bluuebunny/crossref_metadata_2025 huggingface dataset:
Stakeholder perspectives on social screening in US healthcare settings
Authors: Aceves Benjamín , De Marchis Emilia , Loomba Vishalli , Brown Erika M. , Gottlieb Laura M.
Published: March 2023

Background

Evidence on the health impacts of social conditions has led US healthcare systems to consider identifying and addressing social adversity—e.g. food, housing, and transportation insecurity—in care delivery settings. Social screening is one strategy being used to gather patient information about social circumstances at the point of care. While several recent studies describe the rapid proliferation of social screening activities, little work has explored either why or how to implement social screening in clinical settings. Our study objectives were to assess diverse healthcare stakeholder perspectives on both the rationale for social screening and evidence needed to inform practice and policy-relevant implementation decisions.

Methods

We convened five focus groups with US experts representing different stakeholder groups: patient advocates, community-based organizations, healthcare professionals, payers, and policymakers. In total, 39 experts participated in approximately 90-minute long focus groups conducted between January-March 2021. A inductive thematic analysis approach was used to analyze discussions.

Results

Three themes emerged from focus groups, each reflecting the tension between the national enthusiasm for screening and existing evidence on the effectiveness and implementation of screening in clinical settings: (1) ambiguity about the rationale for social screening; (2) concerns about the relavence of screening tools and approaches, particularly for historically marginalized populations; (3) lack of clarity around the resources needed for implementation and scaling.

Conclusion

While participants across groups described potential benefits of social screening, they also highlighted knowledge gaps that interfered with realizing these benefits. Efforts to minimize and ideally resolve these knowledge gaps will advance future social screening practice and policy.
Vaginal and neonatal microbiota in pregnant women with preterm premature rupture of membranes and consecutive early onset neonatal sepsis
Authors: dos Anjos Borges Luiz Gustavo , Pastuschek Jana , Heimann Yvonne , Dawczynski Kristin ,   PEONS study group, Bergner Michael , Haase Roland , Stubert Johannes , Olbertz Dirk , Plumeier Iris , Kahl Silke , Heroven Ann Kathrin , Schleußner Ekkehard , Pieper Dietmar H. , Zöllkau Janine
Published: March 2023

Background

Preterm premature rupture of membranes (PPROM), which is associated with vaginal dysbiosis, is responsible for up to one-third of all preterm births. Consecutive ascending colonization, infection, and inflammation may lead to relevant neonatal morbidity including early-onset neonatal sepsis (EONS). The present study aims to assess the vaginal microbial composition of PPROM patients and its development under standard antibiotic therapy and to evaluate the usefulness of the vaginal microbiota for the prediction of EONS. It moreover aims to decipher neonatal microbiota at birth as possible mirror of the in utero microbiota.

Methods

As part of the PEONS prospective multicenter cohort study, 78 women with PPROM and their 89 neonates were recruited. Maternal vaginal and neonatal pharyngeal, rectal, umbilical cord blood, and meconium microbiota were analyzed by 16S rRNA gene sequencing. Significant differences between the sample groups were evaluated using permutational multivariate analysis of variance and differently distributed taxa by the Mann–Whitney test. Potential biomarkers for the prediction of EONS were analyzed using the MetaboAnalyst platform.

Results

Vaginal microbiota at admission after PPROM were dominated by Lactobacillus spp. Standard antibiotic treatment triggers significant changes in microbial community (relative depletion of Lactobacillus spp. and relative enrichment of Ureaplasma parvum) accompanied by an increase in bacterial diversity, evenness and richness. The neonatal microbiota showed a heterogeneous microbial composition where meconium samples were characterized by specific taxa enriched in this niche. The vaginal microbiota at birth was shown to have the potential to predict EONS with Escherichia/Shigella and Facklamia as risk taxa and Anaerococcus obesiensis and Campylobacter ureolyticus as protective taxa. EONS cases could also be predicted at a reasonable rate from neonatal meconium communities with the protective taxa Bifidobacterium longum, Agathobacter rectale, and S. epidermidis as features.

Conclusions

Vaginal and neonatal microbiota analysis by 16S rRNA gene sequencing after PPROM may form the basis of individualized risk assessment for consecutive EONS. Further studies on extended cohorts are necessary to evaluate how far this technique may in future close a diagnostic gap to optimize and personalize the clinical management of PPROM patients.

Trial registration

NCT03819192, ClinicalTrials.gov. Registered on January 28, 2019.
Linkage to hepatitis C treatment in two opioid substitution treatment units in Gothenburg, Sweden: a retrospective cohort study
Authors: Ydreborg Magdalena , Lundström Emil , Kolleby Rosanna , Lexén Sofia , Pizarro Elena , Lindgren Jessica , Wejstål Rune , Larsson Simon B.
Published: March 2023

Background

Chronic infection with the hepatitis C virus (HCV) is common in people with former or current injection drug use. Among the patients in the opioid substitution treatment (OST) program in Gothenburg, Sweden, more than 50% had been infected with HCV. However, many patients did not have any follow-up for their infection and the linkage to treatment could be improved.

Methods

A model of care for HCV was introduced at an OST unit in Gothenburg, Sweden, in 2017. The aim was to increase testing and linkage to HCV treatment. A nurse and a medical doctor, both specialized in infectious diseases, performed on-site testing at the OST unit with transient liver elastography (Fibroscan) to evaluate the fibrosis stage and initiated HCV treatment. This study retrospectively reviewed the patients’ medical records to assess information regarding participation in the model of care, hepatitis C status, linkage to treatment and treatment outcome.

Results

Among the 225 patients enrolled in OST at baseline, 181 were still in the OST program at the end of study (December 31st, 2018). In total, 29 patients, most of whom did not attend the Clinic of Infectious Diseases, were referred to the model of care. By the end of study, 17 patients (100% of those treated) reached sustained virologic response. In parallel, an additional 19 patients got treatment directly at the Clinic of Infectious Diseases.

Conclusion

Integrating HCV screening and examination in an OST unit successfully linked patients to treatment. However, not all patients received treatment. To reach the goal of eliminating HCV, different models of care are needed.
A sequential, multiple assignment randomized trial comparing web-based education to mobile video interpreter access for improving provider interpreter use in primary care clinics: the mVOCAL hybrid type 3 study protocol
Authors: Lion K. Casey , Zhou Chuan , Fishman Paul , Senturia Kirsten , Cole Allison , Sherr Kenneth , Opel Douglas J. , Stout James , Hazim Carmen E. , Warren Louise , Rains Bonnie H. , Lewis Cara C.
Published: March 2023

Background

Individuals who use a language other than English for medical care are at risk for disparities related to healthcare safety, patient-centered care, and quality. Professional interpreter use decreases these disparities but remains underutilized, despite widespread access and legal mandates. In this study, we compare two discrete implementation strategies for improving interpreter use: (1) enhanced education targeting intrapersonal barriers to use delivered in a scalable format (interactive web-based educational modules) and (2) a strategy targeting system barriers to use in which mobile video interpreting is enabled on providers’ own mobile devices.

Methods

We will conduct a type 3 hybrid implementation-effectiveness study in 3–5 primary care organizations, using a sequential multiple assignment randomized trial (SMART) design. Our primary implementation outcome is interpreter use, calculated by matching clinic visits to interpreter invoices. Our secondary effectiveness outcome is patient comprehension, determined by comparing patient-reported to provider-documented visit diagnosis. Enrolled providers (n = 55) will be randomized to mobile video interpreting or educational modules, plus standard interpreter access. After 9 months, providers with high interpreter use will continue as assigned; those with lower use will be randomized to continue as before or add the alternative strategy. After another 9 months, both strategies will be available to enrolled providers for 9 more months. Providers will complete 2 surveys (beginning and end) and 3 in-depth interviews (beginning, middle, and end) to understand barriers to interpreter use, based on the Theoretical Domains Framework. Patients who use a language other than English will be surveyed (n = 648) and interviewed (n = 75) following visits with enrolled providers to understand their experiences with communication. Visits will be video recorded (n = 100) to assess fidelity to assigned strategies. We will explore strategy mechanism activation to refine causal pathway models using a quantitative plus qualitative approach. We will also determine the incremental cost-effectiveness of each implementation strategy from a healthcare organization perspective, using administrative and provider survey data.

Discussion

Determining how these two scalable strategies, alone and in sequence, perform for improving interpreter use, the mechanisms by which they do so, and at what cost, will provide critical insights for addressing a persistent cause of healthcare disparities.

Trial registration

NCT05591586.
P-15 promotes chondrocyte proliferation in osteoarthritis by regulating SFPQ to target the Akt-RUNX2 axis
Authors: Li Yuanli , Nie Junlan , Deng Changgong , Li Hong
Published: March 2023

Background

The disruption of chondrocyte proliferation and differentiation is a critical event during the process of joint injury in osteoarthritis (OA). P-15 peptides could bind to integrin receptors on various precursor cells, promote cell adhesion, release growth factors, and promote the differentiation of osteoblast precursor cells. However, the role of P-15 in OA, particularly in chondrocyte proliferation, is not fully understood.

Methods

The activity of SFPQ and RUNX2 in the bone tissue of patients with osteoarthritis was analyzed using quantitative real-time polymerase chain reaction (qRT-PCR). Interleukin-1β (IL-1β) inducer was performed to establish an in vitro model of OA. Cell proliferation was measured by CCK-8 assay. The expressions of COL2a1, ACAN, COMP, SOX9, and BMP2 related to cartilage differentiation were detected using qRT-PCR. In addition, the expression levels of SFPQ, AKT, p-AKT, and RUNX2 were detected using Western blotting.

Results

The results showed that the expression of SFPQ was significantly decreased and the expression of RUNX2 was significantly increased in osteoarthritis cartilage tissue. P-15 peptide reversed IL-1β-induced cell proliferation obstruction and alleviated chondrocyte damage. Furthermore, P-15 polypeptide increased the expression levels of cartilage differentiation genes COL2a1, ACAN, and BMP2, while decreasing the expression of COMP and SOX9 in an inverse dose-dependent manner. Then specific interfering RNA proved that P-15 maintains chondrocyte stability and is associated with the SFPQ gene. Finally, we confirmed that P-15 inhibited the Akt-RUNX2 pathway, which is regulated in the expression of SFPQ.

Conclusions

P-15 can mitigate chondrocyte damage and osteoarthritis progression by inhibiting cell death and modulating SFPQ-Akt-RUNX2 pathway, offering an opportunity to develop new strategies for the treatment of osteoarthritis.
Biochemical and mutational analyses of HEXA in a cohort of Egyptian patients with infantile Tay-Sachs disease. Expansion of the mutation spectrum
Authors: Ibrahim Doaa M. A. , Ali Ola S. M. , Nasr Hala , Fateen Ekram , AbdelAleem Alice
Published: March 2023

Background

Tay-Sachs disease (TSD), an autosomal recessively inherited neurodegenerative lysosomal storage disease, reported worldwide with a high incidence among population of Eastern European and Ashkenazi Jewish descent. Mutations in the alpha subunit of HEXA that encodes for the β-hexosaminidase-A lead to deficient enzyme activity and TSD phenotype. This study is the first to highlight the HEXA sequence variations spectrum in a cohort of Egyptian patients with infantile TSD.

Results

This study involved 13 Egyptian infant/children patients presented with the infantile form of TSD, ten of the 13 patients were born to consanguineous marriages. β-hexosaminidase-A enzyme activity was markedly reduced in the 13 patients with a mean activity of 3 µmol/L/h ± 1.56. Sanger sequencing of the HEXA’ coding regions and splicing junctions enabled a detection rate of ~ 62% (8/13) in our patients revealing the molecular defects in eight patients; six homozygous-mutant children (five of them were the product of consanguineous marriages) and two patients showed their mutant alleles in heterozygous genotypes, while no disease-causing mutation was identified in the remaining patients. Regulatory intragenic mutations or del/dup may underlie the molecular defect in those patients showing no relevant pathogenic sequencing variants or in the two patients with a heterozygous genotype of the mutant allele. This research identified three novel, likely pathogenic variants in association with the TSD phenotype; two missense, c.920A > C (E307A) and c.952C > G (H318D) in exon 8, and a single base deletion c.484delG causing a frameshift E162Rfs*37 (p.Glu162ArgfsTer37) in exon 5. Three recurrent disease-causing missense mutations; c.1495C > T (R499C), c.1511G > A(R504H), and c.1510C > T(R504C) in exon 13 were identified in five of the eight patients. None of the variants was detected in 50 healthy Egyptians’ DNA. Five variants, likely benign or of uncertain significance, S3T, I436V, E506E, and T2T, in exons 1, 11,13, & 1 were detected in our study.

Conclusions

For the proper diagnostics, genetic counseling, and primary prevention, our study stresses the important role of Next Generation Sequencing approaches in delineating the molecular defect in TSD-candidate patients that showed negative Sanger sequencing or a heterozygous mutant allele in their genetic testing results. Interestingly, the three recurrent TSD associated mutations were clustered on chromosome 13 and accounted for 38% of the HEXA mutations detected in this study. This suggested exon 13 as the first candidate for sequencing screening in Egyptian patients with infantile TSD. Larger studies involving our regional population are recommended, hence unique disease associated pathogenic variations could be identified.
Corticosteroid in anti-inflammatory treatment of pediatric acute myocarditis: a systematic review and meta-analysis
Authors: Yao Qi , Zhan Shanshan
Published: March 2023

Background

To evaluate the efficacy of corticosteroids in anti-inflammatory treatment of pediatric acute myocarditis.

Methods

We searched PubMed, Embase and Cochrane library and included studies before October 2022 for clinical trials, observational studies and retrospective studies which reported on children with acute myocarditis treated with corticosteroid anti-inflammatory therapy. The quality of the clinical trials was assessed by Jadad score as an exclusion criterion.

Results

This systematic review included 6 studies involving 604 pediatric patients with acute myocarditis. Corticosteroid therapy was not associated with reduced risk of mortality due to acute myocarditis (P = 0.53; RR = 0.87; 95% CI = 0.58 to 1.33) compared to anti-failure treatment. There was a significant improvement in pediatric patients’ left ventricular function measured by left ventricular ejection fraction in the group on corticosteroid anti-inflammatory treatment (P = 0.0009; MD = 11.93%; 95% CI = 4.87% to 18.99%). No conclusion can be drawn due to the high heterogeneity in meta-analyses of risk of getting to a clinical endpoint (death or heart transplantation) and changes in left ventricular end-diastolic diameter (LVEDD).

Conclusions

Corticosteroid anti-inflammatory therapy in pediatric acute myocarditis patients showed no significant improvement in reducing the risk of mortality, but showed significant improvement in LVEF.
Outcomes in critically Ill HIV-infected patients between 1997 and 2020: analysis of the OUTCOMEREA multicenter cohort
Authors: Gaillet Antoine , Azoulay Elie , de Montmollin Etienne , Garrouste-Orgeas Maité , Cohen Yves , Dupuis Claire , Schwebel Carole , Reignier Jean , Siami Shidasp , Argaud Laurent , Adrie Christophe , Mourvillier Bruno , Ruckly Stéphane , Forel Jean-Marie , Timsit Jean-Francois
Published: March 2023

Purpose

Despite antiviral therapy (ART), 800,000 deaths still occur yearly and globally due to HIV infection. In parallel with the good virological control and the aging of this population, multiple comorbidities [HIV-associated-non-AIDS (HANA) conditions] may now be observed.

Methods

HIV adult patients hospitalized in intensive care unit (ICU) from all the French region from university and non-university hospital who participate to the OutcomeRea™ database on a voluntary basis over a 24-year period.

Results

Of the 24,298 stays registered, 630 (2.6%) were a first ICU stay for HIV patients. Over time, the mean age and number of comorbidities (diabetes, renal and respiratory history, solid neoplasia) of patients increased. The proportion of HIV diagnosed on ICU admission decreased significantly, while the median duration of HIV disease as well as the percentage of ART-treated patients increased. The distribution of main reasons for admission remained stable over time (acute respiratory distress > shock > coma). We observed a significant drop in the rate of active opportunistic infection on admission, while the rate of active hemopathy (newly diagnosed or relapsed within the last 6 months prior to admission to ICU) qualifying for AIDS increased—nonsignificantly—with a significant increase in the anticancer chemotherapy administration in ICU. Admissions for HANA or non-HIV reasons were stable over time. In multivariate analysis, predictors of 60-day mortality were advanced age, chronic liver disease, past chemotherapy, sepsis-related organ failure assessment score > 4 at admission, hospitalization duration before ICU admission > 24 h, AIDS status, but not the period of admission.

Conclusion

Whereas the profile of ICU-admitted HIV patients has evolved over time (HIV better controlled but more associated comorbidities), mortality risk factors remain stable, including AIDS status.
The physiologic response to epinephrine and pediatric cardiopulmonary resuscitation outcomes
Authors: Morgan Ryan W. , Berg Robert A. , Reeder Ron W. , Carpenter Todd C. , Franzon Deborah , Frazier Aisha H. , Graham Kathryn , Meert Kathleen L. , Nadkarni Vinay M. , Naim Maryam Y. , Tilford Bradley , Wolfe Heather A. , Yates Andrew R. , Sutton Robert M. ,   the ICU-RESUS and the Eunice Kennedy Shriver National Institute of Child Health and Human Development Collaborative Pediatric Critical Care Research Network Investigator Groups, Ahmed Tageldin , Bell Michael J. , Bishop Robert , Bochkoris Matthew , Burns Candice , Carcillo Joseph A. , Dean J. Michael , Diddle J. Wesley , Federman Myke , Fernandez Richard , Fink Ericka L. , Friess Stuart H. , Hall Mark , Hehir David A. , Horvat Christopher M. , Huard Leanna L. , Maa Tensing , Manga Arushi , McQuillen Patrick S. , Mourani Peter M. , Notterman Daniel , Pollack Murray M. , Sapru Anil , Schneiter Carleen , Sharron Matthew P. , Srivastava Neeraj , Tabbutt Sarah , Viteri Shirley , Wessel David , Yates Andrew R. , Zuppa Athena F.
Published: March 2023

Background

Epinephrine is provided during cardiopulmonary resuscitation (CPR) to increase systemic vascular resistance and generate higher diastolic blood pressure (DBP) to improve coronary perfusion and attain return of spontaneous circulation (ROSC). The DBP response to epinephrine during pediatric CPR and its association with outcomes have not been well described. Thus, the objective of this study was to measure the association between change in DBP after epinephrine administration during CPR and ROSC.

Methods

This was a prospective multicenter study of children receiving ≥ 1 min of CPR with ≥ 1 dose of epinephrine and evaluable invasive arterial BP data in the 18 ICUs of the ICU-RESUS trial (NCT02837497). Blood pressure waveforms underwent compression-by-compression quantitative analysis. The mean DBP before first epinephrine dose was compared to mean DBP two minutes post-epinephrine. Patients with ≥ 5 mmHg increase in DBP were characterized as “responders.”

Results

Among 147 patients meeting inclusion criteria, 66 (45%) were characterized as responders and 81 (55%) were non-responders. The mean increase in DBP with epinephrine was 4.4 [− 1.9, 11.5] mmHg (responders: 13.6 [7.5, 29.3] mmHg versus non-responders: − 1.5 [− 5.0, 1.5] mmHg; p < 0.001). After controlling for a priori selected covariates, epinephrine response was associated with ROSC (aRR 1.60 [1.21, 2.12]; p = 0.001). Sensitivity analyses identified similar associations between DBP response thresholds of ≥ 10, 15, and 20 mmHg and ROSC; DBP responses of ≥ 10 and ≥ 15 mmHg were associated with higher aRR of survival to hospital discharge and survival with favorable neurologic outcome (Pediatric Cerebral Performance Category score of 1–3 or no worsening from baseline).

Conclusions

The change in DBP following epinephrine administration during pediatric in-hospital CPR was associated with return of spontaneous circulation.
The association of dietary insulin load and dietary insulin index with body composition among professional soccer players and referees
Authors: Beba Mohammad , Gholizadeh Mohammad , Sharifi Mohammad , Seifbarghi Tohid , Djafarian Kurosh
Published: March 2023

Background

There has been limited research undertaken about the association of dietary insulin load (DIL) and dietary insulin index (DII) with body composition in non-athletic adults, however, to the best of our knowledge No previous study has investigated such an association in an athletic population.

Purpose

The aim of this study was to explore the association of DII and DIL with body compositions in male and female soccer players and referees.

Methods

The cross-sectional study was conducted on 199 professional male and female soccer players and referees. A 147-item semi-quantitative food frequency questionnaire (FFQ) was adopted to congregate the participants’ dietary data. Body composition was measured using InBody to gain a detailed understanding of fat mass, percent body fat (PBF), lean mass, percent muscle mass (PMM), and bone mineral content (BMC). Waist circumference (WC), hip circumference (HC), waist-to-hip ratio (WHR), and waist-to-height ratio (WHtR) were obtained from all participants. Other body composition parameters include a body shape index (ABSI), abdominal volume index (AVI), body adiposity index (BAI), body roundness index (BRI), conicity index (CI), weight-adjusted waist index (WWI) and waist-to-hip-to-height ratio (WHHR) were calculated using a particular defined formula.

Results

Results of multiple linear regression revealed that there is a significant association between DIL and BMI (P = 0.04) in < 18 male soccer players, CI (P = 0.04) and WWI (P = 0.03) in ≥ 18 female soccer players, PBF (P = 0.02), PMM (P = 0.01) and WWI (P = 0.01) in ≥ 18 female soccer players. Nevertheless, no significant associations between DIL and body composition parameters were found in the referees. Additionally, there is a significant association between DII and BMC (P = 0.02) in male soccer referees, however, no significant associations were found in young soccer players and female athletes.

Conclusion

This study demonstrates that DIL is positively associated with BMI, CI, and WWI in male soccer players and PBF, and WWI in female soccer players. Although, there was an observed negative association between DIL and PMM in females. In addition, a significant negative association between DII and BMC was observed in male soccer players.
The existence of discrete solitons for the discrete coupled nonlinear Schrödinger system
Authors: Huang Meihua , Zhou Zhan
Published: March 2023

In this paper, we investigate the nonlinear coupled discrete Schrödinger equations with unbounded potentials. We find simple sufficient conditions for the existence of discrete soliton solution by using the Nehari manifold approach and the compact embedding theorem. Furthermore, by comparing the value of the action functional at the discrete soliton solution with those at nonzero solutions of one component zero, we demonstrate that both components of the discrete soliton solution are nontrivial.
Antimicrobial photodynamic therapy with Ligularia fischeri against methicillin-resistant Staphylococcus aureus infection in Caenorhabditis elegans model
Authors: Ha Ngoc Minh , Hwang Hoseong , Alam Seemi Tasnim , Nguyen Uyen Tran Tu , Lee Soon Kwang , Park Jin-Soo , Kim Jin-Chul , Kwon Hak Cheol , Kwon Jaeyoung , Kang Kyungsu
Published: March 2023

The high prevalence of methicillin-resistant Staphylococcus aureus (MRSA) infection threatens the effectiveness of current clinical settings. Antimicrobial photodynamic therapy (APDT) is a promising alternative to antibiotics for treating infections due to its low resistance. This study aimed to evaluate the antibacterial properties of APDT with L. fischeri extract (LFE) against MRSA and various skin and oral pathogens in vitro and its photopharmaceutical actions in Caenorhabditis elegans. The antimicrobial activities of APDT with LFE against pathogens were evaluated using plate counting method. The chemical profile was characterized using high-performance liquid chromatography and spectrophotometry. The growth rate assay, lifespan assay, and bacterial attachment on worms were performed to assess the therapeutics effects in C. elegans. The swab method was used for the detection of pathogens on the micropig skin surface. The APDT treatment with L. fischeri extract (LFE, 20 µg/mL) and red light (intensity of 120 W/m2) reduced 4.3–4.9 log (colony forming unit/mL) of Staphylococcus aureus, MRSA, Cutibacterium acnes, Streptococcus mutans; and 2.4 log (CFU/mL) of Candida albicans. Chemical analysis revealed that LFE enriched three active photosensitizers. APDT reduced bacterial populations on worms, recovered growth retardation, and improved lifespan in MRSA-infected C. elegans without causing severe side effects. The surface eradication of MRSA after exposure to LFE with red light was demonstrated on micropig skin. These findings highlight the significance of L. fischeri as a natural resource for the safe phototreatment of MRSA infection in the biomedical and cosmeceutical industries.
Association between traumatic brain injury and mental health care utilization: evidence from the Canadian Community Health Survey
Authors: Kureshi Nelofar , Clarke David B. , Feng Cindy
Published: March 2023

Background

Mental health disorders are a common sequelae of traumatic brain injury (TBI) and are associated with worse health outcomes including increased mental health care utilization. The objective of this study was to determine the association between TBI and use of mental health services in a population-based sample.

Methods

Using data from a national Canadian survey, this study evaluated the association between TBI and mental health care utilization, while adjusting for confounding variables. A log-Poisson regression model was used to estimate unadjusted and adjusted prevalence ratios (PR) and 95% confidence intervals (CI).

Results

The study sample included 158,287 TBI patients and 25,339,913 non-injured individuals. Compared with those were not injured, TBI patients reported higher proportions of chronic mental health conditions (27% vs. 12%, p < 0.001) and heavy drinking (33% vs. 24%, p = 0.005). The adjusted prevalence of mental health care utilization was 60% higher in patients with TBI than those who were not injured (PR = 1.60, 95%; CI 1.05–2.43).

Conclusions

This study suggests that chronic mental health conditions and heavy drinking are more common in individuals with TBI. The prevalence of mental health care utilization is 60% higher in TBI patients compared with those who are not injured after adjusting for sociodemographic factors, mental health conditions, and heavy drinking. Future longitudinal research is required to examine the temporality and direction of the association between TBI and the use of mental health services.
Instant formation of horizontally ordered nanofibrous hydrogel films and direct investigation of peculiar neuronal cell behaviors atop
Authors: Park Jaeil , Nguyen Thi Thuy Chau , Lee Su-Jin , Wang Sungrok , Heo Dongmi , Kang Dong-Hee , Tipan-Quishpe Alexander , Lee Won-June , Lee Jongwon , Yang Sung Yun , Yoon Myung-Han
Published: March 2023

Background

Hydrogels have been widely used in many research fields owing to optical transparency, good biocompatibility, tunable mechanical properties, etc. Unlike typical hydrogels in the form of an unstructured bulk material, we developed aqueous dispersions of fiber-shaped hydrogel structures with high stability under ambient conditions and their application to various types of transparent soft cell culture interfaces with anisotropic nanoscale topography.

Method

Nanofibers based on the polyvinyl alcohol and polyacrylic acid mixture were prepared by electrospinning and hydrogelified to nano-fibrous hydrogels (nFHs) after thermal crosslinking and sulfuric acid treatment. By modifying various material surfaces with positively-charged polymers, negatively-charged superabsorbent nFHs could be selectively patterned by employing micro-contact printing or horizontally aligned by applying shear force with a wired bar coater.

Results

The angular distribution of bar-coated nFHs was dramatically reduced to ± 20° along the applied shear direction unlike the drop-coated nFHs which exhibit random orientations. Next, various types of cells were cultured on top of transparent soft nFHs which showed good viability and attachment while their behaviors could be easily monitored by both upright and inverted optical microscopy. Particularly, neuronal lineage cells such as PC 12 cells and embryonic hippocampal neurons showed highly stretched morphology along the overall fiber orientation with aspect ratios ranging from 1 to 14. Furthermore, the resultant neurite outgrowth and migration behaviors could be effectively controlled by the horizontal orientation and the three-dimensional arrangement of underlying nFHs, respectively.

Conclusion

We expect that surface modifications with transparent soft nFHs will be beneficial for various biological/biomedical studies such as fundamental cellular studies, neuronal/stem cell and/or organoid cultures, implantable probe/device coatings, etc.
Potentials and challenges of using co-design in health services research in low- and middle-income countries
Authors: Singh Devendra Raj , Sah Rajeeb Kumar , Simkhada Bibha , Darwin Zoe
Published: March 2023

Co-design with people having poor access to health services and fragile health systems in low- and middle-income countries can be momentous in bringing service users and other stakeholders together to improve the delivery and utilisation of health services. There is ample of evidence from high-income countries regarding how co-design can translate available evidence into developing acceptable, feasible, and adaptable health solutions in different settings. However, there is limited literature on co-design in health research in the context of low- and middle-income countries. Therefore, it is crucial to understand how knowledge about collaborative working can be translated into policy and practice in the context of low- and middle-income countries. Thus, this paper discusses the concept of co-design, co-production, and co-creation in health and the potentiality and challenges of using co-design in health services research in low- and middle-income countries. Despite the challenges, the co-design research has considerable potential to encourage the meaningful engagement of service users and other stakeholders in developing, implementing, and evaluating real-world solutions in low- and middle-income countries. It is essential to balance power dynamics in a co-design process through mutual recognition and respect, participant diversity, and reciprocity and flexibility in sharing. The inclusive and collaborative approach to working is complex due to existing rigid hierarchical structures, socio-cultural beliefs, political interference and working practices. However, this could be minimised by developing transparent terms of reference that reflect the value and benefits of equal partnership in particular co-design work.
Patient factors associated with receipt of psychological and pharmacological treatments among individuals with common mental disorders in a Swedish primary care setting
Authors: Cullen Alexis E. , Lindsäter Elin , Rahman Syed , Taipale Heidi , Tanskanen Antti , Mittendorfer-Rutz Ellenor , Helgesson Magnus
Published: March 2023

Background

Psychological and pharmacological therapies are the recommended first-line treatments for common mental disorders (CMDs) but may not be universally accessible or utilised.

Aims

To determine the extent to which primary care patients with CMDs receive treatment and the impact of sociodemographic, work-related and clinical factors on treatment receipt.

Method

National registers were used to identify all Stockholm County residents aged 19–64 years who had received at least one CMD diagnosis (depression, anxiety, stress-related) in primary care between 2014 and 2018. Individuals were followed from the date of their first observed CMD diagnosis until the end of 2019 to determine treatment receipt. Associations between patient factors and treatment group were examined using multinomial logistic regression.

Results

Among 223 271 individuals with CMDs, 30.6% received pharmacotherapy only, 16.5% received psychological therapy only, 43.1% received both and 9.8% had no treatment. The odds of receiving any treatment were lower among males (odds ratio (OR) range = 0.76 to 0.92, 95% CI[minimum, maximum] 0.74 to 0.95), individuals born outside of Sweden (OR range = 0.67 to 0.93, 95% CI[minimum, maximum] 0.65 to 0.99) and those with stress-related disorders only (OR range = 0.21 to 0.51, 95% CI[minimum, maximum] 0.20 to 0.53). Among the patient factors examined, CMD diagnostic group, prior treatment in secondary psychiatric care and age made the largest contributions to the model (R2 difference: 16.05%, 1.72% and 1.61%, respectively).

Conclusions

Although over 90% of primary care patients with CMDs received pharmacological and/or psychological therapy, specific patient groups were less likely to receive treatment.
The Transcaruncular Corridor of the Medial Transorbital Approach to the Frontal Lobe: Technical Nuances and Applications
Authors: Polster Sean P. , Beale Oliver , Patel Vijay A. , Abou-Al-Shaar Hussam , Stefko S. Tonya , Gardner Paul A.
Published: March 2023

BACKGROUND AND IMPORTANCE:

Medial orbital access through a transcaruncular corridor has yet to be fully characterized as a potential approach to intradural lesions within the skull base. Transorbital approaches present unique potential in the management of complex neurological pathologies and require subspecialty collaboration across multiple disciplines.

CLINICAL PRESENTATION:

A 62-year-old man presented with progressive confusion and mild left-sided weakness. He was found to have a right frontal lobe mass with significant vasogenic edema. A comprehensive systemic workup was otherwise unremarkable. A multidisciplinary skull base tumor board conference recommended a medial transorbital approach through transcaruncular corridor, which was performed by neurosurgery and oculoplastics services. Postoperative imaging demonstrated gross total resection of the right frontal lobe mass. Histopathologic evaluation was consistent with amelanotic melanoma with BRAF (V600E) mutation. At his last follow-up visit, 3 months after surgery, the patient did not experience any visual symptoms and had an excellent cosmetic outcome after surgery.

CONCLUSION:

The transcaruncular corridor through a medial transorbital approach provides a safe and reliable access to the anterior cranial fossa.
The Effects of an Acute Bout of Aerobic or Resistance Exercise on Nonexercise Physical Activity
Authors: Thomas Jason V. , Tobin Selene Y. , Mifflin Mark Garrett , Burns Ryan D. , Bailey Ryan R. , Purcell Sarah A. , Melanson Edward L. , Cornier Marc-Andre , Halliday Tanya M.
Published: March 2023

Introduction/Purpose

A reduction in nonexercise physical activity (NEPA) after exercise may reduce the effectiveness of exercise interventions on weight loss in adults with overweight or obesity. Aerobic exercise (AEx) and resistance exercise (REx) may have different effects on NEPA. The purpose of this secondary analysis was to examine the effect of a single bout of AEx or REx on NEPA and sedentary behavior in inactive adults with overweight or obesity.

Methods

Adults with overweight or obesity (n = 24; 50% male; age, 34.5 ± 1.5 yr; body mass index, 28.5 ± 0.9 kg·m−2) not meeting current physical activity guidelines completed a single 45-min bout of AEx, REx, or a sedentary control on different days in random order. After each condition, participants’ NEPA was recorded for 84 h by accelerometer. Time spent sedentary and in light, moderate, and vigorous physical activity; steps; metabolic equivalent of task (MET)-hours; and sit-to-stand transitions were calculated using activity count data.

Results

No differences were observed in the percent of waking time spent sedentary and in light, moderate, and vigorous activity between conditions (P > 0.05). No differences were observed in steps, MET-hours, or sit-to-stand transitions between conditions (P > 0.05). NEPA responses were variable among individuals, with approximately half of participants reducing and half increasing NEPA over the 84 h after each exercise condition.

Conclusion

NEPA was not reduced after an acute bout of AEx or REx in a sample of inactive adults with overweight or obesity.
In vitro & in vivo μελέτη της επίδρασης του αναστολέα της SRC τυροσινικής κινάσης Dasatinib και του χημειοθεραπευτικού ντοσεταξέλη σε πειραματικά μοντέλα Triple-negative καρκίνου του μαστού
Authors: Πάσσος Ιωάννης
Published: March 2023

ΕΙΣΑΓΩΓΗ: Ο όρος «Τριπλά- Αρνητικός Καρκίνος του Μαστού (TNBC) αναφέρεταιστο περίπου 15% των καρκίνων του μαστού που στερούνται της έκφρασης τωνοιστρογονικών (ER) και προγεστερονικών υποδοχέων (PR) και δεν εμφανίζουνέκφραση του γονιδίου του υποδοχέα του ανθρώπινου επιδερμικού αυξητικούπαράγοντα 2 (HER2). Ο TNBC αποτελεί μια ετερογενή ομάδα όγκων με ένα κοινόχαρακτηριστικό: μια επιθετική φύση με υψηλότερα ποσοστά υποτροπής και βραχύτερησυνολική επιβίωση σε σύγκριση με άλλους υποτύπους καρκίνου του μαστού. Έως καισήμερα, δεν έχει εγκριθεί κάποια στοχευμένη θεραπεία για τον TNBC, με τηνκυτταροτοξική χημειοθεραπεία να αποτελεί τη βασική θεραπεία. ΣΚΟΠΟΣ: Η πειραματική μελέτη της επίδρασης του χημειοθεραπευτικού ντοσεταξέληκαι του αναστολέα κινασών bcr/abl δασατινίμπη σε κυτταρικές σειρές Τριπλά-Αρνητικού Καρκίνου του Μαστού (in vitro), καθώς και σε πειραματικά μοντέλαποντικών που προσβλήθηκαν από τον TNBC (in vivo). ΥΛΙΚΑ ΚΑΙ ΜΕΘΟΔΟΙ: Κυτταρικές σειρές TNBC καλλιεργήθηκαν και χορηγήθηκανσε αυτές διάφορες συγκεντρωσεις ντοσεταξέλης και δασατινίμπης (από 5 nM έως100nM). Ο κυτταρικός θάνατος και η απόπτωση μελετήθηκαν με την τεχνική τηςκυτταρομετρίας ροής. Οι κυτταρικές σειρές TNBC εν συνεχεία ενοφθαλμίστηκαν σεBALB/c άτριχα αθυμικά ποντίκια για έκφραση του όγκου in vivo. Τα ζώα τουεργαστηρίου χωρίστηκαν σε τέσσερις ομάδες (group A: Control, group B: DOC, groupC: DAS, group D: DOC + DAS) και θεραπεύτηκαν αντίστοιχα με τους παραπάνωφαρμακευτικούς παράγοντες και τους συνδυασμούς τους. Οι όγκοι αφαιρέθηκαν,συντηρήθηκαν σε διάλυμα φορμαλδεΰδης 10%, τοποθετήθηκαν σε παραφφίνη καιστάλθηκαν για περαιτέρω ιστολογική αξιολόγηση (χρώση αιματοξυλίνης- εωσίνης καιανοσοϊστοχημική ανάλυση) για εκτίμηση της αναστολής εξέλιξης του όγκου. ΑΠΟΤΕΛΕΣΜΑΤΑ: Η ντοσεταξέλη έχει σημαντική επίδραση στην αναστολήκυτταρικού πολλαπλασιασμού και την επαγωγή απόπτωσης in vitro, με τακυτταροτοξικά αποτελέσματά της να χρήζουν ιδιαίτερης προσοχής και σημασίας. Ηεπίδραση της δασατινίμπης in vitro κρίνεται στατιστικά σημαντική, στον τομέα τηςαπόπτωσης και της μείωσης (αναστολής κυτταρικού πολλαπλασιασμού) του όγκου, μεαποδεκτό προφίλ ανεπιθύμητων ενεργειών. Στην in vivo πειραματική διαδικασία, ησυνδυασμένη δράση των δύο παραγόντων φαίνεται πως έχει σημαντικό κλινικόόφελος, λαμβάνοντας ταυτόχρονα υπόψη το προφίλ τοξικότητας της ντοσεταξέλης. ΣΥΜΠΕΡΑΣΜΑΤΑ: Ο TNBC είναι μια δύσκολη στη θεραπεία ογκολογική οντότητα,ακόμα και σε πειραματικό επίπεδο. Παρατηρούνται ενθαρρυντικά αποτελέσματα πουαφορούν στην προσθήκη στοχευμένων θεραπειών (δασατινίμπη) στη συμβατικήκυτταροτοξική χημειοθεραπεία (ντοσεταξέλη), τόσο in vitro όσο και in vivo, τα οποίαχρήζουν περαιτέρω αξιολόγησης.
Essays on the economics of corruption
Authors: Μπατζιλής Δημήτριος
Published: March 2023

Η διατριβή αποτελείται από μελέτες στα οικονομικά της διαφθοράς, που έχουν στόχο να συμβάλλουν στη κατανόηση των αιτιών του φαινομένου και των τρόπων πρόληψης του, χρησιμοποιώντας μεθόδους εφαρμοσμένης μικροοικονομετρίας. Το πρώτο μέρος της διατριβής αναλύει τη σχέση μεταξύ εκλογικής ανταγωνιστικότητας και κακοδιαχείρισης στο τοπικό επίπεδο. Το δεύτερο μέρος της διατριβής αναλύει τη σχέση μεταξύ νομοθεσίας και πρακτικών διαφθοράς σε διεθνείς επιχειρηματικές σχέσεις.
Ρητορικές κατασκευές προφορικού σεξισμού
Authors: Φλούλη Αναστασία
Published: March 2023

Ο προφορικός σεξισμός αφορά στη λεκτική κυρίως έκφραση εχθρικών, αλλά και καλοπροαίρετων, σεξιστικών σχολίων, τα οποία συμβάλλουν στη διατήρηση της πατριαρχίας, ενισχύοντας ταυτόχρονα τον μισογυνισμό. Αποτελεί ένα εξαιρετικά επικίνδυνο φαινόμενο που επιβαρύνει σε μεγάλο βαθμό τα άτομα που το υφίστανται, ενώ ταυτόχρονα ενισχύει τις υπάρχουσες εξουσιαστικές δομές μεταξύ των φύλων. Παρά το γεγονός ότι τα σεξιστικά σχόλια είναι πλήρως ενσωματωμένα στον λόγο, ελάχιστα έχει μελετηθεί η χρήση τους σε προφορικό επίπεδο. Σκοπός της παρούσας διδακτορικής διατριβής είναι η διερεύνηση των ρητορικών κατασκευών προφορικού σεξισμού στον λόγο τριάντα γυναικών και είκοσι ανδρών που συμμετείχαν εθελοντικά σε ατομικές ημι-δομημένες συνεντεύξεις. Ειδικότερα, διερευνώνται τα συστήματα λόγου από τα οποία αντλούν οι συμμετέχουσες και οι συμμετέχοντες για τη νοηματοδότηση του προφορικού σεξισμού και μελετώνται οι θέσεις υποκειμένου που κατασκευάζουν στον λόγο τους. Η φουκωική ανάλυση λόγου επιλέχθηκε, τόσο από μεθοδολογική όσο και από θεωρητική σκοπιά, ως ο πλέον κατάλληλος τρόπος αποτύπωσης των συστημάτων λόγου που χρησιμοποιούν οι συμμετέχουσες και οι συμμετέχοντες για να δομήσουν, να ερμηνεύσουν ή/και να δικαιολογήσουν σεξιστικά σχόλια. Επιπλέον, η έμφυλη φύση του υπό μελέτη θέματος οδήγησε στην υιοθέτηση μιας φεμινιστικής οπτικής στη συνολική διερεύνηση του. Τα ευρήματα της έρευνας αναμένεται να παρέχουν μια νέα κατανόηση του τρόπου με τον οποίο οι ρητορικές κατασκευές προφορικού σεξισμού σχετίζονται με τις έμφυλες διακρίσεις και την καταπίεση των γυναικών και, κατά συνέπεια, κρίνονται ως σημαντικά για την προώθηση της ισότητας των φύλων.
Semiclassical WKB problems for non-self-adjoint Dirac operators with decaying potentials
Authors: Χατζηζήσης Νικόλαος
Published: March 2023

Σ' αυτή τη δουλειά, μελετάμε την ασυμπτωτική συμπεριφορά των δεδομένων σκέδασης μερικών τελεστών τύπου Ντιράκ με δυναμικά που φθίνουν στο άπειρο.
Τα έργα διαγωνισμού για φλάουτο και πιάνο (Solos de Concours) του Κονσερβατουάρ του Παρισιού, από τον Paul Taffanel έως τον Marcel Moyse (1894-1948)
Authors: Παπαϊωάννου Σταυρούλα-Βιβή
Published: March 2023

Η παρούσα διατριβή είναι μία προσπάθεια εμβάθυνσης σε ένα συγκεκριμένο τμήμα του ρεπερτορίου του φλάουτου, τα Έργα Διαγωνισμού για φλάουτο και πιάνο (Solos de Concours). Τα επιλεγμένα Έργα Διαγωνισμού συνετέθησαν και εκδόθηκαν στο Παρίσι μεταξύ των ετών 1894 και 1948, όντας τα επιβεβλημένα έργα για τους διαγωνισμούς αποφοίτησης των σπουδαστών φλάουτου του Κονσερβατουάρ του Παρισιού την ίδια περίοδο. Για να επιτευχθεί ο σκοπός της περιεκτικής συλλογής πληροφοριών, η διατριβή δομείται σε δύο βασικά κεφάλαια. Το 1ο κεφάλαιο πραγματεύεται το ιστορικό πλαίσιο της Γαλλικής Σχολής Φλάουτου και τα χαρακτηριστικά της. Επίσης, συμπεριλαμβάνει την εξέλιξη του Κονσερβατουάρ του Παρισιού στο χρόνο, τους καθηγητές φλάουτου σε αυτό και τους διευθυντές του. Επίσης, αναφέρονται ιστορικά και κατασκευαστικά χαρακτηριστικά του φλάουτου πριν από την καθιέρωση του νέου φλάουτου τύπου Boehm και την αποδοχή του από τους καθηγητές του Κονσερβατουάρ το 1860. Μετά από σύντομη αναφορά στους πρωτοπόρους καθηγητές της Γαλλικής Σχολής Φλάουτου, παρουσιάζονται βιογραφικές πληροφορίες για τον καθηγητή φλάουτου Louis Dorus, όπως επίσης και περιεκτικά βιογραφικά χαρακτηριστικά καθώς και εργογραφίες των καθηγητών φλάουτου Paul Taffanel και Philippe Gaubert. Το 2ο κεφάλαιο επικεντρώνεται στη συλλογή βιογραφικών στοιχείων για τους συνθέτες των επιλεγμένων Έργων Διαγωνισμού, όπως επίσης και στις συνθέσεις τους για φλάουτο. Κάθε Έργο παρουσιάζεται μέσω στοιχείων ανάλυσης σχετικών με τονικά και θεματικά χαρακτηριστικά, καταλήγοντας σε σχόλια για τις προκλήσεις και τις ιδιαιτερότητες του μουσικού υλικού και της ερμηνείας του. Τα δώδεκα Έργα Διαγωνισμού τα οποία μελετώνται έχουν επιλεχθεί έχοντας ως στόχο την κάλυψη όλης της επιλεγμένης περιόδου: Ballade του A. Périlhou (1903), Nocturne et Allegro Scherzando του Ph. Gaubert (1906), Andante Pastoral et Scherzettino του P. Taffanel (1907), Dans la Forêt Enchantée του L. Moreau (1912), Sicilienne, Op.60, του H. Büsser (1915), Incantation et Danse, Op.173, του M. Delmas (1924), Andante et Allegro en Style Ancien του M. d'Ollone (1926), Romance et Scherzo του G. Grovlez (1927), Divertissement Pastoral του J. Mazellier (1931), Concertino σε Μι μείζονα του H. Tomasi (1945), Sonatine του P. Sancan (1946), και Fantaisiestück, Op.67, του H. Martelli (1947).
International organisations, migration and the private sector
Authors: Λημνιός-Σεκέρης Ιωάννης
Published: March 2023

Η διδακτορική διατριβή διερευνά τη σχέση των διεθνών οργανισμών, των κρατών και των επιχειρήσεων, με τη διαχείριση της μεταπολεμικής μετανάστευσης από την Ευρώπη προς τις υπερπόντιες χώρες του Δυτικού Μπλοκ. Κεντρική ιδέα είναι πως η μεταναστευτική διαδικασία παράγει κέρδος το οποίο καρπώνονται όσοι μεσολαβούν στη διευκόλυνσή της. Υποστηρίζει δηλαδή, ότι η ίδια η μετανάστευση δημιουργεί και υποστηρίζεται από μία ‘βιομηχανία’ μετανάστευσης (migration industry). Εξετάζει λοιπόν ακριβώς τη δημιουργία και την οργάνωση της μεταναστευτικής υποδομής (migration infrastructure), δηλαδή τις υλικές προϋποθέσεις και τους μηχανισμούς μέσω των οποίων η ανθρώπινη κινητικότητα εκτός των εθνικών συνόρων, αποτέλεσε αντικείμενο διακρατικής διαχείρισης με παράλληλο στόχο την ενίσχυση της επιχειρηματικής κερδοφορίας. Στο κέντρο της έρευνας είναι η Διακυβερνητική Επιτροπή Μεταναστεύσεως εξ Ευρώπης (ΔΕΜΕ), τα κράτη-μέλη της, και οι ναυτιλιακές και οι αεροπορικές εταιρίες υπό την σημαία τους, οι οποίες συμμετείχαν στη μεταφορά μεταναστών και προσφύγων υπό την αιγίδα της ΔΕΜΕ μεταξύ 1951 και 1980.