Advances in experimental medicine and biology最新文献

Introduction: The attitudes of healthcare providers towards people with mental illness have caused significant concern for the research community.

Aim: The purpose of this systematic review was to examine the literature on the attitudes of healthcare professionals working in primary care settings towards people with mental illness.

Methodology: A systematic search was conducted in the PubMed database, focusing on cross-sectional articles published between 2017 and 2024. The search used the concepts of 'healthcare professionals', 'primary health care', 'attitudes', 'stigma', and 'mental illness'. Articles that met the inclusion and exclusion criteria were summarized.

Results: A total of 214 studies were identified in the initial search, with 12 studies included in the final review. Eleven of the 12 studies were conducted in Asia, the Middle East, South America, and Africa, and one study in Europe. Negative attitudes towards people with mental illness were a common finding among primary healthcare professionals in these studies. Contributing factors included low educational levels, older age, cultural influences, personal contact with people with mental illness, and insufficient mental health training. Educational and training interventions were recommended in all studies to improve these attitudes.

Conclusions: Healthcare professionals working in primary care often hold negative attitudes towards people with mental illness. The need for further education and training for healthcare professionals should be comprehensively addressed in future research.

Purpose: This study investigates the rates and causes of treatment discontinuation in one of the two public residential inpatient therapeutic programs for alcohol use disorder in Greece. Both programs are managed by the Department for the Treatment of Alcohol Use Disorder at the Psychiatric Hospital of Attica. The program examined in this study lasts 3 months and is followed by a Comprehensive Community Reintegration phase.

Methods: The study analyzed reasons for treatment discontinuation among 402 consecutive admissions to the residential program. Data were collected from the Patient Registry and participants' Medical and Clinical Records.

Results: Of the 402 consecutive admissions, 156 participants (38.8%) discontinued the program during the residential phase. Among these, 37.82% left voluntarily against medical advice, 6.4% left due to physical health issues, and 3.84% left due to a relapse of comorbid psychiatric disorders. The remaining participants were discharged and referred to other care facilities for reasons including forming intimate relationships (13%), verbal abuse (5.12%), unauthorized use of benzodiazepines (11.5%), and testing positive for drugs or alcohol (7.68%).

Conclusions: A significant proportion of participants in the residential inpatient therapeutic program for alcohol use disorder discontinue treatment, with over a half leaving voluntarily despite thorough preadmission preparation. This highlights ongoing clinical challenges, including addressing emerging psychopathological issues within the program's structured environment and enhancing participants' motivation for treatment.

Patients with hemoglobinopathies have both acute and chronic complications of the disease, which negatively affect their quality of life. The assessment of quality of life and mental resilience in these patients is an important tool to document both the degree of their burden and the important role of mental resilience as a tool to improve quality of life. The aim of the study was to assess the quality of life of people with hemoglobinopathies in Greece, their mental resilience, and their satisfaction with life. A cross-sectional study involving 96 adult patients with hemoglobinopathies was conducted. The instruments used were the "Connor-Davidson Resilience Scale," the "Life Satisfaction Scale (Satisfaction With Life Scale)," and the "Quality of Life Scale (WHOQOL-BREF)." According to the results, increased mental resilience and good adaptation to the stress of the disease, fairly high life satisfaction, and a fairly good level of quality of life were recorded. Little difference in quality of life was observed between thalassemia patients and sickle cell anemia patients.

This research examines the effectiveness of combining psychometric tests with computational models for diagnosing neurodegenerative and vascular forms of dementia. The goal is to enhance diagnostic accuracy using tools such as the Hachinski Ischemic Score (HIS), Mini-Mental State Examination (MMSE), and Montreal Cognitive Assessment (MoCA), in conjunction with machine learning technologies. The research framework integrates computational models to better analyze psychometric test data, aiming for early disease detection and more accurate differential diagnosis. The results suggest that this combined approach can reduce misdiagnosis rates and contribute to personalized patient treatment by creating an innovative diagnostic framework based on each patient's unique profile.

Introduction: Pediatric Palliative Care is a field that demands specific knowledge and skills.

Aim: The purpose of the study was to explore the knowledge of pediatric nursing staff concerning palliative care.

Methodology: In this multicenter, cross-sectional descriptive study, we used convenience sampling, consisting of 115 nursing staff who worked in general pediatric, pediatric oncology, pediatric surgery units, and Pediatric and Neonatal Intensive Care Units of the three biggest hospitals of Thessaloniki (Greece's second-largest city). The research tools included the demographic and working data of the participants and the Palliative Care Quiz for Nursing. The statistical package SPSS 26.0 was used, and the significance level was set at 0.05.

Results: The mean age of the participants was 43.1 ± 10.0 years, the majority (96.5%) were women and 82.6% of them were registered nurses. The total score mean value of correct answers was 7.4 ± 2,6. It was found that the total score of correct answers was associated with the participants' previous training on palliative care (p = 0,033) and the consideration that they applied palliative care in their clinical practice (p = 0.005). On the contrary, no relationship was found between the total score of knowledge and the demographic characteristics of the participants.

Conclusions: The knowledge of the pediatric nursing staff concerning palliative care is inadequate. Training programs concerning palliative care could improve health professional's level of knowledge as well as the quality of the provided care.

Birds are among the most diverse and threatened vertebrates on the planet. Occupying a vast array of global ecosystems, avian species are adapted to a variety of climates and enduring a range of stressors including anthropogenic and climate-related challenges. However, despite their adaptations to varied ecosystems, avian populations are declining at an alarming rate as seen in data from various global regions. In addition, illegal trade and loss of habitat impose significant stress on birds. It is critical to understand the life history of short- and long-lived birds, unique characteristics of birds including migratory patterns, effects of environmental chemicals, and other stressors on vulnerable life stages. Moreover, the ability to monitor wild populations is critical, and field-friendly health metrics must be developed. Understanding avian biology across the diversity of species and their critical resource requirements is critical to conservation. Although the hypothalamic-pituitary-gonadal (HPG) axis and neuroendocrine regulation of reproduction have many conserved mechanisms, the unique characteristics of avian physiology must be understood for effective conservation. The deleterious effects of developmental exposures to environmental chemicals, especially endocrine-disrupting chemicals (EDCs), can alter lifetime reproduction, and the adverse effects are exerted differentially in songbirds (altricial) versus precocial species. Examples are provided for the involved physiological mechanisms, with consideration of neuroendocrine mechanisms that modulate responses to environmental stressors. In addition, the role of vultures as scavengers and the demise of Old World vultures are presented as a case study.

Prolactin is a key hormone that plays significant roles in reproduction, extending far beyond its well-known function in mammalian lactation. It is vital for reproductive success across diverse taxa, including birds, fish, reptiles, and amphibians, where it regulates critical reproductive behaviors and physiological processes like parental care, pregnancy maintenance, embryonic diapause, immunity, osmoregulation, metamorphosis, and molting. Environmental cues often fine-tune its actions to ensure reproduction occurs under optimal conditions. Conversely, dysregulation of prolactin can severely impact reproduction. While hyperprolactinemia is the most common pituitary disorder affecting fertility in women and other species, including elephants, hypoprolactinemia can lead to inadequate parental care due to poor milk production or inadequate brooding. Environmental stressors such as pollution and climate change can further disrupt prolactin levels, compounding reproductive failures. Its sensitivity to social and environmental stressors has led to its increasing recognition as a valuable biomarker for animal welfare assessment. Elucidating prolactin's multifaceted functions can substantially advance our comprehension of reproductive strategies across diverse taxa. These insights could potentially inform and enhance conservation efforts for threatened species ex situ and in situ, contributing to more effective wildlife management and preservation strategies. Here, we review the role of prolactin in reproduction, health, and welfare across species, with a particular emphasis on elephants. Nearly three decades of elephant studies, facilitated by accessible blood sampling, have yielded valuable insights into its physiological roles and association with reproductive dysfunction. While many prolactin mechanisms in elephants have similarities to those observed in other species and humans, there are notable differences that warrant further study to enhance our understanding of its role in physiology and behavior and contribute to our broader knowledge of reproductive endocrinology across species.

Fishes are by far the most species-rich group of vertebrates, with 36,105 species currently recognized, approximately the same number of species as that of all non-fish vertebrates combined. Recent decades have witnessed dramatic population declines for many fish species, together with a loss in overall fish biodiversity. Globally, fish biodiversity is being threatened by a multitude of anthropogenic impacts including overfishing, habitat loss, pollution, aquaculture, loss of river connectivity, climate change and the impact of alien species. Nowhere is the world's biodiversity crisis more acute than in freshwater ecosystems. While rivers, lakes and wetlands cover less than 1% of the planet's total surface, they are home to over half the world´s fish species. One-third of freshwater fishes are now threatened with extinction, and 80 species have become extinct in recent years. This review covers the main drivers of declining fish biodiversity and details remedial strategies aimed at conserving both marine and freshwater fish biodiversity. The preservation of genetic resources through the cryobanking of reproductive cells and tissues, collectively known as germplasm, will increasingly become a valuable tool in the conservation of fish biodiversity. It is expected that the ability to establish cryobanks for the full range of fish germplasm, including sperm, oocytes, embryos and germ cells will be of key importance to the conservation of threatened fish species, as well as to fishery management and aquaculture. With the help of a range of emerging reproductive technologies, frozen germplasm will play a key role in future in situ and ex situ conservation initiatives. The rapid advance in next-generation sequencing technologies, together with the proliferation of resources such as fully sequenced fish genomes, is expected to result in a rapid expansion in the application of conservation genomics to the field of fish conservation and be instrumental in formulating future management strategies directed at conserving fish biodiversity, through both in situ and ex situ conservation initiatives.

There is widespread consensus that hypoxia limits the effectiveness of cancer therapy. This has led to interventions to increase oxygen (O₂) levels in tumors in patients, but success in clinical trials has been very limited and therefore clinical practice has not incorporated such interventions. The limiting step for successful intervention is the need to identify which tumors are hypoxic, whether they respond to interventions to increase O₂, and the timing of the response. Consequently, many techniques have been advanced to measure O₂ in tumors, but to date, none has been able to measure O₂ directly in the tumor repeatedly under clinically applicable conditions (i.e., without perturbing clinical flow). Initial efforts at Dartmouth demonstrated that in vivo electron paramagnetic resonance (EPR) spectroscopy, using three types of injected or implanted O₂ sensors, could provide the desired data under the desired conditions. Two types, injected paramagnetic India ink and an implanted coated derivative of lithium phthalocyanine, were successfully tested in clinical studies. However, their use is limited to tumors <1 cm of the surface. Consequently, Dartmouth developed a third O₂ sensor, an "implantable resonator" (IR), to allow measuring in tumors at any depth; the IR has been successfully tested in preclinical studies. However, because the IR requires implanting at greater depth than the other types, its invasiveness was considered to be a drawback for clinical studies. Therefore, Clin-EPR and colleagues at the University of Chicago made additional technical improvements to the IR and proposed a new approach, called the multisite oxygen sensor (MOS), that allows its use in clinical studies without adding any invasiveness to therapy the patient is already undergoing. Specifically, the MOS is being designed to use in conjunction with a frequently used therapeutic approach (HDR brachytherapy delivered with an afterloader), applied initially to cervical cancer. HDR brachytherapy requires the invasive placement of multiple needles into the tumor and leaves them in situ for days during the course of treatment. Using these same needles, modified to be permeable to O₂, would allow the MOS, inserted inside each needle, to simultaneously measure O₂ at multiple locations throughout the tumor. This O₂ measurement session could be repeated periodically during the course of therapy. We report preliminary technical studies of the modified MOS and the proposed modified brachytherapy needles, demonstrating in vitro the feasibility of our new approach to provide important information about tumor hypoxia during the course of radiation therapy without needing any additional invasiveness beyond standard of care therapy.