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- Wong, B. H. C., et al.
(författare)
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Self-Harm in Children and Adolescents Who Presented at Emergency Units During the COVID-19 Pandemic: An International Retrospective Cohort Study
- 2023
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Ingår i: Journal of the American Academy of Child and Adolescent Psychiatry. - : Elsevier BV. - 0890-8567. ; 62:9, s. 998-1009
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To compare psychiatric emergencies and self-harm at emergency departments (EDs) 1 year into the pandemic, to early pandemic and pre pandemic, and to examine the changes in the characteristics of self-harm presentations.Method: This retrospective cohort study expanded on the Pandemic-Related Emergency Psychiatric Presentations (PREP-kids) study. Routine record data in March to April of 2019, 2020, and 2021 from 62 EDs in 25 countries were included. ED presentations made by children and adolescents for any mental health reasons were analyzed.Results: Altogether, 8,174 psychiatric presentations were recorded (63.5% female; mean [SD] age, 14.3 [2.6] years), 3,742 of which were self-harm presentations. Rate of psychiatric ED presentations in March to April 2021 was twice as high as in March to April 2020 (incidence rate ratio [IRR], 1.93; 95% CI, 1.60-2.33), and 50% higher than in March to April 2019 (IRR, 1.51; 95% CI, 1.25-1.81). Rate of self-harm presentations doubled between March to April 2020 and March to April 2021 (IRR, 1.98; 95% CI, 1.68-2.34), and was overall 1.7 times higher than in March to April 2019 (IRR, 1.70; 95% CI, 1.44-2.00). Comparing self-harm characteristics in March to April 2021 with March to April 2019, self-harm contributed to a higher proportion of all psychiatric presentations (odds ratio [OR], 1.30; 95% CI, 1.05-1.62), whereas female representation in self-harm presentations doubled (OR, 1.98; 95% CI, 1.45-2.72) and follow-up appointments were offered 4 times as often (OR, 4.46; 95% CI, 2.32-8.58).Conclusion: Increased pediatric ED visits for both self-harm and psychiatric reasons were observed, suggesting potential deterioration in child mental health. Self-harm in girls possibly increased and needs to be prioritized. Clinical services should continue using follow-up appointments to support discharge from EDs.Diversity & Inclusion Statement: One or more of the authors of this paper self-identifies as a member of one or more historically underrepresented racial and/or ethnic groups in science. We actively worked to promote inclusion of historically underrepresented racial and/or ethnic groups in science in our author group. While citing references scientifically relevant for this work, we also actively worked to promote inclusion of historically underrepresented racial and/or ethnic groups in science in our reference list. The author list of this paper includes contributors from the location and/or community where the research was conducted who participated in the data collection, design, analysis, and/or interpretation of the work.
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- Caccavo, D., et al.
(författare)
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Effects of HPMC substituent pattern on water up-take, polymer and drug release: An experimental and modelling study
- 2017
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Ingår i: International Journal of Pharmaceutics. - : Elsevier BV. - 0378-5173 .- 1873-3476. ; 528:1-2, s. 705-713
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Tidskriftsartikel (refereegranskat)abstract
- The purpose of this study was to investigate the hydration behavior of two matrix formulations containing the cellulose derivative hydroxypropyl methylcellulose (HPMC). The two HPMC batches investigated had different substitution pattern along the backbone; the first one is referred to as heterogeneous and the second as homogenous. The release of both the drug molecule theophylline and the polymer was determined. Additionally, the water concentrations at different positions in the swollen gel layers were determined by Magnetic Resonance Imaging. The experimental data was compared to predicted values obtained by the extension of a mechanistic Fickian based model. The hydration of tablets containing the more homogenous HPMC batch showed a gradual water concentration gradient in the gel layer and could be well predicted. The hydration process for the more heterogeneous batch showed a very abrupt step change in the water concentration in the gel layer and could not be well predicted. Based on the comparison between the experimental and predicted data this study suggests, for the first time, that formulations with HPMC of different heterogeneities form gels in different ways. The homogeneous HPMC batch exhibits a water sorption behavior ascribable to a Fick's law for the diffusion process whereas the more heterogeneous HPMC batches does not. This conclusion is important in the future development of simulation models and in the understanding of drug release mechanism from hydrophilic matrices.
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- Caccavo, D., et al.
(författare)
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Mathematical modelling of the drug release from an ensemble of coated pellets
- 2017
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Ingår i: British Journal of Pharmacology. - : Wiley. - 1476-5381 .- 0007-1188. ; 174:12, s. 1797-1809
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Tidskriftsartikel (refereegranskat)abstract
- Background and PurposeCoated pellets are widely used as oral drug delivery systems, being highly accepted by patients and with several advantages compared to single unit devices. However, their behaviour needs to be elucidated so as to improve the effectiveness of the formulations and reduce production costs. In spite of this important issue, few mathematical modelling studies have been attempted, mostly due to the complexities arising from the system's polydispersity (non-homogeneous multiple-unit particulate systems), which has been scarcely investigated using mechanistic models. Experimental approachA mechanistic mathematical model was developed that was able to describe the single pellet behaviour in terms of hydration, drug dissolution, diffusion and release and particle size. This model was then extended to describe and predict the behaviour of mono- and polydispersed ensembles of pellets. Key ResultsThe polydispersity arising from the size and distribution of the inert core was shown to have a minimal effect on the drug release profile, whereas the thickness and distribution of the polymeric film was found to be the key parameter determining the drug release. Conclusions and ImplicationsThe mechanistic model developed, which is capable of determining the polydispersity of the drug delivery system, was able to predict the release kinetics from ensembles of pellets and to highlight the key parameters that need to be controlled in the production of pellet-based drug delivery systems, demonstrating its use as a powerful predictive tool.
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- Caccavo, D., et al.
(författare)
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Understanding the adhesion phenomena in carbohydrate-hydrogel-based systems: Water up-take, swelling and elastic detachment
- 2015
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Ingår i: Carbohydrate Polymers. - : Elsevier BV. - 0144-8617. ; 131, s. 41-49
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Tidskriftsartikel (refereegranskat)abstract
- The bio-adhesion is a complex phenomenon which takes place when two materials (at least one of biological nature, the other usually is a polymeric one) are held together for extended periods of time, usually for local drug delivery purposes. Despite bio-adhesion is widely exploited in commercial pharmaceuticals such as the buccal patches, the underlying phenomena of the process are not completely clarified yet. In this study experimental tests, in which the role of biological membranes is played by a water-rich agarose gel whereas patches are mimicked by hydrogel tablets (made of Carbopol or of Carbopol added with NaCl), have been used to analyze the behavior of the model system above described. Tablets have been forced to adhere on the agarose gel, and after a given contact time they have been detached, recording the required forces. Furthermore weight gain of the tablets (the water transported from the agarose gel toward the tablet) has been quantified. Water transport (during the time in which the contact between tablet and agarose gel is held) and elastic part of mechanical response during the detachment are modelled to achieve a better understanding of the adhesion process. Both the two sub-models nicely reproduce, respectively, the weight gain as well as the swelling of the Carbopol tablets, and the point at which the mechanical response ceases to be purely elastic.
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- Fustin, JM, et al.
(författare)
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Methylation deficiency disrupts biological rhythms from bacteria to humans
- 2020
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Ingår i: Communications biology. - : Springer Science and Business Media LLC. - 2399-3642. ; 3:1, s. 211-
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Tidskriftsartikel (refereegranskat)abstract
- The methyl cycle is a universal metabolic pathway providing methyl groups for the methylation of nuclei acids and proteins, regulating all aspects of cellular physiology. We have previously shown that methyl cycle inhibition in mammals strongly affects circadian rhythms. Since the methyl cycle and circadian clocks have evolved early during evolution and operate in organisms across the tree of life, we sought to determine whether the link between the two is also conserved. Here, we show that methyl cycle inhibition affects biological rhythms in species ranging from unicellular algae to humans, separated by more than 1 billion years of evolution. In contrast, the cyanobacterial clock is resistant to methyl cycle inhibition, although we demonstrate that methylations themselves regulate circadian rhythms in this organism. Mammalian cells with a rewired bacteria-like methyl cycle are protected, like cyanobacteria, from methyl cycle inhibition, providing interesting new possibilities for the treatment of methylation deficiencies.
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- Kazlauske, Jurgita, 1981, et al.
(författare)
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Determination of the release mechanism of Theophylline from pellets coated with Surelease (R)-A water dispersion of ethyl cellulose
- 2017
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Ingår i: International Journal of Pharmaceutics. - : Elsevier BV. - 0378-5173 .- 1873-3476. ; 528:1-2, s. 345-353
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this study was to investigate the water transport over free standing films based on the aqueous ethyl cellulose (EC) coating Surelease (R) and the drug (Theophylline) release mechanism from coated pellets. It was found that the main drug release rate from pellets was controlled by a diffusion mechanism. However, the drug release rate was altered by addition of sodium chloride to the external release medium. A decrease in the drug release rate when sodium chloride is added to the release medium has traditionally been used to indicate an osmotic drug release mechanism. However, our findings that the release rate decreased by sodium chloride addition could be explained by sodium chloride diffusing through the coating layer into the inner parts of the pellets, decreasing the solubility of Theophylline. This gave a reduced drug concentration gradient over the coating layer and thus a slower release rate. Furthermore, this study shows, as expected, that the transport of water through Surelease (R) films into the pellets was faster than the transport out of Theophylline (approx. seven times), which was the reason why the pellets were swelling during the release. It was also shown that the drug release rate, determined for both whole dose release and for single pellets, decreased with increasing thickness (from 16 to 51 mm) of the coating layer controlling the drug release rate.
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- Malafronte, Loredana, 1986, et al.
(författare)
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Combined convective and microwave assisted drying: Experiments and modelling
- 2012
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Ingår i: Journal of Food Engineering. - : Elsevier BV. - 0260-8774 .- 1873-5770. ; 112:4, s. 304-312
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Tidskriftsartikel (refereegranskat)abstract
- The drying process is largely used in many different industrial applications, such as treatment of foods,production of cosmetics and pharmaceuticals, manufacturing of paper, wood and building materials,polymers and so on.Physical and mathematical models can constitute useful tools to establish the influence of the main process variables on the final product quality, in order to apply an effective production control. In this work, simulation model was developed to describe combined convective/microwave assisted drying. In particular, a multi-physics approach was applied to take into account heat and two mass balances (for liquid water and for water vapor) and Maxwell’s equations to describe electromagnetic field propagation.Potato matrix was selected as food material; a waveguide with a rectangular cross section, equipped with a hot air circulator device, was used as microwave applicator. The proposed model was found able to describe the process, being thus a useful tool for design and management of the process itself.
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