Sustainable permeable biobarriers for atrazine removal in packed bed biofilm reactors

The synergy between two supported bacterial biofilms of S. equisimilis and P. putida and a sustainable biocarrier (raw pine) was studied, working both as biobarriers for the treatment of water contaminated with atrazine. Firstly, the effects of ATZ exposure on bacterial growth were evaluated, with Gram-positive S. equisimilis being a more tolerant bacterium to higher amounts of the herbicide. The bioremoval of ATZ by S. equisimilis concentrated biomass was then assessed, reaching around 83.5% after 15 days due to the potential degradation by the biomass and biosorption by the solids, with overlapping of both mechanisms. The optimization of bacterial biofilm attachment onto raw pine prior to bioremoval assays in lab-scale packed bed biofilm reactors was performed by varying initial biomass concentration, inocula growth time and hydrodynamic conditions. Lastly, the optimized biosystems were tested as sustainable remediation designs to treat water contaminated with the selected herbicide. Results reveal an added beneficial effect towards the bioremoval of atrazine using supported biofilms onto raw pine, reaching 90.42% and 79.71% by S. equisimilis and P. putida biofilms, respectively, over 58.31% increase when compared to sorption on fixed bed of pine. The coupling of biosorption/biodegradation favors the bioremoval process significantly.

A U.S. Cancer Center's Interactive Cancer Education Program for Spanish-Speaking Latinos during COVID-19 Pandemic

PURPOSE/OBJECTIVE(S)

Cancer is a leading cause of mortality in U.S. Latino adults, a group with limited access to screening, higher rates of advanced disease, and prone to online misinformation. Our project created a Facebook Live social media video campaign on general cancer prevention, screening, risk, information, and resources, targeting Spanish-monolingual Latinos during the COVID-19 pandemic.

MATERIALS/METHODS

Our project consisted of a hybrid video campaign model released to Facebook social media platform between October and December 2021, where pre-recorded videos or livestream interviews were delivered in Spanish with auto-generated, language-concordant subtitles to increase accessibility for the hearing-impaired. The videos featured fluent and ethnically concordant cancer topic experts. The content of these videos included introductions to the local academic cancer center as a resource, general cancer risk factors, screening, early detection and lifestyle modifications. The livestream interview format consisted of structured questions followed by time allocation for community members to ask questions in real time through Facebook Live comments. At interview conclusion, the recording was promptly uploaded within minutes for future replay. Performance metrics as reported by Facebook media analytics were collected, including total views, people reached, impressions, engagements, and shares.

RESULTS

A total of 7 videos (4 pre-recorded, 3 livestream interviews) were released onto Facebook social media platform generating 2 hours, 55 minutes, and 32 seconds of playtime, 161 shares, 1000 engagements, 12,000 views, 19,000 people reached, and 34,000 impressions from October 2021 to January 2022. The video with the most views (4,400), people reached (7,100), and impressions (10,000) was the pre-recorded "The importance of a healthy diet in the prevention of cancer." The video with the least views (355), people reached (747), and impressions (904) was the livestream interview, "Cancer and nutrition." The pre-recorded videos accumulated more views (9,607) than the livestream interviews (2,707). The highest performing livestream interview by views, people reached, impressions, shares, and engagements were, "Cancer in the Latino community."

CONCLUSION

Our project bidirectionally engaged Spanish-monolingual Latino community members and culturally/linguistically concordant cancer experts during the COVID-19 pandemic. Strengths included developing community partnerships and collaborations, providing evidence-based cancer information in a culturally responsive manner to a marginalized group, and presenting an academic cancer center as an accessible resource to its community. Programmatic efforts to improve our project include formalizing evaluation strategies to capture medical engagement via cancer screening and detection rates, delivering focused cancer discussions by disease sites, and further expanding audience base through mixed media formats.

Anxiety symptoms in critically ill COVID-19 survivors and its association with post-discharge health concerns

Introduction

Evidence suggest that critically ill COVID-19 patients are at higher risk of developing anxiety symptoms, which may be related to or exacerbated by patients concerns regarding their health status and recovery.

Objectives

To assess anxiety symptoms in critically ill COVID-19 survivors, 1-2 months after hospital discharge and to analyze its association with concerns reported by patients regarding their own health status and recovery.

Methods

In the framework of MAPA prospective research, this preliminary study included COVID-19 patients admitted in the Intensive Care Medicine Department (ICMD) of a University Hospital. Patients were excluded if they had an ICMD length of stay (LoS) ≤24h, terminal illness, major auditory impairment or inability to communicate at the evaluation time. Participants were assessed at a scheduled telephone follow-up appointment, with Generalized Anxiety Disorder Scale (GAD-7). Additional questions were asked to assess the survivors’ post-discharge concerns regarding discrimination against for COVID-19, infection of a family member, re-infection or sequelae related to COVID-19.

Results

Eighty-three patients were included (median age=63 years; 63% male) and 24% had anxiety symptoms. Anxiety scores were higher in survivors who reported being afraid of being discriminated against for COVID-19 (30% vs 10%; p=0.034), being re-infected (100% vs 79%; p=0.032) and having sequelae (94% vs 44%; p<0.001).

Conclusions

These findings revealed that anxiety is common in COVID-19 survivors and is associated with post-discharge patients concerns that may limit patient daily living. This study emphasizes the importance of psychological assessment and follow-up of the COVID-19 survivors, in order to support these patients recovery.

Disclosure

No significant relationships.

Psychopathology after epilepsy surgery: a retrospective study

Introduction

In patients submitted to refractory epilepsy surgery, psychiatric comorbidity is high (affecting 1 in every 3 patients), with descriptions of improvement, worsening and emergence of de novo psychopathology.

Objectives

Identifying the prevalence of psychopathology and associated risk factors in a group of patients submitted to refractory epilepsy surgery.

Methods

Retrospective observational study. Non systematic literature review.

Results

We observed 42 patients, 45.2% female and 54.8% male, with an average age of 46.5 years (SD±11.6). The average age of presentation of epilepsy was 18.8 years (SD±12.7), 97.6% with temporal lobe epilepsy and 2.4% with parietal lobe epilepsy, 50% in each hemisphere. 19% had surgical complications and 40.5% had post-surgical recurrence of crisis. 45.2% presented with pre-surgical psychopathology (33.3% affective disorders, 16.7% anxiety disorders, 2.4% psychotic disorders, 2.4% neurodevelopmental disorders and 2.4% substance use disorders). Post-surgically, 50% improved, 20.8% maintained and 29.2% worsened their psychopathology and 21.4% had de novo psychopathology. We didn’t find associations between the analyzed variables and the worsening or appearance of de novo psychopathology.

Conclusions

The worsening or appearance of de novo psychopathology is a well known phenomenon in patients submitted to refractory epilepsy surgery. In our sample there were cases of improvement, maintenance, worsening and emergence of de novo psychopathology, however we weren’t able to identify the factors associated with these different outcomes. Our study was retrospective and had a small sample, as limitations. Further, better-designed studies are necessary to identify risk factors for psychiatric disorders, allowing their effective prevention and treatment.

Disclosure

No significant relationships.

Epicardial mapping as first intention approach for structural ventricular tachycardia ablation

Funding Acknowledgements

Type of funding sources: None.

Introduction

In several structural arrhythmogenic diseases that comprise intricate endocardial, intramural and epicardial substrates, endocardial ablation of ventricular tachycardia (VT) is not sufficient and epicardial ablation has lately become a complementary and necessary tool.

Purpose

To evaluate the clinical characteristics of patients (pts) most suitable for first intention epicardial VT ablation.

Methods

Single-center prospective study of consecutive pts with structural heart disease undergoing first intention epicardial VT mapping between August 2015 and June 2021. Decision for epicardial approach was based on the etiology, VT electrocardiogram (ECG) and cardiac magnetic resonance (CMR) results. Under general anesthesia, subxiphoid access using a Tuhoy needle was done using fluoroscopic guidance and with high-density epicardial mapping was performed. Epicardial ablation was performed if relevant arrhythmogenic findings were locally confirmed.

Results

First intention epicardial VT ablation was attempted in 18 pts (mean age 59.8±12 years,94% male) of whom 16 had non-ischemic dilated cardiomyopathy (NICM,idiopathic:11; post-myocardis:4; hereditary:1) and 2 had right ventricular arrhythmogenic cardiomyopathy. Mean LVEF was 33% and 79% had a previous ICD (53% in primary prevenon). 69% were referred for ablation due to arrhythmic storm (1pt in cardiogenic shock). Epicardial access was achieved in 17 pts (94%), without acute complications. In 35% pts with NICM the decision for epicardial approach was based on the detection of subepicardial CMR delayed-hyperenhancement and relevant epicardial arrhythmic substrate was confirmed by mapping in all cases. In 3 pts radiofrequency (RF) applicaons were not performed at epicardium, as no abnormal electrograms were locally detected, and an addional endocardial approach was prosecuted. The mean overall procedure and fluoroscopic time were 123 and 28min, respectively, with a mean RF application me of 51min. After the procedure 1pt required pericardial drainage due to inflammatory pericardial effusion. No other acute complications occurred. During a mean follow-up of 2.8±1.8 years, only 3pts (17%) had VT recurrence; 5pts (28%) died due to end-stage heart failure and 2pts (11%) underwent heart transplantation.

Conclusion

In NICM a first intention epicardial VT ablation performed by experienced operators/centers is efficient, particularly if guided by CMR findings,and presents a safety profile.

Mitral valve prolapse: impact of mitral valve disjunction in a large single-center

Funding Acknowledgements

Type of funding sources: None.

Introduction

Despite being known for more than a century, mitral valve prolapse (MVP) is an

entity not fully understood with controversial data regarding the prognosis.

Aim

To characterize a sample of patients with MVP and to access the frequency of

complications associated with MVP (arrhythmias, hospital admissions and death).

Methods

Single-center retrospective study of consecutive patients with MVP documented in

transthoracic echocardiogram between January 2014 and October 2019. MVP was defined as

systolic displacement of the mitral leaflet into the left atrium≥ 2 mm from the mitral annular

plane. Demographic, clinical, echo, EKG data were collected as well as major adverse events at follow-up. Categorical variables were reported in absolute number and/or % and continuous variables were reported as mean and SD or median and IQR. The results were obtained using Chi-square and ANOVA tests.

Results

247 patients were included (mean age 62.9 ± 18 years, 61% male). The mean

distance of the MVP was 6mm (IQR 5-9). The posterior mitral valve leaflet (PL) was the most

frequently involved (49%), followed by involvement of both leaflets (BL) (27%) and the anterior

leaflet (AL) (25%). Patients with MVP of PL were older compared to patients with BL and AL

involvement (68 ±15 vs 58 ± 17 vs 59 ± 22 years, respectively, p &lt; 0.001) and had longer QT

interval (419 ± 35 vs 403 ± 25 vs 410 ± 34ms, respectively, p = 0.013). 70.4% (174) had

significant MR. Mitral annulus disjunction (MAD) was present in 9.3% (n = 23). The mean LVEF was 63% ± 6.3% and LV mass was 124,7 ± 41g/m2. Most of the patients were in sinus rhythm (SR) (78%). 13.3% had hospital admission for cardiovascular cause and 8.5% (n = 21) died.

During a mean follow-up of 30 ± 19 months, 25.1% of the patients had de novo atrial fibrillation (AF), 8 patients (3%) were submitted to supraventricular dysrhythmia ablation. 16.2% had premature ectopic ventricular complexes, 2.4% non-sustained VT, 0.4% sustained VT, 0.8% needed ICD, 8.5% had a pacemaker. 25% of the patients underwent mitral valve intervention (23.9% to surgical intervention and 3 to percutaneous). 12% of the patients had a hospital admission for CV cause and 8.5% of the patients died.

In multivariate analysis, hospitalization for CV cause (OR 7.27, p = 0.011, CI 95% 1.59- 33.3), higher NYHA class (III-IV) (p = 0.036 OR 5.7 CI95% 1.125-28.84) and the presence of LBBB (p = 0.021 OR = 6.78 CI95% 1.13-28.85) were independent predictors of mortality.

MAD was not associated with the outcomes. SR (OR 0.3, p = 0.014, CI95% 0.119-0.786) and prolapse (OR 0.37, p = 0.035, CI95%0.148-0.935) according to the ESC classification (comparing to flail and billowing) predicted survival.

Conclusion

MVP was traditionally described as a benign entity. However, in our population it was associated with significant mitral regurgitation, some requiring intervention. Besides that, 44% had arrhythmias, with AF occurring in about 25%, hospitalization in 13.3% and cardiovascular death in 8.5%.

Is balloon cryoablation effective in common pulmonary trunk?

Introduction

Common pulmonary trunk (CPT) accounts for the most frequent pulmonary vein anatomical variation. The most frequent technique used for pulmonary vein isolation (PVI) is point-by-point radiofrequency, using cryoablation (CB) is still debatable. Some few studies have shown the feasibility and safety of CB in CPT atrial fibrillation (AF) patients (pts), most of them performed angio-CT prior to ablation.

Purpose

To analyzed AF pts with and without CPT submitted to CB in regarding of success rate and safety.

Methods

Single-center retrospective study of consecutive AF pts refractory to antiarrhythmics submitted to CB between 2017 and 2020. Before the procedure auriculography was performed in all pts to verify variations in pulmonary veins, however the procedure was not modify regarding the presence of CPT. Clinical records were analyzed to determine baseline characteristics, success rate and complications. Monitoring was performed with a 7-day event loop recorder at 3, 6 and 12 months and annually from the 2nd year. Success was defined by recurrence of AF (duration &gt;30 seconds). Kaplan Meier survival curves were used to estimate the risk of events and the groups were compared using Chi-square and Mann-Whitney analysis.

Results

A total of 232 pts (60±12 years, 68% males) underwent CB. 29 pts had CPT (28 – common left pulmonary trunk and 2 – common right pulmonary trunk). Baseline characteristics were similar between groups, except for CHA2DS2VASc score and prior cerebrovascular disease history which were higher in CPT pts (3±2 vs 2±2, p=0.001; 24.1% vs 6.8%, p=0.007, respectively). The mean baseline CHA2DS2VASc was 2±2 and the median post-CB follow-up was 135 (IQ 32–249) days.

Both the 1 and 3 year arrhythmic recurrence after AF ablation was not significantly different when comparing CPT and non CPT group with a 3 year success rate of 95.8% in pts with CPV against 86.5% in pts without CPT (p=0.299).

There was no difference between groups (p=0.296; p=0,164, respectively) regarding the time of the procedure, radiation dose and rate of complications.

Conclusions

In our experience, balloon cryoablation for PVI is a safe and successful procedure in patients with CPT anatomical variation.

Funding Acknowledgement

Type of funding sources: None.

Headache service quality evaluation: implementation of quality indicators in primary care in Europe

BACKGROUND

Lifting The Burden (LTB) and European Headache Federation (EHF) have developed a set of headache service quality indicators, successfully tested in specialist headache centres. Their intended application includes all levels of care. Here we assess their implementation in primary care.

METHODS

We included 28 primary-care clinics in Germany (4), Turkey (4), Latvia (5) and Portugal (15). To implement the indicators, we interviewed 111 doctors, 92 nurses and medical assistants, 70 secretaries, 27 service managers and 493 patients, using the questionnaires developed by LTB and EHF. In addition, we evaluated 675 patients' records. Enquiries were in nine domains: diagnosis, individualized management, referral pathways, patient education and reassurance, convenience and comfort, patient satisfaction, equity and efficiency of headache care, outcome assessment and safety.

RESULTS

The principal finding was that Implementation proved feasible and practical in primary care. In the process, we identified significant quality deficits. Almost everywhere, histories of headache, especially temporal profiles, were captured and/or assessed inaccurately. A substantial proportion (20%) of patients received non-specific ICD codes such as R51 ("headache") rather than specific headache diagnoses. Headache-related disability and quality of life were not part of routine clinical enquiry. Headache diaries and calendars were not in use. Waiting times were long (e.g., about 60 min in Germany). Nevertheless, most patients (> 85%) expressed satisfaction with their care. Almost all the participating clinics provided equitable and easy access to treatment, and follow-up for most headache patients, without unnecessary barriers.

CONCLUSIONS

The study demonstrated that headache service quality indicators can be used in primary care, proving both practical and fit for purpose. It also uncovered quality deficits leading to suboptimal treatment, often due to a lack of knowledge among the general practitioners. There were failures of process also. These findings signal the need for additional training in headache diagnosis and management in primary care, where most headache patients are necessarily treated. More generally, they underline the importance of headache service quality evaluation in primary care, not only to identify-quality failings but also to guide improvements. This study also demonstrated that patients' satisfaction is not, on its own, a good indicator of service quality.

Mitral annulus disjunction: is it a marker of ominous prognosis?

Funding Acknowledgements

Type of funding sources: None.

Introduction

Mitral annulus disjunction (MAD) has been proposed as a contributing factor for arrythmias and mitral regurgitation in patients with mitral valve prolapse (MVP), however its clinical relevance is still under investigation.

Objective

To evaluate the frequency of MAD in MVP patients, to characterize clinically patients with MAD and assess potential markers for events.

Methods

Single-center retrospective study of consecutive patients with MVP documented in transthoracic echocardiogram between January 2014 and October 2019. MVP was defined according to the 2017 AHA recommendations; MAD was defined as a separation between mitral valve annulus and the left ventricle free wall. Demographic, clinical, echocardiographic, electrocardiographic data were collected. The results were obtained using Chi-square and Mann-Whitney tests; logistic regression was used to find predictors of events.

Results

247 patients were included (mean age 62.9 ± 18 years, 61% males), of these 23 (9.3%) had MAD (mean age 56 ± 20 years, 56.5% males). The maximum diameter of MAD was 10 ± 3mm (range 5-18). 21 patients (92.3%) had mitral regurgitation, and it was at least of moderate severity in 65.2% of patients. Most of the patients (91.3, n = 21) were in sinus rhythm (SR).

During follow-up (FUP) of 29 ± 19 months, 39% (n = 9) of the patients developed symptoms, 22% (n = 5) had atrial fibrillation (AF), 4.3% (n = 1) had acute aortic syndrome (AAS), 4.3% (n = 1) needed ICD, 22% (n = 5) were submitted to mitral valve intervention, 8.7% (n = 2) were admitted to hospital and 8.7% (n = 2) died. None of the patients presented sustained ventricular arrhythmias (SVA) as assessed in regular Holter monitoring.

These patients had more AAS and needed more ICD in FUP compared to patients without MAD (p = 0.007 and p = 0.006, respectively)

Mitral cord rupture (p = 0.04), age (p = 0.044), maximum velocity of tricuspid regurgitation (p = 0.04) and IVS thickness (p = 0.017) were associated with AF in MAD patients. in univariate analysis, interventricular septum thickness was a predictor of AF in this subgroup (OR 4.0, 95%CI 1.1-14.3, p = 0-032) The presence of SR was associated with survival (p = 0.03). There were no predictors of hospital admission or mitral intervention.

Conclusion

Patients with MAD had a relatively benign prognosis with few events during follow-up, although with more AAS and ICD in FUP. In our sample, AF was more common than SVA. Left ventricle hypertrophy was a predictor of AF and sinus rhythm was associated with survival. Larger studies with more patients and other methods of imaging are needed to confirm our results.

A software for quantification of vessel density in glaucoma: An OCT-Angiography study

PURPOSE

To assess the capillary vessel density in the peripapillary region of glaucoma patients in comparison to controls using automated software.

METHODS

We performed an observational, cross-sectional case-control study with 72 eyes of glaucoma patients (with strict selection criteria) and 30 age-matched healthy controls. We used an optical coherence tomography angiography device (Triton, Topcon) with scans of 4.5×4.5mm centered on the optic nerve head, excluding images of poor quality. Since this device does not quantify vessel density, we wrote software (with Visual Studio©) that allowed us to remove large blood vessels and quantify the capillary density in the peripapillary region. We tested the ability of OCT-A to differentiate glaucoma from controls using the receiver operating characteristic curve (ROC). We also verified whether VD was correlated with visual field mean deviation.

RESULTS

VD was significantly lower in glaucoma than in controls, notably the whole-image VD of 72.45±7.45% in glaucoma and 77.87±3.77% in controls (P<0.001). VD values were correlated with visual fields (Spearman correlation of 0.33; P 0.0017). ROC was moderate (color VD of 0.629±0.143), but better than that of the visual field (0.229±0.077) or the retinal nerve fiber layer thickness assessed by OCT (0.326±0.064).

CONCLUSIONS

This software is useful for quantifying vessel density at the optic disc, peripapillary and capillary levels and for documenting glaucomatous changes in vascularization. OCT-A might be useful in diagnosis of glaucoma.

Are we aiming for different metabolic targets in heart failure patients?

Introduction

Metabolic control plays an important role on major cardiovascular events (MACE) prevention. The 2019 ESC guidelines on dyslipidaemia management recommend tighter LDL-cholesterol (LDL-C) control in order to prevent cardiovascular events. However, it is not yet proven that thigh control of dyslipidaemia, glycaemic levels and body mass index (BMI) in Heart Failure (HF) patients (pts) have an impact on prognosis.

Objective

To evaluate the impact of LDL-C, HbA1c and BMI values on HF pts mortality and MACE rates.

Methods

Single centre study that included consecutive pts hospitalized for acute / decompensated chronic HF in a tertiary Hospital between January 2016 to December 2018 and followed for 12 months. The impact of LDL-C, HbA1c and BMI on mortality and MACE was assessed using Cox regression and Kaplan-Meier curve, after adjustment for age, sex, functional class and ejection fraction. A safety cut-off was established when any of these variables was deemed protective using ROC curve analysis.

Results

Two hundred twenty-four patients (71.68±13.45 years, 63.8% males) were included. Eighty-four (37.5%) pts had type 2 diabetes, 39.7% had ischemic heart disease and the median left ventricular ejection fraction was 34% (IQR 25–49.5; 60.3% HFrEF; 13.8% HFmrEF; 22.3% HFpEF). The median BMI was 25.4 kg/m2 (IQR 23.1–30.5), HbA1c, 6.4% (IQR 5.6–6.8) and LDL-C, 89.5 mg/dL (IQR 64–106); 145 (64.7%) pts were medicated with statins. The overall mortality and MACE rates during follow-up were 16.1% and 21.0%, respectively. According to the CV risk classification 39.7% pts were at very high risk and 19.6% pts at high risk. On multivariate analysis HbA1c (HR 1.5 IQR 1.1–1.9; p=0.007) and female sex (HR 9.453 IQR 2.4–37.2; p=0.001) were independent predictors of mortality, whereas LDL-C (OR 1.05 IQR 1.022–1.075; p&lt;0.001) and BMI (OR 1.23 IQR 1.075–1.404; p=0.002) were independent protective factors. LDL-C and BMI had no effect on MACE rates, although HbA1c was an independent predictor of MACE (HR 1.27 IQR 1.03–1.57; p=0.026). For high and very high-risk pts there was still a protective trend on mortality, although non-significant, for higher levels of LDL-C (OR 1.04 IQR 0.99–1.075; P=NS). Protective LDL-C cut-off were estimated for the whole population (LDL-C 88mg/dL; AUC 0.819; sn 56.6%, sp 100%) and for the high and very-high CV risk pts (LDL-C 84mg/dL; AUC 0.815; sn 59.3%; sp 100%). A BMI safety cut-off for mortality of 25.75 kg/m2 was found (AUC 0.627; sn 61.2%; sp 58.3%).

Conclusion

This study supports the theory of the obesity and LDL-C paradox in HF. Lower LDL-C and BMI increased mortality and there is no trade-off effect on MACE rates, supporting the idea that LDL-C and BMI should not be aggressively addressed in HF pts. In our cohort a cut-off level of LDL-C below 88mg/dL is associated with higher mortality. On the other hand, diabetes should be actively treated as HbA1c predicts death and MACE in HF pts.

Funding Acknowledgement

Type of funding source: None

AB0982 SERUM ALBUMIN LEVELS AND DEPRESSION IN JSLE

Background:

Albumin is a negative acute phase response protein synthesized in the liver, being an important marker of inflammation. Under inflammatory conditions, the transcapillary escape rate of albumin may increase, leading to hypoalbuminaemia. Systemic lupus erythematosus (SLE) is a chronic condition involving multiple organ systems, inducing functional disability and psychological burden responsible for noteworthy depressive symptoms1. Depression may be related with psychosocial, environmental and biological factors, disease activity and its severity, age and sex2. Several studies show that immune activation and increased concentrations of positive and decreased concentrations of negative acute phase proteins are involved in the pathogenesis of depression3. As albumin has the capacity to bind homocysteine, lowered serum albumin levels leads to hyperhomocysteinemia, a well-known risk factor for depression. Moreover, hypoalbuminaemia decrease the availability of tryptophan, an essential amino acid from which the neurotransmitter serotonin is derived, and induce oxidative stress, which further decreases antioxidant levels in people with depression.

Objectives:

To assess the association between serum albumin levels and depressive symptoms in juvenile-onset SLE (jSLE) patients.

Methods:

A cross-sectional sample of jSLE patients, currently aged ≥ 16 years, completed a psychosocial assessment including quality of life (SF-36) anxiety and depressive symptoms (HADS) and cognitive assessment (MMSE), between October 2018- May 2019. Local Ethics Committee approved the study. All patients fulfilled both 2012 and 2019 EULAR/ACR classification criteria for SLE. Juvenile-onset was defined as age at diagnosis <18 years. Demographics and clinical characteristics were collected. Statistical analysis was performed with SPSS®. Variables were compared with spearman correlations tests.

Results:

30 jSLE patients were included (90%female) in the study, with median (min-max) age of 21 (16-35) years, with mean (SD) age of diagnosis of 15.8 ± 2.1. Median albumin serum level was 41.7 (16.7-46.3) g/dL. Psychosocial assessment revealed a mean (SD) score in HADS - Depression of 3.9 (3.3), HADS - Anxiety of 9 (4.3), MMSE of 27.7 (1.8), Physical health SF-36 of 66.8 (9.9) and Mental health SF-36 of 68.9 (17.5). 23.3 % jSLE showed mild cognitive impairment, 63.3% anxiety and 13.3% depression. We observed significant inverse linear relationships between serum albumin levels and depressive symptoms score (p=0.042, ρ=-0.380) and with anxiety symptoms score ((p=0.029, ρ=-0.406). No significant correlations were detected between albumin serum concentrations and cognitive assessment.

Conclusion:

Our findings are consistent with studies previously reporting the potentially protective effect of high serum albumin levels on mental health in different populations. A possible inflammation related aetiology for depression in jSLE patients is highlighted, further explained through the protective roles played by albumin in inflammation, infection, and oxidative damage.

References:

[1]Zhang, L. et al. Prevalence of depression and anxiety in systemic lupus erythematosus: a systematic review and meta-analysis. BMC Psychiatry 17, 70 (2017)

[2]Figueiredo-Braga M et al. Depression and anxiety in systemic lupus erythematosus: The crosstalk between immunological, clinical, and psychosocial factors. Medicine (Baltimore). 2018;97(28)

[3]Livia Ambrus & Sofie Westling. Inverse association between serum albumin and depressive symptoms among drug-free individuals with a recent suicide attempt, Nordic Journal of Psychiatry, 73:4-5, 229-232

Disclosure of Interests:

None declared

AB0561 AUTOMATIC QUANTIFICATION OF INTERSTITIAL LUNG DISEASE FROM CHEST COMPUTED TOMOGRAPHY IN SYSTEMIC SCLERODERMA

Background:

Scleroderma-associated interstitial lung disease (SSc-ILD) is often observed in patients with systemic scleroderma (SSc) and its diagnosis contributes to early treatment decisions1,2.

Objectives:

The present study aims to automatically quantify SSc-ILD from high-resolution chest-computed tomography (HRCT) and to evaluate the association between interstitial lung disease (ILD) extension and lung function impairment.

Methods:

Ninety-four patients with SSc and 27 lung-healthy subjects matched for gender, weight, height, and age underwent HRCT, spirometry and carbon monoxide diffusion capacity (DLCO). SSc-ILD was determined as the tissue mass present between -500 and +100 Hounsfield Units normalized by the total lung tissue mass (TLM). Cut off was the highest value obtained in the control group (25% of TLM). All data are presented as mean and standard deviations (Table I). An ANOVA test followed by Bonferroni post-hoc correction was used for comparisons among groups.

Results:

From 94 patients with SSc, 64 were classified as having pulmonary involvement (SSc-ILD) and 30 as not having pulmonary involvement (SSc No-ILD). In SSc-ILD subjects, there was a significant reduction in forced vital capacity (FVC), carbon monoxide diffusion capacity (DLCO) and carbon monoxide diffusion capacity normalized by alveolar ventilation (DLCO/A) when compared with SSc No-ILD and control group.

Conclusion:

The proposed method allows the automatic quantification of SSc-ILD from HRCT and ILD extent is associated with pulmonary function impairment.

References:

[1]Doyle TJ, Dellaripa PF. Lung Manifestations in the Rheumatic Diseases. CHEST. 2017 Dec;152(6):1283–95.

[2]Saketkoo LA, Magnus JH, Doyle MK. The primary care physician in the early diagnosis of systemic sclerosis: the cornerstone of recognition and hope. The American Journal of the Medical Sciences. 2014 Jan;347(1):54–63.

Table 1.

Demographic variables, pulmonary function tests and densitovolumetry considering scleroderma patients with less or greater pulmonary involvement.

Control GroupN = 27SSc No-ILDN = 30SSc-ILDN = 64p-valueDemographic DataFemales16 (59.2)28 (93.3)58 (90.1)-Age (years)37.9 ± 14.851.2 ± 12.256 ± 14<0.011a,bBMI (kg/m2)26.7 ± 5.124.1 ± 5.025.9 ± 5.7-Lung Function FVC (% predicted)100.2 ± 9.299.9 ± 19.869.8 ± 16.7<0.001b,c DLco (% predicted)103 ± 13.383.8 ± 14.263.4 ± 20.3<0.002a,b,cDLco/A (% predicted)112.7 ± 17.485.7 ± 12.979.2 ± 20.6<0.001a,bDensitovolumetryTLV mL4675 ± 9864471 ± 9163492 ± 1120<0.001b,cLung Tissue Mass (g)793 ± 125756 ± 159731 ± 155- ILD Extent (% LTM)17 ± 222.9 ± 1.232.6 ± 8<0.003a,b,c

a: Statistically significant difference between No-ILD SSc and control group; b and c: Statistically significant difference between SSc-ILD vs control group and SSc No-ILD, respectively.

Disclosure of Interests:

None declared

The ESC ACCA EAPCI EORP acute coronary syndrome ST-elevation myocardial infarction registry

Aims 

The Acute Cardiac Care Association (ACCA)–European Association of Percutaneous Coronary Intervention (EAPCI) Registry on ST-elevation myocardial infarction (STEMI) of the EurObservational programme (EORP) of the European Society of Cardiology (ESC) registry aimed to determine the current state of the use of reperfusion therapy in ESC member and ESC affiliated countries and the adherence to ESC STEMI guidelines in patients with STEMI.

Methods and results 

Between 1 January 2015 and 31 March 2018, a total of 11 462 patients admitted with an initial diagnosis of STEMI according to the 2012 ESC STEMI guidelines were enrolled. Individual patient data were collected across 196 centres and 29 countries. Among the centres, there were 136 percutaneous coronary intervention centres and 91 with cardiac surgery on-site. The majority of centres (129/196) were part of a STEMI network. The main objective of this study was to describe the demographic, clinical, and angiographic characteristics of patients with STEMI. Other objectives include to assess management patterns and in particular the current use of reperfusion therapies and to evaluate how recommendations of most recent STEMI European guidelines regarding reperfusion therapies and adjunctive pharmacological and non-pharmacological treatments are adopted in clinical practice and how their application can impact on patients’ outcomes. Patients will be followed for 1 year after admission.

Conclusion 

The ESC ACCA-EAPCI EORP ACS STEMI registry is an international registry of care and outcomes of patients hospitalized with STEMI. It will provide insights into the contemporary patient profile, management patterns, and 1-year outcome of patients with STEMI.

Bioreceptivity index for granitic rocks used as construction material

Bioreceptivity is a fundamental concept in the ornamental stone industry and in the fields of cultural heritage and civil engineering to understand the susceptibility of stone constructions to biological colonisation and subsequent biodeterioration. However, a bioreceptivity index (BI) has not yet been established for any construction material. The aim of the present study is developing a simple, robust and well-founded BI for granitic rocks. For this purpose, a standardised laboratory protocol was used to grow phototrophic biofilms on several varieties of granite. The colonisation was then assessed by chlorophyll fluorescence and colour measurements. Based on the results thus obtained, a BI including two components (BI_growth and BI_colour) is proposed. BI_growth quantifies the extent of the biological growth and BI_colour quantifies the colour change undergone by the stone due to the colonisation, which can be considered the bioreceptivity perceptible to the human eye. The values of BI, BI_growth and BI_colour were fitted to a scale of 0-10, thus enabling qualitative classification of the lithotypes according to their primary bioreceptivity. Eleven varieties of granite commonly used as construction material and with a honed surface finish (one variety with three additional surface finishes: polished, sawn and sanded) were thus assigned the corresponding BI, which represents a new quality factor for the stone industry. The index can therefore be used by end-users as a decision-making tool in the selection of appropriate lithotypes for building and/or ornamental purposes.

Lomos de cerdo Alentejano y blanco ahumados vs curados

Este estudo pretende avaliar as características dos dois tipos de lombo de porco, Alentejano e Branco, processados com tecnologias distintas, a fumagem, apreciada em Portugal, ao contrário dos restantes países da Europa que preferem produtos que utilizam exclusivamente a secagem para obter um produto curado. Utilizaram-se 6 porcos de Raça Alentejana, cruzados a 50% com Duroc, criados em regime extensivo, classificados como classe 2 pelo decreto-lei nº95/2014 e 6 porcos cruzados brancos, criados em regime intensivo. Com peso após o abate 120 kg e 100 kg., respectivamente. O processamento dos lombos decorreu na Salsicharia Estremocense. A avaliação entre lombos de porco de raça “Alentejana” e brancos cruzados, fumados e secos, foi realizada com base em análises físico-químicas, (pH, aW, CRA, Humidade, Cinza, Gordura total, Proteína bruta, Fibra, ABVT e TBA), e sensorial (prova QDA).

Artifact detection in accelerometer signals acquired from the carotid

Manual pulse palpation is the common procedure to assess pulse in unconscious patients. This is an error prone procedure during cardiopulmonary resuscitation and therefore automatic pulse detection techniques are being investigated. Accelerometry is an interesting sensing modality for this type of applications. However, accelerometers are highly prone to movement artifacts. Hence, one challenge in designing a solution using accelerometers is to handle motion artifacts properly. In this paper we investigate computationally simple features and classifier to capture movement artifacts in accelerometer signals acquired from the carotid. In particular, based on data obtained from health subjects we show that it is possible to use simple features to achieve an artifact detection sensitivity and specificity higher than 90%.

The colored Hanbury Brown-Twiss effect

The Hanbury Brown-Twiss effect is one of the celebrated phenomenologies of modern physics that accommodates equally well classical (interferences of waves) and quantum (correlations between indistinguishable particles) interpretations. The effect was discovered in the late thirties with a basic observation of Hanbury Brown that radio-pulses from two distinct antennas generate signals on the oscilloscope that wiggle similarly to the naked eye. When Hanbury Brown and his mathematician colleague Twiss took the obvious step to propose bringing the effect in the optical range, they met with considerable opposition as single-photon interferences were deemed impossible. The Hanbury Brown-Twiss effect is nowadays universally accepted and, being so fundamental, embodies many subtleties of our understanding of the wave/particle dual nature of light. Thanks to a novel experimental technique, we report here a generalized version of the Hanbury Brown-Twiss effect to include the frequency of the detected light, or, from the particle point of view, the energy of the detected photons. Our source of light is a polariton condensate, that allows high-resolution filtering of a spectrally broad source with a high degree of coherence. In addition to the known tendencies of indistinguishable photons to arrive together on the detector, we find that photons of different colors present the opposite characteristic of avoiding each others. We postulate that fermions can be similarly brought to exhibit positive (boson-like) correlations by frequency filtering.

Automatic attentional processing of faces with disease cues

Introduction

Stimuli that are relevant to our survival, especially those that signal the presence of a threat in the environment (e.g., threatening faces), automatically attract our attention.

Objective

The same may be true for faces displaying subtle disease cues as they may signal danger of potential contamination and, hence, disease-avoidance behaviour, which was the focus of the present research.

Aim

The present study investigated, for the first time to our knowledge, whether faces with disease cues (DF), compared to control stimuli (faces without such cues) (CF), interfered with the participants’ performance in a letter discrimination task.

Method

Eighty-six (44 women) university students volunteered to participate in a letter discrimination task where 240 DF and 240 CF were presented.

Results

The results confirmed our hypothesis by showing that for DF, compared to CF, participants took longer to discriminate the target letters. Moreover, the results from a further rating task showed that DF, compared to CF, were rated as significantly more disgusting and associated with disease, thus confirming our experimental manipulation and suggesting that disgust may be driving automatic attention to DF.

Conclusions

Our findings provide important insights on the possible influence of exogenous attention to disease cues in social avoidance behaviour, which may have relevant implications in clinical disorders with disgust at its core.

Disclosure of interest

The authors have not supplied their declaration of competing interest.