

Abstract:

With the rise of virtually costless, mobile-based trading platforms, stock market trading activity has increased significantly over the past decade, particularly for the millennial generation. This increased stock market attention, combined with the recent market turmoil due to the economic upset caused by COVID-19, make the topics of market-timing and forecasting particularly relevant. While the overall stock market saw an unprecedented, historically-long bull market from March 2009 to February 2020, the end of that bull market reignited a search by investors for a way to reduce risk and increase return. Similar searches for outperformance occurred in the early, and late 2000’s as the Dotcom bubble burst and the Great Recession led to years of negative returns for mean-variance, index investors. Extensive research has been conducted on fundamental analysis, technical analysis, macroeconomic indicators, microeconomic indicators, and other techniques—all using different methodologies and investment periods—in pursuit of higher returns with lower risk. The enormous variety of timeframes, data, and methodologies used by the diverse forecasting methods makes it difficult to compare the outcome of each method directly to other methods. This paper establishes a process to evaluate the market-timing methods in an apples-to-apples manner based on simplicity, performance, and feasibility. Preliminary findings show that certain technical analysis models provide a higher return with lower risk when compared to the buy-and-hold method and to other market-timing strategies. Furthermore, technical analysis models tend to be easier for individual investors both in terms of acquiring the data and in analyzing it, making technical analysis-based market-timing methods the preferred choice for retail investors.

Keywords: buy-and-hold, forecast, market-timing, probit, technical analysis

Procedia PDF Downloads 93

Authors: Enze Zhang

Abstract:

One of the most challenging steps in implementing virtual water content (VWC) analysis of crops is to get properly the total volume of consumptive water use (CWU) and, therefore, the choice of a reliable crop CWU estimation method. In practice, lots of previous researches obtaining CWU of crops follow a classical procedure for calculating crop evapotranspiration which is determined by multiplying reference evapotranspiration by appropriate coefficient, such as crop coefficient and water stress coefficients. However, this manner of calculation requires lots of field experimental data at point scale and more seriously, when current growing conditions differ from the standard conditions, may easily produce deviation between the calculated CWU and the actual CWU. Since evapotranspiration caused by crop planting always plays a vital role in surface water-energy balance in an agricultural region, this study decided to alternatively estimates crop evapotranspiration by Budyko framework. After brief introduce the development process of Budyko framework. We choose a modified Budyko framework under unsteady-state to better evaluated the actual CWU and apply it in an agricultural irrigation area in North China Plain which rely on underground water for irrigation. With the agricultural statistic data, this calculated CWU was further converted into VWC and its subdivision of crops at the annual scale. Results show that all the average values of VWC, VWC_blue and VWC_green show a downward trend with increased agricultural production and improved acreage. By comparison with the previous research, VWC calculated by Budyko framework agree well with part of the previous research and for some other research the value is greater. Our research also suggests that this methodology and findings may be reliable and convenient for investigation of virtual water throughout various agriculture regions of the world.

Keywords: virtual water content, Budyko framework, consumptive water use, crop evapotranspiration

Procedia PDF Downloads 331

Authors: Ika Jorum

Abstract:

The aim of this collaborative project was to develop library support that contributes in a long-term way to a technical university’s work on increased equality in education. The background was an assessment made by the Higher Education Authority that showed the need for improvement regarding equality in several programs at the university. The university’s Vice President for equality and Vice President for sustainability announced funds for projects that supported the improvement of equality in education. The library was granted funding for a one-year project that aimed both to support teachers in order to embed equality in education and to support the library staff and improve the organization’s own work. The part of the project that was directed to teachers was performed as activities in different areas and forms, such as acquisition and collections, teaching, exhibitions and book discussions. Besides the activities and support that was offered to teachers, the education team had journal clubs in order to develop and embed equality in their own teaching. The part that was directed to library staff and management was performed as workshops in collaboration with Equality Office in order to identify areas where the library could make improvements on work with equality and inclusion. The expectation was that the activities would be well attended since the project team had got indications that the content would be relevant. The outcome of this project was that some activities turned out to be more attended than others and what is expected to be found relevant, for example, a workshop on information searching from a gender and equality perspective for teachers, might still not attract participants. On the other hand, Ph.D. students and students participated in the book discussions and wanted them to continue after the project had ended. Results will be shared both on what was successful and what was challenging. Some reflections will be given on what can be done to attract participants to activities in the area of gender equality that is most likely relevant for the expected attendants and how results from a project on gender equality can be integrated into an organization’s daily work.

Keywords: equality, higher education, critical information literacy, collaboration

Procedia PDF Downloads 66

Authors: Heba Salem

Abstract:

This paper aims to share the researcher’s experience of using e-Portfolios as an assessment tool to follow up on students’ learning experiences and performance throughout the semester. It also aims at highlighting the importance of students’ self-reflection in the process of language learning. The paper begins by introducing the advanced media course, with its focus on listening and speaking skills, and introduces the students’ profiles. Then it explains the students’ role in the e-portfolio process as they are given the option to choose a listening text they studied throughout the semester and to choose a recorded oral production of their collection of artifacts throughout the semester. Students showcase and reflect on their progress in both listening comprehension and speaking. According to the research, re-listening to work given to them and to their production is a means of reflecting on both their progress and achievement. And choosing the work students want to showcase is a means to promote independent learning as well as self-expression. Students are encouraged to go back to the class learning outcomes in the process of choosing the work. In their reflections, students express how they met the specific learning outcome. While giving their presentations, students expressed how useful the experience of returning and going over what they covered to select one and going over their production as well. They also expressed how beneficial it was to listen to themselves and literally see their progress in both listening comprehension and speaking. Students also reported that they grasped more details from the texts than they did when first having it as an assignment, which coincided with one of the class learning outcomes. They also expressed the fact that they had more confidence speaking as well as they were able to use a variety of vocabulary and idiomatic expressions that students have accumulated. For illustration, this paper includes practical samples of students’ tasks and instructions as well as samples of their reflections. The results of students’ reflections coincide with what the research confirms about the effectiveness of the e-portfolios as a means of assessment. The employment of e-Portfolios has two-folded benefits; students are able to measure the achievement of the targeted learning outcomes, and teachers receive constructive feedback on their teaching methods.

Keywords: e-portfolios, assessment, self assessment, listening and speaking progress, foreign language, reflection, learning out comes, sharing experience

Procedia PDF Downloads 93

Authors: Karimeh Alnuaimi, Manal Kassab, Reem Ali, Khitam Mohammad, Kholoud Shattnawi

Abstract:

Aim: To compare pregnancy outcomes of Syrian refugee women and Jordanian women. Background and introduction: The current conflict in Syria continues to displace thousands to neighboring countries, including Jordan. Pregnant refugee women are therefore facing many difficulties are known to increase the prevalence of poor reproductive health outcomes and antenatal complications. However, there is very little awareness of whether Syrian refugee women have different risks of pregnancy outcomes than Jordanian women. Methods: Using a retrospective cohort design, we examined pregnancy outcomes for Syrian refugee (N = 616) and Jordanian women (N = 644) giving birth at two governmental Hospitals in the north of Jordan, between January 1, 2014, and December 31, 2014. A checklist of 13 variables was utilized. The primary outcome measures were delivery by Caesarean section, maternal complications, low birth weight (< 2500 g), Apgar score and preterm delivery (< 37 weeks' gestational age). Results: Statistical analysis revealed that refugee mothers had a significant increase in the rate of cesarean section and the higher rate of anemia, a lower neonates’ weight, and Apgar scores when compared to their Jordanian counterparts. Discussion and Conclusion: Results were congruent with findings from other studies in the region and worldwide. Minimizing inequalities in pregnancy outcomes between Syrian refugees and Jordan women is a healthcare priority. Implications for nursing and health policy: The findings could guide the planning and development of health policies in Jordan that would help to alleviate the situation regarding refugee populations. The action is required by the policy makers, specifically targeting public and primary health care services, to address the problem of adequately meeting the need for antenatal care of this vulnerable population.

Keywords: pregnancy, Syrian refugee, Jordanian women, comparative study

Procedia PDF Downloads 357

Authors: Min-Feng Hsieh

Abstract:

Nowadays, we are facing a highly competitive environment in which the situation for survival has come even more critical than ever before. The challenge we will be confronted with is no longer can be dealt with the single system of knowledge. The abilities we urgently need to acquire is something that can lead us to cross over the boundaries between different disciplines and take us to a neutral ground that gathers and integrates powers and intelligence that surrounds us. This paper aims at discussing how a trans-disciplinary design course organized by the College of Design at Chaoyang University can react to this modern challenge. By orchestrating an experimental course format and by developing a series of coaching strategies, a trans-disciplinary learning environment has been created and practiced in which students selected from five different departments, including Architecture, Interior Design, Visual Design, Industrial Design, Landscape and Urban Design, are encouraged to think outside their familiar knowledge pool and to learn with/from each other. In the course of implementing this program, a parallel research has been conducted alongside by adopting the theory and principles of Action Research which is a research methodology that can provide the course organizer emergent, responsive, action-oriented, participative and critically reflective insights for the immediate changes and amendments in order to improve the effect of teaching and learning experience. In the conclusion, how the learning and teaching experience of this trans-disciplinary design studio can offer us some observation that can help us reflect upon the constraints and division caused by the subject base curriculum will be pointed out. A series of concepts for course design and teaching strategies developed and implemented in this trans-disciplinary course are to be introduced as a way to promote learners’ self-motivated, collaborative, cross-disciplinary and student-centered learning skills. The outcome of this experimental course can exemplify an alternative approach that we could adopt in pursuing a remedy for dealing with the problematic issues of the current educational practice.

Keywords: course design, coaching strategy, subject base curriculum, trans-disciplinary

Procedia PDF Downloads 198

Authors: Jamal Alasiri, Naif Hakeem, Saoud Almaslmani

Abstract:

Background: Patients with humeral shaft fractures have two different treatment options. Surgical therapy has lesser risks of non-union, mal-union, and re-intervention than non-surgical therapy. These positive clinical outcomes of the surgical approach make it a preferable treatment option despite the risks of radial nerve palsy and additional surgery-related risk. We aimed to evaluate patients’ outcomes and return to work after surgical vs. non-surgical management of shaft humeral fracture. Methods: We used databases, including PubMed, Medline, and Cochrane Register of Controlled Trials, from 2010 to January 2022 to search for potential randomised controlled trials (RCTs) and cohort studies comparing the patients’ related outcome measures and return to work between surgical and non-surgical management of humerus fracture. Results: After carefully evaluating 1352 articles, we included three RCTs (232 patients) and one cohort study (39 patients). The surgical intervention used plate/nail fixation, while the non-surgical intervention used a splint or brace procedure to manage shaft humeral fracture. The pooled DASH effects of all three RCTs at six (M.D: -7.5 [-13.20, -1.89], P: 0.009) I2:44%) and 12 months (M.D: -1.32 [-3.82, 1.17], p:0.29, I2: 0%) were higher in patients treated surgically than in non-surgical procedures. The pooled constant Murley score at six (M.D: 7.945[2.77,13.10], P: 0.003) I2: 0%) and 12 months (M.D: 1.78 [-1.52, 5.09], P: 0.29, I2: 0%) were higher in patients who received non-surgical than surgical therapy. However, pooled analysis for patients returning to work for both groups remained inconclusive. Conclusion: Altogether, we found no significant evidence supporting the clinical benefits of surgical over non-surgical therapy. Thus, the non-surgical approach remains the preferred therapeutic choice for managing shaft humeral fractures due to its lesser side effects.

Keywords: shaft humeral fracture, surgical treatment, Patient-related outcomes, return to work, DASH

Procedia PDF Downloads 93

Authors: Ruqaiya Khalil, Saman Usmani, Zaheer Ul-Haq

Abstract:

The accurate characterization of ligand binding affinity is indispensable for designing molecules with optimized binding affinity. Computational tools help in many directions to predict quantitative correlations between protein-ligand structure and their binding affinities. Molecular dynamics (MD) simulation is a modern state-of-the-art technique to evaluate the underlying basis of ligand-protein interactions by characterizing dynamic and energetic properties during the event. Autoimmune diseases arise from an abnormal immune response of the body against own tissues. The current regimen for the described condition is limited to immune-modulators having compromised pharmacodynamics and pharmacokinetics profiles. One of the key player mediating immunity and tolerance, thus invoking autoimmunity is Interleukin-2; a cytokine influencing the growth of T cells. Molecular dynamics simulation techniques are applied to seek insight into the inhibitory mechanisms of newly synthesized compounds that manifested immunosuppressant potentials during in silico pipeline. In addition to estimation of free energies associated with ligand binding, MD simulation yielded us a great deal of information about ligand-macromolecule interactions to evaluate the pattern of interactions and the molecular basis of inhibition. The present study is a continuum of our efforts to identify interleukin-2 inhibitors of both natural and synthetic origin. Herein, we report molecular dynamics simulation studies of Interluekin-2 complexed with different antagonists previously reported by our group. The study of protein-ligand dynamics enabled us to gain a better understanding of the contribution of different active site residues in ligand binding. The results of the study will be used as the guide to rationalize the fragment based synthesis of drug-like interleukin-2 inhibitors as immune-modulators.

Keywords: immuno-modulators, MD simulation, protein-ligand interaction, structure-based drug design

Procedia PDF Downloads 252

Authors: Laura Çami (Vorpsi), Xhon Skënderi

Abstract:

In today's rapidly evolving technological landscape, the traditional principles of contract law are facing significant challenges. The emergence of new technologies, such as electronic signatures, smart contracts, and online dispute resolution mechanisms, is transforming the way contracts are formed, interpreted, and enforced. This paper examines the implications of these technological advancements on the constitutional principles of contract law. One of the fundamental principles of contract law is freedom of contract, which ensures that parties have the autonomy to negotiate and enter into contracts as they see fit. However, the use of technology in the contracting process has the potential to disrupt this principle. For example, online platforms and marketplaces often offer standard-form contracts, which may not reflect the specific needs or interests of individual parties. This raises questions about the equality of bargaining power between parties and the extent to which parties are truly free to negotiate the terms of their contracts. Another important principle of contract law is the requirement of consideration, which requires that each party receives something of value in exchange for their promise. The use of digital assets, such as cryptocurrencies, has created new challenges in determining what constitutes valuable consideration in a contract. Due to the ambiguity in this area, disagreements about the legality and enforceability of such contracts may arise. Furthermore, the use of technology in dispute resolution mechanisms, such as online arbitration and mediation, may raise concerns about due process and access to justice. The use of algorithms and artificial intelligence to determine the outcome of disputes may also raise questions about the impartiality and fairness of the process. Finally, it should be noted that there are many different and complex effects of technical improvements on the fundamental constitutional foundations of contract law. As technology continues to evolve, it will be important for policymakers and legal practitioners to consider the potential impacts on contract law and to ensure that the principles of fairness, equality, and access to justice are preserved in the contracting process.

Keywords: technological advancements, constitutional principles, contract law, smart contracts, online dispute resolution, freedom of contract

Procedia PDF Downloads 125

Authors: Nurcan Cetinkaya

Abstract:

The aim of the study was to estimate the microbial-N flow to small intestine based on daily urinary purine derivatives(PD) mainly xanthine, hypoxanthine, uric acid and allantoin excretion in Angora goats fed by grass hay and concentrate (Period I); barley straw and concentrate (Period II). Daily urine samples were collected during last 3 days of each period from 10 individually penned Angora bucks( LW 30-35 Kg, 2-3 years old) receiving ad libitum grass hay or barley straw and 300 g/d concentrate. Fresh water was always available. 4N H2SO4 was added to collected daily urine .samples to keep pH under 3 to avoid of uric acid precipitation. Diluted urine samples were stored at -20°C until analysis. Urine samples were analyzed for xanthine, hypoxanthine, uric acid, allantoin and creatinine by High-Performance Liquid Chromatographic Method (HPLC). Urine was diluted 1:15 in ratio with water and duplicate samples were prepared for HPLC analysis. Calculated mean levels (n=60) for urinary xanthine, hypoxanthine, uric acid, allantoin, total PD and creatinine excretion were 0.39±0.02 , 0.26±0.03, 0.59±0.06, 5.91±0.50, 7.15±0.57 and 3.75±0.40 mmol/L for Period I respectively; 0.35±0.03, 0.21±0.02, 0.55±0.05, 5.60±0.47, 6.71±0.46 and 3.73±0.41 mmol/L for Period II respectively.Mean values of Period I and II were significantly different (P< 0.05) except creatinine excretion. Estimated mean microbial-N supply to the small intestine for Period I and II in Angora goats were 5.72±0.46 and 5.41±0.61 g N/d respectively. The effects of grass hay and barley straw feeding on microbial-N supply to small intestine were found significantly different (P< 0.05). In conclusion, grass hay showed a better effect on the ruminal microbial protein synthesis compared to barley straw, therefore; grass hay is suggested as roughage source in Angora goat feeding.

Keywords: angora goat, HPLC method, microbial-N supply to small intestine, urinary purine derivatives

Procedia PDF Downloads 217

Authors: Praveen Adusumilli, Meher Lakshmi Konatam, Sadashivudu Gundeti, Stalin Bala

Abstract:

The invention of trastuzumab has changed the treatment of breast cancer and lives of many patients all over the world. Despite many patients getting benefitted from the drug, it is out of reach for most of the patients. There is very limited real world data regarding the epidemiology and clinical outcome of Her2neu positive breast cancer patients. Materials and Methods: This is a retrospective analysis of breast cancer patients presenting to a tertiary care cancer centre in Southern India from 2007 to2013. All early and locally advanced breast cancer patients, who were Her2neu 3+ on IHC are included in the study and evaluated in terms of epidemiology, 3-year disease free survival (DFS)and 5-year overall survival(OS). Chemotherapy regimens used were-FAC 6 cycles or AC 4 cycles followed by 12 cycles of weekly paclitaxel . Trastuzumab was given after 6 cycles of FAC or weekly with paclitaxel followed by 3weekly maintenance until 1 year. Results: Over the period of this study there were 885 newly diagnosed cases of carcinoma breast, of which 242 (27%) were Her2neu positive, 360(40%) were hormone receptor positive, and 212(24%) were triple negative. A total of 71(8%) were Her2neu equivocal of which only 10 patients got FISH test done. Of the 212 newly diagnosed patients, only 74 (29%) opted to have standard of care therapy with trastuzumab at our centre, out of which 52(24%), 8(3%), received under insurance, paying basis respectively. 14(9%) patients received the care as part of clinical trial program (ALTTO trial). 7 (9.72%) patients developed decrease of ejection fraction by greater than 10%, requiring stoppage of trastuzumab out of which 5 were restarted in 2 months. Patients receiving trastuzumab along with chemotherapy had longer 3year DFS 92% vs. 60% (p value<0.0001) when compared to chemotherapy alone. 5 year OS was 87% vs 44% (p-value <0.0001) compared to chemotherapy alone. Conclusion: Trastuzumab with chemotherapy improves the DFS and OS in Her2neu positive patients. The biggest constraint is the cost of the treatment and absence of universal health security net to treat all patients with this diagnosis.

Keywords: breast cancer, Her 2 neu positive, real world data, Trastuzumab

Procedia PDF Downloads 163