bluuebunny/crossref_metadata_2025 huggingface dataset:
Late X-ray flares from the interaction of a reverse shock with a stratified ejecta in GRB afterglows: simulations on a moving mesh
Authors: Ayache Eliot H , van Eerten Hendrik J , Daigne Frédéric
Published: May 2020

Late activity of the central engine is often invoked in order to explain the flares observed in the early X-ray afterglow of gamma-ray bursts, either in the form of an active neutron star remnant or (fall-back) accretion on to a black hole. However, these scenarios are not always plausible, in particular when flares are delayed to very late times after the burst. Recently, a new scenario was proposed that suggests X-ray flares can be the result of the passing of a long-lived reverse shock through a stratified ejecta, with the advantage that it does not require late-time engine activity. In this work, we numerically demonstrate this scenario to be physically plausible, by performing one-dimensional simulations of ejecta dynamics and emission using our novel moving-mesh relativistic hydrodynamics code. Improved efficiency and precision over previous work enables the exploration of a broader range of set-ups. We can introduce a more physically realistic description of the circumburst medium mass density. We can also locally trace the cooling of electrons when computing the broad-band emission from these set-ups. We show that the synchrotron cooling time-scale can dominate the flare decay time if the stratification in the ejecta is constrained to a localized angular region inside the jet, with size corresponding to the relativistic causal connection angle, and that it corresponds to values reported in observations. We demonstrate that this scenario can produce a large range of observed flare times, suggesting a connection between flares and initial ejection dynamics rather than with late-time remnant activity.
Shape model and spin direction analysis of PHA (436724) 2011 UW158: a large superfast rotator
Authors: Monteiro Filipe , Silva José Sergio , Tamayo Francisco , Rodrigues Teresinha , Lazzaro Daniela
Published: May 2020

Observations of the large superfast rotator (436724) 2011 UW158 were carried out at the Observatório Astronômico do Sertão de Itaparica (OASI, Brazil) between May and October 2015, before and after it made a close approach to Earth in July 2015. These observations allowed us to obtain 11 light curves, and additional observations at the San Pedro Mártir Observatory (Baja California, Mexico) in March 2017 provided a light curve. From the obtained light curves we could confirm the fast rotation, 0.61071 h, of the near-Earth object (NEO) and by applying the inversion method, we derived a prograde sense of rotation and a quite elongated shape model with rough dimensions a/b  = 2.0, a/c = 4.2, and b/c  = 2.1. The best determined pole directions suggest that the maximum amplitude of the light curves was obtained from an equatorial view. The reconstructed shape models are in good agreement with the shape elongation and asymmetric shape reported by radar observations. As 2011 UW158 has an uncommon rotation period for asteroids larger than ∼200 m, we used the determined parameters to calculate the minimum internal cohesion strength required to keep its structure intact. We have found that a minimum cohesion ranging from 176 to 295 Pa is required in case the NEO has a composition similar to that of C-type asteroids, and from 364 to 451 Pa for the E-type. Therefore, we suggest that 2011 UW158, if not monolithic, requires a significant cohesion force to keep it spinning so fast.
Three-dimensional structure of the Sagittarius dwarf spheroidal core from RR Lyrae
Authors: Ferguson Peter S , Strigari Louis E
Published: May 2020

We obtain distances to a sample of RR Lyrae in the central core of the Sagittarius dwarf spheroidal galaxy from OGLE data. We use these distances, along with RR Lyrae from Gaia DR2, to measure the shape of the stellar distribution within the central ∼2 kpc. The best-fitting stellar distribution is triaxial, with axis ratios 1 : 0.76 : 0.43. A prolate-spheroid model is ruled out at high statistical significance relative to the triaxial model. The major axis is aligned nearly parallel to the sky plane as seen by an Earth-based observer and is nearly perpendicular to the direction of the Galactic Centre. This result may be compared to cosmological simulations which generally predict that the major axis of the dark matter distribution of subhalos is aligned with the Galactic Centre. The triaxial structure that we obtain can provide important constraints on the Sagittarius progenitor, as well as the central dark matter distribution under the assumption of dynamical equilibrium.
From the Tree of Knowledge and the Golem of Prague to Kosher Autonomous Cars: The Ethics of Artificial Intelligence Through Jewish Eyes
Authors: Goltz Nachshon (Sean) , Zeleznikow John , Dowdeswell Tracey
Published: May 2020

This article discusses the regulation of artificial intelligence from a Jewish perspective, with an emphasis on the regulation of machine learning and its application to autonomous vehicles and machine learning. Through the Biblical story of Adam and Eve as well as Golem legends from Jewish folklore, we derive several basic principles that underlie a Jewish perspective on the moral and legal personhood of robots and other artificially intelligent agents. We argue that religious ethics in general, and Jewish ethics in particular, show us that the dangers of granting moral personhood to robots and in particular to autonomous vehicles lie not in the fact that they lack a soul—or consciousness or feelings or interests—but because to do so weakens our own ability to develop as fully autonomous legal and moral persons. Instead, we argue that existing legal persons should continue to maintain legal control over artificial agents, while natural persons assume ultimate moral responsibility for choices made by artificial agents they employ in their service. In the final section of the article we discuss the trolley dilemma in the context of governing autonomous vehicles and sketch out an application of Jewish ethics in a case where we are asking Artificial Intelligence to make life and death decisions. Our novel contribution is two-fold; first, we bring a religious approach to the discussion of the ethics of Artificial Intelligence which has hitherto been dominated by secular Western philosophies; second, we raise the idea that artificial entities who are trained through machine learning can be ethically trained in much the same way that human are—through reading and reflecting on core religious texts. This is both a way of ensuring the ethical regulation of artificial intelligence, but also promotes other core values of regulation, such as democratic engagement and user choice.
Anterior Subcutaneous Transposition With Expanded Polytetrafluoroethylene (ASTEP) for Cubital Tunnel Syndrome: Technical Note
Authors: Eroglu Umit , Bozkurt Melih , Tomlinson Samuel B , Kahilogullari Gokmen , Al-Beyati Eyyub S M , Ozgural Onur , Orhan Ozgur , Ugur Hasan Caglar , Attar Ayhan , Caglar Sukru , Unlu Agahan , Cohen-Gadol Aaron A
Published: May 2020

BACKGROUND

Ulnar nerve entrapment neuropathy at the elbow is the most common upper-extremity entrapment neuropathy after carpal tunnel syndrome. Surgical treatment can be complicated by perineural scarring and fibrosis, which may lead to recurrent symptoms. Expanded polytetrafluoroethylene (ePTFE) is a synthetic polymer with antiadhesive properties.

OBJECTIVE

To introduce the operative technique and outcomes of anterior subcutaneous transposition with ePTFE (ASTEP) in primary and recurrent cubital tunnel neuropathy.

METHODS

We studied 14 adult patients (11 men, 3 women; mean age, 45 yr) with cubital tunnel neuropathy (10 primary, 4 revision) who underwent surgery with the ASTEP technique between January 2008 and May 2018. Pain, numbness in the fourth/fifth fingers, and weakness of the intrinsic hand muscles were the most common presenting symptoms. Surgical outcomes were assessed using the modified McGowan and Wilson-Krout criteria.

RESULTS

The average (± standard deviation) preoperative symptom duration was 12.1 ± 5.2 mo (McGowan Grade 1, n = 5; Grade 2, n = 6; Grade 3, n = 3). No intraoperative or postoperative complications were observed with the ASTEP technique. Postoperative follow-up ranged from 9 mo to 7 yr (mean, 4.3 yr). All 14 patients experienced improvement in or complete resolution of their symptoms after this unique intervention.

CONCLUSION

Our novel technique of anterior transposition of the ulnar nerve with ePTFE was safe and highly effective in treating primary and recurrent ulnar nerve entrapment neuropathy at the elbow and represents an alternative to the current techniques.
New estimation of the curvature effect for the X-ray vacuum diffraction induced by an intense laser field
Authors: Seino Y , Inada T , Yamazaki T , Namba T , Asai S
Published: May 2020

Quantum electrodynamics predicts X-ray diffractions under a high-intensity laser field via virtual charged particles, and this phenomenon is called vacuum diffraction (VD). In this paper, we derive a new formula to describe VD in a head-on collision geometry of an X-ray free-electron laser (XFEL) pulse and a laser pulse. The wavefront curvature of the XFEL pulse is newly considered in this formula. With this formula, we also discuss the curvature effect on VD signals based on realistic parameters at the SACLA XFEL facility.
Perspectives COVID-19 and PPE in context: an interview with China
Authors: Harvey Jessica
Published: May 2020

The author aims to depict the current COVID-19 pandemic and personal protective equipment (PPE) crisis in the UK. The current situation is put into context exploring the history of global outbreaks of infectious disease and what has been learnt. These lessons are then applied and weighed against the recent response to coronavirus. An in depth interview with a UK biomedical SME based in Shanghai, China is reported in order to inform future procurement of PPE. It is hoped that an appreciation of the dynamic nature of the market will allow adaptations to be made in order to secure reliable supply chains moving forwards.
Role of Dynamic Contrast Enhanced MRI and DWI in the Pre-operative Assessment of Endometrial & Cervical Carcinoma
Authors: Mohammed F S , Chalabi N A , Halim N N , Metwally Z M M , Elsayed A A M E
Published: May 2020

Purpose

of this study is : To assess the efficacy of dynamic contrast enhanced MRI and diffusion weighted imaging in the preoperative assessment & staging of endometrial & cervical carcinoma and accordingly stratification of best treatment options.

Methods

The study included 40 patients having uterine malignancy 20 with endometrial carcinoma and 20 with cervical carcinoma (between 32 and 76 years) referred from Gynecologists to Radiodiagnosis Department after histologic diagnosis. Each patient was subjected to full history taking, routine laboratory investigations, preliminary trans-vaginal ultrasound and MR examination including: Conventional MRI, DCE-MRI and DWI. All cases were staged with the aid of T2WIs, DCE-MRI & DWI. Technique was performed using a standard 1.5 Tesla unit (Acheiva, Philips).

Results

The study showed that DCE-MRI & DWI improve the accuracy of T2WI in staging of endometrial & cervical cancer.

Conclusion

Using DCE-MRI & DWI improves differentiation of tumor & non-tumor tissue in cervical and endometrial cancer, thus improves the accuracy of pre-surgical mapping, assessment of treatment response and prediction of treatment outcome. That will be without increasing the expected morbidity from unnecessary procedures and accordingly increase the overall patient’s survival.
Role of high resolution ultrasonography in ankle overuse and sports injuries
Authors: Monib A M , Sakr H M , Allam A E , Mahmoud M A
Published: May 2020

Purpose

of this study is : To emphasize the role of high resolution USG in ankle sports and overuse injuries. thus assessing its ability to detect early abnormalities at diffusion level.

Methods

This study was conducted at the radiology department, faculty of medicine, Ain-Shams University following the approval by the scientific and ethics committee on 30 patients between 22 and 59 years suffering from ankle soft tissue injuries. The patients were referred from the orthopedic department, outpatient clinics of El-Demerdash hospital or private clinics.

Results

The study showed that, in Tendinous pathology, Achilles tendon is the most commonly injured ankle tendon, followed by tibialis posterior and the tendinitis/teno-synovitis was the most encountered tendons pathology. In ligamentous injuries, anterior talo-fibular ligament and calcaneo-fibular ligaments were the most frequently injured ligaments. Associated pathology included effusion and retro-calcaneal bursitis. Comparison to clinical data ultrasonography proved to be more accurate tool in diagnosis and characterization of ankle soft tissue injuries.

Conclusion

Ultrasound is an excellent tool for imaging focal soft tissue abnormalities, and used as primary tool of investigation.
Role of Magnetic Resonance defecography in assessment of pelvic floor dysfunction
Authors: Moussa M S , Abdelkhaleq Y I , Botros S M , Montasser A A
Published: May 2020

Purpose

to assess the role of the role of MR defecography in assessment of pelvic floor failure .

Methods and Material

Thirty-six patients (twenty-seven female and nine male) with female and male patients, complaining of stress urinary incontinence, constipation, fecal incontinence or pelvic organ prolapse.

Results

MRI revealed 18 cystocele (50%), compared to physical examination 2 cases(5.6%),MRI revealed 28 rectocele ( 77.8%) compared to physical examination that showed 13 (36.1%) , MRI revealed 10 uterine descent (40.7%), compared to physical examination 6 (22.2%) I, MRI revealed 7 enterocele (19.4%) compared to physical examination that was negative. MRI revealed level I/II facial defect in and level III facial defect in, 19 cases of Intussusception (52.8%), urethral hypermobility in 14 (38.9%), sphincteric defect 7 (19.4%), levator angle weakness in 30 cases (83.3%), iliococcygeaus muscle tear in 5 cases (13.9%), puborectalis tear in 3 cases (8.3%),anorectal decent in 26 cases (72.2%), genital hiatus width in 23 (63.9%)

Conclusion

Dynamic MR imaging is a necessary tool in the diagnosis of multicompartment pelvic organ prolapse and it provides good concordance with clinical examination
Role of diffusion weighted MRI in differentiation between benign and malignant hepatic focal lesions
Authors: Abdurrahman L A , Ali A H , Abdelmotelb E M
Published: May 2020

Background

Magnetic resonance imaging (MRI) is playing an increasing role in the assessment of patients with liver disease due to its high soft tissue resolution, lack of ionizing radiation and ability to provide functional data. Diffusion-weighted (DW)-MRI is a functional imaging technique that is now widely used as a standard imaging sequence, together with unenhanced T1/T2 weighted imaging and contrast-enhanced imaging for liver evaluation.

Objective

The aim of this study is to clarify the role of Diffusion Weighted Magnetic Resonance Imaging (DW MRI) in the detection of hepatic focal lesions and its ability to differentiate benign from malignant hepatic focal lesions.

Patients and Methods

This study carried out in Radiology Department of Ain Shams University Hospitals. This study included 25 patients. All patients were subjected to careful history taking, abdominal US, laboratory examinations, and liver MRI.

Result

The difference between the mean ADC values of benign and malignant lesions was significant. No significant differences in ADC values among the different benign lesions or among the different malignant lesions.

Conclusion

Diffusion-weighted imaging (DWI) offers the possibility to obtain criteria for characterization of focal liver lesions with subsequent differentiation between benign and malignant hepatic focal lesions without the need for contrast agent administration-by quantifying diffusion effects via apparent diffusion coefficient (ADC) measurements.
The Privilege of Proton Magnetic Resonance Spectroscopy in Evaluating Ovarian Tumors
Authors: Hafez A A , Nasr M A , Salman N L
Published: May 2020

Background

Exclusion of malignancy in ovarian mass is of paramount importance. It is the most crucial step after identification of a mass and it has a profound effect on the patient's management. So, a reliable method with which to differentiate a benign from a malignant ovarian mass would provide a basis for optimal preoperative planning and may also reduce the number of unnecessary laparotomies for patients undergoing treatment for benign disease.

Objective

The aim of our study is to highlight the role of magnetic resonance spectroscopy as a non-invasive technique which may effectively assist in differentiating benign from malignant ovarian masses.

Patients and Methods

This study included 20 patients with adnexal masses as suggested by preliminary pelvic ultrasound examination. referred from the Gynecology Department to the Radiology Department at Ain shams university hospitals. nine were benign, two were borderline, and six were malignant tumors and 3 were hemorrhagic cyst. Endometriosis, tubo-ovarian abscess.

Results

Our study revealed sharp choline peak in some benign as well as some malignant cases and so Cho peak could not help in the differential diagnosis between benign and malignant tumors, creatine, lipid and NAA were detected in both benign and malignant tumors, also Choline/Creatine Ratio fairly can differentiate between benign and malignant tumors with cut off point = 3.750 at sensitivity = 75.0% & specificity = 100.0% .

Conclusion

Our study had some factors that affect the results. First, the sample size were not enough to achieve a good results, second, diversity of samples and the complicated tumor histopathologic and morphologic features.
T83. SUBSTANCE-INDUCED PSYCHOSIS LINKED TO BOTH INFECTIONS AND SCHIZOPHRENIA
Authors: Hjorthøj Carsten , Starzer Marie , Benros Michael , Nordentoft Merete
Published: May 2020

Background

Substance-induced psychosis is an under-researched phenomenon, and little is known about its etiology (other than exposure to substances) and long-term prognosis. In this presentation, we aim to present results from two recent studies, one of which was recently published and the other is currently in the process of being analyzed. The first study investigates rates and predictors of conversion from substance-induced psychosis; the second study investigates the association between severe infections and substance-induced psychosis, including the contribution of infections on conversion to schizophrenia.

Methods

Both studies utilized the nationwide Danish registers.

In study 1, we included all people diagnosed with substance-induced psychosis from 1994 to 2014 (n=6,788). These were followed using the Kaplan-Meier method and Cox proportional hazards regression to estimate rates and predictors of conversion to schizophrenia or bipolar disorder.

In study 2, we included the entire Danish population born since 1981 (n=2,256,779). These were followed in Cox proportional hazards regression models, linking hospital-requiring infections as time-varying covariates to development of substance-induced psychosis. In further analyses, we followed those who had developed substance-induced psychosis to determine whether infections would influence the risk of converting to schizophrenia.

Results

Study 1: Overall, 32.2% (95% CI 29.7–34.9) of patients with a substance-induced psychosis converted to either bipolar or schizophrenia-spectrum disorders. The highest conversion rate was found for cannabis-induced psychosis, with 47.4% (95% CI 42.7–52.3) converting to either schizophrenia or bipolar disorder. Young age was associated with a higher risk of converting to schizophrenia. Self-harm was significantly linked to a higher risk of converting to both schizophrenia and bipolar disorder.

Study 2: Infections increased the risk of substance-induced psychosis (HR=1.30, 95% CI 1.22–1.39) in the fully adjusted model. Hepatitis was the infection most strongly associated with substance-induced psychosis, at HR=3.42 (95% CI 2.47–4.74). Different sites of infections showed associations with different types of substance-induced psychosis. Finally, hepatitis increased the risk of conversion to schizophrenia with HR=1.87 (95% CI 1.07–3.26).

Discussion

Substance-induced psychosis is strongly associated with the development of severe mental illness, and a long follow-up period is needed to identify the majority of cases. Infections appear to play a role in the etiology of substance-induced psychosis which is very similar to the role infections play in the etiology of schizophrenia. This lends strong support to the existence of an immune-related component to psychosis in general, and not just to schizophrenia.
T86. RELEVANCE OF CANNABIS USE AS A PREDICTOR OF CLINICAL OUTCOME IN FIRST-EPISODE SCHIZOPHRENIA SPECTRUM DISORDER PATIENTS OVER 24 MONTHS OF TREATMENT
Authors: Scheffler Frederika , Luckhoff Hilmar , du Plessis Stefan , Phahladira Lebogang , Asmal Laila , Kilian Sanja , Emsley Robin
Published: May 2020

Background

Cannabis use is generally associated with an unfavourable course of illness in first-episode schizophrenia, including non-remission of psychopathology symptoms, higher rates of relapse and re-hospitalization, and poorer functioning. The aim of this study was to explore the influence of cannabis use on clinical and treatment outcomes in first-episode schizophrenia spectrum disorder patients over 24 months of assured antipsychotic treatment.

Methods

The present longitudinal study included 123 minimally treated or antipsychotic-naive first-episode patients assessed over 24 months of treatment with flupenthixol decanoate according to a standardized regimen. Time to relapse, rates of symptomatic and functional remission, as well as recovery were compared between cannabis users (n=41) and non-users (n=82) stratified based on a combination of self-report and urine toxicology results over the course of treatment. In addition, visit-wise changes in psychopathology severity and overall functioning were compared between these two study groups. We hypothesized that 1) ongoing cannabis use would present with more severe psychopathology and poorer overall level of functioning, and 2) rates of remission and recovery would be lower in cannabis users compared to their non-using counterparts.

Results

At study entry, cannabis-using patients were younger, more likely to be male and to use methamphetamine, and scored lower in social and occupational functioning. Moreover, while cannabis users were more likely to relapse at any point over 24 months of treatment, cannabis non-users were more likely to achieve remission within the first six months, although this effect was not statistically significant. However, our most important finding was the interaction between cannabis use and time for total psychopathology as well as for the PANSS positive factor. While differences were not evident at either study entry or endpoint, cannabis users recovered at a slower rate than non-users.

Discussion

These results suggest a poorer treatment response in cannabis users compared to non-users in the context of assured adherence to antipsychotic medication. Therefore, regardless of the neurobiological impact of cannabis use in schizophrenia, the behaviour of substance use itself needs to be targeted as part of first-line treatment in order to improve the treatment outcomes of substance-using patients.
T100. BELIEFS ABOUT THE SELF AND OTHERS IN PARANOIA
Authors: Brown Poppy , Waite Felicity , Rovira Aitor , Nickless Alecia , Freeman Daniel
Published: May 2020

Background

Compassionate imagery may be one method of targeting the negative beliefs about the self and others that paranoid thoughts build upon. This talk presents two interventionist-causal studies testing this hypothesis, one targeting compassion for the self and one targeting compassion for others. These studies form part of the programme of work testing the manipulation of putative causal factors in paranoia, in individuals from the general population scoring highly for current paranoid ideation.

Methods

Two hundred such individuals were recruited. The studies used a randomised controlled experimental design, with embedded tests for mediation. Study one targeted self-compassion via creation of a compassionate coach image. Study two targeted compassion for others via loving kindness meditation. Individuals repeatedly entered neutral virtual reality social environments and changes in compassion and paranoia were assessed.

Results

Study one showed that, in comparison to the control group, those who practised compassionate coach imagery significantly increased in self-compassion (group difference=2.12, C.I.=1.57;2.67, p=<0.0001, d=1.4) and decreased in paranoia (group difference=-1.73, C.I.=-2.48;-0.98, p=<0.0001, d=0.8). Mediation analysis indicated that change in self-compassion explained 57% of the change in paranoia. Study two showed that in comparison to the control group, those who practised loving kindness meditation significantly increased their compassion for others (group difference=3.26, 95% C.I.: 2.72;3.80, p=<0.0001, d=1.7), and decreased their paranoia (group difference=-1.70, C.I.=-2.51;-0.89, p=<0.0001, d=0.8). Change in compassion for others explained 63% of the change in paranoia.

Discussion

Together, the studies suggest that targeting negative beliefs about the self and others using compassionate imagery causes reductions in paranoia, which may have benefits in clinical populations.
T102. TELEPROM-Y: IMPROVING ACCESS AND EXPERIENCE OF MENTAL HEALTHCARE FOR YOUTH THROUGH VIRTUAL MODELS OF CARE
Authors: Forchuk Cheryl , Collins Kerry , Eichstedt Julie , Reiss Jeffrey , Booth Richard , Fisman Sandra , Rudnick Abraham , Hoch Jeffrey , Lizotte Daniel , Isaranuwatchai Wanrudee , Wang Xianbin
Published: May 2020

Background

About 1 in 5 youth have a mental illness, with 75 percent of all mental illnesses having their onset in childhood or adolescence (Kim-Cohen et al., 2003). In Ontario, 157,900 youth rated their mental health as fair or poor, a significant increase from 2007 (Boak et al., 2014). Not only do mental health concerns cause difficulties at onset, they can also disrupt important life transitions and developmental milestones, as well as being burdensome throughout the individual’s lifespan (Ratnasingham et al., 2012). Consequently, new care approaches are needed.

The TELEPROM-Y project will evaluate outpatient health care delivery using InputHealth’s electronic Collaborative Health Record (CHR) at London Health Sciences Centre, St. Joseph’s Health Care London, Woodstock General Hospital, and community agencies including Youth Opportunities Unlimited, WAYS Mental Health Support, and Leads Employment Services.

Methods

120 youth (ages 14–25) will be recruited from the caseloads of 46 mental healthcare providers. Participants will use a smartphone application (app) to connect to the Collaborative Health Record. Semi-structured interviews will be conducted at baseline, 6, and 12 months. This is a participatory action research project utilizing a pre-post, mixed-methods design. A standardized evaluation framework will be instituted to facilitate systematic effectiveness, economic, ethical, and policy analyses.

Some of the functions of the app, available for Apple and Android phones, include: making/changing/cancelling appointments; text messaging; emailing, and filling out questionnaires/surveys. If the youth are unable to attend a scheduled appointment in person, the care-provider and youth can have a virtual visit, similar to FaceTime or Skype. Virtual visits should reduce missed appointments.

Results

Descriptive information thus far of 104 participants: Psychotic Disorder (e.g. schizophrenia) (13, 12.6%), Developmental handicap (e.g. Autism) (7, 6.8%), Anxiety Disorder (e.g. PTSD) (73, 70.9%), Disorder of childhood/adolescence (e.g. ADHD) (37, 35.9%), Substance-related disorder (13, 12.6%), Personality Disorder (17, 16.5%), Mood Disorder (e.g. depression, bipolar mood disorder) (70, 68.0%), Unknown (4, 3.9%), Other (19, 18.4%).

Discussion

We anticipate that through the usage of the TELEPROM-Y app the participant and care-provider experience will be enhanced, leading to 1) improved healthcare outcomes and patient quality of life, and 2) reduced healthcare costs by preventing hospitalization and reducing the need for face-to-face outpatient visits.
T112. PTSD AS A MEDIATOR OF THE RELATIONSHIP BETWEEN TRAUMA AND PSYCHOTIC EXPERIENCES
Authors: Strelchuk Daniela , Hammerton Gemma , Croft Jazz , Heron Jon , Zammit Stanley , Wiles Nicola , Turner Katrina
Published: May 2020

Background

Trauma exposure is linked to the development of psychotic illnesses, but little is known about potentially modifiable mechanisms underlying this relationship. Despite the high prevalence of PTSD symptoms in psychotic illnesses, only a few studies have examined the role of PTSD as a mediator, and these were all cross-sectional. This study aims to examine whether PTSD symptoms mediate the relationship between trauma and psychotic experiences (PE), using data from a large birth cohort study.

Methods

We used data from the Avon Longitudinal Study of Parents and Children (ALSPAC) to test whether: a) PTSD symptoms (at age 15) mediate the relationship between childhood trauma (age 0–14 years) and adolescent frequent or distressing psychotic experiences (age 12–18 years) (study of adolescent PE; n = 2,952), and b) PTSD symptoms (reported at age 24 for traumatic event occurring before age 19) mediate the relationship between childhood/adolescent trauma (age 0–17 years) and incident frequent or distressing psychotic experiences in early adulthood (age 19–24 years) (study of adult PE; n = 2,492).

Associations between the variables of interest were examined with logistic regression, and mediation with the parametric g-computation formula. As sensitivity analyses, we i) examined broader and narrower psychotic outcomes, ii) included a measure of psychotic-like experiences at age 14 years as an intermediate confounder in the mediation model for adolescent psychotic experiences, and iii) repeated analyses using imputed data.

Results

Exposure to trauma was associated with increased odds of psychotic experiences and PTSD symptoms both in adolescence and early adulthood (p<0.001). The association between PTSD and psychotic experiences was stronger in adolescence (p<0.001) than in adulthood (p=0.03). There was moderate evidence that PTSD symptoms mediated the relationship between childhood trauma and adolescent psychotic experiences (proportion mediated 14%), though evidence of mediation was much weaker for adult PE (proportion mediated 8%).

In sensitivity analyses we observed similar results when using imputed data, and when modelling psychotic experiences at age 14 as an intermediate confounding for the adolescent PE outcome. The proportion mediated increased when examining more narrowly defined outcomes (19% for adolescent psychotic disorder).

Discussion

These findings provide some evidence consistent with the thesis that psychotic experiences and disorder can occur consequent to PTSD symptoms after trauma exposure. Targeting PTSD symptoms might help prevent the occurrence of psychotic experiences and disorder in people with a trauma history.
T114. THE CAUSAL DYNAMICS OF PARANOIA IN PATIENTS WITH SCHIZOPHRENIA: A THEORY DRIVEN NETWORK ANALYSIS
Authors: Bird Jessica , Evans Robin , Taylor Kathryn M , Molodynski Andrew , Waite Felicity , Freeman Daniel
Published: May 2020

Background

A cognitive account identifies six key psychological maintenance factors for persecutory delusions. However, a complex system of causation is likely where these factors interact in their influence on paranoid ideas. We set out to evaluate the causal dynamics of paranoia with theory-driven network approaches.

Methods

1809 patients with non-affective psychosis attending UK mental health services completed assessments of paranoia, hallucinations, insomnia, self-esteem, worry, anxious avoidance, analytic reasoning, and psychological well-being. To assess causal patterns, we estimated, first, an undirected partial correlation network and then, second, adopted a Bayesian approach with Directed Acyclic Graphs to discover the directed causal pathways best supported by the data.

Results

The networks showed that with all other variables controlled, paranoia had direct causal interactions with hallucinations, negative self-beliefs, insomnia, worry, and avoidance. Hallucinations and negative self-beliefs were most directly linked to paranoia, whereas indirect paths had prominent influences on the causal effects for insomnia, worry, and avoidance. The direction of these interactions was uncertain, but negative self-beliefs and insomnia were more likely to influence paranoia than vice versa. Self-report reasoning was likely unrelated to paranoia once other factors were controlled. Causal factors were highly interconnected, with insomnia, negative self-beliefs, avoidance, and worry most directly linked to other variables. Most interactions were likely reciprocal, except for hallucinations which were unlikely to influence other variables and significantly caused by insomnia and avoidance.

Discussion

The findings are consistent with a complex system of interacting causation in the maintenance of paranoia. The patterns observed support the cognitive model of persecutory delusions, highlighting multiple pathways of causal interaction between paranoia and theoretically important factors. Interventions directly targeting these factors are likely to lead to multiple benefits, alleviating paranoia both directly and indirectly through connections with other causally related symptoms.
T119. NO DIFFERENCE BETWEEN VOLITIVE AND EXPRESSIVE NEGATIVE SYMPTOMS FOR EARLY TREATMENT RESPONSE IN FIRST EPISODE OF PSYCHOSIS ANTIPSYCHOTIC NAïVE PATIENTS
Authors: Haguiara Bernardo , Koga Tonsig Gabriela , Kagan Simão , Cavalcante Daniel , Noto Cristiano , Bressan Rodrigo , Gadelha Ary
Published: May 2020

Background

Negative symptoms are associated with a range of poor clinical and real-life functioning outcomes in people with schizophrenia. The division of negative symptoms into two separate factors, named “expressive deficits” and “social amotivation” could enable more accurate analysis and the development of new therapeutic tools. We aim to investigate whether the different symptoms that make up the negative dimension at baseline differently predict treatment response in first episode psychosis (FEP) antipsychotic naïve patients.

Methods

Patients with FEP (n=80), without previous use of antipsychotics, were recruited at an emergency service in São Paulo, Brazil, between 2014 and 2019. Individuals were assessed at admission and after 10 weeks of follow-up. Patients with schizophrenia, schizoaffective disorder and schizophreniform disorder were included. The diagnosis was confirmed using the Structured Clinical Interview for DSM-IV Disorders (SCID-I). Patients were evaluated with the Positive and Negative Syndrome Scale (PANSS) at the baseline and after 10 weeks of treatment. The “expressive deficits” factor was defined as the sum of the six following items of the PANSS: N1 (blunted affect), N3 (poor rapport), N6 (lack of spontaneity and flow of conversation), G5 (mannerisms and posturing), G7 (motor retardation), G13 (disturbance of volition). The “social amotivation” factor was defined as the sum of N2 (emotional withdrawal), N4 (passive/apathetic social withdrawal) and G16 (active social avoidance). To evaluate treatment response, we used the difference between the PANSS score at baseline and after ten weeks of follow-up (delta-PANSS). We performed three linear regressions, one using the “expressive deficits” factor, one using the “social amotivation” factor and another using the total negative symptom score at baseline.

Results

The mean age was 26.01 years old (SD ± 7.2), and the majority was male (58.75%). “Expressive deficits” (p=0.005, R-squared=0.084, F-test=8.28, β=8.24, df=78), “social amotivation” (p=0.009, R-squared=0,072, F-test=7.14, β=5.59, df=78); and negative symptoms (p=0.002, R-squared=0.105, F-test=10.23, β=9.08, df=78) at baseline behaved similarly in relation to delta-PANSS. All measures of negative symptoms are highly correlated to PANSS total at both time points.

Discussion

The results were different from our initial hypothesis of worse outcome for patients with higher expressive negative symptoms. We found that negative symptoms overall and both subdomains are highly correlated to PANSS total in acute phase in early stages, what can explain the association to better outcomes with antipsychotic treatment. Longer follow-up can help us to investigate whether differences between the subdomains of negative symptoms can be observed in more stable patients.
T121. BLUNTED AFFECT EARLY PROGRESSION IN DRUG-NAïVE FIRST EPISODE SCHIZOPHRENIA PATIENTS: 10-WEEK FOLLOW UP
Authors: Kagan Simão , Coutinho Luccas , Cavalcante Daniel , Noto Mariane , Nakamura André , Bressan Rodrigo A , Cordeiro Quirino , Belangero Sintia , Noto Cristiano , Gadelha Ary , Neto Ary Gadelha de Alencar Araripe , Gadelha Ary
Published: May 2020

Background

The study of individual negative symptoms is encouraged as they may have separate neurobiological substrates and require specific therapeutic strategies. Blunted affect is a decrease in the observed expression of emotion and may be more fluctuant than expected. We aim to investigate early trajectories of blunted affect in first episode schizophrenia (FES) patients without previous antipsychotic-treatment.

Methods

We included 82 first episode psychosis antipsychotic naïve patients meeting the DSM-IV criteria for schizophrenia, schizoaffective or schizophreniform disorder. All participant started risperidone (1-4mg) after the first assessment. Socioeconomic and demographic data were collected at baseline. Positive and Negative Syndrome Scale (PANSS) was applied at both assessments. PANSS negative component item N1 was used to access blunted affect. Participants were divided into three groups for each assessment according to their N1 score: (i) absence of symptoms - score 1 or 2; (ii) Mild intensity - score 3 or 4; and (iii) Severe intensity - score 5 to 7.

Results

Mean age was 25.77 (sd: ±7.27) years-old and 61% were male. Mean total PANSS was 92.74 (sd: ± 22.37) at baseline and 65.54 (sd: ± 20.42) at follow up. Mean risperidone dose at follow up was 3.71 (± 1.51). Forty three (52%) study participants had persistence of blunted affect at 10-week follow up regardless of symptom intensity. Sixteen (19.5%) patients never displayed blunted affect. In fact, the most common trajectories include participants who persists with the same symptom severity (n=48). Symptoms improved in 17 participants and got worse in 17 as well. Only one participant started the study without symptom and evolved to high intensity at follow up, while no participant started the study with high severity symptoms and evolved to absence of symptoms.

Discussion

Our study suggests that blunted affect exhibit different trajectories, but its intensity tends to remain stable over short-term follow up. Blunted affect may be unresponsive to risperidone at the beginning of treatment. Most of the previous studies addressed trajectories of negative symptoms as a group. Only few addressed the progression of blunted affect and, to the best of our knowledge, this is the first to use a sample of drug-naïve FES patients. Also, we selected only participants in use of risperidone after first assessment in order to reduce bias. A sample of drug naïve FES patients brings opportunities like assessing the course of blunted affect at an early phase of the condition and reducing confounders such as chronicity and exposure to antipsychotics.
T128. ATTACHMENT REPRESENTATIONS IN CHILDREN AT FAMILIAL HIGH RISK OF SEVERE MENTAL DISORDERS. ASSOCIATIONS WITH PSYCHOPATHOLOGY, LEVEL OF FUNCTIONING, AND PSYCHOTIC EXPERIENCES
Authors: Gregersen Maja , Ellersgaard Ditte Vestbjerg , Søndergaard Anne , Christiani Camilla , Hemager Nicoline , Spang Katrine Søborg , Burton Birgitte Klee , Uddin Md Jamal , Ohland Jessica , Gantriis Ditte , Greve Aja , Mors Ole , Plessen Kerstin Jessica , Nordentoft Merete , Clemmensen Lars , Jepsen Jens Richardt Møllegaard , Thorup Anne Amalie Elgaard
Published: May 2020

Background

There is evidence of higher rates of insecure and disorganized attachment in infancy in children born to parents with severe mental disorders, but evidence on attachment in middle childhood for these children is lacking. This study aims to explore attachment representations in seven-year-old children born to parents with schizophrenia or bipolar disorder. We also aim to explore possible associations between attachment and psychopathology, level of functioning, and psychotic experiences in these children.

Methods

The Danish High Risk and Resilience Study VIA 7 is a prospective cohort study of 522 seven-year-old children born in Denmark. The cohort consists of children where one or both parents have been diagnosed with a schizophrenia spectrum disorder (N=202), children where one or both parents have been diagnosed with bipolar affective disorder (N=120) and children where neither of the parents have been diagnosed with these disorders (N=200). Attachment representations were assessed with the Story Stem Assessment Protocol whereas psychopathology, level of functioning, and psychotic experiences were assessed with K-SADS.

Results

Data analyses are ongoing but preliminary results indicate that there are no significant differences in attachment representations between the three groups of children, but that there are associations between higher rates of insecure and disorganized attachment and a higher risk of psychopathology. Results will be presented at the SIRS-conference.

Discussion

Understanding attachment and its correlates in children at familial high risk of severe mental disorders is important in order to strengthen our understanding of developmental trajectories towards mental disorders in these children.
T130. A SURVEY OF MENTAL HEALTH LITERACY USING THE INTERNET IN JAPAN
Authors: Yamaguchi Taiju , Oguchi Yoshiyo , Ojio Yasutaka , Mori Ryoichi , Oooka Minako , Baba Yoko , Funatogawa Tomoyuki , Katagiri Naoyuki , Tsujino Naohisa , Nemoto Takahiro , Mizuno Masafumi
Published: May 2020

Background

Insufficient mental health literacy (MHL) of the general public is one of the major factors that prevent early intervention for mental illness. Insufficient MHL may exacerbate the stigma attached to people with mental illness. In Japan, there have been few large-scale surveys to determine the MHL level of the general public. Hence, we conducted a large-scale internet-based survey of 3000 citizens, to clarify the knowledge, attitudes and behaviors of the general public with respect to “prevention of and recovery from mental illness.”

Methods

We conducted a survey of 3000 citizens (aged 18 to 79 years, 1483 males and 1517 females) to determine their MHL level, using a questionnaire posted on the internet. The survey consisted of 22 questions about MHL, grouped into 8 categories.

Results

The results of our survey were as follows:

Discussion

It was found that in Japan, many citizens were aware of the importance of mental health, but that there was still a stigma attached to people with mental illness. In addition, they were found to be still poorly aware of representative mental illnesses, such as depression and schizophrenia. For improving these aspects, the MHL level of the general public needs to be further improved. In Japan, it has been pointed out that education on mental health is insufficient. However, education on mental health as a course on “prevention of and recovery from mental illness” is expected to be started in high schools in 2022. This would be expected to further improve the MHL level of the general public in the near future.
T139. OXYTOCIN ENHANCES NEURAL EFFICIENCY IN INFERRING OTHERS’ SOCIAL EMOTIONS IN PEOPLE AT CLINICAL HIGH RISK FOR PSYCHOSIS
Authors: Schmidt André , Davies Cathy , Paloyelis Yannis , Rutigliano Grazia , Cappucciati Marco , De Micheli Andrea , Ramella-Cravaro Valentina , Provenzani Umberto , Scutt Eleanor , Oliver Dominic , Murguia Silvia , Zelaya Fernando , Allen Paul , Shergill Sukhi , Morrison Paul , Williams Steven , Taylor David , Lythgoe David J , Borgwardt Stefan , McGuire Philip , Fusar-poli Paolo
Published: May 2020

Background

Negative symptoms are core contributors to social deficits in psychosis. However, currently available interventions do not significantly ameliorate negative symptoms or social outcomes in individuals at Clinical High Risk of Psychosis (CHR-P). Given its critical role in human social behaviour and cognition, the oxytocin (OT) system is a promising target for the treatment of social impairments in CHR-P subjects.

Methods

In a double-blind, placebo-controlled, crossover design, 30 CHR-P males were studied using functional magnetic resonance imaging (fMRI) on two occasions, once after 40IU intranasal OT and once after placebo. A modified version of the Sally-Anne task was used to record brain activation during inferring others’ beliefs (cognitive empathy) and social emotions (emotional empathy). The Reading the Mind in the Eyes Test was acquired to test whether OT effects were mediated by baseline social-emotional abilities.

Results

OT did not modulate behavioural task performance but reduced activation in the bilateral inferior frontal gyrus compared with placebo during emotional empathy. Furthermore, the relationship between brain activation and task performance after OT administration was mediated by baseline social-emotional abilities; while task accuracy during emotional empathy increased with decreasing activation in the left inferior frontal gyrus in CHR-P individuals with low social-emotional abilities, there was no such relationship in CHR-P individual with high social-emotional abilities.

Discussion

These findings suggest that OT enhances neural efficiency in inferring others’ social emotions in those people at clinical high risk for psychosis with attenuated emotional empathy.