Disparity in cancer survival between urban and rural patients--how can clinicians help reduce it?

Many reasons for the disparity in survival of 5-7% between rural and urban cancer patients relate to government policies and funding issues. However rural healthcare workers, particularly medical practitioners, can make an impact on reducing this disparity with attention to factors such as reducing referral processing time, using telemedicine, and ensuring ongoing education of rural patients regarding risk factors and screening programs, among other strategies

5 years of teleoncology in North Queensland: a sustainable model

Background: The Townsville Cancer Centre (TCC) has been delivering its medical oncology services closer to home for patients from 19 rural centres via teleoncology since 2007. Patients are satisfied with this model of care. The aim is to describe the services extended to rural patients and the resource improvements enjoyed by rural hospitals as a result of teleoncology over this period. Methods: Data for patients treated via teleoncology from 1st April 2007 to 31st March 2012 was extracted from the oncology information system of TCC. Demographic details and type of services provided are presented descriptively. Results: A total of 170 patients were seen in 800 consultations over 60 months. Median age was 58 years (20–89), males 46% and females 54%. 25 patients were from remote indigenous communities. Most common cancer types were breast (37%), colorectal (21%) and lung (22%). A total of 87 patients received chemotherapy in Mount Isa, supervised remotely from Townsville via video conference with curative intent in 30% and palliative intent in the rest. Examples of chemotherapy regimens included docetaxel, doxorubicin and cyclophosphamide (TAC), bleomycin, etoposide and cisplatin (BEP), methotreaxte and ifosfamide infusion. 15 patients were seen urgently and appropriate treatment initiated within 24 hours in Mount Isa, thus avoiding inter hospital transfer. Six admitted patients were seen on regular ward rounds. Severe toxicities included one death from pneumonia, one stroke and one resuscitated cardiac arrest. By improving the resources in Mount Isa hospital to accommodate these services, numbers of oncology specific medical and allied health practitioners and service capability have improved. Conclusion: Teleoncology model can enhance rural service capabilities and health resources so that comprehensive medical oncology services can be sustainably provided to rural areas by remote supervision

Tele Oncology for Cancer Care in Rural Australia

Rural cancer patients in Australia and other countries with significant rural populations face difficulties with accessing various sub specialist services mainly because of shortage of health care work force and long travel distances to access these services (Underhill et al, 2009). Partly as a result, their survival is lower than their urban counterparts (Campbell et al, 2001; Australian Institute of Health and Welfare, 2010; Sabesan and Piliouras, 2009). To improve equity of access and quality of life, clinics and treatment centres should be located closer to homes in rural towns. Currently, there are several models of care exist to address some of the issues as follows (Underhill et al, 2009): (1) medical oncologists travel to larger rural towns and chemotherapy is administered there. Frequency of these visits range between weekly to three monthly intervals; (2) patients travel to larger centres for consultation and return to their home towns to receive their chemotherapy; (3) patient’s travel to major towns to see the specialists and to receive chemotherapy. These models are often inadequate, expensive and cause problems for patients, specialists as well as rural doctors who would ultimately care for these patients

Component-based Attention for Large-scale Trademark Retrieval

The demand for large-scale trademark retrieval (TR) systems has significantly increased to combat the rise in international trademark infringement. Unfortunately, the ranking accuracy of current approaches using either hand-crafted or pre-trained deep convolution neural network (DCNN) features is inadequate for large-scale deployments. We show in this paper that the ranking accuracy of TR systems can be significantly improved by incorporating hard and soft attention mechanisms, which direct attention to critical information such as figurative elements and reduce attention given to distracting and uninformative elements such as text and background. Our proposed approach achieves state-of-the-art results on a challenging large-scale trademark dataset.Comment: Fix typos related to authors' informatio

MTRNet: A Generic Scene Text Eraser

Text removal algorithms have been proposed for uni-lingual scripts with regular shapes and layouts. However, to the best of our knowledge, a generic text removal method which is able to remove all or user-specified text regions regardless of font, script, language or shape is not available. Developing such a generic text eraser for real scenes is a challenging task, since it inherits all the challenges of multi-lingual and curved text detection and inpainting. To fill this gap, we propose a mask-based text removal network (MTRNet). MTRNet is a conditional adversarial generative network (cGAN) with an auxiliary mask. The introduced auxiliary mask not only makes the cGAN a generic text eraser, but also enables stable training and early convergence on a challenging large-scale synthetic dataset, initially proposed for text detection in real scenes. What's more, MTRNet achieves state-of-the-art results on several real-world datasets including ICDAR 2013, ICDAR 2017 MLT, and CTW1500, without being explicitly trained on this data, outperforming previous state-of-the-art methods trained directly on these datasets.Comment: Presented at ICDAR2019 Conferenc

Access to Clinical Trials Closer to Home Using Tele-health

The purpose of this chapter is to outline key considerations for increasing access to clinical trials for people with cancer living in rural and remote locations, and outline the contribution of tele-health models to facilitate study activity across rural and remote locations. Regional and rural group of the Clinical Oncology Society of Australia (COSA), the peak multidisciplinary cancer clinician body in Australia, has developed the Australasian Teletrial Model in collaboration with its stakeholders to improve rural access to clinical trials. Benefits of this model are not limited to regional, rural and remote systems. This model has the potential to connect larger centres even within the same city and improve the rate of recruitment of highly specialised clinical trials, including rare cancer trials. This model has been developed in consideration of the requirements for the proper conduct of clinical trials ensuring the protection of the rights and safety of trial participants and quality data for the demonstration of safe and efficacious cancer treatments. Ethical and safe conduct of clinical trials using this model requires that the following aspects are considered and addressed by implementation plans

GENETIC DIVERGENCE ANALYSIS FOR CERTAIN YIELD AND QUALITY TRAITS IN RICE (ORYZA SATIVA L.) GROWN IN IRRIGATED SALINE LOW LAND OF ANNAMALAINAGAR, SOUTH INDIA

Genetic diversity among twenty six genotypes of rice genotypes from four states of South Eastern Region of India was evaluated using Mahalanobis D2 statistic. The experimental materials were evaluated during Samba season (August- December) 2005 and 2006 at the Plant Breeding Farm (11o 24’ N latitude and 79o 44’ E longitude, + 5.79 m MSL), Annamalai University, Annamalainagar, Tamilnadu, South India. Based on 12 morphological and quality characters namely, days to first flower, productive tillers per plant, panicle length (cm), number of grains per panicle, 1000 grain weight (g), grain length (mm), grain breadth (mm), grain L/B ratio, kernel length (mm), kernel breadth (mm), kernel L/B ratio and grain yield per plant (g) these genotypes were grouped into 13 clusters. Cluster I with seven genotypes was the largest cluster followed by Cluster V with four genotypes. Clusters IV, VII, VIII, X, XI, XII and XIII were mono genotypic clusters. Genotypes from more than one place of origin were grouped in one cluster, and genotypes from one state were grouped in more than one cluster. Geographical origin was not found to be a good parameter of genetic divergence. Clusters VI, III, and XII exhibited high values for most of the characters. The intra cluster distance was maximum (D = 100.90) in cluster I. The maximum inter cluster distance (D2 = 8235.56) was recorded between clusters II and III. Cluster XII recorded highest mean value for grain yield per plant and lowest mean value for days to first flower. Number of grains per panicle (42.71%) followed by days to first flower (25.62%) contributed maximum to total divergence. Hybridization among genotypes AUR 4, Annamalai mutant ponmani, Karnool sona, Jeeraga samba, AUR 7 and PY 5 from clusters III, II, XII and IX which had maximum inter-cluster distances and desirable values for days to first flower, number of grains per panicle, kernel length, kernel breadth, 1000 grain weight and grain yield per plant is likely to produce heterotic combinations and wide variability is segregating generations

Telemedicine platforms must be leveraged to strengthen rural health systems

[Extract] Telemedicine is a technology that has come of age, now it must be put to use to address inequities in cancer care. The principles and applications of telemedicine have undergone rapid evolution over the last two years globally.1, 2 Prior to the COVID-19 pandemic, the utilisation of telemedicine was largely driven by local champions and lacked systematic uptake despite Government investment and incentives at both state and commonwealth levels. The pandemic and the resulting need for social distancing saw rapid and widespread adoption of telephone and telehealth services aided by Government funding, even for patients in metropolitan areas. Now is the time to leverage this momentum to embed telemedicine in our health systems

STUDIES ON GENETIC CORRELATION AND PATH COEFFICIENT ANALYSIS OF BLACKGRAM (Vigna mungo [L.] Hepper) GENOTYPES UNDER SALINITY

A study was carried out with twenty-one blackgram genotypes in coastal saline low land in three seasons to study the genetic correlation and path coefficient analysis. Eleven seed yield and yield contributing traits were recorded on the genotypes raised in RBD design with two replications. Based on the pooled analysis, plant height, pods per plant and yield per plant recorded high PCV and GCV value. High heritability along with genetic advance as percent of mean observed for days to first flowering, plant height, primary branches, clusters per plant, pods per plant and yield per plant. Genotypic correlation studies revealed that yield per plant had positive significant correlation with plant height, clusters per plant, pods per plant, pod length and seeds per pod. Path coefficient analysis indicated high positive direct effect of pods per plant and pod length on yield per plant in saline condition. The genotype VBG-10010 performed well under saline environment over seasons. &nbsp