El impacto de COVID-19 en los hábitos saludables y el bienestar psicológico de jugadoras de balonmano chilenas

[ES] Este estudio tuvo como objetivo evaluar el impacto de la cuarentena por COVID-19 sobre los hábitos saludables en una muestra formada por jugadoras de balonmano de élite internacional chilenas. Las participantes rellenaron dos veces una encuesta online sobre sus niveles de actividad física, actitudes alimentarias, calidad del sueño y bienestar psicológico. La encuesta se envió cuatro semanas después de que se impusieran las restricciones a la movilidad en Chile, y 16 semanas más tarde, justo después de que comenzara la relajación de dichas restricciones. Se analizó a un total de 18 jugadoras de balonmano que competían en categorías senior, junior o juvenil. Los datos obtenidos indicaron que los niveles de actividad física disminuyeron significativamente, así como el bienestar psicológico. No se observaron cambios significativos en las actitudes alimentarias ni en la calidad del sueño, aunque se detectó una reducción significativa de los problemas de sueño. Las características sociodemográficas y deportivas no parecieron producir un efecto diferencial sobre las variables evaluadas.[EN] This study aimed to assess the impact of the COVID-19 lockdown on healthy habits in a sample made up of Chilean international elite female handball players. Participants filled in an online survey regarding their physical activity levels, eating attitudes, sleep quality and psychological well-being, twice. The survey was sent within four weeks after mobility restrictions were imposed in Chile, and 16 weeks later, just after the easing of those restrictions began. A total of 18 female handball players who were competing in senior, junior or juvenile categories were analyzed. The obtained data indicated that physical activity levels decreased significantly, as well as psychological well-being. No significant changes were observed in the eating attitudes and sleep quality, although a significant reduction of sleep problems was detected. Sociodemographic and sport-related characteristics did not seem to produce a differential effect on the variables assessed.S

Computed tomography-based identification of ganglionated plexi to guide cardioneuroablation for vasovagal syncope

This study shows that CT-based EFP-guided CNA for CI-VVS is feasible, can assist RF delivery with high precision, and has the potential to overcome the interpatient variability that affects CNA when performed solely by anatomic landmarks. Further larger studies with longer follow-up are required to improve CT-based identification of GPs and our understanding of GP pathophysiology

Quantitative analysis of lead position vs. correction of electrical dyssynchrony in an experimental model of LBBB/CRT

International audienceCardiac resynchronization therapy (CRT) is a recommended treatment in patients with electrical dyssynchrony such as left bundle branch block (LBBB). The determination of the optimal leads position, and the quantification of the changes in electrical activation are two current major challenges. In this paper, we investigate these aspects through electroanatomical data from a controlled experimental protocol, which studied pigs with no structural disease under LBBB and CRT conditions. We propose to use a quasi-conformal mapping technique to standardize electroanatomical maps of endo- and epi-cardial walls of both ventricles to a common reference geometry, in which simple quantitative indices can be computed. Then, we investigate the relation between leads and simple surrogates of the recovery of the electrical activation based either on total activation times or on the spatial distribution of the patterns. Our methodology allows a better understanding of the complex electrical activation patterns in LBBB and CRT, and confirms hypotheses about the optimal leads position from previous studies

Restauración de las olmedas ibéricas (Ulmus minor y U. laevis) en zonas riparias de la Comunidad de Madrid

El proyecto LIFE+ “Olmos Vivos” (LIFE13 BIO/ES/000556) tiene como objetivo la restauración de unas formaciones vegetales, las olmedas, que por diversos motivos prácticamente han desaparecido del paisaje forestal español, a pesar de haber poseído un alto valor ecológico y cultural. La grafiosis ha constituido una de las enfermedades forestales más devastadoras, y supuso la práctica desaparición de las olmedas ibéricas de Ulmus minor . En el caso de Ulmus laevis , la alteración de su hábitat ligado a zonas temporalmente encharcadas y riberas ha provocado que las poblaciones españolas se encuentren en riesgo de desaparición. Gracias a la obtención de siete clones de U. minor resistentes a la grafiosis como fruto del Programa del Olmo (UPM-MAGRAMA), el presente proyecto permitirá reintroducir la especie en diversas localizaciones de ribera de los ríos Jarama y Tajo. Asimismo, se plantarán brinzales obtenidos de agrupaciones relícticas de U. laevis , con el fin de aumentar sus poblaciones y conservar sus recursos genéticos, en terrenos de naturaleza silícea de las riberas del río Jarama y Arroyo Viñuelas. El desarrollo del proyecto, de cinco años y tres meses de duración 2014-2019), prevé la plantación de unas 16 700 plantas. Al mismo tiempo se recuperará en nuestras ciudades y pueblos la presencia del olmo, mediante plantaciones con fines divulgativos en entornos urbanos y paseos históricos, para devolver así el protagonismo cultural a un árbol que siempre estuvo entre nosotros, presidiendo las reuniones en las plazas y acompañando con su sombra en muchos caminos de nuestra geografía

Clinical impact of aging on outcomes of cardioneuroablation for reflex syncope or functional bradycardia. Results from the cardionEuroabLation: patiEnt selection, imaGe integrAtioN and outComEs. The ELEGANCE multicenter study

Background: Cardioneuroablation (CNA) is a novel treatment for reflex syncope. The effect of aging on CNA efficacy is not fully understood. Objective: We assessed the impact of aging on candidacy and efficacy of CNA for treating vasovagal syncope (VVS), carotid sinus syndrome (CSS) and functional bradyarrhythmia. Methods: The ELEGANCE multicenter study assessed CNA in patients with reflex syncope or severe functional bradyarrhythmia. Patients underwent pre-CNA Holter ECG, head-up tilt testing (HUT) and electrophysiologic study. CNA candidacy and efficacy was assessed in 14 young (18-40 years), 26 middle-aged (41-60 years) and 20 older (>60 years) patients. Results: Sixty patients (37 men; mean age: 51±16 years) underwent CNA. The majority (80%) had VVS, 8% CSS, and 12% functional bradycardia/AV block. Pre-CNA Holter ECG, HUT and EP findings did not differ across age groups. Acute CNA success was 93%, without differences between age groups (p=0.42). Post-CNA HUT response was negative in 53%, vasodepressor in 38%, cardioinhibitory in 7% and mixed in 2%, without differences across age groups (p=0.59). At follow-up (8 months, IQR:4-15), 53 (88%) patients were free of symptoms. Kaplan-Meier curves did not show differences in event-free survival between age groups (p=0.29). The negative predictive value of a negative HUT was 91.7%. Conclusions: CNA is a viable treatment for reflex syncope and functional bradyarrhythmia in all ages, and is highly effective in mixed VVS. HUT is a key-step of post-ablation clinical assessment

Functional mapping to reveal slow conduction and substrate progression in atrial fibrillation

Aims: The aim of our study was to analyse the response to short-coupled atrial extrastimuli to identify areas of hidden slow conduction (HSC) and their relationship with the atrial fibrillation (AF) phenotype. Methods and results: Twenty consecutive patients with paroxysmal AF and persistent AF (10:10) underwent the first pulmonary vein isolation procedure. Triple short-coupled extrastimuli were delivered in sinus rhythm (SR), and the evoked response was analysed: sites exhibiting double or highly fragmented electrograms (EGM) were defined as positive for HSC (HSC+). The delta of the duration of the bipolar EGM was analysed, and bipolar EGM duration maps were built. High-density maps were acquired using a multipolar catheter during AF, SR, and paced rhythm. Spatial co-localization of HSC+ and complex fractionated atrial EGMs (CFAE) during AF was evaluated. Persistent AF showed a higher number and percentage of HSC+ than paroxysmal AF (13.9% vs. 3.3%, P < 0.001). The delta of EGM duration was 53 ± 22ms for HSC+ compared with 13 ± 11 (10)ms in sites with negative HSC (HSC-) (P < 0.001). The number and density of HSC+ were lower than CFAE during AF (19 vs. 56 per map, P < 0.001). The reproducibility and distribution of HSC+ in repeated maps were superior to CFAE (P = 0.19 vs. P < 0.001). Sites with negative and positive responses showed a similar bipolar voltage in the preceding sinus beat (1.65 ± 1.34 and 1.48 ± 1.47mV, P = 0.12). Conclusion: Functional mapping identifies more discrete and reproducible abnormal substrates than mapping during AF. The HSC+ sites in response to triple extrastimuli are more frequent in persistent AF than in paroxysmal AF

Aprendizaje Servicio e Innovación Social desde la Universidad

El Aprendizaje Servicio es una estrategia docente necesaria para el desarrollo de iniciativas de emprendimiento e innovación social, que partan desde la Universidad, y que se puedan incorporar en las diferentes áreas de conocimiento de la UC

Automatic and interpretable prediction of the site of origin in outflow tract ventricular arrhythmias: machine learning integrating electrocardiograms and clinical data

The treatment of outflow tract ventricular arrhythmias (OTVA) through radiofrequency ablation requires the precise identification of the site of origin (SOO). Pinpointing the SOO enhances the likelihood of a successful procedure, reducing intervention times and recurrence rates. Current clinical methods to identify the SOO are based on qualitative analysis of pre-operative electrocardiograms (ECG), heavily relying on physician’s expertise. Although computational models and machine learning (ML) approaches have been proposed to assist OTVA procedures, they either consume substantial time, lack interpretability or do not use clinical information. Here, we propose an alternative strategy for automatically predicting the ventricular origin of OTVA patients using ML. Our objective was to classify ventricular (left/right) origin in the outflow tracts (LVOT and RVOT, respectively), integrating ECG and clinical data from each patient. Extending beyond differentiating ventricle origin, we explored specific SOO characterization. Utilizing four databases, we also trained supervised learning models on the QRS complexes of the ECGs, clinical data, and their combinations. The best model achieved an accuracy of 89%, highlighting the significance of precordial leads V1-V4, especially in the R/S transition and initiation of the QRS complex in V2. Unsupervised analysis revealed that some origins tended to group closer than others, e.g., right coronary cusp (RCC) with a less sparse group than the aortic cusp origins, suggesting identifiable patterns for specific SOOs

Experimental and genetic evidence for the impact of CD5 and CD6 expression and variation in inflammatory bowel disease

Crohn's disease (CD) and ulcerative colitis (UC) are inflammatory bowel diseases (IBD) resulting from the interaction of multiple environmental, genetic and immunological factors. CD5 and CD6 are paralogs encoding lymphocyte co-receptors involved in fine-tuning intracellular signals delivered upon antigen-specific recognition, microbial pattern recognition and cell adhesion. While CD5 and CD6 expression and variation is known to influence some immune-mediated inflammatory disorders, their role in IBD remains unclear. To this end, Cd5- and Cd6-deficient mice were subjected to dextran sulfate sodium (DSS)-induced colitis, the most widely used experimental animal model of IBD. The two mouse lines showed opposite results regarding body weight loss and disease activity index (DAI) changes following DSS-induced colitis, thus supporting Cd5 and Cd6 expression involvement in the pathophysiology of this experimental IBD model. Furthermore, DNA samples from IBD patients of the ENEIDA registry were used to test association of CD5 (rs2241002 and rs2229177) and CD6 (rs17824933, rs11230563, and rs12360861) single nucleotide polymorphisms with susceptibility and clinical parameters of CD (n=1352) and UC (n=1013). Generalized linear regression analyses showed association of CD5 variation with CD ileal location (rs2241002CC) and requirement of biological therapies (rs2241002C-rs2229177T haplotype), and with poor UC prognosis (rs2241002T-rs2229177T haplotype). Regarding CD6, association was observed with CD ileal location (rs17824933G) and poor prognosis (rs12360861G), and with left-sided or extensive UC, and absence of ankylosing spondylitis in IBD (rs17824933G). The present experimental and genetic evidence support a role for CD5 and CD6 expression and variation in IBD's clinical manifestations and therapeutic requirements, providing insight into its pathophysiology and broadening the relevance of both immunomodulatory receptors in immune-mediated disorders