Atrial Fibrillation in Congenital Heart Disease

The increasing prevalence of AF in a growing population of adults with congenital heart disease (CHD) poses new challenges to clinicians involved in the management of these patients. Distinctive underlying anatomies, unique physiological aspects, a high diversity of corrective surgeries and associated comorbidities can complicate clinical decision-making. In this review, the authors provide an overview of the current knowledge on epidemiology and pathophysiology, with a special focus on the differences to the non-CHD population and the clinical impact of AF in adults with CHD. Acute and long-term management strategies are summarised, including the use of antiarrhythmic drugs, catheter or surgical ablation and prophylaxis of thromboembolism. Finally, gaps of knowledge and potential areas of future research are highlighted

A terapia antiplaquetária na alta hospitalar e prognóstico a longo prazo na síndrome de Takotsubo: dados do Registro Nacional Espanhol (RETAKO)

Síndrome de Takotsubo; Disfunción endotelial; Tratamiento antiplaquetarioSíndrome de Takotsubo; Disfunció endotelial; Tractament antiplaquetariTakotsubo syndrome; Endothelial dysfunction; Antiplatelet treatmentIntroduction Endothelial dysfunction and platelet activation have been highlighted as possible mediators in Takotsubo syndrome (TTS). Nevertheless, to date, evidence on the usefulness of antiplatelet therapy in TTS remains controversial. The aim of our study is to evaluate long-term prognosis in TTS patients treated with antiplatelet therapy (APT) at hospitalization discharge. Material and methods An ambispective cohort study from the Spanish National Takotsubo Registry database was performed (June 2002 to March 2017). Patients were divided into two groups: those who received APT at hospital discharge (APT cohort) and those who did not (non-APT cohort). Primary endpoint was all-cause death. Secondary endpoints included the composite of recurrence or readmission and a composite of death, recurrence or readmission. Results From a total of 741 patients, 728 patients were alive at discharge. Follow-up was performed in 544 patients, who were included in the final analysis: 321 patients (59.0%) in the APT cohort and 223 patients (41.0%) in the non-APT cohort. The APT cohort had a better clinical presentation and received more heart failure and acute coronary syndrome-like therapies (angiotensin converting enzyme inhibitors/angiotensin receptor blockers: 75.1% vs. 51.1%; p<0.001, betablockers: 71.3% vs. 50.7%; p<0.001, statins: 67.9% vs. 33.2%; p<0.001). After adjusting for confounder factors, APT at discharge was a protective factor for all-cause death (adjusted hazard ratio (HR) 0.315, 95% confidence interval (CI): 0.106-0.943; p=0.039) and the composite endpoint of all-cause death, recurrence or readmission (adjusted HR 0.318, 95% CI: 0.164-0.619; p=0.001) at month 25 of follow-up. Conclusion Patients with TTS receiving APT at discharge presented better prognosis up to two-years of follow-up compared with their counterparts not receiving APT

Making city in the "non-city" : the integration of irregular settlements in Andalusia. A case study

The problems associated with numerous irregular buildings existing in Andalucia today, demands a new approach. In order to deepen the definition of strategies of urbano-territorial integration of these settlements, we present a case study in which, at the end of its implementation in agent-based simulation models, we summarize the ODD Protocol which will form the basis of the simulation, indicating the determining factors to consider for an effective and participatory planning, that minimize the progressive estrangement between the normative framework and the reality that is tried to order

Network-based analysis reveals differences in plant assembly between the native and the invaded ranges

Associated with the introduction of alien species in a new area, interactions with other native species within the recipient community occur, reshaping the original community and resulting in a unique assemblage. Yet, the differences in community assemblage between native and invaded ranges remain unclear. Mediterranean grasslands provide an excellent scenario to study community assembly following transcontinental naturalisation of plant species. Here, we compared the community resemblance of plant communities in Mediterranean grasslands from both the native (Spain) and invaded (Chile) ranges. We used a novel approach, based on network analysis applied to co-occurrence analysis in plant communities, allowing us to study the co-existence of native and alien species in central Chile. This useful methodology is presented as a step forward in invasion ecology studies and conservation strategies. We found that community structure differed between the native and the invaded range, with alien species displaying a higher number of connections and, therefore, acting as keystones to sustain the structure within the invaded community. Alien species acting like keystones within the Chilean grassland communities might exacerbate the threat posed by biological invasions for the native biodiversity assets. Controlling the spread of the alien species identified here as keystones should help managing potential invasion in surrounding areas. Network analyses is a free, easy-to-implement and straightforward visual tool that can be widely used to reveal shifts in native communities and elucidate the role of multiple invaders into communitie

Making city in the "Non-City": the integration of irregular settlements in Andalusia. A case study

The problems associated with numerous irregular buildings existing in Andalucia today, demands a new approach. In order to deepen the definition of strategies of urbano-territorial integration of these settlements, we present a case study in which, at the end of its implementation in agent-based simulation models, we summarize the ODD Protocol which will form the basis of the simulation, indicating the determining factors to consider for an effective and participatory planning, that minimize the progressive estrangement between the normative framework and the reality that is tried to order.

Ecotypic differentiation and phenotypic plasticity combine to enhance the invasiveness of the most widespread daisy in Chile, Leontodon saxatilis

Dispersal and reproductive traits of successful plant invaders are expected to undergo strong selection during biological invasions. Numerous Asteraceae are invasive and display dimorphic fruits within a single flower head, resulting in differential dispersal pathways - wind-dispersed fruits vs. nondispersing fruits. We explored ecotypic differentiation and phenotypic plasticity of seed output and fruit dimorphisms in exotic Chilean and native Spanish populations of Leontodon saxatilis subsp. rothii. We collected flower heads from populations in Spain and Chile along a rainfall gradient. Seeds from all populations were planted in reciprocal transplant trials in Spain and Chile to explore their performance in the native and invasive range. We scored plant biomass, reproductive investment and fruit dimorphism. We observed strong plasticity, where plants grown in the invasive range had much greater biomass, flower head size and seed output, with a higher proportion of wind-dispersed fruits, than those grown in the native range. We also observed a significant ecotype effect, where the exotic populations displayed higher proportions of wind-dispersed fruits than native populations. Together, these patterns reflect a combination of phenotypic plasticity and ecotypic differentiation, indicating that Leontodon saxatilis has probably increased propagule pressure and dispersal distances in its invasive range to enhance its invasiveness

The invasiveness of Hypochaeris glabra (Asteraceae): Responses in morphological and reproductive traits for exotic populations

Scientists have been interested in many topics driven by biological invasions, such as shifts in the area of distribution of plant species and rapid evolution. Invasiveness of exotic plant species depends on variations on morphological and reproductive traits potentially associated with reproductive fitness and dispersal ability, which are expected to undergo changes during the invasion process. Numerous Asteraceae are invasive and display dimorphic fruits, resulting in a bet-hedging dispersal strategy ±wind-dispersed fruits versus animal-dispersed fruits±. We explored phenotypic differentiation in seed morphology and reproductive traits of exotic (Chilean) and native (Spanish) populations of Hypochaeris glabra. We collected flower heads from five Spanish and five Chilean populations along rainfall gradients in both countries. We planted seeds from the ten populations in a common garden trial within the exotic range to explore their performance depending on the country of origin (native or exotic) and the environmental conditions at population origin (precipitation and nutrient availability). We scored plant biomass, reproductive traits and fruit dimorphism patterns. We observed a combination of bet-hedging strategy together with phenotypic differentiation.Native populations relied more on bet-hedging while exotic populations always displayed greater proportion of wind-dispersed fruits than native ones. This pattern may reflect a strategy that might entail a more efficient long distance dispersal of H. glabra seeds in the exotic range, which in turn can enhance the invasiveness of this species

Persistent pain management in an oncology population through pain neuroscience education, a multimodal program: PaiNEd randomized clinical trial protocol

Pain is one of the most persistent symptoms after cancer treatment. The central nervous system can erroneously stay in its alarm phase, altering the pain experience of patients who have cancer. Pain neuroscience education (PNE) with multimodal approaches may benefit these patients.“Subvenciones para la Financiación de la Investigación, Desarrollo e Innovación (I+D+I) Biomédica y en Ciencias de la Salud, Consejería de Salud y Familias”, of the Andalusian Regional Government (PI-0171-2020

2D self-assembly of o-OPE foldamers for chiroptical barcoding

We report on the preparation and characterization of two dimensional (2D) films of (S,S,P)-1 and (R,R,M)-1ortho-oligophenylene ethylene (o-OPE) enantiomers presenting high values of circularly polarized luminescence (CPL). The amphiphilic character of these two molecules allows a precise 2D self-assembly at the air/water interface and an efficient transfer onto a glass solid support. The morphological and chiroptical characterization of the solid supports after the transfer of 1, 8, 16 and 32 Langmuir films of (S,S,P)-1 and (R,R,M)-1 has been carried out. The strong chiroptical values of these monomers allow reliable ECD measurements to be obtained after a single transfer, with ECD values increasing as the number of transferred films increases. The semi-liquid behavior of the monomers on the solid substrate allows CPL measurements free of photoselection artifacts that show values similar to those obtained in solution and independent of monomer concentration. All these properties have allowed us to develop the first simple organic molecule (SOM)-based chiroptical barcoding presenting positive and negative regions as a proof of concept

Conflictos sociales y mediación universitaria en el Espacio Europeo de Educación Superior

Este artículo expone los principales datos y conclusiones obtenidas en el Workshop realizado en el año 2016 entre la Universidad de Málaga y Leuven (Bélgica). La líneas de investigación se centra en los conflictos sociales que se producen en el ámbito universitario.El presente trabajo, trata de analizar los conflictos que se producen en el ámbito universitario relacionados con la implementación del Espacio Europeo de Educación Superior y la nueva metodología docente derivada del mismo, que provocan disyuntivas sociales específicas. Estos conflictos, se hacen plausibles en la conciliación, el aprendizaje y el desarrollo del proceso educativo. Por un lado, con la asistencia obligatoria y la dedicación de tiempo que requiere al estudiante en la Universidad y de trabajo en casa. Por otro, por la situación devenida de los recortes en becas universitarias y la necesidad que impone esta reforma educativa de acreditación del B1 como lengua extranjera para la obtención del Título de Graduado. Estas circunstancias, construyen realidades relativas a los significados que el ámbito universitario tiene para las personas, e inciden en las oportunidades del alumnado en condiciones de igualdad en función de su situación social y personal. En el estudio, se analizan las causas y se definen los tipos de conflictos, así como su relación con la citada reforma