RepoMed (Medizinische Hochschule Hannover)
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Unseen dualities: underdiagnosis of substance use disorders in borderline personality disorder
Full text linkDigital Transformation in Patient Organizations: Interview and Focus Group Study
Full text linkBackground Patient organizations (POs) are an integral part of the health care landscape, serving as advocates and support systems for patients and their families. As the digitalization of health care accelerates, POs are challenged to adapt their diverse roles to digital formats. However, the extent and form of POs' digital adaptation and the challenges POs encounter in their digital transformation remain unexplored. Objective This study aims to investigate the digital transformation processes within POs. We examined the types of digital activities and processes implemented, people involved in respective tasks, challenges encountered, and attitudes toward the digitalization of POs. Methods The study was carried out by the multicenter interdisciplinary research network Pandora. We adopted a qualitative exploratory approach by conducting 37 semistructured interviews and 2 focus groups with representatives and members of POs in Germany. Results were obtained using a deductive-inductive approach based on a qualitative content analysis. Methods and results were reported in accordance with the COREQ (Consolidated Criteria for Reporting Qualitative Research) checklist. Results POs primarily apply basic digital tools to engage in communication, health education, and information dissemination. Some also develop specific mobile apps and collect health data through patient registries. Volunteers cover a considerable part of the workload. Sometimes, POs collaborate with external partners, such as health professionals or other nonprofit organizations. Furthermore, many (13/46, 28%) interviewees referred to the importance of involving members in digitalization efforts to better meet their needs. However, they described the actual practices used to involve members in, for example, developing digital services as limited, passive, or implicit. When evaluating digital transformation processes, representatives and members of POs expressed generally positive attitudes and acknowledged their potential to improve the accessibility of support services, management efficiency, and outreach. Still, resource constraints; the complexity of digital initiatives; and accessibility issues for certain demographic groups, especially older persons, were frequently mentioned as challenges. Several (15/46, 33%) interviewees highlighted POs' increasing responsibility to support their members' digital competencies and digital health literacy. Conclusions POs are actively involved in the digital transformation of health services. To navigate challenges and further shape and sustain digital activities and processes, POs may benefit from governance frameworks, that is, a clear plan outlining with whom, how, and with what objectives digital projects are being realized. Support from public, scientific, and policy institutions to enhance the process through training, mentorship, and fostering collaborative networks seems warranted
Sozialpsychiatrie im Gegenwind : ein hannoverscher Sozialpsychiater besichtigt sein Berufsleben: Band I: Vom Studienbeginn bis zum Beschluss zur Auflösung der Sozialpsychiatrie an der Medizinischen Hochschule (1974-2004)
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iPSC-based hepatic organoids reveal a heterozygous MYO5B variant as driver of intrahepatic cholestasis
Full text linkBackground Hereditary intrahepatic cholestasis is caused by variants of various genes involved in enterohepatic bile circulation, metabolization, and conjugation. Originally classified into 3 groups, the number of contributing genes is still increasing, underlining the need for a deeper understanding of the molecular interaction during intrahepatic cholestasis. Methods In the present study, we investigate the interplay of heterozygous variants in 3 cholestasis-associated genes (ABCB11, ABCB4, and MYO5B) by exploiting iPSC-based hepatic organoids from a patient suffering from recurrent intrahepatic cholestasis. Results Functional characterization of MRP2-mediated cholyl-lysyl-fluorescein (CLF) and BSEP-mediated Tauro-nor-THCA-24-DBD transport demonstrated a marked reduction of transport in MYO5B-deficient organoids, in comparison to unaffected control organoids. Moreover, iPSC-based organoids derived from the patient carrying 3 heterozygous variants in ABCB11, ABCB4, and MYO5B also exhibited absence of BSEP-mediated Tauro-nor-THCA-24-DBD transport, but functional MRP2-mediated CLF-transport. Interestingly, CRISPR/Cas9-mediated correction of the mutated ABCB11 allele could not restore the impaired BSEP function, suggesting the heterozygous MYO5B variant as the main driver of the transport deficiency. In fact, CRISPR/Cas-mediated correction of the MYO5B variant finally resulted in a restoration of the BSEP-mediated Tauro-nor-THCA-24-DBD transport. Conclusions iPSC-based organoids serve as an authentic model for functional assessment of the hepatobiliary transport with fluorescent substrates. This allows the characterization of variants of uncertain significance and other variants in cholestasis-associated genes and revealed that a heterozygous MYO5B variant increases the susceptibility to defective hepatobiliary BSEP-mediated transport
Evaluation of Cocoon Silk as an Annular Closure Material in a Rodent Disk Model: Minimal Behavioral Burden Despite Pronounced Inflammatory Reaction
No full textDie zur Verfügung gestellten präklinischen Rohdaten sind im Rahmen einer tierexperimentellen Studie im Zeitraum 05.02.2022 bis 11.03.2022 erhoben (Genehmigungsnummer beim LAVES Nds.: 33.8-42502-04-21/3771) Es handelt sich um klinische Scorewerte, die entsprechend des im Materialteils des Manuskripts dargestellten Score erhoben wurden und Messdaten der von-Frey-Testung zur Schmerzevaluation, deren Erhebung ebenfalls im Material und Methodenteil des Manuskripts beschrieben ist. Die Daten werden im Excel-Format zur Verfügung gestellt werden. Von im Folgenden angefertigten histologischen Schnitten wurden Toluidin und H&E-Färbungen durchgeführt. Exemplarische Schnitte aus den relevanten Bereichen sind im pdf-Format zur Verfügung gestellt sowie die pathohistologische Bewertung eines erfahrenen Pathologen von exemplarischen Schnitten, vornehmlich um verbliebenes Seidematerial im Gewebe
Characterization of cultured mesenchymal stroma/stem cells and effects on different cancer cell populations
Full text linkVitamin A deficiency attenuates cardiac rupture in Stra6-deficient hearts following ischemic injury
Full text linkBackground: Stimulated by retinoic acid gene 6 (STRA6) is a cell surface receptor that regulates cellular uptake of vitamin A metabolites and cardiac development. We hypothesized that Stra6 expression attenuates ischemic injury-induced heart failure following myocardial infarction (MI) by vitamin A-dependent mechanisms. Methods: MI was induced in mice with Stra6 germline deletion, vitamin A deficiency (VitAD) by combined lecithin-retinol acyltransferase (Lrat) germline deletion and feeding with a vitamin A-deficient diet. Contractile function was determined by transthoracic echocardiography, cardiac structure was assessed by histological analysis, and gene profiling was performed by RNA sequencing. Results: Stra6 deletion and VitAD did not impact contractile function and cardiac structure under basal conditions. Stra6 deficiency resulted in myocardial rupture, with the majority of mice dying by 4 days post-MI, which additional VitAD attenuated. Interestingly, contractile function, mRNA expression of heart failure markers, and cardiac structure were not different between groups 3 days post-MI. Gene profiling 3 days post-MI revealed decreased Wnt signaling in Stra6-deficient relative to wildtype hearts, which was reversed by VitAD. Conclusion: The present study identifies an unexpected role for VitAD, which preserves Wnt signaling and attenuates cardiac rupture in Stra6-deficient hearts following ischemic injury