THU0618-HPR PSYCHOSOCIAL CHANGES IN RHEUMATIC DISEASE: A NURSING LED CROSS-SECTIONAL STUDY

Background:Nursing management in Rheumatic Diseases (RD) is focused on global patient care. Starting from basic knowledge of diagnostic and therapeutic management, nurses can assess the impact of RD on patients' quality of life not only at the physical level, but also at the psychological, social, and emotional levels.Objectives:To evaluate psycosocial changes in RD patients through nursing-led Patient-Reported OutcomesMethods:We performed a cross-sectional study of 100 RD patients compared with 100 healthy volunteers matched for age, sex and BMI. Specialist nurses invited patients and volunteers to complete questionnaires on quality of life through seven domains (anxiety, depression, fatigue, sleep disturbance, pain interference, physical functions and satisfaction with participation in social roles) of the Patient-Reported Outcomes Measurement Information System (PROMIS).Results:Among 100 RD patients, 52 (52%) had a diagnosis of Rheumatoid Arthritis; 17 (17%) had a diagnosis of axial spondylorthritis (Ankylosing Spondylitis and Psoriatic Artritis); 25 (25%) had connectivitis (i.e. Lupus, Systemic Sclerosis, Sjögren Syndrome), and finally 6 (6%) had vasculitis. Median disease duration was 7±5 years. Just under half (43%) of RD patients had active disease measured by specific disease activity index. As shown in table 1, no significant difference highlight between the two groups with regard to anthropompetric and demographic characteristics. We found that patients report significantly greater psychosocial changes than healthy controls. More specifically, as shown in figure 1A, mean T score for anxiety, depression, fatigue and sleep disturbances were significantly higher in the RD patients than in healthy controls (56 ± 9 vs 48 ± 8 p<0.001; 52 ± 9 vs 46 ± 8 p <0.001; 58 ± 8vs 48 ± 8 p <0.001; 52 ± 10 vs 44 ± 8 p <0.001) respectively. Moreover, also in the social dimension in terms of pain interference, physical functions and satisfaction with participation in social roles, patients showed a median T score worse than healthy controls (Fig.1B).Table 1Patients(N=100)Healthy(N=100)pDemographic and AnthropometricAge (years)52.5±1151±18nsGender n male (%)43 (43)47 (47)nsBMI (Kg/m2)25.1±427.8±4nsSmoke n (%)52 (52)46 (46)nsMarital Status n not married (%)42(42)41 (41)nsOccupation n yes (%)31 (31)35 (35)nsEducation level n degree (%)54 (54)64 (64)nsRheumatoid Arthritis52 (52)-Axial Spondylorthritis17 (17)-Connectivitis25 (25)-Vasculitis6 (6)-Disease duration (years)7.1±5.18-Disease Activity n yes (%)43 (43)-Medications n (% patients)-NSAID7 (7)-Steroids26 (26)-Biological Treatment54 (54)-Methotrexate34 (34)-Continuous variables are shown as mean ± standard deviation. Categorical variables are presented as number and proportion. The overall p-value was calculated by the Mann–Whitney non-parametric test for independent samples and by Chi-square test as appropriateFigure 1.Median T Score stratified by study group. Data are shown as mean and standard deviation. The overall p-value wascalculated by the Mann–Whitney non-parametric test for independent samples.Conclusion:This exploratory study highlights the need to adopt validated questionnaires in clinical practice, and demonstrates that PROMIS is a valid, objective, and standardized instrument that can help nursing staff to better define the consequences of the disease in a patient's daily life.References:[1]Minnock P, McKee G, Kelly A, et al. Nursing sensitive outcomes in patients with rheumatoid arthritis: a systematic literature review.Int. J. Nurs. Stud., 77 (2017), pp. 115-129[2]Bartlett SJ, Orbai AM, Duncan T, et al. Reliability and validity of selected PROMIS measures in people with rheumatoid arthritis. PloS One. 2015Disclosure of Interests:None declare

The Emergence of the Infrared transient VVV-WIT-06

We report the discovery of an enigmatic large-amplitude (ΔKs> 10.5 mag) transient event in near-IR data obtained by the VISTA Variables in the Via Lactea (VVV) ESO Public Survey. The object (designated VVV-WIT-06) is located at R.A. = 17:07:18.917, decl. = -39:06:26.45 (J2000), corresponding to Galactic coordinates l = 347.14539, b = 0.88522. It exhibits a clear eruption, peaking at Ks = 9 mag during 2013 July and fading to Ks ~ 16.5 in 2017. Our late near-IR spectra show post-outburst emission lines, including some broad emission lines (upward of {FWHM} ~ 3000 k/s). We estimate a total extinction of A_V=10--15 mag in the surrounding field, and no progenitor was observed in ZYJHKs images obtained during 2010-2012 (down to Ks> 18.5 mag). Subsequent deep near-IR imaging and spectroscopy, in concert with the available multiband photometry, indicate that VVV-WIT-06 may be either: (I) the closest Type I SN observed in about 400 years, (II) an exotic high-amplitude nova that would extend the known realm of such objects, or (III) a stellar merger. In all of these cases, VVV-WIT-06 is a fascinating and curious astrophysical target under any of the scenarios considered.Peer reviewe

A Hubble Space Telescope survey for novae in M87 – III. Are novae good standard candles 15 d after maximum brightness?

Ten weeks of daily imaging of the giant elliptical galaxy M87 with the Hubble Space Telescope (HST) has yielded 41 nova light curves of unprecedented quality for extragalactic cataclysmic variables. We have recently used these light curves to demonstrate that the observational scatter in the so-called maximum-magnitude rate of decline (MMRD) relation for classical novae is so large as to render the nova-MMRD useless as a standard candle. Here, we demonstrate that a modified Buscombe–de Vaucouleurs hypothesis, namely that novae with decline times t_2 > 10 d converge to nearly the same absolute magnitude about two weeks after maximum light in a giant elliptical galaxy, is supported by our M87 nova data. For 13 novae with daily sampled light curves, well determined times of maximum light in both the F606W and F814W filters, and decline times t_2 > 10 d we find that M87 novae display M_(606W,15) = −6.37 ± 0.46 and M_(814W,15) = −6.11 ± 0.43. If very fast novae with decline times t_2 < 10 d are excluded, the distances to novae in elliptical galaxies with stellar binary populations similar to those of M87 should be determinable with 1σ accuracies of ± 20 per cent with the above calibrations

Water-peptide dynamics during conformational transitions

Transitions between metastable conformations of a dipeptide are investigated using classical molecular dynamics simulation with explicit water molecules. The distribution of the surrounding water at different moments before the transitions and the dynamical correlations of water with the peptide's configurational motions indicate that the water molecules represent an integral part of the molecular system during the conformational changes, in contrast to the metastable periods when water and peptide dynamics are essentially decoupled

HST FUV spectroscopy of the short orbital period recurrent nova CI Aql: Implications for white dwarf mass evolution

An HST COS Far UV spectrum (1170 A to 1800 A) was obtained for the short orbital period recurrent novae (T Pyxidis subclass), CI Aquilae. CI Aql is the only classical CV known to have two eclipses of sensible depth per orbit cycle and also have pre- and post-outburst light curves that are steady enough to allow estimates of mass and orbital period changes. Our FUV spectral analysis with model accretion disks and NLTE high gravity photospheres, together with the Gaia parallax, reveal CI Aql's FUV light is dominated by an optically thick accretion disk with an accretion rate of the order of $4\times 10^{-8}$ $M_{\odot}/yr$. Its database of light curves, radial velocity curves, and eclipse timings is among the best for any CV. Its orbit period ($P$), $dP/dt$, and reference time are re-derived via simultaneous analysis of the three data types, giving a dimensionless post-outburst $dP/dt$ of $-2.49\pm 0.95\times 10^{-10}$. Lack of information on loss of orbital to rotational angular momentum leads to some uncertainty in the translation of $dP/dt$ to white dwarf mass change rate, $dM_1/dt$, but within the modest range of $+4.8\times 10^{-8}$ to $+7.8\times 10^{-8}$ $M_{\odot} /yr$. The estimated white dwarf mass change through outburst for CI Aql, based on simple differencing of its pre- and post outburst orbit period, is unchanged from the previously published $+5.3 \times 10^{-6} M_{\odot}$. At the WD's estimated mass increase rate, it will terminate as a Type Ia supernova within 10 million years

A Hubble Space Telescope survey for novae in M87 – III. Are novae good standard candles 15 d after maximum brightness?

Ten weeks of daily imaging of the giant elliptical galaxy M87 with the Hubble Space Telescope (HST) has yielded 41 nova light curves of unprecedented quality for extragalactic cataclysmic variables. We have recently used these light curves to demonstrate that the observational scatter in the so-called maximum-magnitude rate of decline (MMRD) relation for classical novae is so large as to render the nova-MMRD useless as a standard candle. Here, we demonstrate that a modified Buscombe–de Vaucouleurs hypothesis, namely that novae with decline times t_2 > 10 d converge to nearly the same absolute magnitude about two weeks after maximum light in a giant elliptical galaxy, is supported by our M87 nova data. For 13 novae with daily sampled light curves, well determined times of maximum light in both the F606W and F814W filters, and decline times t_2 > 10 d we find that M87 novae display M_(606W,15) = −6.37 ± 0.46 and M_(814W,15) = −6.11 ± 0.43. If very fast novae with decline times t_2 < 10 d are excluded, the distances to novae in elliptical galaxies with stellar binary populations similar to those of M87 should be determinable with 1σ accuracies of ± 20 per cent with the above calibrations

Inflows, Outflows, and a Giant Donor in the Remarkable Recurrent Nova M31N 2008-12a? - Hubble Space Telescope Photometry of the 2015 Eruption

The recurrent nova M31N 2008-12a experiences annual eruptions, contains a near-Chandrasekhar mass white dwarf, and has the largest mass accretion rate in any nova system. In this paper, we present Hubble Space Telescope (HST) WFC3/UVIS photometry of the late decline of the 2015 eruption. We couple these new data with archival HST observations of the quiescent system and Keck spectroscopy of the 2014 eruption. The late-time photometry reveals a rapid decline to a minimum luminosity state, before a possible recovery / re-brightening in the run-up to the next eruption. Comparison with accretion disk models supports the survival of the accretion disk during the eruptions, and uncovers a quiescent disk mass accretion rate of the order of $10^{-6}\,M_\odot\,\mathrm{yr}^{-1}$, which may rise beyond $10^{-5}\,M_\odot\,\mathrm{yr}^{-1}$ during the super-soft source phase - both of which could be problematic for a number of well-established nova eruption models. Such large accretion rates, close to the Eddington limit, might be expected to be accompanied by additional mass loss from the disk through a wind and even collimated outflows. The archival HST observations, combined with the disk modeling, provide the first constraints on the mass donor; $L_\mathrm{donor}=103^{+12}_{-11}\,L_\odot$, $R_\mathrm{donor}=14.14^{+0.46}_{-0.47}\,R_\odot$, and $T_\mathrm{eff, donor}=4890\pm110$ K, which may be consistent with an irradiated M31 red-clump star. Such a donor would require a system orbital period $\gtrsim5$ days. Our updated analysis predicts that the M31N 2008-12a WD could reach the Chandrasekhar mass in < 20 kyr

Eclipses During the 2010 Eruption of the Recurrent Nova U Scorpii

The eruption of the recurrent nova U Scorpii on 28 January 2010 is now the all-time best observed nova event. We report 36,776 magnitudes throughout its 67 day eruption, for an average of one measure every 2.6 minutes. This unique and unprecedented coverage is the first time that a nova has any substantial amount of fast photometry. With this, two new phenomena have been discovered: the fast flares in the early light curve seen from days 9-15 (which have no proposed explanation) and the optical dips seen out of eclipse from days 41-61 (likely caused by raised rims of the accretion disk occulting the bright inner regions of the disk as seen over specific orbital phases). The expanding shell and wind cleared enough from days 12-15 so that the inner binary system became visible, resulting in the sudden onset of eclipses and the turn-on of the supersoft X-ray source. On day 15, a strong asymmetry in the out-of-eclipse light points to the existence of the accretion stream. The normal optical flickering restarts on day 24.5. For days 15-26, eclipse mapping shows that the optical source is spherically symmetric with a radius of 4.1 R_sun. For days 26-41, the optical light is coming from a rim-bright disk of radius 3.4 R_sun. For days 41-67, the optical source is a center-bright disk of radius 2.2 R_sun. Throughout the eruption, the colors remain essentially constant. We present 12 eclipse times during eruption plus five just after the eruption.Comment: ApJ in press. 60 pages, 17 figure

Molecular Profiling Reveals Biologically Discrete Subsets and Pathways of Progression in Diffuse Glioma

Therapy development for adult diffuse glioma is hindered by incomplete knowledge of somatic glioma driving alterations and suboptimal disease classification. We defined the complete set of genes associated with 1,122 diffuse grade II-III-IV gliomas from The Cancer Genome Atlas and used molecular profiles to improve disease classification, identify molecular correlations, and provide insights into the progression from low- to high-grade disease. Whole-genome sequencing data analysis determined that ATRX but not TERT promoter mutations are associated with increased telomere length. Recent advances in glioma classification based on IDH mutation and 1p/19q co-deletion status were recapitulated through analysis of DNA methylation profiles, which identified clinically relevant molecular subsets. A subtype of IDH mutant glioma was associated with DNA demethylation and poor outcome; a group of IDH-wild-type diffuse glioma showed molecular similarity to pilocytic astrocytoma and relatively favorable survival. Understanding of cohesive disease groups may aid improved clinical outcomes