Estrategias de afrontamiento que mejoran la depresión en pacientes con esclerosis múltiple, un instrumento para enfermería: revisión sistemática.

La esclerosis múltiple (EM) es una enfermedad crónica neurodegenerativa que no tiene cura. La depresión está presente en muchos pacientes con EM motivada entre otros factores por el carácter impredecible e incapacitante de la misma. Las estrategias de afrontamiento (EA) son un recurso personal que ha demostrado su eficacia en la reducción de los síntomas depresivos de estos enfermos. El objetivo principal de este trabajo es determinar las EA eficaces para manejar la depresión en los pacientes con EM. La búsqueda se llevó a cabo desde el mes de septiembre del 2019 hasta el mes de abril de 2020. Las fuentes de datos utilizadas fueron Pubmed, WOS y CUIDEN PLUS y se incluyeron artículos de acceso libre y gratuito en inglés y español publicados en los últimos 5 años tras la lectura de título y resumen. Las EA beneficiosas para tratar la depresión en pacientes con EM recogidas en este trabajo son: la medicina complementaria y alternativa, la búsqueda de apoyo a la religión, la aceptación de la enfermedad, el crecimiento, la restricción, la desconexión conductual, la reinterpretación positiva, la resolución de problemas y la búsqueda de apoyo social. Es posible que un asesoramiento sobre la eficacia de las mismas sea una intervención útil que ayude a los pacientes con EM que padecen depresión a cambiar su comportamiento de afrontamiento por uno más adaptativo y que sean los profesionales de enfermería los que jueguen un papel más relevante en el proceso

Inflationary and phase-transitional primordial magnetic fields in galaxy clusters

Primordial magnetic fields (PMFs) are possible candidates for explaining the observed magnetic fields in galaxy clusters. Two competing scenarios of primordial magnetogenesis have been discussed in the literature: inflationary and phase-transitional. We study the amplification of both large- and small-scale correlated magnetic fields, corresponding to inflation- and phase transition-generated PMFs, in a massive galaxy cluster. We employ high-resolution magnetohydrodynamic cosmological zoom-in simulations to resolve the turbulent motions in the intracluster medium. We find that the turbulent amplification is more efficient for the large-scale inflationary models, while the phase transition-generated seed fields show moderate growth. The differences between the models are imprinted on the spectral characteristics of the field (such as the amplitude and the shape of the magnetic power spectrum) and therefore on the final correlation length. We find a one order of magnitude difference between the final strengths of the inflation- and phase transition-generated magnetic fields, and a factor of 1.5 difference between their final coherence scales. Thus, the final configuration of the magnetic field retains information about the PMF generation scenarios. Our findings have implications for future extragalactic Faraday rotation surveys with the possibility of distinguishing between different magnetogenesis scenarios.Comment: 21 pages, 13 figures, comments welcom

Evolution of primordial magnetic fields during large-scale structure formation

Primordial magnetic fields could explain the large-scale magnetic fields present in the Universe. Inflation and phase transitions in the early Universe could give rise to such fields with unique characteristics. We investigate the magneto-hydrodynamic evolution of these magnetogenesis scenarios with cosmological simulations. We evolve inflation-generated magnetic fields either as (i) uniform (homogeneous) or as (ii) scale-invariant stochastic fields, and phase transition-generated ones either as (iii) helical or as (iv) non-helical fields from the radiation-dominated epoch. We find that the final distribution of magnetic fields in the simulated cosmic web shows a dependence on the initial strength and the topology of the seed field. Thus, the observed field configuration retains information on the initial conditions at the moment of the field generation. If detected, primordial magnetic field observations would open a new window for indirect probes of the early universe. The differences between the competing models are revealed on the scale of galaxy clusters, bridges, as well as filaments and voids. The distinctive spectral evolution of different seed fields produces imprints on the correlation length today. We discuss how the differences between rotation measures from highly ionized regions can potentially be probed with forthcoming surveys.Comment: 26 pages, 17 figures, comments welcom

Enter Culture, Exit Arts? The Transformation of Cultural Hierarchies in European Newspaper Culture Sections, 1960–2010

Peer reviewe

Noninvasive Assessment of Complexity of Atrial Fibrillation Correlation With Contact Mapping and Impact of Ablation

[EN] Background: It is difficult to noninvasively phenotype atrial fibrillation (AF) in a way that reflects clinical end points such as response to therapy. We set out to map electrical patterns of disorganization and regions of reentrant activity in AF from the body surface using electrocardiographic imaging, calibrated to panoramic intracardiac recordings and referenced to AF termination by ablation. Methods: Bi-atrial intracardiac electrograms of 47 patients with AF at ablation (30 persistent, 29 male, 63 +/- 9 years) were recorded with 64-pole basket catheters and simultaneous 57-lead body surface ECGs. Atrial epicardial electrical activity was reconstructed and organized sites were invasively and noninvasively tracked in 3-dimension using phase singularity. In a subset of 17 patients, sites of AF organization were targeted for ablation. Results: Body surface mapping showed greater AF organization near intracardially detected drivers than elsewhere, both in phase singularity density (2.3 +/- 2.1 versus 1.9 +/- 1.6; P=0.02) and number of drivers (3.2 +/- 2.3 versus 2.7 +/- 1.7; P=0.02). Complexity, defined as the number of stable AF reentrant sites, was concordant between noninvasive and invasive methods (r(2)=0.5; CC=0.71). In the subset receiving targeted ablation, AF complexity showed lower values in those in whom AF terminated than those in whom AF did not terminate (P<0.01). Conclusions: AF complexity tracked noninvasively correlates well with organized and disorganized regions detected by panoramic intracardiac mapping and correlates with the acute outcome by ablation. This approach may assist in bedside monitoring of therapy or in improving the efficacy of ongoing ablation procedures.This article was supported in part by: Instituto de Salud Carlos III FEDER (Fondo Europeo de Desarrollo Regional; IJCI-2014-22178, DTS16/00160; PI14/00857, PI16/01123; PI17/01059; PI17/01106), Generalitat Valenciana Grants (APOSTD/2017 and APOSTD/2018) and projects (GVA/2018/103); National Institutes of Health (Dr Narayan: R01 HL85537; K24 HL103800); EITHealth 19600 AFFINE.Rodrigo Bort, M.; Martínez Climent, BA.; Hernández-Romero, I.; Liberos Mascarell, A.; Baykaner, T.; Rogers, AJ.; Alhusseini, M.... (2020). Noninvasive Assessment of Complexity of Atrial Fibrillation Correlation With Contact Mapping and Impact of Ablation. Circulation Arrhythmia and Electrophysiology. 13(3):236-246. https://doi.org/10.1161/CIRCEP.119.007700S236246133Calkins H Hindricks G Cappato R Kim YH Saad EB Aguinaga L Akar JG Badhwar VBrugada J Camm J etal 2017 HRS/EHRA/ECAS/APHRS/SOLAECE expert consensusstatement on catheter and surgical ablation of atrial fibrillation: Executive summary. J Arrhythm.2017;33:369-409Narayan SM Krummen DE Clopton P Shivkumar K Miller JM. Direct or coincidentalelimination of stable rotors or focal sources may explain successful atrial fibrillation ablation:on-treatment analysis of the CONFIRM trial (Conventional ablation for AF with or without focalHaissaguerre M Hocini M Denis A Shah AJ Komatsu Y Yamashita S Daly M Amraoui SZellerhoff S Picat MQ etal. Driver domains in persistent atrial fibrillation. Circulation.2014;130:530-8.Atienza F Almendral J Ormaetxe JM Moya A Martínez-Alday JD Hernández-Madrid ACastellanos E Arribas F Arias MÁ Tercedor L etal. Comparison of radiofrequency catheterablation of drivers and circumferential pulmonary vein isolation in atrial fibrillation: aAtienza, F., Almendral, J., Ormaetxe, J. M., Moya, Á., Martínez-Alday, J. D., Hernández-Madrid, A., … Jalife, J. (2014). Comparison of Radiofrequency Catheter Ablation of Drivers and Circumferential Pulmonary Vein Isolation in Atrial Fibrillation. Journal of the American College of Cardiology, 64(23), 2455-2467. doi:10.1016/j.jacc.2014.09.053Seitz J Bars C Théodore G Beurtheret S Lellouche N Bremondy M Ferracci A Faure JPenaranda G Yamazaki M etal. AF Ablation Guided by Spatiotemporal ElectrogramDispersion Without Pulmonary Vein Isolation: A Wholly Patient-Tailored Approach. J Am CollGuillem MS Climent AM Millet J Arenal Á Fernández-Avilés F Jalife J Atienza FBerenfeld O. Noninvasive localization of maximal frequency sites of atrial fibrillation by bodysurface potential mapping. Circ Arrhythm Electrophysiol. 2013;6:294-301.Ramirez FD Birnie DH Nair GM Szczotka A Redpath CJ Sadek MM Nery PB. Efficacyand safety of driver-guided catheter ablation for atrial fibrillation: A systematic review and metaRamirez, F. D., Birnie, D. H., Nair, G. M., Szczotka, A., Redpath, C. J., Sadek, M. M., & Nery, P. B. (2017). Efficacy and safety of driver-guided catheter ablation for atrial fibrillation: A systematic review and meta-analysis. Journal of Cardiovascular Electrophysiology, 28(12), 1371-1378. doi:10.1111/jce.13313Baykaner T Rogers AJ Meckler GL Zaman J Navara R Rodrigo M Alhusseini MKowalewski CAB Viswanathan MN Narayan SM etal. Clinical Implications of Ablation ofDrivers for Atrial Fibrillation: A Systematic Review and Meta-Analysis. Circ ArrhythmBrachmann J Hummel JD Wilber DJ Sarver AE Rapkin J Shpun S Szili-Torok T.Prospective randomized comparison of rotor ablation vs. conventional ablation for treatment ofVijayakumar R Vasireddi SK Cuculich PS Faddis MN Rudy Y. MethodologyConsiderations in Phase Mapping of Human Cardiac Arrhythmias. Circ ArrhythmAlhusseini M Vidmar D Meckler GL Kowalewski CA Shenasa F Wang PJ Narayan SMRappel WJ. Two Independent Mapping Techniques Identify Rotational Activity Patterns at Sitesof Local Termination During Persistent Atrial Fibrillation. J Cardiovasc Electrophysiol.2017;28:615-622.Miller JM Kalra V Das MK Jain R Garlie JB Brewster JA Dandamudi G. Clinical Benefitof Ablating Localized Sources for Human Atrial Fibrillation: The Indiana University FIRMZaman JAB Baykaner T Clopton P Swarup V Kowal RC Daubert JP Day JD Hummel JSchricker AA Krummen DE etal. Recurrent Post-Ablation Paroxysmal Atrial FibrillationShares Substrates With Persistent Atrial Fibrillation: An 11-Center Study. JACC ClinYushkevich PA Zhang H Gee JC. Continuous medial representation for anatomicalstructures. IEEE Trans Med Imaging. 2006;25:1547-64.Remondino F. 3-D reconstruction of static human body shape from image sequence.Remondino, F. (2004). 3-D reconstruction of static human body shape from image sequence. Computer Vision and Image Understanding, 93(1), 65-85. doi:10.1016/j.cviu.2003.08.006Eggert DW Lorusso A Fish RB. Estimating 3-D rigid body transformations: a comparisonRodrigo M Guillem MS Climent AM Pedrón-Torrecilla J Liberos A Millet J FernándezRodrigo, M., Guillem, M. S., Climent, A. M., Pedrón-Torrecilla, J., Liberos, A., Millet, J., … Berenfeld, O. (2014). Body surface localization of left and right atrial high-frequency rotors in atrial fibrillation patients: A clinical-computational study. Heart Rhythm, 11(9), 1584-1591. doi:10.1016/j.hrthm.2014.05.013Rodrigo M Climent AM Liberos A Fernández-Avilés F Berenfeld O Atienza F GuillemMS. Highest dominant frequency and rotor positions are robust markers of driver location duringMS. Technical Considerations on Phase Mapping for Identification of Atrial Reentrant Activityin Direct- and Inverse-Computed Electrograms. Circ Arrhythm Electrophysiol.2017;10:e005008.Castells F Mora C Rieta JJ Moratal-Pérez D Millet J. Estimation of atrial fibrillatory wavefrom single-lead atrial fibrillation electrocardiograms using principal component analysisconcepts. Med Biol Eng Comput. 2005;43:557-560.Rodrigo M Climent AM Liberos A Hernandez-Romero I Arenal A Bermejo J FernandezAviles F Atienza F Guillem MS. Solving Inaccuracies in Anatomical Models forElectrocardiographic Inverse Problem Resolution by Maximizing Reconstruction Quality. IEEERodrigo, M., Climent, A. M., Liberos, A., Hernandez-Romero, I., Arenal, A., Bermejo, J., … Guillem, M. S. (2018). Solving Inaccuracies in Anatomical Models for Electrocardiographic Inverse Problem Resolution by Maximizing Reconstruction Quality. IEEE Transactions on Medical Imaging, 37(3), 733-740. doi:10.1109/tmi.2017.2707413Honarbakhsh S Schilling RJ Providência R Dhillon G Sawhney V Martin CA Keating EFinlay M Ahsan S Chow A etal. Panoramic atrial mapping with basket catheters: Aquantitative analysis to optimize practice patient selection and catheter choice. J CardiovascElectrophysiol. 201;28:1423-1432Knecht S Sohal M Deisenhofer I Albenque JP Arentz T Neumann T Cauchemez BDuytschaever M Ramoul K Verbeet T etal. Multicentre evaluation of non-invasive biatrialmapping for persistent atrial fibrillation ablation: the AFACART study. Europace.2017;19:1302-1309.Metzner A Wissner E Tsyganov A Kalinin V Schlüter M Lemes C Mathew S Maurer THeeger CH Reissmann B etal. Noninvasive phase mapping of persistent atrial fibrillation inhumans: Comparison with invasive catheter mapping. Ann Noninvasive Electrocardiol.2018;23:e12527.Duchateau J Sacher F Pambrun T Derval N Chamorro-Servent J Denis A Ploux S HociniM Jaïs P Bernus O etal. Performance and limitations of noninvasive cardiac activationDuchateau, J., Sacher, F., Pambrun, T., Derval, N., Chamorro-Servent, J., Denis, A., … Dubois, R. (2019). Performance and limitations of noninvasive cardiac activation mapping. Heart Rhythm, 16(3), 435-442. doi:10.1016/j.hrthm.2018.10.010Rudy Y. Letter to the Editor-ECG imaging and activation mapping. Heart Rhythm. 2019;16:e50-e.Podziemski P Zeemering S Kuklik P van Hunnik A Maesen B Maessen J Crijns HJWillems S Verma A Betts TR Murray S Neuzil P Ince H Steven D Sultan A Heck PMHall MC etal. Targeting Nonpulmonary Vein Sources in Persistent Atrial Fibrillation IdentifiedLim HS Hocini M Dubois R Denis A Derval N Zellerhoff S Yamashita S Berte BMahida S Komatsu Y etal. Complexity and Distribution of Drivers in Relation to Duration ofCamm AJ Breithardt G Crijns H Dorian P Kowey P Le Heuzey JY Merioua I PedrazziniL Prystowsky EN Schwartz PJ etal. Real-life observations of clinical outcomes with rhythmand rate-control therapies for atrial fibrillation RECORDAF (Registry on Cardiac RhythmCamm, A. J., Breithardt, G., Crijns, H., Dorian, P., Kowey, P., Le Heuzey, J.-Y., … Weintraub, W. (2011). Real-Life Observations of Clinical Outcomes With Rhythm- and Rate-Control Therapies for Atrial Fibrillation. Journal of the American College of Cardiology, 58(5), 493-501. doi:10.1016/j.jacc.2011.03.034Kowalewski CAB Shenasa F Rodrigo M Clopton P Meckler G Alhusseini MI SwerdlowMA Joshi V Hossainy S Zaman JAB etal. Interaction of Localized Drivers and DisorganizedActivation in Persistent Atrial Fibrillation: Reconciling Putative Mechanisms Using MultipleChelu MG King JB Kholmovski EG Ma J Gal P Marashly Q AlJuaid MA Kaur G SilverMA Johnson KA etal. Atrial Fibrosis by Late Gadolinium Enhancement Magnetic ResonanceImaging and Catheter Ablation of Atrial Fibrillation: 5-Year Follow-Up Data. J Am Heart Assoc.2018;7:e006313.Guillem MS Bollmann A Climent AM Husser D Millet-Roig J Castells F. How manyleads are necessary for a reliable reconstruction of surface potentials during atrial fibrillation?De la Salud Guillem, M., Bollmann, A., Climent, A. M., Husser, D., Millet-Roig, J., & Castells, F. (2009). How Many Leads Are Necessary for a Reliable Reconstruction of Surface Potentials During Atrial Fibrillation? IEEE Transactions on Information Technology in Biomedicine, 13(3), 330-340. doi:10.1109/titb.2008.2011894Rodrigo M Climent AM Liberos A Fernández-Aviles F Atienza F Guillem MS BerenfeldO. Minimal configuration of body surface potential mapping for discrimination of left versu

Combined treatment for at-risk drinking and smoking cessation among Puerto Ricans: A randomized clinical trial

Tobacco and alcohol use are linked behaviors that individually and synergistically increase the risk for negative health consequences. This study was a two-group, randomized clinical trial evaluating the efficacy of a behavioral intervention, “Motivation And Problem Solving Plus” (MAPS+), designed to concurrently address smoking cessation and the reduction of at-risk drinking. Targeted interventions may promote coaction, the likelihood that changing one behavior (smoking) increases the probability of changing another behavior (alcohol use). Puerto Ricans (N=202) who were smokers and at-risk drinkers were randomized to standard MAPS treatment focused exclusively on smoking cessation (S-MAPS), or MAPS+, focused on cessation and at-risk drinking reduction. Drinking outcomes included: number of at-risk drinking behaviors, heavy drinking, binge drinking, and drinking and driving. MAPS+ did not have a significant main effect on reducing at-risk drinking relative to S-MAPS. Among individuals who quit smoking, MAPS+ reduced the number of drinking behaviors, the likelihood of meeting criteria for heavy drinking relative to S-MAPS, and appeared promising for reducing binge drinking. MAPS+ did not improve drinking outcomes among individuals who were unsuccessful at quitting smoking. MAPS+ showed promise in reducing at-risk drinking among Puerto Rican smokers who successfully quit smoking, consistent with treatment enhanced coaction. Integrating an alcohol intervention into cessation treatment did not reduce engagement in treatment, or hinder cessation outcomes, and positively impacted at-risk drinking among individuals who quit smoking. Findings of coaction between smoking and drinking speak to the promise of multiple health behavior change interventions for substance use treatment and chronic disease prevention

Long-term survival in a child with severe encephalopathy, multiple respiratory chain deficiency and GFM1 mutations

BACKGROUND: Mitochondrial diseases due to deficiencies in the mitochondrial oxidative phosphorylation system (OXPHOS) can be associated with nuclear genes involved in mitochondrial translation, causing heterogeneous early onset and often fatal phenotypes. CASE REPORT: The authors describe the clinical features and diagnostic workup of an infant who presented with an early onset severe encephalopathy, spastic-dystonic tetraparesis, failure to thrive, seizures and persistent lactic acidemia. Brain imaging revealed thinning of the corpus callosum and diffuse alteration of white matter signal. Genetic investigation confirmed two novel mutations in the GFM1 gene, encoding the mitochondrial translation elongation factor G1 (mtEFG1), resulting in combined deficiencies of OXPHOS. DISCUSSION: The patient shares multiple clinical, laboratory and radiological similarities with the 11 reported patients with mutations involving this gene, but presents with a stable clinical course without metabolic decompensations, rather than a rapidly progressive fatal course. Defects in GFM1 gene confer high susceptibility to neurologic or hepatic dysfunction and this is, to the best of our knowledge, the first described patient who has survived beyond early childhood. Reporting of such cases is essential so as to delineate the key clinical and neuroradiological features of this disease and provide a more comprehensive view of its prognosis

Palaeogenomics of Upper Palaeolithic to Neolithic European hunter-gatherers

Modern humans have populated Europe for more than 45,000 years. Our knowledge of the genetic relatedness and structure of ancient hunter-gatherers is however limited, owing to the scarceness and poor molecular preservation of human remains from that period. Here we analyse 356 ancient hunter-gatherer genomes, including new genomic data for 116 individuals from 14 countries in western and central Eurasia, spanning between 35,000 and 5,000 years ago. We identify a genetic ancestry profile in individuals associated with Upper Palaeolithic Gravettian assemblages from western Europe that is distinct from contemporaneous groups related to this archaeological culture in central and southern Europe, but resembles that of preceding individuals associated with the Aurignacian culture. This ancestry profile survived during the Last Glacial Maximum (25,000 to 19,000 years ago) in human populations from southwestern Europe associated with the Solutrean culture, and with the following Magdalenian culture that re-expanded northeastward after the Last Glacial Maximum. Conversely, we reveal a genetic turnover in southern Europe suggesting a local replacement of human groups around the time of the Last Glacial Maximum, accompanied by a north-to-south dispersal of populations associated with the Epigravettian culture. From at least 14,000 years ago, an ancestry related to this culture spread from the south across the rest of Europe, largely replacing the Magdalenian-associated gene pool. After a period of limited admixture that spanned the beginning of the Mesolithic, we find genetic interactions between western and eastern European hunter-gatherers, who were also characterized by marked differences in phenotypically relevant variants.Open access funding provided by Max Planck Society. This project has received funding by the European Research Council under the European Union’s Horizon 2020 research and innovation programme under grant agreements no. 803147-RESOLUTION (to S.T.), no. 771234-PALEoRIDER (to W.H.), no. 864358 (to K.M.), no. 724703 and no. 101019659 (to K.H.). K.H. is also supported by the Deutsche Forschungsgemeinschaft (DFG FOR 2237). E.A. has received funding from the Van de Kamp fonds. PACEA co-authors of this research benefited from the scientific framework of the University of Bordeaux’s IdEx Investments for the Future programme/GPR Human Past. A.G.-O. is supported by a Ramón y Cajal fellowship (RYC-2017-22558). L. Sineo, M.L. and D.C. have received funding from the Italian Ministry of University and Research (MUR) PRIN 2017 grants 20177PJ9XF and 20174BTC4R_002. H. Rougier received support from the College of Social and Behavioral Sciences of CSUN and the CSUN Competition for RSCA Awards. C.L.S. and T. Saupe received support from the European Union through the European Regional Development Fund (project no. 2014-2020.4.01.16-0030) and C.L.S. received support from the Estonian Research Council grant PUT (PRG243). S. Shnaider received support from the Russian Science Foundation (no. 19-78-10053).Peer reviewe

Causes and Consequences of Political Clientelism: Mexico's PRD in Comparative Perspective

PRD politicians and officials widely use clientelism to structure their relationships with citizens. This is not only due to the entrenchment of clientelism in Mexican politics, or to high rates of poverty and inequality, but also to the limited institutionalization of democratic rules inside the party. The latter stems largely from the party’s electoral strategy in its formative years and has resulted in uncontrolled factional battles that play out through clientelism. The Brazilian PT faced external and internal conditions quite similar to those of the PRD, but its early focus on organization building and policy change allowed it to avoid clientelism to a greater degree. The analysis problematizes the trend of using minimalist definitions that assume clientelism to be non-democratic because these result in conceptual stretching and decreased explanatory power