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In our practice, there is a growing need to perform gastrostomy tube placement in infants and young children with feeding difficulties. To avoid possible complications arising from pull-through method (pull-through PEG) we began to perform a one-step endoscopic gastrostomy with a gastropexy device (push GT). This study aimed to evaluate the safety of this technique in infants and young children. In our study, 60 pull-through PEG and push GT procedures were retrospectively analysed in patients between 2.83 and 8.6 kg. We analysed the adverse events in both groups. Age, sex, weight, diagnosis, early (occurring ≤ 7 days after the procedure) and late (occurring > 7 days after the procedure) complications were compared in the two groups. Median follow-up duration was 12 months. Early minor complications occurred only in the push GT group, but this was not statistically significant. There was no significant difference between the groups regarding early major complications. Late minor complications were significantly more common in the push GT group. There were no late major complications in the push GT group, which is statistically significant. In infants and young children, push GT with a gastropexy device is a safe method to perform gastrostomy even in patients unsuitable for pull-through PEG placement.

Soft chemical ionization mass spectrometry (SCI-MS) techniques can be used to accurately quantify volatile organic compounds (VOCs) in air in real time; however, differentiation of isomers still represents a challenge. A suitable pre-separation technique is thus needed, ideally capable of analyses over a few tens of seconds. To this end, a bespoke fast gas chromatography (GC) instrument with an electrically heated 5 m long metallic capillary column was coupled to selected ion flow tube mass spectrometry (SIFT-MS) measurements. To assess the performance of this combination, a case study of monoterpene isomer (C10H16) analyses was carried out. The monoterpenes were quantified by SIFT-MS using H3O+ reagent ions (analyte ions C10H17+, m∕z 137, and C6H9+, m∕z 81) and NO+ reagent ions (analyte ions C10H16+, m∕z 136, and C7H9+, m∕z 93). The combinations of the fragment ion relative intensities obtained using H3O+ and NO+ were shown to be characteristic of the individual monoterpenes. Two non-polar GC columns (Restek Inc.) were tested: the advantage of MXT-1 was shorter retention, whilst the advantage of MXT-Volatiles was better separation. Thus, it is possible to identify components of a monoterpene mixture in less than 45 s using the MXT-1 column and to separate them in less than 180 s using the MXT-Volatiles column. Quality of the separation and the sensitivity of present technique (limit of detection, LOD, ∼16 ppbv) was found to be inferior compared to commercially available fast GC solutions coupled with proton transfer reaction mass spectrometry (PTR-MS, LOD ∼1 ppbv) due to the limited sample flow through the column. However, using combinations of two reagent ions improved identification of monoterpenes not well resolved by the chromatograms. As an illustrative example, the headspace of needle samples of three conifer species was analysed by both reagent ions and with both columns showing that mainly α-pinene, β-pinene and 3-carene were present. The system can thus be used for direct rapid monitoring of monoterpenes above 20 ppbv, such as applications in laboratory studies of monoterpene standards and leaf headspace analysis. Limitation of the sensitivity due to the total sample flow can be improved using a multi-column pre-separation.

Background Cariprazine is metabolised mainly by CYP3A4 and to a lesser extent by CYP2D6. Aim This study aimed to evaluate the effects of erythromycin, a moderate cytochrome P450 (CYP)3A4 inhibitor, on the pharmacokinetics of cariprazine in male patients with schizophrenia, and to assess the influence of CYP2D6 phenotypes on cariprazine metabolism. Methods Forty-two patients received oral doses of 1.5 mg cariprazine alone for 28 days (to reach steady state), followed by a co-administration of cariprazine 1.5 mg daily with erythromycin 500 mg twice daily (BID) and Enterol 250 mg BID for 21 days, followed by a 14-day post-treatment period. Blood samples were collected at predefined time points and analysed for cariprazine, its two active metabolites: desmethyl cariprazine (DCAR) and didesmethyl cariprazine (DDCAR), and erythromycin using validated high performance liquid chromatography-tandem mass spectrometry methods. CYP2D6 phenotypes were determined by genotyping. The pharmacokinetic parameters were calculated using non-compartmental analysis. Results Erythromycin increased the area under the curve (AUC τ ) and peak concentration ( C max ) of Total cariprazine (cariprazine + DCAR + DDCAR) by about 40–50% but did not affect the time to peak concentration ( T max ). The CYP2D6 phenotypes had no substantial effect on the pharmacokinetics of cariprazine and its metabolites, either alone or in combination with erythromycin. Cariprazine was well tolerated and safe. Conclusion The findings suggest that co-administration of cariprazine with moderate CYP3A4 inhibitors may require dose adjustment or monitoring; however, pharmacogenetic testing for CYP2D6 is not necessary for optimising cariprazine therapy. Trial Registration Trial registration number (EudraCT Number): 2018-003721-28. Date of registration: 21-SEP-2018.

IntroductionThe aim of this study was to identify low-risk traits of schizophrenia among healthy undergraduate student volunteers, and the investigation of these traits with regards to their specificity in contrast to individuals with a latent disposition towards bipolar disorder. Self-agency, as a phenomenon closely related to psychomotor functioning, provides a unique opportunity for the investigation of subjective self-perception.ObjectivesThe implicit self-agency performances that are considered illness- (or risk state-) specific were compared between groups to find early markers of a specific schizotypic developmental path.MethodsIn a sample of 710 healthy university students, with the help of screening questionnaires, we were able to successfully form two risk groups, in one of them the emphasis on cyclothymia (CTF: Cyclothymia factor group, N=25), and in the other (PSF: Positive schizotypy factor group, N=26) the tendency to unusual experiences and paranoid thinking emphasis was typical. We assigned a properly matched control group (N=29) displaying both features on average. We focused on the implicit aspect of self-agency, using the well-known paradigm of intentional binding, as well as the self-developed device that exclusively tests the pre-reflexive feeling of movement initiation, the sense of self-agency.ResultsDuring the examination of intentional binding, although the specific predictive and retrospective component indicators did not show any significant difference for either group, the association of the sound alone could induce a binding effect in the control group. In the predictable frequency condition, there was a strong significant effect (W = 65.00, p = .007, rrb = -.60), and in the non-predictable condition a trend-level effect. Remarkably, this binding effect did not develop in either the CTF or PSF groups, indicating an implicit agency impairment in both risk groups. However, during the examination of sense of self-agency, we observed a disturbance specifically among healthy college students with positive schizotypal traits, in the form of falsely attributing their movement initiation to external influences. The percentage of this ‘miss’-type answering differed between groups, H(2) = 7.68, p = .021, ε2 = .10. The Dwass-SteelCritchlow-Fligner pairwise comparisons showed that this difference was due to the PSF Group showing a significant difference from the Control Group (W = -3.83, p = .019), but not from the CTF group, and the CTF Group also did not differ from the Control Group.ConclusionsThus, in premorbid conditions, in at-risk groups of non-help-seeking individuals, or in cases of early detection of prodromal abnormalities, objective confirmation of suspected susceptibility to schizophrenia may be aided by, among other things, instrumental assessment of self-agency.Disclosure of InterestNone Declared

Background: Celiac disease (CD) is a chronic immune-mediated enteropathy that is treated exclusively with a lifelong gluten-free diet (GFD). Hepatic involvement, including hepatic steatosis (HS), is common in both newly diagnosed and long-term GFD-treated CD patients. Limited data exist regarding HS prevalence and risk factors in CD, and the effects of dietary patterns, including GFD and the Mediterranean diet (MD), remain unclear. Objective: This study investigated the prevalence and severity of HS in newly diagnosed, pre-GFD and GFD-treated CD patients compared to non-celiac control subjects, while assessing the influence of dietary adherence. Methods: In a nested cross-sectional study within the ARCTIC trial (NCT05530070), 290 Hungarian adults were enrolled (60 pre-GFD CD, 156 CD on GFD, and 74 control subjects). HS was assessed by ultrasonography, and dietary adherence was evaluated using the Standardized Dietitian Evaluation and Mediterranean Diet Score (MDS). Binary regression models were applied to identify predictors of HS. Results: HS was diagnosed in 34% of participants, most frequently in pre-GFD CD patients. BMI was the strongest predictor of HS both overall and within the CD cohort (OR = 1.27; 95% CI: 1.16, 1.42; p < 0.001). Neither adherence to GFD nor overall MD adherence significantly influenced the prevalence of HS. Severity of HS correlated with higher BMI, older age, and diabetes prevalence, while individual MD components, including olive oil consumption, were associated with milder HS. Conclusions: HS is more prevalent in CD patients, particularly pre-GFD patients, and is strongly associated with BMI. While overall dietary patterns did not significantly impact HS, certain diet components may modulate severity.

IntroductionThis study was carried out to map psychosis spectrum disorder risk factors.ObjectivesOur goal was to find what kind of instrumental methods may help to detect latent liabilities for schizophrenia and bipolar affective disorderMethodsUsing online questionnaires n=710 students were screened. Groups were formed based on the inclusion criteria: N = 25 people prone to mood swings, N = 30 people prone to odd experiences and delusive thinking, and a normal control group with N = 30 people. Personality, temperament, self-experiences, affectivity scales, and cognitive screening were conducted in addition to actigraphy coupled with a mobile application for detecting subjective experiences (EMA). Furthermore, instrumental examination of self-agency, testing time interval discrimination and (re)production, eye-tracking, EEG-microstates, and laboratory testing of inflammatory, immunologic and cardio-metabolic measures of allostatic load were applied.ResultsSelf-experience disorders: both risk groups showed significantly higher scores than the control group (CG). Self-agency: based on incorrectly attributed responses, the positive schizotypy risk factor (PSF) group differed from the CG (p = 0.003). Antisaccade study: the PSF group showed a difference from the CG (p = 0.002). Actigraphy: based on the distributions of diurnal cumulative activities, it distinguished those with a cyclothymic risk factor (CTF) from the CG (67% probability in the k-means clustering procedure).ConclusionsHealthy students with a latent liability for schizotypy or bipolarity could be distinguished by some targeted laboratory methods. Susceptibility for bipolarity was indicated by actigraphic analyzes, and the risk for schizotypal development was indicated by deficiencies in the self-agency experience and by anti-saccadic eye movement disorders.DisclosureNo significant relationships.

(ProQuest: ... denotes formulae and/or non-USASCII text omitted; see image) A search is presented for a high-mass Higgs boson in the ..., ..., ..., and ... decay modes using the ATLAS detector at the CERN Large Hadron Collider. The search uses proton-proton collision data at a centre-of-mass energy of 8 TeV corresponding to an integrated luminosity of 20.3 fb... The results of the search are interpreted in the scenario of a heavy Higgs boson with a width that is small compared with the experimental mass resolution. The Higgs boson mass range considered extends up to ... for all four decay modes and down to as low as 140 ..., depending on the decay mode. No significant excess of events over the Standard Model prediction is found. A simultaneous fit to the four decay modes yields upper limits on the production cross-section of a heavy Higgs boson times the branching ratio to ... boson pairs. 95 % confidence level upper limits range from 0.53 pb at ... GeV to 0.008 pb at ... GeV for the gluon-fusion production mode and from 0.31 pb at ... GeV to 0.009 pb at ... GeV for the vector-boson-fusion production mode. The results are also interpreted in the context of Type-I and Type-II two-Higgs-doublet models.

This long awaited book discusses both ancient and modern shamanism, demonstrating its longevity and spatial distribution. The book is divided into eleven thought-provoking chapters that are organised into three sections: mind-body, nature, and culture. It discusses the clear associations with this sometimes little-understood ritualised practice, and asks what shamanism is and if tangible evidence can be extracted from a largely fragmentary archaeological record. The book offers a novel portrayal of the material culture of shamanism by collating carefully selected studies by specialists from three different continents, promoting a series of new perspectives on this idiosyncratic and sometimes intangible phenomenon.

The Pixel Luminosity Telescope is a silicon pixel detector dedicated to luminosity measurement at the CMS experiment at the LHC. It is located approximately 1.75 m from the interaction point and arranged into 16 “telescopes”, with eight telescopes installed around the beam pipe at either end of the detector and each telescope composed of three individual silicon sensor planes. The per-bunch instantaneous luminosity is measured by counting events where all three planes in the telescope register a hit, using a special readout at the full LHC bunch-crossing rate of 40 MHz. The full pixel information is read out at a lower rate and can be used to determine calibrations, corrections, and systematic uncertainties for the online and offline measurements. This paper details the commissioning, operational history, and performance of the detector during Run 2 (2015–18) of the LHC, as well as preparations for Run 3, which will begin in 2022.

Terrestrial biogeochemical models are essential tools to quantify climate–carbon cycle feedback and plant–soil relations from local to global scale. In this study, a theoretical basis is provided for the latest version of the Biome-BGCMuSo biogeochemical model (version 6.2). Biome-BGCMuSo is a branch of the original Biome-BGC model with a large number of developments and structural changes. Earlier model versions performed poorly in terms of soil water content (SWC) dynamics in different environments. Moreover, lack of detailed nitrogen cycle representation was a major limitation of the model. Since problems associated with these internal drivers might influence the final results and parameter estimation, additional structural improvements were necessary. In this paper the improved soil hydrology as well as the soil carbon and nitrogen cycle calculation methods are described in detail. Capabilities of the Biome-BGCMuSo v6.2 model are demonstrated via case studies focusing on soil hydrology, soil nitrogen cycle, and soil organic carbon content estimation. Soil-hydrology-related results are compared to observation data from an experimental lysimeter station. The results indicate improved performance for Biome-BGCMuSo v6.2 compared to v4.0 (explained variance increased from 0.121 to 0.8 for SWC and from 0.084 to 0.46 for soil evaporation; bias changed from -0.047 to-0.007 m3m-3 for SWC and from -0.68 to -0.2 mmd-1 for soil evaporation). Simulations related to nitrogen balance and soil CO2 efflux were evaluated based on observations made in a long-term field experiment under crop rotation. The results indicated that the model is able to provide realistic nitrate content estimation for the topsoil. Soil nitrous oxide (N2O) efflux and soil respiration simulations were also realistic, with overall correspondence with the observations (for the N2O efflux simulation bias was between -0.13 and-0.1 mgNm-2d-1, and normalized root mean squared error (NRMSE) was 32.4 %–37.6 %; forCO2 efflux simulations bias was 0.04–0.17 gCm-2d-1, while NRMSE was 34.1 %–40.1 %). Sensitivity analysis and optimization of the decomposition scheme are presented to support practical application of the model. The improved version of Biome-BGCMuSo has the ability to provide more realistic soil hydrology representation as well as nitrification and denitrification process estimation, which represents a major milestone.