bluuebunny/crossref_metadata_2025 huggingface dataset:
Antidepressant-Coincident Manic Episode in a Prepubertal Girl Presenting With Obsessive-Compulsive or Related Disorders: A Case Report
Authors: Sevda Pinki , Rajpurohit Surendra Singh , Suthar Navratan , Gupta Charul , Biyyala Deepika
Published: August 2024

Aims

Obsessive-Compulsive or Related Disorders (OCRDs) comprise a group of disorders characterized by repetitive thoughts and behaviours and are fairly less prevalent among children. The recommended treatment for OCRDs involves high doses of antidepressants, specifically selective serotonin reuptake inhibitors (SSRIs), along with non-pharmacological management. However, evidence suggests that the risk of inducing mania with antidepressants may be especially high in children and adolescents aged 14 years and younger.

Methods

Here, we present a case of a nine-year girl, studying in fifth standard, with normal birth and development history, with no past/family history of psychiatric illness, presented with psychiatric illness of one-year duration and was diagnosed with Trichotillomania, Obsessive-Compulsive Disorder, Skin picking and Onychophagia as per the 11th revision of International Classification of Diseases (ICD-11). After initiating tab. escitalopram 5 mg for 10 days, child developed a manic episode, which leads to a diagnostic dilemma as well as difficulties in her further management. In view of the bipolarity, escitalopram was stopped and the child was started on tab. aripiprazole 2.5 mg which was gradually up-titrated to 7.5 mg/day, following which the manic episode completely resolved and there was also improvement in OCD, hair pulling and skin picking behaviour. Later for the remaining symptoms few sessions of Habit reversal therapy were held. Currently the patient is maintaining well on aripiprazole 7.5 mg for the last six months.

Results

The uniqueness of this case is demonstrated through current limited literature on comorbid OCRDs and antidepressant coincident manic episode, especially in children in whom diagnosing manic episode possess a great challenge owing to various differential diagnosis. While deciding pharmacological therapy in children with OCRDs or Mania the efficacy as well as their safety profile should be considered. Currently there are no medications approved by FDA for treatment of acute manic episode in patients below 10 years of age and use of SSRI which are considered first line for treatment of some OCRDs may exaggerate the manic episode. In literature, second generation antipsychotics such as aripiprazole is found to be useful for the management of both manic episode (as monotherapy) as well as OCD (as an adjuvant). In this case aripiprazole monotherapy led to significant improvement in both groups of symptoms.

Conclusion

Thus, SSRIs should be used cautiously in children with OCRDs and aripiprazole along with other approved non-pharmacological management strategies can be considered as a good treatment option in children with OCRDs and anti-depressant coincident manic episode.
Approaches to improving mental healthcare for autistic people: systematic review
Authors: Loizou Sofia , Pemovska Tamara , Stefanidou Theodora , Foye Una , Cooper Ruth , Kular Ariana , Greenburgh Anna , Baldwin Helen , Griffiths Jessica , Saunders Katherine R. K. , Barnett Phoebe , Minchin Matilda , Brady Gráinne , Ahmed Nafiso , Parker Jennie , Chipp Beverley , Olive Rachel R. , Jackson Robin , Timmerman Amanda , Sapiets Suzi , Driskell Eva , Parsons Bethany , Spain Debbie , Totsika Vaso , Mandy Will , Pender Richard , Clery Philippa , Trevillion Kylee , Lloyd-Evans Brynmor , Simpson Alan , Johnson Sonia
Published: August 2024

Background

Autistic people have a high likelihood of developing mental health difficulties but a low chance of receiving effective mental healthcare. Therefore, there is a need to identify and examine strategies to improve mental healthcare for autistic people.

Aims

To identify strategies that have been implemented to improve access, experiences of care and mental health outcomes for autistic adults, and to examine evidence on their acceptability, feasibility and effectiveness.

Method

A co-produced systematic review was conducted. MEDLINE, PsycINFO, CINHAL, medRxiv and PsyArXiv were searched. We included all study designs reporting acceptability or feasibility outcomes and empirical quantitative study designs reporting effectiveness outcomes. Data were synthesised using a narrative approach.

Results

A total of 30 articles were identified. These included 16 studies of adapted mental health interventions, eight studies of service improvements and six studies of bespoke mental health interventions developed for autistic people. There was no conclusive evidence on effectiveness. However, most bespoke and adapted approaches appeared to be feasible and acceptable. Identified adaptations appeared to be acceptable and feasible, including increasing knowledge and detection of autism, providing environmental adjustments and communication accommodations, accommodating individual differences and modifying the structure and content of interventions.

Conclusion

Many identified strategies are feasible and acceptable, and can be readily implemented in services with the potential to make mental healthcare more suitable for autistic people, but important research gaps remain. Future research should address these and investigate a co-produced package of service improvement measures.
Confidence in Adherence to Antidepressant Prescribing Guidelines Among Liaison Psychiatrists
Authors: Zac-Williams Lois , Smith Gareth
Published: August 2024

Aims

This project aims to increase confidence among Liaison Psychiatrists (LPs) in North East London Foundation Trust (NELFT) regarding their adherence to the prescribing guidelines for antidepressants by 25% in accordance with the standard set by Psychiatric Liaison Accreditation Network (PLAN).

Background The prescribing guidelines in this project are based on Standard 21 from 7th Edition Standards as devised by PLAN which states:

“When medication is prescribed, specific treatment goals are set with the patient, the risks (including interactions) and benefits are discussed, a timescale for response is set and patient consent is recorded.”

This project focuses on antidepressants because they are one of the widely used medications in psychiatry that doctors of all grades working in Liaison Psychiatry will be familiar with to some extent. Adhering to this validated guideline would promote gaining informed consent and patients’ involvement in their care, which studies have shown can increase adherence to treatment.

Methods

Circulated an eight-question survey by email based on Standard 21 of 7th Edition Standards document by PLAN to LPs in NELFT. Conducted two Plan-Do-Study-Act (PDSA) cycles. The first PDSA uses a teaching session as the intervention and explained the importance of antidepressant guidelines and what areas LPs need to address with patients. The second intervention uses a poster to reinforce the key points. After each intervention a reissued survey assesses the change in responses.

Results

The baseline survey response rate was 10 out of 15 LPs, made up of seven consultants, two registrars and one foundation year doctor. The lowest levels of confidence were reported around providing patients with printed information on their prescribed antidepressant with the majority of consultants reporting the lowest level of confidence. The highest levels of confidence across all medical grades were reported around discussing a specific treatment goal and explaining the benefits of treatment with antidepressant medication.

Conclusion

From the baseline data, it can be concluded that providing patients with printed information on newly prescribed antidepressants is the area that LPs, particularly consultants, are the least confident about regarding their adherence to prescribing guidelines. Future cycles of this quality improvement project can assess how incorporating teaching on antidepressant prescribing guidelines into trust induction sessions impacts LPs confidence in their adherence.
Harm-Reduction for Substance Misuse in Young People: A Service Evaluation of Southampton's Drug and Alcohol Support Hub (DASH)
Authors: Walker Camilla , Primavesi Charlotte , Popoola Pelumi , Walmsley Emily
Published: August 2024

Aims

This project aims to evaluate Southampton's Drugs and Alcohol Support Hub Service (DASH) for young people (YP) provided by the charity, No Limits. It aims to produce insights and recommendations for No Limits to improve their service for YPs and positively influence local commissioning and governmental bodies. This project was part of the Wessex Public Health Fellowship for Junior Doctors, which aims to provide experience of working in public health and teach relevant research skills.

Methods

An adapted-Donabedian framework was implemented and a review of the literature informed a ‘harm-reduction’ lens for analysis. Mixed methods were used: Quantitative analysis reviewed data from 50 (anonymised) YPs. All data were routinely collected by No Limit's staff as Young People Outcome Records (YPORs) and Client Information Reviews (CIRs), as well as outcome measures collected quarterly for the National Drug Treatment Monitoring Service (NDTMS). Qualitative methods included a thematic analysis of five semi-structured interviews with service providers.

Results

Cannabis and alcohol were the most commonly reported problem drugs for YP (48% and 36%, respectively). In terms of smoking per weekdays, 67% of YPs were using cannabis for the same number of days and 15% had decreased smoking days. For smoking in grams, 26% were smoking the same amount of cannabis compared with 41% smoking less. For alcohol, 41% consumed fewer units and 44% had increased alcohol-free days. Importantly, 63% of YPs reported increased quality of life and 59% increased happiness.

Thematic analysis generated seven themes: harm reduction, mental health, relationships and trust, inter-agency working, YP-led care, individual outcomes and differences between reported outcomes and care provided. Harm reduction for most meant helping the YP build healthier relationships with drugs vis-à-vis enforcing abstinence. Trust was necessary for service providers to support YP reach their goals and YP-led, individualised goals benefitted most. Next, service providers often supported YP with mental health and sometimes this created challenges beyond their professional capabilities, thus emphasising the importance of collaborative inter-agency working. Lastly, providers were frustrated with required NDTMS outcome measures given they failed to capture service benefits.

Conclusion

DASH service's ‘harm reduction’ approach to supporting YP with substance misuse is in-line with evidence-based best practice guidance. However, reported NDTMS outcomes remain driven by an abstinence-informed agenda. This policy is grounded in governmental policies that do not consider the nuance of substance misuse disorders and are reflective of Nancy Reagan's 1980s ‘Just say No’ campaign. To prioritise the health and mental health of young people, government must reframe their policy on substance misuse.
Evaluation of Tertiary Neuropsychiatry Pilot Service: Pitfalls, Challenges, Outcomes and Success
Authors: Rudrappa Roopa , Jawahar Kaanthan , Andrews Nicholas , French Katie , Rathnaiah Mohanbabu
Published: August 2024

Aims

Neuropsychiatry, being at the interface between Neurology and Psychiatry, can fulfil the unmet needs of a cohort of people with complex presentations including psychiatry symptoms associated with neurological diseases and atypical psychiatry presentations with possible underlying aberrant brain processes. However, the development and provision of Neuropsychiatry services have lagged behind in the United Kingdom and some parts of the world, at the cost of ongoing symptom burden and reduced quality of life for vulnerable groups of patients. We set up a tertiary pilot service of Neuropsychiatry in Derbyshire from March 2022 and have been successfully operating both outpatient Neuropsychiatry clinics as well as inreach on to psychiatric wards. We set out to evaluate our service and explore the challenges and outcomes associated with our service development.

Methods

A mixed methods evaluation was completed, and the data were extracted from patient records and assessments. Feedback responses were obtained from referring clinicians and service users utilising structured feedback forms for each group. A thematic analysis approach was completed for qualitative responses. More than 140 patients have already been assessed by our Neuropsychiatry service to date, out of which we completed an initial analysis of records of 70 patients referred between March 2022 and February 2023. We further revisited the challenges (lack of resources including clinic space, admin and dedicated electronic medical records (EMR) section).

Results

67% of referrals were from Neurology services with Functional Neurological Disorder (FND) predominating. 74% of patients referred had more than one diagnosis/symptom cluster. Patients reported significant benefits and overall positive experiences from the service. One patient reported, “After 3 years I finally not only have answers to my symptoms but also an explanation as to why. Without this service, I believe I would be still struggling.” Similar positive feedback was obtained from referring clinicians.

Conclusion

Our results demonstrate that a successful tertiary Neuropsychiatry service can be established and run even under challenging circumstances including lack of resources. Our service now has a dedicated clinic running every week, a dedicated EMR section and we are currently in the process of submitting business plans towards sustainable commissioning. Furthermore, our service has been instrumental in reducing the length of inpatient stay, facilitating early discharges, diagnosing and treating reversible conditions that mimicked primary psychiatric issues, as well as improving the quality of life of a vulnerable cohort of people previously diagnosed with complex conditions such as FND and personality disorders.
Factors Influencing Time From Diagnosis to Treatment of Breast Cancer and the Impact of Longer Waiting Time on Survival in Kathmandu Valley, Nepal: A Population-Based Study
Authors: Subedi Ranjeeta , Houssami Nehmat , Nickson Carolyn , Dhimal Meghnath , David Michael , Yu Xue Qin
Published: August 2024

PURPOSE

Longer time between breast cancer (BC) diagnosis and treatment initiation is associated with poorer survival, and this may be a factor behind disparities in global survival rates. We assessed time to BC treatment in the Kathmandu Valley, Nepal, including factors associated with longer waiting times and their impact on survival.

METHODS

We conducted a retrospective population-based study of BC cases recorded in the Kathmandu Valley Population-Based Cancer Registry between 2018 and 2019. Fieldwork survey through telephone was undertaken to collect additional sociodemographic and clinical information. Logistic regression was performed to identify factors associated with longer time to treatment, and Kaplan-Meier and Cox proportional hazard regression was used to examine survival time and evaluate the association between longer time to treatment and survival.

RESULTS

Among the 385 patients with BC, one third waited >4 weeks from diagnosis to initial treatment. Lower education was associated with longer time to treatment (adjusted odds ratio, 1.63 [95% CI, 1.03 to 2.60]). The overall 3-year survival rate was 88.6% and survival was not associated with time to treatment ( P = .50). However, advanced stage at diagnosis was associated with poorer survival (adjusted hazard ratio, 4.09 [95% CI, 1.27 to 13.23]). There was some indication that longer time to treatment was associated with poorer survival for advanced-stage patients, but data quality limited that analysis.

CONCLUSION

In the Kathmandu Valley, Nepal, women with a lower education tend to wait longer from BC diagnosis to treatment. Patients with advanced-stage BC had poorer survival, and longer waiting time may be associated with poorer survival for women diagnosed with advanced-stage disease.
Neurologic Manifestations of Rheumatologic Disorders
Authors: McCombe Jennifer A.
Published: August 2024

OBJECTIVE

This article provides an overview of the neurologic manifestations of sarcoidosis and select rheumatologic disorders. An approach to the assessment and differential diagnosis of characteristic clinical presentations, including meningitis and vasculitis, is also reviewed. A review of treatment options is included as well as discussion of distinct areas of overlap, including rheumatologic disease in the setting of neuromyelitis spectrum disorder and demyelinating disease in the setting of tumor necrosis factor-α inhibitors.

LATEST DEVELOPMENTS

An increased understanding of the immune mechanisms involved in sarcoidosis and rheumatologic diseases has resulted in a greater diversity of therapeutic options for their treatment. Evidence directing the treatment of the central nervous system (CNS) manifestations of these same diseases is lacking, with a paucity of controlled trials.

ESSENTIAL POINTS

It is important to have a basic knowledge of the common CNS manifestations of rheumatologic diseases and sarcoidosis so that they can be recognized when encountered. In the context of many systemic inflammatory diseases, including systemic lupus erythematosus, IgG4-related disease, and sarcoidosis, CNS disease may be a presenting feature or occur without systemic manifestations of the disease, making familiarity with these diseases even more important.
Autoimmune Neuromuscular Disorders Associated With Neural Antibodies
Authors: Dubey Divyanshu
Published: August 2024

OBJECTIVE

This article reviews autoimmune neuromuscular disorders and includes an overview of the diagnostic approach, especially the role of antibody testing in a variety of neuropathies and some other neuromuscular disorders.

LATEST DEVELOPMENTS

In the past few decades, multiple antibody biomarkers associated with immune-mediated neuromuscular disorders have been reported. These biomarkers are not only useful for better understanding of disease pathogenesis and allowing more timely diagnosis but may also aid in the selection of an optimal treatment strategy.

ESSENTIAL POINTS

Recognition of autoimmune neuromuscular conditions encountered in inpatient or outpatient neurologic practice is very important because many of these disorders are reversible with prompt diagnosis and early treatment. Antibodies are often helpful in making this diagnosis. However, the clinical phenotype and electrodiagnostic testing should be taken into account when ordering antibody tests or panels and interpreting the subsequent results. Similar to other laboratory investigations, understanding the potential utility and limitations of antibody testing in each clinical setting is critical for practicing neurologists.
Safety and Efficacy of Management for Intraprocedural Rupture During Endovascular Treatment for Intracranial Aneurysms
Authors: Hirai Sakyo , Hanazawa Ryoichi , Yoshimura Masataka , Shigeta Keigo , Sato Yohei , Taira Naoki , Kawano Yoshihisa , Karakama Jun , Obata Yoshiki , Hara Mutsuya , Yamada Kenji , Ishii Yosuke , Sawada Kana , Imae Shogo , Wakabayashi Hikaru , Sagawa Hirotaka , Fujita Kyohei , Fujii Shoko , Takahashi Satoru , Hirakawa Akihiro , Nemoto Shigeru , Sumita Kazutaka
Published: August 2024

BACKGROUND AND OBJECTIVES:

Although intraprocedural rupture (IPR) is rare, it is a devastating complication of endovascular treatment (EVT) for intracranial aneurysms. Very few studies have been conducted on IPR, and the safety and efficacy of management techniques of IPR have not been investigated.

METHODS:

Patients who experienced IPR during EVT between 2013 and 2022 were enrolled from a multicenter observational registry. We examined the safety and efficacy of the management of IPR using imaging markers, including increased hemorrhage and ischemic lesions, which were evaluated using postoperative computed tomography and diffusion-weighted imaging, respectively.

RESULTS:

Of the 3269 EVTs for intracranial aneurysms, 74 patients who experienced IPR (2.26%) were analyzed. Fifty-five patients (3.36%) experienced IPR among 1636 EVT cases for ruptured aneurysms. Multivariate analysis revealed that increased hemorrhage was significantly associated with poor outcomes (odds ratio [OR], 6.37 [95% CI, 1.00-40.51], P = .050), whereas ischemic lesions were not. Regarding management techniques of IPR, antihypertensive medication use was significantly associated with increased hemorrhage (OR, 14.16 [95% CI, 2.35-85.34], P = .004). Heparin reversal was an independent factor for ischemic lesions (OR, 8.92 [95% CI, 1.54-51.58], P = .014).

CONCLUSION:

Although the setting of IPR may be miscellaneous, and optimal management varies depending on individual cases, heparin reversal might be associated with ischemic complications, and its role in the successful hemostasis in IPR during EVT for ruptured aneurysms remains unclear.
What Are We Transfusing? Evaluating the Quality and Clinical Utility of Intraoperatively Salvaged Red Blood Cells in Spinal Deformity Surgery: A Nonrandomized Controlled Trial
Authors: Kurland David B. , Alber Daniel , Smith Andrew , Ahmed Shah , Orringer Daniel , Frempong-Boadu Anthony , Lau Darryl
Published: August 2024

BACKGROUND AND OBJECTIVES:

Intraoperative red blood cell (RBC) salvage is frequently used in contemporary spine surgery, despite clinical concern in its efficacy as a surrogate for blood-banked allogeneic packed RBCs (pRBCs). During spine surgery, salvaged RBCs (sRBCs) are exposed to injurious high-heat electrocautery, prolonged stasis, and abrasive pharmaceuticals, potentially making sRBCs a poor blood substitute. We therefore sought to scientifically and objectively define the quality of sRBCs in the context of complex spine surgery.

METHODS:

This is a single-center, prospective, nonrandomized controlled trial of patients undergoing posterior-based multilevel thoracolumbar instrumented fusion for spinal deformity with planned use of intraoperative RBC salvage between June 2022 and July 2023. Surgeries were performed by fellowship-trained spinal neurosurgeons and orthopedic surgeons. The participants were split based on transfusion of sRBCs (given sufficient yield) vs no sRBC transfusion. Primary outcomes were RBC electrolyte composition, indices, deformability, and integrity, which were evaluated in comparison blood samples: Baseline, pRBC, and sRBC. Secondary outcomes were related to clinical effects of sRBC transfusion. Morphological assessment used Stimulated Raman Histology and machine learning. Deformability was assessed using ektacytometry.

RESULTS:

A total of 174 patients were included. The mean age was 50.2years ±25.4, 58.6% was female, the mean level fused was 10.0 ± 3.9, and 58.0% received sRBCs (median 207.0 mL). sRBCs differed significantly on standard laboratory measures, had a high proportion (30.7%) of shrunken and irregularly spiculated morphologies, and demonstrated abnormal deformability and relaxation kinetics. The hemolysis index was significantly elevated in sRBCs (2.9 ± 1.8) compared with Baseline samples and pRBCs (P < .01). Transfusion of sRBCs was associated with suboptimal resuscitation and provided no practical clinical benefit.

CONCLUSION:

RBCs salvaged during posterior thoracolumbar spine surgery are irreversibly injured, with hemolysis index exceeding Food and Drug Administration and Council of Europe transfusion standards in all samples, questioning their efficacy and safety as a blood substitute.
Resting Energy Expenditure, Metabolic and Sex Hormones in Two Phases of the Menstrual and Hormonal Contraceptive Cycles
Authors: LÖFBERG IDA E. , KARPPINEN JARI E. , LAATIKAINEN-RAUSSI VESA , LEHTI MAARIT , HACKNEY ANTHONY C. , IHALAINEN JOHANNA K. , MIKKONEN RITVA S.
Published: August 2024

Introduction

Resting energy expenditure (REE) may fluctuate during the menstrual cycle (MC), due to the physiological effects of estradiol (E2) and progesterone. This study examined changes in REE and metabolic hormones (leptin, ghrelin, thyroid hormones), and dietary intake in two hormonally distinct groups, naturally menstruating women (NoOC) and women using monophasic combined oral contraceptives (COC).

Methods

Measurements included REE by indirect calorimetry, body composition by bioimpedance, and blood samples for hormone analysis in the early follicular and midluteal phases of the MC in the NoOC group (n = 38) or the active and inactive phases of the COC cycle (COC; n = 19). Participants recorded their food intake for 3 d after measurements. A secondary analysis was completed for the NoOC group without REE outliers (difference between measurements >1.5 × interquartile range, n = 4).

Results

In the NoOC group, luteal phase REE was 40 kcal higher than follicular phase REE (95% confidence interval (CI), −2 to 82 kcal·d−1, d = 0.20, P = 0.061). Leptin (d = 0.35, P < 0.001), triiodothyronine (T3; d = 0.26, P = 0.05), and fat intake (d = 0.48, P = 0.027) were higher, and thyroxine (d = 0.21, P = 0.041) was lower in the luteal phase. After excluding outliers, REE was 44 kcal higher in the luteal phase than in the follicular phase (95% CI, 12–76 kcal·d−1, d = 0.22, P = 0.007). In the COC group, the mean difference in REE was −2 kcal (95% CI, −82 to 79 kcal·d−1) between active and inactive phases, whereas T3 was higher in the inactive phase (d = 0.01, P = 0.037).

Conclusions

REE increases only slightly from the follicular to the luteal phase but remains unchanged between COC phases. Increases in T3, leptin, and fat intake during the luteal phase might echo metabolic fluctuations that parallel female sex hormones during the MC.
Pediatric onset neuronal ceroid lipofuscinoses: Unraveling clinical and genetic specifications
Authors: Saher Gul Ahdi  , Alvi Javeria Raza , Muhammad Azeem Ashfaq  , Tipu Sultan
Published: August 2024

Objective: To unravel the clinical and genetic specifications of Neuronal ceroid lipofuscinosis (NCL).
Methods: This is a retrospective cross-sectional study conducted in the Department of Pediatric Neurology Children Hospital and University of Child Health Sciences, Lahore, Pakistan from March 2017 to March 2022. The primary outcome was to measure genotype-phenotype correlation by segregation of phenotypes according to genotype. The secondary outcomes included a correlation between genotype and distribution of age(s) of onset.
Results: One hundred fifty three patients clinically diagnosed with NCL underwent genetic testing and pathologic mutation was identified in 32.7% of patients. About 59.6% were male and 37.2% had an affected sibling. The median age was 5.46±1.95 years at the onset of the first symptom i.e., myoclonic seizures in 68%, and motor difficulty in 24%. Other features found were global developmental delay (56%), hypotonia (23%), visual impairment (80%), ataxia (22%), and disc pallor (56%). The most common type was CLN6 (Ceroid lipofuscinosis neuronal) (42%), CLN2 (16%) followed by CLN7 (12%). When 50 patients with recognized mutations were compared with 103 patients with no mutation, family history (p=0.049), early visual loss (p=0.016), hypotonia (p=0.001), white matter signals (p=0.026) and pan-atrophy(p=0.047) was statistically significant in the genetically confirmed NCL. Multiple pairwise comparisons indicated that the estimated age of onset for the CLN1 and CLN2 mutation group was significantly lower than other genotypes including CLN6 (p 0.012), CLN10 (p 0.007) and CLN12 (p 0.007).
Conclusion: Following a detailed review of NCL symptomatology, a clinically-oriented approach should be used for a rapid diagnosis with confirmation by targeted molecular testing for future genetic counseling.
doi: https://doi.org/10.12669/pjms.40.8.8006
How to cite this: Ahdi SG, Alvi JR, Ashfaq A, Sultan T. Pediatric onset neuronal ceroid lipofuscinoses: Unraveling clinical and genetic specifications. Pak J Med Sci. 2024;40(8):---------. doi: https://doi.org/10.12669/pjms.40.8.8006
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Θετικές επιπτώσεις της τηλεόρασης και των διαδραστικών ψηφιακών παιχνιδιών στις γνωστικές ικανότητες των παιδιών
Authors: Σόλαρης Ιωάννης
Published: August 2024

Τα νέα ψηφιακά μέσα στη σύγχρονη εποχή της τεχνολογίας και των μέσων επικοινωνίας ολοένα και περισσότερο γοητεύουν τα παιδιά και γίνονται ελκυστικά στον χρόνο που αφιερώνεται για την ψυχαγωγία τους. Πρόκειται ιδίως για την τηλεόραση και για τα διαδραστικά ηλεκτρονικά παιχνίδια, στα οποία εκτίθενται τα παιδιά σε όλο και μικρότερη ηλικία και από τα οποία επομένως επηρεάζονται στις σκέψεις, τα συναισθήματα και τη συμπεριφορά τους. Πιο συγκεκριμένα, είναι σημαντική η εστίαση στη δυνάμει θετική επίδραση των δύο ανωτέρω μέσων στη γνωστική ανάπτυξη των παιδιών, σε αντίθεση με την έντονη κριτική για αρνητικά αποτελέσματα. Σκοπός της παρούσας εργασίας είναι η εξέταση των θετικών επιπτώσεων-επιδράσεων της τηλεόρασης και των διαδραστικών ψηφιακών παιχνιδιών σε συγκεκριμένες γνωστικές ικανότητες των παιδιών της πρώτης (3 έως 6 ετών) και μέσης παιδικής ηλικίας (6 έως 10 ετών). Τα συμπεράσματα απορρέουν από τη βιβλιογραφική επισκόπηση εμπειρικών ερευνών της τελευταίας εικοσαετίας που σχετίζονται με το προς διερεύνηση αντικείμενο.
Όλο το τεύχος
Authors: Σουλιώτη Μάγδα
Published: August 2024

'Ολο το τεύχος
Monte-Carlo calculations of evaporation and fission in excited spallation reaction fragments
Authors: Chatziioanidis Panajiotis , Nicolis Nikolaos
Published: August 2024

We report on a transcription of the Java program MCEF into FORTRAN. The program MCEF is suitable for fast Monte-Carlo calculations of the evaporation process and fission of highly excited fragments produced in spallation nuclear reactions. We studied the Java algorithm, analyzed the physics that govern the de-excitation process, converted the physics into FORTRAN functions, checked that the program’s fundamental functions work properly, and compared the program’s results to experimental data. The evaporation process translates well into the code, which has the advantage of being easily understood by the user, runs quickly, and is compatible with available related programs. Comparisons with the experimental data indicate the need for possible improvements and extensions of the present code.
A comparative study of γ-ray spectrometers in various applications
Authors: Barlas Alexandros , Siltzovalis Giwrgos , Balodima Paraskevi , Mertzimekis Theo J. , Madesis Ioannis , Lagaki Varvara
Published: August 2024

The present work concentrates on the detailed study of various types of γ-radiation spectrometers used mainly for applications. More specifically, various experiments were carried out to characterize and compare two (2) different high-purity germanium (HPGe) detectors, one (1) NaI scintillation detector, three (3) CdZnTe (CZT) detectors with standard calibration sources (152Eu, 137Cs and 22Na). In the context of the present work, the main focus was on the efficiency and the energy resolution of the detectors, but also on the angular response and operation of the CZT.
Radioactivity mapping of beach sand by mobile in situ gamma-ray spectrometry
Authors: Patiris Dionysios , Tsabaris Christos , Maramathas Christos , Alexakis Stylianos , Roumelioti Spyridoula Konstantina
Published: August 2024

A new method for prompt radioactivity mapping of beach sand is under development. It is based on mobile in situ gamma-ray spectrometry exploiting low- and medium-resolution portable scintillator systems. Two case study applications are presented which took place during IAEA’s RER1020 and CRP F22074 projects, aiming to determine the main methodological features, capabilities, and limitations of the new method. In general, spectra of very short acquisition time (20s) are obtained by a mobile unit (man or vehicle) along transects on the beach sand. The statistic of each spectrum is extremely low for individual analysis however, the spatial resolution of each measurement is preserved high (a few meters). The distribution of the total counting rate is used to classify the spectra, according to quartiles, into four classes (high, low, medium-high, and medium-low). For each class, the spectra are combined into one of a total acquisition time high enough for spectrometric analyses. Laboratory HPGe measurements and simulation studies were used to calculate the efficiency of selected photo-peak energies. The first maps obtained by the mobile method are in very good agreement with those obtained by grid sampling and laboratory analyses. Critical aspects under further investigation regard the varied physical parameters of the beach sand (density, water content, porosity) and the complicated detection geometry both of them strongly related to the detection efficiency.
Quantifying athermal recombination corrected radiation damage in ion irradiated Fe and W utilizing the SRIM code
Authors: Mitsi Eleni , Apostolopoulos George
Published: August 2024

Athermal recombination corrected displacements per atom (arc-dpa) is a recently proposed correction to the standard Norgett-Robinson-Torrens (NRT) model employed for radiation damage calculations, which takes into account intra-cascade recombination. The correction is not yet implemented in any of the widely used ion transport codes, and special data handling is required to obtain arc-dpa damage parameters in ion irradiations. In the current work, the widely used code SRIM was employed to calculate arc-dpa parameters in two metals of key interest for fusion materials research, Fe and W. For this, an interpolation was devised for the ion energy deposited to target damage, which was then used for post-processing of SRIM output. The NRT- and arc-dpa results obtained with this method are in general agreement with previous studies.
Probing new physics with nuclear recoil data from COHERENT
Authors: Papoulias Dimitrios K.
Published: August 2024

We exploit the full coherent elastic neutrino-nucleus scattering (CEvNS) dataset reported by the COHERENT Collaboration. In particular, we combine the most recent CsI-2021 measurement with the liquid argon (LAr) measurement from the 2020 campaign. In view of the increased statistics, the refined treatment of quenching effects and the better understanding of the error budget, the present study leads to improved constraints for a set of interactions within and beyond the Standard Model (SM). In terms of a dedicated statistical analysis we provide up-to-date limits on the weak the weak mixing angle and the neutron nuclear radius. With respect to beyond the SM phenomena, we improve previous bounds on electromagnetic neutrino properties and novel light mediator scenarios.
Radiological characterization of ITER materials
Authors: Kourgiantakis Rafail , Vasilopoulou Theodora , Diakaki Maria , Kokkoris Michael , Savva Marilia I. , Stamatelatos Ion-Evangelos
Published: August 2024

Samples of ITER materials were irradiated at the Joint European Torus (JET) to study their activation properties under neutron irradiation in a real fusion environment. The samples were irradiated at JET during the 2021 Tritium-Tritium (T-T) and Deuterium-Tritium (D-T) plasma experimental campaigns, with neutron flux levels and energy spectra comparable to the ones expected at ITER, and then distributed to European labs for gamma-spectroscopic measurements. In this work, the methodology of gamma-spectroscopic analysis performed at NCSRD is presented. The activated samples were measured using a high purity germanium detector to identify the produced radionuclides and quantify their induced activity levels. Correction factors, calculated using the MCNP code and the TrueCoinc program, were applied to account for the effects of self-attenuation of photons within the sample and true-coincidence summing in the detector, respectively. This work provides experimental data on the activation properties of materials used in ITER, which is important for the radiation protection of personnel and the safe handling of activated reactor components during maintenance activities, as well as for the decommissioning planning of ITER materials and their safe disposal as waste or for recycling.
Gamma-spectroscopic analysis of NORM samples
Authors: Vasilopoulou Theodora , Lazaraki Despoina , Kalamara Antigoni , Savva Marilia I.
Published: August 2024

Two samples of Naturally Occurring Radioactive Materials (NORM) were studied using gamma-spectrometry in order to determine their radioactivity levels. The samples consisted of phosphate ore and phosphogypsum, a by-product of the phosphate fertilizer industry. Customized containers of standard geometry were filled with the above materials and then sealed with epoxy resin in order to prevent gaseous isotopes from emanating. The samples were measured by means of gamma spectrometry using a High-Purity Germanium detector. The full energy peak efficiency calibration of the detector was performed experimentally, using reference volume sources of the same geometry and density as those of the samples. To account for the true coincidence summing effect and the self-attenuation of gamma-rays within the samples volume, appropriate correction factors were calculated using the TrueCoinc software and the MCNP code, respectively. In both samples, 228Ac, 214Bi, 235U, 214Pb, 212Pb, 234Th, 208Tl and 40K were detected, with activity levels varying per isotope. The results of the present study provide information on the activity levels of NORM, which is important for Occupational Radiological Exposure assessments of workers in industries involving NORM, such as the phosphate fertilizer industry, as well as for the protection of the environment.
Fast-timing measurements of nuclear lifetimes in the Z ~ 50 region
Authors: Vasileiou Polytimos , Mertzimekis Theo J. , Zyriliou Aikaterini , Chalil Achment , Efstathiou Margarita , Karadimas Angelos , Koseoglou Pavlos , Bonatsos Dennis , Martinou Andriana , Peroulis Spyridon K. , Minkov Nikolay , Mărginean Nicolae , Mihai Constantin , Costache Cristian , Lică Razvan , Mihai Radu E. , Borcea Ruxandra , Turturica Andrei , Florea Nicoleta
Published: August 2024

The neutron–deficient region around the Z=50 major shell closure provides fertile grounds for nuclear structure studies, as single–particle degrees of freedom compete with collective phenomena to form several of the observed spectroscopic properties. This work reports on the progress and the preliminary results of a recent experiment performed at IFIN–HH, in Magurele, Romania, focused around the measurement of lifetimes of excited states in neutron–deficient Te isotopes, by means of the Fast Electronic Scintillation Timing (FEST, or fast–timing) technique. A 11B beam of Elab = 35 MeV impinging on a 5 mg/cm2 natAg target was used to populate excited states in 115−120Te. The γ rays de-exciting these levels were detected by the ROSPHERE array, in its mixed 15 HPGe + 10 LaBr3(Ce) detector configuration. Additionally, the SORCERER particle detector array was coupled to ROSPHERE, enabling the study of p-γ and p-γ-γ coincident events. The combination of experimental findings and theoretical predictions from several models, including the newly developed proxy-SU(3), is anticipated to offer valuable insights into the dynamic shape evolution of the investigated isotopes.
Characterization of a Diamond, SiC and Si Detector Response to Neutron Beams at the NCSR “Demokritos”
Authors: Kaperoni Kalliopi , Diakaki Maria , Kokkoris Mike , Weiss Christina , Griesmayer Erich , Melbinger Julian , Axiotis Michail , Chasapoglou Sotiris , Vlastou Roza , Fragner Theodor
Published: August 2024

Detecting low energy neutrons (below 6 MeV) can be a challenge mostly due to the high γ-ray contamination and the low efficiency of the detectors. Over the last years semiconductor neutron detectors have been developed and due to their unique characteristics, they have been proven useful in numerous applications. Diamond, SiC and Si are the most popular materials for constructing resilient semiconductor detectors. Diamond exhibits excellent physical and electrical properties and it is the material of choice when high energy resolution, irradiation resistance and hardness is required. Silicon (Si) is the most commonly used material for semiconductor detectors, used in microelectronics as well as in various radiation applications. In addition, SiC shows increased radiation resistance and over the last decades it is used for applications in harsh environments, including extreme temperatures and intense radiation conditions. There is also a great interest in studying SiC based semiconductors, since it is a new and promising material, currently not available in the market and the substrate thicknesses produced are very limited.  In this work, a study was made with a Diamond a Si and a SiC detector to detect four low neutron energies: 2.45 MeV, 2.95 MeV, 3.45 MeV and 3.95 MeV, with quasi-monogenetic neutron beams at the NCSR “Demokritos”. The experimental spectra were extracted, the calibration of the detectors used was performed and the elastic scattering spectrum was compared with the angular distribution.
How effective is dentin autograft for socket preservation and implant site preparation: A systematic review protocol.
Authors: Sivaraman Karthik , Rajwar Eti , Chopra Aditi , Cherukara George , Mehrotra Shubhankar , Datta Namrata , Koshy Bindhu
Published: August 2024

Background Socket preservation is a surgical procedure aimed at preserving the dimensions of the alveolar bone following tooth extraction. It is performed by filling the extraction socket with bone graft material with or without a barrier membrane. Recently, dentine obtained from extracted teeth has been tried as an autograft for socket preservation. Studies have compared the use of dentin to other bone grafts, however, systematic reviews evaluating the efficacy of dentin for socket preservation are limited. Hence, this systematic review protocol is proposed to generate evidence on the efficacy of dentin as a viable alternative to other bone graft materials for socket preservation. Methods This systematic review protocol was prepared according to the Methodological Expectations of the Cochrane Intervention Reviews (MECIR) guidelines. It will be conducted using the Cochrane Handbook for Systematic Review of Interventions. PubMed, Scopus, Web of Science, EMBASE, Epistemonikos, Cochrane Central, and EBSCO databases and clinical trial registries, will be searched for all randomized controlled trials (RCTs) and non-randomized studies that have used autologous dentin graft (either in particulate/putty, or/matrix form) for socket preservation. The radiographic and clinical assessment of bone and soft tissue healing of the preserved sockets along with patient-related outcomes following surgery will be assessed. The risk of bias assessment of the RCTs and Non-RCTs will be assessed using the ‘Cochrane Risk of Bias assessment tool (ROB II) and ROBINS-I respectively. The certainty of evidence will be assessed by the GRADE approach. Discussion This evidence is important for dental clinicians and the public to make an informed decision when choosing graft material for socket preservation. The extracted teeth are considered biological waste; however, this evidence provides scope for using a less invasive autograft for bone regenerative procedures. Systematic review registration PROSPERO: CRD42021201958 (Registered on 15/02/2021).
Exploring the impact of hydrotherapy interventions on stress reduction in construction workers: A scoping review protocol
Authors: Sihonqo Banathi , Kuupiel Desmond , Nxumalo Celenkosini Thembelenkosini , Mokgadi Mokgobole Ursula , Mpofana Nomakhosi
Published: August 2024

Background The global construction industry causes considerable stress to workers, affecting them physically and mentally. Stress, a reaction to difficult situations, can cause negative health effects. The demanding environment of a construction site increases stress, which leads to psychological, physical, and behavioral reactions. Traditional treatments often have side effects and social stigma. Hydrotherapy, which uses water for healing, offers a promising alternative that promotes relaxation and detoxification. Its multiple benefits make it a valuable stress management tool. This scoping review aims to critically analyze existing interventions on physiological well-being popular in the construction industry and to investigate the biological responses of hydrotherapy to stress markers. Finally, make recommendations that support the health of construction industry workers. Methods An evaluation funneled by the Arksey and O’Malley framework, improvements plus suggestions by Levac, Colquhoun and O’Brien, Daudt et al., with the 2015 Johanna Briggs Institute guidelines will be performed. Organized electronic explorations of records and search engines including Scopus, PubMed, CINAHL Complete, Google Scholar, plus IEEE Xplore will be conducted to retrieve distributed peer-reviewed articles from all research projects, excluding reviews and gray published works. All literature, research questions and sub-questions meeting the inclusion criteria will be integrated in this evaluation. All searched literature is transferred to the Endnote 21 library. The quality evaluation of the involved papers will be achieved by applying the MMAT 2018 version. Discussion We envision charting applicable sources on stress, researching the efficacy of treatment alternatives for stress as well as assessing their correlation with quality of life in construction workers. This study is expected to expose research gaps, which could guide future accomplishment research on stress treatment mediations.
Development of a core outcome set for maternal and perinatal health research and surveillance in light of emerging and ongoing epidemic threats
Authors: Pingray Veronica , Klein Karen , Alonso Juan Pedro , Belizan María , Radice Gabriella , Babinska Magdalena , Berrueta Mabel , Bonet Mercedes
Published: August 2024

Background Maternal and perinatal health is often directly and indirectly affected during infectious disease epidemics. Yet, a lack of evidence on epidemics' impact on women and their offspring delays informed decision-making for healthcare providers, pregnant women, women in the post-pregnancy period and policy-makers. To rapidly generate evidence in these circumstances, we aim to develop a Core Outcome Set (COS) for maternal and perinatal health research and surveillance in light of emerging and ongoing epidemic threats. Methods We will conduct a Systematic Review and a four-stage modified Delphi expert consensus. The systematic literature will aim to inform experts on outcomes reported in maternal and perinatal research and surveillance during previous epidemics. The expert consensus will involve two individual, anonymous online surveys to rate outcomes' importance and suggest new ones, one virtual meeting to discuss disagreements, and one in-person meeting to agree on the final COS, outcomes definitions and measurement methods. Four panels will be established to participate in the modified Delphi with expertise in (a) maternal and perinatal health, (b) neonatal health, (c) public health and emergency response, and (d) representation of civil society. We will recruit at least 20 international experts for each stakeholder group, with diverse backgrounds and gender, professional, and geographic balance. Only highly-rated outcomes (with at least 80% of ratings being 7–9 on a 9-point Likert scale) and no more than 10% of low ratings (1–3) will be included in the final COS. Conclusions Implementing this COS in future maternal and perinatal research and surveillance, especially in the context of emerging and ongoing epidemic threats, will facilitate the rapid and systematic generation of evidence. It will also enhance the ability of policy-makers, healthcare providers, pregnant women and women in the post-pregnancy period and their families to make well-informed choices in challenging circumstances.