Acute physical-activity related increases in interoceptive ability are not enhanced with simultaneous interoceptive attention

Interoception, the sense of the internal body, is proposed to support self-regulation, and consequently influence mental health. Researchers have therefore shown interest in improving the ability to accurately monitor internal signals (i.e., interoceptive accuracy, IAcc). Research suggests that cardiac IAcc is modifiable by both manipulations of interoceptive attention (guided attention towards the internal body), and interoceptive exposure (strategically inducing somatic signals e.g., via physical activity). Whilst successful in isolation, it is unclear whether a combined approach (i.e., directing attention towards the internal body when signals are more salient) could elicit greater benefits. In a 2 × 2 within-subject design, 48 healthy adults (M_age = 25.98 ± 4.73 years, 50% female) completed four 20-min conditions varying in both attentional focus (interoceptive vs exteroceptive) and physical activity (active vs rest), with cardiac IAcc measured immediately after. Results revealed a main effect for physical activity (p < 0.001), however, there was no effect for attentional focus (p = 0.397), and no interaction effect (p = 0.797). Differential analyses showed that a higher sporting background increased sensitivity to physical activity-related increases in cardiac IAcc (p = 0.031). Findings indicate that (irrespective of attentional focus) moderate-vigorous physical activity-based interventions have the potential to increase cardiac IAcc, with certain individuals potentially benefiting more.

Fully automated machine learning-based selection of optimal bSSFP frequency offset for artifact reduction in cardiac MRI

Funding Acknowledgements

Type of funding sources: Private company. Main funding source(s): Research Support from Siemens Healthineers GmbH.

Background

In bSSFP sequences commonly used for cardiac MRI, signal modulation (e.g. banding artifacts) due to B0 inhomogeneity is often observed, especially at higher field strengths. The spatial position of these artifacts can be shifted by a frequency offset to reduce artifacts in a region of interest (ROI), e.g. the heart. To this end, frequency scout (FS) scans are acquired to visually select the optimal frequency offset [1,2]. In this work, we propose a fully automated image-based system for selecting the optimal frequency offset on FS images based on machine learning.

Methods

The proposed prototype system consists of four main steps (Fig.1). First, a pre-trained deep-learning-based whole heart segmentation network is applied on a four chamber-view FS image to localize the ROI where artifacts should be reduced. Second, high frequency components within the ROI (for each frequency offset in the FS series) are extracted by successive processing of Fourier transformation, high-pass filtering, inverse Fourier transformation and subtraction over series. and N images with the lowest high-frequency content are selected. Third, an adaptive weighting map for each FS image is generated which penalizes signal deviations from a pixel-wise median that is calculated based on the selected images [3]. By averaging the maps and selecting the frame with maximum percentage, the optimal frequency offset is selected.

A total of 38 datasets, acquired on multiple clinical 3T MRI scanners (MAGNETOM Skyra, Vida, Prisma, Lumina; Siemens Healthcare, Erlangen, Germany), were used to evaluate the proposed system. All FS series were annotated manually and used to compare with the system output. The experts were allowed to select multiple possible optimal FS images within a FS series. In case of multiple annotations, the system output was labelled as correct when it selected one of the offsets chosen by the expert. Further, the generated weighting maps were visually evaluated.

Results

The proposed system achieved an accuracy of 92.1% compared to experts’ ground truth annotations. From the failed cases (n=3), the maximum difference was off by 2 frames. Based on the generated weighting maps, a reasonable decision on the selection of the optimal frequency offset is made. The algorithm successfully selects an FS image with minimized banding and flow artifacts within the ROI (Fig. 2a). Further, it reveals that the generated weighting map correctly suppress areas containing artifacts (Fig. 2b).

Conclusions

Initial results demonstrate the feasibility of the proposed system to automatically select the optimal frequency offset on FS scans. Therefore, it can improve the automation of a cardiac MRI workflow. An example of the result of each step

Stress signaling and STAT1 activation characterize the keratinocytic gene expression pattern in Hidradenitis suppurativa

BACKGROUND

The pathogenetic factors generating the innate immune signal necessary for T cell activation, initiation and chronification of Hidradenitis suppurativa (HS, also known as Acne inversa) are still poorly understood. Emerging evidence suggests that a defective keratinocyte function critically contributes to HS disease development and progression.

OBJECTIVES

To elucidate the role of keratinocytes in HS lesion formation, we compared the transcriptomes of lesional and perilesional epidermis isolated from HS patients by RNA sequencing (RNA Seq).

METHODS

Pairwise-matched lesional and perilesional HS skin samples of five different donors were obtained and epidermal keratinocytes freshly isolated and processed for RNA extraction and RNA seq. Lesionally regulated genes were analyzed by large scale promotor analysis and functional annotation clustering to identify epidermally overrepresented transcription factor binding sites and functionally related gene groups. Results were experimentally validated with independent epidermal isolates of patient-matched lesional and perilesional HS skin employing qRT-PCR, cell culture, immunoblot, and immunostaining.

RESULTS

We show that HS is characterized by a strong epidermal stress state evident by a significant overrepresentation of an AP-1-driven gene signature and a substantial activation of the stress-activated cJun N-terminal kinase (JNK) pathway in lesional epidermis. Additionally, our data reveal a strong induction of STAT1 activation in lesional HS epidermis that likely results from IFNγ production and triggered expression of key inflammatory genes coordinating innate immune activation and the adaptive T cell response in HS.

CONCLUSIONS

Our data implicate a key role of stress signaling and JAK/STAT1 activation in disease progression of HS and suggest interference with JAK/STAT1 signaling as a potentially promising therapeutic approach for HS.

From Stable PH-Ylides to α-Carbanionic Phosphines as Ligands for Zwitterionic Catalysts

Although ylides are commonly used reagents in organic synthesis, the parent methylphosphine MePH2 only exists in its phosphine form in the condensed phase. Its ylide tautomer H3 P+ -CH2 - is considerably higher in energy. Here, we report on the formation of bis(sulfonyl)methyl-substituted phosphines of the type (RO2 S)2 C(H)-PR2, which form stable PH ylides under ambient conditions, amongst the first examples of an acyclic phosphine which only exists in its PH ylide form. Depending on the exact substitution pattern the phosphines form an equilibrium between the PH ylide and the phosphine form or exist as one of both extremes. These phosphines were found to be ideal starting systems for the facile formation of α-carbanionic phosphines. The carbanion-functionalization leads to a switch from electron-poor to highly electron-rich phosphines with strong donor abilities and high basicities. Thus, the phosphines readily react with different electrophiles exclusively at the phosphorus atom and not at the carbanionic center. Furthermore, the anionic nature of the phosphines allows the formation of zwitterionic complexes as demonstrated by the isolation of a gold(I) complex with a cationic metal center. The cationic gold center allows for catalytic activity in the hydroamination of alkyne without requiring a further activation step.

Development of Entrustable Professional Activities for Specialist Hospice and Palliative Care Pharmacists

CONTEXT

Entrustable professional activities (EPAs) translate competencies into explicit, practical terms that clearly state the expected roles and responsibilities of clinicians who have achieved proficiency and expertise in a field. EPAs are defined for Hospice and Palliative Medicine physicians but not for other members of Hospice and Palliative Care (HAPC) interprofessional teams, including pharmacists.

OBJECTIVES

The objective of this study was to develop EPAs for HAPC pharmacists.

METHODS

An 11-member workgroup of HAPC pharmacists was convened to develop candidate EPAs using nominal group and modified-Delphi methods. Content validity index was used as a measure of consensus, defined a priori at ≥ 60%. Vetting occurred via intra- and interprofessional stakeholder reactor groups and a national survey of HAPC pharmacists.

RESULTS

Following an iterative process of workgroup and stakeholder consensus-building, 15 HAPC pharmacist EPAs were developed. Among the workgroup, all 15 EPAs reached ≥ 70% consensus, indicating appropriate internal validity. In a national survey of 185 HAPC pharmacists with a 20% response rate, 13 EPAs were rated by most respondents as "essential" and 2 were rated by most respondents as "important but not essential." Respondents indicated the 15 EPA set represented the core professional activities of HAPC pharmacists well (median rating of 5 on a Likert-like scale, IQR 1).

CONCLUSION

Fifteen consensus EPAs describe essential activities of HAPC pharmacists in direct patient care, leadership, education, and scholarship. These EPAs will further guide pharmacist training programs, HAPC services seeking to incorporate a specialized pharmacist on the team, and currently practicing HAPC pharmacists.

Hypertriton Production in p-Pb Collisions at sqrt[s_{NN}]=5.02 TeV

The study of nuclei and antinuclei production has proven to be a powerful tool to investigate the formation mechanism of loosely bound states in high-energy hadronic collisions. The first measurement of the production of _{Λ}^{3}H in p-Pb collisions at sqrt[s_{NN}]=5.02  TeV is presented in this Letter. Its production yield measured in the rapidity interval -1<y<0 for the 40% highest-multiplicity p-Pb collisions is dN/dy=[6.3±1.8(stat)±1.2(syst)]×10^{-7}. The measurement is compared with the expectations of statistical hadronization and coalescence models, which describe the nucleosynthesis in hadronic collisions. These two models predict very different yields of the hypertriton in charged particle multiplicity environments relevant to small collision systems such as p-Pb, and therefore the measurement of dN/dy is crucial to distinguish between them. The precision of this measurement leads to the exclusion with a significance larger than 6.9σ of some configurations of the statistical hadronization model, thus constraining the theory behind the production of loosely bound states at hadron colliders.

Innovative Tele-Instruction Approach Impacts Basic Life Support Performance: A Non-inferiority Trial

Background

Sustaining Basic Life Support (BLS) training during the COVID-19 pandemic bears substantial challenges. The limited availability of highly qualified instructors and tight economic conditions complicates the delivery of these life-saving trainings. Consequently, innovative and resource-efficient approaches are needed to minimize or eliminate contagion while maintaining high training standards and managing learner anxiety related to infection risk.

Methods

In a non-inferiority trial 346 first-year medical, dentistry, and physiotherapy students underwent BLS training at AIXTRA—Competence Center for Training and Patient Safety at the University Hospital RWTH Aachen. Our objectives were (1) to examine whether peer feedback BLS training supported by tele-instructors matches the learning performance of standard instructor-guided BLS training for laypersons; and (2) to minimize infection risk during BLS training. Therefore, in a parallel group design, we compared arm (1) Standard Instructor Feedback (SIF) BLS training (Historical control group of 2019) with arm (2) a Tele-Instructor Supported Peer-Feedback (TPF) BLS training (Intervention group of 2020). Both study arms were based on Peyton's 4-step approach. Before and after each training session, objective data for BLS performance (compression depth and rate) were recorded using a resuscitation manikin. We also assessed overall BLS performance via standardized instructor evaluation and student self-reports of confidence via questionnaire. Non-inferiority margins for the outcome parameters and sample size calculation were based on previous studies with SIF. Two-sided 95% confidence intervals were employed to determine significance of non-inferiority.

Results

The results confirmed non-inferiority of TPF to SIF for all tested outcome parameters. A follow-up after 2 weeks found no confirmed COVID-19 infections among the participants.

Conclusion

Tele-instructor supported peer feedback is a powerful alternative to in-person instructor feedback on BLS skills during a pandemic, where infection risk needs to be minimized while maximizing the quality of BLS skill learning.

Trial registration

https://www.drks.de/drks_web/navigate.do?navigationId=trial.HTML&TRIAL_ID=DRKS00025199, Trial ID: DRKS00025199.

Taking back control of the Data. Developing an all in one System to monitor training post quality and provide trainer feedback

Introduction

We will present experience developing a system for monitoring training placements in psychiatry and community paediatrics, and how this was expanded to provide an automated anonymised MSF for trainers for annual appraisal and will identify trainers in need of additional support and other post/training programme issues. The session will be of interest to educators and medical education leads with practical tips and lessons learnt over the last 8 years since the system was first developed.

Objectives

The system was also used to identify trainers in need of additional support and other post/training programme issues.

Methods

We used an electronic system to gain the infromation as stated in the introduction.

Results

Over the last 8 years we have collected data using this system. the results for our trust will be displayed annoymously but the system is the ficus of this presenation.

Conclusions

The advantages of the system are that it runs throughout the year (so covers each post and placement), has high trainee response rates, has no selection bias (compared with some other MSF systems) and the results are embedded within local quality systems and individual consultant appraisals. The data that the system collects can help provide robust evidence when investigating concerns that might only arise periodically (for example through the annual GMC trainee survey in the UK). We believe that this system will be applicable for doctors providing training in other countries and empowers the improvement of psychiatric training for the profession.

Disclosure

No significant relationships.

Assessing the chemical anthropocene - Development of the legacy pollution fingerprint in the North Sea during the last century

The North Sea and its coastal zones are heavily impacted by anthropogenic activities, which has resulted in significant chemical pollution ever since the beginning of the industrialization in Europe during the 19th century. In order to assess the chemical Anthropocene, natural archives, such as sediment cores, can serve as a valuable data source to reconstruct historical emission trends and to verify the effectiveness of changing environmental legislation. In this study, we investigated 90 contaminants covering inorganic and organic pollutant groups analyzed in a set of sediment cores taken in the North Seas' main sedimentation area (Skagerrak). We thereby develop a chemical pollution fingerprint that records the constant input of pollutants over time and illustrates their continued great relevance for the present. Additionally, samples were radiometrically dated and PAH and PCB levels in porewater were determined using equilibrium passive sampling. Furthermore, we elucidated the origin of lead (Pb) contamination utilizing non-traditional stable isotopic analysis. Our results reveal three main findings: 1. for all organic contaminant groups covered (PAHs, OCPs, PCBs, PBDEs and PFASs) as well as the elements lead (Pb) and titanium (Ti), determined concentrations decreased towards more recent deposited sediment. These decreasing trends could be linked to the time of introductions of restrictions and bans and therefor our results confirm, amongst possible other factors, the effectiveness of environmental legislation by revealing a successive change in contamination levels over the decades. 2. concentration trends for ΣPAH and ΣPCB measured in porewater correspond well with the ones found in sediment which suggests that this method can be a useful expansion to traditional bulk sediment analysis to determine the biologically available pollutant fraction. 3. Arsenic (As) concentrations were higher in younger sediment layers, potentially caused by emissions of corroded warfare material disposed in the study area after WW II.

Characteristics of patients with brain metastases from human epidermal growth factor receptor 2-positive breast cancer: subanalysis of Brain Metastases in Breast Cancer Registry

Background

Up to 40% of patients with metastatic human epidermal growth factor receptor 2 (HER2)-positive breast cancer develop brain metastases (BMs). Understanding of clinical features of these patients with HER2-positive breast cancer and BMs is vital.

Patients and methods

A total of 2948 patients from the Brain Metastases in Breast Cancer registry were available for this analysis, of whom 1311 had primary tumors with the HER2-positive subtype.

Results

Patients with HER2-positive breast cancer and BMs were—when compared with HER2-negative patients—slightly younger at the time of breast cancer and BM diagnosis, had a higher pathologic complete response rate after neoadjuvant chemotherapy and a higher tumor grade. Furthermore, extracranial metastases at the time of BM diagnosis were less common in HER2-positive patients, when compared with HER2-negative patients. HER2-positive patients had more often BMs in the posterior fossa, but less commonly leptomeningeal metastases. The median overall survival (OS) in all HER2-positive patients was 13.2 months (95% confidence interval 11.4-14.4). The following factors were associated with shorter OS (multivariate analysis): older age at BM diagnosis [≥60 versus <60 years: hazard ratio (HR) 1.63, P < 0.001], lower Eastern Cooperative Oncology Group status (2-4 versus 0-1: HR 1.59, P < 0.001), higher number of BMs (2-3 versus 1: HR 1.30, P = 0.082; ≥4 versus 1: HR 1.51, P = 0.004; global P = 0.015), BMs in the fossa anterior (HR 1.71, P < 0.001), leptomeningeal metastases (HR 1.63, P = 0.012), symptomatic BMs at diagnosis (HR 1.35, P = 0.033) and extracranial metastases at diagnosis of BMs (HR 1.43, P = 0.020). The application of targeted therapy after the BM diagnosis (HR 0.62, P < 0.001) was associated with longer OS. HER2-positive/hormone receptor-positive patients showed longer OS than HER2-positive/hormone receptor-negative patients (median 14.3 versus 10.9 months; HR 0.86, P = 0.03), but no differences in progression-free survival were seen between both groups.

Conclusions

We identified factors associated with the prognosis of HER2-positive patients with BMs. Further research is needed to understand the factors determining the longer survival of HER2-positive/hormone receptor-positive patients.

•

Patients with HER2-positive BMs from breast cancer have the best prognosis compared with other tumor subtypes.

•

Among HER2-positive patients, hormone receptor-positive patients have the longest survival.

•

HER2-targeted therapy is significantly associated with a better prognosis in patients with BMs.

•

On average, two HER2-targeted therapy lines were administered prior to the development of BMs.

•

New compounds are urgently needed to improve the outcome of this subgroup of patients.

0296 Vigilant Attention Performance Advantage Conferred by TNFα G308A Polymorphism is Associated with Diminished Delta and Theta Power in the Non-REM Sleep EEG

Introduction

Carriers of the A allele of a single nucleotide polymorphism of the TNFα gene (G308A, rs1800629) are relatively resilient to vigilant attention performance impairment from total sleep deprivation (TSD), as compared to G/G homozygotes, and even exhibit a small performance advantage at baseline. The mechanism underlying this effect remains unclear. As TNFα is a sleep regulatory substance, we investigated whether TNFα G308A genotype is associated with systematic differences in markers of sleep homeostasis.

Methods

N=168 healthy young adults (ages 27.4±5.4y; 86 women) participated in one of seven in-laboratory TSD studies. During TSD, performance was assessed every 2–3h using a psychomotor vigilance test (PVT). The TSD period was preceded and followed by nocturnal sleep opportunities (baseline and recovery, respectively), which were recorded polysomnographically and scored according to AASM criteria. The EEG (C3-M2 derivation) of stages N2 and N3 non-REM sleep was investigated using spectral analysis.

Results

The genotype distribution of the sample was 0.6% A/A, 26.8% A/G, 72.6% G/G, in Hardy-Weinberg equilibrium (P=0.14). As documented previously, A allele carriers, compared to G/G homozygotes, had fewer PVT lapses (RTs&gt;500ms) at baseline and during TSD, indicating greater resilience to sleep deprivation. During both baseline and recovery sleep, A allele carriers, compared to G/G homozygotes, displayed reduced power in the delta (0.8–4.0Hz; P=0.017) and theta (4.2–8.0Hz; P=0.004) bands of the non-REM sleep EEG.

Conclusion

The performance advantage of the A allele carriers brings to mind the “banking sleep” phenomenon previously observed in sleep deprivation studies with prior sleep extension, suggesting that the A allele carriers gained this advantage by essentially being able to bank sleep. If this interpretation is correct, then the diminished power in the delta and theta bands of the non-REM sleep EEG in the A allele carriers, which suggests reduced homeostatic sleep pressure during both baseline and recovery sleep, may imply that the A allele carriers operate at a lower homeostatic setpoint due to an underlying advantage in the recuperative efficiency of sleep.

Support (If Any)

NIH R01HL070154, R21CA167691, R01HL105768; ONR N00014-13-C-0063, N00014-13-1-0302, FAA DTFAAC-11-A-00003, CDMRP W81XWH-16-1-0319, USAMRDC W81XWH-05-1-0099, and an SRS Elliot D. Weitzman, M.D. Research Grant.

0024 ARC Genotype Modulates EEG Spectral Power Following Total Sleep Deprivation

Introduction

Sleep homeostasis is manifested by a robust increase in slow wave sleep (SWS) following acute total sleep deprivation (TSD), with concomitant changes in spectral power of the non-REM (NREM) sleep EEG marked by substantial interindividual differences. We previously found that a single nucleotide polymorphism of the activity-regulated cytoskeleton associated protein (ARC) gene modulates SWS rebound following TSD. Here we sought to determine whether ARC genotype is also associated with interindividual differences in spectral power of the NREM sleep EEG.

Methods

50 healthy adults (27.3±4.9 years; 28 females) participated in one of two in-laboratory studies. Each participant had a 10h baseline sleep opportunity (22:00–08:00), 38h TSD, and a 10h recovery sleep opportunity (22:00–08:00). Sleep periods were recorded polysomnographically and visually scored according to AASM criteria. Genomic DNA was assayed for the ARC c.*742 + 58C&gt;T non-coding SNP, rs35900184. Log-transformed NREM sleep EEG spectral power (C3-M3 derivation) over 0.2 Hz frequency bins in each of four frequency bands – delta (0.8–4.0 Hz), theta (4.2–8.0 Hz), alpha (8.2–12.0 Hz), and beta (12.2–16.0 Hz) – was analyzed by band using mixed-effects ANOVA with fixed effects for ARC genotype, night (baseline, recovery), frequency bin, and their interactions. Analyses included study and age as covariates and a random effect over subjects on the intercept.

Results

The genotype distribution in this sample was 33 C/C homozygotes, 11 C/T heterozygotes, and 6 T/T homozygotes. There was a significant ARC by night interaction in the theta (F2,1833=5.94, p=0.003) and alpha (F2,1833=8.58, p&lt;0.001) bands. Compared to baseline sleep, during recovery sleep C/C homozygotes had 18.9% more theta power and 8.7% more alpha power, C/T heterozygotes had 17.9% more theta power and 7.6% more alpha power, and T/T homozygotes had 20.0% more theta power and 15.1% more alpha power.

Conclusion

Our results show that ARC genotype mediates the NREM sleep EEG response to TSD; compared to C allele carriers, homozygosity for the T allele is associated with a much more pronounced increase in alpha power, as well as a larger increase in theta power. The functional implications of this ARC effect remain to be determined.

Support (If Any)

ONR N00014-13-1-0302, NIH R21CA167691, and USAMRDC W81XWH-18-1-0100.

C65 POST–DISCHARGE ARRHYTHMIC RISK STRATIFICATION OF PATIENTS WITH ACUTE MYOCARDITIS AND LIFE–THREATENING VENTRICULAR TACHYARRHYTHMIAS

Aims

The outcomes of patients presenting with acute myocarditis and life–threatening ventricular arrhythmias (LT–VA) are unclear. The aim of this study was to assess the incidence and predictors of recurrent major arrhythmic events (MAEs) after hospital discharge in this patient population.

Methods and Results

We retrospectively analysed 156 patients (median age 44 years; 77% male) discharged with a diagnosis of acute myocarditis and LT–VA from 16 hospitals worldwide. Diagnosis of myocarditis was based on histology or the combination of increased markers of cardiac injury and cardiac magnetic resonance (CMR) Lake Louise criteria. MAEs were defined as the relapse, after discharge, of sudden cardiac death or successfully defibrillated ventricular fibrillation, or sustained ventricular tachycardia (sVT) requiring implantable cardioverter–defibrillator therapy or synchronized external cardioversion. Median follow–up was 23months [first to third quartile (Q1–Q3) 7–60]. Fifty–eight (37.2%) patients experienced MAEs after discharge, at a median of 8 months (Q1–Q3 2.5–24.0 months; 60.3% of MAEs within the first year). At multivariable Cox analysis, variables independently associated with MAEs were presentation with sVT [hazard ratio (HR) 2.90, 95% confidence interval (CI) 1.38–6.11]; late gadolinium enhancement involving ≥2 myocardial segments (HR 4.51, 95% CI 2.39–8.53), and absence of positive short–tau inversion recovery (STIR) (HR 2.59, 95% CI 1.40–4.79) at first CMR.

Conclusions

In this international multicentre study, patients discharged free from HTx or LVAD after an acute myocarditis complicated by LT–VA had a recurrence of MAEs during follow–up of 37.2%, after a median time of 8 months. Initial CMR pattern and sVT at presentation stratify the risk of arrhythmia recurrence.

Polarization of Λ and Λ[over ¯] Hyperons along the Beam Direction in Pb-Pb Collisions at sqrt[s]_{NN}=5.02 TeV

The polarization of the Λ and Λ[over ¯] hyperons along the beam (z) direction, P_{z}, has been measured in Pb-Pb collisions at sqrt[s_{NN}]=5.02  TeV recorded with ALICE at the Large Hadron Collider (LHC). The main contribution to P_{z} comes from elliptic flow-induced vorticity and can be characterized by the second Fourier sine coefficient P_{z,s2}=⟨P_{z}sin(2φ-2Ψ_{2})⟩, where φ is the hyperon azimuthal emission angle and Ψ_{2} is the elliptic flow plane angle. We report the measurement of P_{z,s2} for different collision centralities and in the 30%-50% centrality interval as a function of the hyperon transverse momentum and rapidity. The P_{z,s2} is positive similarly as measured by the STAR Collaboration in Au-Au collisions at sqrt[s_{NN}]=200  GeV, with somewhat smaller amplitude in the semicentral collisions. This is the first experimental evidence of a nonzero hyperon P_{z} in Pb-Pb collisions at the LHC. The comparison of the measured P_{z,s2} with the hydrodynamic model calculations shows sensitivity to the competing contributions from thermal and the recently found shear-induced vorticity, as well as to whether the polarization is acquired at the quark-gluon plasma or the hadronic phase.

Unemployed individuals contact GPs more frequently but report lower satisfaction: results of the population-based DEGS1 and the GPCare-1 patient survey

Unemployment is associated with a variety of adverse health-related outcomes, yet little data on primary care services for this risk group exist. Using data from two surveys, we analyzed the frequency of GP contacts and patients' experiences with GPs comparing unemployed with employed individuals. Data of the German Health Interview and Examination Survey for Adults (DEGS1), a nationwide cross-sectional study (n = 8151), were analyzed regarding associations between employment status and the number of GP visits. The General Practice Care-1 study (GPCare-1), a cross-sectional questionnaire survey (n = 813), evaluated patients' communication with their GP. Data were collected from June to August 2020 in 12 teaching practices affiliated with our university. The statistical analysis included individuals of working age (18-64 years old) (DEGS1 n = 5659, GPCare-1 n = 587). In both studies, working age subpopulations were analyzed (DEGS1: n = 5659 of 8151, GPCare-1: n = 587 of 813). In DEGS1, the prevalence of unemployment was 6.5% (n = 372). Unemployed individuals had more GP contacts in the last 12 months (4.50 vs. 2.86, p < 0.001). In the GPCare-1 study, unemployed individuals (6.6%, n = 39) were significantly less satisfied with GP communication: enough space in consultations (42.9% vs. 60.3%, p = 0.043), feeling comfortable to address sensitive topics (44.1% vs. 65.9%, p = 0.010), problems taken very seriously by GP (48.6% vs. 70.6%, p = 0.007). Yet, they were more willing to accept GPs' help for psychosocial burdens (67.6% vs. 47.6%, p = 0.024). GPs should be aware that patients with unemployment wish more support to cope with their burdening situation.

Measurement of the Groomed Jet Radius and Momentum Splitting Fraction in pp and Pb-Pb Collisions at sqrt[s_{NN}]=5.02 TeV

This article presents groomed jet substructure measurements in pp and Pb-Pb collisions at sqrt[s_{NN}]=5.02  TeV with the ALICE detector. The soft drop grooming algorithm provides access to the hard parton splittings inside a jet by removing soft wide-angle radiation. We report the groomed jet momentum splitting fraction, z_{g}, and the (scaled) groomed jet radius, θ_{g}. Charged-particle jets are reconstructed at midrapidity using the anti-k_{T} algorithm with resolution parameters R=0.2 and R=0.4. In heavy-ion collisions, the large underlying event poses a challenge for the reconstruction of groomed jet observables, since fluctuations in the background can cause groomed parton splittings to be misidentified. By using strong grooming conditions to reduce this background, we report these observables fully corrected for detector effects and background fluctuations for the first time. A narrowing of the θ_{g} distribution in Pb-Pb collisions compared to pp collisions is seen, which provides direct evidence of the modification of the angular structure of jets in the quark-gluon plasma. No significant modification of the z_{g} distribution in Pb-Pb collisions compared to pp collisions is observed. These results are compared with a variety of theoretical models of jet quenching, and provide constraints on jet energy-loss mechanisms and coherence effects in the quark-gluon plasma.

A190 EPIDEMIOLOGY OF MUSCULOSKELETAL MANIFESTATIONS IN PAEDIATRIC INFLAMMATORY BOWEL DISEASE: A SYSTEMATIC REVIEW

Background

Paediatric inflammatory bowel disease (p-IBD) is a chronic and relapsing gastrointestinal disorder of childhood with associated long-term morbidity. Several extraintestinal manifestations (EIMs) are described, the most common being joint pain and/or inflammation. In 1986, Passo et al. were the first to describe the association of arthritis in p-IBD patients. However, since then, data on the epidemiology, patient and disease factors associated with, treatments for, and outcomes of p-IBD associated musculoskeletal (MSK) disease are not well-established.

Aims

Our study aims to summarize the literature on the epidemiology of MSK EIMs in p-IBD in the era of biologics.

Methods

A systematic review of the literature was performed. PubMed, Embase, Cochrane Library, Web of Science Core Collection, and CINAHL databases were searched with relevant keywords. Studies in English published from January 1, 2000 to December 21, 2020 were included. In total, 3893 papers were identified and screening was performed by two independent reviewers (AA, MS). Conflicts were resolved by a third reviewer (EC, RB). Study and population characteristics were recorded. The primary outcomes of interest were MSK symptoms at presentation and their course, method of diagnosis and definitions used for MSK EIMs. Risk of bias assessment was performed using the JBI Critical Appraisal Tools.

Results

Thirteen studies were included for full review, which were primarily single-centre observational studies with retrospective or cross-sectional design. The method of diagnosis for MSK EIMs varied across the studies, with only 4 studies stating the involvement of a rheumatologist in diagnosis. The definitions also varied, with MSK EIMs such as peripheral arthritis, axial arthritis, enthesopathy, and arthralgia included. Only 7 studies focused on MSK EIMs as their primary outcome, while the remainder reported on all p-IBD associated EIMs. There was a wide range in the prevalence of MSK EIMs from 2–35% (Figure 1). Four studies reported on the therapeutic response of MSK EIMs, and only 3 of those reported on biologic use. Risk of bias demonstrated heterogeneity in the quality of included studies.

Conclusions

This is the first systematic review of the literature for MSK EIMs in p-IBD. Analysis was limited due to variability in study design and data-reporting methods. Included studies reported prevalence of MSK EIMs, but the ascertainment of MSK EIMs, both method and definition varied with a clear lack in standardization. Our study demonstrates the need for further research of the MSK associations of p-IBD and to explore optimal management to advance care for this group of children.

Funding Agencies

None

Effects of surface roughness and mineralogy on the sorption of Cm(III) on crystalline rock

Crystalline rock is one of the host rocks considered for a future deep geological repository for highly active radiotoxic nuclear waste. The safety assessment requires reliable information on the retention behavior of minor actinides. In this work, we applied various spatially resolved techniques to investigate the sorption of Curium onto crystalline rock (granite, gneiss) thin sections from Eibenstock, Germany and Bukov, Czech Republic. We combined Raman-microscopy, calibrated autoradiography and µTRLFS (micro-focus time-resolved fluorescence spectroscopy) with vertical scanning interferometry to study in situ the impact of mineralogy and surface roughness on Cm(III) uptake and molecular speciation on the surface. Heterogeneous sorption of Cm(III) on the surface depends primarily on the mineralogy. However, for the same mineral class sorption uptake and strength of Cm(III) increases with growing surface roughness around surface holes or grain boundaries. When competitive sorption between multiple mineral phases occurs, surface roughness becomes the major retention parameter on low sorption uptake minerals. In high surface roughness areas primarily Cm(III) inner-sphere sorption complexation and surface incorporation are prominent and in selected sites formation of stable Cm(III) ternary complexes is observed. Our molecular findings confirm that predictive radionuclide modelling should implement surface roughness as a key parameter in simulations.