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IntroductionDespite considerable growth in the last years in treatments and research in first episode psychosis (FEP), little attention has been given to the priorities of these young people, in particular, gaining employment. For most people, work is a normal part of everyday life and can be considered one of the most important factors in promoting recovery and social inclusion. Nevertheless, these patients show low employment rates (varying from 23% to 65%) since the beginning of the psychotic symptoms and even after their contact with mental health services. But, although completing education and access to employment is a critical part for the recovery of these patients, few studies have focused on this outcome.ObjectivesTo determine the employment rate and its possible predictor factors in a FEP sample after 5 years follow – up.Methods190 FEP treated between June 2010 and July 2013 at the ETEP Program at Hospital del Mar were included. Inclusion criteria were: 1) age 18-35 years; 2) fulfillment of DSM-IV-TR criteria for brief psychotic disorder, schizophreniform disorder, schizophrenia or unspecified psychosis; 3) no previous history of severe neurological medical conditions or severe traumatic brain injury; 4) IQ level < 80, and 5) no substance abuse or dependence disorders except for cannabis and/or nicotine use. All patients underwent an assessment at baseline including sociodemographic and clinical variables (substance use, DUP, PANSS and GAF). Moreover, employment status has recorded at 5 years follow – up as dichotomyc variable (being employment defined as having either a full-/part-time job, being a student at school or university, or being involved in a study/training program). SPSS program was used for statistical analyzes.ResultsIn our FEP sample, the employment rate was 34.2%. We observed significative differences in sex (p = 0.013), cannabis use (p = 0.022) and GAF scores (p = 0.016) between un/employed patients. Nevertheless, in the logistic regression model (ENTER METHOD) only female sex remained as predictor of higher employment rate (95% CI 1.13 to 4.85; p = 0.022) at 5 years follow – up.ConclusionsOur results suggest that females with a FEP have a better outcome in terms of employment rates, consistent with some previous studies. Some authors suggest that it could be explained by the fact that female patients used to have shorter DUP or more affective symptomatology, which has been also related to a better outcome. Nevertheless, we did not find any differences in these other variables in our sample. Employment not only provides financial independence but also structure and purpose, opportunities for socializing and developing new relationships, a sense of identity, self-worth and meaning in life. Thus, given its importance in FEP functional recovery, more studies in this field are needed to improve patients vocational achievements and determine which specific approaches would each of them need.Disclosure of InterestNone Declared

Hydrothermal carbonization (HTC) has emerged as a pivotal technology in the battle against climate change and fosters circular economies. Operating within a unique reaction environment characterized by water as a solvent and moderate temperatures at self-generated pressures, HTC efficiently converts biomass residues into valuable bio-based products. Despite HTC’s potential—from the management of challenging biomass wastes to the synthesis of advanced carbons and the implementation of biorefineries—it encounters hurdles transitioning from academic exploration to industrial implementation. Gaps persist, from a general comprehension of reaction intricacies to the difficulty of large-scale integration with wastewater treatments, to the management of process water, to the absence of standardized assessment techniques for HTC products. Addressing these challenges demands collaboration to bridge the many scientific sectors touched by HTC. Thus, this article reviews the current state of some hot topics considered crucial for HTC development: It emphasizes the role of HTC as a cornerstone for waste management and biorefineries, highlighting potentialities and challenges for its development. In particular, it surveys fundamental research aspects, delving into reaction pathways, predictive models, analytical techniques, and HTC modifications while exploring HTC’s crucial technological applications and challenges, with a peculiar focus on combined HTC, wastewater integration, and plant energy efficiency.

Although bioreactor landfills have many advantages associated with them, challenges remain, including the persistence of ammonia-nitrogen in the leachate. It has been suggested that ammonia-nitrogen is one of the most significant long-term pollution problem in landfills and is likely a parameter that will determine when landfill postclosure monitoring may end. The fate of nitrogen in bioreactor landfills is not well understood. As more landfills transition operation to bioreactors, more attention must be paid to how operating the landfill as a bioreactor may affect the fate of nitrogen. Processes such as sorption, volatilization, nitrification, denitrification, anaerobic ammonium oxidation, and dissimilatory nitrate reduction may all occur.

This is the first in a collection of three papers introducing the science with an ultra-violet (UV) space telescope on an approximately 130 kg small satellite with a moderately fast re-pointing capability and a real-time alert communication system approved for a Czech national space mission. The mission, called Quick Ultra-Violet Kilonova surveyor—QUVIK , will provide key follow-up capabilities to increase the discovery potential of gravitational wave observatories and future wide-field multi-wavelength surveys. The primary objective of the mission is the measurement of the UV brightness evolution of kilonovae, resulting from mergers of neutron stars, to distinguish between different explosion scenarios. The mission, which is designed to be complementary to the Ultraviolet Transient Astronomy Satellite—ULTRASAT , will also provide unique follow-up capabilities for other transients both in the near- and far-UV bands. Between the observations of transients, the satellite will target other objects described in this collection of papers, which demonstrates that a small and relatively affordable dedicated UV-space telescope can be transformative for many fields of astrophysics.

Psychotic disorders typically manifest from late adolescence to early adulthood, and an earlier onset might be associated with greater symptom severity and a worse long-term prognosis. This study aimed to compare the cognitive characteristics of patients with first-episode psychosis (FEP) by their age at onset. We included 298 patients diagnosed with FEP and classified them as having an early onset (EOS), youth onset (YOS), or adult onset (AOS) based on age limits of ≤ 18 years (N = 61), 19–24 years (N = 121), and ≥ 25 years (N = 116), respectively. Socio-demographic and clinical variables included age at baseline, gender, socio-economic status, antipsychotic medication, DSM-IV diagnoses assessed by clinical semi-structured interview, psychotic symptom severity, and age at onset. Neuropsychological assessment included six cognitive domains: premorbid intelligence, working memory, processing speed, verbal memory, sustained attention, and executive functioning. The EOS group had lower scores than the YOS or AOS groups in global cognition, executive functioning, and sustained attention. Although the scores in the YOS group were intermediate to those in the EOS and AOS groups for most cognitive factors, no statistically significant differences were detected between the YOS and AOS groups. Age at onset results in specific patterns of cognitive interference. Of note, impairment appears to be greater with EOS samples than with either YOS or AOS samples. A longitudinal study with a larger sample size is needed to confirm our findings.

Negative symptoms prevalent in schizophrenia are associated with poor outcome. Developing new instruments to identify new treatments was highlighted at the NIMH-MATRICS Consensus Development Conference on Negative Symptoms. The new Brief Negative Symptoms scale (BNSS) demonstrated strong psychometric properties, but there is a need for validating it in non-English languages. A multi-center study was conducted to validate the Spanish version of the BNSS (BNSS-Sp) in 20 schizophrenia patients, following the original BNSS validation methodology. We found strong inter-rater, test–retest and internal consistency properties (for the total BNSS-Sp, intraclass correlation coefficient=0.97, Pearson's correlation coefficient r=0.95 (p<0.001), Cronbach's alpha=0.98).

Purpose Clinical pathways are used to organize complex care processes by providing structure and standardization. The multidisciplinary approach of oral appliance (OA) therapy for sleep-disordered breathing (SDB) is a complex and dynamic process suitable for such a structured pathway approach. Methods A clinical pathway for patients referred for OA therapy was developed and implemented. The aim of this study was to evaluate the impact of this clinical pathway on the time to delivery of the OA and the organization of the multidisciplinary dental sleep clinic (MDSC). The latter was achieved using the care process self-evaluation tool (CPSET). Results First, development and implementation of the clinical pathway gave structure and shortened the mean time to delivery by 102 days (240 ± 70 vs. 138 ± 33 days) (Mann–Whitney U : P  < 0.001). Second, the CPSET scores were obtained in a cohort of 49 healthcare professionals involved in the pathway. Overall, patient-focused organization received the highest scores (80.5 ± 9.0 %), whereas cooperation with primary care received the lowest score (66.7 ± 12.4 %). Conclusions This is the first project on clinical pathways in OA therapy for SDB. The implementation of the pathway in our MDSC has created a significant shortening of the time to delivery. A first evaluation of the clinical pathway using the CPSET scores indicates that all disciplines involved should be thoroughly informed in an ongoing approach.

To produce hydrochar with less volatile matter (VM) and more fixed carbon (FC) to increase its stability, this study compared the hydrothermal carbonization (HTC) of hen (HM) and swine (SM) manures at typical HTC sub-critical temperature of 210 °C and slightly super-critical temperature of 400 °C. Physico-chemical properties such as proximate analysis; ultimate analysis; Brunauer–Emmett–Teller (BET) surface area; higher heating value (HHV); chemical oxygen demand (COD); and inorganic nutrients of hydrochar, gaseous, and liquid products were determined. As expected, both VM and yield decreased with temperature. The heats of HTC reactions were estimated to be exothermic, ranging from −5.7 to −8.6 MJ/kg. The FC approximately doubled, while VM significantly decreased with a yield of 42.7%, suggesting the high potential of producing more stable hydrochar via near-critical HTC (NCHTC) treatment of SM. Additional work is needed before recommendations on carbonization temperatures can be made. Specifically, there is a need to experimentally investigate how the chars produced from each carbonization condition influence plant growth and soil emissions.

The objective of this study is to determine whether cannabis influences BDNF levels in patients with psychosis (FEP) and healthy volunteers (HV) to help understand the role of BDNF in psychosis. We assessed the association between BDNF and cannabis in a cohort of FEP antipsychotic-naïve patients and HV, whilst controlling for other potential confounding factors. 70 FEP drug-naive patients and 57 HV were recruited. A sociodemographic variable collection, structured clinical interview, weight and height measurement, substance use determination, and blood collection to determine BDNF levels by ELISA analysis were done. In FEP patients, cannabis use was associated with BDNF levels (high cannabis use was associated with lower BDNF levels). Moreover, cannabis use was statistically significantly associated with age (high use of cannabis was associated with younger age). In HV, no relationship between cannabis use and BDNF levels was observed. Otherwise, cannabis use was significantly associated with tobacco use, so that high cannabis users were also high tobacco users. This study showed a different association between cannabis use and BDNF levels in FEP patients compared with HV, particularly, with high doses of cannabis. These findings may help understand the deleterious effects of cannabis in some vulnerable individuals, as well as discrepancies in the literature.

IntroductionSchizophrenia is a severe and common psychiatric disorder characterized by disturbed brain development. Brain-derived neurotrophic factor (BDNF) mediates differentiation and survival of neurons as well as synaptic plasticity during the brain development. Several studies have shown decreased serum levels of BDNF in chronic, first episode, and drug naïve schizophrenia patients. Folate provides the substrate for intracellular methylation reactions that are essential to normal brain development and function. Abnormal folate metabolism has been implicated in schizophrenia. For example, reduced maternal folate intake associated with an increased risk for schizophrenia. Also, low blood levels of folate have been reported in patients with schizophrenia, and are associated with clinical manifestation especially in the negative symptom domain.ObjectivesWith this study, we want to know how BDNF levels at baseline in drug-naïve FEP are associated with folic acid.MethodsFifty drug-naïve FEP treated between April 2013 and July 2017 at the ETEP Program at Hospital del Mar were included. Inclusion criteria were: 1) age 18-35 years; 2) DSM-IV-TR criteria for brief psychotic disorder, schizophreniform disorder, schizophrenia or unspecified psychosis; 3) no previous history of severe neurological medical conditions or severe traumatic brain injury; 4) presumed IQ level > 80, and 5) no substance abuse or dependence disorders except for cannabis and/or nicotine use. All patients underwent an assessment at baseline including sociodemographic and clinical variables. Fasting blood samples were obtained before administering any medication at baseline and used to determine folic acid and BDNF levels.ResultsIn our drug-naïve FEP sample, folic acid levels showed a significative positive correlation with BDNF levels at baseline (r = 0.584; p = 0.003). Moreover, we did a lineal regression model that showed that the baseline variables that better predict BDNF levels were folic acid levels, and cannabis use.ConclusionsOur results are consistent with the findings from some of previous studies that also shows that lower folic acid levels are associated with lower BNDF levels at baseline in drug-naïve FEP. Folate deficiency is associated with cerebrovascular and neurological diseases, and mood disorders. The importance of folate in the nervous system was initially demonstrated in studies that established a greatly increased risk of neurodevelopmental disorders in the offspring of folate-deficient pregnant women. In the adult, epidemiological studies have linked lack of folate to neurodegenerative and neuropsychiatric diseases. However, the mechanisms by which chronic folate deficiency adversely affects CNS function are incompletely understood. Some studies in animals models have hypothesized that folate deficiency in animals could be associated with pyramidal cell loss and reduced hippocampal BDNF.Disclosure of InterestNone Declared