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Opening up? Exploring motives and needs of students and staff of a Dutch university on disclosing mental health issues to inform decision aid development
Background Decisions about disclosing mental health issues can be difficult, especially in the university setting. For this reason, students and staff of universities might benefit from decision support tools, such as the use of a decision aid. Currently, little is known about if and how people in this setting disclose and how decision support should look like. This study aims to address this gap by exploring disclosure experiences and preferences for support. Methods Semi-structured interviews were conducted with staff (n = 10) and students (n = 10), including participants who decided to (not) disclose their mental health condition. The participants were asked to complete a short questionnaire. Subsequently, they were interviewed about the decision to disclose and their needs regarding a potential disclosure decision aid. Interviews were analyzed using the Framework method. Results Most students chose not to disclose, whereas most staff did. Students and staff described advantages and disadvantages of disclosing. Reported advantages included support, relief, understanding, and safety. Risks included (fear of) stigmatization and career concerns. Not disclosing can prevent unwanted questions but can also lead to misunderstandings. Regarding decision support, both students and staff preferred a brief online tool. Conclusion In conclusion, both students and staff encounter challenges when it comes to deciding whether to disclose their mental health status. A decision aid can be a valuable tool to support them in making their decision.
Self-referencing ultrafast wide-field pump-probe microscopy
Correction: Effective thermal conductivity model of particle-filled composite materials with distributed inner heat sources
Aging influences nucleolar responses to traumatic brain injury in Drosophila
Traumatic brain injury (TBI) affects millions of people globally each year, yet effective treatments remain limited. A major challenge is the complexity of cellular and molecular responses to brain injury, many of which overlap with those seen in aging. A key hallmark of aging is nucleolar enlargement in brain and other tissues, reflecting increased ribosome biogenesis. Nucleolar size is regulated by the target of rapamycin (TOR) signaling pathway, which during aging is aberrantly activated. Inhibiting TOR reduces nucleolar size and extends lifespan in several model organisms. Using a Drosophila melanogaster model of closed-head TBI, we investigated whether injury influences nucleolar dynamics. Immunofluorescence microscopy of fibrillarin, a major nucleolar protein, revealed that brains of young, injured flies had substantially larger nucleoli than uninjured controls within one day of injury. Over the following weeks, the difference gradually diminished as nucleolar size increased in uninjured flies, eventually matching that of injured flies, which remained relatively stable. Additionally, heterogeneity in nucleolar size across cells became more pronounced with injury and aging. Finally, injury of older flies resulted in little or no nucleolar enlargement and even shrinkage within a few days of injury. These results suggest that TBI and aging converge on shared mechanisms that regulate nucleolar size, which may reach a maximal limit through either process. Consistent with this, mortality at 24 hours post-injury in young flies was significantly reduced by pharmacological inhibition of TOR with rapamycin or RapaLink-1, indicating that nucleolar enlargement contributes to TBI-induced damage. Overall, our results suggest that TBI accelerates the aging-associated increase in nucleolar size, implicating elevated ribosome biogenesis in TBI pathogenesis and highlighting TOR inhibition as a promising therapeutic approach.
High-throughput printing of functionally gradient material from self-propagation
Optimizing photovoltaic power prediction at extreme altitudes using stacking metamodels and dimensionality reduction
Impact of imperceptible motion delay in avatar head movement away from a target on preference formation
This study investigated the effect of imperceptible motion delay in avatar head movements on preference formation among operators. Despite the growing importance of avatars in various applications, there is a notable lack of research on how subtle manipulations of avatar movements influence operator cognition and decision-making. By aligning the head and gaze directions, we developed a virtual avatar system designed to subtly manipulate the operator’s attention toward specific objects using motion delay. The experimental results revealed that operators tend to prefer objects presented without motion delay, suggesting a negative effect of motion delay on preference formation. These findings highlight motion delay as a significant factor in directing attention and shaping preferences in virtual environments, which have implications for enhancing user experience and optimizing human–computer interaction design. It also emphasizes the necessity of protective measures in avatar-based systems to guard against subtle influences and underscores the ethical and security concerns related to these technologies.
Transposon invasion of primate genomes shaped human inflammatory enhancers and susceptibility to inflammatory diseases
Abstract Human inflammatory response reflects adaptive alteration of immune-cell regulatory elements during human evolution. Yet the impact of the deeper evolutionary history of these elements, within primate genomes reshaped by transposon expansions, remains unclear. Tracing sequence changes in human immune-cell enhancers back to macaque and analysing proinflammatory transcription factor binding, we show that primate-specific endogenous retroviruses and Alu transposons introduced functional NF-κB and IRF1 motifs, contributing most to the great-ape–specific pool. After the human-macaque split, these motifs tend to evolve toward higher predicted binding affinity. In modern humans, positive selection favoured alleles, often Alu-derived, that increase enhancer affinity for NF-κB, and Alu-containing enhancers are enriched in signatures of adaptation. Highly mutable, Alus disproportionately contribute to the pool of adaptive alleles, including at enhancers linked to inflammatory diseases. We propose that primate-specific transposons facilitated the evolution of inflammatory responses in great apes, with Alus shaping adaptive potential in modern humans.
Risk assessment of heavy metals in north of Iran (Sari) rice and implications for human health
What matters most to older adults in treatment decision making: A discrete choice experiment
Introduction Medical decision making is often guided bydisease-specific outcomes such as life extension or survival. Especially for older adults other outcomes like maintaining independence can be equally vital or more important. Enhanced insight into the priorities of community dwelling older adults can optimize treatment decision making and refine healthcare policy. The aim of this study was is to identify which outcomes are prioritized by adults of 50 years and older when choosing between treatment options with various outcomes in a hypothetical case of a life-threatening disease. Methods We conducted a Discrete Choice Experiment (DCE) with individuals aged ≥50, comparing six pairs of hypothetical treatmentoptions with five attributes: life expectancy, independence, pain, memory complaints and societal costs. Attribute utility was analyzed using a conditional logit model, and latent class analyses were employed to explore preferences in groups. Data collection took place at a four-day national fair for people aged 50 or older in Utrecht, Netherlands. Results In total 333 volunteers (233 female, mean 70 yr, SD 7.7) completed the DCE. Most participants prioritized maintaining independence, followed by life expectancy and the avoidance of severe physical or cognitive impairments (p < .05). Life expectancy only had a positive impact when it was extended by two years. Avoiding high societal costs also influenced preferences. Latent class analysis identified two subgroups: one (approximately 25% of participants) prioritized life expectancy, willing to compromise on other factors, while the other emphasized independence and minimizing societal costs. Interaction tests between respondents’ characteristics and preferences showed no significant differences. Conclusions When confronted with a (possible) life threatening disease, most people aged ≥ 50 yr prioritize remaining independence and the absence of severe pain and severe memory complaints above life expectancy. A smaller subgroup prioritized life expectancy above other attributes. These attributes – including societal costs – should be taken in to account in individual treatment decision making, in clinical guidelines and national healthcare policy.
Biomimetic self-reinforcing recyclable biomass-derived inherently-safe sustainable materials
Age Stratified Analyses of TyG Index eGDR and Additive Effects on T2DM Outcomes in Prevalence and Mortality
Retraction: The PI3K/AKT/mTOR Signaling Pathway Is Overactivated in Primary Aldosteronism
AI-powered spatial cell phenomics enhances risk stratification in non-small cell lung cancer
Abstract Risk stratification remains a critical challenge in non-small cell lung cancer patients for optimal therapy selection. In this study, we develop an artificial intelligence-powered spatial cellomics approach that combines histology, multiplex immunofluorescence imaging and multimodal machine learning to characterize the complex cellular relationships of 43 cell phenotypes in the tumor microenvironment in a real-world retrospective cohort of 1168 non-small cell lung cancer patients from two large German cancer centers. The model identifies cell niches associated with survival and achieves a 14% and 47% improvement in risk stratification in the two main non-small cell lung cancer subtypes, lung adenocarcinoma and squamous cell carcinoma, respectively, combining niche patterns with conventional cancer staging. Our results show that complex immune cell niche patterns identify potentially undertreated high-risk patients qualifying for adjuvant therapy. Our approach highlights the potential of artificial intelligence powered multiplex imaging analyses to better understand the contribution of the tumor microenvironment to cancer progression and to improve risk stratification and treatment selection in non-small cell lung cancer.
Establishing and validating syndromic surveillance of gastrointestinal infections using routine emergency department data, Germany, 2019–2023
Abstract Gastrointestinal infections in Germany account for 24.5 million outpatient visits annually. To enhance outbreak detection and trend monitoring, we developed and validated a syndrome definition for syndromic surveillance of gastrointestinal infections in emergency departments. We selected presenting complaints (Canadian Emergency Department Information System) and diagnoses (ICD-10) to develop the syndrome definition. Validation involved cross-correlation analysis of syndromic and laboratory-based surveillance trends (norovirus-gastroenteritis, rotavirus-gastroenteritis, campylobacteriosis and salmonellosis notifications). We included emergency departments from the German AKTIN registry with continuous data transmission (01/2019–06/2023). Our novel syndrome definition combined complaints (diarrhoea, vomiting, nausea) and diagnoses (intestinal infectious diseases). Across 864,353 visits in 7 emergency departments, 2.1% (n = 18,158) were gastrointestinal infection cases. Of those, 57% (n = 10,424) were female; 23% were aged 0–19 years (n = 4108); and 23% 20–39 years (n = 4116). Trends were similar between surveillance systems. Cross-correlation was 0.73 (95%-confidence interval 0.61–0.85; p < 0.001) at lag − 1, indicating a 1-week relative reporting delay of laboratory-based surveillance. Coherent trends and significant cross-correlation validated our syndrome definition. This novel automated syndromic surveillance complements laboratory-based surveillance while offering improved timeliness and reduced workload. Therefore, it was implemented in Germany’s national routine surveillance of emergency departments.
Investigating multimorbidity patterns and associated risk factors in the fasa adults cohort study (FACS): A latent class analysis
Background Multimorbidity, defined as the co-occurrence of multiple health conditions, is a major global public health concern. This study aimed to identify latent classes of multimorbidity and associated risk factors in Iranian adults. Method This cross-sectional study analyzed baseline data from 10,131 adults who participated in the Fasa Adults Cohort Study (FACS) in southern Iran. Multimorbidity was defined as the presence of two or more of 11 chronic diseases, including hypertension, dyslipidemia, stroke, osteoarthritis, depression, type two diabetes mellitus, obesity, osteoporosis, cardiovascular disease, thyroid disease, and respiratory disease. Latent class analysis (LCA) was used for cluster participants, and multinomial logistic regression was conducted to investigate the association between age, sex, education level, socioeconomic status, daily sleep duration, physical activity, and multimorbidity. Result The prevalence of multimorbidity was 40.3%. Three latent classes were identified: healthy (66.8%), dyslipidemia (14.1%), and cardio-metabolic conditions (19.1%). Older age increased the odds of belonging to dyslipidemia (odds ratio (OR) = 1.04 [95% confidence interval (CI): 1.03–1.05]) and cardio-metabolic conditions (OR = 1.10 [95% CI: 1.09–1.11]) classes. Similarly, women were at higher odds than men of being in dyslipidemia (OR = 2.49 [95% CI: 2.05–3.02]) and cardio-metabolic conditions (OR = 3.35, 95% CI: 2.79–4.03]) classes. Employed participants showed decreased odds of having cardio-metabolic conditions (OR = 0.66 [95% CI: 0.55–0.80]). However, very high socioeconomic status was a risk factor for cardio-metabolic conditions (OR = 1.44 [95% CI: 1.16–1.78]) and dyslipidemia (OR = 1.35 [95% CI: 1.10–1.65]). Higher physical activity and sleeping for 8 hours or more were protective factors against cardio-metabolic conditions (OR = 0.74 [95% CI: 0.63–0.87]). Moreover, medium or high dietary intake increased the odds of belonging to the dyslipidemia class (OR = 1.46 [95% CI: 1.09–1.94] and OR = 1.57 [95% CI: 1.16–2.11], respectively). Conclusion Using LCA, we identified distinct subgroups of chronic diseases, showing hidden patterns of multimorbidity associated with several risk factors. This approach offers deeper knowledge of disease clustering, contributes to a more comprehensive understanding of multimorbidity, and shows the importance of regional health challenges in designing targeted public health interventions.
Structural insights into context-specific inhibition of bacterial translation by macrolides
Exploring the therapeutic potential of Kirkia tenuifolia Engl. stem bark extract and its bioactive compounds through experimental and computational approaches
Combined effect of nutritional inflammation as well as depression on mortality in middle-aged and elderly people with osteoporosis and osteopenia
Background Inflammation, nutritional status, and depression interact complexly, impacting health outcomes. This study investigates their associations with all-cause and cardiovascular mortality in middle-aged and elderly individuals with osteoporosis. Methods Using NHANES data from 2007 to 2023, the study applied Cox regression models and restricted cubic spline plots to assess the effects of ALI (Advanced Lung Cancer Inflammation Index) and PHQ-9 scores on mortality outcomes in osteoporosis patients. Subgroup, threshold, and mediation analyses were also conducted. Results The study included 862 cases of all-cause mortality and 211 cardiovascular deaths. Higher ALI was associated with reduced mortality risk, while higher PHQ-9 scores indicated increased mortality risk. Combined analysis showed that osteoporosis patients with high ALI and no depressive symptoms had the lowest mortality risk. Restricted cubic spline and threshold analyses revealed a linear negative correlation between ALI and mortality risk and a nonlinear positive correlation between PHQ-9 scores and mortality risk. Subgroup analysis showed gender, physical activity, and sleep status influenced the interaction between ALI/PHQ-9 and mortality risk. Causal mediation analysis with bootstrapping found that ALI mediated 3.9% of the effect of osteoporosis on all-cause mortality and 5.6% on cardiovascular mortality, while PHQ-9 scores mediated 6.6% of cardiovascular mortality. Conclusion A significant negative correlation exists between ALI and mortality risk in osteoporosis patients, while PHQ-9 scores correlate positively. Favorable nutrition and inflammation, coupled with the absence of depression, help reduce mortality risks.