The needs of gynecological cancer survivors at the end of primary treatment: A scoping review and proposed model to guide clinical discussions

OBJECTIVE

Gynecological cancer (GC) survivors have unmet needs when they complete primary cancer treatment. Despite this, no known research has summarized these needs and survivors' suggestions to address them. We conducted a scoping review to fill these gaps and develop a model useful to guide clinical discussions and/or interventions.

METHODS

English, full length, and accessible primary studies describing the needs of GC survivors were included. No restrictions on date nor country of publication were applied. Two reviewers screened and extracted data, which was verified by a third reviewer.

RESULTS

Seventy-one studies met the inclusion criteria for data extraction. Results were thematically grouped into seven dimensions: physical needs, sexuality-related concerns, altered self-image, psychological wellbeing, social support needs, supporting the return to work, and healthcare challenges and preferences. After consulting with a stakeholder group (a GC survivor, clinicians, and researchers), the dimensions were summarized into a proposed model to guide clinical assessments and/or interventions.

CONCLUSION

Results illuminate the diverse needs of GC survivors as they complete primary cancer treatment and their recommendations for care to meet these needs.

PRACTICE IMPLICATIONS

The resulting model can be used to guide assessments, discussions and/or interventions to optimally prepare GC survivors for transition out of primary cancer treatment.

Transgender people in the nursing discourse: An integrative review

OBJECTIVE

To integrate and analyse the literature produced by nurses in terms of care, education and understanding of the reality of transgender (trans) people.

DESIGN

An integrative review methodology guided by the framework proposed by Whittemore and Knafl.

DATA SOURCES

The search strategy was applied in the following databases: Medline, Embase, Scopus, Web of Science and CINAHL, as well as in Biblioteca Virtual de Saúde, during February and March 2021, with no time frame.

REVIEW METHODS

The references found were assessed according to the eligibility criteria established. The information of the articles included was extracted, and a thematic analysis was performed to synthesize the review findings.

RESULTS

The searches in the databases yielded 2859 articles; 985 after removing duplicates, and 33 articles were included in this review. Three major themes were identified: (1) Understanding the trans universe through the trans perspective; (2) Understanding health and nursing care for trans people; and (3) Trans women as the focus of health and nursing care. The themes evidenced in the lens of nurses and clients the importance of nursing training at all levels to prepare professionals on how to provide culturally competent nursing care for this population and reduce healthcare inequities.

CONCLUSION

Nurses must work to provide a space for convergence and enhancement of the rights of trans people and cease to be a verticalized care model. To such end, it is necessary to devise places and possibilities to teach and learn, to construct and reconstruct a culturally competent nursing care.

IMPACT

This review highlighted the current knowledge and identified gaps in the understanding of nurses, health professionals and students about the experience lived by trans people, resulting from the lack of training and continuing education of these professionals.

Pharmacological Targeting of Senescence with ABT-263 in Experimental Heart Failure with Preserved Ejection Fraction

Funding Acknowledgements

Type of funding sources: Public grant(s) – National budget only. Main funding source(s): Fundação Ciência e Tecnlogia

HFpEF is the most common form of heart disease in the elderly and is associated with high morbidity and mortality. Our understanding of HFpEF pathophysiology is limited and development of efficient therapies that alter the clinical course of the disease has proved greatly challenging. Although aging is a risk factor of HFpEF1, the involvement of aging hallmarks such as cell senescent and immunosenescence is unclear. Recently, a link between endothelial senescence and HFpEF development was demonstrated in mice with accelerated aging [1], endorsing anti-aging pharmacologic as potential new therapeutic alternatives for HFpEF. In fact, the senolytic (drugs that selectively promote apoptosis of senescent cells) ABT-263 has already proven efficacy in the context of cardiovascular diseases. Further studies are needed to clarify the relevance of aging and of anti-aging therapies in the context of HFpEF.

Using ZSF1 obese rats (ZSF1-Ob) as model of HFpEF we showed from 18 weeks signs of immunosenescence compared to ZSF1-Ln, namely an increased frequency of circulating myeloid cells and decreased frequency of T and B cells. Concomitantly, expression of pro-inflammatory factors (IL-6, IL-1, TGF-β, TNF-α) was upregulated in peripheral blood mononuclear cells (PBMCs) of ZSF1-Ob which also displayed characteristic features of cell senescence (p21 expression, lysosomal endogenous Beta-galactosidase (SA-B-Gal) senescence-associated secretory phenotype (SASP) and up-regulation of BCL-XL. Importantly, no signs of cellular senescence (SA-B-gal, pH2AX and senescence associated pathways) were found in the main hematopoietic organs (spleen and bone marrow). Alongside, these systemic alterations, an upsurge of cellular senescence was observed in myocardium of ZSF1-Ob rats, particularly in endothelial and hematopoietic cells. Serum of ZSF1-Ob rat was able to induce activation and cellular senescence of cardiac microvascular endothelial cells, indicating that systemic circulating factors may be the upstream mechanism of cellular senescence and dysfunction in HFpEF. Analysis of HFpEF patients and a control cohort adjusted to main co-morbidities further demonstrated accumulation of senescent monocytes in HFpEF patients. In these patients, the senescence marker SA-B-Gal correlated with plasmatic brain natriuretic peptide (BNP) levels and pulmonary artery systolic pressure. Targeting aging hallmarks through the treatment of ZSF1-Ob rat with ABT-263 resulted in a reduction in circulating senescent cells, decreased systemic and local inflammation, re-established immune proportions, restore the levels of circulating BNP and attenuated myocardial remodeling, particularly endothelial dysfunction and fibrosis.

Collectively these findings support that premature cellular senescence contributes to the establishment of a deleterious pro-inflammatory environment in HFpEF and that senolytic agents hold promise for the treatment of this syndrome.

Cannabis use and violent behavior

Introduction

Cannabis is the most commonly used psychoactive drug, particularly among adolescents and young adults. Accordingly, to the European Drug Report 2021, the prevalence of cannabis use is about five times that of other substances, so that last year cannabis use among EU inhabitants aged 15 to 24y is estimated at 19.2 %. Even though most human research has concluded that Δ9-tetrahydrocannabinol (THC), tends to dampen rather than provoke aggression in acute doses, recent evidence suggests a relationship between cannabis usage and violent behavior, especially when associated with neurodevelopment stages.

Objectives

To review the existing evidence on the association between cannabis and violence in young adults and provide an overview of possible mechanisms explaining this relation.

Methods

Literature review was based on PubMed/ MEDLINE, using key words inclusive for violence, cannabis and adolescence. Studies included focused the young-adults population and considered the relation between cannabis use and behaviors reported as acts of physical violence. Studies were excluded if they included self-harm behaviors.

Results

Recent studies, including case-reports, showed a global moderate association between cannabis use and violence. Preliminary data has even highlighted a potential larger effect in more frequent users. Also, the cannabis role in the central nervous system (CNS), with most expression in the limbic cortices, and especially as it participates in a variety of brain function modulations - including executive functions, inhibition/impulsivity, and emotional control, has been pointed as one of the main arguments for this relation.

Conclusions

Further studies may shed light on the effects of cannabis use on behavior.

Disclosure

No significant relationships.

OP0001 “I WILL NEVER FORGET THE SHAME I FELT”: A SURVEY TO PEOPLE WITH A RHEUMATIC DISEASE ABOUT INVALIDATION FROM HEALTH PROFESSIONALS AND OTHER PEOPLE

Background

The term invalidation refers to the patients’ perception that their medical condition is not recognised, either in denying, lecturing, not supporting or not acknowledging the condition. This may be the felt from health professionals themselves but also from family, friends, at work and in other social areas, imposing great suffering.[1] The European Alliance of Associations for Rheumatology (EULAR) has made efforts to raise awareness for the burden imposed by rheumatic and musculoskeletal conditions (RMDs) and promote the best quality of care, including recognition and psychosocial support. However, it is unclear how frequent and severe the problem remains nowadays.

Objectives

The aims of this national survey were: (i) to identify the levels of invalidation and lack of understanding felt by adults with RMDs from health professionals and other people, (ii) to investigate the relationship between invalidation, sociodemographic characteristics and disease; and (iii) to understand its impact on people’s life and health outcomes.

Methods

An online survey was developed by the national health professionals in rheumatology and patients’ organisations and opened between May and December of 2021. The questionnaire included demographic and disease information, the Illness Invalidation Inventory (3*I),[1] with additional questions in a Likert format and open questions for a detailed understanding of the phenomenon. The 3*I is composed of 8 items, measured from 1 (=never) to 5 (=very often), forming two factors: Discounting (mean of 5 items; lower scores indicating more discounting) and Lack of understanding (mean of 3 items; Higher scores representing higher lack of understanding).

Quantitative data were analysed using descriptive statistics. Associations were tested with a t-student and ANOVA one-way test (Bonferroni correction). Open responses were categorised using the content analysis technique, and themes were defined a posteriori.

Results

From the > 1500 responses obtained, 1410 responses were filled out completely (mean age of 46 years [SD=11], 95% females, 60% with FM, among which 59% were diagnosed in the last 5 years).

Invalidation was reported by 86% of the participants and 70% rated ≤5 on a scale from 0 (nothing) to 10 (totally) on feeling understood by other people. Invalidation was mostly felt from family (56%), health professionals (48%), friends (39%) and social environment (38%). The impact of this invalidation is mainly on the psychological well-being (58%), also reducing seeking health care (41%) and therapeutic adherence (17%), affecting work (41%), and to a less extent, (family) relations (31%).

Figure 1 shows the frequency of responses and means scores on the 3*I items and factors for participants with and without FM. The burden is greater for people with FM, which was statistically significant. People with higher education felt more discounting and more lack of understanding. No differences (p>0.05) were observed for gender or civil status.

Figure 1.

Percentages of responses per type of disease for the eight items of the Illness Invalidation Inventory.

Elucidative expressions of invalidation were shared, mostly by people with FM, encompassing their ability to work and need for social support, faking pain and treatment efficacy, and even intimacy aspects. These emotionally uncomfortable situations can be linked to lesser engagement with healthcare and disease management, and therefore, with worse health outcomes.

Conclusion

Invalidation remains a source of suffering, affecting well-being and health outcomes. Specific awareness and educational campaigns are needed to target this problem on different play-actors.

References

[1]Kool MB, et al. Ann Rheum Dis 2014;73:551–556. doi:10.1136/annrheumdis-2012-201807

Disclosure of Interests

None declared.

Serotonin Type 2a Receptor in the Prefrontal Cortex Controls Perirhinal Cortex Excitability During Object Recognition Memory Recall

Previous experiences can drive adaptive behavior based on different characteristics, including contextual ones. Indeed, contextual information can be used as a criterion to guide the recall of the most relevant memory trace and the inhibition of others. The medial Prefontal Cortex (mPFC) has been proposed as an area that plays a pivotal role in regulating the retrieval of memory traces in downstream regions. Also, we have shown that mPFC Serotonin 2a Receptors (5-HT2aR) modulates the retrieval of a contextually guided recognition memory task and modulates the retrieval and reconsolidation of memories in the Perirhinal Cortex (PRH). However, how the mPFC output mediated by the 5-HT2aR activity is modulating memory retrieval in the PRH is a question that remains unclear. To tackle this question, we analyzed neuronal activity in the PRH and mPFC, by measuring expression of the immediate early gene c-Fos. We combined behavioral, pharmacological and immunohistochemical techniques to examine how mPFC 5-HT2aR controls mPFC and the PRH activity. We found that blockade of mPFC 5-HT2aR increase the level of c-Fos expression in the PHR and that this increase correlates with animals' performance in the task. We also found an increase in c-Fos expression in the mPFC after mPFC 5-HT2aR blockade that does not correlate with the animals' behavioral response. However, these changes showed a significant correlation with those observed in the PRH. These results suggest that mPFC 5-HT2aR signaling may modulate the behavioral response during memory recall by controlling the neuronal activation in the PRH.

The use of simulation-based education in cancer care: a scoping review protocol

Simulation-based education can be an effective strategy to educate nurses and physicians across the continuum of cancer care. However, there is still a lack of studies collating and synthesizing the literature around the types, functionalities and delivery systems of simulation-based education to educate different professional groups about cancer care.

To collate and synthesize the literature on how simulation has been used to educate nurses and physicians about cancer care.

Scoping review methodology according to the Joanna Briggs Institute framework. Published literature is going to be searched through Medline (OVID), CINAHL, EMBASE and PsycINFO. Unpublished literature will be searched through ResearchGate, OpenGrey and open access theses and dissertations. Articles will be considered if the population is nurses (including nurse practitioners) and/or physicians, if they use any type of simulation as an educational strategy as the concept of interest, and if the context is cancer care. This review will consider experimental, quasi-experimental, observational, quantitative and qualitative studies designs, text and opinion papers and unpublished literature.

Results from this scoping review will generate a solid underpinning for nursing and medical community to empower evidenced innovation through the further development of simulation-based educational interventions.

Predictions of sardine and the Portuguese continental shelf ecosystem dynamics under future fishing, forced-biomass and SST scenarios

We used the Ecopath with Ecosim ecosystem model to assess the future effects of multiple stressors on sardine and the Portuguese continental shelf ecosystem. We assessed individual and combined impacts of changes in sardine fishing pressure, biomass of sardine competitors and predators and sea surface temperature (SST). This study demonstrated that the greatest impact on sardine stock is caused by projected SST rise whose effect is dominant and detrimental to sardine stock regardless of other conditions, including sardine fishing at maximum sustainable yield (FMSY). The largest impact on ecosystem stability, maturity and diversity of flows was observed under the forced-biomass scenarios that simulate changes in biomass of sardine predators and competitors. Moreover, these stressors alongside FMSY are projected to play an important role in the future evolution of the sardine stock. Results presented in this study can assist long-term and strategic management of the Iberian sardine stock.

Reflection on moving research forward during COVID-19: Strategies to continue, conclude and commence

The COVID-19 pandemic required oncology nursing researchers to immediately and drastically adjust their research activities. During the 33rd Annual CANO/ ACIO Conference Roundtable Workshop October 2021 - Moving Research Forward During COVID-19, oncology nurses gathered to share and discuss strategies they will continue, conclude, and commence when leading research during and beyond the pandemic. Workshop participants identified the use of low technology, such as telephone and virtual calls without video, as a valuable data collection strategy they will continue for individual interviews. In contrast, attendees expressed their desire to stop conducting virtual focus groups when public health measures are lifted. Oncology nurses indicated an interest in beginning to use a hybrid in-person/virtual data collection approach and incorporate some technological features, such as QR codes, for recruiting participants. Workshop attendees also reflected on the impact of COVID-19 on oncology nursing practice and education, highlighting future research priorities and considerations.

Nontuberculous Mycobacteria in Portugal: Trends from the last decade

INTRODUCTION AND OBJECTIVES

Nontuberculous mycobacteria (NTM) are opportunistic human pathogens found in the environment. The transmission seems to be associated with inhalation of aerosol droplets, ingestion or trauma events. Recent studies indicate that NTM disease is increasing worldwide, however, the true clinical impact of NTM infections is difficult to determine due to challenges in discriminating between disease and colonization as they are ubiquitous in the environment. In addition, understanding the epidemiology of NTM is difficult and has not yet been established. In this work, we used a country NTM representative collection from the National Reference Laboratory for Tuberculosis (NRL-TB) of the National Institute of Health (INSA), to characterize the circulation trends of NTM species in Portugal and the most affected regions, contributing to a better understanding of the NTM epidemiology.

MATERIAL AND METHODS

We conducted a nationwide retrospective study where all individuals with positive NTM cultures at the NRL-TB of the INSA from 2014 to December 2020 were included. Positive cultures were identified using GenoType Mycobacterium CM/AS® (Hain Lifescience) according to manufacturer's instructions, or hsp65 DNA sequencing as previously described. Social-demographic data from patients were also analyzed and patients classified into 3 groups according only to microbiological data, "definite NTM disease", "NTM colonization" and, "possible NTM disease".

RESULTS

In the period 2014-2020, the NRL-TB performed 50397 cultures. Among these, 1118 cultures were NTM positive retrieved from 944. Most of our cases were in patients whose mean age was 64±15.9 years, and no significant differences between gender was observed, although more frequent in male patients. Overall, from the 944 cases, we were able to identified 93 "definite NTM disease" cases and 79 "possible NTM disease". Mycobacterium avium complex (MAC) (40,8%), Mycobacterium abscessus-chelonae complex (MABC) (9,6%) and Mycobacterium fortuitum (6,3%) were responsible for most of the infections. The geographical distribution of NTM cases varied significantly and was possible to observe that was independent of population density. The region were most cases occurred was Lisbon Metropolitan Area (31,9%), followed by North (25,3%) and Centre (24,4%), however North region has the highest number of "definite NTM disease" cases (n=33).

CONCLUSIONS

This is the first national wide epidemiological study on this subject, contributing to a better understanding of NTM dynamics in Portugal. MAC was the NTM species responsible for the majority of infections and, LMA the region with the highest number of cases. It was also possible to conclude that the number of NTM isolates is independent of the demography of the region.

Comparing ultrastable lasers at 7 × 10-17 fractional frequency instability through a 2220 km optical fibre network

Ultrastable lasers are essential tools in optical frequency metrology enabling unprecedented measurement precision that impacts on fields such as atomic timekeeping, tests of fundamental physics, and geodesy. To characterise an ultrastable laser it needs to be compared with a laser of similar performance, but a suitable system may not be available locally. Here, we report a comparison of two geographically separated lasers, over the longest ever reported metrological optical fibre link network, measuring 2220 km in length, at a state-of-the-art fractional-frequency instability of 7 × 10-17 for averaging times between 30 s and 200 s. The measurements also allow the short-term instability of the complete optical fibre link network to be directly observed without using a loop-back fibre. Based on the characterisation of the noise in the lasers and optical fibre link network over different timescales, we investigate the potential for disseminating ultrastable light to improve the performance of remote optical clocks.

Impact of an enhanced screening program on the detection of non-AIDS neoplasias in patients with human immunodeficiency virus infection

BACKGROUND

The incidence of non-AIDS defining cancer (NADC) is higher in people living with HIV (PLWH) than in the general population, and it is already one of the leading causes of death in the HIV-infected population. It is estimated that the situation will be aggravated by the progressive aging of PLWH. Early diagnosis through intensive cancer screening may improve the ability for therapeutic interventions and could be critical in reducing mortality, but it might also increase expenditure and harms associated with adverse events. The aim of this study is to evaluate an enhanced screening program for early diagnosis of cancer in PLWH compared to standard practice. The specific objectives are (1) to compare the frequency of cancer diagnosed at an early stage, (2) to analyze safety of the enhanced program: adverse events and unnecessary interventions, (3) to analyze the cost-utility of the program, and (4) to estimate the overall and site-specific incidence of NADC in PLWH.

METHODS

We will conduct a multicenter, non-blinded, randomized, controlled trial, comparing two parallel arms: conventional vs enhanced screening. Data will be recorded in an electronic data collection notebook. Conventional intervention group will follow the standard of care screening in the participating centers, according to the European AIDS Clinical Society recommendations, and the enhanced intervention group will follow an expanded screening aimed to early detection of lung, liver, anal, cervical, breast, prostate, colorectal, and skin cancer. The trial will be conducted within the framework of the Spanish AIDS Research Network Cohort (CoRIS).

DISCUSSION

The trial will evaluate the efficacy, safety, and efficiency of an enhanced screening program for the early diagnosis of cancer in HIV patients compared to standard of care practice. The information provided will be relevant since there are currently no studies on expanded cancer screening strategies in patients with HIV, and available data estimating cost effectiveness or cost-utility of such as programs are scarce. An enhanced program for NADC screening in patients with HIV could lead to early diagnosis and improve the prognosis of these patients, with an acceptable rate of unnecessary interventions, but it is critical to demonstrate that the benefits clearly outweigh the harms, before the strategy could be implemented.

TRIAL REGISTRATION

ClinicalTrials.gov NCT04735445. Registered on 25 June 2019.

Organ donation after medical assistance in dying: a scoping review protocol

OBJECTIVE

This scoping review will collate and summarize the current literature on what is known worldwide about organ donation following medical assistance in dying. The information gathered will be used to inform updates of current and future policies on organ donation following medical assistance in dying in Canada.

INTRODUCTION

Medical assistance in dying is a controversial and contentious issue worldwide. While more countries are legalizing medical assistance in this regard, very few allow organ donation after such assistance has been given. At present, Canada, Belgium, and The Netherlands are the only three countries that permit this procedure. This scoping review will be conducted to summarize the current state of evidence and practices regarding organ donation following medical assistance in dying.

INCLUSION CRITERIA

This review will consider articles and documents on individuals who choose organ donation following medical assistance in dying. Articles will be considered for inclusion if they explore organ donation following medical assistance in dying at home or in any health care setting in any country. Quantitative and qualitative studies, text and opinion papers, gray literature, and unpublished materials provided by researchers will be considered for inclusion.

METHODS

This review will be conducted in accordance with the JBI methodology for scoping reviews. Published and unpublished materials will be included. Databases will include MEDLINE, Embase, CINAHL, PsycINFO, Web of Science - Science Citation Index and Social Science Citation Index, and Academic Search Complete. Relevant gray literature and materials from organ donation organizations will be included. Two independent reviewers will screen all material, extract data, and complete the descriptive examination.

Measurement of the lamella thickness during droplet impact onto differently wettable smooth surfaces using an extension of the LASER Pattern Shift Method with naturally occurring patterns

This study shows that the LASER Pattern Shift Method (LPSM) is a powerful measurement technique for film thickness measurements. In this paper, the approach of the LPSM is extended, which is now able to measure the lamella thickness during droplet impacts on smooth surfaces using the naturally occurring air bubble shadows. With the help of this rather new measurement technique, the influence of different experimental parameters on the lamella thickness could be systematically assessed, e.g., the influence of impact velocity, liquid properties, and surface wettability. Upon comparing the obtained results to an analytical correlation in the literature, good agreement could be found for its validity range.

Correlation profiles between interoception and exteroception in psychotic patients versus healthy controls

Introduction

Individual abilities to perceive internal and external sensations are defined respectively as interoception and exteroception: the dysregulation of these functions can explain many psychotic symptoms. (Ardizzi et al. 2016)

Objectives

We evaluated the differences in the interoceptive and exteroceptive perception between 39 patients with psychosis and 250 healthy controls using self-administered questionnaires. The association between interoception and exteroception in the two groups was also tested.

Methods

The tests we used are AASP (Adolescent / Adult Sensory Profile) and MAIA (Multidimensional Assessment of Interoceptive Awareness). Differences were measured with t-tests, associations with spearman’s correlation.

Results

Significant differences emerged between the two samples in the AASP total score and in its Low registration (LR) and Sensory Avoiding (SA) sub-scales and in the MAIA total score and in all its sub-scales except “Not Worrying” (Fig.1). Different patterns of associations between AASP and MAIA were observed: psychotic patients showed negative correlations between MAIA and AASP in the LR and Sensation Seeking (SS) sub-scales and in the auditory (AU) and tactile (TO) sensory channels. Healthy controls, positive correlations emerged between MAIA and AASP in the Sensation Seeking (SK) sub-scale and in the “perception of movement” (MO) sub-score (Fig.2)(Fig.3).

Conclusions

Higher scores of psychotic patients in AASP and MAIA reveal both a disregulated sensory related behavior and a hightened awareness towards internal stimuli. The negative correlation between the two scales in psychotic subjects highlights the importance of the interaction between internal and external perception in determining the global subjective experience.

Early Cerebrovascular Ultrasonography as a Predictor of Hemorrhagic Transformation After Thrombectomy

OBJECTIVES

To determine the predictive value of early transcranial color-coded sonography (TCCS) for intracranial hemorrhage (ICH) in patients with large artery occlusion (LAO) stroke of carotid circulation, who were submitted to endovascular therapy (EVT) with successful reperfusion.

MATERIALS AND METHODS

Retrospective study evaluating a cohort of consecutive stroke patients with LAO of the carotid circulation that were recanalyzed with EVT. We measured angle-corrected peak systolic velocities, end-diastolic velocities and mean flow velocities (PSV, EDV and MFV) of the symptomatic and asymptomatic middle cerebral artery (MCA). The ratio between MFV of the symptomatic MCA and MFV of the asymptomatic MCA (MCA-Ra) was calculated. Parenchymal hematoma in the 24 hours control CT was considered as ICH. Univariate associations and multivariate analyses were used to identify early independent predictors for ICH among TCCS findings.

RESULTS

We included 234 patients, mean age 72.5 (SD 12.6) years, 52.1% male. The mean time between recanalization and TCCS was 12.3 hours (range 3-22). Patients who developed postinterventional ICH showed a higher MCA-Ra (1.02 ± 0.26 vs 1.16 ± 0,21, p = 0.036). In multivariate analysis, only higher MCA-Ra remained independently associated with postinterventional ICH (OR: 6.778, 95%CI: 1.152-39.892, p = 0.034). A value of MCA-Ra ≥ 1,05 was associated with ICH, showing a sensitivity of 81.3% and a specificity of 65.9%; the AUC based of the ROC analysis was 0.688 (95% CI 0.570-0.806).

CONCLUSION

TCCS performed within the first 24 hours after stroke onset can help to predict hemorrhagic transformation in patients with LAO.

Phenomenological Constraints on the Transport Properties of QCD Matter with Data-Driven Model Averaging

Using combined data from the Relativistic Heavy Ion and Large Hadron Colliders, we constrain the shear and bulk viscosities of quark-gluon plasma (QGP) at temperatures of ∼150-350  MeV. We use Bayesian inference to translate experimental and theoretical uncertainties into probabilistic constraints for the viscosities. With Bayesian model averaging we propagate an estimate of the model uncertainty generated by the transition from hydrodynamics to hadron transport in the plasma's final evolution stage, providing the most reliable phenomenological constraints to date on the QGP viscosities.

Bipolar mania with psychosis vs without psychosis: A clinical characterization with indirect measures of severity

Introduction

The presence of psychotic symptoms is highest during acute episodes of bipolar mania. There is no evidence base regarding the implications of psychosis in the prognosis of bipolar disorder, despite common assumption that their occurrence reflects greater disease severity.

Objectives

We aim to compare sociodemographic and clinical characteristics of inpatients admitted for bipolar mania with and without psychotic features.

Methods

Retrospective observational study of inpatients admitted between January 1^st 2017 and 31 October 2020 in a psychiatry inpatient unit of a tertiary hospital. Descriptive analysis of the results was performed using the SPSS software, version 26.0.

Results

Between 2017 and October 2020 there were 103 admissions due to mania bipolar I disorder, 53.4% (n=55) with psychotic symptoms. When compared with mania without psychosis, psychotic mania was associated to male gender (71.1% to 39.7%; c²(1, N = 103) = 10,06; p = 0.02) and younger age (t(103) = -2.43; p = 0.017). The proportion of compulsory admissions and average length of stay were similar between mania with psychosis and mania without psychosis. Also, having a manic bipolar episode with psychotic symptoms was not associated to being prescribed a long-acting injectable antipsychotic.

Conclusions

The presence of psychotic symptoms in bipolar manic episodes were associated to male gender and younger age but not to indirect measures of illness severity.

Disclosure

No significant relationships.