Search results for: Pulmonary Embolism Severity Index (PESI) score

Authors: Neslihan Demirci, Serdar Durdağı

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Mycobacterium tuberculosis is still a worldwide disease-causing agent that, according to WHO, led to the death of 1.5 million people from tuberculosis (TB) in 2020. The bacteria reside in macrophages located specifically in the lung. There is a known quadruple drug therapy regimen for TB consisting of isoniazid (INH), rifampin (RIF), pyrazinamide (PZA), and ethambutol (EMB). Over the past 60 years, there have been great contributions to treatment options, such as recently approved delamanid (OPC67683) and bedaquiline (TMC207/R207910), targeting mycolic acid and ATP synthesis, respectively. Also, there are natural compounds that can block the tryptophanyl-tRNA synthetase (TrpRS) enzyme, chuangxinmycin, and indolmycin. Yet, already the drug resistance is reported for those agents. In this study, the newly released TrpRS enzyme structure is investigated for potential inhibitor drugs from already synthesized molecules to help the treatment of resistant cases and to propose an alternative drug for the quadruple drug therapy of tuberculosis. Maestro, Schrodinger is used for docking and molecular dynamic simulations. In-house library containing ~8000 compounds among FDA-approved indole-containing compounds, a total of 57 obtained from the ChemBL were used for both ATP and tryptophan binding pocket docking. Best of indole-containing 57 compounds were subjected to hit expansion and compared later with virtual screening workflow (VSW) results. After docking, VSW was done. Glide-XP docking algorithm was chosen. When compared, VSW alone performed better than the hit expansion module. Best scored compounds were kept for ten ns molecular dynamic simulations by Desmond. Further, 100 ns molecular dynamic simulation was performed for elected molecules according to Z-score. The top three MMGBSA-scored compounds were subjected to steered molecular dynamic (SMD) simulations by Gromacs. While SMD simulations are still being conducted, ponesimod (for multiple sclerosis), vilanterol (β₂ adrenoreceptor agonist), and silodosin (for benign prostatic hyperplasia) were found to have a significant affinity for tuberculosis TrpRS, which is the propulsive force for the urge to expand the research with in vitro studies. Interestingly, top-scored ponesimod has been reported to have a side effect that makes the patient prone to upper respiratory tract infections.

Keywords: drug repurposing, molecular dynamics, tryptophanyl-tRNA synthetase, tuberculosis

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Authors: A. Benaiche

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In the current situation, the automobile has become the main means of locomotion. It allows traveling long distances, encouraging urban sprawl. To counteract this trend, the train is often proposed as an alternative to the car. Simultaneously, the favoring of urban development around public transport nodes such as railway stations is one of the main issues of the coordination between urban planning and transportation and the keystone of the sustainable urban development implementation. In this context, this paper focuses on the study of the spatial structuring dynamics around the railway. Specifically, it is a question of studying the demographic dynamics in rail corridors of Nantes, Angers and Le Mans (Western France) basing on the radiation of railway stations. Consequently, the methodology is concentrated on the knowledge of demographic weight and gains of these corridors, the index of urban intensity and the mobility behaviors (workers’ travels, scholars' travels, modal practices of travels). The perimeter considered to define the rail corridors includes the communes of urban area which have a railway station and communes with an access time to the railway station is less than fifteen minutes by car (time specified by the Regional Transport Scheme of Travelers). The main tools used are the statistical data from the census of population, the basis of detailed tables and databases on mobility flows. The study reveals that the population is not tightened along rail corridors and train use is minimal despite the presence of a nearby railway station. These results lead to propose guidelines to make the train, a real vector of mobility across the rail corridors.

Keywords: coordination between urban planning and transportation, rail corridors, railway stations, travels

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Authors: Mahsa Taghavi

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In the treatment of breast cancer, tamoxifen is a regularly prescribed medication. The effect of tamoxifen on breast cancer patients' EMT pathways was studied. In this study to see if it had any effect on the cancer cells' resistance to tamoxifen and to look for specific miRNAs associated with EMT. In this work, we used continuous and integrated bioinformatics analysis to choose the optimal GEO datasets. Once we had sorted the gene expression profile, we looked at the mechanism of signaling, the ontology of genes, and the protein interaction of each gene. In the end, we used the GEPIA database to confirm the candidate genes. after that, I investigated critical miRNAs related to candidate genes. There were two gene expression profiles that were categorized into two distinct groups. Using the expression profile of genes that were lowered in the EMT pathway, the first group was examined. The second group represented the polar opposite of the first. A total of 253 genes from the first group and 302 genes from the second group were found to be common. Several genes in the first category were linked to cell death, focal adhesion, and cellular aging. Two genes in the second group were linked to cell death, focal adhesion, and cellular aging. distinct cell cycle stages were observed. Finally, proteins such as MYLK, SOCS3, and STAT5B from the first group and BIRC5, PLK1, and RAPGAP1 from the second group were selected as potential candidates linked to tamoxifen's influence on the EMT pathway. hsa-miR-1204 and hsa-miR-639 have a very close relationship with the candidates genes according to the node degrees and betweenness index. With this, the action of tamoxifen on the EMT pathway was better understood. It's important to learn more about how tamoxifen's target genes and proteins work so that we can better understand the drug.

Keywords: tamoxifen, breast cancer, bioinformatics analysis, EMT, miRNAs

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Authors: B. O. Diyaolu, E. A. Okebanjo

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Children in today’s world need attention and care even with their physique as obesity is also at the increased. Several factors can be responsible for obesity in children and adequate attention is paramount in other not to accommodate it into adolescent period. This study investigated perceived determinants of obesity among primary school pupils in Eti Osa Local Government area of Lagos State. Descriptive survey research design was used and population was all obese pupils in Eti Osa Local Government Area of Lagos State. 92 pupils were selected from randomly picked 12 primary schools while purposive sampling technique was used to pick primary 4-6 pupils. With the aid of body mass index (BMI) and age percentile chart the obese pupils were selected. The instrument for the study was a self-developed and structured questionnaire on perceived determinant of obesity. The questionnaire was divided into three sections. The Cronbach’s Alpha reliability coefficient of 0.74 was obtained. The hypotheses were tested at 0.05 significant levels. The completed questionnaire was collated coded and analyzed using descriptive statistics of frequency counts and percentage and inferential statistics of chi-square (X²). Findings of this study revealed that physical activities and parental influences were determinant of obesity. Physical activity is essential in reducing the rate of obesity in Eti Osa Local Government Area both at home and within the school environment. Primary schools need to create more playing ground for pupils to exercise themselves. Parents need to cater for their children diet ensuring not just the quantity but the quality as well.

Keywords: feeding pattern, obese pupils, parental influence, physical activities

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Authors: M. Sanjarani, A. Danehkar, A. Mashincheyan, A. H. Javid, S. M. R. Fatemi

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The oil spill in marine water has direct impact on coastal resources and community. Environmental Sensitivity Index (ESI) map is the first step to assess the potential impact of an oil spill and minimize the damage of coastal resources. In order to create Environmental Sensitivity Maps for the Chabahar bay (Iran), information has been collected in three different layers (Shoreline Classification, Biological and Human- uses resources) by means of field observations and measurements of beach morphology, personal interviews with professionals of different areas and the collection of bibliographic information. In this paper an attempt made to prepare an ESI map for sensitivity to oil spills of Chabahar bay coast. The Chabahar bay is subjected to high threaten to oil spill because of port, dense mangrove forest,only coral spot in Oman Sea and many industrial activities. Mapping the coastal resources, shoreline and coastal structures was carried out using Satellite images and GIS technology. The coastal features classified into three major categories as: Shoreline Classification, Biological and Human uses resources. The important resources classified into mangrove, Exposed tidal flats, sandy beach, etc. The sensitivity of shore was ranked as low to high (1 = low sensitivity,10 = high sensitivity) based on geomorphology of Chabahar bay coast using NOAA standards (sensitivity to oil, ease of clean up, etc). Eight ESI types were found in the area namely; ESI 1A, 1C, 3A, 6B, 7, 8B,9A and 10D. Therefore, in the study area, 50% were defined as High sensitivity, less than 1% as Medium, and 49% as low sensitivity areas. The ESI maps are useful to the oil spill responders, coastal managers and contingency planners. The overall ESI mapping product can provide a valuable management tool not only for oil spill response but for better integrated coastal zone management.

Keywords: ESI, oil spill, GIS, Chabahar Bay, Iran

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Authors: Ali Mahmoud, Shadi Najjar, Mounir Mabsout, Kassim Tarhini

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Empirical expressions for estimating the wheel load distribution and live-load bending moment are typically specified in highway bridge codes such as the AASHTO procedures. The purpose of this paper is to analyze the reliability levels that are inherent in reinforced concrete slab bridges that are designed based on the simplified empirical live load equations in the AASHTO LRFD procedures. To achieve this objective, bridges with multi-lanes (three and four lanes) and different spans are modeled using finite-element analysis (FEA) subjected to HS20 truck loading, tandem loading, and standard lane loading per AASHTO LRFD procedures. The FEA results are compared with the AASHTO LRFD moments in order to quantify the biases that might result from the simplifying assumptions adopted in AASHTO. A reliability analysis is conducted to quantify the reliability index for bridges designed using AASHTO procedures. To reach a consistent level of safety for three- and four-lane bridges, following a previous study restricted to one- and two-lane bridges, the live load factor in the design equation proposed by AASHTO LRFD will be assessed and revised if needed by alternating the live load factor for these lanes. The results will provide structural engineers with more consistent provisions to design concrete slab bridges or evaluate the load-carrying capacity of existing bridges.

Keywords: reliability analysis of concrete bridges, finite element modeling, reliability analysis, reinforced concrete bridge design, load carrying capacity

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Authors: R. Sharma, S. Kumar, C. Sharma

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A number of toxic chlorophenolic compounds are formed during pulp bleaching. The nature and concentration of these chlorophenolic compounds largely depends upon the amount and nature of bleaching chemicals used. These compounds are highly recalcitrant and difficult to remove but are partially removed by the biochemical treatment processes adopted by the paper industry. Identification and estimation of these chlorophenolic compounds has been carried out in the primary and secondary clarified effluents from the paper mill by GCMS. Twenty-six chorophenolic compounds have been identified and estimated in paper mill waste waters. Electrochemical treatment is an efficient method for oxidation of pollutants and has successfully been used to treat textile and oil waste water. Electrochemical treatment using less expensive anode material, stainless steel electrodes has been tried to study their removal. The electrochemical assembly comprised a DC power supply, a magnetic stirrer and stainless steel (316 L) electrode. The optimization of operating conditions has been carried out and treatment has been performed under optimized treatment conditions. Results indicate that 68.7% and 83.8% of cholorphenolic compounds are removed during 2 h of electrochemical treatment from primary and secondary clarified effluent respectively. Further, there is a reduction of 65.1, 60 and 92.6% of COD, AOX and color, respectively for primary clarified and 83.8%, 75.9% and 96.8% of COD, AOX and color, respectively for secondary clarified effluent. EC treatment has also been found to increase significantly the biodegradability index of wastewater because of conversion of non- biodegradable fraction into biodegradable fraction. Thus, electrochemical treatment is an efficient method for the degradation of cholorophenolic compounds, removal of color, AOX and other recalcitrant organic matter present in paper mill waste water.

Keywords: chlorophenolics, effluent, electrochemical treatment, wastewater

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Authors: H. Kamide, T. Arai

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This study aims to clarify factors of courtesy to things and the effect of courtesy on a sense of unity with things based on the teaching of Buddha. The teaching of Buddha explains when dealing with things in a courteous manner carefully, the border between selves and the external world disappears, then both are united. This is an example in Buddhist way that explains the connections with all existences, and in the modern world, it is also a lesson that humans should not let matters go to waste and treat them politely. In order to reveal concrete ways to practice courtesy to things, we clarify the factors of courtesy (Study 1) and examine the effect of courtesy on the sense of unity with the things (Study 2). In Study 1, 100 Japanese (mean age=54.39, SD=15.04, 50% female) described freely about what is courtesy to things that they use daily. These descriptions were classified, and 25 items were made asking for the degree of courtesy to the things. Then different 678 Japanese (mean age=44.72, SD=13.14, 50% female) answered the 25 items on 7-point about tools they use daily. An exploratory factor analysis revealed two factors. The first factor (α=.97) includes 'I deal with the thing carefully' and 'I clean up the thing after use'. This factor reflects how gently people care about things. The second factor (α=.96) includes 'A sense of self-control has come to me through using the thing' and 'I have got inner strength by taking care of the thing'. The second factor reflects how people learn by dealing with things carefully. In this Study 2, 200 Japanese (mean age=49.39, SD=11.07, 50% female) answered courtesy about things they use daily and the degree of sense of unity with the things using the inclusion of other in the self scale, replacing 'Other' with 'Your thing'. The ANOVA was conducted to examine the effect of courtesy (high/low level of two factors) on the score of sense of unity. The results showed the main effect of care level. People with a high level of care have a stronger sense of unity with the thing. The tendency of an interaction effect is also found. The condition with a high level of care and a high level of learning enhances the sense of unity more than the condition of a low level of care and high level in learning. Study 1 found that courtesy is composed of care and learning. That is, courtesy is not only active care to the things but also to learn the meaning of the things and grow personally with the things. Study 2 revealed that people with a high level of care feel a stronger sense of unity and also people with both a high level of care and learn tend to do so. The findings support the idea of the teaching of Buddha. In the future, it is necessary to examine a combined effect of care and learning.

Keywords: courtesy, things, sense of unity, the teaching of Buddha

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Authors: Masuma Novak, Daniel Novak

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Background: Sweden along with other Nordic countries has the highest incidence of type 1 diabetes mellitus (T1DM) worldwide. The trend is increasing globally. The diagnosis is often given at the emergency clinic when children arrive with cardinal symptom of T1DM. Children with T1DM are known to have an increased risk of microvascular- and macrovascular complications. A family history of cardiovascular complications may further increase their risk. Clinically evident diabetes-related vascular complications are however rarely visible in childhood and adolescence, whereby an intensive diabetes treatment and normoglycemic control is a goal for every child. This study is a risk evaluation of children with T1DM based on their family’s cardiovascular history. Method: Since 2005 the Better Diabetes Diagnosis (BDD) study is a nationwide Swedish prospective cohort study that recruits new-onset T1DM who are less than 18 years old at time of diagnosis. For each newly diagnosed child, blood samples are collected for specific HLA genotyping and islet autoantibody assays and their family’s cardiovascular history is evaluated. As part of the BDD study, during the years 2010-2013 all children diagnosed with T1DM at the Queen Silvia’s Children’s Hospital in Sweden were asked about their family’s cardiovascular history. Questions regarded maternal and paternal high blood pressure, stroke, and myocardial infarction before the age of 55 years, and hyperlipidemia were answered. A maximum risk score of eight was possible. All children are clinically observed prospectively for early functional and structural abnormalities such as protein uremia, blood pressure, and retinopathy. Results: A total of 275 children aged 0 to 18 years were diagnosed with T1DM at the Queen Silvia’s Children’s Hospital emergency clinic during this four year period. The participation rate was 99.7%. 26.4% of the children had no hereditary cardiovascular risk factors. 22.7 % had one risk factor and 18.8% had two risk factors. 14.8% had three risk factors. 9.7% had four risk factors and 7.5% had five risk factors or more. Conclusion: Among children with T1DM in Sweden there is a difference in hereditary cardiovascular risk factors. These results indicate that children with T1DM who also have increased hereditary cardiovascular risk factors should be monitored closely with early screening for functional and structural cardiovascular abnormalities. This is a very preliminary and ongoing study which will be complemented with the cardiovascular risk analysis among children without T1DM.

Keywords: children, type I diabetes, emergency clinic, CVD risk

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Authors: Howaida I. Abd-Alla, Nagwa M. M. Shalaby

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The fruit rind of Fortunella margarita (Nagami Kumkuat) was investigated for its chemical constituents. Thirteen metabolites were obtained and classified into, a sterol; β-sitosterol (1) and twelve phenolic compounds, three coumarins; xanthotoxin (2), isopimpinellin (3), umbelliferone (4), nine flavonoids of O-glycosides of flavone; apigenin-7-O-β-D-glucopyranoside (5), apigenin-7-O-rhamnoglucoside (rhoifolin) (6), C-glycosides; vitexin (7), vicenin II (8), and the methoxylated; 6-methoxyapigenin-7-methyl ether (9) and tangeretin (10) as well as flavanones class; naringenin (11), liquiritigenin (12), hesperdin (hesperetin-7-rhamnoglucoside) (13). All compounds were identified for the first time in F. margarita except compound (8). The major glycosides 5, 6, and 13 and total crude extract showed potential antiviral activity against live Newcastle disease virus vaccine strains (Komarov and LaSota) and live infectious bursitis viruses vaccine strain D78 replication in VERO cell cultures and on specific pathogen-free embryonated chicken eggs. Antiviral inhibitory concentration fifty (IC50), cytotoxic concentration fifty (CC50), and therapeutic index (TI) were calculated. In addition, the extract and compounds 7 and 13 showed marked antimicrobial activity against different strains of fungi, Gram-positive and negative bacteria, including some foodborne pathogens of animal origin, caused human disease. These results suggested that the extract of F. margarita may be considered potentially useful as a source of natural antiviral and antimicrobial agents. It can be used as an ingredient for functional food and/or pharmaceuticals.

Keywords: antimicrobial, antiviral, Fortunella margarita, Nagami Kumkuat, phenolic secondary metabolites

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Authors: Yu-Wen Lin, Li-Ni Liu

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Introduction: Fatigue is the most common symptoms experienced by cancer patients undergoing chemotherapy. Patients receiving anticancer therapies develop a higher proportion of fatigue compared with patients who do not receive anticancer therapies. Fatigue has significant impacts on quality of life, daily activities, mood status, and social behaviors. A warm-water footbath (WWF) at 41℃ promotes circulation and removes metabolites resulting in improving sleep and relieving fatigue. The aim of this study is to determine the effectiveness of WWF for relieving fatigue with cancer patients undergoing chemotherapy. Materials and Methods: This is a single-center, prospective, quasi-experimental design study in the oncology ward in Taiwan. Participants in this study were assigned to WWF group as experimental group and standard care group as a control group by purposive sampling. In the WWF group, the participants were asked to soak their feet in 42-43℃ water 15 minutes for consecutive 6 days at one day before chemotherapy. Each participant was evaluated for fatigue level by the Taiwanese version of the Brief Fatigue Inventory (BFI-T). BFI-T was completed for consecutive 8 days of the study. The primary outcome was compared the BFI-T score of WWF group to the standard care group. Results: There were 60 participants enrolled in this study. Thirty participants were assigned to WWF group and 30 participants were assigned to standard care group. Both groups have comparable characteristic. The BFI-T scores of both groups were increased associated with the days of chemotherapy. The highest BFI-T scores of both groups were on the day 4 of chemotherapy. The BFI-T scores of both groups were decreased since day 5 and significantly decreased in WWF group on day 5 compared to standard care group (4.17 vs. 5.7, P ＜ .05). At the end of the study the fatigue at its worse were significantly decreased in WWF group (2.33 vs. 4.37, P ＜ .001). There was no adverse event reported in this study. Conclusion: WWF is an easy, safe, non-invasive, and relatively inexpensive nursing intervention for improving fatigue of cancer patients undergoing chemotherapy. In summary, this study shows the WWF is a simple complementary care method, and it is effective for improving and relieving fatigue in a short time. Through improving fatigue is a way to enhance the quality of life which is important for cancer patients undergoing chemotherapy. Larger prospective randomized controlled trial and long-term effectiveness and outcomes of WWF should be performed to confirm this study.

Keywords: chemotherapy, warm-water footbath, fatigue, Taiwanese version of the brief fatigue inventory

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Authors: Rachel M. Edelstein, John D. Van Horn, Karen M. Schmidt, Sydney N. Cushing

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As a consequence of sports-related concussions, female athletes have been documented as reporting more symptoms than their male counterparts, in addition to incurring longer periods of recovery. However, the role of sex and its potential influence on symptom reporting and recovery outcomes in concussion management has not been completely explored. The present aims to investigate the relationship between female concussion symptom severity and the presence of assessment bias. The Sport Concussion Assessment Tool 3 (SCAT3), collected by the NCAA and DoD CARE Consortium, was quantified at five different time points post-concussion. N= 1,258 NCAA athletes, n= 473 female (soccer, rugby, lacrosse, ice hockey) and n=785 male athletes (football, rugby, lacrosse, ice hockey). A polytomous Item Response Theory (IRT) Graded Response Model (GRM) was used to assess the relationship between sex and symptom reporting. Differential Item Functioning (DIF) and Differential Group Functioning (DGF) were used to examine potential group-level bias. Interactions for DIF were utilized to explore the impact of sex on symptom reporting among NCAA male and female athletes throughout and after their concussion recovery. DIF was significantly detected after B-H corrections displayed in limited items; however, one symptom, “Pressure in Head” (-0.29, p=0.04 vs -0.20, p =0.04), was statistically significant at both < 6 hours and 24-48 hours. Thus, implies that at < 6 hours, males were 29% less likely to indicate “Pressure in the Head” compared to female athletes and 20% less likely at 24-48 hours. Overall, the DGF suggested significant group differences, suggesting that male athletes might be at a higher risk for returning to play prematurely (logits = -0.38, p < 0.001). However, after analyzing the SCAT 3, a clinically relevant trend was discovered. Twelve out of the twenty-two symptoms suggest higher difficulty in female athletes within three or more of the five-time points. These symptoms include Balance Problems, Blurry Vision, Confusion, Dizziness, Don’t Feel Right, Feel in Fog, Feel Slow Down, Low Energy, Neck Pain, Sensitivity to Light, Sensitivity to Noise, Trouble Falling Asleep. Despite a lack of statistical significance, this tendency is contrary to current literature stating that males may be unclear on symptoms, but females may be more honest in reporting symptoms. Further research, which includes possible modifying socioecological factors, is needed to determine whether females may consistently experience more symptoms and require longer recovery times or if, parsimoniously, males tend to present their symptoms and readiness for play differently than females. Such research will help to improve the validity of current assumptions concerning male as compared to female head injuries and optimize individualized treatments for sports-related head injuries.

Keywords: female athlete, sports-related concussion, item response theory, concussion assessment

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Authors: Eleni Stefania Kalapoda

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Recurring heat waves due to the global climate change emergency pose continuous risks to human health and urban resources. Local and state decision-makers incorporate Heat Vulnerability Indices (HVIs) to quantify and map the relative impact on human health in emergencies. These maps enable government officials to identify the highest-risk districts and to concentrate emergency planning efforts and available resources accordingly (e.g., to reevaluate the location and the number of heat-relief centers). Even though the framework of conducting an HVI is unique per municipality, its accuracy in assessing the heat risk is limited. To resolve this issue, varied housing-related metrics should be included. This paper quantifies and classifies NYC’s single detached housing typology within high-vulnerable NYC districts using detailed energy simulations and post-processing calculations. The results show that the variation in indoor heat risk depends significantly on the dwelling’s design/operation characteristics, concluding that low-ventilated dwellings are the most vulnerable ones. Also, it confirmed that when building-level determinants of exposure are excluded from the assessment, HVI fails to capture important components of heat vulnerability. Lastly, the overall vulnerability ratio of the housing units was calculated between 0.11 to 1.6 indoor heat degrees in terms of ventilation and shading capacity, insulation degree, and other building attributes.

Keywords: heat vulnerability index, energy efficiency, urban heat, resiliency to heat, climate adaptation, climate mitigation, building energy

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Authors: Mkpoikanke Sunday Otu

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Introduction: Career anxiety is a common issue among university students, particularly in developing countries like Nigeria. This anxiety can significantly impact students' academic performance, overall well-being, and future career prospects. Therefore, it is crucial to explore effective interventions that can alleviate career anxiety among university students. The primary aim of this study was to determine the effectiveness of a psychosocial intervention in reducing career anxiety among Nigerian university students. The study employed a group randomized trial research design to further analyze the impact on career anxiety. Methodology: A total of 306 university students from various universities in Akwa Ibom State, Nigeria, were recruited for this study. The participants were purposively selected to ensure diversity and represent a range of academic disciplines. A group randomized trial research design was employed, with participants randomly assigned to either the treatment group or the control group. The treatment group received a comprehensive psychosocial intervention, while the control group served as a comparison group. The Career Anxiety Questionnaire (CAQ) was used to assess career anxiety levels among the participants. The CAQ is a validated and reliable tool that assesses various aspects of career-related anxiety, including uncertainty, fear, and self-doubt. It was administered to the participants at baseline (before the intervention), immediately after the intervention, and at follow-up (after the intervention). Results: Data analysis was conducted using statistical techniques, including analysis of variance (ANOVA). The results demonstrated that the treatment group showed a significantly lower mean score of career anxiety compared to the control group (p-value<0.05). This finding suggests that the psychosocial intervention was effective in reducing the career anxiety levels of the participants at post-test and follow-up. Conclusion: The findings of this study provide compelling evidence that psychosocial interventions have a significant impact on the reduction of career anxiety among Nigerian university students. The treatment group demonstrated a significant reduction in career anxiety scores, indicating the effectiveness of this intervention. Additionally, this study highlights the importance of addressing the career anxiety challenges faced by university students. By implementing targeted interventions, educational institutions can play a vital role in supporting the overall well-being and success of their students, both academically and professionally.

Keywords: psychosocial intervention, career anxiety, psychoeducation, university students

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Authors: Mami Miyasaka, Kaichi Yanaoka

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Attention Deficit/Hyperactivity Disorder (ADHD) is a neurodevelopmental disorder characterized by inattention, hyperactivity, and impulsivity; symptoms often manifest during childhood. In children with ADHD, the development of inhibitory processes is impaired. Inhibitory control allows people to avoid processing unnecessary stimuli and to behave appropriately in various situations; thus, people with ADHD require interventions to improve inhibitory control. Positive or negative reinforcements (i.e., reward or punishment) help improve the performance of children with such difficulties. However, in order to optimize impact, reward and punishment must be presented immediately following the relevant behavior. In regular elementary school classrooms, such supports are uncommon; hence, an alternative practical intervention method is required. One potential intervention involves setting goals to keep children motivated to perform tasks. This study examined whether goal setting improved inhibitory performances, especially for children with severe ADHD-related symptoms. We also focused on giving feedback on children's task performances. We expected that giving children feedback would help them set reasonable goals and monitor their performance. Feedback can be especially effective for children with severe ADHD-related symptoms because they have difficulty monitoring their own performance, perceiving their errors, and correcting their behavior. Our prediction was that goal setting by itself would be effective for children with mild ADHD-related symptoms, and goal setting based on feedback would be effective for children with severe ADHD-related symptoms. Japanese elementary school children and their parents were the sample for this study. Children performed two kinds of go/no-go tasks, and parents completed a checklist about their children's ADHD symptoms, the ADHD Rating Scale-IV, and the Conners 3rd edition. The go/no-go task is a cognitive task to measure inhibitory performance. Children were asked to press a key on the keyboard when a particular symbol appeared on the screen (go stimulus) and to refrain from doing so when another symbol was displayed (no-go stimulus). Errors obtained in response to a no-go stimulus indicated inhibitory impairment. To examine the effect of goal-setting on inhibitory control, 37 children (Mage = 9.49 ± 0.51) were required to set a performance goal, and 34 children (Mage = 9.44 ± 0.50) were not. Further, to manipulate the presence of feedback, in one go/no-go task, no information about children’s scores was provided; however, scores were revealed for the other type of go/no-go tasks. The results revealed a significant interaction between goal setting and feedback. However, three-way interaction between ADHD-related inattention, feedback, and goal setting was not significant. These results indicated that goal setting was effective for improving the performance of the go/no-go task only with feedback, regardless of ADHD severity. Furthermore, we found an interaction between ADHD-related inattention and feedback, indicating that informing inattentive children of their scores made them unexpectedly more impulsive. Taken together, giving feedback was, unexpectedly, too demanding for children with severe ADHD-related symptoms, but the combination of goal setting with feedback was effective for improving their inhibitory control. We discuss effective interventions for children with ADHD from the perspective of goal setting and feedback. This work was supported by the 14th Hakuho Research Grant for Child Education of the Hakuho Foundation.

Keywords: attention deficit disorder with hyperactivity, feedback, goal-setting, go/no-go task, inhibitory control

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Authors: Pronab Ganguly, Ahmed A. Moustafa

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Holistic management of schizophrenia involves mainstream pharmacological intervention, complimentary medicine intervention, therapeutic intervention and other psychosocial factors such as accommodation, education, job training, employment, relationship, friendship, exercise, overall well-being, smoking, substance abuse, suicide prevention, stigmatisation, recreation, entertainment, violent behaviour, arrangement of public trusteeship and guardianship, day-day-living skill, integration with community, and management of overweight due to medications and other health complications related to medications amongst others. Our review shows that there is no integrated survey by combining all these factors. An international web-based survey was conducted to evaluate the significance of all these factors and present them in a unified manner. It is believed this investigation will contribute positively towards holistic management of schizophrenia. There will be two surveys. In the pharmacological intervention survey, five popular drugs for schizophrenia will be chosen and their efficacy as well as harmful side effects will be evaluated on a scale of 0 -10. This survey will be done by psychiatrists. In the second survey, each element of therapeutic intervention and psychosocial factors will be evaluated according to their significance on a scale of 0 - 10. This survey will be done by care givers, psychologists, case managers and case workers. For the first survey, professional bodies of psychiatrists in English speaking countries will be contacted to request them to ask their members to participate in the survey. For the second survey, professional bodies of clinical psychologist and care givers in English speaking countries will be contacted to request them to ask their members to participate in the survey. Additionally, for both the surveys, relevant professionals will be contacted through personal contact networks. For both the surveys, mean, mode, median, standard deviation and net promoter score will be calculated for each factor and then presented in a statistically significant manner. Subsequently each factor will be ranked according to their statistical significance. Additionally, country specific variation will be highlighted to identify the variation pattern. The results of these surveys will identify the relative significance of each type of pharmacological intervention, each type of therapeutic intervention and each type of psychosocial factor. The determination of this relative importance will definitely contribute to the improvement in quality of life for individuals with schizophrenia.

Keywords: schizophrenia, holistic management, antipsychotics, quality of life

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Authors: Fusun Akdag

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Today, as business becomes increasingly global, managers/leaders of multinational companies or local companies work with employees or customers from a variety of cultural backgrounds. To do this effectively, they need to develop cultural competence. Therefore, cultural intelligence (CQ) becomes a vitally important aptitude and skill, especially for leaders. The organizational success or failure depends upon the way, the kind of leadership which has been provided to its members. The culture we are born into deeply effects our values, beliefs, and behavior. Cultural intelligence (CQ) focuses on how well individuals can relate and work across cultures. CQ helps minimize conflict and maximize performance of a diverse workforce. The term 'decision,' refers to a commitment to a course of action that is intended to serve the interests and values of particular people. One dimension of culture that has received attention is individualism-collectivism or, independence-interdependence. These dimensions are associated with different conceptualizations of the 'self.' Individualistic cultures tend to value personal goal pursuit as opposed to pursuit of others’ goals. Collectivistic cultures, by contrast, view the 'self' as part of a whole. Each person is expected to work with his or her in-group toward goals, generally pursue group harmony. These differences underlie cross-cultural variation in decision-making, such as the decision modes people use, their preferences, negotiation styles, creativity, and more. The aim of this study is determining the effect of CQ on decision making styles of male and female managers in Turkey, an emergent economy framework. The survey is distributed to gather data from managers at various companies. The questionnaire consists of three parts: demographics, The Cultural Intelligence Scale (CQS) to measure the four dimensions of cultural intelligence and General Decision Making Style (GMDS) Inventory to measure the five subscales of decision making. The results will indicate the Turkish managers’ score at metacognitive, cognitive, motivational and behavioral aspects of cultural intelligence and to what extent these scores affect their rational, avoidant, dependent, intuitive and spontaneous decision making styles since business leaders make dozens of decisions every day that influence the success of the company and also having an impact on employees, customers, shareholders and the market.

Keywords: cultural intelligence, decision making, gender differences, management styles,

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Authors: Mohmd Sarireh

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The geotechnical study can be employed successfully to assess and follow the expected development or delay in the project construction. The development project of city center or downtown was taken as a case study for the investigation of the project conditions that might support progress or cause delay. The project was proposed to build 7447 m2 by reinforced concrete mainly to serve and support the services provided to people in Tafila. The project construction had faced challenges and obstacles such as soil collapse because of excavation of the weak soil that found in the project site. In addition, the topography of the project area showed a high slope from South-West to North. The slope through the project footprint reached to 83.3% which is considered very high slope. One year and a half proposed to finish the project construction since the 1st of March 2013 and it was planned to be finished by the 31th of August 2014, but the project needs more than one year and a half as extension according to the consultant engineer. The collecting of data was conducted through the interviews with the engineers and officials, and by analyzing the soil reports and samples taken during design and excavation. The major findings came out to weak and fractured soil and construction waste that were found at project site. Also, soil was considered very fine according to the plasticity index (PI) values, in addition to the high depths required for foundation that contribute to the collapse of soil and the increase of project cost. The current project aims to present how the unseen conditions can delay the project construction and increase the cost of the project that rises to JD8.305 Million.

Keywords: geotechnical, management, progress, risk, soil unseen conditions management

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Authors: Wathig Hashim Mohamed Ibrahim

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Twenty Five polymorphic microsatellite out of 50 Loci were used to genotype some camel (Camelus dromedarius) types and subtypes in Sudan (Naylawi, Shanapla, Lahawi, Kinani, Rashaydi, Bani-Aamir, Annafi, Bishari Shallagyai and Bishari Arririt) and that from Qatar (OmmaniHJ, OmmaniKH, Majaheem, Pakistani Sindi, Pakistani Punjabi and Pakistani) and for comparative; one type from Somalia (Aarhou) and another from Chad (Spotted) were investigated. The highest number of alleles were 23 in Locus CVRL 01, and lowest were 2 in YWLL 59. The observed heterozygosity (Hobs) were 0.950 and 0.049 for VOLP08 and YWLL09, respectively, while the expected heterozygosity (HExp) were 0.915 and 0.362 for Locus VOLP67 and YWLL58, respectively, and the HExp mean was 0.7378. Polymorphic Information Content (PIC) ranged between 0.907 - 0.345 in Locus VOLP67 and YWLL58, and the PIC mean was 0.7002. The genetic distance ranged between 0.545 – 0.098 for Shallagyai (Bishari subtype) – Pakistani Sindi subtype and between Annafi - Rashaydi, respectively. The genetic distance between spotted and all types ranged between 0.223 with Arririt (Bishari subtype) and 0.463 with Punjabi (Pakistani subtype) that found in Qatar, while all types with Aarhou ranged between 0.215 for Arririt and 0.469 with Punjabi (Pakistani subtype). The dondrogram shows that there is a relationship between the genetic makeup and geographical distributions and also between the genetic makeup and phenotypic characteristic. Individual assignment was calculated, 46.62% correctly assigned and 46.87% quality index. Hardy Weinberg Equivalent (HWE) was also calculated. Key words: Camel, genotype, polymorphic microsatellite

Keywords: camel, genotype, polymorphic microsatellite, types and subtypes

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Authors: J. Mrazek, R. Skala, S. Bysakh, Ivan Kasik

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Lanthanide-doped yttrium titanium oxides, which crystallize in a pyrochlore structure with general formula (RExY1-x)2Ti2O7 (RE=rare earth element), have been extensively investigated in recent years for their interesting physical and chemical properties. Despite that the pure pyrochlore structure does not present luminescence ability, the presence of yttrium ions in the pyrochlore structure significantly improves the luminescence properties of the RE. Moreover, the luminescence properties of pyrochlores strongly depend on the size of formed nanocrystals. In this contribution, we present a versatile sol-gel synthesis of nanocrystalline EuYTi2O7pyrochlore. The nanocrystalline powders and thin films were prepared by the condensation of titanium(IV)butoxide with europium(III) chloride followed by the calcination. The introduced method leads to the formation of the highly-homogenous nanocrystalline EuYTi2O7 with tailored grain size ranging from 20 nm to 200 nm. The morphology and the structure of the formed nanocrystals are linked to the luminescence properties of Eu3+ ions incorporated into the pyrochlore lattice. The results of XRD and HRTEM analysis show that the Eu3+ and Y3+ ions are regularly distributed inside the lattice. The lifetime of Eu3+ ions in calcinated powders is regularly decreasing from 140 us to 68 us and the refractive index of prepared thin films regularly increases from 2.0 to 2.45 according to the calcination temperature. The shape of the luminescence spectra and the decrease of the lifetime correspond with the crystallinity of prepared powders. The results present fundamental information about the effect of the size of the nanocrystals to their luminescence properties. The promising application of prepared nanocrystals in the field of lasers and planar optical amplifiers is widely discussed in the contribution.

Keywords: europium, luminescence, nanocrystals, sol-gel

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Authors: Ahmed Yousef A. Al Sultan

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Introduction: The aim of this review is based on clinical research that studies the changes in middle cerebral artery velocity using Transcranial Doppler (TCD) and cerebral oxygen saturation using cerebral oximetry in patients undergoing carotid endarterectomy (CEA) surgery under local anesthesia (LA). Patients with or without neurological symptoms during the surgery are taking a role in this study using triplet method of cerebral oximetry, transcranial doppler and awake test in detecting any cerebral ischemic symptoms. Methods: about one hundred patients took part during their CEA surgeries under local anesthesia, using triple assessment mentioned method, Patients requiring general anesthesia be excluded from analysis. All data were recorded at eight surgery stages separately to serve this study. Results: In total regional cerebral oxygen saturation (rSO2), middle cerebral artery (MCA) velocity, and pulsatility index were significantly decreased during carotid artery clamping step in CEA procedures on the targeted carotid side. With most observed changes in MCA velocity during the study. Discussion: Cerebral oxygen saturation and middle cerebral artery velocity were significantly decreased during clamping step of the procedures on the targeted side. The team with neurological symptoms during the procedures showed higher changes of rSO2 and MCA velocity than the team without neurological symptoms. Cerebral rSO2 and MCA velocity significantly increased directly after de-clamping of the internal carotid artery on the affected side.

Keywords: awake testing, carotid endarterectomy, cerebral oximetry, Tanscranial Doppler

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Authors: Knol Hester, Müller Swantje, Danchenko Natalya

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Objective: Falls in older people cause an autonomy loss and result in an economic burden. LCare is an AI-based application to manage fall risks. The study's aim was to assess the effect of LCare use on patient outcomes in nursing homes in Germany. Methods: LCare identifies and monitors fall risks through a 3D-gait analysis and a digital questionnaire, resulting in tailored recommendations on fall prevention. A study was conducted with AOK Baden-Württemberg (01.09.2019- 31.05.2021) in 16 care facilities. Assessments at baseline and follow-up included: a fall risk score; falls (baseline: fall history in the past 12 months; follow-up: a fall record since the last analysis); fall-related injuries and hospitalizations; gait speed; fear of falling; psychological stress; nurses experience on app use. Results: 94 seniors were aged 65-99 years at the initial analysis (average 84±7 years); 566 mobility analyses were carried out in total. On average, the fall risk was reduced by 17.8 % as compared to the baseline (p<0.05). The risk of falling decreased across all subgroups, including a trend in dementia patients (p=0.06), constituting 43% of analyzed patients, and patients with walking aids (p<0.05), constituting 76% of analyzed patients. There was a trend (p<0.1) towards fewer falls and fall-related injuries and hospitalizations (baseline: 23 seniors who fell, 13 injury consequences, 9 hospitalizations; follow-up: 14 seniors who fell, 2 injury consequences, 0 hospitalizations). There was a 16% improvement in gait speed (p<0.05). Residents reported less fear of falling and psychological stress by 38% in both outcomes (p<0.05). 81% of nurses found LCare effective. Conclusions: In the presented study, the use of LCare app was associated with a reduction of fall risk among nursing home residents, improvement of health-related outcomes, and a trend toward reduction in injuries and hospitalizations. LCare may help to improve senior resident care and save healthcare costs.

Keywords: falls, digital healthcare, falls prevention, nursing homes, seniors, AI, digital assessment

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Authors: Barari Alireza, Seyed Hossein Alavi, Ghasemi Mohamad

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Objectives: VEGF and PDGF play central role in the processes of angiogenesis and vascular changes in most body tissues. The aim of the present study to determine effect of endurance training with ginseng on VEGF and PDGF levels is untrained female. Methods: Statistic society of this study was untraining male students of Azad University of Sari Branch in year of 2012-2013. Forty young untrained female (age 21.3 ± 0.90 year, height162.08±8.07cm , body weight 65.45± 7.6 kg and body mass index [BMI] 23.23 ± 2.64 kg/m2) were randomly divided into four groups: control(C), endurance(E), ginseng (G), endurance and ginseng (EG). Participants in training groups performed endurance training for 6 weeks and three sessions per week with 60-80% HRmax. Subjects perform endurance training and consumed ginseng for six weeks. Blood samples from the subjects before and after the test was performed. One wey ANOVA were used to test for differences between group and pair T-test were used for differences within groups. In all cases, P<0.05 was considered to be statistically significant. Results: A higher and significant Vo2 max was found in E and EG groups, while no change in other groups. BMI and Fat% were significantly decreased in EG group. No significant difference was found between and within groups in VEGF level. A higher and significant PDGF was only in endurance group, while there was significant reduction observed in G and EG groups. One-way ANOVA for PDGF showed significant difference between groups. Conclusion: The finding of the current study indicated that ginseng likely could through reducing of angiogenesis factors Such as VEGF and PDGF and reduced activity of tumor necrosis factor and inhibited inflammatory process.

Keywords: endurance, ginseng, VEGF, PDGF, untrained female

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Authors: Meng-Huan Wu, Wei-Er Wang, Tsu-Nai Wang, Wei-Jian Hsu, Vincent Chin-Hung Chen

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Objective: Studies have reported a strong link between asthma and bipolar disorder. We conducted a 17-year community-based large cohort study to examine the relationship between asthma, early smoking initiation, and bipolar disorder during adolescence and early adulthood. Methods: A total of 162,766 participants aged 11–16 years were categorized into asthma and non-asthma groups at baseline and compared within the observation period. Covariates during late childhood or adolescence included parental education, cigarette smoking by family members of participants, and participant’s gender, age, alcohol consumption, smoking, and exercise habits. Data for urbanicity, prednisone use, allergic comorbidity, and Charlson comorbidity index were acquired from the National Health Insurance Research Database. The Cox proportional-hazards model was used to evaluate the association between asthma and bipolar disorder. Results: Our findings revealed that asthma increased the risk of bipolar disorder after adjustment for key confounders in the Cox proportional hazard regression model (adjusted HR: 1.31, 95% CI: 1.12-1.53). Hospitalizations or visits to the emergency department for asthma exhibited a dose–response effect on bipolar disorder (adjusted HR: 1.59, 95% CI: 1.22-2.06). Patients with asthma with onset before 20 years of age who smoked during late childhood or adolescence had the greatest risk for bipolar disorder (adjusted HR: 3.10, 95% CI: 1.29-7.44). Conclusions: Patients newly diagnosed with asthma had a 1.3 times higher risk of developing bipolar disorder. Smoking during late childhood or adolescence increases the risk of developing bipolar disorder in patients with asthma.

Keywords: adolescence, asthma, smoking, bipolar disorder, early adulthood

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Authors: Kornanong Yuenyongchaiwat, Duangnate Pepatsitipong, Panthip Sangprasert

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High blood pressure and diabetes have been suggested as being non-communicable disease (NCDs), and there is one of the components of the definition of metabolic syndrome. Therefore, the purpose of this study was to evaluate the effect of a 12-week pedometer based community walking intervention on change in resting blood pressure and blood glucose in participants with overweight in the community setting. Method: Participants were recruited both males and females who had a sedentary lifestyle aged 35-59 years (mean aged 49.67 years). A longitudinal quasi-experimental study was designed with 35 overweight participants who had body mass index ≥ 25 kg/m2. These volunteers were assigned to the 12-week pedometer-based walking program (an accumulated at least 10,000 steps a day). Blood pressure and blood glucose were measured initially before and after 12-week intervention. Results: Systolic blood pressure and heart rate were significantly lower in 30 individuals who had accumulated 10,000 steps d-1 in the intervention group at 12 week follow-up (-13.74 mmHg and 5.3 bpm, respectively). In addition, reduction in blood glucose (-14.89 mmol) in the intervention participants was statistically significant (p < .001). A regression analysis indicated that reductions in systolic blood pressure were significantly related to the increase in steps per day. Conclusion: The accumulation of least 10,000 steps d-1 resulted in decreased resting systolic blood pressure and blood glucose in overweight participants. This has also shown that an increase in physical activity in overweight participants with sedentary lifestyle by accumulating at least 10,000 steps a day can reduce the risk of cardiovascular disease (e.g., hypertension and diabetes).

Keywords: blood glucose, blood pressure, diabetes, hypertension, physical activity, walking

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Authors: Xinqi Guo, Karen R. Dobkins

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Background and Objectives: Humans are probably the only animals whose minds are constantly filled with thoughts, feelings and emotions. Previous studies have investigated human minds from different dimensions, including its proportion of time for not being present, its representative format, its personal relevance, its temporal locus, and affect valence. The current study aims at characterizing human mind by employing Experience Sampling Methods (ESM), a self-report research procedure for studying daily experience. This study emphasis on answering the following questions: 1) How does the contents of the inner experience vary across demographics, 2) Are certain types of inner experiences correlated with level of mindfulness and mental well-being (e.g., are people who spend more time being present happier, and are more mindful people more at-present?), 3) Will being prompted to report one’s inner experience increase mindfulness and mental well-being? Methods: Participants were recruited from the subject pool of UC San Diego or from the social media. They began by filling out two questionnaires: 1) Five Facet Mindfulness Questionnaire-Short Form, and 2) Warwick-Edinburgh Mental Well-being Scale, and demographic information. Then they participated in the ESM part by responding to the prompts which contained questions about their real-time inner experience: if they were 'at-present', 'mind-wandering', or 'zoned-out'. The temporal locus, the clarity, and the affect valence, and the personal importance of the thought they had the moment before the prompt were also assessed. A mobile app 'RealLife Exp' randomly delivered these prompts 3 times/day for 6 days during wake-time. After the 6 days, participants completed questionnaire (1) and (2) again. Their changes of score were compared to a control group who did not participate in the ESM procedure (yet completed (1) and (2) one week apart). Results: Results are currently preliminary as we continue to collect data. So far, there is a trend that participants are present, mind-wandering and zoned-out, about 53%, 23% and 24% during wake-time, respectively. The thoughts of participants are ranked to be clearer and more neutral if they are present vs. mind-wandering. Mind-wandering thoughts are 66% about the past, consisting 80% of inner speech. Discussion and Conclusion: This study investigated the subjective account of human mind by a tool with high ecological validity. And it broadens the understanding of the relationship between contents of mind and well-being.

Keywords: experience sampling method, meta-memory, mindfulness, mind-wandering

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Authors: R. Khenata, T. Djied, R. Ahmed, H. Baltache, S. Bin-Omran, A. Bouhemadou

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We predict structural, phase transition as well as opto-electronic properties of the filled-tetrahedral (Nowotny-Juza) NaZnAs compound in this study. Calculations are carried out by employing the full potential (FP) linearized augmented plane wave (LAPW) plus local orbitals (lo) scheme developed within the structure of density functional theory (DFT). Exchange-correlation energy/potential (EXC/VXC) functional is treated using Perdew-Burke and Ernzerhof (PBE) parameterization for generalized gradient approximation (GGA). In addition to Trans-Blaha (TB) modified Becke-Johnson (mBJ) potential is incorporated to get better precision for optoelectronic properties. Geometry optimization is carried out to obtain the reliable results of the total energy as well as other structural parameters for each phase of NaZnAs compound. Order of the structural transitions as a function of pressure is found as: Cu2Sb type → β → α phase in our study. Our calculated electronic energy band structures for all structural phases at the level of PBE-GGA as well as mBJ potential point out; NaZnAs compound is a direct (Γ–Γ) band gap semiconductor material. However, as compared to PBE-GGA, mBJ potential approximation reproduces higher values of fundamental band gap. Regarding the optical properties, calculations of real and imaginary parts of the dielectric function, refractive index, reflectivity coefficient, absorption coefficient and energy loss-function spectra are performed over a photon energy ranging from 0.0 to 30.0 eV by polarizing incident radiation in parallel to both [100] and [001] crystalline directions.

Keywords: NaZnAs, FP-LAPW+lo, structural properties, phase transition, electronic band-structure, optical properties

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Authors: Lin Dong, Fei Shi

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Based on the railway network and the principles of space syntax, the study attempts to reconstruct the spatial relationship of the passenger network connections from space and time perspective. According to the travel time data of main stations in the Yangtze River Delta urban agglomeration obtained by the Internet, the topological drawing of railway network under different time sections is constructed. With the comprehensive index composed of connection and integration, the accessibility and network operation efficiency of the railway network in different time periods is calculated, while the fairness of the network is analyzed by the fairness indicators constructed with the integration and location entropy from the perspective of horizontal and vertical fairness respectively. From the analysis of the efficiency and fairness of the railway passenger transport network, the study finds: (1) There is a strong regularity in regional system accessibility change; (2) The problems of efficiency and fairness are different in different time periods; (3) The improvement of efficiency will lead to the decline of horizontal fairness to a certain extent, while from the perspective of vertical fairness, the supply-demand situation has changed smoothly with time; (4) The network connection efficiency of Shanghai, Jiangsu and Zhejiang regions is higher than that of the western regions such as Anqing and Chizhou; (5) The marginalization of Nantong, Yancheng, Yangzhou, Taizhou is obvious. The study explores the application of spatial syntactic theory in regional traffic analysis, in order to provide a reference for the development of urban agglomeration transportation network.

Keywords: spatial syntax, the Yangtze River Delta, railway passenger time, efficiency and fairness

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Authors: Modi Alsubaie, Chris Dickens, Barnaby Dunn, Andy Gibson, Obioha Ukoumunned, Alison Evans, Rachael Vicary, Manish Gandhi, Willem Kuyken

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Background: Depression co-occurs in 20% of people with cardiovascular disorders, can persist for years and predicts worse physical health outcomes. While psychosocial treatments have been shown to effectively treat acute depression in those with comorbid cardiovascular disorders, to date there has been no evaluation of approaches aiming to prevent relapse and treat residual depression symptoms in this group. Therefore, the current study aimed to examine the feasibility and acceptability of a randomised controlled trial design evaluating an adapted version of mindfulness-based cognitive therapy (MBCT) designed specifically for people with co-morbid depression and cardiovascular disorders. Methods: A 3-arm feasibility randomised controlled trial was conducted, comparing MBCT adapted for people with cardiovascular disorders plus treatment as usual (TAU), mindfulness-based stress reduction (MBSR) plus TAU, and TAU alone. Participants completed a set of self-report measures of depression severity, anxiety, quality of life, illness perceptions, mindfulness, self-compassion and affect and had their blood pressure taken immediately before, immediately after, and three months following the intervention. Those in the adapted-MBCT arm additionally underwent a qualitative interview to gather their views about the adapted intervention. Results: 3400 potentially eligible participants were approached when attending an outpatient appointment at a cardiology clinic or via a GP letter following a case note search. 242 (7.1%) were interested in taking part, 59 (1.7%) were screened as being suitable, and 33 (<1%) were eventually randomised to the three groups. The sample was heterogeneous in terms of whether they reported current depression or had a history of depression and the time since the onset of cardiovascular disease (one to 25 years). Of 11 participants randomised to adapted MBCT seven completed the full course, levels of home mindfulness practice were high, and positive qualitative feedback about the intervention was given. Twenty-nine out of 33 participants randomised completed all the assessment measures at all three-time points. With regards to the primary outcome (depression), five out of the seven people who completed the adapted MBCT and three out of five under MBSR showed significant clinical change, while in TAU no one showed any clinical change at the three-month follow-up. Conclusions: The adapted MBCT intervention was feasible and acceptable to participants. However, aspects of the trial design were not feasible. In particular, low recruitment rates were achieved, and there was a high withdrawal rate between screening and randomisation. Moreover, the heterogeneity in the sample was high meaning the adapted intervention was unlikely to be well tailored to all participants needs. This suggests that if the decision is made to move to a definitive trial, study recruitment procedures will need to be revised to more successfully recruit a target sample that optimally matches the adapted intervention.

Keywords: mindfulness-based cognitive therapy (MBCT), depression, cardiovascular disorders, feasibility, acceptability

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Authors: Wissam Saliba, Mandy Nicholson

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Secretory carcinoma (SC) is a rare type of salivary gland cancer. It was first realized as a distinct type of malignancy in 2010and wasinitially termed “mammary analogue secretory carcinoma” because of similarities with secretory breast cancer. The name was later changed to SC. Most SCs originate in parotid glands, and most harbour a rare gene mutation: ETV6-NTRK3. This mutation is rare in common cancers and common in rare cancers; it is present in most secretory carcinomas. Disease outcomes for SC are usually described as favourable as many cases of SC are lowgrade (LG), and cancer growth is slow. In early stages, localized therapy is usually indicated (surgery and/or radiation). Despitea favourable prognosis, a sub-set of casescan be much more aggressive.These cases tend to be of high-grade(HG).HG casesare associated with a poorer prognosis.Management of such cases can be challenging due to limited evidence for effective systemic therapy options. This case report describes the clinical management of a 46-year-oldmale patient with a unique case of SC. He was initially diagnosed with a low/intermediate grade carcinoma of the left parotid gland in 2009; he was treated with surgery and adjuvant radiation. Surgical pathology favoured primary salivary adenocarcinoma, and 2 lymph nodes were positive for malignancy. SC was not yet realized as a distinct type of cancerat the time of diagnosis, and the pathology reportvalidated this gap by stating that the specimen lacked features of the defined types of salivary carcinoma.Slow-growing pulmonary nodules were identified in 2017. In 2020, approximately 11 years after the initial diagnosis, the patient presented with malignant pleural effusion. Pathology from a pleural biopsy was consistent with metastatic poorly differentiated cancer of likely parotid origin, likely mammary analogue secretory carcinoma. The specimen was sent for Next Generation Sequencing (NGS); ETV6-NTRK3 gene fusion was confirmed, and systemic therapy was initiated.One cycle ofcarboplatin/paclitaxel was given in June 2020. He was switched to Larotrectinib (NTRK inhibitor (NTRKi)) later that month. Larotrectinib continued for approximately 9 months, with discontinuation in March 2021 due to disease progression. A second-generation NTRKi (Selitrectinib) was accessed and prescribedthrough a single patient study. Selitrectinib was well tolerated. The patient experienced a complete radiological response within~4 months. Disease progression occurred once again in October 2021. Progression was slow, and Selitrectinib continuedwhile the medical team performed a thorough search for additional treatment options. In January 2022, a liver lesion biopsy was performed, and NGS showed an NTRKG623R solvent-front resistance mutation. Various treatment pathways were considered. The patient pursuedanother investigational NTRKi through a clinical trial, and Selitrectinib was discontinued in July 2022. Excellent performance status was maintained throughout the entire course of treatment.It can be concluded that NTRK inhibitors provided satisfactory treatment efficacy and tolerance for this patient with high-grade transformation and NTRK gene fusion cancer. In the future, more clinical research is needed on systemic treatment options for high-grade transformations in NTRK gene fusion SCs.

Keywords: secretory carcinoma, high-grade transformations, NTRK gene fusion, NTRK inhibitor

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