Análisis retrospectivo de un protocolo asistencial cognitivo-conductual contextual grupal breve en adolescentes atendidos en un centro de salud mental público

Tesis doctoral inédita leída en la Universidad Autónoma de Madrid, Facultad de Medicina, Departamento de Psiquiatría. Fecha de lectura: 12 de Septiembre de 2013

The Role of Bmp- and Fgf Signaling Modulating Mouse Proepicardium Cell Fate

Bmp and Fgf signaling are widely involved in multiple aspects of embryonic development. More recently non coding RNAs, such as microRNAs have also been reported to play essential roles during embryonic development. We have previously demonstrated that microRNAs, i.e., miR-130, play an essential role modulating Bmp and Fgf signaling during early stages of cardiomyogenesis. More recently, we have also demonstrated that microRNAs are capable of modulating cell fate decision during proepicardial/septum transversum (PE/ST) development, since over-expression of miR-23 blocked while miR- 125, miR-146, miR-223 and miR-195 enhanced PE/ST-derived cardiomyogenesis, respectively. Importantly, regulation of these microRNAs is distinct modulated by Bmp2 and Fgf2 administration in chicken. In this study, we aim to dissect the functional role of Bmp and Fgf signaling during mouse PE/ST development, their implication regulating post-transcriptional modulators such as microRNAs and their impact on lineage determination. Mouse PE/ST explants and epicardial/endocardial cell cultures were distinctly administrated Bmp and Fgf family members. qPCR analyses of distinct microRNAs, cardiomyogenic, fibrogenic differentiation markers as well as key elements directly epithelial to mesenchymal transition were evaluated. Our data demonstrate that neither Bmp2/Bmp4 nor Fgf2/Fgf8 signaling is capable of inducing cardiomyogenesis, fibrogenesis or inducing EMT in mouse PE/ST explants, yet deregulation of several microRNAs is observed, in contrast to previous findings in chicken PE/ST. RNAseq analyses in mouse PE/ST and embryonic epicardium identified novel Bmp and Fgf family members that might be involved in such cell fate differences, however, their implication on EMT induction and cardiomyogenic and/or fibrogenic differentiation is limited. Thus our data support the notion of species-specific differences regulating PE/ST cardiomyogenic lineage commitment

Too dense to go through: The importance of low-mass clusters for satellite quenching

We study the evolution of satellite galaxies in clusters of the C-EAGLE simulations, a suite of 30 high-resolution cosmological hydrodynamical zoom-in simulations based on the EAGLE code. We find that the majority of galaxies that are quenched at $z=0$ ($\gtrsim$ 80$\%$) reached this state in a dense environment (log$_{10}$M$_{200}$[M$_{\odot}$]$\geq$13.5). At low redshift, regardless of the final cluster mass, galaxies appear to reach their quenching state in low mass clusters. Moreover, galaxies quenched inside the cluster that they reside in at $z=0$ are the dominant population in low-mass clusters, while galaxies quenched in a different halo dominate in the most massive clusters. When looking at clusters at $z>0.5$, their in-situ quenched population dominates at all cluster masses. This suggests that galaxies are quenched inside the first cluster they fall into. After galaxies cross the cluster's $r_{200}$ they rapidly become quenched ($\lesssim$ 1Gyr). Just a small fraction of galaxies ($\lesssim 15\%$) is capable of retaining their gas for a longer period of time, but after 4Gyr, almost all galaxies are quenched. This phenomenon is related to ram pressure stripping and is produced when the density of the intracluster medium reaches a threshold of $\rho_{\rm ICM}$ $\sim 3 \times 10 ^{-5}$ n$_{\rm H}$ (cm$^{-3}$). These results suggest that galaxies start a rapid-quenching phase shortly after their first infall inside $r_{200}$ and that, by the time they reach $r_{500}$, most of them are already quenched.Comment: 14 pages, 8 figures, Submitted to MNRA

El tratamiento grupal de adolescentes con trastornos graves de la personalidad: una aproximación contextual

El presente trabajo se centra en los trastornos mentales graves en la adolescencia, y más específicamente en los trastornos de personalidad. La Terapia Dialéctico Conductual (DBT) es uno de los tratamientos con más evidencia para adolescentes con este tipo de trastornos. Entre las terapias contextuales, la DBT se centra en la reducción de los trastornos de conducta graves, haciendo énfasis en el entrenamiento de habilidades. La relación terapéutica es uno de los componentes clave para tratar la patología de personalidad en adolescentes. Asimismo, la combinación con otras terapias contextuales, como la Psicoterapia Analítica Funcional (PAF), permite un mayor efecto de la DBT. El objetivo de este artículo es mostrar cómo la PAF, combinada con estrategias de otras psicoterapias contextuales, supone una mejora clínica en adolescentes con trastornos de personalidad graves. En este artículo se describe la intervención clínica ambulatoria realizada con cuatro adolescentes de entre 13 y 17 años de edad, diagnosticadas de enfermedad mental grave y con criterios de trastornos de personalidad. Los principales síntomas evaluados fueron la impulsividad, los intentos de suicidio, las autolesiones, la auto y heteroagresividad, los síntomas psicóticos y los problemas del yo. El instrumento de medida utilizado fue el Inventario Clínico para Adolescentes de Millon (MACI). Tras una intervención de cuatro meses, se observó un descenso en las escalas clínicas significativas del MACI. También se encontró una mejoría en cognición, tendencias suicidas, regulación emocional y experiencia del yo

El tratamiento grupal de adolescentes con trastornos graves de la personalidad: Una aproximación contextual

El presente trabajo se centra en los trastornos mentales graves en la adolescencia, y más específicamente en los trastornos de personalidad. La Terapia Dialéctico Conductual (DBT) es uno de los tratamientos con más evidencia para adolescentes con este tipo de trastornos. Entre las terapias contextuales, la DBT se centra en la reducción de los trastornos de conducta graves, haciendo énfasis en el entrenamiento de habilidades. La relación terapéutica es uno de los componentes clave para tratar la patología de personalidad en adolescentes. Asimismo, la combinación con otras terapias contextuales, como la Psicoterapia Analítica Funcional (PAF), permite un mayor efecto de la DBT. El objetivo de este artículo es mostrar cómo la PAF, combinada con estrategias de otras psicoterapias contextuales, supone una mejora clínica en adolescentes con trastornos de personalidad graves. En este artículo se describe la intervención clínica ambulatoria realizada con cuatro adolescentes de entre 13 y 17 años de edad, diagnosticadas de enfermedad mental grave y con criterios de trastornos de personalidad. Los principales síntomas evaluados fueron la impulsividad, los intentos de suicidio, las autolesiones, la auto y heteroagresividad, los síntomas psicóticos y los problemas del yo. El instrumento de medida utilizado fue el Inventario Clínico para Adolescentes de Millon (MACI). Tras una intervención de cuatro meses, se observó un descenso en las escalas clínicas significativas del MACI. También se encontró una mejoría en cognición, tendencias suicidas, regulación emocional y experiencia del yo

Impact of immunosuppression regimen on COVID-19 mortality in kidney transplant recipients: Analysis from a Colombian transplantation centers registry

Introducción: El impacto de los diferentes esquemas de inmunosupresión en receptores de trasplante de órganos sólidos es desconocido. El conocimiento del comportamiento de la enfermedad bajo diferentes esquemas de inmunosupresión es escaso. Nuestra experiencia intenta determinar el riesgo de muerte en receptores de trasplante renal con COVID-19 bajo dos esquemas diferentes de inmunosupresión. Métodos: Describimos la experiencia en receptores de trasplante renal con infección por SARS-CoV-2 en siete centros de trasplante renal en la ciudad de Bogotá, durante el primer año de pandemia y previo al inicio de los programas de vacunación. Las características demográficas, la presentación clínica, los esquemas de inmunosupresión y las estrategias de tratamiento fueron comparadas entre pacientes recuperados y fallecidos, un análisis de sobrevida fue llevado a cabo entre esquemas basados en inhibidores de calcineurina y esquemas libres de inhibidores de calcineurina. Resultados: Entre los 165 casos confirmados, 28 murieron (17%), los factores de riesgo identificados para mortalidad en el análisis univariado fueron: edad mayor de 60 años, diabetes, un esquema de inmunosupresión basado en inhibidores de calcineurina y pacientes recibiendo esteroides en el momento del diagnóstico. En el análisis multivariado, la presencia de hipoxemia en el momento del diagnóstico (p = 0,000) y un esquema de inmunosupresión basado en inhibidores de calcineurina (p = 0,002) fueron predictores independientes de mortalidad. El análisis de sobrevida encontró un riesgo mayor de mortalidad en pacientes bajo esquemas de inmunosupresión con inhibidores de calcineurina vs. aquellos libres de inhibidores de calcineurina, con tasas de mortalidad respectivas en 21,7 y 8,5% (p = 0,036). Conclusiones: Nuestros resultados sugieren que los inhibidores de calcineurina no aportan mayor protección en pacientes con trasplante renal y COVID-19 en comparación con esquemas libres de inhibidores de calcineurina, siendo necesario realizar análisis que permitan evaluar los desenlaces con diferentes esquemas de inmunosupresión en receptores de trasplante renal con infección por SARS-CoV-2.Q2Q3Receptores de trasplante renal con infección por SARS-CoV-2Background: The impact of immunosuppression in solid organ transplant recipients with SARS-CoV-2 infection is unknown. The knowledge about the behavior of different immunosuppression schemes in clinical outcomes is scarce. This study aimed to determine the risk of death in kidney transplant recipients with COVID-19 under two different schemes of immunosuppression. Methods: We describe our experience in kidney transplant recipients with SARS-CoV-2 infection in seven transplant centers during the first year of the pandemic before starting the vaccination programs in the city of Bogotá. Demographic characteristics, clinical presentation, immunosuppression schemes at presentation, and global treatment strategies were compared between recovered and dead patients; survival analysis was carried out between calcineurin inhibitors based regimen and free calcineurin inhibitors regimen. Results: Among 165 confirmed cases, 28 died (17%); the risk factors for mortality identified in univariate analysis were age older than 60 years (p = .003) diabetes (p = .001), immunosuppression based on calcineurin inhibitors (CNI) (p = .025) and patients receiving steroids (p = .041). In multivariable analysis, hypoxemia (p = .000) and calcineurin inhibitors regimen (p = .002) were predictors of death. Survival analysis showed increased mortality risk in patients receiving CNI based immunosuppression regimen vs. CNI free regimens mortality rates were, respectively, 21.7% and 8.5% (p = .036). Conclusions: Our results suggest that the calcineurin inhibitors probably do not provide greater protection compared to calcineurin inhibitor free schemes being necessary to carry out analyzes that allow us to evaluate the outcomes with different immunosuppression schemes in solid organ transplant recipients with SARS-CoV-2 infection.https://orcid.org/0000-0001-9852-749Xhttps://orcid.org/0000-0003-0960-9480Revista Internacional - IndexadaN

Galaxy classification: deep learning on the OTELO and COSMOS databases

Context. The accurate classification of hundreds of thousands of galaxies observed in modern deep surveys is imperative if we want to understand the universe and its evolution. Aims. Here, we report the use of machine learning techniques to classify early- and late-type galaxies in the OTELO and COSMOS databases using optical and infrared photometry and available shape parameters: either the Sersic index or the concentration index. Methods. We used three classification methods for the OTELO database: 1) u-r color separation , 2) linear discriminant analysis using u-r and a shape parameter classification, and 3) a deep neural network using the r magnitude, several colors, and a shape parameter. We analyzed the performance of each method by sample bootstrapping and tested the performance of our neural network architecture using COSMOS data. Results. The accuracy achieved by the deep neural network is greater than that of the other classification methods, and it can also operate with missing data. Our neural network architecture is able to classify both OTELO and COSMOS datasets regardless of small differences in the photometric bands used in each catalog. Conclusions. In this study we show that the use of deep neural networks is a robust method to mine the cataloged dataComment: 20 pages, 10 tables, 14 figures, Astronomy and Astrophysics (in press

The OTELO survey. A case study of [O III]4959,5007 emitters at <z> = 0.83

The OTELO survey is a very deep, blind exploration of a selected region of the Extended Groth Strip and is designed for finding emission-line sources (ELSs). The survey design, observations, data reduction, astrometry, and photometry, as well as the correlation with ancillary data used to obtain a final catalogue, including photo-z estimates and a preliminary selection of ELS, were described in a previous contribution. Here, we aim to determine the main properties and luminosity function (LF) of the [O III] ELS sample of OTELO as a scientific demonstration of its capabilities, advantages, and complementarity with respect to other surveys. The selection and analysis procedures of ELS candidates obtained using tunable filter (TF) pseudo-spectra are described. We performed simulations in the parameter space of the survey to obtain emission-line detection probabilities. Relevant characteristics of [O III] emitters and the LF([O III]), including the main selection biases and uncertainties, are presented. A total of 184 sources were confirmed as [O III] emitters at a mean redshift z=0.83. The minimum detectable line flux and equivalent width (EW) in this ELS sample are $\sim$5 $\times$ 10$^{-19}$ erg s$^{-1}$ cm$^{2}$ and $\sim$6 \AA, respectively. We are able to constrain the faint-end slope ($\alpha = -1.03\pm0.08$) of the observed LF([O III]) at z=0.83. This LF reaches values that are approximately ten times lower than those from other surveys. The vast majority (84\%) of the morphologically classified [O III] ELSs are disc-like sources, and 87\% of this sample is comprised of galaxies with stellar masses of M$_\star$ $<$ 10$^{10}$ M$_{\odot}$.Comment: v1: 16 pages, 6 figures. Accepted in Astronomy \& Astrophysics. v2: Author added in metadat

The OTELO survey: the star formation rate evolution of low-mass galaxies

We present the analysis of a sample of \ha\,, \hb\ and \oii\ emission line galaxies from the \otelo\ survey, with masses typically below log(M_*/M_\sun) \sim 9.4 and redshifts between $z \sim 0.4$ and 1.43. We study the star formation rate, star formation rate density, and number density and their evolution with redshift. We obtain a robust estimate of the specific star formation rate -- stellar mass relation based on the lowest mass sample published so far. We also determine a flat trend of the star formation rate density and number density with redshift. Our results suggest a scenario of no evolution of the number density of galaxies, regardless of their masses, up to redshift $z\sim1.4$. This implies a gradual change of the relative importance of the star forming processes, from high-mass galaxies to low-mass galaxies, with decreasing redshift. We also find little or no variation of the star formation rate density in the redshift range of $0.4<z<1.43$.Comment: 8 pages, 3 figures, accepted for publication in ApJ letter