Heat Transfer by Sweat Droplet Evaporation

Sweating regulates the body temperature in extreme environments or during exercise. Here, we investigate the evaporative heat transfer of a sweat droplet at the microscale to unveil how the evaporation complexity of a sweat droplet would affect the body's ability to cool under specific environmental conditions. Our findings reveal that, depending on the relative humidity and temperature levels, sweat droplets experience imperfect evaporation dynamics, whereas water droplets evaporate perfectly at equivalent ambient conditions. At low humidity, the sweat droplet fully evaporates and leaves a solid deposit, while at high humidity, the droplet never reaches a solid deposit and maintains a liquid phase residue for both low and high temperatures. This unprecedented evaporation mechanism of a sweat droplet is attributed to the intricate physicochemical properties of sweat as a biofluid. We suppose that the sweat residue deposited on the surface by evaporation is continuously absorbing the surrounding moisture. This route leads to reduced evaporative heat transfer, increased heat index, and potential impairment of the body's thermoregulation capacity. The insights into the evaporative heat transfer dynamics at the microscale would help us to improve the knowledge of the body's natural cooling mechanism with practical applications in healthcare, materials science, and sports science.

Comparative histological description of the intestine in platyfish (Xiphophorus maculatus) and swordtail fish (Xiphophorus helleri)

This study aimed to provide a comprehensive analysis of the histological structure of intestinal tissues of platyfish (Xiphophorus maculatus) and swordtail fish (Xiphophorus helleri). Specifically, the objectives were: (1) to compare the structural adaptations of their intestines related to their distinct feeding habits, diet, and digestive strategies; and (2) to explore their potential as animal models for intestinal disease research. Through detailed examination of tissue morphology, cell types, and structural features, this study found that both species lack a stomach, with the intestine directly connected to the esophagus. Additionally, this study proposes a new division of the intestine into anterior and posterior segments based on distinct histological characteristics. The anterior segment may be adapted for temporary food storage and digestion and was characterized by elongated epithelial cells and thin intestinal folds. In contrast, the posterior segment displayed shorter villi and higher concentrations of goblet cells. This study is the first to describe in detail the intestinal morphology of platyfish and swordtail fish. These findings contribute significantly to the understanding of the comparative anatomy and physiology of these fish species, highlighting their potential as valuable models for intestinal biology research.

Evaluating Droplet Survivability on Face Masks with X-ray Microtomography

When a person talks, coughs, or sneezes, respiratory droplets are expelled and inevitably land on several surfaces, representing a route for respiratory disease transmission. Here, face masks act as a barrier by obstructing the passage of droplets during exhalation and inhalation. Being constantly exposed to respiratory events and carrying droplet residue, understanding the evaporation and absorption dynamics for tiny droplets on face masks and the fate of viral particle deposition is necessary to analyze the contamination risk. We explore the ideal design for masks from the interaction of mask surfaces with surrogate respiratory droplets by X-ray microscopy and microtomography. We show that the respiratory droplet survivability is significantly reduced in masks with a hydrophilic surface where absorption takes place, leading to a reduction of the postevaporation droplet residue at the mask surface compared with a hydrophobic surface. The results allow us to propose a better mask layer design dependent on wettability, reducing the risk of contamination from respiratory droplets.

The European Insomnia Guideline: An update on the diagnosis and treatment of insomnia 2023

Progress in the field of insomnia since 2017 necessitated this update of the European Insomnia Guideline. Recommendations for the diagnostic procedure for insomnia and its comorbidities are: clinical interview (encompassing sleep and medical history); the use of sleep questionnaires and diaries (and physical examination and additional measures where indicated) (A). Actigraphy is not recommended for the routine evaluation of insomnia (C), but may be useful for differential-diagnostic purposes (A). Polysomnography should be used to evaluate other sleep disorders if suspected (i.e. periodic limb movement disorder, sleep-related breathing disorders, etc.), treatment-resistant insomnia (A) and for other indications (B). Cognitive-behavioural therapy for insomnia is recommended as the first-line treatment for chronic insomnia in adults of any age (including patients with comorbidities), either applied in-person or digitally (A). When cognitive-behavioural therapy for insomnia is not sufficiently effective, a pharmacological intervention can be offered (A). Benzodiazepines (A), benzodiazepine receptor agonists (A), daridorexant (A) and low-dose sedating antidepressants (B) can be used for the short-term treatment of insomnia (≤ 4 weeks). Longer-term treatment with these substances may be initiated in some cases, considering advantages and disadvantages (B). Orexin receptor antagonists can be used for periods of up to 3 months or longer in some cases (A). Prolonged-release melatonin can be used for up to 3 months in patients ≥ 55 years (B). Antihistaminergic drugs, antipsychotics, fast-release melatonin, ramelteon and phytotherapeutics are not recommended for insomnia treatment (A). Light therapy and exercise interventions may be useful as adjunct therapies to cognitive-behavioural therapy for insomnia (B).

Limits to lifespan growth

A long-standing human lifespan debate is revival, and the consensus is yet to come on whether the maximum human lifespan is reaching a limit or not. This study discusses how mathematical constraints inherent in survival curves indicate a limit on maximum lifespans, implying that humans would have inevitable limits to lifespan growth.

Sleep patterns in childhood: a longitudinal assessment from the Generation XXI birth cohort

OBJECTIVE

To describe sleep-wake patterns in young children, based on sleep characteristics in early infancy and preschool ages, identifying their main sociodemographic characteristics, and to assess the association between different sleep characteristics at both ages.

METHOD

We included 1092 children from the Generation XXI birth cohort, evaluated at six months and four years of age, by face-to-face interviews. Sleep patterns were constructed through latent class analysis and structured equation modeling, including data on wake-up time and bedtime, afternoon naps, locale of nighttime sleep and night awakenings. To estimate the association between sociodemographic characteristics and sleep patterns, odds ratios and 95% confidence intervals were computed using logistic regression.

RESULTS

Two sleep patterns were identified through latent class analysis: pattern 1 was characterized by earlier bedtime and wake-up times, while pattern 2 was defined by later times. When compared with pattern 1, pattern 2 was more frequent among children whose mothers had changed from partnered to not partnered until preschool age and those who did not stay at the kindergarten, and was less common among those with siblings. Through structured equation modeling, an aggregating factor was identified at preschool age, which was mainly correlated with bedtime and wake-up time. A positive association between sleep characteristics evaluated in early infancy and in preschool ages was observed.

CONCLUSIONS

Sleep patterns and circadian sleep preferences seem to be developed early in life, which highlight the importance of promoting an adequate sleep hygiene from infancy, assuming its impact on sleep quality during the life course.

High density deposits of binary colloids

Colloids are essential materials for modern inkjet printing and coating technology. For printing and coating, it is desirable to have a high density of colloids with uniformity. Binary colloids, which consist of different size colloidal particles, have the potential to achieve high coating density and uniformity from size effects. We report a strategy to attain high-density deposits of binary colloids with uniform, crack-free, and symmetric deposits through droplet evaporation on micropillar arrays. We modify surfaces of micropillar arrays with plasma treatment to control their surface energy and investigate how binary colloidal fluids turn into well-controlled deposits during evaporation with X-ray microscopic and tomographic characterizations. We attribute temporary surface energy modification of micropillar arrays to the well-controlled high-density final deposits. This simple, low-cost, and scalable strategy would provide a viable way to get high-quality, high-density deposits of colloids for various applications.

Erector spinae plane block for surgery of esophageal atresia in a preterm neonate

Pain management during and after thoracotomy is challenging in premature neonates. Ultrasound-guided fascial plane block techniques, such as the erector spinae plane block are a relatively new regional anesthesia technique and have emerged as an alternative to thoracic epidural due to its clinical effectiveness, ease of administration and theoretically being safer to perform. The relative ease of identifying anatomical landmarks compared to the paravertebral block, as well as its safety profile compared to an epidural, may have contributed to the erector spinae plane Bs growing popularity. Currently, however, the published evidence for the efficacy of regional anesthesia techniques in low birth weight newborns undergoing this surgery is limited to few isolated case reports. Herein we describe the use of unilateral erector spinae plane block as part of anesthesia and postoperative analgesia management of surgical correction of esophageal atresia in a preterm neonate.

Body dysmorphic disorder treatment: about a clinical case

Introduction

Body dysmorphic disorder (BDD) is a relatively common disorder characterized by a preoccupation with non-existent or slight defects in appearance. It was first described in 1886 by Morselli as dysmorphophobia.

Objectives

This work reviews the current available data on BDD and its treatment options and describes a clinical case that reports an improvement in symptomatology after surgery.

Methods

Non-systematic review of the literature with selection of scientific articles published in the past 10 years; by searching Pubmed and Medscape databases using the combination of MeSH descriptors. The following MeSH terms were used: “body dysmorphic disorder”, “dysmorphophobia”. Clinical file consultation.

Results

The usual treatment involves a combination of psychotherapy and pharmacotherapy. Antidepressant medication, mainly selective serotonin reuptake inhibitors (SSRIs) have been used. If the symptoms do not improve, a different SSRI can be considered or clomipramine, venlafaxine or second-generation antipsychotics can be useful.

Conclusions

The role of surgery remains controversial, several studies indicating that the symptoms typically worsen after an aesthetic procedure because the preoccupation shifts to a different body area. However a recent study reported 32 of the 41 patients that underwent surgery were highly satisfied with the outcome. In our clinical case, our patient, a 20-year-old female with non-delusional dysmorphic ideas about her nose initiated treatment with paroxetine with poor response and was, against medical opinion, submitted to a rhinoplasty. Three weeks after the surgery there was an improvement in preoccupation about her nose. More research should be made to clarify the role of surgery in this disorder that often lacks adequate therapeutical response.

Disclosure

No significant relationships.

Seizures and alcohol withdrawal: A literature review

Introduction

Seizures occur in about 3% cases of alcohol withdrawal. They usually appear within 48 hours after abrupt cessation, and are characterized by a reduction in seizure threshold secondary to adaptation to alcohol. More than 50% of individuals will experience a new seizure and in 5% of these cases, progression to a sustained epilepticus status can occur.

Objectives

The aim is to do a review of the literature on alcohol withdrawal and the onset of seizures in individuals with alcohol addiction.

Methods

A literature review was conducted using the PubMed search database.

Results

Alcohol is a central nervous system (CNS) depressant and chronic consumption causes neuroadaptation in order to maintain homeostasis. This adaptation involves the upregulation of excitatory neurotransmitters systems and the downregulation of inhibitory ones. When consumption is abruptly discontinued, the depressive contribution of alcohol to a previously established balance is disrupted, resulting in withdrawal symptoms associated to a generalized CNS’ hyperexcitability state.Critical episodes increase the risk of delirium tremens, a fatal condition in 20% of untreated cases. Thus, the treatment and prevention of seizure recurrences is essential: the clinical guidelines of the American Society of Addiction Medicine 2020, offer an action proposal. Pharmacological therapy after seizures is the preferential treatment: intravenous administration of fast-acting benzodiazepines (lorazepam and diazepam) is the first line treatment.

Conclusions

It is essential to monitor signs and symptoms that alert us to the appearance of seizures associated to alcohol withdrawal, effectively treat these cases, prevent recurrences, and provide a quality follow-up for these patients.

Disclosure

No significant relationships.

From Akute Primäre Verruckheit to Bouffée Delirante: The background of Acute Transient Psychosis

Introduction

Ever since the end of the 19th century that descriptions of acute and transient psychosis (ATP) have been found in the literature. Psychiatrists from different countries gave different names for these types of episodes, throughout the ages. Those early descriptions were an important part of the development of the concept of acute and transient psychotic disorders (F23: ICD-10).

Objectives

This review aims to provide historical background of the development of different concepts to describe ATP.

Methods

Non-systematic review of literature on acute and transient psychotic disorders, bouffee delirante, brief psychotic disorder, atypical psychosis.

Results

In 1876, K.Westphal introduced the term akute primäre Verruckheit, refering to a sudden paranoia associated with delusion ideas and hallucinations. In 1895, Magnan described Bouffée delirante, characterized by a recorrent, sudden psychosis with polymorphic symptoms. Later (1924), the term cycloid psychosis was introduced by K.Kleist: phasic psychosis with good prognosis. Different concepts appeared throughout history: psychogenic psychosis (Wimmer,1916); atypical psychosis (Mitsuda,1942), holodisfrenia (Barahona,1957). Nowadays, the classification systems include many of these concepts in the same categories: Schizophreniform disorder, Brief psychotic disorder (DSM-5), and ATP (F23 in ICD-10).

Conclusions

All throughout the History of Psychiatry, there was an evolution of concepts associated to ATP. They were strongly influenced by different time epochs. It is important to have context on the historical background of the concepts used in the contemporaneous Psychiatry. Diagnosis is challenging due to their heterogeneous presentation. There are not many studies available, because of ATP’s low diagnostic stability.

Disclosure

No significant relationships.

POS0496 CHILDREN WITH JUVENILE IDIOPATHIC ARTHRITIS HAVE ALTERATIONS IN B AND T FOLLICULAR CELL SUBSETS IN PERIPHERAL BLOOD

Background

Juvenile idiopathic arthritis (JIA) is the most common rheumatic disease in children1. Our group has recently demonstrated that extended oligoarticular (eoJIA) and polyarticular JIA (pJIA) mostly evolve to a rheumatoid arthritis (RA) like phenotype in adulthood2. Disturbances in B cells, T follicular helper (Tfh) and T follicular regulatory (Tfr) cell immune responses are associated with the pathogenesis of RA3,4, but their exact role in JIA development is not entirely known.

Objectives

The main goal of this study was to characterize the frequency and phenotype of B, Tfh and Tfr cells in peripheral blood of children with eoJIA and pJIA when compared to healthy controls and children with persistent oligoarticular JIA (poJIA).

Methods

Blood samples were collected from children with eoJIA (n=5), pJIA (n=11) and poJIA (n=19) treated with disease modifying anti-rheumatic drugs. A group of age-matched healthy individuals (n=8) was used as control. Peripheral blood mononuclear cells were isolated and the frequency and phenotype of B, Tfh and Tfr cells were evaluated by flow cytometry.

Results

The frequency of B, Tfh and Tfr cells was similar between JIA patients and controls. Children with eoJIA and pJIA, but not poJIA, had higher levels of naïve B cells and lower frequencies of post-switch memory B cells and plasmablasts when compared to controls. Th17-like Tfh cells were significantly increased in all JIA patients when compared to controls. B cell phenotype was similar between JIA patients and controls, but a reduced activated phenotype of Tfh cells was observed in JIA patients in comparison to controls.

Conclusion

Changes in B and Tfh cell subpopulations, but not in Tfr cells, were found in peripheral blood of children with JIA when compared to controls. The increased frequencies of Th17-like Tfh cells detected in JIA when compared to controls suggests a potential role of these cells in JIA pathogenesis. A treatment effect on the activation state of B, Tfh and Tfr cells cannot be excluded.

References

[1]Ravelli, A. & Martini, A. Juvenile Idiopathic Arthritis. Lancet 369, 767–778 (2007).

[2]Oliveira-ramos, F. et al. Juvenile idiopathic arthritis in adulthood: fulfillment of classification criteria for adult rheumatic diseases, long-term outcomes and predictors of inactive disease, functional status and damage. 1–10 (2016)

[3]Moura, R. A., Graca, L. & Fonseca, J. E. To B or not to B the conductor of rheumatoid arthritis orchestra. Clin. Rev. Allergy Immunol. 43, 281–291 (2012).

[4]Deng, J., Wei, Y., Fonseca, V. R., Graca, L. & Yu, D. T follicular helper cells and T follicular regulatory cells in rheumatic diseases. Nat. Rev. Rheumatol. 15, 475–490 (2019).

Acknowledgements

C. Tomé was supported by a fellowship from Fundação para a Ciência e a Tecnologia (FCT) (PD/BD/135520/2018), Portugal. This work was supported by a grant from Sociedade Portuguesa de Reumatologia.

Disclosure of Interests

None declared.

A 10-year mirror-image study of effectiveness and cost of long-acting paliperidone palmitate injectable in patients with schizophrenia or schizoaffective disorder

Acute episodes of Schizophrenia and Schizoaffective Disorder often require hospitalizations and/or psychiatry emergency room (PER) visits, with significant economic burden. Long-acting injectables (LAI), such as the once-monthly Palmitate Paliperidone LAI (1MPP) are effective in suppressing symptoms and raise treatment adherence. This study is the first aimed at evaluating long-term efficacy of initiation of 1MPP. This was a mirror-image study with a total 10 year observational length. Sample was divided into five different groups according to time span of observation: 2,4,6,8, and 10 years. Number of participants per group was 162, 129, 95, 77 and 35, respectively. Main outcomes were number and length of hospitalizations and number of PER visit. Significant reductions in these outcomes after initiation of 1MPP were found in all groups. Subgroups consisting only of patients with full adherence were evaluated, and these had better outcomes. A cost evaluation was also performed, which demonstrated decreases every year, for all main outcomes. Sensitivity analysis in the 2-year group showed results in this time-frame are independent of gender, diagnosis, previous LAI or 1MPP initiation setting. Initiation of 1MPP reduces number and length of hospitalizations up to 5 years, decreasing associated costs. This study increases evidence supporting use of 1MPP in patients with Schizophrenia or Schizoaffective disorder.

Growing use of valproic acid in substance use disorders

Introduction

Valproic acid is an antiepileptic drug used in different fields of Psychiatry. It is known mostly for its use in managing patients with bipolar affective disorder. In psychiatry of addiction, there is still no approved indications for its usage, but it is widely prescribed in treating alcohol and cocaine abuse, due to the existence of studies in these addictions.

Objectives

This review aims to clarify the relation between valproic acid and dependences, particularly cocaine.

Methods

Non-systematic literature review using a PubMed search, using the following key words: “valproate”; “cocaine use”.

Results

Cocaine dependence can decrease GABA levels in humans. Valproic acid has multiple mechanisms that favour the synthesis of GABA, potentiating its release and postsynaptic GABAergic response. Because of this, valproic acid was found effective in promoting abstinence and in reducing the use of cocaine. There are studies that support the valproic acid’s use in alcohol and cocaine dependences. Valproic acid has been shown to be promising in relapse prevention. It has also showed efficacy in the management of impulsivity and irritability, what makes it useful in managing patients with borderline personality disorder – patients at higher risk for alcohol or substance use disorders.

Conclusions

Cocaine addiction involves different phenomena and may respond to distinct pharmacologic approaches. Although some studies need to be confirmed by larger clinical trials, valproic acid seems a promising agent as one of some potential treatments for cocaine dependence. Further studies are required in this field to come to more reliable conclusions.

Disclosure

No significant relationships.

The phenomenology of motivation

Introduction

The concept of motivation pervades our professional and personal lives. Motivation is almost impossible to be observed directly, it is a construct for the interpretation of a behaviour that “calls the attention”.

Objectives

This work reviews the current available data on the phenomenological description of motivation and the abnormalities of motivation.

Methods

Non-systematic review of the literature with selection of scientific articles published in the past 10 years; by searching Pubmed and Medscape databases using the combination of MeSH descriptors. The following MeSH terms were used: “motivation”, “psychopathology”, “phenomenology”.

Results

Abnormalities in motivation may involve diminution or exacerbation. Anhedonia is the absence of pleasure in relation to usually pleasurable activities, it occurs in depression and schizophrenia where the pleasurable intrinsic motivation that acts as incentive for behaviour may be lost. In mania it may be increased so that mundane activities become unduly fascinating and rewarding.

Conclusions

Countless theories have been proposed to explain human motivation but each sheds light on specific aspects of motivation, neglecting others. This diversity creates confusion because most theories have areas of conceptual overlap and disagreement. To facilitate the development of studies, an agreement should be achieved on an operational definition of motivation.

Disclosure

No significant relationships.

Cannabis use and cognitive impairment in schizophrenia

Introduction

Neurocognitive deficits amongst patients with schizophrenia are considered one of schizophrenia’s central features. These deficits appear to be present from the first episode of psychosis (FEP) and certain cognitive impairments could be components of a genetic vulnerability to schizophrenia. Regarding research on cannabis and cognition in schizophrenia, different studies have assessed neurocognitive functions: memory, attention/vigilance, processing speed, verbal learning, executive functions, and verbal fluency.

Objectives

The aim is to do a review of recent findings concerning the association of cannabis use with cognition in schizophrenia.

Methods

A literature review was conducted using the PubMed search database.

Results

Patients with schizophrenia and concomitant cannabis use are associated with worse performance in immediate verbal learning, and in some studies with worse working memory performance. There is an improvement of verbal memory when they cease the cannabis’ consumption. Regarding attention capacity and memory types assessed, the results are controversial. In FEP, heavy cannabis use during the previous year correlates with slower processing speed. Also, FEP-patients with cannabis use but no family history of psychosis perform worse in executive functions, while those with a family history of psychosis perform better.

Conclusions

The studies of psychosis, cannabis and cognition differ in relevant aspects, which might be connected to the result variability. Therefore, before solid conclusions can be reached, it is important to carry out longitudinal studies to understand the changes in the cognitive variables, which can depend on the pattern of cannabis’ use (concurrent or prior to the FEP). Possible confounding variables that might be present should be acknowledged.

Disclosure

No significant relationships.

Droplet evaporation on porous fabric materials

Droplet evaporation on porous materials is a complex dynamic that occurs with spontaneous liquid imbibition through pores by capillary action. Here, we explore water dynamics on a porous fabric substrate with in-situ observations of X-ray and optical imaging techniques. We show how spreading and wicking lead to water imbibition through a porous substrate, enhancing the wetted surface area and consequently promoting evaporation. These sequential dynamics offer a framework to understand the alterations in the evaporation due to porosity for the particular case of fabric materials and a clue of how face masks interact with respiratory droplets.

Topological heterogeneity and evaporation dynamics of irregular water droplets

Water droplets sitting between wires are ubiquitous in nature and industry, often showing irregular (non-spherical) droplet shapes. To understand their topological singularity and evaporation mechanism, measuring volume changes of irregular water droplets is essential but highly challenging for small-volume water droplets. Here we experimentally explore topological heterogeneity and evaporation dynamics for irregular water droplets between wires with four-dimensional X-ray microtomography that directly provides images in three spatial dimensions as a function of time, enabling us to get three-dimensional structural and geometric information changes with time. We find that the topological heterogeneity of an irregular droplet is due to the local contact lines and the evaporation dynamics of an irregular droplet is governed by the effective contact radius. This study may offer an opportunity to understand how the topological heterogeneity contributes to the evaporation dynamics of irregular water droplets.

Evaporation and deposition of inclined colloidal droplets

Colloidal droplets on flat solid substrates commonly leave symmetric ring-like deposits due to coffee-ring flows during evaporation. On inclined substrates, droplet shapes may become asymmetric by gravity. On this basis, it is not clear how their evaporation dynamics and final deposits are changed depending on inclination. Here we explore evaporation and deposition dynamics of colloidal droplets on inclined substrates, mainly by controlling colloidal particle size, substrate inclination, and relative humidity, which are crucial to gravitational intervention and evaporation dynamics. We experimentally investigate two different flows with opposite directions: downward sedimentation flows by gravity (\documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$v_s$$\end{document}vs) and upward capillary flows by evaporation (\documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$v_c$$\end{document}vc). We find that the competition of two flows determines the formation of final deposits with a flow speed ratio of \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$\alpha = v_s/v_c$$\end{document}α=vs/vc. Notably, for \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$\alpha$$\end{document}α\documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$\ll$$\end{document}≪ 1, evaporation-driven upward flows overwhelm sedimentation-driven downward flows, resulting in accentuated particle movement towards the top ring, which seems to defy gravitational intervention. We suggest a possible explanation for the flow speed dependence of final deposits in evaporating colloidal droplets. This study offers a framework to understand the intervention of inclination to the formation of final deposits and how to overcome the deposit pattern radial asymmetry, achieving symmetric deposit widths from inclined colloidal droplets.

Immunization with RBD-P2 and N protects against SARS-CoV-2 in nonhuman primates

Since the emergence of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), various vaccines are being developed, with most vaccine candidates focusing on the viral spike protein. Here, we developed a previously unknown subunit vaccine comprising the receptor binding domain (RBD) of the spike protein fused with the tetanus toxoid epitope P2 (RBD-P2) and tested its efficacy in rodents and nonhuman primates (NHPs). We also investigated whether the SARS-CoV-2 nucleocapsid protein (N) could increase vaccine efficacy. Immunization with N and RBD-P2 (RBDP2/N) + alum increased T cell responses in mice and neutralizing antibody levels in rats compared with those obtained using RBD-P2 + alum. Furthermore, in NHPs, RBD-P2/N + alum induced slightly faster SARS-CoV-2 clearance than that induced by RBD-P2 + alum, albeit without statistical significance. Our study supports further development of RBD-P2 as a vaccine candidate against SARS-CoV-2. Also, it provides insights regarding the use of N in protein-based vaccines against SARS-CoV-2.

Knowledge Creation on Edible Vaccines

In this paper we delve into the health sector and explore the way vaccines might change in the near future. As new challenges emerge, health professionals are faced with the need for innovative, effective answers to many issues, such as health-threatening viruses and diseases, that grow increasingly more complex, calling for new and practical solutions. Building on this framework, we have decided to address edible vaccines - a completely innovative and simpler way to administer vaccines - not only to understand if it is viewed in a favorable light but also to find out how the knowledge regarding these vaccines can be increased. After a thorough literature review, it became clear that the information about edible vaccines is not evident and easy to access. We then decided to apply a mixed methodology in our study, based on 15 interviews, in person and by email, addressing healthcare professionals, with the intent of gathering their experience and possible knowledge about vaccines. Additionally, an online survey was created and answered by 370 concerned citizens, in order to ascertain their knowledge and receptiveness to this matter. Hereupon, we concluded that, in both samples, there was very limited knowledge about these vaccines, it becoming obvious how important it is to transmit qualified information through accessible means, such as newscasts, scientific papers and magazines, health centers and hospitals, among others. Regarding the level of acceptance by the public in general, our results show that this innovation is dependent on its correct disclosure and propagation, since it is of great advantage and benefit for society. In sum, how the relevant knowledge (including proof of effectiveness) is managed and disseminated will be key.   traditional vaccines, edible vaccines, field work, mixed methodology, Genetically modified organisms, GMOs

Dermatitis artefacta and psychiatric illness: Brief review and case report

Introduction

Psychodermatologic disorders are conditions involving an interaction between the mind and the skin. Dermatitis artefacta (DA), also known as factitial dermatitis, is a frequently unrecognized psychocutaneous illness, in which the patient creates skin lesions to satisfy the unconscious need to presume a sick role. It is more common in women and in patients with a diagnosis of psychiatric illness. This is an exclusion diagnosis and organic causes should be ruled out. Treatment of DA can be challenging and it needs to involve a multidisciplinary approach consisting of dermatologists and mental health professionals.

Objectives

From a case report the authors intend to present a literature review of dermatitis artefacta.

Methods

Observation the patient and review the clinical file. Consultation published and referenced scientific articles on PubMed.

Results

60 year old man, diagnosed with Bipolar Disorder, was admitted for manic decompensation of his pathology. During physical examination he had sparse erythematous lesions, more exuberant in the neck, scalp, belly and upper limbs. The diagnosis of artifact dermatitis was made after excluding other possible causes.

Conclusions

Treatment of DA can be challenging and it needs to involve a multidisciplinary approach. Dermatitis artefacta is a long-term disorder, and patients need regular follow up with a dermatologist and a psychiatrist because relapses are common. These doctors must be aware of this possible pathology in order to make a correct diagnosis and treatment of psychiatric disorders that sometimes coexist with skin lesions. The prognosis for most patients is poor leading to self-injury, scarring and poor cosmesis.

Disclosure

No significant relationships.

Persistant genital arousal disorder and venlafaxine: A case report

Introduction

In this presentation we describe the case of a woman referred to the Sexology Department after having developed symptoms of Persistent Genital Arousal (PGAD) for the last 5 years, during treatment for Depression with Venlafaxine. PGAD is a clinical entity first described in 2001 by Leiblum and Nathan. Despite having received more attention in the last few years, its etiology remains unclear, with numerous causal factors of different natures being suggested.

Objectives

We aim to describe this clinical case of PGAD and to discuss the possible etiological factors involved as well as to make a brief revision of the literature on this topic.

Methods

We conducted a detailed interview, focused on the nature of the complaints, psychological history, medications, diet and neurologic disorders and performed a thorough clinical examination. We also searched for relevant articles in medical databases such as PubMed and Google Scholar.

Results

A 52 year-old woman previously treated for Depression with Venlafaxine complains of involuntary sensations of genital arousal, with perceived vasocongestion, tingling and pulsatlity during her journey to work in public transportations. The symptoms subsided only after getting home 8-10 hours later and reaching orgasm by masturbating. She stopped Venlafaxine in 2015, but these symptoms persisted. Some authors suggest a link between SSRIs/SNRIs and PGAD.

Conclusions

PGAD is a relatively recent addition to our diagnostic catalog with increasingly more cases being reported in the last few years. It is likely that the condition, however, has no discrete etiology and that a customized approach will be necessary to successfully treat most patients.

The importance of mental and sexual health in addressing people with hiv - the double stigma

Introduction

Having a mental disorder is associated with increased vulnerability to the transmission of the Human Immunodeficiency Virus (HIV) and the prevalence of HIV is higher in people with a severe mental disorder. People with psychiatric comorbidities such as bipolar affective disorder and depressive disorder, post-traumatic stress disorder (physical or sexual abuse) and/or psychoactive substance use have a higher risk of HIV infection.

Objectives

This work is intended to expose the importance of integrating mental health care with the care of HIV patients.

Methods

The authors conducted a non-systematic review of the literature, conducting research through Pubmed and Medscape using the keywords ‘Preexposure prophylaxis’, ‘HIV’, ‘Mental health problems’.

Results

Several factors may contribute to the high comorbidity between HIV and Mental Disorders, including socio-demographic factors, weak social and environmental structures, as well as internalized stigma, social and experienced discrimination. Mental health problems may interfere with the care needed for prevention, including regular HIV testing and/or adherence to Preexposure Prophylaxis (PrEP); and influence access to and adherence to antiretroviral treatment.

Conclusions

This compelling evidence makes the necessary contribution of integrating mental health into an assessment and continuous treatment of the HIV patient, on the other hand, the assessment and treatment of mental disorders should address sexual health.

The coronavirus pandemic impact on involuntary hospitalization

Introduction

Compulsory admission is the last line of intervention in individuals who suffer from severe mental disorders, based on the principles of therapeutic need and social protection. In Portugal, the law configures this measure as a hospitalization by court order. The SARS-CoV-2 coronavirus is a global public health emergency, with multifaceted consequences for people’s lives and health. Several studies are showing a great impact of the pandemic on the overall mental health.

Objectives

The aim is to assess the impact of the pandemic on the number of involuntary hospitalizations, their socio-demographic and clinical characteristics, and study the differences between 2019 and 2020.

Methods

Consultation of all patient’s clinical files that were involuntarily admitted in Hospital Magalhães Lemos during 2019 and 2020. Statistical analysis of data.

Results

The authors claim to investigate the impact of the pandemic on involuntary hospitalizations, the factors of admission and decompensation and other clinical characteristics, by comparing the involuntary hospitalizations during 2019 and 2020. The authors believe that the number of compulsory admissions increased significantly with the pandemic. They also believe that factors such as increased or relapsed consumption of alcohol and drugs, suicide attempts, missed appointments and long-term injectable medication are at the root of this increase in 2020.

Conclusions

This study helps to analyze the impact of the new coronavirus on compulsory hospitalizations and allows to understand the main factors that aggravate the underlying pathologies. Thus, understanding the targets of greater attention from psychiatrists to avoid the decompensation of patients in times of pandemic in which we currently live.

Disclosure

No significant relationships.

Catatonia induced by abrupt discontinuation of clozapine - case report

Introduction

Catatonia is characterized by a bizarre and severe psychomotor change. According to DSM-5, the presence of three or more symptoms is necessary to affirm the diagnosis: stupor, catalepsy, brain flexibility, mutism, negativism, posturing, mannerisms, stereotypes, agitation not influenced by external stimuli, grimaces, echolalia or echopraxia. The association between first- and second-generation antipsychotics (AP) and the onset of catatonia is well established in the literature. In contrast, clozapine is one of the second-generation APs that is recognized for its effectiveness in treating catatonia, rather than inducing it. However, it has been documented that abrupt discontinuation of clozapine can induce rapid clinical deterioration with multiple presentations including: psychoses, cholinergic rebound states, serotonergic syndromes and catatonia.

Objectives

Review the literature on catatonia associated with abrupt interruption of clozapine. Describe a clinical case.

Methods

Observation of the patient and consultation the clinical file. Non-systematic literature review on catatonia, clozapine, side effects associated with rapid discontinuation and respective treatment.

Results

34-year-old man, with the diagnosis of Schizoaffective Disorder. Admitted due to an acute decompensation with psychotic symptoms resistant to treatment requiring the introduction of clozapine. In the absence of a clinical response, clozapine was suspended, with the consequent appearance of catatonia resistant to benzodiazepines in high doses.

Conclusions

Its already well established that the abrupt discontinuation of clozapine can trigger catatonia. This clinical case and literature review suits to emphasize the importance of educating psychiatrists on the adverse effects of psychiatric drugs and, in this case, the cautious discontinuation of clozapine in order to avoid its rebound effects.

αIIbβ3 variants in ten families with autosomal dominant macrothrombocytopenia: Expanding the mutational and clinical spectrum

Background

Rare pathogenic variants in either the ITGA2B or ITGB3 genes have been linked to autosomal dominant macrothrombocytopenia associated with abnormal platelet production and function, deserving the designation of Glanzmann Thrombasthenia-Like Syndrome (GTLS) or ITGA2B/ITGB3-related thrombocytopenia.

Objectives

To describe a series of patients with familial macrothrombocytopenia and decreased expression of αIIbβ3 integrin due to defects in the ITGA2B or ITGB3 genes.

Methods

We reviewed the clinical and laboratory records of 10 Portuguese families with GTLS (33 patients and 11 unaffected relatives), including the functional and genetic defects.

Results

Patients had absent to moderate bleeding, macrothrombocytopenia, low αIIbβ3 expression, impaired platelet aggregation/ATP release to physiological agonists and low expression of activation-induced binding sites on αIIbβ3 (PAC-1) and receptor-induced binding sites on its ligand (bound fibrinogen), upon stimulation with TRAP-6 and ADP. Evidence for constitutive αIIbβ3 activation, occurred in 2 out of 9 patients from 8 families studied, but also in 2 out of 12 healthy controls. We identified 7 missense variants: 3 in ITGA2B (5 families), and 4 in ITGB3 (5 families). Three variants (αIIb: p.Arg1026Trp and p.Arg1026Gln and β3: p.Asp749His) were previously reported. The remaining (αIIb: p.Gly1007Val and β3: p.Thr746Pro, p.His748Pro and p.Arg760Cys) are new, expanding the αIIbβ3 defects associated with GTLS. The integration of the clinical and laboratory data allowed the identification of two GTLS subgroups, with distinct disease severity.

Conclusions

Previously reported ITGA2B and ITGB3 variants related to thrombocytopenia were clustered in a confined region of the membrane-proximal cytoplasmic domains, the inner membrane clasp. For the first time, variants are reported at the outer membrane clasp, at the transmembrane domain of αIIb, and at the membrane distal cytoplasmic domains of β3. This is the largest single-center series of inherited macrothrombocytopenia associated with αIIbβ3 variants published to date.

Do Isolamento Social ao Crescimento Pessoal: Reflexões Sobre o Impacto Psicossocial da Pandemia

INTRODUÇÃO: Esta é uma reflexão que combina o olhar integrado da Psiquiatria, da Psicologia Clínica e da Neuropsicologia sobre o impacto psicossocial da pandemia por COVID-19. As secções seguintes abordam algumas das dimensões da existência humana mais afetadas pela pandemia, através de um diálogo entre duas perspetivas: o existencialismo e a ciência. [...]

Burnout among Portuguese oncology healthcare providers – Differences between pediatric an adult teams

Introduction

Burnout is characterized by emotional exhaustion, depersonalization and reduced personal accomplishment, resulting from the inability to cope with chronic job stress. The literature suggests that staffs working in adult oncology are at risk of burnout. At the same time, research found that pediatric staff experiences a different set of stressors when compared with colleagues working in adult oncology. However, no studies were identified which directly compared prevalence and sources of Burn-out on pediatric and adult oncology staff.

Objectives

To compare the differences on prevalence and sources of burnout between pediatric and adult oncology multidisciplinary teams.

Methods

Pediatric and adult oncology professionals, including medical and nursing from a Portuguese oncology center completed the Portuguese version of the Copenhagen Burnout Inventory. Data was analyzed using SPSS.

Results

Since the study is currently ongoing the authors will only be able to provide final results and conclusions by the time of submission of our work presentation, in March 2016. However, according to the literature available, we are expecting to found symptoms of Burnout in the superior limit of normality, with differences in the major sources of stress between adult and pediatric professionals.

Conclusion

The differences in the challenges experienced by adult and pediatric teams highlight the importance of adequate prevention strategies to specific needs of each unit. Further investigation of stress across a wider range of professional disciplines is required in order to explore this gap.

Disclosure of interest

The authors have not supplied their declaration of competing interest.

Examining the Dimensionality, Reliability, and Invariance of the Depression, Anxiety, and Stress Scale–21 (DASS-21) Across Eight Countries

This study evaluated the dimensionality, invariance, and reliability of the Depression, Anxiety, and Stress Scale–21 (DASS-21) within and across Brazil, Canada, Hong Kong, Romania, Taiwan, Turkey, United Arab Emirates, and the United States ( N = 2,580) in college student samples. We used confirmatory factor analyses to compare the fit of four different factor structures of the DASS-21: a unidimensional model, a three-correlated-factors model, a higher order model, and a bifactor model. The bifactor model, with three specific factors (depression, anxiety, and stress) and one general factor (general distress), presented the best fit within each country. We also calculated ancillary bifactor indices of model-based dimensionality of the DASS-21 and model-based reliability to further examine the validity of the composite total and subscale scores and the use of unidimensional modeling. Results suggested the DASS-21 can be used as a unidimensional scale. Finally, measurement invariance of the best fitting model was tested across countries indicating configural invariance. The traditional three-correlated-factors model presented scalar invariance across Canada, Hong Kong, Romania, Taiwan, and the United States. Overall, these analyses indicate that the DASS-21 would best be used as a general score of distress rather than three separate factors of depression, anxiety, and stress, in the countries studied.

A grounded theory approach to understand the Portuguese emerging adult self-initiated expatriates’ cross-cultural adaptation in the United Kingdom

Purpose

The purpose of this paper is to inductively develop a model of cross-cultural adaptation for emerging adult self-initiated expatriates (SIEs).

Design/methodology/approach

Data were collected through semi-structured interviews with 18 Portuguese emerging adult SIEs, aged between 18 and 29 years, residing in the UK from 5 months to 2 years. The analysis of these interviews through a grounded theory, using computer-assisted qualitative data analysis software (Atlas.ti), allowed describing what constitutes participants’ cross-cultural adaptation and what are its determinants.

Findings

Five dimensions of cross-cultural adaptation emerged (cultural, emotional, social, practical and work), along with 18 determinants related with four different levels: personal, interpersonal, societal and situational. These determinants are related with the pre- and post-relocation phases of participants’ expatriation experience and some of them act as buffers, capturing a more integrative picture of the cross-cultural adaption process.

Research limitations/implications

In order to enhance the validity of the inductively identified relationships between cross-cultural adaptation and its determinants, the authors consider that they could be empirically tested.

Originality/value

This study points to several contributions in the fields of cross-cultural adaptation, emerging adulthood and self-initiated expatriation. By considering this study’s sample, the authors contributed to Farcas and Gonçalves’ (2016) call for more research focusing on emerging adult SIEs. In doing so, the authors simultaneously addressed the gap in the emerging adulthood literature regarding the focus on non-university samples of emerging adults. The methodology of this study can also be considered a contribution. By conducting interviews with emerging adult SIEs and analyzing them through a grounded theory approach, the authors were able to develop a model of cross-cultural adaptation. To the best of the authors’ knowledge, this is the first model which was inductively developed, enabling a broad understanding of emerging adult SIEs’ cross-cultural adaptation, in terms of what constitutes and influences it.

Highly porous multiwalled carbon nanotube buckypaper using electrospun polyacrylonitrile nanofiber as a sacrificial material

Polyacrylonitrile (PAN) was solubilized in N,N-dimethyl formamide (DMF) and the electrospinning process has been employed to obtain PAN nanofibers (PF). Multiwalled carbon nanotubes (MWCNT) were dispersed with the aid of Triton X-100 surfactant and subsequently centrifugated. Buckypapers (BP/PF) were prepared by vacuum filtration procedure of MWCNT suspension supernatant stacking four PF layers over a nylon membrane. The PF removal was carried out by immersing the BP/PF system in DMF and removal periods of 10 and 30 min were evaluated. Scanning electron microscopy (SEM) has not shown any PAN residue in the MWCNT network resulting in highly porous BP. However, by Fourier transform infrared spectroscopy (FT-IR) a PAN band was found around of 2243 cm-1 corresponding to nitrile group (C≡N). Besides, PAN leftover was evidenced by thermogravimetric analysis (TGA), high-resolution transmission electron microscopy (HR-TEM), electrical characterization through four-point probe, nitrogen adsorption at 77 K, and X-ray diffraction (XRD).

Radiation therapy facility risk analysis in Brazil with SEVRRA software

Risk assessment deals with processes, accident-initiating events, barriers and risk ratings to unveil the fragility and weakness of some processes; within this study, specifically related to radiation therapy facilities. Barriers are technical or organizational safety measures put in place to avoid, prevent, detect, control, reduce or mitigate the consequences of an accident once an initiating event has occurred. In this work, radiological risk analysis was performed for a set of 20 Brazilian radiotherapy facilities making use of the freeware sevrra risk-management software. The objective of this study was to define parameters that could be useful in creating an overall risk profile. This profile would be helpful for establishing priorities for decision making and support a risk-informed regulatory process. The most relevant missing barriers in facilities were identified according to three parameters: the 'importance index', 'impacted facilities index' and the 'barrier-effectiveness index'. Barriers such as 'in vivo dosimetry in the first treatment session', 'weekly in vivo dosimetry to detect errors in the dose delivering process', 'annual external audit for the control of reference dose rate' and 'independent verification of calibration by various medical physicists with a different dosimetry equipment' were found to be the most effective in reducing the risk level of the facilities. The present investigation reinforces the need to strengthen the mechanisms that guarantee the effectiveness of such barriers in radiation therapy procedures.

Upper bound dose values for meson radiation in heavy-ion therapy

Radiation treatment of cancer has evolved to include massive particle beams, instead of traditional irradiation procedures. Thus, patient doses and worker radiological protection have become issues of constant concern in the use of these new technologies, especially for proton- and heavy-ion-therapy. In the beam energies of interest of heavy-ion-therapy, secondary particle radiation comes from proton, neutron, and neutral and charged pions produced in the nuclear collisions of the beam with human tissue atoms. This work, for the first time, offers the upper bound of meson radiation dose in organic tissues due to secondary meson radiation in heavy-ion therapy. A model based on intranuclear collision has been used to follow in time the nuclear reaction and to determine the secondary radiation due to the meson yield produced in the beam interaction with nuclei in the tissue-equivalent media and water. The multiplicity, energy spectrum, and angular distribution of these pions, as well as their decay products, have been calculated in different scenarios for the nuclear reaction mechanism. The results of the produced secondary meson particles has been used to estimate the energy deposited in tissue using a cylindrical phantom by a transport Monte Carlo simulation and we have concluded that these mesons contribute at most 0.1% of the total prescribed dose.

Ion chambers compliance results of Brazilian radiation therapy facilities

The Brazilian Nuclear Energy Commission (cnen) has been making a constant effort to keep up to date with international standards and national needs to strengthen the status of radiological protection of the country. The guidelines related to radiation therapy facilities have been revised in the last five years in order to take into consideration the most relevant aspects of the growing technology as well as to mitigate the accidents or incidents observed in practice. Hence, clinical dosimeters have gained special importance in this matter. In the present work, we discuss the effectiveness of regulation and inspections to the enforcement of instrument calibration accuracy for the improvement of patient dosimetry and quality control. As a result, we observed that the number of calibrated instruments, mainly well chambers, is increasing each year. The same behavior is observed for instruments employed in technologically advanced radiation treatments such as intensity modulated radiotherapy, volumetric therapy and stereotatic radiosurgery. We ascribe this behavior to the new regulation.

Portuguese recommendations for the prevention, diagnosis and management of primary osteoporosis - 2018 update

BACKGROUND

Advances in osteoporosis (OP)case definition, treatment options, optimal therapy duration and pharmacoeconomic evidence in the national context motivated the Portuguese Society of Rheumatology (SPR) to update the Portuguese recommendations for the diagnosis and management of osteoporosis published in 2007.

METHODS

SPR bone diseases' working group organized meetings involving 55 participants (rheumatologists, rheumatology fellows and one OP specialist nurse) to debate and develop the document. First, the working group selected 11 pertinent clinical questions for the diagnosis and management of osteoporosis in standard clinical practice. Then, each question was investigated through literature review and draft recommendations were built through consensus. When insufficient evidence was available, recommendations were based on experts' opinion and on good clinical practice. At two national meetings, the recommendations were discussed and updated. A draft of the recommendations full text was submitted to critical review among the working group and suggestions were incorporated. A final version was circulated among all Portuguese rheumatologists before publication and the level of agreement was anonymously assessed using an online survey.

RESULTS

The 2018 SPR recommendations provide comprehensive guidance on osteoporosis prevention, diagnosis, fracture risk assessment, pharmacological treatment initiation, therapy options and duration of treatment, based on the best available evidence. They attained desirable agreement among Portuguese rheumatologists. As more evidence becomes available, periodic revisions will be performed. Target audience and patient population: The target audience for these guidelines includes all clinicians. The target patient population includes adult Portuguese people. Intended use: These recommendations provide general guidance for typical cases. They may not be appropriate in all situations - clinicians are encouraged to consider this information together with updated evidence and their best clinical judgment in individual cases.