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ObjectiveOne of the main problems of lung transplantation is the shortage of organs as well as reduced survival rates. In the absence of an international standardized model for lung donor-recipient allocation, we set out to develop such a model based on the characteristics of past experiences with lung donors and recipients with the aim of improving the outcomes of the entire transplantation process.MethodsThis was a retrospective analysis of 404 lung transplants carried out at the Reina Sofía University Hospital (Córdoba, Spain) over 23 years. We analyzed various clinical variables obtained via our experience of clinical practice in the donation and transplantation process. These were used to create various classification models, including classical statistical methods and also incorporating newer machine-learning approaches.ResultsThe proposed model represents a powerful tool for donor-recipient matching, which in this current work, exceeded the capacity of classical statistical methods. The variables that predicted an increase in the probability of survival were: higher pre-transplant and post-transplant functional vital capacity (FVC), lower pre-transplant carbon dioxide (PCO2) pressure, lower donor mechanical ventilation, and shorter ischemia time. The variables that negatively influenced transplant survival were low forced expiratory volume in the first second (FEV1) pre-transplant, lower arterial oxygen pressure (PaO2)/fraction of inspired oxygen (FiO2) ratio, bilobar transplant, elderly recipient and donor, donor-recipient graft disproportion requiring a surgical reduction (Tailor), type of combined transplant, need for cardiopulmonary bypass during the surgery, death of the donor due to head trauma, hospitalization status before surgery, and female and male recipient donor sex.ConclusionsThese results show the difficulty of the problem which required the introduction of other variables into the analysis. The combination of classical statistical methods and machine learning can support decision-making about the compatibility between donors and recipients. This helps to facilitate reliable prediction and to optimize the grafts for transplantation, thereby improving the transplanted patient survival rate.

Understanding how mangroves respond to sea level rise is critical for coastal management and conservation. This study investigates the feasibility of two remote sensing techniques, Light Detection and Ranging (LiDAR) and Structure-from-Motion (SfM) photogrammetry, to monitor changes in mud elevation that are critical to mangrove establishment dynamics. SfM photogrammetry can provide low-cost 3D modeling from imagery, while LiDAR provides high-precision elevation and vegetation data. Our analysis shows that SfM photogrammetry provides reasonably accurate surface elevation data with a root mean square error (RMSE) of 0.14 meters and a significant correlation coefficient (r = 0.74) compared to LiDAR measurements. This highlights the complementarity between the two, as the effectiveness of SfM photogrammetry is in the early stages of colonization, and then the need to use LiDAR with dense vegetation as the mangroves mature. This shows that a simple method of photogrammetry can remain effective until the vegetation reaches a certain threshold, and this can be particularly useful in the perspective of using mud elevation as a first low-cost diagnosis for potential mangrove rehabilitation project to assess the colonization suitability of mudflats.

The south coast of Java has warmed at a much lower rate than adjacent ocean locations over the last three decades (1982-2015). This behavior can be observed during the upwelling season (July-October) and it is especially patent in August and September when upwelling attains the highest values. Although different warming rates (ocean-coast) had been previously observed in other areas around the world, this behavior was always linked to situations where upwelling increased or remained unchanged. South Java warming is observed at ocean locations and cooling near shore but under a scenario of decreasing upwelling (~30% in some cases). The origin of coastal cooling is due to changes in the vertical structure of the water column. A vein of subsurface water, which has cooled at a rate higher than 0.3°C per decade, is observed to enter from the northwestern part of the study area following the South Java Current. This water only manifests at surface near coast, where it is pumped up by coastal upwelling.

Objective: Despite the increasing reports of blaNDM in Enterobacterales in Brazil, comprehensive whole genome sequencing (WGS) data remain scarce. To address this knowledge gap, our study focuses on the characterization of the genome of an New Delhi Metallo-β-lactamase (NDM)-1-producing Klebsiella quasipneumoniae subsp. quasipneumoniae (KQPN) clinical strain isolated in Brazil. Methods: The antimicrobial susceptibility profile of the A-73.113 strain was performed by agar dilution or broth microdilution following the Brazilian Antimicrobial Susceptibility Testing Committee/European Committee on Antimicrobial Susceptibility Testing recommendations. WGS was performed using the Illumina® NextSeq platform and the generated reads were assembled using the SPAdes software. The sequences obtained were submitted to the bioinformatics pipelines to determine the sequence type, resistome, plasmidome, and virulome. Results: The A-73.113 strain was identified as KQPN and was susceptible to polymyxins (MICs, ≤0.25 µg/mL), tigecycline (MIC, 0.5 µg/mL), ciprofloxacin (MIC, 0.5 µg/mL), and levofloxacin (MIC, 1 µg/mL). WGS analysis revealed the presence of genes conferring resistance to β-lactams (blaNDM-1, blaCTX-M-15, blaOXA-9, blaOKP-A-5, blaTEM-1), aminoglycosides [aph(3′)-VI, aadA1, aac(6′)-Ib], and fluoroquinolones (oqxAB, qnrS1, aac(6′)-Ib-cr]. Additionally, the presence of the plasmid replicons Col(pHAD28), IncFIA(HI1), IncFIB(K) (pCAV1099-114), IncFIB(pQil), and IncFII(K), as well as virulence-encoding genes fimABCDEFGHIK (type 1 fimbria), pilW (type IV pili), iutA (aerobactin), entABCDEFS/fepABCDG/fes (Ent siderophores), iroE (salmochelin), and allABCDRS (allantoin utilization) was verified. Furthermore, we found that the A-73.113 strain belongs to ST1040. Conclusions: Here we report the genomic characteristics of an NDM-1-producing KQPN ST1040 strain isolated from blood cultures in Brazil. These data will enhance our comprehension of how this species contributes to the acquisition and dissemination of blaNDM-1 in Brazilian nosocomial settings.

The ongoing research focuses on exploring the potential of Careya arborea (CA) fiber, banana fiber (BF), and epoxy composites as sustainable alternatives to petroleum-based products and synthetic fibers. The aim is to enhance the interfacial bonding and overall performance of these composites while reducing reliance on traditional materials. The study investigates the adhesion between CA fiber, BF (both chemically treated), and epoxy with polylactic acid (PLA) coating. Specifically, it examined how the PLA coating affects the mechanical properties, including tensile strength, flexural strength, impact resistance, and water absorption behavior, of the fabricated composites. Mechanical characterizations of the composite specimens are conducted following ASTM standards. The PLA-coated and NaOH-treated specimens significantly improved their tensile strength (20.56%) and flexural strength (16.7%), and significantly reduced their water absorption capacity (by 47.6%) compared to the untreated ones. These findings highlight the promise of using treated natural fibers and PLA coatings to create more sustainable and high-performance composite materials.

Abstract We investigate a family of axial symmetry solution constructed in general relativity (GR) within the framework of Ricci-inverse (RI) gravity theory. In GR, these solutions admitted closed time-like curves at an instant of time from an initial spacelike hypersurface in a causally well-behaved manner, thus, violates the causality condition. Our aim is to examine these axial symmetry solutions within the context of Ricci-inverse gravity theory to determine whether closed time-like curves still appear in this new gravity theory. We consider two Classes of RI-gravity models: (i) Class-II models defined by a function $$f=f({\mathcal {R}}, A^{\mu \nu }\,A_{\mu \nu })$$ f = f ( R , A μ ν A μ ν ) gravity and (ii) Class-III models defined by $$f=f({\mathcal {R}},{\mathcal {A}}, A^{\mu \nu }\,A_{\mu \nu })$$ f = f ( R , A , A μ ν A μ ν ) , where $$A^{\mu \nu }$$ A μ ν is the anti-curvature tensor, $${\mathcal {A}}=g_{\mu \nu }\,A^{\mu \nu }$$ A = g μ ν A μ ν as its scalar, and $$R^{\mu \nu }$$ R μ ν is the Ricci tensor. We are able solved the modified field equations considering these axial symmetry solutions as background in RI-gravity with null radiation as the matter content and the cosmological constant. This confirms that the chosen family of axial symmetry solutions are valid solutions in RI-gravity theory and, consequently, closed time-like curves is still form, analogous to their formation in GR.

Abstract São Vicente Medical Spa is located in mainland Portugal (Southwest Europe) and has been using thermal waters for therapeutic purposes for a long time. The Romans were known to have used its sulphureous waters around 2000 years ago. The spa has a Roman bathhouse that is still visible today, and its ruins were discovered during recent excavations. In this work are presented some elements of the Roman baths, the current baths, as well as the main aspects of the thermal park, with the location of the sulphureous water abstractions, including the classic thermal spring, which discharges water at a temperature of 18.6 ºC. The geomorphological, geological, and hydrogeological aspects are outlined, giving particular attention to the water chemistry of the various abstractions to develop multiple applications of geothermometers to contribute to the knowledge of the geohydraulic model at depth and the geothermal potential of the aquifer system. The conclusions are drawn from a conceptual model, including the reservoir depth, which, according to various scenarios, will be between 3 km and 8 km, in a favorable situation, respectively, to reach groundwater with temperatures between 112 ºC and 118 ºC. Finally, some remarks are made about the location of the new groundwater abstraction and the depth to be reached to increase the exploitation flows and their temperature. Lastly, it outlined new studies to improve the current geohydraulic model and to investigate its relationship with the deep aquifer systems in its neighborhood, namely the Entre-os-Rios hydromineral system.

This study describes the process of co-developing an operational climate forecast service for the viticulture sector. Weather and climate conditions affect grapevine development in cultivars: anticipating the atmospheric variables in the coming weeks and months is thus relevant for effectively managing vineyards, as impacts will be felt in wine production, biodiversity, and a wide range of related aspects. The operational service was co-developed with two types of users: impact modellers, who are the intermediary users incorporating climate forecast outputs in phenological and disease models, and end-users from the wine sector with vineyards in various European locations. For the operational service, sub-seasonal and seasonal climate forecasts were tailored considering their needs. The initial steps of the co-production process identified relevant decisions for which the service was essential and co-defined effective ways to deliver the climate information. Afterwards the climate forecasts outputs were integrated with impact model data. Substantial efforts were directed at the harmonisation of climate services information with the decision-making system of end-users. Because end-users need to navigate, comprehend, and select from various alternative options amidst uncertainty, significant emphasis has been placed on crafting the visual representation of the climate service, incorporating interactive elements, and cognitive considerations, thereby enhancing the overall user experience. Practical implications: Weather and climate conditions affect the development of cultivars: phenological stages, disease risk, or wine quality. This study presents the co-production process for deploying a climate service for vineyard management. The service consists of the near-real-time operational provision of sub-seasonal and seasonal climate forecasts. This service aims to help vineyard managers make decisions by anticipating the climate conditions up to three months in advance for a set of essential climate variables. The service includes the requirements of a set of intermediary users, which are disease risk and phenology researchers who feed their impact models with the provided climate forecasts. To our knowledge, it is the first time that sub-seasonal and seasonal climate forecasts have been integrated into an operational service for vineyard management.The service was developed during the VitiGEOSS project, the primary outcome of which is the VitiGEOSS platform: a single entry-point solution for wine producers aiming to boost vineyard sustainability. Three pilot plots are used for the service development: the Douro region in Portugal, the Catalonia region in Spain, and the Campania region in Italy. The co-production is seen as an iterative, interactive and collaborative process that brings together a plurality of knowledge sources to mutually define problems and develop usable products to address these problems. The process can be divided into three phases: initial co-exploration, co-design and co-development.The co-exploration phase consisted of conducting a benchmark analysis, identifying available services to viticulture and highlighting the gap that the newly developed solution could fill in. In the co-design phase, more intense engagement methods were implemented to communicate the capabilities of climate forecasts and design the product’s visualisation. Finally, the co-evaluation consisted of an ad hoc and ongoing process during the recurring meetings and a final workshop conducted with direct and potential users to obtain feedback on using the platform and potential further developments.As a result, the operational post-processing workflow of the sub-seasonal and seasonal state-of-the-art model outputs was adapted to include users’ requirements. The workflow includes the downscaling of model outputs to increase their spatial resolution, the storage of sub-seasonal climate forecasts at daily frequencies to feed phenological impact models, the provision of past climate simulations to train the impact models, the bias-adjust of climate forecasts to reduce systematic model errors, the assessment of the climate forecasts to aware users on their quality and the deployment of a server to allow access to impact modellers.The variables provided are mean, minimum and maximum temperature, accumulated precipitation and solar radiation. The final co-designed product consists of a graphic of bars. The user can select the location and variable, and the forecasts for the next four weeks or the next three months are displayed for the sub-seasonal and seasonal climate forecasts, respectively. For each week or month, three bars show the tercile probabilities of above-normal, normal or below-normal conditions for the time of the year. The limits of the tercile categories are also displayed, which helps to understand the averaged values of the variable in the selected region and the time of the year calculated with information from the past. The probabilities of extremes, i.e. exceeding (non-exceeding) the percentile 90th (10th), are displayed as extra bars for each week and month in case the prediction is skilful and they are greater than 40%.Last but not least, the results of the skill assessment are shown. This skill assessment consists of calculating a metric for each location, initialisation date and forecast time. When this metric, known as skill score, is positive (negative), the climate model forecast is better (worse) than the climatology (the climatology is a naive forecast which considers all categories equiprobable by definition). If the skill is negative, which means there is no proof of the added value of using the numerical model prediction, the bars are blurred, and the user can still be informed of the tercile category limits.The service has been provided for almost two consecutive years. During this period, we have confirmed the value of some key recommendations from literature when co-producing a climate service. Especially relevant is the need to invest time and resources to conduct a good co-production process by repeating the iterative process. We also tested the idea of providing information in the format of seasonal climate forecast outlooks to end-users before the service was operational. In this way, the climate service process would be ‘slowed down’, by which the use of climate data is incorporated more slowly and allows for place-based knowledge from the resource managers to be included too.One of the most challenging questions is the communication of the probabilistic forecasts product and their quality. The probabilistic nature of climate forecasts is sometimes understood by novice users as the incapacity to provide a deterministic forecast. Similarly, negative skill leads users to interpret the forecast fails. Overall, the perception of the service quality can be low. To avoid this perception, the co-producing process is essential to engage with users and redefine the service if possible.In this work, we have tried different ways to overcome low-quality perception. The users requested access to the climate forecasts for their vineyard plots. For that reason, the downscaling technique was applied to increase the spatial resolution, and the bar plots were designed to show the forecast for a specific location. However, to improve the perception of the forecast quality, the forecast can be contextualised by providing the forecast in the format of a map of the surrounding areas.Despite all these limitations, end-users reported on the extreme importance of climate information. Furthermore, end-users can benefit from getting the climate services integrated with the impact models to take maximum advantage of all services and make timely decisions, but also receiving this information in a clear, parsimonious and direct format that is intuitive and can be easily incorporated into the decision-making processes is key for the sustainability of their farm fields.After the operational provision of the climate forecast service, some implications of our findings have been detected: ● Combined downscaling and contextualisation. Downscaling techniques help to provide more accurate information at the location scale. Nevertheless, the spatial visualization over large regions may help to contextualize the climate forecasts, and that is also beneficial for end-user interpretation of the climate-related information. ● Skill. Efforts to provide more skilful climate forecasts are required, as well as alternative information to be used in situations where skill is lacking (e.g.: past climate information). The skill assessment is crucial to inform users about forecast reliability and accuracy. It enhances user understanding and trust in the service by generating realistic expectations. ● Operationalisation. Reducing the time for data processing or increasing the computational resources will allow the provision of climate forecasts that are closer to the date of production. Users will benefit from earlier access to the information than the current time-lapse. ● Co-production. The co-production process ensures the service is designed based on user needs and feedback which is more likely to be adopted and effectively utilized by users. This process never ends, so, it needs to be applied if future developments or requests are included in the current service. ● Support for sustainability. End-users benefit from the integration of the climate forecast along with phenological and disease risk services. Further explorations to include more climate variables in the service and in the impact models will be beneficial for end-users. For instance, the probabilities of extreme events help vineyard managers prepare for potential adverse conditions, while, safeguarding vineyards against weather impacts through proactive measures. ● Capacity building. By training users about the nature of climate forecasts, they can enhance the preparedness and resilience response to varying climate conditions. New information and products could be co-explored to co-evaluate their utility and usefulness.

Food allergy represents an increasing global health issue, significantly impacting society on a personal and on a systems-wide level. The gold standard for diagnosing food allergy, the oral food challenge, is time-consuming, expensive, and carries risks of allergic reactions, with unpredictable severity. There is, therefore, an urgent need for more accurate, scalable, predictive diagnostic techniques. In this review, we discuss possible future directions in the world of food allergy diagnosis. We start by describing the current clinical approach to food allergy diagnosis, highlighting novel diagnostic methods recommended for use in clinical practice, such as the basophil activation test and molecular allergology, and go on to discuss tests that require more research before they can be applied to routine clinical use, including the mast cell activation test and bead-based epitope assay. Finally, we consider exploratory approaches, such as IgE glycosylation, IgG4, T and B cell assays, microbiome analysis, and plasma cytokines. Artificial intelligence is assessed for potential integrated interpretation of panels of diagnostic tests. Overall, a framework is proposed suggesting how combining established and emerging technologies can effectively enhance the accuracy of food allergy diagnosis in the future.

IntroductionSubstance abuse is a major public health problem. In recent years, ketamine, which is a parenteral anesthetic, has been consumed increasingly as an illicit drug together with alcohol, although little is known of how this association alters brain activity. The present study investigated the influence of progressive doses of ketamine, associated with alcohol, on electrophysiological activity.MethodsFor this, 72 late-adolescent (8–10-week-old) male Wistar rats received either ketamine only, at low (10 mg/kg), intermediate (20 mg/kg) or high (30 mg/kg) doses via intraperitoneal injection, or alcohol (2 mL/100 g) via oral gavage followed by ketamine (at low, intermediate, and high doses). Electroencephalograms (EEG) and electromyographic recordings were obtained 5 min after the final application of the drug.ResultsWhen administered alone, ketamine resulted in an increase in delta, theta, beta, and gamma brainwaves, with a more pronounced effect being detected at the highest dose (30 mg/kg) in the case of the delta, beta, and gamma waves. The amplitude of the alpha brainwaves was reduced at all doses of ketamine, but less intensively at the highest dose. When administered alone, alcohol reduced all the brainwaves, with the reduction in the alpha waves being exacerbated by ketamine at all doses, and that of the theta and beta waves being boosted at the lowest dose. The intermediate dose of ketamine (20 mg/kg) reverted the alcohol-induced reduction in the theta and gamma waves, whereas the high dose increased delta, theta, beta, and gamma bandpower.DiscussionOverall, then, while ketamine enhances the depressant effects of alcohol on the alpha brainwave at all doses, a low dose intensified this effect on the theta and beta 175 waves, whereas a high dose produces neuronal hyperexcitability in the theta and 176 gamma bandpower.

Abstract Background Pulmonary fibrosis (PF) represents the pathologic end stage of several interstitial lung diseases (ILDs) associated with high morbidity and mortality rates. However, current treatments can only delay disease progression rather than provide a cure. The role of inflammation in PF progression is well-established, but new insights into immune regulation are fundamental for developing more efficient therapies. c-MET signaling has been implicated in the migratory capacity and effector functions of immune cells. Nevertheless, the role of this signaling pathway in the context of PF-associated lung diseases remains unexplored. Methods To determine the influence of c-MET in immune cells in the progression of pulmonary fibrosis, we used a conditional deletion of c-Met in immune cells. To induce pulmonary fibrosis mice were administered with bleomycin (BLM) intratracheally. Over the course of 21 days, mice were assessed for weight change, and after euthanasia at different timepoints, bronchoalveolar lavage fluid cells and lung tissue were assessed for inflammation and fibrosis. Furthermore, c-MET expression was assessed in cryobiopsy sections, bronchoalveolar lavage fluid cells samples and single cell RNA-sequencing dataset from human patients with distinct interstitial lung diseases. Results c-MET expression was induced in lung immune cells, specifically in T cells, interstitial macrophages, and neutrophils, during the inflammatory phase of BLM-induced PF mouse model. Deletion of c-Met in immune cells correlated with earlier weight recovery and improved survival of BLM-treated mice. Moreover, the deletion of c-Met in immune cells was associated with early recruitment of the immune cell populations, normally found to express c-MET, leading to a subsequent attenuation of the cytotoxic and proinflammatory environment. Consequently, the less extensive inflammatory response, possibly coupled with tissue repair, culminated in less exacerbated fibrotic lesions. Furthermore, c-MET expression was up-regulated in lung T cells from patients with fibrosing ILD, suggesting a potential involvement of c-MET in the development of fibrosing disease. Conclusions These results highlight the critical contribution of c-MET signaling in immune cells to their enhanced uncontrolled recruitment and activation toward a proinflammatory and profibrotic phenotype, leading to the exacerbation of lung injury and consequent development of fibrosis.

Abstract In this paper, we investigate a causality-violating four-dimensional space-time, an extension of the two-dimensional Misner space within the framework of modified gravity theories, specifically in the context of Ricci-inverse gravity. To explore this, we focus on two classes of models denoted as $$f({\mathcal {R}}, A^{\mu \nu }\,A_{\mu \nu })$$ f ( R , A μ ν A μ ν ) and $$f({\mathcal {R}}, {\mathcal {A}}, A^{\mu \nu }\,A_{\mu \nu })$$ f ( R , A , A μ ν A μ ν ) , and derive the modified field equations using the four-dimensional space-time under consideration. Here, $$A^{\mu \nu }$$ A μ ν is the anti-curvature tensor defined by inverse of the Ricci tensor $$R_{\mu \nu }$$ R μ ν , that is, $$A^{\mu \nu }=R^{-1}_{\mu \nu }$$ A μ ν = R μ ν - 1 . Additionally, $${\mathcal {A}}$$ A denotes its scalar, defined as $${\mathcal {A}}=g_{\mu \nu }\,A^{\mu \nu }$$ A = g μ ν A μ ν . Our analysis shows that in both models, the modified field equations can be solved by considering the matter energy content as a pure radiation field including the cosmological constant. Furthermore, we demonstrate that the energy density of the pure radiation field and the cosmological constant undergo modifications due to the coupling parameters, and these modifications converge to the results of general relativity when these parameters are set to zero. This observation confirms the possibility of causality violation in the form of closed time-like curves within the framework of Ricci-inverse gravity theory.

Abstract Sepsis results from systemic, dysregulated inflammatory responses to infection, culminating in multiple organ failure. Here, we demonstrate the utility of CD5L for treating experimental sepsis caused by cecal ligation and puncture (CLP). We show that CD5L’s important features include its ability to enhance neutrophil recruitment and activation by increasing circulating levels of CXCL1, and to promote neutrophil phagocytosis. CD5L-deficient mice exhibit impaired neutrophil recruitment and compromised bacterial control, rendering them susceptible to attenuated CLP. CD5L-/- peritoneal cells from mice subjected to medium-grade CLP exhibit a heightened pro-inflammatory transcriptional profile, reflecting a loss of control of the immune response to the infection. Intravenous administration of recombinant CD5L (rCD5L) in immunocompetent C57BL/6 wild-type (WT) mice significantly ameliorates measures of disease in the setting of high-grade CLP-induced sepsis. Furthermore, rCD5L lowers endotoxin and damage-associated molecular pattern (DAMP) levels, and protects WT mice from LPS-induced endotoxic shock. These findings warrant the investigation of rCD5L as a possible treatment for sepsis in humans.

Abstract Background T-cell membrane scaffold proteins are pivotal in T cell function, acting as versatile signaling hubs. While CD6 forms a large intracellular signalosome, it is distinguished from typical scaffolds like LAT or PAG by possessing a substantial ectodomain that binds CD166, a well-characterized ligand expressed on most antigen-presenting cells (APC), through the third domain (d3) of the extracellular region. Although the intact form of CD6 is the most abundant in T cells, an isoform lacking d3 (CD6∆d3) is transiently expressed on activated T cells. Still, the precise character of the signaling transduced by CD6, whether costimulatory or inhibitory, and the influence of its ectodomain on these activities are unclear. Methods We expressed CD6 variants with extracellular deletions or cytosolic mutations in Jurkat cells containing eGFP reporters for NF-κB and NF-AT transcription factor activation. Cell activation was assessed by eGFP flow cytometry following Jurkat cell engagement with superantigen-presenting Raji cells. Using imaging flow cytometry, we evaluated the impact of the CD6-CD166 pair on cell adhesiveness during the antigen-dependent and -independent priming of T cells. We also examined the role of extracellular or cytosolic sequences on CD6 translocation to the immunological synapse, using immunofluorescence-based imaging. Results Our investigation dissecting the functions of the extracellular and cytosolic regions of CD6 revealed that CD6 was trafficked to the immunological synapse and exerted tonic inhibition wholly dependent on its cytosolic tail. Surprisingly, however, translocation to the synapse occurred independently of the extracellular d3 and of engagement to CD166. On the other hand, CD6 binding to CD166 significantly increased T cell:APC adhesion. However, this activity was most evident in the absence of APC priming with superantigen, and thus, in the absence of TCR engagement. Conclusions Our study identifies CD6 as a novel ‘on/off’ scaffold-receptor capable of modulating responsiveness in two ways. Firstly, and independently of ligand binding, it establishes signaling thresholds through tonic inhibition, functioning as a membrane-bound scaffold. Secondly, CD6 has the capacity for alternative splicing-dependent variable ligand engagement, modulating its checkpoint-like activity.

Abstract Alternative cementitious materials able to partially replace or supplement the use of Portland cement, such as geopolymers, are becoming increasingly attractive due to lower emissions of air pollutants during their production. In addition, coupling geopolymers with additive manufacturing technologies such as 3D printing can contribute to achieving some of the Sustainable Development Goals (SDG) of settling housing issues. Additive manufacturing allows producing pre-fabricated building elements or even entire houses. However, enabling 3D printing using geopolymers requires understanding concepts of rheology, technology, and material sciences, such as different possibilities of formulations, rheological behavior, printing parameters, curing methods, reinforcement content, and fiber type. Cylindrical specimens were printed both with and without polypropylene fibers by controlling the geopolymer matrix formulation, printer displacement speed, mass percentage of fibers, and material flow through the printer’s extruder nozzle.

ABSTRACT The limited temporal completeness and taxonomic accuracy of species lists, made available in a traditional manner in scientific publications, has always represented a problem. These lists are invariably limited to a few taxonomic groups and do not represent up-to-date knowledge of all species and classifications. In this context, the Brazilian megadiverse fauna is no exception, and the Catálogo Taxonômico da Fauna do Brasil (CTFB) (http://fauna.jbrj.gov.br/), made public in 2015, represents a database on biodiversity anchored on a list of valid and expertly recognized scientific names of animals in Brazil. The CTFB is updated in near real time by a team of more than 800 specialists. By January 1, 2024, the CTFB compiled 133,691 nominal species, with 125,138 that were considered valid. Most of the valid species were arthropods (82.3%, with more than 102,000 species) and chordates (7.69%, with over 11,000 species). These taxa were followed by a cluster composed of Mollusca (3,567 species), Platyhelminthes (2,292 species), Annelida (1,833 species), and Nematoda (1,447 species). All remaining groups had less than 1,000 species reported in Brazil, with Cnidaria (831 species), Porifera (628 species), Rotifera (606 species), and Bryozoa (520 species) representing those with more than 500 species. Analysis of the CTFB database can facilitate and direct efforts towards the discovery of new species in Brazil, but it is also fundamental in providing the best available list of valid nominal species to users, including those in science, health, conservation efforts, and any initiative involving animals. The importance of the CTFB is evidenced by the elevated number of citations in the scientific literature in diverse areas of biology, law, anthropology, education, forensic science, and veterinary science, among others.

Abstract The current study analyzed the intersecting biophysical, biochemical, and functional properties of extracellular particles (EPs) with the human immunodeficiency virus type‐1 (HIV‐1) beyond the currently accepted size range for HIV‐1. We isolated five fractions (Frac‐A through Frac‐E) from HIV‐infected cells by sequential differential ultracentrifugation (DUC). All fractions showed a heterogeneous size distribution with median particle sizes greater than 100 nm for Frac‐A through Frac‐D but not for Frac‐E, which contained small EPs with an average size well below 50 nm. Synchronized and released cultures contained large infectious EPs in Frac‐A, with markers of amphisomes and viral components. Additionally, Frac‐E uniquely contained EPs positive for CD63, HSP70, and HIV‐1 proteins. Despite its small average size, Frac‐E contained membrane‐protected viral integrase, detectable only after SDS treatment, indicating that it is enclosed in vesicles. Single particle analysis with dSTORM further supported these findings as CD63, HIV‐1 integrase, and the viral surface envelope (Env) glycoprotein (gp) colocalized on the same Frac‐E particles. Surprisingly, Frac‐E EPs were infectious, and infectivity was significantly reduced by immunodepleting Frac‐E with anti‐CD63, indicating the presence of this protein on the surface of infectious small EPs in Frac‐E. To our knowledge, this is the first time that extracellular vesicle (EV) isolation methods have identified infectious small HIV‐1 particles (smHIV‐1) that are under 50 nm. Collectively, our data indicate that the crossroads between EPs and HIV‐1 potentially extend beyond the currently accepted biophysical properties of HIV‐1, which may have further implications for viral pathogenesis.

Abstract Purpose Percentage of positive cores involved on a systemic prostate biopsy has been established as a risk factor for adverse oncologic outcomes and is a National Comprehensive Cancer Network (NCCN) independent parameter for unfavorable intermediate-risk disease. Most data from a radiation standpoint was published in an era of conventional fractionation. We explore whether the higher biological dose delivered with SBRT can mitigate this risk factor. Methods A large single institutional database was interrogated to identify all patients diagnosed with localized prostate cancer (PCa) treated with 5-fraction SBRT without ADT. Pathology results were reviewed to determine detailed core involvement as well as Gleason score (GS). High-volume biopsy core involvement was defined as ≥ 50%. Weighted Gleason core involvement was reviewed, giving higher weight to higher-grade cancer. The PSA kinetics and oncologic outcomes were analyzed for association with core involvement. Results From 2009 to 2018, 1590 patients were identified who underwent SBRT for localized PCa. High-volume core involvement was a relatively rare event observed in 19% of our cohort, which was observed more in patients with small prostates (p

Abstract Malaria is the leading parasitic disease worldwide, with P. vivax being a major challenge for its control. Several studies have indicated metabolomics as a promising tool for combating the disease. The study evaluated plasma metabolomic profiles of patients with recurrent and non-recurrent P. vivax malaria in the Brazilian Amazon. Metabolites extracted from the plasma of P. vivax-infected patients were subjected to LC–MS analysis. Untargeted metabolomics was applied to investigate the metabolic profile of the plasma in the two groups. Overall, 51 recurrent and 59 non-recurrent patients were included in the study. Longitudinal metabolomic analysis revealed 52 and 37 significant metabolite features from the recurrent and non-recurrent participants, respectively. Recurrence was associated with disturbances in eicosanoid metabolism. Comparison between groups suggest alterations in vitamin B6 (pyridoxine) metabolism, tyrosine metabolism, 3-oxo-10-octadecatrienoate β-oxidation, and alkaloid biosynthesis II. Integrative network analysis revealed enrichment of other metabolic pathways for the recurrent phenotype, including the butanoate metabolism, aspartate and asparagine metabolism, and N-glycan biosynthesis. The metabolites and metabolic pathways predicted in our study suggest potential biomarkers of recurrence and provide insights into targets for antimalarial development against P. vivax.

The Paris Agreement aims to limit global warming, and one of the most polluting sectors is heavy industry, where cement production is a significant contributor. This work briefly explores some alternatives, recycling, reducing clinker content, waste heat recovery, and carbon capture, discussing their advantages and drawbacks. Then, it examines the economic viability and benefits of increasing oxygen concentration in the primary burning air from 21 to 27 vol.%, which could improve clinker production by 7%, and the production of hydrogen through PEM electrolysis to make up 5% of the fuel thermal fraction, considering both in a cement plant producing 3000 tons of clinker per day. This analysis used reference values from Secil, an international company for cement and building materials, to determine the required scale of the oxygen and hydrogen production, respectively, and calculate the CAPEX of each approach. It is concluded that oxygen enrichment can provide substantial fuel savings for a relatively low cost despite a possible significant increase in NOx emissions. However, hydrogen production at this scale is not currently economically viable.

Abstract Background The incidence of melanoma is increasing worldwide. Since metastatic melanoma is highly aggressive, it is important to decipher all the biological aspects of melanoma cells. In this context, we have previously shown that metastatic FEMX-I melanoma cells release small (

Abstract In this paper we examine the pair production through the Breit–Wheeler process $$\gamma ~\gamma \rightarrow e^+ e^-$$ γ γ → e + e - in a thermal background. We compute the thermal contribution to the Breit–Wheeler differential cross section within the thermofield dynamics formalism. We evaluate in details the cross section for this process, which possess a surprisingly simple expression valid for any temperature $$\beta $$ β , from which we discuss some physically relevant aspects. We also consider the high temperature regime of the cross section in order to have a better understanding about its thermal behavior.

Considering the mismatch between the renewable source availability and energy demand, energy storage is increasingly vital for achieving a net-zero future. The daily/seasonal disparities produce a surplus of energy at specific moments. The question is how can this “excess” energy be stored? One promising solution is hydrogen. Conventional hydrogen storage relies on manufactured vessels. However, scaling the technology requires larger volumes to satisfy peak demands, enhance the reliability of renewable energies, and increase hydrogen reserves for future technology and infrastructure development. The optimal solution may involve leveraging the large volumes of underground reservoirs, like salt caverns and aquifers, while minimizing the surface area usage and avoiding the manufacturing and safety issues inherent to traditional methods. There is a clear literature gap regarding the critical aspects of underground hydrogen storage (UHS) technology. Thus, a comprehensive review of the latest developments is needed to identify these gaps and guide further R&D on the topic. This work provides a better understanding of the current situation of UHS and its future challenges. It reviews the literature published on UHS, evaluates the progress in the last decades, and discusses ongoing and carried-out projects, suggesting that the technology is technically and economically ready for today’s needs.

Abstract In this paper, the existence of a massive dark photon, associated with a new gauge group is considered. The dark photon can be kinetically mixed with the photon. To study some applications, the thermo field dynamics formalism is used. Exploring the topological structure of this approach, the influence of dark photons on the Stefan–Boltzmann law and the Casimir effect at zero and finite temperature is calculated.

Abstract This paper proposes using reinforcement learning (RL) to schedule maintenance tasks, which can significantly reduce direct operating costs for airlines. The approach consists of a static algorithm for long-term scheduling and an adaptive algorithm for rescheduling based on new maintenance information. To assess the performance of both approaches, three key performance indicators (KPIs) are defined: Ground Time, representing the hours an aircraft spends on the ground; Time Slack, measuring the proximity of tasks to their due dates; and Change Score, quantifying the similarity level between initial and adapted maintenance plans when new information surfaces. The results demonstrate the efficacy of RL in producing efficient maintenance plans, with the algorithms complementing each other to form a solid foundation for routine tasks and real-time responsiveness to new information. While the static algorithm performs slightly better in terms of Ground Time and Time Slack, the adaptive algorithm excels overwhelmingly in terms of Change Score, offering greater flexibility in handling new maintenance information. The proposed RL-based approach can improve the efficiency of aircraft maintenance and has the potential for further research in this area.

Abstract FOXO family of proteins are transcription factors involved in many physiological and pathological processes including cellular homeostasis, stem cell maintenance, cancer, metabolic, and cardiovascular diseases. Genetic evidence has been accumulating to suggest a prominent role of FOXOs in lifespan regulation in animal systems from hydra, C elegans, Drosophila, and mice. Together with the observation that FOXO3 is the second most replicated gene associated with extreme human longevity suggests that pharmacological targeting of FOXO proteins can be a promising approach to treat cancer and other age-related diseases and extend life and health span. However, due to the broad range of cellular functions of the FOXO family members FOXO1, 3, 4, and 6, isoform-specific targeting of FOXOs might lead to greater benefits and cause fewer side effects. Therefore, a deeper understanding of the common and specific features of these proteins as well as their redundant and specific functions in our cells represents the basis of specific targeting strategies. In this review, we provide an overview of the evolution, structure, function, and disease-relevance of each of the FOXO family members.

ABSTRACT Objective: To evaluate the cumulative incidence, risk factors, and outcomes of COVID-19 in patients with Cushing's disease (CD). Subjects and methods: In all, 60 patients with CD following up in our outpatient clinic answered via phone interview a questionnaire about the occurrence of COVID-19 infection documented by RT-PCR (including the diagnosis date and clinical outcome) and vaccination status. Clinical and biochemical data on disease activity (hypercortisolism) and comorbidities (obesity, diabetes mellitus, and hypertension) were obtained from the patients' electronic medical records. Risk ratios (RRs) of risk factors were obtained using univariate and multivariate analyses. Results: The cumulative incidence of COVID-19 in patients with CD during the observation period was 31.7%, which was higher than that in the general reference population (9.5%). The cumulative incidence of COVID-19 was significantly higher in patients with hypercortisolism (57% versus 17% in those without hypercortisolism, p = 0.012) and obesity (54% versus 9% in those without obesity, p < 0.001) but not in patients with hypertension or diabetes mellitus. On multivariate analysis, hypercortisolism and obesity were each independent risk factors for COVID-19 (RR 2.18, 95% CI 1.06-4.46, p = 0.033 and RR 5.19, 95% CI 1.61-16.74, p = 0.006, respectively). Conclusion: The incidence of COVID-19 in patients with CD was associated with hypercortisolism, as expected, and obesity, a novel and unexpected finding. Thus, correction of hypercortisolism and obesity should be implemented in patients with CD during the current and future COVID-19 outbreaks.

This study aimed to isolate, purify and characterize secondary metabolites present in Amburana acreana leaves, native to the state of Rondônia, using classical chromatographic methods and 1D, 2D nuclear magnetic resonance spectroscopy. From the hydroethanolic leaves extract of A. acreana, p-hydroxybenzoic acid, vanillic acid, coumarin, campesterol 3-β-D-glucoside and amburoside B, all known compounds, were identified. To the best of our knowledge, this is the first report of isolation and chemical characterization of secondary metabolites in A. acreana. In addition, in vitro assays indicated that amburoside B does not have inhibitory potential on the growth of gram-negative bacteria. The presence of these compounds suggests that, thus far, amburosides (A and B) could be chemotaxonomic markers of the genus Amburana.

Climate change is showing its impacts now more than ever. The intense use of fossil fuels and the resulting CO2 emissions are mainly to blame, accentuating the need to develop further the available energy conversion and storage technologies, which are regarded as effective solutions to maximize the use of intermittent renewable energy sources and reduce global CO2 emissions. This work comprehensively overviews the most recent progress and trends in the use of transition metal-based electrocatalysts for three crucial reactions in electrochemical energy conversion and storage, namely, the oxygen evolution (OER), oxygen reduction (ORR), and hydrogen evolution (HER) reactions. By analyzing the state-of-the-art polyoxometalates (POMs) and metal-organic frameworks (MOFs), the performance of these two promising types of materials for OER, ORR, and HER is compared to that of more traditional transition metal oxides and alloy-based electrocatalysts. Both catalytic activity and stability are highly influenced by the adsorption energies of the intermediate species formed in each reaction, which are very sensitive to changes in the microstructure and chemical microenvironment. POMs and MOFs allow these aspects to be easily modified to fine-tune the catalytic performances. Therefore, their chemical tunability and versatility make it possible to tailor such properties to obtain higher electrocatalytic activities, or even to obtain derived materials with more compelling properties towards these reactions.

Bast fibers are defined as those obtained from the outer cell layers of the bast of various plant families. They are finding use in textile applications and are widely used as reinforcements for green composites, as bast fibers are perceived as “sustainable”. There is a growing demand for bast fibers across the world due to their renewable and biodegradable nature. The bast fibers are mainly composed of cellulose, which potentially considers the growing techniques, harvesting and extraction processes of bast fibers most used to produce fibers with appropriate quality to apply in the daily lives of modern men and women in contemporary society. This review paper looks at many aspects of natural fibers, with a focus on plant bast fibers, including their impact on prehistoric and historical society. This review shows that bast fibers are competitive compared to man-made fibers in many applications, but variability in mechanical properties and low tenacity may limit their use in high-strengthh composites and extend to, particularly in aerospace, automotive, packaging, building industries, insulation, E-composites (Eco composites), geotextiles and many other applications are currently being explored. Considering, important characteristics of bast fibers include physical, mechanical, and chemical properties. This makes bast fibers one of the most important classes of plant fibers to use as reinforcing agents in thermosetting/thermoplastic polymer matrices. And the effect of bast fibers as reinforcement in the properties of ECO-composites, GREEN-composites, BIO-composites, lightweight composites. Bast fibers play an important role in sustainability, the preservation of the health of the environment, the well-being of the next generation, and even the daily lives of men and women in the contemporary world.

Introduction/Justification: Merkel Cell Carcinoma (MCC) is a rare and aggressive cutaneous neoplasm characterized by a high tendency for recurrence and metastasis, primarily affecting older adults with fair skin. The introduction of PET/CT with 18F-FDG has significantly enhanced the diagnosis and management of MCC, providing superior sensitivity in detecting occult disease compared to computed tomography. This advancement profoundly impacts patient staging and therapeutic decisions. Similarly, non-Hodgkin lymphomas, a heterogeneous group of neoplasms originating from B cells, T cells, or natural killer cells, also benefit from PET/CT for diagnosis and follow-up, underscoring the significance of this modality in oncological practice. Herein, we present a rare case of synchronous Merkel cell carcinoma and non-Hodgkin lymphoma. Report: A 61-year-old male patient with a history of treated diffuse large B-cell lymphoma and multiple comorbidities presented with symptoms of progressive asthenia, night sweats without fever, weight loss, and a nodular reddish lesion on the left thigh; no palpable lymph nodes were found. Initial blood work showed pancytopenia; bone marrow biopsy did not reveal infiltration by high-grade histological non-Hodgkin lymphoma, but could not rule out focal infiltration by a low-grade histological lymphoma of immunophenotype B. Further investigation included a skin nodule biopsy, histopathologically consistent with Merkel cell carcinoma. PET/CT revealed extensive neoplastic involvement, including a retroperitoneal mass, neoplastic involvement of multiple bilateral lymph node chains, diffuse hyperdensities throughout the body, and a pulmonary nodule. Biopsy of the retroperitoneal mass confirmed low-grade non-Hodgkin lymphoma, suggesting a follicular subtype. The patient underwent resection of the Merkel cell carcinoma lesion in his thigh. A compromised deep margin was detected, warranting adjuvant radiotherapy and adjuvant chemotherapy with cisplatin + etoposide, administered concurrently with rituximab for lymphoma treatment. Conclusion: This case underscores the complexity of diagnosing and treating synchronous neoplasms, emphasizing the need for a multidisciplinary and individualized approach. 18F-FDG-PET/CT plays a pivotal role in detecting occult disease and assessing the extent of the conditions in this setting.

Objetivo: describir las características de los pacientes con infarto agudo de miocardio sin lesiones coronarias obstructivas (MINOCA), así como sus desenlaces cardiovasculares a dieciocho meses. Materiales y método: estudio de cohortes, ambispectivo, de los pacientes que fueron llevados a angiografía coronaria por diagnóstico de infarto agudo de miocardio (IAM), entre los años 2015 y 2019. Se seleccionó el grupo de MINOCA y obtuvieron datos de desenlaces como reconsultas y eventos cardiovasculares mayores a dieciocho meses. Resultados: de los 433 pacientes incluidos, 141 (33%) cumplían definición de MINOCA; el dolor torácico y los equivalentes anginosos fueron las manifestaciones clínicas más prevalentes (62 y 62.4% respectivamente). La mayoría se presentaron con IAM sin elevación del ST (92.1%), con FEVI ≥ 50% (42.6%). En el seguimiento a dieciocho meses, se obtuvieron datos de 102 pacientes, de los que el 22% reconsultó y 18% presentó reinfarto. La mortalidad durante el seguimiento fue del 12% por causa cardiovascular y del 36% por todas las causas. Conclusiones: se encontró una mayor proporción de MINOCA respecto a lo descrito en la literatura y con predominio de manifestaciones clínicas atípicas. Es llamativo, igualmente, el alto porcentaje importante de preinfartos y muerte de origen cardiovascular durante el seguimiento de esta cohorte.

Introduction The European Journal of Psychiatric Trainees was founded in 2022 as the official journal of the European Federation of Psychiatric Trainees (EFPT) to offer a peer-reviewed open-access scientific journal with minimal article processing charges. The journal is edited by trainees and early career psychiatrists and published its first issue in July 2023. The journal aims to facilitate publishing experience and opportunities for trainees. To reflect the global identity and inclusivity of psychiatric research, the journal changed its name in 2023 to become the International Journal of Psychiatric Trainees. Objectives To present the International Journal of Psychiatric Trainees, the successor of the European Journal of Psychiatric Trainees, and other practical aspects related to the article submission. Methods We will reflect on the International Journal of Psychiatric Trainees, focusing on what this name change will imply for the journal’s scope, mission and readership. Results Due to training programmes’ requirements or out of interest, psychiatric trainees are encouraged to conduct scientific research. However, several known barriers to scientific publishing exist, ranging from a lack of mentorship and supervision to limited scientific support. Like the European Journal of Psychiatric Trainees, the International Journal of Psychiatric Trainees continues to be an open-access, double-blind peer-reviewed journal with minimal/no publication fees that publishes original and innovative research as well as clinical, theory, perspective, and policy articles and reviews in the field of psychiatric training, psychiatry, and mental health. Since the difficulties and needs in creating research output are not exclusive to European trainees, the journal will become more attractive to readers and authors from other countries while increasing the diversity of articles. The first International Journal of Psychiatric Trainees issue will be dedicated to the 31st EFPT Forum with the theme “Trainee Mental Health”, containing articles reporting on the projects from National Psychiatric Trainee Associations looking into trainee mental health. Submissions for the regular edition remain open, and articles should be submitted through the manuscript submission platform (https://ijpt.scholasticahq.com) Conclusions The International Journal of Psychiatric Trainees aims to be an educative scientific journal for psychiatric trainees and other psychiatry and mental health researchers. The name change and its increased openness will help the authors reach a wider readership while the journal can feature a more comprehensive record of psychiatric research through its global scope. Disclosure of Interest None Declared

Introduction tardive dysphoria is a relatively new term used to describe the phenomenon of clinical worsening of depression after long-term antidepressant use. Most of the theories proposed to explain this talk about antidepressants tachyphylaxis that implies the loss of efficacy with its prolonged use, or even a pro-depressant effect of antidepressants when used for long periods of time. Objectives to explore the concept of tardive dysphoria, potential causes and clinical implications, by making a literature review on the topic. Moreover we pretend to understand the challenges in its diagnosis and treatment. Methods bibliographical search in PubMed database, using the key-words “long-term antidepressant”, “tardive dysphoria” and “antidepressant tachyphylaxis”, limited to works published in the last twenty years. Results from our search resulted 53 articles, 26 were chosen for further analysis. Conclusions the concept of tardive dysphoria is controversial, namely doubt persists if it constitutes a clinical entity by itself caused by long-term antidepressant use or if it simply relates to cases of treatment-resistant depression. We conclude that it is necessary further investigation in this area given the significant implications on clinical practice specifically in the psychopharmacological treatment with antidepressants, which is very common in psychiatric and general practices, with antidepressants being used to treat many mental health conditions. Disclosure of Interest None Declared

Introduction Anatomical Therapeutic Chemical (ATC) indication-based classification system is the World Health Organization (WHO) drug classification system and it is widely used in clinical and researh practice, however there has been questions around the scientific base of this (1, 2). Neuroscience-based Nomenclature (NbN) has been developed by representatives from 5 international organizations, with specific expertise in psychopharmacology, to address the issues around neuropsychopharmacological drug classification and improve the focus on pharmacological domains and mode of action: ECNP – European College of Neuropsychopharmacology ACNP – American College of Neuropsychopharmacology AsCNP – Asian College of Neuropsychopharmacology CINP – International College of Neuropsychopharmacology IUPHAR – International Union of Basic and Clinical Pharmacology References: 1. Nutt DJ. Beyond psychoanaleptics - can we improve antidepressant drug nomenclature? [published correction appears in J Psychopharmacol. 2009 Sept;23(7):861]. J Psychopharmacol. 2009;23(4):343-345. doi:10.1177/0269881109105498 2. Zohar J, Stahl S, Moller HJ, et al. A review of the current nomenclature for psychotropic agents and an introduction to the Neuroscience-based Nomenclature. Eur Neuropsychopharmacol. 2015;25(12):2318-2325. doi:10.1016/j.euroneuro.2015.08.019 Objectives As NbN is a novel classification system that can be used as a teaching tool as well as for other purposes, we aimed to understand the experience, views and needs of the psychiatric trainees and early career psychiatrists who will shape the future of psychiatry, around drug classification systems. Methods The ethical clearance of the study was obtained from King’s College London. We prepared an online survey (https://forms.gle/FCSdVTFH4U5QNn5t8) with a multinational group of early career pscyhiatrists who met through the CINP and EFPT, and test-run the survey with a small group of psychiatric trainees. The online survey was then disseminated via emailing lists and groups of early careers psychiatrists as well as through social media. Results At the time of this abstract submission, the data collection is ongoing. Results will include analyses of the experience with different drug classifcations systems, awareness, views and attainment of NbN, stratified according to the demographic data (country, careers status, main work setting). Conclusions The findings from this study will shed light on the views and needs of early career psychiatrists on the topic from clinical and academic aspects, a previously unexplored perspective on drug classification systems. The findings can inform the planning of various strategies to address areas to improve the use and teaching of these tools. Disclosure of Interest None Declared

Introduction Psychiatric patients, and schizophrenia patients in particular, have a lower average life expectancy than the general population, and the high prevalence of physical illnesses contributes to this. In the case of cancer, the incidence seems to be the same or lower compared to the general population, but on the other, the prognosis is frankly worse. Objectives We aim to collect evidence about the relationship between cancer and schizophrenia. Methods Based on a clinical case of a patient diagnosed with schizophrenia who died of an occult neoplasm, we conducted a narrative review of the literature concerning cancer screening, incidence, mortality and prognosis in patients with schizophrenia. Results A 39-year-old male patient was diagnosed with schizophrenia when he was 26 years older. The patient was single, had no children, lived alone and was retired due to his psychiatric condition. He was admitted to the inpatient ward in January 2023 due to a psychotic relapse after abandoning the prescribed treatment. He remained hospitalised for 14 days, and oral and injectable antipsychotic therapy was reinstated. He was discharged to the psychiatric day hospital unit to promote psychosocial rehabilitation. During this period, he complained about unspecified back pain but did not present any other physical symptoms. Two months later, he was evaluated by his psychiatrist as an outpatient, and his general condition had become significantly poorer. He had lost over 20 kilograms, his skin was pale, and he complained of back pain. He was referred to an internal medicine consultation. Still, before it was scheduled, he came to the emergency department and was admitted due to digestive bleeding, asthenia and low back pain, with a weight loss of around 25 kilograms. An abdominal mass was palpated on physical examination, and the chest x-ray showed a “balloon drop” pattern, indicating pulmonary metastases. Two days after being admitted to the internal medicine ward, he died of cardiac arrest. It is known that the stigma that mentally ill patients suffer often contributes to a delay in diagnosing medical illnesses. In addition, frequent social isolation and poor social family support do not help these patients seek medical care when their physical condition deteriorates. Low adherence to cancer screening and avoidance of routine health care often add to this delay. Conclusions As physicians who often deal with individuals with severe mental illnesses, psychiatrists should be extra aware of risk factors and keep a heightened suspicion of medical conditions. They should also promote the adoption of beneficial health behaviours and encourage participation in cancer screening and other relevant health programs. Disclosure of Interest None Declared