Search results for: significant risk factors in megaprojects

Authors: Ahmed Ghachem, Denis Prud’homme, Rémi-Rabasa-Lhoret, M. Brochu

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Objective: To compare the effects of a CR on body composition, lipid profile and glucose homeostasis in obese postmenopausal women with and without MetS. Methods: Secondary analyses were performed on seventy-three inactive obese postmenopausal women (age: 57.7 ± 4.8 yrs; body mass index: 32.4 ± 4.6 kg/m2) who participated in the 6-month caloric restriction arm of a study of the Montreal-Ottawa New Emerging Team. The harmonized MetS definition was used to categorized participants with MetS [n = 20, 27.39%] and without MetS [n = 53, 72.61%]. Variables of interest were: body composition (DXA), body fat distribution (CT scan), glucose homeostasis at the fasting state and during a euglycemic/hyperinsulinemic clamp, fasting lipids and resting blood pressure. Results: By design, the MetS group had a worse cardiometabolic profile; while both groups were comparable for age. Fifty-five patients out of seventy-three displayed no change in MetS status after the intervention. Twelve participants out of twenty (or 60.0%) in the MetS group had no more MetS after weight loss (P= NS); while six participants out of fifty three (or 11.3%) in the other group developed the MetS after the intervention (P= NS). Overall, indices of body composition and body fat distribution improved significantly and similarly in both groups (P between 0.03 and 0.0001). Furthermore, with the exception of triglyceride levels and triglycerides/HDL-C ratio, which decrease significantly more in the MetS group (P ≤ 0.05), no difference was observed between groups for the other variables of the cardiometabolic profile. Conclusion: Despite no overall significant effects on MetS, heterogeneous results were obtained in response to weight loss in the present study; with some improving the MetS while other displaying deteriorations. Further studies are needed in order to identify factors and phenotypes associated with positive and negative cardiometabolic responses to CR intervention.

Keywords: menopause, obesity, physical inactivity, metabolic syndrome, caloric restriction, weight loss

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Authors: Jiandong Ren, Lijun Zhao, Peng Chen

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Nafamostat (NA), a synthetic broad-spectrum serine protease inhibitor, has been routinely employed for the treatment of acute pancreatitis (AP) and other inflammatory-associated diseases in some East Asia countries. Although the potent inhibitory activity against inflammation-related proteases such as thrombin, trypsin, kallikrein, plasmin, coagulation factors and complement factors is generally considered to be responsible for the anti-inflammatory effects of NA, precise target and molecular mechanism underlying the anti-inflammatory activity in the treatment of AP remain largely unknown yet. As an intracellular inflammatory signaling platform, the NOD-like receptor protein 3 (NLRP3) inflammasome is recently identified to be involved in the development of AP. In present study, we have revealed that NA alleviated pancreatic injury in a caerulein-induced AP model by inhibiting the NLRP3 inflammasome activation in pancreas. Mechanistically, NA interacted with HDAC6, a cytoplasmic deacetylase implicated in the NLRP3 inflammasome pathway, and efficiently abrogated the function of HDAC6. This property enabled NA to influence HDAC6 dependent NF-κB transcriptional activity and thus block NF-κB-driven transcriptional priming of NLRP3 inflammasome. Moreover, NA exerted the potential to interfere HDAC6-mediated intracellular transport of NLRP3, thereby leading to the failure of NLRP3 inflammasome activation. Our current work has provided valuable insight into the molecular mechanism underlying the immunomodulatory effect of NA in treatment of AP, highlighting its promising application in prevention of NLRP3 inflammasome-associated inflammatory pathological damage.

Keywords: acute pancreatitis, HDAC6, nafamostat, NLRP3 inflammasome

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Authors: Valentin Nicorescu, Nicoleta C. Predescu, Camelia Papuc, Iuliana Gajaila, Carmen D. Petcu

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The oxidation of the fresh muscle oxymyoglobin (bright red colour) to metmyoglobin (brown colour) leads to discoloration of red meats. After slaughter, enzymatic systems involved in metmyoglobin reduction are continually depleted as time post-mortem progresses, thus the meat colour is affected. Phenolic compounds are able to scavenge reactive species involved in oxymyoglobin oxidation and to reduce metmyoglobin to oxymyoglobin. The aim of this study was to investigate the effect of polyphenols extracted from hawthorn fruits on the stability of oxymyoglobin and myofibrillar proteins in ground pork subject to refrigeration for 6 days. Hawthorn polyphenols (HP) were added in ground pork in 100, 200 and 300 ppm concentrations. Oxymyoglobin and metmyoglobin were evaluated spectrophotometrically at every 2 days and electrophoretic pattern of myofibrillar proteins was investigated at days 0 and 6 by Sodium Dodecyl Sulfate Polyacrylamide Gel Electrophoresis (SDS-PAGE). For all meat samples, oxymyoglobin concentration significantly decreased during the first 4 days of refrigeration. After 6 days, the significant decrease of oxymyoglobin concentration continued only in the negative control samples. In samples treated with HP and butylated hydroxylanisole (BHA - positive control), oxymyoglobin concentration increased after 6 days of refrigeration, the highest levels complying with the following order: 100 ppm HP > 200 ppm HP > 300 ppm HP > 100 ppm BHA. The increase in metmyoglobin was coincidental with the decrease in oxymyoglobin; metmyoglobin concentration progressively increased during the first 4 days of refrigeration in all meat samples. After 6 days, in meat samples treated with HP and BHA, lower metmyoglobin concentrations were found (compared to day 4), respecting the following order: 100 ppm HP < 200 ppm HP < 300 ppm HP < 100 ppm BHA. These results showed that hawthorn polyphenols and BHA reduced metmyoglobin (MbFe3+) to oxymyoglobin (MbFe2+), and the strongest reducing character was recorded for 100 ppm HP. After 6 days of refrigeration, electrophoretic pattern of myofibrillar proteins showed minor changes compared to day 0, indicating that HP prevent protein degradation as well as synthetic antioxidant BHA. Also, HP did not induce cross-links in the myofibrillar proteins, to form protein aggregates, and no risk of reducing their ability to retain water was identified. The pattern of oxymyoglobin and metmyoglobin concentrations determined in this study showed that hawthorn polyphenols are able to reduce metmyoglobin to oxymyoglobin and to delay oxymyoglobin oxidation, especially when they are added to ground meat in concentration of 100 ppm. This work was carried out through Partnerships in priority areas Program – PN II, implemented with the support of MEN – UEFISCDI (Romania), project nr. 149/2014.

Keywords: Hawthorn polyphenols, metmyoglobin, oxymyoglobin, proteins stability

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Authors: Mahnaz Seyedoshohadaee

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Background and Aims: Hospitalization of one of the family members in the hospital, especially in the emergency department, causes anxiety and psychological problems in family members and others. The way nurses interact with patients and their companions can play an important role in controlling and managing their anxiety. This study aims to determine the relationship between the anxiety of family members of patients referring to emergency departments and their views on the communication skills of nurses. Materials and Methods: The current research was a descriptive-correlation cross-sectional study on 263 family members of patients referred to the department. The emergency of two selected medical training centers affiliated with Iran University of Medical Sciences was performed. The samples were selected continuously in 2018 based on the inclusion criteria. Information was collected using the Health Communication Questionnaire (HCCQ) and Beck Anxiety Questionnaire (BAI). To analyze the data, Pearson's correlation coefficient, independent t-tests, analysis of variance, and Kruskal-Wallis were used at a significance level of 0.05. The data was analyzed using SPSS version 16 statistical software. Results: The mean score of communication skills of emergency department nurses from the point of view of patients' companions was at a low level (74.36 with a standard deviation of 3.7). 3.75% of patients' companions had anxiety at a mild level. There was no statistically significant correlation between the anxieties of the patient's companions. The anxiety of the patient's companions had a statistically significant relationship with the educational level (P=0.039), economic status (P=0.033), and family relationship with the patient (P=0.001). Also, the average anxiety score in children was significantly higher than that of patients' wives (P=0.008). The triage level of the patient also had a statistically significant relationship with the anxiety of the patient's companions (P>0.001). Conclusion: Most of the family members of the patients referred to the emergency room experienced mild anxiety. Also, from their point of view, the communication skills of emergency nurses were at a weak level. Despite the fact that there was no statistically significant relationship between the patient's family member's anxiety and their opinion about nurses' communication skills in this study, it seems that the weak communication skills of nurses from the patient's family member's point of view need special attention. The results of the present study can provide the necessary grounds for planning to improve the communication skills of nurses and also control the anxiety of patient caregivers through in-service training or other incentive mechanisms.

Keywords: anxiety, family, emergency department, communication skills, nurse

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Authors: V. V. Lakshmi, Y. V. S. Annapurna

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Urinary tract infection (UTI) is one of the most common infectious diseases seen in the community. Susceptible individuals experience multiple episodes, and progress to acute pyelonephritis or uro-sepsis or develop asymptomatic bacteriuria (ABU). Ability to cause extraintestinal infections depends on several virulence factors required for survival at extraintestinal sites. Presence of virulence phenotypes enhances the pathogenicity of these otherwise commensal organisms and thus augments its ability to cause extraintestinal infections, the most frequent in urinary tract infections(UTI). The present study focuses on detection of the virulence characters exhibited by the uropathogenic organism and most common factors exhibited in the local pathogens. A total of 700 isolates of E.coli and Klebsiella spp were included in the study. These were isolated from patients from local hospitals reported to be suffering with UTI over a period of three years. Isolation and identification was done based on Gram character and IMVIC reactions. Antibiotic sensitivity profile was carried out by disc diffusion method and multi drug resistant strains with MAR index of 0.7 were further selected.. Virulence features examined included their ability to produce exopolysaccharides, protease- gelatinase production, hemolysin production, haemagglutination and hydrophobicity test. Exopolysaccharide production was most predominant virulence feature among the isolates when checked by congo red method. The biofilms production examined by microtitre plates using ELISA reader confirmed that this is the major factor contributing to virulencity of the pathogens followed by hemolysin production

Keywords: Escherichia coli, Klebsiella sp, Uropathogens, Virulence features.

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Authors: Shivayogi Charantimath

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Radiotherapy and chemotherapy are effective for treating malignancies but are associated with side effects like oral mucositis. Chlorhexidine gluconate is one of the most commonly used mouthwash in prevention of signs and symptoms of mucositis. Evidence shows that chlorhexidine gluconate has side effects in terms of colonization of bacteria, bad breadth and less healing properties. Thus, it is essential to find a suitable alternative therapy which is more effective with minimal side effects. Curcumin, an extract of turmeric is gradually being studied for its wide-ranging therapeutic properties such as antioxidant, analgesic, anti-inflammatory, antitumor, antimicrobial, antiseptic, chemo sensitizing and radio sensitizing properties. The present study was conducted to evaluate the efficacy and safety of topical curcumin gel on radio-chemotherapy induced oral mucositis in cancer patients. The aim of the study is to evaluate the efficacy and safety of curcumin gel in the management of oral mucositis in cancer patients undergoing radio chemotherapy and compare with chlorhexidine. The study was conducted in K.L.E. Society’s Belgaum cancer hospital. 40 oral cancer patients undergoing the radiochemotheraphy with oral mucositis was selected and randomly divided into two groups of 20 each. The study group A [20 patients] was advised Cure next gel for 2 weeks. The control group B [20 patients] was advised chlorhexidine gel for 2 weeks. The NRS, Oral Mucositis Assessment scale and WHO mucositis scale were used to determine the grading. The results obtained were calculated by using SPSS 20 software. The comparison of grading was done by applying Mann-Whitney U test and intergroup comparison was calculated by Wilcoxon matched pairs test. The NRS scores observed from baseline to 1^st and 2^nd week follow up in both the group showed significant difference. The percentage of change in erythema in respect to group A was 63.3% for first week and for second week, changes were 100.0% with p = 0.0003. The changes in Group A in respect to erythema was 34.6% for 1^st week and 57.7% in second week. The intergroup comparison was significant with p value of 0.0048 and 0.0006 in relation to group A and group B respectively. The size of the ulcer score was measured which showed 35.5% [P=0.0010] of change in Group A for 1^st and 2^nd week showed totally reduction i.e. 103.4% [P=0.0001]. Group B showed 24.7% change from baseline to 1^st week and 53.6% for 2^nd week follow up. The intergroup comparison with Wilcoxon matched pair test was significant with p=0.0001 in group A. The result obtained by WHO mucositis score in respect to group A shows 29.6% [p=0.0004] change in first week and 75.0% [p=0.0180] change in second week which is highly significant in comparison to group B. Group B showed minimum changes i.e. 20.1% in 1^st week and 33.3% in 2^nd week. The p value with Wilcoxon was significant with 0.0025 in Group A for 1^st week follow up and 0.000 for 2^nd week follow up. Curcumin gel appears to an effective and safer alternative to chlorhexidine gel in treatment of oral mucositis.

Keywords: curcumin, chemotheraphy, mucositis, radiotheraphy

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Authors: Qian Sun, Dannie Dai, Vivian Lou

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Background: Changes in population structure and modernization have left traditional channels of achieving intergenerational solidarity in crisis. Policies and projects purposefully structuring intergenerational interaction are regarded as effective ways to enhance positive attitude changes between generations. However, few inter-generational interaction program has put equal emphasis on promoting positive changes on both attitude and behavior across generational groups. Objective: This study evaluated the effectiveness of an intergenerational interaction program which aims to facilitate positive attitude and behavioral interaction between both young and old individuals in Hong Kong. Method: A quasi-experimental design was adopted with the sample of 150 older participants and 161 young participants. Among 73 older and 78 young participants belong to experiment groups while 77 older participants and 84 young participants belong to control groups. The Age Group Evaluation and Description scale (AGED) was adopted to measure attitude toward young people by older participants and the Chinese version of Kogan’s Attitude towards Older People (KAOP) as well as Polizzi’s refined version of the Ageing Semantic Differential Scale (ASD) were used to measure attitude toward older people by the younger generation. The interpersonal behaviour of participants was assessed using Beglgrave’s behavioural observation tool. Six primary verbal or non-verbal interpersonal behaviours including smiles, looks, touches, encourages, initiated conversations and assists were identified and observed. Findings Effectiveness of attitude and behavior changes on both younger and older participants was confirmed in results. Compared with participants from the control group, experimental participants of elderly showed significant positive changes of attitudes toward the younger generation as assessed by AGED (F=138.34, p < .001). Moreover, older participants showed significant positive changes on three out of six behaviours (visual attention: t=2.26, p<0.05; initiate conversation: t=3.42, p<0.01; and touch: t=2.28, p<0.05). For younger participants, participants from experimental group showed significant positive changes in attitude toward older people (with F-score of 47.22 for KAOP and 72.75 for ASD, p<.001). Young participants also showed significant positive changes in two out of six behaviours (visual attention: t=3.70, p<0.01; initiate conversation: t=2.04, p<0.001). There is no significant relationship between attitude change and behaviour change in both older (p=0.86) and younger (p=0.22) groups. Conclusion: This study has brought practical implications for social work. The effective model of this program could assist social workers and allied professionals to design relevant projects for nurture intergenerational solidarity. Furthermore, insignificant results between attitude and behavior changes revealed that attitude change was not a strong predictor for behavior change, hence, intergenerational programs against age-stereotype should put equal emphasis on both attitudinal and behavioral aspects.

Keywords: attitude and behaviour changes, intergenerational interaction, intergenerational solidarity, program design

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Authors: Jae-Hyun Choi, Sung-Soo Bae, Sangyoung Yoon, Hong-Ku Yun, Jiyoung Kwahk

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This study was conducted to investigate the effect of ocular dominance on recognition performance using a single-lens smart display designed for cycling. A total of 36 bicycle riders who have been cycling consistently were recruited and participated in the experiment. The participants were asked to perform tasks riding a bicycle on a stationary stand for safety reasons. Independent variables of interest include ocular dominance, bike usage, age group, and information layout. Recognition time (i.e., the time required to identify specific information measured with an eye-tracker), error rate (i.e. false answer or failure to identify the information in 5 seconds), and user preference scores were measured and statistical tests were conducted to identify significant results. Recognition time and error ratio showed significant difference by ocular dominance factor, while the preference score did not. Recognition time was faster when the single-lens see-through display on the dominant eye (average 1.12sec) than on the non-dominant eye (average 1.38sec). Error ratio of the information recognition task was significantly lower when the see-through display was worn on the dominant eye (average 4.86%) than on the non-dominant eye (average 14.04%). The interaction effect of ocular dominance and age group was significant with respect to recognition time and error ratio. The recognition time of the users in their 40s was significantly longer than the other age groups when the display was placed on the non-dominant eye, while no difference was observed on the dominant eye. Error ratio also showed the same pattern. Although no difference was observed for the main effect of ocular dominance and bike usage, the interaction effect between the two variables was significant with respect to preference score. Preference score of daily bike users was higher when the display was placed on the dominant eye, whereas participants who use bikes for leisure purposes showed the opposite preference patterns. It was found more effective and efficient to wear a see-through display on the dominant eye than on the non-dominant eye, although user preference was not affected by ocular dominance. It is recommended to wear a see-through display on the dominant eye since it is safer by helping the user recognize the presented information faster and more accurately, even if the user may not notice the difference.

Keywords: eye tracking, information recognition, ocular dominance, smart headware, wearable device

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Authors: Rashidah Ghazali, Herlina Abdul Rahim, Mashitah Shikh Maidin, Shafishuhaza Sahlan, Noramli Abdul Razak

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Sound exposure effects have been investigated by broadcasting a group of broilers with sound of Quran verses (Group B) whereas the other group is the control broilers (Group C). The growth rate comparisons in terms of weight and raw meat texture measured by shear force have been investigated. Twenty-seven broilers were randomly selected from each group on Day 24 and weight measurement was carried out every week till the harvest day (Day 39). Group B showed a higher mean weight on Day 24 (1.441±0.013 kg) than Group C. Significant difference in the weight on Day 39 existed for Group B compared to Group C (p< 0.05). However, there was no significant (p> 0.05) difference of shear force in the same muscles (breast and drumstick raw meat) of both groups but the shear force of the breast meat for Group B and C broilers was lower (p < 0.05) than that of their drumstick meat. Thus, broadcasting the sound of Quran verses in the coop can be applied to improve the growth rate of broilers for producing better quality poultry.

Keywords: broilers, sound, shear force, weight

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Authors: Nafiseh Noormohammadi, Ahmad Sobhani Najafabadi

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Hypericins (hypericin and pseudohypericin) are natural napthodianthrone derivatives produced by Hypericum perforatum (St. John’s Wort), which have many medicinal properties such as antitumor, antineoplastic, antiviral, and antidepressant activities. Production and accumulation of hypericin in the plant are influenced by both genetic and environmental conditions. Despite the existence of different high-throughput data on the plant, genetic dimensions of hypericin biosynthesis have not yet been completely understood. In this research, 21 high-quality RNA-seq data on different parts of the plant were integrated into metabolic data to reconstruct a coexpression network. Results showed that a cluster of 30 transcripts was correlated with total hypericin. The identified transcripts were divided into three main groups based on their functions, including hypericin biosynthesis genes, transporters, detoxification genes, and transcription factors (TFs). In the biosynthetic group, different isoforms of polyketide synthase (PKSs) and phenolic oxidative coupling proteins (POCPs) were identified. Phylogenetic analysis of protein sequences integrated into gene expression analysis showed that some of the POCPs seem to be very important in the biosynthetic pathway of hypericin. In the TFs group, six TFs were correlated with total hypericin. qPCR analysis of these six TFs confirmed that three of them were highly correlated. The identified genes in this research are a rich resource for further studies on the molecular breeding of H. perforatum in order to obtain varieties with high hypericin production.

Keywords: hypericin, St. John’s Wort, data mining, transcription factors, secondary metabolites

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Authors: Bo Yan, Amy Y. M. Chow

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Bereavement is recognized as a universal challenging experience. It is important to gather research evidence on protective factors in bereavement. Hope is considered as one of the protective factors in previous coping studies. The present study aims to add knowledge by investigating hope at the first month after death to predict psychological symptoms altogether including complicated grief (CG), anxiety, and depressive symptoms at the seventh month. The data were collected via one-on-one interview survey in a longitudinal project with Hong Kong hospice users (sample size 105). Most participants were at their middle age (49-year-old on average), female (72%), with no religious affiliation (58%). Bayesian Structural Equation Modeling (BSEM) analysis was conducted on the longitudinal dataset. The BSEM findings show that hope at the first month of bereavement negatively predicts both CG and anxiety symptoms at the seventh month but not for depressive symptoms. Age and gender are controlled in the model. The overall model fit is good. The current study findings suggest assessing hope at the first month of bereavement. Hope at the first month after the loss is identified as an excellent predictor for complicated grief and anxiety symptoms at the seventh month. The result from this sample is clear, so it encourages cross-cultural research on replicated modeling and development of further clinical application. Particularly, practical consideration for early intervention to increase the level of hope has the potential to reduce the psychological symptoms and thus to improve the bereaved persons’ wellbeing in the long run.

Keywords: anxiety, complicated grief, depressive symptoms, hope, structural equational modeling

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Authors: Oti Ibiam, Alexanda O. Kalu

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Human Resource Accounting is the process of identifying and measuring data about human resources and communicating this information to interested parties in order to meaningful investment decisions. In recent time, firms focus has shifted to human resource accounting so as to ensure efficiency and effectiveness in their operations. This study focused on the effect of human resource accounting on the financial performance of Banks in Nigerian. The problem that led to the study revolves around the current trend whereby Nigeria banks do not efficiently account for the input of human resource in their annual statement, thereby instead of capitalizing human resources in their statement of financial position; they expend it in their income statement thereby reducing their profit after tax. The broad objective of this study is to determine the extent to which human resource accounting affects the financial performance and value of Nigerian Banks. This study is therefore considered significant because, there are still universally, grey areas to be sorted out on the subject matter of human resources accounting. In the bid to achieve the study objectives, the researcher gathered data from sixteen commercial banks. Data were collected from both primary and secondary sources using an ex-post facto research design. The data collected were then tabulated and analyzed using the multiple regression analysis. The result of hypothesis one revealed that there is a significant relationship between Capitalized Human Resource Cost and post capitalization Profit before tax of banks in Nigeria. The finding of hypothesis two revealed that the association between Capitalized Human Resource Cost and post capitalization Net worth of banks in Nigeria is significant. The finding in Hypothesis three reveals that there is a significant difference between pre and post capitalization profit before tax of banks in Nigeria. The study concludes that human resources accounting positively influenced financial performance of banks in Nigeria within the period under study. It is recommended that standards should be set for human resources identification and measurement in the banking sector and also the management of commercial banks in Nigeria should have a proper appreciation of human resource accounting. This will enable managers to take right decision regarding investment in human resource. Also, the study recommends that policies on enhancing the post capitalization profit before tax of banks in Nigeria should pay great attention to capitalized human resources cost, net worth and total asset as the variables significantly influenced post capitalization profit before tax of the studied banks in Nigeria. The limitation of the study centers on the limited number of years and companies that was adopted for the study.

Keywords: capitalization, human resources cost, profit before tax, net worth

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Authors: Farah Syazwani Hilmy Zaki

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Background: Compared to adult cardiopulmonary resuscitation (CPR), high-quality research and evidence on pediatric CPR remain relatively scarce. This knowledge gap hinders the development of optimal guidelines and best practices for resuscitating children. Objectives: To explore pediatric intensive care unit (PICU) CPR current practices in PICU of Institut Jantung Negara (IJN) Malaysia. Method: The research employed a qualitative approach, utilising case study research design. The data collection process involved in-depth interviews and reviewing the Resuscitation Feedback Form. Purposive sampling was used to select two cases consisting of 14 participants. The study participants comprised a cardiologist, one anaesthetist, and twelve nurses. The data collected were transcribed and entered into NVivo software to facilitate theme development. Subsequently, thematic analysis was conducted to analyse the data. Findings: The study yielded key findings regarding the enhancement of PICU CPR practices. These findings are categorised into four themes, namely routine procedures, resuscitation techniques, team dynamics, and individual contributions. Establishment of cohesive team is crucial in facilitating the effectiveness of resuscitation. According to participants, lack of confidence, skills and knowledge presents significant obstacles to effective PICU CPR. Conclusion: The findings of this study indicate that the participants express satisfaction with the current practices of PICU CPR. However, the research also highlights the need for enhancements in various areas, including routine procedures, resuscitation techniques, as well as team and individual factors. Furthermore, it was suggested that additional training be conducted on the resuscitation process to enhance the preparedness of the medical team.

Keywords: cardiopulmonary resuscitation, feedback, nurses, pediatric intensive care unit

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Authors: Mehwish Sarfaraz Ahmad

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Background: There is a prevailing perception in Pakistan that private hospitals offer better services than government hospitals. Unfortunately, Pakistan faces challenges in providing efficient healthcare due to limited resources and management capabilities, resulting in demotivation among healthcare workers. Aim: The purpose of this study was to conduct a comprehensive assessment of the occupational health and well-being of healthcare workers in both public and private sector tertiary care hospitals in Lahore, Pakistan, to compare the well-being of healthcare professionals in these two sectors and investigate the influence of workplace culture and experiences on their overall health. Methods: A cross-sectional study was conducted using a validated International Questionnaire, and data from 440 participants was collected using a stratified random sampling technique from a diverse group of healthcare professionals from the public and private tertiary care hospitals in Lahore, Pakistan. The researcher conducted a comparative analysis using appropriate statistical tests, such as Anova, t-tests, chi-square tests, and regression analysis, to explore potential relationships between various factors. Results: The majority of respondents (70.2%) reported their health as "Good" or "Very good, a small percentage (8.2%) rated their health as "Poor," while 24.1% considered their health as "Fair". 39.6% reported being satisfied with their workplace culture, while a majority of 60.4% indicated being unsatisfied with their workplace culture. Results showed that workplace culture has a positive correlation with the overall health and well-being of healthcare professionals. The study found significant differences in health ratings, prevalence of chronic health conditions, workplace culture, and safety perceptions between healthcare professionals in public and private sector tertiary care hospitals. Conclusion: The study's findings emphasize the significance of promoting a positive workplace culture, ensuring workplace safety, and addressing chronic health conditions among healthcare workers.

Keywords: occupational health and well-being, workplace culture, frequency of fatigue, availabity of benefits

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Authors: Zahra Tork

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Before the spread of the Internet and the use of mobile phones, women were generally far from society and many restrictions were applied to them, but after the spread of the Internet and the cultural and social changes brought about by it, women in society got a new one and many restrictions regarding them disappeared; As we can see today, many women, like men, have a high social base, they earn for themselves, they can travel alone, stay out late at night, take personal and family photos or videos on virtual pages. Publish themselves (while before this, showing or publishing photos of women was considered dishonorable or indecent). In this article, an attempt is made to examine the effect of the internet on mobile phones and virtual social networks in changing beliefs, norms and social values and their relationship with the social mobility of women and the effect of these factors on social and human development be paid. For this reason, social and human development is discussed first, and then the role of the media in development is explained, and finally, the social mobility of women is discussed. Since the purpose of this study is to better understand the social mobility of Iranian women through the development of the Internet in mobile phones, a qualitative study using focus groups has been adopted. The results of this research indicated that the Internet has caused changes in the value and cultural system of the Iranian people, and women have also redefined their roles and identity. In this new definition, many of the past restrictions have disappeared and women have gained the same freedoms as men. Finally, these factors (change in values and norms and redefinition of the role of women) joined hands and caused the social mobility of women in Iran.

Keywords: development of communication in Iran, development of mobile phones, development of the Internet, women's social group, social mobility

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Authors: Ahmad A. Kader

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In the principles of Microeconomics course taught during the Fall Semester 2019, 158out of 179 students participated in the completion of two questionnaires and a survey describing their demographic and academic profiles. The two questionnaires include the 29 items of the Rotter Locus of Control Scale and the 52 items of the Schraw andDennisonMetacognitive Awareness Scale. The 52 items consist of 17 items describing knowledge of cognition and 37 items describing the regulation of cognition. The paper is intended to show the combined influence of locus of control, metacognitive knowledge, and metacognitive regulation on student performance. The survey covers variables that have been tested and recognized in economic education literature, which include GPA, gender, age, course level, race, student classification, whether the course was required or elective, employments, whether a high school economic course was taken, and attendance. Regression results show that of the economic education variables, GPA, classification, whether the course was required or elective, and attendance are the only significant variables in their influence on student grade. Of the educational psychology variables, the regression results show that the locus of control variable has a negative and significant effect, while the metacognitive knowledge variable has a positive and significant effect on student grade. Also, the adjusted R square value increased markedly with the addition of the locus of control, metacognitive knowledge, and metacognitive regulation variables to the regression equation. The t test results also show that students who are internally oriented and are high on the metacognitive knowledge scale significantly outperform students who are externally oriented and are low on the metacognitive knowledge scale. The implication of these results for educators is discussed in the paper.

Keywords: locus of control, metacognitive knowledge, metacognitive regulation, student performance, economic education

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Authors: Martina Santobuono, Wing Sze Chan, Elettra D'Amico, Henriette Selck

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Chemicals in modern society are fundamental in many different aspects of daily human life. We use a wide range of substances, including polychlorinated compounds, pesticides, plasticizers, and pharmaceuticals, to name a few. These compounds are excessively produced, and this has led to their introduction to the environment and food resources. Municipal and industrial effluents, landfills, and agricultural runoffs are a few examples of sources of chemical pollution. Many of these compounds, such as pharmaceuticals, have been proven to mimic or alter the performance of the hormone system, thus disrupting its normal function and altering the behavior and reproductive capability of non-target organisms. Antidepressants are pharmaceuticals commonly detected in the environment, usually in the range of ng L⁻¹ and µg L⁻¹. Since they are designed to have a biological effect at low concentrations, they might pose a risk to the native species, especially if exposure lasts for long periods. Hydrophobic antidepressants, like the selective serotonin reuptake inhibitor (SSRI) Sertraline, can sorb to the particles in the water column and eventually accumulate in the sediment compartment. Thus, deposit-feeding organisms may be at particular risk of exposure. The polychaete Capitella teleta is widespread in estuarine organically enriched sediments, being a key deposit-feeder involved in geochemistry processes happening in sediments. Since antidepressants are neurotoxic chemicals and endocrine disruptors, the aim of this work was to test if sediment-associated Sertraline impacts burrowing- and feeding behavior as well as reproduction capability in Capitella teleta in a chronic exposure set-up, which could better mimic what happens in the environment. 7 days old juveniles were selected and exposed to different concentrations of Sertraline for an entire generation until the mature stage was reached. This work was able to show that some concentrations of Sertraline altered growth and the time of first reproduction in Capitella teleta juveniles, potentially disrupting the population’s capability of survival. Acknowledgments: This Ph.D. position is part of the CHRONIC project “Chronic exposure scenarios driving environmental risks of Chemicals”, which is an Innovative Training Network (ITN) funded by the European Union’s Horizon 2020 research and innovation program under the Marie Sklodowska-Curie Actions (MSCA).

Keywords: antidepressants, Capitella teleta, chronic exposure, endocrine disruption, sublethal endpoints, neurotoxicity

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Authors: Mohammed Seid, Aklilu Azazh, Fikre Enquselassie, Engida Yisma

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Background: Road traffic injuries are the eighth leading cause of death globally, and the leading cause of death for young people. More than a million people die each year on the world’s roads, and the risk of dying as a result of a road traffic injury is highest in the Africa. Methods: A prospective hospital-based study was undertaken to assess injury characteristics and outcome of road traffic accident among victims at Adult Emergency Department of Tikur Anbesa specialized hospital, Addis Ababa, Ethiopia. A structured pre-tested questionnaire was used to gather the required data. The collected data were analyzed using SPSS version 16.0. Results: A total of 230 road traffic accident victims were studied. The majority of the study subjects were men 165 (71.7%) and the male/female ratio was 2.6:1. The victims’ ages ranged from 14 to 80 years with the mean and standard deviations of 32.15 and ± 14.38 years respectively. Daily laborers (95 (41.3%)) and students (28 (12.2%)) were the majority of road traffic accident victims. Long-distance travelling Minibus (16.5%) was responsible for the majority of road traffic crash followed by followed by Taxi (14.8%) and pedestrians (62.6%) accounted for the majority of road traffic accident. Head (50.4%) and musculoskeletal (extremities) (47.0%) were the most common body region injured. Fractures (78.0%) and open wounds (56.5%) were the most common type of injuries sustained. Treatment of fracture was the most common procedure performed in 57.7 % of the victims. The overall length of hospital stay (LOS) ranged from 1 day to 61 days with mean (± standard deviation) of 7.12 ± 10.5 days and the mortality rate was 7.4 %. A significant higher proportion of victims aged 14-55 years were had less likelihood of death compared to those victims aged more than 55 years of age [Adjusted OR = 0.1 (95% CI: 0.01, 0.82)]. Conclusions: This study showed diverse injury characteristics and high morbidity and mortality among the victims attending Adult Emergency Department of Tikur Anbesa specialized hospital, Addis Ababa, Ethiopia. The findings reflect that road traffic accident is a major public health problem. Urgent road traffic accident preventive measures and prompt treatment of the victims are warranted in order to reduce morbidity and mortality among the victims.

Keywords: road traffic accident, injury characteristics, outcome, Tikur Anbesa specialized hospital, Addis Ababa, Ethiopia

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Authors: Karen Koellner, Nanette Seago, Jennifer Jacobs, Helen Garnier

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Although studies of teacher professional development (PD) are prevalent, surprisingly most have only produced incremental shifts in teachers’ learning and their impact on students. There is a critical need to understand what teachers take up and use in their classroom practice after attending PD and why we often do not see greater changes in learning and practice. This paper is based on a mixed methods efficacy study of the Learning and Teaching Geometry (LTG) video-based mathematics professional development materials. The extent to which the materials produce a beneficial impact on teachers’ mathematics knowledge, classroom practices, and their students’ knowledge in the domain of geometry through a group-randomized experimental design are considered. Included is a close-up examination of a small group of teachers to better understand their interpretations of the workshops and their classroom uptake. The participants included 103 secondary mathematics teachers serving grades 6-12 from two US states in different regions. Randomization was conducted at the school level, with 23 schools and 49 teachers assigned to the treatment group and 18 schools and 54 teachers assigned to the comparison group. The case study examination included twelve treatment teachers. PD workshops for treatment teachers began in Summer 2016. Nine full days of professional development were offered to teachers, beginning with the one-week institute (Summer 2016) and four days of PD throughout the academic year. The same facilitator-led all of the workshops, after completing a facilitator preparation process that included a multi-faceted assessment of fidelity. The overall impact of the LTG PD program was assessed from multiple sources: two teacher content assessments, two PD embedded assessments, pre-post-post videotaped classroom observations, and student assessments. Additional data were collected from the case study teachers including additional videotaped classroom observations and interviews. Repeated measures ANOVA analyses were used to detect patterns of change in the treatment teachers’ content knowledge before and after completion of the LTG PD, relative to the comparison group. No significant effects were found across the two groups of teachers on the two teacher content assessments. Teachers were rated on the quality of their mathematics instruction captured in videotaped classroom observations using the Math in Common Observation Protocol. On average, teachers who attended the LTG PD intervention improved their ability to engage students in mathematical reasoning and to provide accurate, coherent, and well-justified mathematical content. In addition, the LTG PD intervention and instruction that engaged students in mathematical practices both positively and significantly predicted greater student knowledge gains. Teacher knowledge was not a significant predictor. Twelve treatment teachers self-selected to serve as case study teachers to provide additional videotapes in which they felt they were using something from the PD they learned and experienced. Project staff analyzed the videos, compared them to previous videos and interviewed the teachers regarding their uptake of the PD related to content knowledge, pedagogical knowledge and resources used. The full paper will include the case study of Ana to illustrate the factors involved in what teachers take up and use from participating in the LTG PD.

Keywords: geometry, mathematics professional development, pedagogical content knowledge, teacher learning

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Authors: Rafia Rafique, Arifa Khadim

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This research investigates the moderating role of job satisfaction between organizational learning and work performance among nurses. Correlation research design was used. Non-probability purposive sampling technique was utilized to recruit a sample of 110 nurses from public hospitals situated in the city of Lahore. The construct of organizational learning was measured using subscale of Integrated Scale for Measuring Organizational Learning. Job satisfaction was measured with the help of Job Satisfaction Survey. Performance of employees (task performance, contextual performance and counterproductive work behavior) was assessed by Individual Work Performance Questionnaire. Job satisfaction negatively moderates the relationship between organizational learning and counterproductive work behavior. Education has a significant positive relationship with organizational learning. Age, current hospital experience, marital satisfaction and salary of the nurses have positive relationship while number of children has significant negative relationship with counterproductive work behavior. These outcomes can be insightful in understanding the dynamics involved in work performance. Based on the result of this study relevant solutions can be proposed to improve the work performance of nurses.

Keywords: counterproductive work behavior, nurses, organizational learning, work performance

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Authors: Kholoud Abdelmaksoud, Mahmoud Emam, Wael Al-Metwaly

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Egypt is known as cradle of civilization due to its ancient history and archeological sites, but Egypt possess also a cradle of Geo-sites, which qualify it to be listed as one of the most important Geo-heritage sites all over the country. Geology and landscape in Abu-Roash area is considered as one of the most important geological places (geo-sites) inside Cairo which help us to know and understand geology and geologic processes, so the area is used mainly for geological education purposes, also the area contain an archeological sites; pyramid complex, tombs, and Coptic monastery which give the area unique importance. Abu-Roash area is located inside Cairo 9 km north of the Giza Pyramids, which make the accessibility to the area easy and safe, the geology of Abu-Roash constitutes a complex Cretaceous sedimentary succession mass with showing outstanding tectonic features (Syrian Arc system event), these features are considered as a Geo-heritage, which will be the main designation of ‘Geo-parks’ establishing. The research is dealing with the numerous geo-sites found in the area, and its geologic and archeological importance, the relation between geo-sites and archeology, also the research proposed a detailed maps for these sites depicting Geo-routes and the hazardous places surrounding Abu-Roash area. The research is proposing a new proposal not applied in Egypt before, establishing a Geo-park, to promote this unique geo-heritage from hazardous factors and anthropogenic effects, also it will offer geo-educational opportunities to the general public and to the scientific community, enhancement of Geo-tourism which will be linked easily with the Ancient Egyptian tourism, it will also provide a significant economic benefit to Abu-Roash residential area. Finally, the research recommends that The United Nations Educational, Scientific and Cultural Organizations promote conservation of geological and geo-morphological heritage to list this area for its importance under the umbrella of geo-parks.

Keywords: geo-park, geo-sites, Abu-roash, archaeological sites, geo-tourism

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Authors: Yusra Tariq

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The Grass 37 gene is presently known in tomatoes, which are the source of healthy substances such as ascorbic acid, polyphenols, carotenoids and nutrients. It has a significant impact on the growth and development of humans. The GRASS 37 gene is a plant Transcription factor group assuming significant parts in various reactions of different Abiotic stresses such as (drought, salinity, thermal stresses, temperature, and bright waves) which could highly affect the growth. Tomatoes are very sensitive to temperature, and their growth or production occurs optimally in a temperature range from 21 C to 29.5 C during the daytime and from 18.5 C to 21 C during the night. This protein acts as a positive regulator of salt stress response and abscisic acid signaling. This study summarizes the structure characterized by molecular formula and protein-binding domains by different bioinformatics tools such as Expasy translate tool, Expasy Portparam, Swiss Prot and Inter Pro Scan, Clustal W tool regulatory procedure of GRASS gene components, also their reactions to both biotic and Abiotic stresses.

Keywords: GRAS37, gene, bioinformatics, tool

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Authors: Shams Khaled Abdelrahman Abdallah Elbaz, Alaa Aldeen Abd Al Hakeem Balbaa

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Purpose: The purpose of this study was to compare the effects of Positional Release Technique versus Kinesio Tape on pain level, pressure pain threshold level and functional disability in patients with back myofascial pain syndrome at iliocostalis lumborum. Backgrounds/significance: Myofascial Pain Syndrome is a common muscular pain syndrome that arises from trigger points which are hyperirritable, painful and tender points within a taut band of skeletal muscle. In more recent literature, about 75% of patients with musculoskeletal pain presenting to a community medical centres suffer from myofascial pain syndrome.Iliocostalis lumborum are most likely to develop active trigger points. Subjects: Thirty patients diagnosed as back myofascial pain syndrome with active trigger points in iliocostalis lumborum muscle bilaterally had participated in this study. Methods and materials: Patients were randomly distributed into two groups. The first group consisted of 15 patients (8 males and 7 females) with mean age 30.6 (±3.08) years, they received positional release technique which was applied 3 times per session, 3/week every other day for 2 weeks. The second group consisted of 15 patients(5 males, 10 females) with a mean age 30.4 (±3.35) years, they received kinesio tape which was applied and changed every 3 days with one day off for a total 3 times in 2 weeks. Both techniques were applied over trigger points of the iliocostalis lumborum bilaterally. Patients were evaluated pretreatment and posttreatment program for Pain intensity (Visual analogue scale), pressure pain threshold (digital pressure algometry), and functional disability (The Oswestry Disability Index). Analyses: Repeated measures MANOVA was used to detect differences within and between groups pre and post treatment. Then the univariate ANOVA test was conducted for the analysis of each dependant variable within and between groups. All statistical analyses were done using SPSS. with significance level set at p<0.05 throughout all analyses. Results: The results revealed that there was no significant difference between positional release technique and kinesio tape technique on pain level, pressure pain threshold and functional activities (p > 0.05). Both groups of patients showed significant improvement in all the measured variables (p < 0.05) evident by significant reduction of both pain intensity and functional disability as well as significant increase of pressure pain threshold Conclusions : Both positional release technique and kinesio taping technique are effective in reducing pain level, improving pressure pain threshold and improving function in treating patients who suffering from back myofascial pain syndrome at iliocostalis lumborum. As there was no statistically significant difference was proven between both of them.

Keywords: positional release technique, kinesio tape, myofascial pain syndrome, Iliocostalis lumborum

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Authors: Dale Daniel G. Bodo

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This study investigated the status of the Laboratory Tools and Equipment of the BSHRT Program of Eastern Visayas State University, Tacloban City Campus. Descriptive-correlation method was used which Variables include profile age, gender, acquired NC II, competencies in HRT and the status of the laboratory facilities, tools, and equipment of the BSHRT program. The study also identified significant correlation between the profile of the respondents and the implementation of the BSHRT Program in terms of laboratory tools and equipment. A self-structured survey questionnaire was used to gather relevant data among eighty-seven (87) BSHRT-OJT students. To test the correlations of variables, Pearson Product Moment Coefficient Correlation or Pearson r was used. As a result, the study revealed very interesting results and various significant correlations among the paired variables and as to the implementation of the BSHRT Program. Hence, this study was done to update the status of laboratory tools and equipment of the program.

Keywords: status, BSHRT Program, laboratory tools and equipment, descriptive-correlation

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Authors: Rabia Qusien

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New media has emerged as a significant force in the society which connects people across the globe. Where new media brought many advantages for its users, there is a darker aspect of new technology in the form of cyberbullying. Researcher has employed survey method to reach to its targeted audience. Sample of 604 respondents was selected from one of metropolitan city of Pakistan Lahore to collect the data. Equal sample from both genders was selected to apply gender analysis. Results of this study indicate that cyber bullying is having significant psychological and educational effects. Females face more cyber bullying incidents as compared to males so they face more severe effects of cyber bullying. A comprehensive analysis of managing strategies depicts that mostly youth tries to handle this issue personally but at times they seek the support of their family and friends when they face severe issues. Due to privacy concerns females get more upset and they are more likely to seek social support from friends and family.

Keywords: cyber bullying, cyber victims, educational impacts, psychological impacts

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Authors: Oluremi I. Bamgbade, Oluwayomi Babatunde

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Governments and nonprofits have been in the support of sustainability as the goal of businesses especially in the construction industry because of its considerable impacts on the environment, economy, and society. However, to measure the degree to which an organisation is being sustainable or pursuing sustainable growth can be difficult as a result of the clear sustainability strategy required to assume their commitment to the goal and competitive advantage. This research investigated the influence of organisational culture and organisational structure in achieving sustainable construction among South African construction firms. A total of 132 consultants from the nine provinces in South Africa participated in the survey. The data collected were initially screened using SPSS (version 21) while Partial Least Squares Structural Equation Modeling (PLS-SEM) algorithm and bootstrap techniques were employed to test the hypothesised paths. The empirical evidence also supported the hypothesised direct effects of organisational culture and organisational structure on sustainable construction. Similarly, the result regarding the relationship between organisational culture and organisational structure was supported. Therefore, construction industry can record a considerable level of construction sustainability and establish suitable cultures and structures within the construction organisations. Drawing upon organisational control theory, these findings supported the view that these organisational internal factors have a strong contingent effect on sustainability adoption in construction project execution. The paper makes theoretical, practical and methodological contributions within the domain of sustainable construction especially in the context of South Africa. Some limitations of the study are indicated, suggesting opportunities for future research.

Keywords: organisational culture, organisational structure, South African construction firms, sustainable construction

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Authors: Usarat Thawornchaisit, Kamalasiri Juthaisong, Kasama Parsongjeen, Phonsiri Phoengchan

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In this study, sludge samples that were collected from the wastewater treatment plant of a printed circuit board manufacturing industry in Thailand were subjected to acid extraction using sulfuric acid as the chemical extracting agent. The effects of sulfuric acid concentration (A), the ratio of a volume of acid to a quantity of sludge (B) and extraction time (C) on the efficiency of copper extraction were investigated with the aim of finding the optimal conditions for maximum removal of copper from the wastewater treatment sludge. Factorial experimental design was employed to model the copper extraction process. The results were analyzed statistically using analysis of variance to identify the process variables that were significantly affected the copper extraction efficiency. Results showed that all linear terms and an interaction term between volume of acid to quantity of sludge ratio and extraction time (BC), had statistically significant influence on the efficiency of copper extraction under tested conditions in which the most significant effect was ascribed to volume of acid to quantity of sludge ratio (B), followed by sulfuric acid concentration (A), extraction time (C) and interaction term of BC, respectively. The remaining two-way interaction terms, (AB, AC) and the three-way interaction term (ABC) is not statistically significant at the significance level of 0.05. The model equation was derived for the copper extraction process and the optimization of the process was performed using a multiple response method called desirability (D) function to optimize the extraction parameters by targeting maximum removal. The optimum extraction conditions of 99% of copper were found to be sulfuric acid concentration: 0.9 M, ratio of the volume of acid (mL) to the quantity of sludge (g) at 100:1 with an extraction time of 80 min. Experiments under the optimized conditions have been carried out to validate the accuracy of the Model.

Keywords: acid treatment, chemical extraction, sludge, waste management

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Authors: K. Genise, S. Murthy

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Introductory Statement: The results of this retrospective chart review suggest the effects of bacterial colonization in critically ill children with viral bronchiolitis, currently unproven, are clinically insignificant. Background: Viral bronchiolitis is one of the most prevalent causes of illness requiring hospitalization among children worldwide and one of the most common reasons for admission to pediatric intensive care. It has been hypothesized that co-infection with bacteria results in more severe clinical outcomes. Conversely, the effects of bacterial colonization in critically ill patients with bronchiolitis are poorly defined. Current clinical management of colonized patients consists primarily of supportive therapies with the role of antibiotics remaining controversial. Methods: A retrospective review of all critically ill children admitted to the BC Children’s Hospital Pediatric Intensive Care Unit (PICU) from 2014-2017 with a diagnosis of bronchiolitis was performed. Routine testing in this time frame consisted of complete pathogen testing, including PCR for Streptococcus pneumoniae. Analyses were performed to determine the impact of bacterial colonization and antibiotic use on a primary outcome of PICU length-of-stay, with secondary outcomes of hospital length-of-stay and duration of ventilation. Results: There were 92 patients with complete pathogen testing performed during the assessed timeframe. A comparison between children with detected Streptococcus pneumoniae (n=22) and those without (n=70) revealed no significant (p=0.20) differences in severity of illness on presentation as per Pediatric Risk of Mortality III scores (mean=3.0). Patients colonized with S. pneumoniae had significantly shorter PICU stays (p=0.002), hospital stays (p=0.0001) and duration of non-invasive ventilation (p=0.002). Multivariate analyses revealed that these effects on length of PICU stay and duration of ventilation do not persist after controlling for antibiotic use, presence of radiographic consolidation, age, and severity of illness (p=0.15, p=0.32). The relationship between colonization and duration of hospital stay persists after controlling for these variables (p=0.008). Conclusions: Children with viral bronchiolitis colonized with S. pneumoniae do not appear to have significantly different PICU length-of-stays or duration of ventilation compared to children who are not colonized. Colonized children appear to have shorter hospital stays. The results of this study suggest bacterial colonization is not associated with increased severity of presenting illness or negative clinical outcomes.

Keywords: bronchiolitis, colonization, critical care, pediatrics, pneumococcal, infection

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Authors: Philip Friedlander, John Rutledge, Jason Suh

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Inhibition of programmed death-1 (PD-1) or its ligand PD-L1 confers therapeutic efficacy in a wide range of solid tumor malignancies. Primary or acquired resistance can develop through activation of immunosuppressive immune cells such as tumor-associated macrophages. The renin angiotensin system (RAS) systemically regulates fluid and sodium hemodynamics, but components are expressed on and regulate the activity of immune cells, particularly of myeloid lineage. We hypothesized that inhibition of RAS would improve the efficacy of PD-1/PD-L-1 treatment. A retrospective analysis was performed through a chart review of patients with solid metastatic malignancies treated with a PD-1/PD-L1 inhibitor between 1/2013 and 6/2019 at Valley Hospital, a community hospital in New Jersey, USA. Efficacy was determined by medical oncologist documentation of clinical benefit in visit notes and by the duration of time on immunotherapy treatment. The primary endpoint was the determination of efficacy differences in patients treated with an inhibitor of RAS ( ace inhibitor, ACEi, or angiotensin blocker, ARB) compared to patients not treated with these inhibitors. To control for broader antihypertensive effects, efficacy as a function of treatment with beta blockers was assessed. 173 patients treated with PD-1/PD-L-1 inhibitors were identified of whom 52 were also treated with an ACEi or ARB. Chi-square testing revealed a statistically significant relationship between being on an ACEi or ARB and efficacy to PD-1/PD-L-1 therapy (p=0.001). No statistically significant relationship was seen between patients taking or not taking beta blocker antihypertensives (p= 0.33). Kaplan-Meier analysis showed statistically significant improvement in the duration of therapy favoring patients concomitantly treated with ACEi or ARB compared to patients not exposed to antihypertensives and to those treated with beta blockers. Logistic regression analysis revealed that age, gender, and cancer type did not have significant effects on the odds of experiencing clinical benefit (p=0.74, p=0.75, and p=0.81, respectively). We conclude that retrospective analysis of the treatment of patients with solid metastatic tumors with anti-PD-1/PD-L1 in a community setting demonstrates greater clinical benefit in the context of concomitant ACEi or ARB inhibition, irrespective of gender or age. This data supports the development of prospective assessment through randomized clinical trials.

Keywords: angiotensin, cancer, immunotherapy, PD-1, efficacy

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Authors: Lakmali Anthony, Madeline Gillies

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Purpose: Long-term survivorship in colorectal cancer (CRC) is increasing as mortality decreases, leading to increased focus on patient-reported outcomes such as quality of life (QoL). CRC patients often have decreased QoL even after treatment is complete. This systematic review of the literature aims to identify psychosocial factors associated with decreased QoL in post-treatment CRC patients. Methodology: This systematic review was performed in accordance with the 2020 Preferred Reporting Items for Systematic Reviews and Meta-Analyses recommendations. The search was conducted in MEDLINE, EMBASE, and PsychINFO using MeSH headings. The two authors screened studies for relevance and extracted data. Results: Seventeen studies were identified, including 6,272 total participants (mean = 392, 58% male) with a mean age of 60.6 years. The European Organisation for Research and Treatment of Cancer QLQ-C30 was the most common measure of QoL (n=14, 82.3%). Most studies (n=15, 88.2%) found that emotional distress correlated with poor global QoL. This was most commonly measured with the Hospital Anxiety & Depression Scale (n=11, 64.7%). Other psychosocial factors associated with QoL were lack of social support, body image, and financial difficulties. Clinicopathologic determinants included presence of stoma and metastasis. Conclusion: This systematic review provides a summary of the psychosocial determinants of poor QoL in post-treatment CRC patients, as well as the most commonly reported measures of these. An understanding of these potentially modifiable determinants of poor outcome is pivotal to the provision of quality, patient-centred care in surgical oncology.

Keywords: colorectal cancer, cancer surgery, quality of life, oncology, social determinants

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