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Barriers to healthcare access and continuity of care among Ukrainian war refugees in Europe : findings from the RefuHealthAccess study
No full textIntroduction: The Russian invasion of Ukraine displaced over 14 million people. By 2024, around 6 million Ukrainian refugees settled in Europe under the EU Temporary Protection Directive, providing permit of residence, work and health care. This influx strained European healthcare systems, particularly in addressing acute injuries. As the stay of refugees in EU countries prolongs, the management of chronic conditions becomes increasingly important. However, there is limited information available about Ukrainian refugees' access to various healthcare services. Aim: The aim of this study was to evaluate perceived accessibility of healthcare services in Europe for Ukrainian war refugees and to identify barriers to healthcare access, in order to inform improvements in healthcare provision. Methods: A cross-sectional online survey was conducted across Europe from July 2023 to April 2024, targeting adult Ukrainian war refugees. Survey explored areas defined as key health care needs. Descriptive, parametric and non-parametric statistical analysis methods were employed in data analysis. Results: Of 659 respondents, 550 (83.4%) were included in the final analysis due to having reported need to use healthcare services in the past year. The most prevalent needs included dental care (82.9%), prescription medication (81.6%), care for acute (78.4%), and chronic conditions (64.0%). Perceived access to care varied across services, with vaccinations rated highest, while chronic condition care rated lowest. Around ¼ of respondents reported that they had to temporarily return to Ukraine for services not available in the countries where they stayed, these being mostly dental and gynaecologic care. The most prevalent barriers reported were long waiting times (64.2%), information barriers (55.5%), and high service costs (49.1%). Discussion: The survey identified several barriers in the access to healthcare system for Ukrainians, particularly for chronic conditions care. Some barriers may be subjective, relating to limited access to information. However, others point to potential shortcomings within national healthcare systems, suggesting areas that require further review and improvement. Conclusions: Addressing language barriers, improving information dissemination, and enhancing chronic condition management were identified as crucial for improving healthcare access for Ukrainian war refugees. Coordinated strategies are needed to support refugees and ensure the sustainability of host healthcare systems
Swedish national cohort of children living with long-term respiratory support (DISCOVERY-P) : cohort profile
No full textPurpose Children living with respiratory support rely on medical technology, either fully or partially, throughout the day to meet their breathing requirements. Although children and young people living with respiratory support at home undergo long-term treatments and make extensive use of health and social care services, there is a notable absence of comprehensive outcome data on this group. The establishment of the first nationwide Course of DISease reported to the Swedish CPAP Oxygen and VEntilator RegistrY paediatrics cohort aims to investigate the disease trajectory, clinical and socioeconomic risk factors influencing incident illness, hospitalisation risk and mortality among children living with respiratory support. Participants Data on patients aged 0–18 years reported to the Swedish National Registry for Respiratory Failure and Sleep Apnoea (Swedevox) 1 January 2015 to 29 July 2021 were merged with seven quality or governmental registries, the National Quality Registry for Intensive Care, the National Medical Birth Register, the Swedish Cause of Death Registry, the Registry for Interventions under the Act on Support and Service to Certain Disabled Persons, the Swedish National Patient Registry and with socioeconomic data from Total Population Registry and Longitudinal Integrated Database for health insurance and labour market studies. Findings to date The cohort includes 716 children, 59% male, who began respiratory support at an average age of 6.4 years (SD 5.4). Among them, 28% use continuous positive airway pressure, 64% long-term mechanical ventilation (LTMV), 3% high-flow oxygen therapy (HFOT) and 5% other methods. Respiratory support is mostly used at night, but many LTMV (54%) and HFOT (81%) users need daytime aid. 77% of LTMV users rely on mask connection, differing from international data. Future plans Future projects include exploring the impact of socioeconomic factors on hospitalisation rates and mortality. The dataset is due for an update in 2026
Role of Electron Spin, Chirality, and Charge Dynamics in Promoting the Persistence of Nascent Nucleic Acid-Peptide Complexes
No full textPrimitive nucleic acids and peptides likely collaborated in early biochemistry. What forces drove their interactions and how did these forces shape the properties of primitive complexes? We investigated how two model primordial polypeptides associate with DNA. When peptides were coupled to a ferromagnetic substrate, DNA binding depended on the substrate's magnetic moment orientation. Reversing the magnetic field nearly abolished binding despite complementary charges. Inverting the peptide chirality or just the cysteine residue reversed this effect. These results are attributed to the chiral-induced spin selectivity (CISS) effect, where molecular chirality and electron spin alter a protein's electric polarizability. The presence of CISS in simple protein-DNA complexes suggests that it played a significant role in ancient biomolecular interactions. A major consequence of CISS is enhancement of the kinetic stability of protein-nucleic acid complexes. These findings reveal how chirality and spin influence bioassociation, offering insights into primitive biochemical evolution and shaping contemporary protein functions
Probing substrate water access through the O1 channel of Photosystem II by single site mutations and membrane inlet mass spectrometry
No full textLight-driven water oxidation by photosystem II sustains life on Earth by providing the electrons and protons for the reduction of CO2 to carbohydrates and the molecular oxygen we breathe. The inorganic core of the oxygen evolving complex is made of the earth-abundant elements manganese, calcium and oxygen (Mn4CaO5 cluster), and is situated in a binding pocket that is connected to the aqueous surrounding via water-filled channels that allow water intake and proton egress. Recent serial crystallography and infrared spectroscopy studies performed with PSII isolated from Thermosynechococcus vestitus (T. vestitus) support that one of these channels, the O1 channel, facilitates water access to the Mn4CaO5 cluster during its S2→S3 and S3→S4→S0 state transitions, while a subsequent CryoEM study concluded that this channel is blocked in the cyanobacterium Synechocystis sp. PCC 6803, questioning the role of the O1 channel in water delivery. Employing site-directed mutagenesis we modified the two O1 channel bottleneck residues D1-E329 and CP43-V410 (T. vestitus numbering) and probed water access and substrate exchange via time resolved membrane inlet mass spectrometry. Our data demonstrates that water reaches the Mn4CaO5 cluster via the O1 channel in both wildtype and mutant PSII. In addition, the detailed analysis provides functional insight into the intricate protein-water-cofactor network near the Mn4CaO5 cluster that includes the pentameric, near planar ‘water wheel’ of the O1 channel.Authors in the list of papers of Abuzer Orkun Aydin's thesis: Aydin A. O., de Lichtenberg C., Liang F., Forsman J., Graca A., Chernev P., Magnuson A., Cheah M. H., Schröder W. P., Ho F., Lindblad P., Debus R. J., Mamedov F., & Messinger J. </p
Complex Dynamics of Data Ecosystems : An Inquiry into the Recurrent Patterns of Action to Manage and Analyse Data
No full textThe rapid datafication of society has impacted every aspect of our daily lives. However, the literature and discussions thus far on data are largely techno-centric. The agency and effect of individuals in data ecosystems are either reduced to a mere facilitative role or backgrounded in the data discourses. In this dissertation, data-related activities such as those found in data management and analytics processes were problematised as digital phenomena that await critical examination through the lens of Routine Dynamics theory. Four studies are presented in this dissertation that investigate how people and technologies enact intricate routines for interoperating data in digital infrastructures; how organisations manage the interplay of humans and technologies for structuring systems and data to implement the single source of truth concept; and how knowledge management models can unpack the intersection of in-house data analytics systems and cloud services in small- and medium-sized organisations to transform raw data into actionable knowledge. The insights from applying Routine Dynamics theory in those first three studies culminated in developing a conceptual model of routines. The theory-informed problematisation of various data-driven activities in an empirical setting less represented in the scientific literature, such as in the nascent data ecosystem of Bhutan, advances the relevant body of knowledge with fresh perspectives on data management and analytics processes. Similarly, the rich account of data that factors in the role of humans will allow individuals and organisations to reframe narratives on data and enrich their data management and analytics practices in complex data ecosystems
Deposition rates in thermal laser epitaxy : simulation and experiment
No full textThe modeling of deposition rates in thermal laser epitaxy (TLE) is essential for the accurate prediction of the evaporation process and for improved dynamic process control. We demonstrate excellent agreement between experimental data and a model based on a finite element simulation that describes the temperature distribution of an elemental source when irradiated with continuous wave laser radiation. The simulation strongly depends on the thermophysical constants of the material, thermal conductivity, specific heat capacity, density, reflectivity and thermal emissivity, data of which is lacking for many elements. Effective values for the parameters may be determined with precision by means of an unambiguous reference provided by the melting point of the material, which is directly observed during the experiments. TLE may therefore be used to study the high temperature thermophysical and optical properties of the elements
Observation of Λ+→Λ0(980)+ and Evidence for Σ(1380)+ in Λ+→Λ+
No full textBased on 6.1 fb(-1) of ethorne- annihilation data collected at center-of-mass energies from 4.600 to 4.843 GeV with the BESIII detector at the BEPCII collider, a partial wave analysis of Lambda(+)(c) -> Lambda pi(+)eta is performed, and branching fractions and decay asymmetry parameters of intermediate processes are determined. The process Lambda(+)(c) -> Lambda a(0)(980)(+) is observed for the first time, and evidence for the pentaquark candidate Sigma(1380)(+) decaying into Lambda pi(+) is found with statistical significance larger than 3 sigma with mass and width fixed to theoretical predictions. The branching fraction product B[ Lambda(+)(c) -> Lambda a(0) (980)(+)]B[a(0)(980)(+) -> pi(+)eta] is determined to be (1.05 +/- 0.16(stat) +/- 0.05(syst) +/- 0.07(ext) )%, which is larger than theoretical calculations by 1-2 orders of magnitude. Here the third (external) systematic is from B(Lambda(+)(c) -> Lambda pi(+)eta). Finally, we precisely obtain the absolute branching fraction B(Lambda(+)(c) -> Lambda pi(+)eta) = (1.94 +/- 0.07(stat) +/- 0.11(syst))%.For complete list of authors see http://dx.doi.org/10.1103/PhysRevLett.134.021901</p
Reactive solute transport simulation of multicomponent cation exchange and diffusion processes in column experiments with clay-rich rock
No full textClays and clay-rich rocks play often an important role in nuclear waste disposal due to their low permeability and high sorption capacity, acting as natural barriers to fluid movement and contaminant migration. Understanding the transport and sorption behaviours of hazardous elements in clay-rich environments is therefore essential for long-term simulations with validated models of experimental data. This study investigates the reactive transport of 17 ionic compounds in the Woodford claystone using both experimental and modelling approaches. The experiment was conducted by injecting a multi-tracer solution into a column filled with crushed claystone, employing a flow-interruption method for examining kinetic behaviour during diffusion-dominated mass transfer. TOUGHREACT V4.0 OMP reactive transport code was applied to replicate the tests, using an advective-diffusive single porosity flow model that considers mineral dissolution/precipitation and cation exchange. The modelling results demonstrated that cation exchange and diffusion, along with advection, were the primary processes influencing ionic concentrations in the experiment. The primary mineral dissolution reactions were pyrite oxidation and silicate weathering, releasing Si, Al, and Fe that reprecipitated or contributed to cation exchange. The findings indicated that the claystone sample effectively sorbs Cs, Pb, and Eu through cation exchange. While the model showed good agreement with the experimental data, an excessive diffusion effect was simulated using the single-porosity model, which would likely be less if employing a dual-porosity model and accounting for immobile water
Divalent intermediates in lanthanide-based photocatalysts : spectroscopic characterization and reactivity
No full textThe reduction of stable trivalent lanthanide species (Ln(III)) by the excited states of organic chromophores is the basis of photocatalytic divalent lanthanide-mediated reduction reactions. While indirect evidence of the photochemical formation of the reactive Ln(II) species is abundant, direct spectroscopic evidence of their presence is scarce. Here, nine chromophores with absorptions covering the near UV and visible ranges were systematically investigated in the presence of Ln(III) ions to evaluate their ability to reduce Eu(III) upon excitation with visible light to the catalytically active Eu(II) species. Irradiated mixtures of Eu(III) and the chromophores were characterized using UV-vis absorption and emission and EPR spectroscopy. Several of the chromophore-Eu(III) combinations were competent photocatalysts in the presence of N,N-diisopropylethylamine or Zn terminal reductants. These results demonstrate that a variety of visible-absorbing chromophores can efficiently generate reactive Eu(II) from Eu(III) to catalyze Ln(II)-mediated reduction reactions