Denmark is one of the safest places for childbirth, yet some women report dissatisfaction with their maternity care. However, some negative birth experiences may remain unreported due to thresholds for complaining. The study aimed to identify patterns of unreported negative birth experiences and to quantify the extent of these dark figures.

A survey was distributed to 3081 women who gave birth at a Danish hospital in 2022, resulting in 1022 responses (response rate = 33.2%). The women reported their birth experiences in categories based on the Healthcare Complaints Analysis Tool (HCAT), specifying problems, harm caused, and whether they had filed a complaint or intended to. Dark figure ratios regarding problems and harm levels were calculated by comparing unreported negative experiences to formally filed complaints based on the survey responses, covering each problem type and harm level.

Of the 1022 respondents, 336 (32.9%) women reported negative birth experiences, yet only 26 women had filed complaints. The remaining 310 unreported cases comprised 787 problems across HCAT categories. The most frequent problems were about communication and quality. The highest dark figure ratios were found within the management domain comprising institutional processes (13.0) and environment (9.9). The dark figure ratios showed an inverse relationship with harm severity, being highest for minimal (19.5) and minor (21.2) harm levels and decreasing for moderate (5.5), major (4.8) and catastrophic (0.3) harm levels.

This study demonstrates a substantial underestimation of negative birth experiences when relying solely on formal complaints, with dark figure ratios ranging from 4.8 to 13, depending on the issue. The inverse relationship between harm severity and dark figure ratios suggests a threshold for filing a complaint, as the likelihood of reporting increases with greater harm. These findings provide novel insights into unreported maternity care experiences, highlighting the need to integrate patient experiences into healthcare improvements.

Research has established that unpaid family members, friends, or others who care for persons with dementia (ie, caregivers) may encounter socioemotional and physical health concerns as a consequence of providing extensive assistance. Similarly, caregivers for people living with traumatic brain injury (TBI) often experience a range of stressors and negative mental health outcomes due to care demands. Individuals with TBI often develop Alzheimer's disease and Alzheimer's disease-related dementia (AD/ADRD). This history of TBI may introduce complications to AD/ADRD caregiving. A comprehensive intervention grounded in the understanding of the complex caregiving context of both diagnoses is warranted to address the unique needs and concerns of TBI-AD/ADRD caregivers.

This study evaluated the feasibility of the TBI-AD/ADRD Caregiver Support Intervention (TACSI) psychoeducational program, designed to support the unique subset of caregivers facing the challenge of assisting relatives with AD/ADRD and a history of TBI. TACSI, a 6-session telehealth intervention, provides tailored psychosocial and psychoeducational coaching. In partnership with the 2 national healthcare centers, 15 caregivers enrolled in the 3-month feasibility study evaluating the design and subsequent refinement of TACSI. Mixed methods data were collected from 3-month follow-up surveys and qualitative data from postintervention interviews.

The feasibility, utility, and acceptance of TACSI were established. Caregivers liked the telehealth delivery and the personalized nature of TACSI, yet some expressed it would have been more beneficial earlier in their caregiving journey.

Caregivers valued the TACSI program. Their feedback has been applied to improve TACSI content and delivery for a larger pilot randomized controlled trial that is currently underway.

There is evidence that Dialogic Scientific Gatherings (DSG) are an effective intervention for inclusive health communication, demonstrating a positive impact on promoting healthy habits. This is particularly relevant for groups that typically face more health issues due to socioeconomic and educational inequalities. However, the implementation of DSG with non-academic Roma women, one of the groups historically suffering from these inequalities, has not yet been studied. To address this knowledge gap, within the framework of the ROM21 "Roma Women Leading Communities' Transformation" research project, four DSG sessions were co-created with non-academic Roma women, in collaboration with a Roma women's association and the research team. The DSG sessions focused on health topics chosen by the participants themselves. The analysis of the interventions by Roma women in the DSG revealed that these sessions provided a space for the collective creation of meaning and knowledge on health topics that concern them. This contributed to overcoming stereotypes about their lack of interest in evidence-based health information that promotes healthy habits. Topics discussed included the relationship between sedentary behavior and diet with diseases such as cancer and childhood obesity, as well as the connection between social ties and mental health. These discussions facilitated an environment conducive to informed health decisions among non-academic Roma women.

Remote cognitive assessments are increasingly used with the rising popularity of teleneuropsychology. Here, we evaluated the performance of the remotely administered Oxford Cognitive Screen (Tele-OCS) compared to in-person administration in adult stroke survivors.

40 stroke survivors ( M age = 69.30, SD = 10.44; sex = 30% female) completed in-person and remote versions of the OCS on average 30 days apart, with different trained examiners. The order of administration was counterbalanced. Cohen's d estimates were used to compare performance between modalities.

We found that the proportion of OCS subtasks impaired did not differ across modalities ( d <.001). With regards to raw subtask scores, only the picture naming subtask and executive score from the trail making subtask were found to be statistically different across modalities, though raw differences were minimal (<1 point difference on average). These statistical differences did not affect impairment classifications.

The Tele-OCS classified cognitive impairments in a comparable way to the in-person version. The validation of the Tele-OCS allows for remote assessment to increase accessibility and pragmatically aid in addressing the clinical need for stroke-specific cognitive screening in a wider population.

Traumatic brain injury (TBI) can cause a wide range of auditory outcomes. This review aimed to investigate common auditory outcomes associated with TBI and explore variations based on severity, aetiology, and gender.

A scoping review was conducted using an established methodological framework, which involved electronic and manual searches of databases and journals. Records published in English were included, which focused on auditory outcomes and assessments associated with non-blast related TBI in individuals 18 years and older. From 19,031 records, 61 met the inclusion criteria. Data were collated and categorized based on the study objectives.

Pure-tone audiometry (56/61) was the most commonly used hearing assessment, followed by otoscopy (27/61), whilst for tinnitus and hyperacusis assessments varied from questionnaires to self-reported problems. Different types of hearing loss were reported; conductive to mixed, of these 41% noted sensorineural hearing loss (SNHL). Normal hearing (≤ 20/25 dB HL) was reported in 31% (19/61) of the studies, however, five studies found abnormal results in central auditory tests despite normal hearing. Severe TBI was reported more frequently compared to other severities (10/23). Although SNHL was noted in 4 studies related to severe TBI, various outcomes were observed ranging from normal hearing to total deafness. Motor-vehicle accidents (MVA) were the most common aetiology (36/61), followed by falls, assaults, and sports injuries. Following MVA, SNHL was observed in 12 studies and CHL was observed across 10 studies. Out of 61 articles, 53% included only male patients, and SNHL was observed more frequently in males (17/33), whilst normal hearing and other types of hearing loss were noted in both genders.

TBI-related auditory impairments are complex, with inconsistent assessment methods and reporting gaps complicating data synthesis. Standardized clinical practices and screening guidelines are crucial for improving auditory assessment and management in this population.

Stem cell plasticity plays key roles in mammalian organogenesis, tissue homeostasis, and carcinogenesis. Given its tolerance to anti-tumor therapy and its promotion on immunosuppressive microenvironment, cancer cell plasticity is a major contributor to cancer recurrence and metastasis. It is necessary to explore novel avenues to resolve the limitations of current treatments.

We established stable cancer cell lines harboring all lamin knockdown and then explored the effects of all lamin deficiency on cancer plasticity and tumorigenesis in both cell and subcutaneous mouse models.

We found that all lamin knockdown disrupts cancer cell plasticity and impairs tumor progression. The deficiency of all lamin subtypes impaired the stemness and cell cycle transition of cancer cell. Lamin knockdown modulated genomic damage and repair pathways, inhibited mitochondrial function, and triggered cellular senescence. Moreover, lamin knockdown within cancer cell suppressed cancer growth in vivo by enhancing the infiltration and activation of functional T cells. Mechanistically, lamin knockdown reduced the expression of inhibitory immune checkpoints and inflammatory factors in cancer cell via the HIF-1 signaling pathway, which led to the increased sensitivity of cancer cells to chemotherapy.

Overall, our findings characterize the significance of nuclear lamins in cancer cell plasticity and offer an attractive way to improve the effectiveness of anti-cancer therapy.

The increasing use of digital devices has led to growing concern over Internet Gaming Disorder (IGD) among younger children. While several tools for the assessment of IGD have been developed, validated questionnaires have primarily been designed for children aged nine years and older, leaving a gap for early detection. This study developed and validated the Internet Gaming Disorder Scale-9 Short Form Japanese version for Children (IGDS9-SF-JC), a self-reported screening tool tailored for lower elementary school children.

The IGDS9-SF-JC was developed in collaboration with pediatric neurologists, child and adolescent psychiatrists, clinical psychologists, and elementary school teachers. This study assessed 525 children aged 6-12 years studying at a public elementary school in Chiba Prefecture, Japan.

The IGDS9-SF-JC demonstrated high internal consistency (Cronbach's α = 0.849). Confirmatory factor analysis indicated a unidimensional structure with acceptable model fit indices (GFI = 0.942, CFI = 0.931, RMSEA = 0.085). In general, boys had significantly higher total scores than girls, and higher scores were associated with ownership of a gaming device and/or a smartphone, longer times spent gaming and video-watching, later bedtimes, and skipping breakfast. These results are consistent with previous findings of IGD and lifestyle factors in older children and adolescents.

The IGDS9-SF-JC expands the applicability of IGD screening to younger children, providing a reliable and valid tool for the early identification and potential intervention of IGD. Further studies are required to refine the instrument and establish clinical cutoff scores using comparison with clinical populations.

Mental health conditions are the leading cause of preventable maternal mortality and morbidity, yet few investigations have examined perinatal bipolar disorders. This study sought to examine racial differences in the odds of having a bipolar disorder diagnosis in perinatal women across self-reported racial groups in a large sample in California, USA.

This cross-sectional study uses data from 3,831,593 women who had singleton live births in California, USA from 2011 to 2019 existing in a linked dataset which included hospital discharge records and birth certificates. International Classification of Diseases codes were used to identify women with a bipolar disorder diagnosis code on the hospital discharge record. Medical charts and birth certificate data was used to extract information on clinical and demographic covariate characteristics. Multivariable logistic regression was used to estimate the odds of having a bipolar disorder diagnosis across different self-reported racial groups.

We identified 19,262 women with bipolar disorder diagnoses. Differences in the presence of a bipolar disorder diagnosis emerged by self-reported race. In the fully adjusted model, Multiracial (selection of two races self-reported) women, compared to single-race White women had the highest odds of having a bipolar disorder diagnosis. Further examination of the all-inclusive Multiracial category revealed differences across subgroups where White/Black, White/American Indian Alaskan Native, and Black/American Indian Alaskan Native women had increased odds for bipolar disorder compared to single race White women.

Differences in bipolar disorder diagnoses exist across racial categories and when compared to White women, Multiracial women had the highest odds of bipolar disorder and thus represent a perinatal population of focus for future intervention studies. The increased burden of mental health problems among Multiracial women is consistent with recent research that employs disaggregated race data. More studies of Multiracial women are needed to determine how self-reported racial categories are related to increased risk for perinatal bipolar disorder.

To examine the effect of Soyasaponin Bb on morphine withdrawal-induced anxiety-like behaviors in male mice and the corresponding mechanism.

The chronic intermittent escalating-dose morphine administration paradigm and spontaneous withdrawal were used to induce anxiety-like behaviors in male mice. Open field test (OFT) and elevated plus maze test (EPM) were used to evaluate anxiety-like behaviors. Soyasaponin Bb was intragastrically administered. Western blot was used to monitor the level of GSK-3β, Nrf2, and superoxidase dismutase in the basolateral amygdala (BLA). Virus-mediated gene overexpression and knockdown were used to manipulate the expression of GSK-3β and Nrf2 in the BLA. Two-way analysis of variance followed by Tukey's test were used to make comparisons for the experiments between four groups. Student's t-test was used to make comparisons for the experiments between two groups.

Intragastric administration of Soyasaponin Bb attenuated morphine withdrawal-induced anxiety-like behaviors in male mice. Soyasaponin Bb rescued GSK-3β/Nrf2 signaling in the BLA in morphine withdrawn mice. Overexpression of GSK-3β in the BLA was sufficient to induce anxiety-like behaviors in male mice. Knockdown of GSK-3β in the BLA attenuated anxiety-like behaviors in male mice. Knockdown of Nrf2 in the BLA was sufficient to induce anxiety-like behaviors in male mice.

Soyasaponin Bb could play anxiolytic effect by regulating GSK-3β/Nrf2 signaling and inhibition of GSK-3β in the BLA may represent a novel therapeutic approach to morphine addiction and anxiety disorders.