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Objective This study used causal inference to estimate the longitudinal effects of contagion in cohabitants and family members on university students' mental health and academic self-efficacy during the COVID-19 pandemic.Design A prospective longitudinal study including a baseline online measurement in May 2020, and online follow-ups after 5 months and 10 months. Participants were recruited through open-access online advertising.Setting Public universities and university colleges in Sweden.Participants The analytical sample included 2796 students.Outcome measures Contagion in cohabitants and in family members was assessed at baseline and at the 5-month follow-up. Mental health and academic self-efficacy were assessed at the 5-month and 10-month follow-ups.Results Mild symptoms reported in cohabitants at baseline resulted in negative mental health effects at follow-up 5 months later, and mild baseline symptoms in family members resulted in negative effects on academic self-efficacy at follow-ups both 5 and 10 months later.Conclusions Notwithstanding the lack of precision in estimated effects, the findings emphasise the importance of social relationships and the challenges of providing students with sufficient support in times of crisis., Funding Agencies|Swedish Research Council (Vetenskapsrdet); National Association of Student Unions

Functional precision medicine (FPM) aims to optimize patient-specific drug selection based on the unique characteristics of their cancer cells. Recent advancements in high throughput ex vivo drug profiling have accelerated interest in FPM. Here, we present a proof-of-concept study for an integrated experimental system that incorporates ex vivo treatment response with a single-cell gene expression output enabling barcoding of several drug conditions in one single-cell sequencing experiment. We demonstrate this through a proof-of-concept investigation focusing on the glucocorticoid-resistant acute lymphoblastic leukemia (ALL) E/R+ Reh cell line. Three different single-cell transcriptome sequencing (scRNA-seq) approaches were evaluated, each exhibiting high cell recovery and accurate tagging of distinct drug conditions. Notably, our comprehensive analysis revealed variations in library complexity, sensitivity (gene detection), and differential gene expression detection across the methods. Despite these differences, we identified a substantial transcriptional response to fludarabine, a highly relevant drug for treating high-risk ALL, which was consistently recapitulated by all three methods. These findings highlight the potential of our integrated approach for studying drug responses at the single-cell level and emphasize the importance of method selection in scRNA-seq studies. Finally, our data encompassing 27 327 cells are freely available to extend to future scRNA-seq methodological comparisons.

Hur vanligt är det att studenter bedriver projekt som inbegriper etiskt känsligt innehåll? I denna artikel redogörs för en undersökning rörande ett högskolepedagogiskt utvecklingsarbete som avser formaliserad etikprövning av studentuppsatser. Undersökningen inbegriper uppsatser som examinerats och godkänts vid fakulteten för hälsa och samhälle vid Malmö universitet under åren 2014–2017. Med etiskt känsligt innehåll avses här känsliga personuppgifter samt intervenerande metoder, som vid forskning kräver etikprövning enligt lag (2003:460) om etikprövning av forskning som avser människor. Av totalt 1215 granskade uppsatser hade 277 (22,8 %) etiskt känsligt innehåll; vanligast var känsliga personuppgifter avseende hälsa. 165 (13.6 %) uppsatser innehöll sådana uppgifter. Etiskt känsligt innehåll var mer vanligt förekommande i uppsatser på avancerad nivå (32,9 %) än på grundnivå (20,4 %). Var femte student på grundnivå genomförde alltså studier som skulle ha krävt Etikprövningsmyndighetens godkännande om de hade varit forskare. Enligt fakultetens riktlinjer ska samtliga studentarbeten med ett innehåll som skulle ha krävt förhandsprövning vid forskning förhandsprövas av fakultetens etikråd för studentarbeten. Men endast 191 av de 277 uppsatser (68,9%) som borde ha genomgått sådan handläggning passerade etikrådet. Implementeringen av formaliserad etikprövning av uppsatsprojekt tycks fungera bäst då studentens handledare är forskarutbildad och kan antas ha egen erfarenhet av etikprövning. Vår undersökning visade också att etikprövningen implementerats i olika grad vid olika institutioner. I artikeln diskuteras möjliga förklaringar till denna skillnad., Ethical Review of Student Projects: The Responsibility of Higher Education Institutions How common is it for students to undertake projects involving ethically sensitive content? This article presents a study on higher education pedagogical development project concerning the formalized ethical review of student essays. The survey included essays that were examined and approved at the Faculty of Health and Society, Malmö university during 2014–2017. Ethically sensitive content refers here to sensitive personal data and intervention methods that, in research, require ethical review according to the Act (2003:460) on ethical review of research involving humans. Out of a total of 1215 examined thesis, 277 (22.8%) contained ethically sensitive content; the most common being personal health-related data. 165 (13.6%) essays contained such information. Advanced level theses had a higher prevalence of ethically sensitive content (32.9%) compared to undergraduate theses (20.4%). This indicates that a significant proportion of undergraduate students undertook projects involving content that would require ethical review if they were researchers. The faculty’s guidelines stipulate that all student works containing content requiring prior ethical review in research, should be reviewed by the faculty’s ethics council. However, only 68.9% of the essays that necessitated such review passed the ethics council, indicating a gap in compliance with ethical review processes. The study suggests that the effectiveness of formalized ethical review of thesis projects is enhanced when the student’s supervisor holds a doctoral degree, likely due to their familiarity and experience with ethical review procedures. Furthermore, the research highlights variations in the implementation of ethical review across different departments within the faculty. The article delves into possible reasons for these discrepancies.

In higher education, students' trust in the university management may affect both mental health and academic self-efficacy. This longitudinal study, conducted during the most challenging course of the COVID-19 pandemic, uses multinomial regression and causal inference to estimate the effects of students' trust in their universities' strategies for managing the pandemic, on students' self-reported changes in mental health and academic self-efficacy. The analyzed sample (N = 2796) was recruited through online advertising and responded to a baseline online survey in the late spring of 2020, with two follow-up surveys five and ten months later. Results show that positive trust in university management of the pandemic protected against experiencing one's mental health and academic self-efficacy as worse rather than unchanged, both five and ten months after the baseline assessment. The findings emphasize the importance of developing and maintaining trust-building measures between academia and students to support students' mental health and academic self-efficacy in times of uncertainty.

Patients with peritoneal metastasis from colorectal cancer (PMCRC) may have a chance of cure when treated with cytoreductive surgery (CRS) combined with heated intraperitoneal chemotherapy (HIPEC)1–5. Choice of chemotherapy for HIPEC has been based on knowledge of its systemic effects, pharmacokinetics, technical feasibility, hyperthermic efficacy enhancement, and tolerance6–8. Selection of cancer drugs for treatment based on phenotypical assessment of patient cancer cell drug sensitivity ex vivo is one approach to personalized cancer treatment. One technique for this is the fluorometric microculture cytotoxicity assay (FMCA) that has been used in drug development and for the development of personalized cancer medicine9–16. This study investigated whether ex vivo assessment of drug sensitivity by the FMCA provides predictive information in terms of peritoneal recurrence-free survival (PRFS) and overall survival (OS) in patients treated with CRS and HIPEC for isolated PMCRC.

Cancer patients often suffer from cancer symptoms, treatment complications and concomitant diseases and are, therefore, often treated with several drugs in addition to anticancer drugs. Whether such drugs, here denoted as 'concomitant drugs', have anticancer effects or interact at the tumor cell level with the anticancer drugs is not very well known. The cytotoxic effects of nine concomitant drugs and their interactions with five anti-cancer drugs commonly used for the treatment of colorectal cancer were screened over broad ranges of drug concentrations in vitro in the human colon cancer cell line HCT116wt. Seven additional tyrosine kinase inhibitors were included to further evaluate key findings as were primary cultures of tumor cells from patients with colorectal cancer. Cytotoxic effects were evaluated using the fluorometric microculture cytotoxicity assay (FMCA) and interaction analysis was based on Bliss independent interaction analysis. Simvastatin and loperamide, included here as an opioid agonists, were found to have cytotoxic effects on their own at reasonably low concentrations whereas betamethasone, enalapril, ibuprofen, metformin, metoclopramide, metoprolol and paracetamol were inactive also at very high concentrations. Drug interactions ranged from antagonistic to synergistic over the concentrations tested with a more homogenous pattern of synergy between simvastatin and protein kinase inhibitors in HCT116wt cells. Commonly used concomitant drugs are mostly neither expected to have anticancer effects nor to interact significantly with anticancer drugs frequently used for the treatment of colorectal cancer.

Background: Alcohol-related sexual consequences are common in college students. A newly developed 41-item Alcohol-Related Sexual Consequences Scale has recently been evaluated in at-risk young adults in the U.S. The current study aims to validate the Scale in Swedish college students. Methods: The occurrence of alcohol-related sexual consequences was assessed by birth gender, relationship status, gender identity/sexual orientation, and age. Negative binomial regression was used to assess convergent and divergent validity. Results: On average, 5.4 (SD 5.1) alcohol-related sexual consequences were experienced past three months. Greater scores were reported in singles, LGBTQ (Lesbian, Gay, Bisexual, Transgender, Queer/Questioning), and younger students. All sex-related covariates showed robust associations with alcohol-related sexual consequences while most alcohol-related covariates were not associated (e.g., convergent validity). All alcohol-related covariates showed robust associations with alcohol consequences while most sex-related covariates were not associated (e.g., divergent validity). In the full model predicting alcohol-related sexual consequences, being a woman, single, and younger were identified as independent predictors. Conclusions: This newly developed scale assessing alcohol-related sexual consequences could be used in both epidemiological studies and intervention studies targeting at-risk students.

Objective: The labor market for mental health professionals increasingly requires competency in digital mental health treatment (DMHT). This presentation targets DMHT practitioners as course developers and teachers, describing proof-of-concept findings based on a) development of a remotely delivered DMHT course; and b) results from a qualitative evaluation of students’ experiences from the first course round. Methods: The course syllabus was developed through two structured workshops, attended by 11 stakeholders with DMHT experience. For the qualitative evaluation, interviews with seven women participants in the first course round were analyzed according to an inductive, phenomenographic approach. Results: The course development process established a 12-week syllabus covering historical development and evidence for DMHT and an 8-week DMHT clinical practicum treating students with common mental health problems. Examination was formulated as individual case reports encompassing reflections on a) the therapist and client roles; b) ethical aspects of DMHT; and c) future innovations for DMHT. The course is offered via a standard learning management system, with the practicum completed on a separate DMHT platform. The qualitative analysis of the first pilot course round, where students role-played therapists and clients, yielded six themes: overall course experience, treatment program and platform, therapist role, client role, supervision and the alliance. Conclusions: This proof-of-concept procedure led to course establishment in two formats: as an ordinary elective course for advanced clinical psychology students, and as a stand-alone national course for health professionals with basic psychotherapy training. Following local adaptation, the course could be replicated at additional universities globally., This work was supported by Uppsala University and funds from the Swedish Research Council.

One in three university students present with mental health symptoms. Help-seeking behavior is low due to emotional and practical barriers. The objectives of this session are to introduce and report on initial findings of the Swedish part of the WHO World Mental Health International College Student (WMH-ICS) project, which aims at mapping students’ mental health problems and proactively deliver internet interventions to those identified at risk. 1) Project introduction: The project conducts annual epidemiological surveys with 15 universities and colleges in Sweden. Students presenting with mental health problems in surveys are offered participation in a three-arm RCT, evaluating guided or unguided transdiagnostic ICBT against waiting list. In an embedded trial-within-trial, participants in treatment showing no improvement are randomized to personally adapted treatment (1:1) at mid-treatment. 2) Students' experiences of a campus-wide mental health surveyBetween 2020–2022, over 2000 college students completing the WMH-ICS survey commented on their experience with it. We report results from an analysis of the open-ended responses using Consensual Qualitative Research- Modified methodology. 3) Feasibility pilot resultsIn a single-group pilot study (n=28), students screening positive for depression (PHQ-9) and/or anxiety (GAD-7) received therapist-guided transdiagnostic ICBT over 8 weeks. We report on feasibility outcomes such as recruitment, uptake, measures of acceptability, and adaptive treatment procedures. 4) Implementing digital psychology in academic curriculumsThe project led to a proof-of-concept course establishment for advanced clinical psychology students and health professionals: “Digital Psychology in Theory and Practice”. We report on the course syllabus and experiences of pilot course participants.

ntroduction While novel approaches for treatment of acute lymphoblastic leukemia (ALL) in children have resulted in significant improvements in survival rates, survivors are faced with potentially life-long challenges as a result of the highly toxic treatment and the outcome for patients who relapse remains poor. The current risk-adapted treatment for ALL in children includes multiple drugs administered sequentially or in combination, with little variation in timing or intensity. Factors that affect varying treatment response between patients and cellular mechanisms that underly response to individual drugs are still under exploration. In this study, we investigate the relationship between ex-vivo drug resistance, transcriptomes, epigenomes and clinical outcome, with the aim of better understanding underlying determinants of treatment response. Methods Pediatric patients diagnosed with B-ALL between 1992 and 2008 in the Nordic countries were included in the study (n = 598). For these patients, ex-vivo drug response to ten clinically used drugs was determined using the fluorometric microculture cytotoxicity assay (FMCA). Clinical data, including follow-up information (overall survival and relapse free survival) was available for all patients. Additionally, DNA-methylation (450K array, n = 383) and gene expression profiling (RNA-seq, n = 119) was performed on a subset of diagnostic patient samples. The patients were stratified into low, medium and high resistance groups based on ex-vivo drug response. The low and high resistance groups were compared with regard to differentially methylated CpG sites or expressed genes associated with individual drug response profiles. Results Overall survival was significantly lower for patients with higher ex-vivo drug resistance to dexamethasone, doxorubicin and thioguanine compared to patients that displayed sensitivity to these drugs (p < 0.05). Similarly, relapse free survival was s