Hospital del Mar Research Institute

This study establishes a robust and clinically applicable calibration protocol for optically stimulated luminescence dosimeters (OSLDs) in diagnostic radiology, with the aim of improving the accuracy of patient dose assessment. A total of 144 OSLDs were systematically irradiated under controlled conditions to assess their dosimetric response across a wide range of tube voltages (40-150 kVp) and square field sizes (10 × 10 cm² to 30 × 30 cm²). The dosimeters exhibited a sensitivity variation of ±6.6%, with an average background dose of 0.0185 mGy. The experimental data revealed a high dependence of OSLD response on photon energy, with dose values increasing by a factor of 11.5, from 0.1393 mGy at 40 kVp to 1.6072 mGy at 150 kVp for a constant field size of 10 × 10 cm². A pronounced non-linear dose escalation was observed in the mid-kVp range (70-100 kVp), where dose measurements increased by 72-90% as field size expanded. Energy and geometry-specific correction factors were derived, showing significant variation with field size, reaching maximum values of 9.81 for the 30 × 30 cm² field at 150 kVp and 7.43 for the 10 × 10 cm² field under the same conditions. Additionally, notable discrepancies were observed between experimentally derived effective beam energies and reference values reported by the International Atomic Energy Agency (IAEA), highlighting the need for localized calibration standards. These findings contribute to the standardization of OSLD calibration protocols in diagnostic radiology and support their implementation for accurate patient dose monitoring in clinical settings.

Schizophrenia and autism share neurobiological mechanisms and overlapping clinical features, often resulting in the emergence of autistic traits in early stages of psychosis. The PANSS Autism Severity Score (PAUSS) provides a rapid measure of autistic features within the standard PANSS assessment. We aimed to determine the prevalence of autistic features in first-episode psychosis (FEP), characterise their clinical, cognitive, and functional profile, and examine their impact on 2-year outcomes. A total of 328 FEP patients were included from the PEPs multicentre cohort, followed for 2 years. Autistic features were rated using PAUSS (cut-off ≥ 30), yielding autistic (n = 38) and non-autistic (n = 290) groups. Sociodemographic, clinical, cognitive, and functional variables were analysed. Longitudinal analyses examined symptomatic remission rates and trajectories of psychopathology and functioning using logistic regression and mixed-model ANOVA. The autistic group represented 11.6% of the sample. At baseline, they exhibited lower birth weight, greater medication side effects, higher general psychopathology and depressive severity, and poorer global functioning. Cognitively, they showed significant deficits in working memory, social cognition, and cognitive reserve compared to the non-autistic group. Over 2 years, this group was 3.6 times less likely to achieve symptomatic remission and consistently exhibited higher symptom severity and lower functioning across all follow-ups. Autistic features in FEP identify a subgroup with a possible distinct profile of neurodevelopmental markers, greater cognitive and functional impairments, and poorer clinical outcomes. Early identification may guide more personalised interventions, although further research is needed to refine PAUSS specificity and develop targeted, tailored treatments.

Abstract Several neurodevelopmental disorders (NDDs) are characterized by impairments in social behavior and affective dysregulation. Converging evidence implicates the endocannabinoid system in the control of both behaviors. However, the brain region-specific contribution of cannabinoid receptor type 1 (CB1R) signaling to these NDD-relevant phenotypes remains unclear. The anterior insular cortex (aINS) is a key integrative hub involved in socio-emotional processing and social novelty recognition. Whether CB1Rs within this region are sufficient to regulate behavioral domains disrupted in NDDs remains unclear. Here, we employed a Cre-dependent viral strategy to selectively restore CB1R mRNA expression in the aINS of global CB1R-deficient mice. Region-specific rescue of CB1R in the aINS normalized social novelty discrimination and reduced anxiety-like behavior as compared to mice lacking CB1R, while leaving basal sociability and locomotor activity unaffected. In addition, insular CB1R re-expression modulated repetitive-like behaviors without broadly altering other behavioral domains. These effects were observed in the absence of off-target expression, supporting the specificity of the genetic manipulation. Our findings demonstrate that CB1R mRNA expression within the aINS is sufficient to regulate distinct socio-emotional and repetitive behavioral domains. These results identify the aINS as a critical CB1-dependent modulatory node and provide mechanistic insight into how region-specific endocannabinoid signaling contributes to behavioral phenotypes relevant to NDDs.

ABSTRACTIntroductionA strong nurse–patient therapeutic relationship is crucial in acute mental health care yet remains challenging, potentially affecting outcomes and perceived quality of care. Interventions that foster structured, person‐centred encounters may address these challenges effectively.AimTo evaluate the effects of the ‘Reserved Therapeutic Space’ intervention in terms of its impact on the improvement of the nurse–patient therapeutic relationship, the quality of care, perceived coercion and humiliation and length of stay.MethodsA multicentre quasi‐experimental trial design in twelve acute mental health units compared the Reserved Therapeutic Space to standard care. Participants completed validated instruments assessing the therapeutic relationship, perceived quality of care and coercion. Mixed‐effects models and survival analyses evaluated intervention effects.ResultsParticipants receiving the Reserved Therapeutic Space reported stronger nurse–patient relationships, higher quality of care ratings and lower coercion scores compared to those receiving standard care. Survival analysis indicated significantly shorter hospitalizations in the intervention group.ImplicationsFindings suggest that dedicating structured time for nurse–patient engagement enhances therapeutic relationships, reduces negative experiences and potentially improves both satisfaction and resource use. Providing structured therapeutic encounters can advance person‐centred, collaborative mental health nursing practices in acute settings. Future research should explore long‐term outcomes of this intervention.

Inflammation is a biological phenomenon beneficial for homeostasis, but it is unfavorable if dysregulated. Although major progress has been made in characterizing inflammation in specific diseases, a global, holistic understanding is still elusive. This is particularly intriguing, considering its function for human health and the potential for modern medicine if fully deciphered. In this study, we leveraged advances in single-cell transcriptomics to delineate inflammatory processes of circulating immune cells during infection, immune-mediated inflammatory diseases and cancer. Our single-cell atlas of more than 6.5 million peripheral blood mononuclear cells from 1,047 patients (56% female, 43% male) and 19 diseases allowed us to learn a comprehensive model of inflammation in circulating immune cells. The atlas expands current knowledge of the biology of inflammation of immune-mediated diseases, acute and chronic inflammatory diseases, infections and solid tumors and lays the foundation to develop a disease classification framework using unsupervised as well as explainable machine learning. Beyond a disease-centered analysis, we charted altered activity of inflammatory molecules in peripheral blood cells, depicting discriminative inflammation-related genes to further understand mechanisms of inflammation. We present a rich resource for the community and lay the groundwork for learning a classifier for inflammatory diseases, presenting cells in circulation as living biomarkers.

Paediatric patients are particularly sensitive to ionizing radiation, and accurate surface dose estimation is crucial in diagnostic X-ray imaging. Standard homogeneous phantoms inadequately reproduce tissue heterogeneity, leading to errors in backscatter evaluation. This study aimed to characterize backscatter factors (BSFs) in a heterogeneous, tissue-equivalent paediatric head phantom under conventional radiography conditions. An in-house epoxy-based heterogeneous phantom was fabricated with five inserts simulating bone, brain, cerebrospinal fluid, eye lens and air cavities. Entrance surface dose (ESD) and BSF measurements were performed using an ionization chamber and a Fujifilm digital X-ray system (40-150 kVp, field sizes: 10 × 10, 20 × 20, 25 × 25cm²). Additional aluminium filtrations of 2.5mm and 3.0mm were applied to evaluate beam hardening effects. Measured ESD increased from 0.82 mGy at 40 kVp to 18.93 mGy at 150 kVp (no filtration, 25 × 25cm²). Applying 3.0mm Al filtration reduced ESD by up to 57% at 60 kVp. Experimental BSFs ranged from 1.1 to 2.1, increasing with tube potential and reaching a maximum under small field size and hardened beam (120 kVp, 10 × 10cm², 3.0mm Al), reflecting enhanced cumulative backscatter energy from heterogeneous tissue interfaces. Compared with IAEA TRS-457 reference data, the heterogeneous phantom yielded higher BSFs than PMMA or water for 10 × 10cm² fields, demonstrating enhanced scatter from realistic tissue interfaces, while lower BSFs were observed for larger fields. The study confirms that homogeneous phantoms may underestimate paediatric backscatter under specific conditions, while heterogeneous phantoms provide more representative dosimetric references, improving BSF estimation and dose optimization.