Transoesophageal echocardiography beyond the Echo-Laboratory. An expert consensus paper of the working group of echocardiography of the Hellenic Society of Cardiology.

Transoesophageal echocardiography (TOE) is a well-established and valid imaging modality, providing more accurate and of higher quality information than transthoracic echocardiography (TTE) for several specific diagnoses and recently a useful guide of an increasing number of catheter-based and surgical interventions. The present paper represents an effort by the Echocardiography Working Group (WG) of the Hellenic Society of Cardiology to state the essential steps of the TOE exam performed beyond the echo lab: a) in the operating rooms intraoperatively during either transcatheter interventions, or cardiothoracic surgery and b) in the intensive care unit for critically ill patients' monitoring. This paper includes information and tips and tricks about the pre-procedural evaluation, the procedural echocardiographic guidance and post - procedural evaluation of the result and potential complications.

Quantification and Mechanistic Investigation of the Spontaneous H2O2 Generation at the Interfaces of Salt-Containing Aqueous Droplets.

There is now much evidence that OH radicals and H2O2 are spontaneously generated at the air-water interface of atmospheric aerosols. Here, we investigated the effect of halide anions (Cl-, Br-, I-), which are abundant in marine aerosols, on this H2O2 production. Droplets were generated via nebulization of water solutions containing Na2SO4, NaCl, NaBr, and NaI containing solutions, and H2O2 was monitored as a function of the salt concentration under atmospheric relevant conditions. The interfacial OH radical formation was also investigated by adding terephthalic acid (TA) to our salt solutions, and the product of its reaction with OH, hydroxy terephthalic acid (TAOH), was monitored. Finally, a mechanistic investigation was performed to examine the reactions participating in H2O2 production, and their respective contributions were quantified. Our results showed that only Br- contributes to the interfacial H2O2 formation, promoting the production by acting as an electron donor, while Na2SO4 and NaCl stabilized the droplets by only reducing their evaporation. TAOH was observed in the collected droplets and, for the first time, directly in the particle phase by means of online fluorescence spectroscopy, confirming the interfacial OH production. A mechanistic study suggests that H2O2 is formed by both OH and HO2 self-recombination, as well as HO2 reaction with H atoms. This work is expected to enhance our understanding of interfacial processes and assess their impact on climate, air quality, and health.

Frequency of sexual dysfunction in outpatients with severe mental illness in Greece.

Introduction: Patients with psychosis can develop sexual dysfunction, which may be related to the disease itself, psychosocial factors, somatic comorbidities, and the use of psychotropic medication. Objective: We aimed to investigate the type and frequency of sexual dysfunction in patients diagnosed with schizophrenia or bipolar disorder in order to assess the side effects of antipsychotics in sexual function. Methods: This is a multicenter, cross-sectional study, involving patients diagnosed with schizophrenia (79.3%) or bipolar disorder (20.7%) treated in the Department of Psychiatry and Community Mental Health Centers from November 2018 to December 2019. Patients were enrolled in the study after signed informed consent. Demographic and clinical data were collected from patients through a semi-structured interview. The Antipsychotics and Sexual Functioning Questionnaire (ASFQ) was administered to assess sexual function. Results: A total of 87 outpatients on antipsychotics were recruited in the study. The mean age was 43.6 years, while the mean duration of the disease was 16.9 years. Overall, only 9.1% of patients spontaneously reported sexual dysfunction. Patients treated with oral first-generation antipsychotics had more difficulties in achieving orgasm and decreased erection capacity. In contrast, patients treated with oral second-generation antipsychotics had decreased ejaculation capacity. Patients on antipsychotic combination therapy were associated with higher rates of sexual anhedonia. Discussion: These results suggest that sexual dysfunction is a side effect of antipsychotic treatment, which was spontaneously rarely reported by patients. It seems essential to obtain a psychosexual clinical history before initiating antipsychotic treatment to evaluate following changes and adopt an individualized strategy to manage sexual dysfunction induced by antipsychotics.

Spontaneous dark formation of OH radicals at the interface of aqueous atmospheric droplets.

Hydroxyl radical (OH) is a key oxidant that triggers atmospheric oxidation chemistry in both gas and aqueous phases. The current understanding of its aqueous sources is mainly based on known bulk (photo)chemical processes, uptake from gaseous OH, or related to interfacial O3 and NO3 radical-driven chemistry. Here, we present experimental evidence that OH radicals are spontaneously produced at the air-water interface of aqueous droplets in the dark and the absence of known precursors, possibly due to the strong electric field that forms at such interfaces. The measured OH production rates in atmospherically relevant droplets are comparable to or significantly higher than those from known aqueous bulk sources, especially in the dark. As aqueous droplets are ubiquitous in the troposphere, this interfacial source of OH radicals should significantly impact atmospheric multiphase oxidation chemistry, with substantial implications on air quality, climate, and health.

Translation and Validation of the Greek Version of the Antipsychotics and Sexual Functioning Questionnaire (ASFQ).

INTRODUCTION: Sexual dysfunction in patients with psychoses may be associated with the psychiatric illness itself (negative symptoms, such as apathy, and avolition), comorbid somatic health, psychosocial factors (stigmatization, discrimination), and the use of psychotropic drugs. In Greece, research into the study of antipsychotic-induced sexual dysfunction is not sufficient. AIM: This study was conducted to translate and validate the Greek version of the Antipsychotics and Sexual Functioning Questionnaire (ASFQ) in a sample of patients receiving antipsychotic treatment. METHODS: A "forward-backward translation" method was applied. A pilot study was conducted with 15 outpatients with schizophrenia and bipolar disorder under antipsychotics treatment. Patients also completed the "Subjects' Response to Antipsychotics (SRA)" questionnaire in order to assess the validity of the ASFQ. The ASFQ and the SRA questionnaire were completed twice within 2 weeks. MAIN OUTCOME MEASURES: Reliability (internal consistency and test-retest) and validity were assessed. RESULTS: The Greek translation of ASFQ was reliable, with excellent internal consistency (Cronbach's a = 0.90 for men and 0.95 for women in both measurements). In addition, the Spearman correlation coefficient was 1 (P< .001) in all Likert-type questions in both assessments. Finally, Spearman correlation coefficients between ASFQ and SRA were moderately positive to strongly positive (between 0.25 and 1) in both assessments, demonstrating moderate to high validity. CONCLUSIONS: The Greek version of the ASFQ has proved to be a reliable and valid clinical instrument, hence it can be used in further studies in the Greek population. Angelaki M, Galanis P, Igoumenou A, et al. Translation and Validation of the Greek Version of the Antipsychotics and Sexual Functioning Questionnaire (ASFQ). J Sex Med 2021;9:100334.

Development and validation of a thermally regulated atmospheric simulation chamber (THALAMOS): A versatile tool to simulate atmospheric processes.

Atmospheric simulation chambers, are unique tools for investigating atmospheric processes in the gas and heterogeneous phases. They can provide a controlled yet realistic environment that simulates atmospheric conditions. In the current study, a Teflon atmospheric simulation chamber of 600 L, named THALAMOS (thermally regulated atmospheric simulation chamber) has been developed and cross-validated. THALAMOS can be operated over the temperature range 233 to 373 K under both static and flow conditions. It is equipped with state of the art instrumentation (selective ion flow tube mass spectrometry (SIFT-MS), long path Fourier transform infrared spectroscopy (FTIR), gas chromatography-mass spectrometry (GC-MS), various analyzers) for the in-line monitoring of both reactants and products. THALAMOS was validated by measuring the rate coefficients of well documented reactions, i.e. the reaction of ethanol with OH radicals and the reaction of dichloromethane with Cl atoms, in a wide temperature range. Two different detection techniques were used in parallel, FTIR and SIFT-MS, to internally cross-validate the obtained results. The measured rate coefficients are in excellent agreement, both between each other and with the literature recommended values. Furthermore, the gas phase oxidation of toluene by Cl atoms (kinetics and product yields) was studied in the temperature range of 253 to 333 K. To the best of our knowledge, THALAMOS is a unique facility on national level and among a few smog chambers internationally that can be operated in such a wide temperature range providing the scientific community with a versatile tool to simulate both outdoor and indoor physicochemical processes.