Precise dating of large flank collapses by single-grain 40Ar/39Ar on pyroclastic deposits from the example of Flores Island (Azores)

Large-scale flank collapses are one of the main hazards associated with the evolution of volcanic islands. Precisely dating such events is critical to evaluate the frequency of destabilization episodes and further assess the triggering mechanism(s) associated with internal and/or external factors, such as volcano dynamics, regional tectonics, and global paleoclimatic changes. Here, we constrain the age of a pumice-rich pyroclastic deposit exposed on the eastern flank of Flores Island (Azores), which we interpret as a co-blast deposit generated by a major flank collapse that destroyed the whole western flank of the former volcanic edifice. Twelve single-grain 40Ar/39Ar analyses, performed on 250-500 µm anorthoclase feldspars (mean K/Ca close to 5) with our high-sensitivity multi-collector NGX mass spectrometer, provide a robust weighted mean age of 1.32 ± 0.01 Ma for this eruption. This new age is consistent with previous K/Ar data bracketing the flank collapse between 1.30 ± 0.04 and 1.18 ± 0.09 Ma, and indicates that this event occurred at the end of the main construction phase of the volcano. The explosion produced pumice-rich layers preceded by a lahar as attested by a polygenetic mudflow deposit underlying the dated deposit. From the geochemistry of lavas erupted just before and after the collapse, we speculate upon the possible role of magmatic processes on flank destabilization. We propose a first hypothesis where differentiation in a shallow magma reservoir could have favored edifice inflation, ground shaking, and flank failure, triggering a decompression-induced violent eruption. Overall, our study shows that high-sensitivity mass spectrometers have now reached analytical performances allowing to measure precisely and accurately ages on relatively small and moderately K-rich single feldspars, which is of the utmost importance for dating heterogeneous blasts and tephra deposits that may have been induced by large-scale flank collapses during the late Quaternary.

Prevalence of Antimicrobial Resistance in Escherichia coli and Salmonella Species Isolates from Chickens in Live Bird Markets and Boot Swabs from Layer Farms in Timor-Leste

The rapid emergence of antimicrobial resistance is a global concern, and high levels of resistance have been detected in chicken populations worldwide. The purpose of this study was to determine the prevalence of antimicrobial resistance in Escherichia coli and Salmonella spp. isolated from healthy chickens in Timor-Leste. Through a cross-sectional study, cloacal swabs and boot swabs were collected from 25 live bird markets and two layer farms respectively. E. coli and Salmonella spp. from these samples were tested for susceptibility to six antimicrobials using a disk diffusion test, and a subset was tested for susceptibility to 27 antimicrobials using broth-based microdilution. E. coli and Salmonella spp. isolates showed the highest resistance towards either tetracycline or ampicillin on the disk diffusion test. E. coli from layer farms (odds ratio:5.2; 95%CI 2.0-13.1) and broilers (odds ratio:18.1; 95%CI 5.3-61.2) were more likely to be multi-drug resistant than those from local chickens. Based on the broth-based microdilution test, resistance to antimicrobials in the Timor-Leste Antimicrobial Guidelines for humans were low, except for resistance to ciprofloxacin in Salmonella spp. (47.1%). Colistin resistance in E. coli was 6.6%. Although this study shows that antimicrobial resistance in chickens was generally low in Timor-Leste, there should be ongoing monitoring in commercial chickens as industry growth might be accompanied with increased antimicrobial use.

Self-perception of dual career barriers and athletic identity in student-athletes with disabilities according to disability type and level of professionalization

The objective of this study was to analyze the perceived barriers to dual career success and athletic identity of student-athletes according to disability type and level of professionalization. The final sample consisted of 203 student-athletes with disabilities from five European countries. The questionnaires used were ESTPORT, EBBS and AIMS. Depending on disability type, it was found that student-athletes with hearing and physical impairment showed the highest difficulty in reconciling sports and studies (p = 0.001); that student-athletes with a hearing impairment showed the highest score in the barrier 'the cost of education is high' (p = 0.023); that student-athletes with a physical impairment had the highest scores in the barrier 'Exercise tires me' (p = 0.013); that student-athletes with cerebral palsy showed the highest scores in the barrier 'I do not have enough university/educational institution support' (p = 0.014) and 'Exercise facilities do not have convenient timetables for me' (p = 0.001). Depending on sports professionalization level, semi-professional student-athletes showed the highest values in the barrier 'the university/educational institution is far from my training center' (p = 0.040); while professional student-athletes had the highest score in the barrier 'exercise takes too much time from family responsibilities' (p = 0.034). In most of the variables related to identity as athletes, professional student-athletes showed the highest values, followed by semi-professional athletes (p = 0.043- < 0.001). In conclusion, the self-perception of barriers is quite relevant, with differences arising from disability type and level of professionalization, whereas the identity as an athlete is only different according to the level of professionalization.

Subzero saline chilling with or without prechilling in icy water improved chilling efficiency and meat tenderness of broiler carcasses

Freshly slaughtered carcasses need to be chilled to improve product quality, meat safety, and processing efficiency. This research investigated the effect of subzero saline chilling (SSC) on broiler carcasses with or without prechilling in icy water. Water immersion chilling at 0.5°C (WIC) or SSC at 4% NaCl/-2.41°C (SSC) was a major chilling step. For the combination of pre- and postchilling, the warm water immersion chilling (WWIC) at 10°C was used as prechilling and the WIC as postchilling (WWIC-WIC), and WIC was used as prechilling and the SSC as postchilling (WIC-SSC). The internal temperature of breast fillets was monitored during chilling. Carcasses in a prechiller were transported to a postchiller when their internal temperature reached 15°C. Chilling was completed when the carcass temperature reached 4.4°C or below, and breast fillets were harvested at 3-h postmortem to measure the pH and sarcomere length. Color (L*, a*, and b*) values were evaluated on both breast skin and skinless breast surfaces. Meat tenderness was evaluated using the breast fillets after overnight storage and cooking to an internal temperature of 76°C. The carcasses in the SSC and WIC-SSC showed shorter chilling times (85-91 min) than those (100-144 min) of WIC and WWIC-WIC. A higher chilling yield was observed for the carcasses in WIC-SSC, and a lower cooking yield was seen for the carcasses in WWIC-WIC than other chilling methods (P < 0.05). The breast fillets of broilers in the SSC and WIC-SSC showed lower shear forces and longer sarcomere length than the WIC and WWIC-WIC. No difference was found for L* and a* values, while lower b* value was observed in the SSC than the other chilling methods (P < 0.05). Based on these results, chilling of broiler carcasses in the SSC (4% NaCl/-2.41°C) with or without prechilling in WIC at 0.5°C significantly improved chilling efficiency and meat tenderness, with minor color changes on carcasses.

Frequency-Dependent Squeezed Vacuum Source for the Advanced Virgo Gravitational-Wave Detector

In this Letter, we present the design and performance of the frequency-dependent squeezed vacuum source that will be used for the broadband quantum noise reduction of the Advanced Virgo Plus gravitational-wave detector in the upcoming observation run. The frequency-dependent squeezed field is generated by a phase rotation of a frequency-independent squeezed state through a 285 m long, high-finesse, near-detuned optical resonator. With about 8.5 dB of generated squeezing, up to 5.6 dB of quantum noise suppression has been measured at high frequency while close to the filter cavity resonance frequency, the intracavity losses limit this value to about 2 dB. Frequency-dependent squeezing is produced with a rotation frequency stability of about 6 Hz rms, which is maintained over the long term. The achieved results fulfill the frequency dependent squeezed vacuum source requirements for Advanced Virgo Plus. With the current squeezing source, considering also the estimated squeezing degradation induced by the interferometer, we expect a reduction of the quantum shot noise and radiation pressure noise of up to 4.5 dB and 2 dB, respectively.

LDLR gene's promoter region hypermethylation in patients with familial hypercholesterolemia

Familial hypercholesterolemia (FH) is characterized by high low-density lipoprotein cholesterol (LDL-C) levels and a high risk of early coronary heart disease. Structural alterations in the LDLR, APOB, and PCSK9 genes were not found in 20-40% of patients diagnosed using the Dutch Lipid Clinic Network (DCLN) criteria. We hypothesized that methylation in canonical genes could explain the origin of the phenotype in these patients. This study included 62 DNA samples from patients with a clinical diagnosis of FH according to the DCLN criteria, who previously tested negative for structural alterations in the canonical genes, and 47 DNA samples from patients with normal blood lipids (control group). All DNA samples were tested for methylation in the CpG islands of the three genes. The prevalence of FH relative to each gene was determined in both groups and the respective prevalence ratios (PRs) were calculated. The methylation analysis of APOB and PCSK9 was negative in both groups, showing no relationship between methylation in these genes and the FH phenotype. As the LDLR gene has two CpG islands, we analyzed each island separately. The analysis of LDLR-island1 showed PR = 0.982 (CI 0.33-2.95; χ² = 0.001; p = 0.973), also suggesting no relationship between methylation and the FH phenotype. Analysis of LDLR-island2 showed a PR of 4.12 (CI 1.43-11.88; χ² = 13,921; p = 0.00019), indicating a possible association between methylation on this island and the FH phenotype.

Towards virtual histology with X-ray grating interferometry

Breast cancer is the most common type of cancer worldwide. Diagnosing breast cancer relies on clinical examination, imaging and biopsy. A core-needle biopsy enables a morphological and biochemical characterization of the cancer and is considered the gold standard for breast cancer diagnosis. A histopathological examination uses high-resolution microscopes with outstanding contrast in the 2D plane, but the spatial resolution in the third, Z-direction, is reduced. In the present paper, we propose two high-resolution table-top systems for phase-contrast X-ray tomography of soft-tissue samples. The first system implements a classical Talbot-Lau interferometer and allows to perform ex-vivo imaging of human breast samples with a voxel size of 5.57 μm. The second system with a comparable voxel size relies on a Sigray MAAST X-ray source with structured anode. For the first time, we demonstrate the applicability of the latter to perform X-ray imaging of human breast specimens with ductal carcinoma in-situ. We assessed image quality of both setups and compared it to histology. We showed that both setups made it possible to target internal features of breast specimens with better resolution and contrast than previously achieved, demonstrating that grating-based phase-contrast X-ray CT could be a complementary tool for clinical histopathology.

Diffraction grating enhanced photoluminescence from etching-free erbium thin films

Micro-structuration by etching is commonly used in integrated optics, adding complex and costly processing steps that can also potentially damage the device performance, owing to degradation of the etched sidewalls. For diffraction grating fabrication, different strategies have been developed to avoid etching, such as layer deposition on a structured surface or grating deposition on top of active layers. However, etching remains one of the best processes for making high aspect ratio diffraction gratings. In this work, we have developed fully structured diffraction gratings (i.e., like fully etched gratings) using lift-off based processing performed in pulsed laser deposited layers, since the combination of both techniques is of great interest for making micro-structures without etching. We have first studied the influence of the lithography doses in the lift-off process, showing that (1) micrometric spatial resolution can be achieved and (2) the sidewall angle can be controlled from 50° to 150° in 0.5 µm thick layers. Using such optimizations, we have then fabricated Er-doped Y₂O₃ uniaxial diffraction gratings with different periods ranging from 3 to 8 µm. The fabricated devices exhibit emission and reflectivity properties as a function of the collection angle in good agreement with the modeling, with a maximum luminescence enhancement of ×15 compared with an unstructured layer at a wavelength of 1.54 µm. This work thus highlights lift-off based processing combined with pulsed laser deposition as a promising technique for etch-free practical applications, such as luminescence enhancement in Er-doped layers.

Probing cellulose-solvent interactions with self-diffusion NMR: Onium hydroxide concentration and co-solvent effects

The molecular self-diffusion coefficients were accessed, for the first time, in solutions of microcrystalline cellulose, dissolved in 30 wt% and 55 wt% aqueous tetrabutylammonium hydroxide, TBAH (aq), and in mixtures of 40 wt% TBAH (aq) with an organic co-solvent, dimethylsulfoxide (DMSO), through pulsed field gradient stimulated echo NMR measurements. A two-state model was applied to estimate α (i.e., average number of ions that "bind" to each anhydroglucose unit) and P_b (i.e., fraction of "bound" molecules of DMSO, TBAH or H₂O to cellulose) parameters. The α values suggest that TBA⁺ ions can bind to cellulose within 0.5 TBA⁺ to 2.3 TBA⁺/AGU. On the other hand, the P_b parameter increases when raising cellulose concentration for TBA⁺, DMSO and water in all solvent systems. Data suggests that TBAH interacts with the ionized OH groups from cellulose forming a sheath of bulky TBA⁺ counterions which consequently leads to steric hindrance between cellulose chains.

Community engagement strengthens pig disease knowledge and passive surveillance in Timor-Leste

Smallholder pig production in Timor-Leste is culturally and economically important for most households. However, regular and ongoing disease surveillance and pig husbandry training for farmers are limited. This article describes collaborative social and diagnostic research followed by a pilot community engagement program to improve farmer and technician knowledge, skills, and working relationships. There were three phases: (1) A qualitative study in 2020 to explore the experiences and knowledge of 133 pig farmers, 6 village leaders, and 16 district veterinary technicians on pig diseases and reporting, treatment methods, and access to information or assistance. (2) A pilot community engagement program in 3 villages in 2021 with the diagnostic investigation with samples analyzed from 27 dead pigs, and (3) Evaluation of community engagement and training outcomes. Results of the qualitative study revealed limited reporting of sick or dead pigs by farmers to veterinary technicians due to a lack of trust in the veterinary diagnostic system. Most technicians lacked experience with sampling or post-mortems so diagnostic training was undertaken for the pilot disease investigation. Evaluation results showed improved knowledge, motivation, and confidence of government staff and farmers. The credibility of veterinary technicians improved and gave them more confidence to work with communities. Farmers felt supported because all aspects of pig husbandry were addressed, and they were more willing to report dead or sick pigs. The project indicates that improved passive disease surveillance can be achieved by engaging communities in smallholder pig farming in Timor-Leste. Further research and testing of the approach in other districts and countries is recommended.

Knowledge, attitudes and practices of government animal health workers on antibiotic use and antibiotic resistance in Timor-Leste

Introduction

Antibiotic resistance is a global health threat, and there is growing concern on the inappropriate use of antibiotics in the livestock sector especially in low and middle income countries. The purpose of the study was to understand the knowledge, attitudes and practices on antibiotic use and antibiotic resistance of government animal health workers in Timor-Leste.

Method

A cross-sectional survey using a census approach was conducted between August 2021 and January 2022 focusing on government animal health workers involved in field work and access to antibiotics. Interviews were face-to-face in the local Tetun language. Descriptive and regression analysis informed by causal diagrams were performed.

Result

The study found poor knowledge of antibiotics among participants, with only 8.0% (13/162) able to correctly answer questions on how antibiotics worked. Knowledge of antibiotic resistance was poor as only 29.0% (47/162) of participants had heard of antibiotic resistance and were able to accurately identify that it made antibiotics less effective. Knowledge of antibiotics and knowledge of antibiotic resistance were crudely associated with being a veterinary technician and having university education. Attitude scores were positively influenced by knowledge of antibiotics and antibiotic resistance. Antibiotics were most commonly used in pigs, cattle and buffalo, with oxytetracycline being the most commonly used antibiotics in pigs and chicken. However, most participants reported a lack in supply of this antibiotic (137/162, 78.4%) and other antibiotics. Empiric use of antibiotics in sick animals was common, and some participants used antibiotics for parasitic diseases. Less than a fifth of participants reported ever using human antibiotics, and use of antibiotics for growth promotion was uncommon.

Conclusion

There is a need to develop Timor-Leste specific treatment guidelines, strengthen veterinary diagnostic support, improve antibiotic procurement, and develop training programs to address knowledge gaps and poor practices found in this study.

The Portuguese observatory on occupational psychosocial factors: contribution for public health

 

To achieve the goal of sustainable employment, considering the profile of the Portuguese working population (PWP), is needed a range of strategies to ensure long, productive, and sustainable careers allied with a better quality of working life, health, and wellbeing, but also with public health policies grounded on scientifically validated and reliable data. This is possible through a comprehensive working system approach that ensures workers will be mentally and physically able to remain at work by the balance between work demands and individual resources allied with public health policies transfer into the workplaces by organizations’ leadership and policy makers. The Portuguese Observatory on Occupational Factors (Popsy@Work) aims at addressing this global challenge by: i) digitally collecting psychosocial data on the PWP; ii) implementing and strengthening of a psychosocial occupational health surveillance digital system; iii) providing reference values for the PWP concerning Psychosocial Health; iv) Transferring to society knowledge and best practices; v) Raising awareness on the importance of psychosocial management in occupational settings based on science. Popsy@work is a digital platform that collects and aggregates psychosocial data analytically and creates a visualization hub adding value to data on the PWP and giving science back to society in a usable way, empowering workers, strengthening organizations and grounding public policies. Pospy@Work considers the development of strategic intelligence on levels and inequalities of psychosocial health and well-being in occupational settings by robust metrics and reference data. Creating opportunities for national policy dialogue on inequalities, including the psychosocial health of the PWP through collaboration with diverse sectors identifying and mapping subgroups of populations whose unmet needs require specific outreach measures.

Key messages

Search for Subsolar-Mass Binaries in the First Half of Advanced LIGO's and Advanced Virgo's Third Observing Run

We report on a search for compact binary coalescences where at least one binary component has a mass between 0.2  M_{⊙} and 1.0  M_{⊙} in Advanced LIGO and Advanced Virgo data collected between 1 April 2019 1500 UTC and 1 October 2019 1500 UTC. We extend our previous analyses in two main ways: we include data from the Virgo detector and we allow for more unequal mass systems, with mass ratio q≥0.1. We do not report any gravitational-wave candidates. The most significant trigger has a false alarm rate of 0.14  yr^{-1}. This implies an upper limit on the merger rate of subsolar binaries in the range [220-24200]  Gpc^{-3} yr^{-1}, depending on the chirp mass of the binary. We use this upper limit to derive astrophysical constraints on two phenomenological models that could produce subsolar-mass compact objects. One is an isotropic distribution of equal-mass primordial black holes. Using this model, we find that the fraction of dark matter in primordial black holes in the mass range 0.2  M_{⊙}<m_{PBH}<1.0  M_{⊙} is f_{PBH}≡Ω_{PBH}/Ω_{DM}≲6%. This improves existing constraints on primordial black hole abundance by a factor of ∼3. The other is a dissipative dark matter model, in which fermionic dark matter can collapse and form black holes. The upper limit on the fraction of dark matter black holes depends on the minimum mass of the black holes that can be formed: the most constraining result is obtained at M_{min}=1  M_{⊙}, where f_{DBH}≡Ω_{DBH}/Ω_{DM}≲0.003%. These are the first constraints placed on dissipative dark models by subsolar-mass analyses.

Long-term effects of Cushing’s Disease on visuospatial planning and executive functioning

Introduction

Patients with remitted Cushing’s Disease (CD) often present persisting impairments in executive and cognitive functioning domains. Little research has been conducted regarding the functional neural correlates of an important executive functioning skill, namely the ability to plan, in these patients.

Objectives

To examine visuospatial planning related brain activity in remitted CD patients and matched controls using functional magnetic resonance imaging (fMRI).

Methods

fMRI scans were made using a 3-Telsa scanner while remitted CD patients (n=21) and age-, gender-, and education matched healthy controls (HCs; n=21) completed a parametric Tower of London (ToL) task. Psychological and cognitive functioning were assessed using validated questionnaires. Clinical severity was assessed retrospectively using the Cushing’s syndrome Severity Index (CSI).

Results

CD Patients were on average 45.1 (SD=7.1) years old, 81% female, and in remission for mean 10.68 (SD=7.69) years. No differences were found in number of correct trials, response times per ToL trial, or in the region of interest analyses. Exploratory wholebrain analyses found that CD patients showed more activation in several brain regions associated with higher cognitive processes on 2-, 3-, and 5-step trials compared to HCs. Over-recruitment of the right parietal operculum cortex in the patients was significantly negatively associated with the prior active disease state on the CSI (r=-0.519, p=0.02).

Conclusions

The increased brain activation during the ToL in remitted CD patients versus controls signals over-recruitment of certain brain areas involved in higher cognitive processes. CD may thus result in long-lasting, subtle scarring effects during demanding executive functioning tasks, despite remission.

Disclosure

No significant relationships.

Knowledge and Practices on Antibiotic Use and Antibiotic Resistance Among Smallholder Pig Farmers in Timor-Leste

Antibiotic resistance is an emerging global health threat which is linked to the overuse and misuse of antibiotics. This study was conducted to understand the knowledge and practices of smallholder pig farmers on antibiotic use and resistance in Timor-Leste. A cross-sectional study using a structured face-to-face interview was conducted in three municipalities. The interview was piloted and implemented in the local Tetun language. This study found that knowledge of antibiotics was very poor as only 12.7% (95% CI: 6.3–23.9) of farmers reported knowing what antibiotics were, and of these only one was able to correctly explain how an antibiotic worked. None of the farmers knew about antibiotic resistance and were able to explain the concept correctly. After the definition of antibiotic was explained to the farmer, only 3.6% (95% CI: 0.8–14.9) reported that their pigs had ever received antibiotics, and the majority of farmers whose pigs had not received antibiotics reported the lack of access to veterinary services. When used, antibiotics were only used for treatment with no reported use for disease prevention or growth promotion. None of the commonly used antibiotics were critically important antimicrobials. Compliance with withdrawal periods was not routinely followed. There is a need to improve access to government veterinary services for farmers in Timor-Leste, while addressing identified knowledge gaps on antibiotics and promoting prudent use practices. The findings from this study serve as baseline information to inform future interventions.

The effects of different spacing allowances in the pullet phase on the eggshell and bone quality of hens in the laying phase

Eggshell and bone quality were investigated at 72 wk of age (WOA) using Lohmann Brown and Dekalb White hens raised with a rearing spacing allowance (SA) of 247 and 299 cm2·bird−1 from days 0 to 16 before being transferred to a common SA (755 cm2·bird−1) for lay cycle. Eggshell thickness, breaking strength, along with tibia and femur weight, breaking strength, length, and ash were measured at 72 WOA. Strain and SA did not interact on any above parameter (P > 0.05). Hens reared in high SA during the pullet phase had heavier tibia and more femur ash, indicating rearing environment during the pullet phase influences the bone quality of hens in the late laying stage (P < 0.05).

Bone scintigraphy in the diagnosis of transthyretin amyloidosis: a different performance in Portuguese hereditary variant?

Introduction

Bone scintigraphy using radioactive technetium-99m and 3,3-diphosphono-1,2-propanodicarboxylic acid (DPD) has been increasingly used to diagnose myocardial involvement of mutated or wild-type transthyretin amyloidosis (ATTR).

However, most studies that proved a high sensitivity and specificity of the technique were not in patients with the “Portuguese variant” (Val30Met) mutation in transthyretin (TTR). Other authors had already suggested that in these patients the DPD scan could be less accurate.

Methods

Observational study of patients referred to Cardiology clinic with suspicion of ATTR cardiomyopathy. We only included patients with data from echocardiogram and DPD scan.

For statistical analyses, SPSS was used, p&lt;0.05 for statistical significance. Logistic regressions were used to test an association between DPD result and different covariates.

Results

Of 273 patients referred with suspicion of cardiac ATTR, we studied 97 patients that did an echocardiogram and a DPD scan.

Among the 75 cases with mutated TTR (Val30Met), median age was 36 (IQR 34) and 60% were males. 60 had increased ventricular wall thickness (IVWT) &gt;12 mm, but only 24 had a positive DPD (defined as a visual score &gt;2). Even though a higher wall thickness was associated with a positive DPD (p=0.004), 18 patients with a negative scan had IVWT &gt;14 mm. The DPD results was significantly associated with prior liver transplantation (LT) – p&lt;0.001; 95% CI (7.1; 503.6) – and age at first symptoms – p&lt;0.001; 95% CI (1.036; 1.113); 66.7±10.5 versus 34.8±10.2 years-old for those with and without a positive scan, respectively. Interestingly, fewer patients with a positive scan had neurologic symptoms (74% versus 96%, p=0.009), ophthalmologic, urologic or renal involvement, even though creatinine clearance was on average lower (p=0.01). We did not find a significant association between DPD result and sex, conduction disorders, NT-proBNP, troponin T or treatment with tafamidis. Patients on tafamidis had on average lower IVWT, independent of age (median of 13 versus 14 mm; p=0.020). 4 patients with negative DPD did an endomyocardial biopsy, that was positive for amyloid in 3 cases.

In comparison, in the 22 cases with wild-type TTR, there were significantly more males (86%) and patients were older (median age was 81 (IQR 9)). All patients had IVWT (that was significantly higher than in mutated ATTR) and DPD scan was negative in only 2 patients (that had a visual score of 1). Systolic dysfunction was significantly more frequent (59% versus 8%). The occurrence of death or hospitalization for heart failure was significantly higher.

Conclusions

DPD-scintigraphy seems more sensitive in patients with late onset mutated ATTR or with wild-type ATTR. It is less accurate in early onset patients with Val30Met mutation and particularly if they underwent LT. In those patients, further investigation is needed before excluding myocardial involvement.

Funding Acknowledgement

Type of funding sources: None.

Orthostatic hypotension in hereditary ATTR Val30Met amyloidosis: predictors and associated clinical features

Introduction

The prevalence of orthostatic hypotension (OH) in patients with mutated transthyretin (TTR) amyloidosis (mATTR) is 40–60%. According to previous studies, OH is frequent and an early feature in patients with Val30Met mutation (the most prevalent form of mATTR).

Aim

To characterize TTR Val30Met patients with OH and to identify clinical characteristics associated with OH development.

Methods

Retrospective study of consecutive Val30Met TTR patients with suspected cardiac involvement observed at our cardiology clinic during 2019. Two groups were defined: group 1: patients without OH; group 2: patients with OH. Data was obtained by chart review. Statistically significant predictors of OH were found using logistic regression.

Results

We included a total of 248 patients (group 1 – 173; group 2 – 75). Group 1 patients were 52% male, median age 45 [interquartile range (IQR) 39–55] and median age at onset 34 (IQR 29,75–46,25) years. Left ventricle hypertrophy [LVH, defined as maximal LV wall thickness (LVT) ≥12 mm] occurred in 26,5%, with median maximal LVT 10 mm (IQR 9–12); 49,7% had conduction disturbances, 30,6% gastrointestinal (GI), 17,3% genitourinary (GU) manifestations and 5% were in Coutinho staging ≥2/3. Group 2 had 56% male, median age of 49 years at evaluation (IQR 42–65) and 35 years at onset (IQR 30–59). LVH was present in 42,9%, with median maximal LVT 11 mm (IQR 10–14); 74,7% had conduction disturbances, 56% GI and 42,7% GU manifestations and 21% were in Coutinho staging ≥2/3.

In univariate analysis, higher age (p=0,005), presence of LVH (p=0,009), conduction disturbances (p&lt;0,001), GU manifestations (p&lt;0,001) and higher Coutinho staging (p&lt;0,001) were all associated with the presence of OH, while age at onset was not (p=0,648). In multivariate analysis, only Coutinho staging [odds ratio (OR) 2.609; 95% confidence interval (95% CI) 1.344–5.065] and GU manifestations (OR 3,151; 95% CI 1,595–6,225) were found to be significant predictors of OH.

Conclusion

Our study suggests that OH is more associated with GU manifestations and Neurologic staging, than with amyloid cardiomyopathy or age, suggesting a predominant neurogenic component. The prevalence of OH in our sample of Val30Met patients was lower than previously described.

Funding Acknowledgement

Type of funding sources: None.

Insomnia at the onset of addiction treatment may be related to earlier relapses: A one-year follow-up study

Introduction

Insomnia has been related to a more severe substance use disorder presentation (1). There are few longitudinal studies in outpatients center for SUD treatment that evaluate how insomnia impacts on relapses.

Objectives

To analyze how insomnia impacts on the time of the first substance relapse in SUD outpatients after the onset of addiction treatment.

Methods

This is a one-year follow-up study performed on 116 patients (73.3% males; mean age 43.4±14.3) for whom we had information from baseline insomnia and the time for the first relapse. A Kaplan-Meier survival analysis was performed. This is part of a greater research on Alexithymia in SUD in a longitudinal study.

Results

The initial sample consisted of 116 patients, information on relapses was available for 113 patients. The main substances used at baseline were alcohol (62.1%), cocaine (56.0%), cannabis (42.2%), and opiates (30.2%).

Conclusions

It is important to evaluate insomnia at the onset of addiction treatment because insomnia may be related to earlier relapses. Furthermore, it should be analyzed further on how insomnia treatment impact on substance relapses. REFERENCES 1. Miller MB, Donahue ML, Carey KB, Scott-Sheldon LAJ. Insomnia treatment in the context of alcohol use disorder: A systematic review and meta-analysis. Drug Alcohol Depend. 2017;181:200-207. doi:10.1016/j.drugalcdep.2017.09.029

Constraints on Cosmic Strings Using Data from the Third Advanced LIGO-Virgo Observing Run

We search for gravitational-wave signals produced by cosmic strings in the Advanced LIGO and Virgo full O3 dataset. Search results are presented for gravitational waves produced by cosmic string loop features such as cusps, kinks, and, for the first time, kink-kink collisions. A template-based search for short-duration transient signals does not yield a detection. We also use the stochastic gravitational-wave background energy density upper limits derived from the O3 data to constrain the cosmic string tension Gμ as a function of the number of kinks, or the number of cusps, for two cosmic string loop distribution models. Additionally, we develop and test a third model that interpolates between these two models. Our results improve upon the previous LIGO-Virgo constraints on Gμ by 1 to 2 orders of magnitude depending on the model that is tested. In particular, for the one-loop distribution model, we set the most competitive constraints to date: Gμ≲4×10^{-15}. In the case of cosmic strings formed at the end of inflation in the context of grand unified theories, these results challenge simple inflationary models.

Constraints on Cosmic Strings Using Data from the Third Advanced LIGO-Virgo Observing Run

We search for gravitational-wave signals produced by cosmic strings in the Advanced LIGO and Virgo full O3 dataset. Search results are presented for gravitational waves produced by cosmic string loop features such as cusps, kinks, and, for the first time, kink-kink collisions. A template-based search for short-duration transient signals does not yield a detection. We also use the stochastic gravitational-wave background energy density upper limits derived from the O3 data to constrain the cosmic string tension Gμ as a function of the number of kinks, or the number of cusps, for two cosmic string loop distribution models. Additionally, we develop and test a third model that interpolates between these two models. Our results improve upon the previous LIGO-Virgo constraints on Gμ by 1 to 2 orders of magnitude depending on the model that is tested. In particular, for the one-loop distribution model, we set the most competitive constraints to date: Gμ≲4×10^{-15}. In the case of cosmic strings formed at the end of inflation in the context of grand unified theories, these results challenge simple inflationary models.

Lipid profile in a population with coronary artery disease in Madeira Island

Funding Acknowledgements

Type of funding sources: None.

Introduction

Coronary artery disease (CAD) remains a leading cause of morbidity and mortality worldwide. We know that plasma level of LDL cholesterol (LDL-C) is strongly associated with atherosclerosis, and its reduction with statins has led to a decrease in the incidence and complications of CAD. According to the 2019 ESC guidelines, in high-risk patient the aim is to achieve an absolute LDL-C treatment goal of &lt;55mg/dL. 2016 ESC guidelines purposed, in the same patients, a LDL-C level of &lt;70mg/dL.

Objective

To evaluate the degree of LDL-C control in coronary artery disease patients according to ESC guidelines.

Materials and Methods

Study analyses of 1687 patients selected from GENEMACOR study population, with at least one &gt; 75% coronary stenosis by angiography (median age 53.3 ± 3 years and 54.8% men).

LDL-C was determined by chemical methods and all patients were statin treated. The population was divided in four groups according to LDL-C levels: inferior to 55mg/dL, inferior to 70mg/dL, inferior to 115mg/dL and superior to 115mg/dL.

Results

LDL-C mean value was 108.7mg/dL, median 105.1mg/dL (P25 83.0 and P75 127.4mg/dL). 150 (8.9%) patients had LDL-C &lt; 55mg/dL vs 1537 (91.1%) with LDL-C ≥ 55 mg/dl. 275 (16.3%) patients had LDL-C &lt; 70 mg/dL vs 1412 (83.7%) with LDL-C ≥ 70 mg/dL.  1084 (64.3%%) patients had LDL &lt; 115 mg/dL vs 603 (35.7%) with LDL-C  ≥ 115 mg/dL.

Conclusion

In our population LDL-C control levels was low, with 91.1% patients with LDL-C ≥ 55mg/dL and 83.7% patients with LDL ≥ 70 mg/dL. It is interesting to note that most of our patients have LDL-C levels above the recommend by the newest and, surprisingly, the 2016 dyslipidemia guidelines. It is therefore important to implement a more intensive treatment strategy of dyslipidemia in coronary patients.

Homocysteine, a predictor of cardiovascular adverse events in coronary artery disease

Funding Acknowledgements

Type of funding sources: None.

OnBehalf

GENEMACOR

Introduction

After the diagnosis of coronary artery disease (CAD), traditional risk factors such as diabetes mellitus, dyslipidemia, hypertension and smoking have been used to assess the risk of major cardiovascular adverse events (MACE). However, despite reduction of these factors, presence of MACE remains high. It is necessary to identify other causal risk factors for MACE in coronary patients and increased plasma Homocysteine (Hcy) level seems to be a likely candidate. However, the influence of Hcy levels in the prognosis of coronary patients presents a limited knowledge.

Objective

To evaluate the influence of high level of Hcy in MACE (defined as a composite endpoint of cardiovascular death, acute myocardial infarction, stroke, admission for heart failure and need to revascularization) of coronary artery patients.

Materials and Methods

Study analyses of 1687 patients selected from GENEMACOR study population, with at least one &gt; 75% coronary stenosis by angiography. That population was divided in three terciles according to the Hcy level and the population of the 2nd tercil (Hcy 11.1-13.6mmol/L) was excluded. The end population of 1118 patients was a median age of 53.1 ± 7.9 years and 77.6% were men. We compared patients in the 1st (Hcy &lt; 11.1mmol/L) and 3rd tercil (Hcy &gt; 13.6mmol/L) during a mean follow up of 5.0 ± 4.8 years.

Results

560 (50.1%) patients were included in the 1st tercil group (median age 51.6 ± 3 years, 72.0% men) and  558 (49.9%) patients were in the 3rd tercil group (median age 54.6 ± 3 years, 83.3% men). In our population, high levels of Hcy were associated with MACE (OR 1.43, 95% CI: 1.12-1.83, p 0.004).

Conclusion

 In our population a higher level of Hcy was associated with adverse prognosis and increased occurrence of MACE. Knowing that elevated homocysteine levels are associated with increased risk of MACE, in these patients is essential to have a more intensive therapeutic strategy.

Antimicrobial Use in Animals in Timor-Leste Based on Veterinary Antimicrobial Imports between 2016 and 2019

Monitoring veterinary antimicrobial use is part of the global strategy to tackle antimicrobial resistance. The purpose of this study was to quantify veterinary antimicrobials imported into Timor-Leste between 2016 and 2019 and describe the antimicrobial import profile of importers. Data were obtained from import applications received by the Ministry of Agriculture and Fisheries (MAF) of Timor-Leste. Import quantities were analysed by antimicrobial class, importance for human medicine, recommended route of administration and type of importer. An average of 57.4 kg (s.d. 31.0 kg) and 0.55 mg/kg (s.d. 0.27 mg/kg) animal biomass of antimicrobials was imported per year. Tetracyclines (35.5%), penicillins (23.7%), and macrolides (15.9%) were the commonly imported antimicrobial classes. Antimicrobials imported for parenteral administration were most common (60.1%). MAF was the largest importer (52.4%). Most of the critically important antimicrobials for human medicine were imported by poultry farms for oral administration and use for growth promotion could not be ruled out. In conclusion, the use of antimicrobials in animals in Timor-Leste is very low, in keeping with its predominantly subsistence agriculture system. Farmer education, development of treatment guidelines, and strengthening of the veterinary service is important for addressing the potential future misuse of antimicrobials especially in the commercial poultry industry.

Cancer-related cognitive impairment in cancer: Examining portuguese cancer survivors’ acceptability and expectations regarding cognitive telerehabilitation interventions

Introduction

Cancer-related cognitive impairment (CRCI) is one of the most frequent and worrying side effects experienced by non-central nervous system (CNS) cancer survivors, generally related to cancer treatments. Considering its detrimental impact on quality of life, including work-related outcomes, it is necessary to identify effective intervention options. Cognitive rehabilitation is considered the first-line intervention to address CRCI, being effective at improving cognitive functioning. Internet-based interventions are emerging as important means of intervention in the field of cognitive rehabilitation (known as cognitive telerehabilitation), considering the potential to overcome accessibility issues and being cost-effective.

Objectives

To assess the acceptability and expectations regarding such interventions, considering the scarce literature.

Methods

A nationwide online survey was disseminated to Portuguese non-CNS cancer survivors, aged 18-65 years, who had finished active treatments, with no metastases/history of neurological or psychiatric disease/alcohol or drug abuse. Preexisting knowledge about CRCI, expectations for support to cognitive difficulties, Internet use for health and support purposes, and intervention needs and preferences in the context of cognitive telerehabilitation were examined; sociodemographic and clinical variables (e.g., age, education, employment status, cancer treatments), as well as cognitive complaints (Portuguese version of the Functional Assessment of Cancer Therapy-Cognitive, FACT-Cog), were also assessed.

Results

Findings from this study are important to help health professionals and researchers understand and identify cancer survivors’ needs regarding cognitive telerehabilitation interventions.

Conclusions

This information could be used as a support and guide for the development and delivery of these interventions for non-CNS cancer survivors.

Optimal and continuous multilattice embedding

Because of increased geometric freedom at a widening range of length scales and access to a growing material space, additive manufacturing has spurred renewed interest in topology optimization of parts with spatially varying material properties and structural hierarchy. Simultaneously, a surge of micro/nanoarchitected materials have been demonstrated. Nevertheless, multiscale design and micro/nanoscale additive manufacturing have yet to be sufficiently integrated to achieve free-form, multiscale, biomimetic structures. We unify design and manufacturing of spatially varying, hierarchical structures through a multimicrostructure topology optimization formulation with continuous multimicrostructure embedding. The approach leads to an optimized layout of multiple microstructural materials within an optimized macrostructure geometry, manufactured with continuously graded interfaces. To make the process modular and controllable and to avoid prohibitively expensive surface representations, we embed the microstructures directly into the 3D printer slices. The ideas provide a critical, interdisciplinary link at the convergence of material and structure in optimal design and manufacturing.

Cortical thickness abnormalities in long-term remitted cushing’s disease

Introduction

Remitted Cushing’s disease (RCD)-patients commonly continue to present persistent psychological and cognitive deficits, and alterations in brain function and structure. Assessing cortical thickness and surface area of RCD-patients may offer further insight into the neuroanatomical substrates of Cushing’s disease.

Objectives

To assess cortical thickness and surface area in RCD-patients in comparison to healthy controls (HCs).

Methods

Structural 3T MRI’s were obtained from 25 long-term RCD-patients, and 25 age-, gender-, and education-matched HCs. T1-weighted images were segmented to extract mean cortical thickness and surface area values of 68 cortical gray matter regions. Paired sample t-tests explored differences between the anterior cingulate cortex (ACC; region of interest), and the whole brain. Validated scales assessed psychiatric symptomatology, self-reported cognitive functioning, and disease severity.

Results

After correction for multiple comparisons, ROI analyses indicated that RCD-patients showed reduced cortical thickness of the left caudal ACC and the right rostral ACC compared to HCs. Whole-brain analyses indicated thinner cortices of the left caudal ACC, left cuneus, left posterior cingulate cortex, right rostral ACC, and bilateral precuneus compared to HCs. No cortical surface area differences were identified. Cortical thickness of the left caudal ACC was inversely associated with anxiety symptoms and disease duration.

Conclusions

In six of 68 regions examined, RCD patients had reduced cortical thickness in comparison to HCs. Cortical thickness of the left caudal ACC was inversely associated with disease duration, suggesting that prolonged and excessive exposure to glucocorticoids may be related to cortical thinning of brain structures involved in emotional and cognitive processing.

Disclosure

No significant relationships.

Integrated efforts to promote mental health care during the SARS-CoV-2 pandemic: Reflecting on the experience of a university helpline

Introduction

The SARS-CoV-2 pandemic is affecting numerous dimensions of our society since the beginning of the outbreak. A significant increase in emotional distress was expected in the general population, particularly among the high-risk groups such as the oldest, chronic patients, healthcare professionals, and psychopathology vulnerable people. There was an urgent need to adapt and create solutions to promote mental health. Given the recommendations to minimize face-to-face interactions, several helplines were widely developed.

Objectives

In this work, we aim to reflect on the experience of a university helpline, that integrated efforts with the regional mental health care services.

Methods

A University helpline was created to give support to the regional community outside academia. The team was created on an online teamwork platform, to communicate through the chat, carry videoconference meetings, and store useful files. A Manchester screening decision tree was adopted, to define a set of guidelines to provide support to the callers, based mainly on the guidelines defined by the Order of Portuguese Psychologists. Liaison with the mental health care services, including other specific helplines, was established.

Results

Notwithstanding all the efforts, the number of received calls was scarce, similarly to helplines created by other national universities and by other entities.

Conclusions

A new approach to psychological intervention in crisis is needed, maintaining integrated efforts, and taking advantage of the opportunity to foster personalized mental health care in the digital era. It is important to continuously assess the value of integrated efforts in patient care and to the healthcare system.