RECOMENDACIONES DE EXPERTOS POR EXPERIENCIA PARA LA PROMOCIÓN DE LA SALUD MENTAL Y EL BIENESTAR PSICOSOCIAL EN TIEMPOS DE PANDEMIA

Estudio cualitativo con enfoque fenomenológico que surge de la necesidad de contar con experiencias y recomendaciones para la promoción de salud mental y bienestar psicosocial en personas diagnosticadas con patología psiquiátrica, desde expertos por experiencia, durante el periodo de aislamiento por pandemia COVID-19. El objetivo del artículo es sintetizar estrategias para promoción de Salud Mental y Bienestar Psicosocial de personas diagnosticadas con patología psiquiátrica, utilizadas por expertos por experiencia. Con respecto a la metodología, se trabajó con tres expertos por experiencia que participaran como acompañantes terapéuticos en Unidades de Salud Mental, donde no se hubieran presentado casos de reagudizaciones que requirieran hospitalización. Se realizaron focus group y entrevistas en profundidad, que fueron sometidas a análisis de contenido, obteniéndose seis categorías: planificación de rutina diaria; realización de actividades recreativas; mantener actitud optimista; recibir información útil y de fuentes confiables; activar red de apoyo social y reconocimiento y manejo del estrés. Estas recomendaciones fueron validadas posteriormente por los expertos por experiencia. Los principales resultados dan cuenta que las estrategias para la promoción de salud mental y bienestar psicosocial utilizadas por expertos por experiencia concuerdan con estrategias descritas en la literatura. Los expertos por experiencia dan valor a mantener una actitud optimista, centrándose en las habilidades desarrolladas por las personas, como el reconocimiento de sus habilidades para enfrentar las dificultades y el sentido del humor

A trail of dark-matter-free galaxies from a bullet-dwarf collision

The ultra-diffuse galaxies DF2 and DF4 in the NGC 1052 group share several unusual properties: they both have large sizes1, rich populations of overluminous and large globular clusters2–6, and very low velocity dispersions that indicate little or no dark matter7–10. It has been suggested that these galaxies were formed in the aftermath of high-velocity collisions of gas-rich galaxies11–13, events that resemble the collision that created the bullet cluster14 but on much smaller scales. The gas separates from the dark matter in the collision and subsequent star formation leads to the formation of one or more dark-matter-free galaxies12. Here we show that the present-day line-of-sight distances and radial velocities of DF2 and DF4 are consistent with their joint formation in the aftermath of a single bullet-dwarf collision, around eight billion years ago. Moreover, we find that DF2 and DF4 are part of an apparent linear substructure of seven to eleven large, low-luminosity objects. We propose that these all originated in the same event, forming a trail of dark-matter-free galaxies that is roughly more than two megaparsecs long and angled 7° ± 2° from the line of sight. We also tentatively identify the highly dark-matter-dominated remnants of the two progenitor galaxies that are expected11 at the leading edges of the trail

Monochromatic globular clusters as a critical test of formation models for the dark matter deficient galaxies NGC1052-DF2 and NGC1052-DF4

It was recently proposed that the dark matter-deficient ultra-diffuse galaxies DF2 and DF4 in the NGC1052 group could be the products of a "bullet dwarf" collision between two gas-rich progenitor galaxies. In this model DF2 and DF4 formed at the same time in the immediate aftermath of the collision, and a strong prediction is that their globular clusters should have nearly identical stellar populations. Here we test this prediction by measuring accurate F606W-F814W colors from deep HST/ACS imaging. We find that the clusters are extremely homogeneous. The mean color difference between the globular clusters in DF2 and DF4 is $-0.003\pm 0.005$ mag and the observed scatter for the combined sample of 18 clusters with $M_V<-8.6$ in both galaxies is $0.015 \pm 0.002$ mag. After accounting for observational uncertainties and stochastic cluster-to-cluster variation in the number of red giants, the remaining scatter is $0.008^{+0.005}_{-0.006}$ mag. Both the color difference and the scatter are an order of magnitude smaller than in other dwarf galaxies, and we infer that the bullet scenario passes an important test that could have falsified it. No other formation models have predicted this extreme uniformity of the globular clusters in the two galaxies. We find that the galaxies themselves are slightly redder than the clusters, consistent with a previously-measured metallicity difference. Numerical simulations have shown that such differences are expected in the bullet scenario, as the galaxies continued to self-enrich after the formation of the globular clusters.Comment: Submitted to the AAS corridor (ApJ Letters or ApJ). It is difficult to visualize the uniformity of these strange clusters. Our best attempt is Fig. 2, where we compare them to globular clusters in Virgo galaxie

Tidal Distortions in NGC1052-DF2 and NGC1052-DF4: Independent Evidence for a Lack of Dark Matter

Two ultra diffuse galaxies in the same group, NGC1052-DF2 and NGC1052-DF4, have been found to have little or no dark matter and to host unusually luminous globular cluster populations. Such low mass diffuse objects in a group environment are easily disrupted and are expected to show evidence of tidal distortions. In this work we present deep new imaging of the NGC1052 group obtained with the Dragonfly Telephoto Array to test this hypothesis. We find that both galaxies show strong position angle twists and are significantly more elongated in their outskirts than in their interiors. The group's central massive elliptical NGC1052 is the most likely source of these tidal disturbances. The observed distortions imply that the galaxies have a low total mass or are very close to NGC1052. Considering constraints on the galaxies' relative distances, we infer that the dark matter halo masses of these galaxies cannot be much greater than their stellar masses. Calculating pericenters from the distortions, we find that the galaxies are on highly elliptical orbits, with a ratio of pericenter to present-day radius Rperi/R0~0.1 if the galaxies are dark matter-free and Rperi/R0~0.01 if they have a normal dark halo. Our findings provide strong evidence, independent of kinematic constraints, that both galaxies are dark matter deficient. Furthermore, the similarity of the tidal features in NGC1052-DF2 and NGC1052-DF4 strongly suggests that they arose at comparable distances from NGC1052. In Appendix A, we describe sbcontrast, a robust method to determine the surface brightness limits of images.Comment: Resubmitted to ApJ after incorporating the referee's comments. The revised version includes a new Appendix A which describes sbcontrast, a method for determining the surface brightness depth of image

A candidate runaway supermassive black hole identified by shocks and star formation in its wake

The interaction of a runaway supermassive black hole (SMBH) with the circumgalactic medium (CGM) can lead to the formation of a wake of shocked gas and young stars behind it. Here we report the serendipitous discovery of an extremely narrow linear feature in HST/ACS images that may be an example of such a wake. The feature extends 62 kpc from the nucleus of a compact star-forming galaxy at z=0.964. Keck LRIS spectra show that the [OIII]/H$\beta$ ratio varies from ~1 to ~10 along the feature, indicating a mixture of star formation and fast shocks. The feature terminates in a bright [OIII] knot with a luminosity of 1.9x10$^{41}$ ergs/s. The stellar continuum colors vary along the feature, and are well-fit by a simple model that has a monotonically increasing age with distance from the tip. The line ratios, colors, and the overall morphology are consistent with an ejected SMBH moving through the CGM at high speed while triggering star formation. The best-fit time since ejection is ~39 Myr and the implied velocity is v~1600 km/s. The feature is not perfectly straight in the HST images, and we show that the amplitude of the observed spatial variations is consistent with the runaway SMBH interpretation. Opposite the primary wake is a fainter and shorter feature, marginally detected in [OIII] and the rest-frame far-ultraviolet. This feature may be shocked gas behind a binary SMBH that was ejected at the same time as the SMBH that produced the primary wake.Comment: Accepted for publication in ApJ Letters. The key data are in Figure 1: a really odd thin streak in HST images, with a complex emission line spectrum. Figure 7 is an illustration of our proposed interpretatio

Combined Forward-Backward Asymmetry Measurements in Top-Antitop Quark Production at the Tevatron

The CDF and D0 experiments at the Fermilab Tevatron have measured the asymmetry between yields of forward- and backward-produced top and antitop quarks based on their rapidity difference and the asymmetry between their decay leptons. These measurements use the full data sets collected in proton-antiproton collisions at a center-of-mass energy of $\sqrt s =1.96$ TeV. We report the results of combinations of the inclusive asymmetries and their differential dependencies on relevant kinematic quantities. The combined inclusive asymmetry is $A_{\mathrm{FB}}^{t\bar{t}} = 0.128 \pm 0.025$. The combined inclusive and differential asymmetries are consistent with recent standard model predictions

Canagliflozin and renal outcomes in type 2 diabetes and nephropathy

BACKGROUND Type 2 diabetes mellitus is the leading cause of kidney failure worldwide, but few effective long-term treatments are available. In cardiovascular trials of inhibitors of sodium–glucose cotransporter 2 (SGLT2), exploratory results have suggested that such drugs may improve renal outcomes in patients with type 2 diabetes. METHODS In this double-blind, randomized trial, we assigned patients with type 2 diabetes and albuminuric chronic kidney disease to receive canagliflozin, an oral SGLT2 inhibitor, at a dose of 100 mg daily or placebo. All the patients had an estimated glomerular filtration rate (GFR) of 30 to &lt;90 ml per minute per 1.73 m2 of body-surface area and albuminuria (ratio of albumin [mg] to creatinine [g], &gt;300 to 5000) and were treated with renin–angiotensin system blockade. The primary outcome was a composite of end-stage kidney disease (dialysis, transplantation, or a sustained estimated GFR of &lt;15 ml per minute per 1.73 m2), a doubling of the serum creatinine level, or death from renal or cardiovascular causes. Prespecified secondary outcomes were tested hierarchically. RESULTS The trial was stopped early after a planned interim analysis on the recommendation of the data and safety monitoring committee. At that time, 4401 patients had undergone randomization, with a median follow-up of 2.62 years. The relative risk of the primary outcome was 30% lower in the canagliflozin group than in the placebo group, with event rates of 43.2 and 61.2 per 1000 patient-years, respectively (hazard ratio, 0.70; 95% confidence interval [CI], 0.59 to 0.82; P=0.00001). The relative risk of the renal-specific composite of end-stage kidney disease, a doubling of the creatinine level, or death from renal causes was lower by 34% (hazard ratio, 0.66; 95% CI, 0.53 to 0.81; P&lt;0.001), and the relative risk of end-stage kidney disease was lower by 32% (hazard ratio, 0.68; 95% CI, 0.54 to 0.86; P=0.002). The canagliflozin group also had a lower risk of cardiovascular death, myocardial infarction, or stroke (hazard ratio, 0.80; 95% CI, 0.67 to 0.95; P=0.01) and hospitalization for heart failure (hazard ratio, 0.61; 95% CI, 0.47 to 0.80; P&lt;0.001). There were no significant differences in rates of amputation or fracture. CONCLUSIONS In patients with type 2 diabetes and kidney disease, the risk of kidney failure and cardiovascular events was lower in the canagliflozin group than in the placebo group at a median follow-up of 2.62 years

Canagliflozin and Cardiovascular and Renal Outcomes in Type 2 Diabetes Mellitus and Chronic Kidney Disease in Primary and Secondary Cardiovascular Prevention Groups

Background: Canagliflozin reduces the risk of kidney failure in patients with type 2 diabetes mellitus and chronic kidney disease, but effects on specific cardiovascular outcomes are uncertain, as are effects in people without previous cardiovascular disease (primary prevention). Methods: In CREDENCE (Canagliflozin and Renal Events in Diabetes With Established Nephropathy Clinical Evaluation), 4401 participants with type 2 diabetes mellitus and chronic kidney disease were randomly assigned to canagliflozin or placebo on a background of optimized standard of care. Results: Primary prevention participants (n=2181, 49.6%) were younger (61 versus 65 years), were more often female (37% versus 31%), and had shorter duration of diabetes mellitus (15 years versus 16 years) compared with secondary prevention participants (n=2220, 50.4%). Canagliflozin reduced the risk of major cardiovascular events overall (hazard ratio [HR], 0.80 [95% CI, 0.67-0.95]; P=0.01), with consistent reductions in both the primary (HR, 0.68 [95% CI, 0.49-0.94]) and secondary (HR, 0.85 [95% CI, 0.69-1.06]) prevention groups (P for interaction=0.25). Effects were also similar for the components of the composite including cardiovascular death (HR, 0.78 [95% CI, 0.61-1.00]), nonfatal myocardial infarction (HR, 0.81 [95% CI, 0.59-1.10]), and nonfatal stroke (HR, 0.80 [95% CI, 0.56-1.15]). The risk of the primary composite renal outcome and the composite of cardiovascular death or hospitalization for heart failure were also consistently reduced in both the primary and secondary prevention groups (P for interaction &gt;0.5 for each outcome). Conclusions: Canagliflozin significantly reduced major cardiovascular events and kidney failure in patients with type 2 diabetes mellitus and chronic kidney disease, including in participants who did not have previous cardiovascular disease

The role of resistin and myeloperoxidase in severe sepsis and septic shock: results from the ALBIOS trial

Background: Inflammatory biomarkers are useful in detecting patients with sepsis. The prognostic role of resistin and myeloperoxidase (MPO) has been investigated in sepsis. Materials and methods: Plasma resistin and MPO were measured on days 1, 2, and 7 in 957 patients enrolled in the Albumin Italian Outcome Sepsis (ALBIOS) trial. The association between resistin and MPO levels on day 1, 2, and 7 and 90-day mortality was assessed. Results: Plasma resistin and MPO concentrations were higher at day 1 and decreased until day 7. Both biomarkers were positively correlated to each other and with physiological parameters. Higher levels of resistin and MPO on day 1 were associated with the development of new organ failures. Patients experiencing death at 90 days showed higher levels of resistin or MPO compared to survivors. At day 1, only MPO in the 4th quartile (Q4), but not resistin, was found to predict 90-day death (adjusted hazard ratio [aHR] 1.55 vs. Q1). At day 2, resistin in the 3rd and 4th quartiles predicted a &gt;40% increase in mortality as also did MPO in the 4th quartile. On day 7, Q4 resistin was able to predict 90-day mortality, while all quartiles of MPO were not. Conclusions: High levels of MPO, but not of resistin, on day 1 were able to predict 90-day mortality. These findings may either suggest that early hyper-activation of neutrophils is detrimental in patients with sepsis or reflect the burden of the inflammatory process caused by sepsis (ALBIOS ClinicalTrials.gov Identifier: NCT00707122)

Whole-Genome-Based Phylogeny and Divergence of the Genus Brucella▿ †

Brucellae are worldwide bacterial pathogens of livestock and wildlife, but phylogenetic reconstructions have been challenging due to limited genetic diversity. We assessed the taxonomic and evolutionary relationships of five Brucella species—Brucella abortus, B. melitensis, B. suis, B. canis, and B. ovis—using whole-genome comparisons. We developed a phylogeny using single nucleotide polymorphisms (SNPs) from 13 genomes and rooted the tree using the closely related soil bacterium and opportunistic human pathogen, Ochrobactrum anthropi. Whole-genome sequencing and a SNP-based approach provided the requisite level of genetic detail to resolve species in the highly conserved brucellae. Comparisons among the Brucella genomes revealed 20,154 orthologous SNPs that were shared in all genomes. Rooting with Ochrobactrum anthropi reveals that the B. ovis lineage is basal to the rest of the Brucella lineage. We found that B. suis is a highly divergent clade with extensive intraspecific genetic diversity. Furthermore, B. suis was determined to be paraphyletic in our analyses, only forming a monophyletic clade when the B. canis genome was included. Using a molecular clock with these data suggests that most Brucella species diverged from their common B. ovis ancestor in the past 86,000 to 296,000 years, which precedes the domestication of their livestock hosts. Detailed knowledge of the Brucella phylogeny will lead to an improved understanding of the ecology, evolutionary history, and host relationships for this genus and can be used for determining appropriate genotyping approaches for rapid detection and diagnostic assays for molecular epidemiological and clinical studies