Seizures Cause Prolonged Impairment of Ventilation, CO2 Chemoreception and Thermoregulation.

Sudden unexpected death in epilepsy (SUDEP) has been linked to respiratory dysfunction, but the mechanisms underlying this association remain unclear. Here we found that both focal and generalized convulsive seizures (GCSs) in epilepsy patients caused a prolonged decrease in the hypercapnic ventilatory response (HCVR; a measure of respiratory CO2 chemoreception). We then studied Scn1a R1407X/+ (Dravet syndrome; DS) and Scn8a N1768D/+ (D/+) mice of both sexes, two models of SUDEP, and found that convulsive seizures caused a postictal decrease in ventilation and severely depressed the HCVR in a subset of animals. Those mice with severe postictal depression of the HCVR also exhibited transient postictal hypothermia. A combination of blunted HCVR and abnormal thermoregulation is known to occur with dysfunction of the serotonin (5-hydroxytryptamine; 5-HT) system in mice. Depleting 5-HT with para-chlorophenylalanine (PCPA) mimicked seizure-induced hypoventilation, partially occluded the postictal decrease in the HCVR, exacerbated hypothermia, and increased postictal mortality in DS mice. Conversely, pretreatment with the 5-HT agonist fenfluramine reduced postictal inhibition of the HCVR and hypothermia. These results are consistent with the previous observation that seizures cause transient impairment of serotonergic neuron function, which would be expected to inhibit the many aspects of respiratory control dependent on 5-HT, including baseline ventilation and the HCVR. These results provide a scientific rationale to investigate the interictal and/or postictal HCVR as noninvasive biomarkers for those at high risk of seizure-induced death, and to prevent SUDEP by enhancing postictal 5-HT tone.SIGNIFICANCE STATEMENT There is increasing evidence that seizure-induced respiratory dysfunction contributes to the pathophysiology of sudden unexpected death in epilepsy (SUDEP). However, the cellular basis of this dysfunction has not been defined. Here, we show that seizures impair CO2 chemoreception in some epilepsy patients. In two mouse models of SUDEP we found that generalized convulsive seizures impaired CO2 chemoreception, and induced hypothermia, two effects reported with serotonergic neuron dysfunction. The defects in chemoreception and thermoregulation were exacerbated by chemical depletion of serotonin and reduced with fenfluramine, suggesting that seizure-induced respiratory dysfunction may be due to impairment of serotonin neuron function. These findings suggest that impaired chemoreception because of transient inhibition of serotonergic neurons may contribute to the pathophysiology of SUDEP.

Low sensitivity of the COVID-19 antigen test (PANBIO™ COVID-19 Ag rapid test) to detect asymptomatic infections in health personnel of the National Institute of Respiratory Diseases.

Background: COVID-19 requires an early diagnosis to optimize management and limit transmission. SARS-CoV-2 is able to spread effectively. Infected asymptomatic individuals have been found to be contagious. RT-qPCR is the currently recommended laboratory method for diagnosing acute infection. However, rapid antigen detection (RAD) tests are not only fast, but require less specialized training. The possibility of using RAD tests to identify asymptomatic patients is attractive, as it could effectively contribute to minimizing the hospital spread of SARS-CoV-2. The objective of the study was to determine the performance of RAD vs. RT-qPCR for the detection of asymptomatic cases in INER health personnel. Methods: In order to follow WHO guidelines, generalized tests, a test station for health care workers was implemented on demand. A rapid test was carried out and a second sample was taken to be processed by RT-qPCR. With the results of both tests we conducted a retrospective study. Sensitivity, specificity, positive predictive value, negative predictive value and negative likelihood ratios were calculated. Results: A total of 1640 RAD tests were performed in health care workers (mean age was 39, 69, 47% with a self-reported comorbidity). Participants provided 1,640 valid RAD/RT-qPCR test pairs with 2% testing positive via RT-qPCR. 12 RAD samples were positive for SARS-CoV-2. Overall sensitivity of the PANBIO ™ COVID-19 Ag Rapid Test test was 35.2%. Conclusions: RADs are not recommended for the detection of asymptomatic cases due to low performance.

Sudden unexpected death in epilepsy: Respiratory mechanisms.

Epilepsy is one of the most common chronic neurologic diseases, with a prevalence of 1% in the US population. Many people with epilepsy live normal lives, but are at risk of sudden unexpected death in epilepsy (SUDEP). This mysterious comorbidity of epilepsy causes premature death in 17%-50% of those with epilepsy. Most SUDEP occurs after a generalized seizure, and patients are typically found in bed in the prone position. Until recently, it was thought that SUDEP was due to cardiovascular failure, but patients who died while being monitored in hospital epilepsy units revealed that most SUDEP is due to postictal central apnea. Some cases may occur when seizures invade the amygdala and activate projections to the brainstem. Evidence suggests that the pathophysiology is linked to defects in the serotonin system and central CO2 chemoreception, and that there is considerable overlap with mechanisms thought to be involved in sudden infant death syndrome (SIDS). Future work is needed to identify biomarkers for patients at highest risk, improve ascertainment, develop methods to alert caregivers when SUDEP is imminent, and find effective approaches to prevent these fatal events.

Techniques for monthly rainfall regionalization in southwestern Colombia.

The knowledge of rainfall regimes is a relevant requirement for many activities such as water resources planning, risk management, agriculture activities management, and other hydrologic applications. The present study has consisted of validating four techniques (one linear, one non-linear, and two hybrids) that allow identifying homogenous regions. We take the monthly rainfall in the Southwestern Colombia (Nariño), an area of 33,268 km2 characterized by complex topography and local factors that can influence the rainfall behavior, to test all techniques. The results showed overall the best performance for the approach related to non-linear principal component analysis and self-organizing map. However, in all mainly prevail two regions: the Andean Region and Pacific Region with a bimodal and unimodal regime, respectively. The bimodal one dominates over the Andes mountains range and the unimodal one the coastal zone. The application of non-linear approaches provided a better understanding of the seasonality of rainfall, and the results may be useful for water resource management.

Complications associated with the use of silicone oil in vitreoretinal surgery: A systemic review and meta-analysis.

Silicone oil (SO) still represents the main choice for long-term intraocular tamponade in complicated vitreoretinal surgery. This review compared the complications associated with the use of SO and other vitreous substitutes after pars plana vitrectomy in patients with different underlying diseases. Meta-analysis was conducted in accordance with PRISMA guidelines. We retrieved randomized clinical trials (RCTs), retrospective case-control and cohort studies evaluating the risk of using SO, published between 1994 and 2020, conducting a computer-based search of the following databases: PubMed, Web of Science, Scopus and Embase. Primary outcome was the rate of complications such as intraocular hypertension, retinal re-detachment, unexpected vision loss or hypotony. Secondary outcome was to compare the rate of adverse events of different SO viscosities, especially emulsification. Forty-three articles were included. There were significant differences in intraocular hypertension (p = 0.0002, OR = 1.66; 95% CI = 1.27-2.18) and the rate of retinal re-detachment (p < 0.0009, OR = 0.65; 95% CI = 0.50-0.64) between SO and other agents, including placebo. However, there were no differences in other complication rates. Silicone oil (SO)-emulsification rate was non-significantly higher in low than high SO viscosity, and results from other complications were comparable in both groups. The high quality of most of the studies included in this study is noteworthy, which provides some certainty to the conclusions. Among them is the high variability of the SO residence time. The fact that ocular hypertension and not hypotension is related to SO use. A clear relationship is not found for the so-called unexplained vision loss, which affects a significant percentage of eyes. Re-detachment cases are less if SO is used and that surprisingly there does not seem to be a relationship in the percentage of emulsification between the low- and high-viscosity silicones. All these data warrant more standardized prospective studies.

A ketogenic diet protects DBA/1 and Scn1aR1407X/+ mice against seizure-induced respiratory arrest independent of ketosis.

Patients with uncontrolled epilepsy have a high risk of sudden unexpected death in epilepsy (SUDEP). Seizure-induced respiratory arrest (S-IRA) is thought to be the determining cause of death in many cases of SUDEP. The goal of the present study was to use Scn1aR1407X/+ (Dravet Syndrome, DS) and DBA/1 mice to determine: (1) the effect of a ketogenic diet (KD) on S-IRA and (2) the relationship between serum ketones and the protective effect of a KD. Ketogenic diet treatment significantly decreased spontaneous seizure-induced mortality in DS mice compared to control (8% vs 39%, p = 0.0021). This protective effect was not abolished when ketosis was prevented by supplementing the KD with glucose (10% mortality, p = 0.0007). In DBA/1 mice, the latency to onset of S-IRA due to audiogenic seizures was delayed from 7.6 to 20.8 seconds by a KD on treatment day (TD) 7 compared to control (p < 0.0001), an effect that was reversed on TD14 when mice were crossed over to a control diet on TD7. ß-Hydroxybutyrate (BHB) levels were significantly decreased in DBA/1 mice on a KD supplemented with glucose (p = 0.0038), but the protective effect was maintained. Our findings show that a KD decreases SUDEP in DS mice and increases the latency to audiogenic S-IRA in DBA/1 mice. In both mouse models, a KD was protective against S-IRA. This effect may be due in part to specific dietary components rather than generation of ketone bodies.

A Data Analytics/Big Data Framework for Advanced Metering Infrastructure Data.

The Advanced Metering Infrastructure (AMI) data represent a source of information in real time not only about electricity consumption but also as an indicator of other social, demographic, and economic dynamics within a city. This paper presents a Data Analytics/Big Data framework applied to AMI data as a tool to leverage the potential of this data within the applications in a Smart City. The framework includes three fundamental aspects. First, the architectural view places AMI within the Smart Grids Architecture Model-SGAM. Second, the methodological view describes the transformation of raw data into knowledge represented by the DIKW hierarchy and the NIST Big Data interoperability model. Finally, a binding element between the two views is represented by human expertise and skills to obtain a deeper understanding of the results and transform knowledge into wisdom. Our new view faces the challenges arriving in energy markets by adding a binding element that gives support for optimal and efficient decision-making. To show how our framework works, we developed a case study. The case implements each component of the framework for a load forecasting application in a Colombian Retail Electricity Provider (REP). The MAPE for some of the REP's markets was less than 5%. In addition, the case shows the effect of the binding element as it raises new development alternatives and becomes a feedback mechanism for more assertive decision making.

Solving the SSVEP Paradigm Using the Nonlinear Canonical Correlation Analysis Approach.

This paper presents the implementation of nonlinear canonical correlation analysis (NLCCA) approach to detect steady-state visual evoked potentials (SSVEP) quickly. The need for the fast recognition of proper stimulus to help end an SSVEP task in a BCI system is justified due to the flickering external stimulus exposure that causes users to start to feel fatigued. Measuring the accuracy and exposure time can be carried out through the information transfer rate-ITR, which is defined as a relationship between the precision, the number of stimuli, and the required time to obtain a result. NLCCA performance was evaluated by comparing it with two other approaches-the well-known canonical correlation analysis (CCA) and the least absolute reduction and selection operator (LASSO), both commonly used to solve the SSVEP paradigm. First, the best average ITR value was found from a dataset comprising ten healthy users with an average age of 28, where an exposure time of one second was obtained. In addition, the time sliding window responses were observed immediately after and around 200 ms after the flickering exposure to obtain the phase effects through the coefficient of variation (CV), where NLCCA obtained the lowest value. Finally, in order to obtain statistical significance to demonstrate that all approaches differ, the accuracy and ITR from the time sliding window responses was compared using a statistical analysis of variance per approach to identify differences between them using Tukey's test.

How glycobiology can help us treat and beat the COVID-19 pandemic.

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) emerged during the last months of 2019, spreading throughout the world as a highly transmissible infectious illness designated as COVID-19. Vaccines have now appeared, but the challenges in producing sufficient material and distributing them around the world means that effective treatments to limit infection and improve recovery are still urgently needed. This review focuses on the relevance of different glycobiological molecules that could potentially serve as or inspire therapeutic tools during SARS-CoV-2 infection. As such, we highlight the glycobiology of the SARS-CoV-2 infection process, where glycans on viral proteins and on host glycosaminoglycans have critical roles in efficient infection. We also take notice of the glycan-binding proteins involved in the infective capacity of virus and in human defense. In addition, we critically evaluate the glycobiological contribution of candidate drugs for COVID-19 therapy such as glycans for vaccines, anti-glycan antibodies, recombinant lectins, lectin inhibitors, glycosidase inhibitors, polysaccharides, and numerous glycosides, emphasizing some opportunities to repurpose FDA-approved drugs. For the next-generation drugs suggested here, biotechnological engineering of new probes to block the SARS-CoV-2 infection might be based on the essential glycobiological insight on glycosyltransferases, glycans, glycan-binding proteins, and glycosidases related to this pathology.

Amygdala lesions reduce seizure-induced respiratory arrest in DBA/1 mice.

Sudden unexpected death in epilepsy (SUDEP) is the most common cause of death in patients with refractory epilepsy. Human studies and animal models suggest that respiratory arrest is the initiating event leading to death in many cases of SUDEP. It has previously been reported that the onset of apnea can coincide with the spread of seizures to the amygdala, and apnea can be reproduced by electrical stimulation of the amygdala. The aim of the current work was to determine if the amygdala is required for seizure-induced respiratory arrest (S-IRA) in a mouse model of SUDEP. Experiments were performed on DBA/1 mice that have audiogenic seizures with a high incidence of fatal postictal respiratory arrest. Electrolytic lesions of the amygdala significantly reduced the incidence of S-IRA without altering seizures, baseline breathing, or the hypercapnic ventilatory response. These results indicate that the amygdala is a critical node in a pathway to the lower brainstem that is needed for seizures to cause respiratory arrest. SIGNIFICANCE STATEMENT: Sudden unexpected death in epilepsy is the most common cause of mortality in patients with refractory epilepsy, and S-IRA is thought to be important in the pathophysiology in many cases. In a patient with epilepsy, the onset of apnea has been shown to coincide with spread of seizures to the amygdala, and in multiple patients, apnea was induced by stimulation of the amygdala. Here, we show that lesions of the amygdala reduced the incidence of S-IRA and death in a mouse model of SUDEP. These results provide evidence that the amygdala may be a critical node in the pathway by which seizures influence the brainstem respiratory network to cause apnea. This article is part of the Special Issue NEWroscience 2018.

The Power of Big Data and Data Analytics for AMI Data: A Case Study.

In recent years, there has been a transformation in the value chain of different industrial sectors, like the electricity networks, with the appearance of smart grids. Currently, the underlying knowledge in raw data coming from numerous devices can mark a significant competitive advantage for utilities. It is the case of the Advanced Metering Infrastructure (AMI). Such technology gets user consumption characteristics at levels of detail that were previously not possible. In this context, the terms big data and data analytics become relevant, which are tools that allow using large volumes of information and the generation of valuable knowledge from raw data that can support data-driven decisions for operating on the grid. This paper presents the results of the big data implementation and data analytics techniques in a case study with smart metering data from the city of London. Implemented big data and data analytic techniques to show how to understand user consumption patterns on a broader horizon, the relationships with seasonal variables identify behaviors related to specific events and atypical consumptions. This knowledge helps support decision making about improving demand response programs and, in general, the planning and operation of the Smart Grid.

A motor learning therapeutic intervention for a child with cerebral palsy through a social assistive robot.

Background: Children with cerebral palsy have difficulty to sit, stand, walk, run and jump independently. Therapy is an important factor in improving these aspects, and if applied in early intervention treatments, when the child is growing, it could have many benefits. These therapies require intensive and extended sessions, which in turn demand dedication and effort. New strategies that provide interesting and motivating interventions are often incorporated to improve the participation and performance of the children in the therapies. Therapies using social assistive robots can be alternative and complementary methods to promote the participation and motivation of children with cerebral palsy.Methods: The objective of this work is to validate the effectiveness of a 16-session physical therapy program to improve the participation and fulfillment of therapeutic objectives on an 8 year-old boy with dyskinetic cerebral palsy for motor learning to walk using a social assistive robot. The therapy program was carried out through a methodological proposal that uses SMART objectives (Specific, Measurable, Achievable, Realistic and Timed), Goal-Directed Therapy (GDT) and its evaluation through Goal Attainment Scaling (GAS). Results: A NAO robot was used as a social assistive robot to support a physical therapy for a child with cerebral palsy. In this work, it was observed that the motivation generated by the interaction with the social assistive robot facilitated the persistence in the walking and the fulfillment of the objectives. Conclusion: Using humanoid robots as social assistive robots may benefit therapeutic processes on children with motor disabilities. The methodology developed provides a formal way to achieve objectives in therapeutic processes for children with cerebral palsy.Implications for rehabilitationIt requires researchers to conduct more studies to validate the potential of the use of social robots in therapeutic interventions that promote development in children with motor disabilities, such as cerebral palsy.Promoting the use of new technologies in therapeutic processes such as humanoid robots allows us to create new strategies to know the impact of this technology in the area of rehabilitation.The use of formal methodologies focused on the patient, along with multidisciplinary teams, could increase the possibilities of using social robots to improve cognitive and motor outcomes in children with cerebral palsy.The formulation of SMART objectives and their quantification through the GAS scale can be used as recommendations to improve the formulation of goals in therapeutic interventions for children with cerebral palsy.

Mapping the neuroanatomy of functional decline in Alzheimer's disease from basic to advanced activities of daily living.

BACKGROUND: Impairments in activities of daily living (ADL) are a criterion for Alzheimer's disease (AD) dementia. However, ADL gradually decline in AD, impacting on advanced (a-ADL, complex interpersonal or social functioning), instrumental (IADL, maintaining life in community), and finally basic functions (BADL, activities related to physiological and self-maintenance needs). Information and communication technologies (ICT) have become an increasingly important aspect of daily functioning. Yet, the links of ADL, ICT, and neuropathology of AD dementia are poorly understood. Such knowledge is critical as it can provide biomarker evidence of functional decline in AD. METHODS: ADL were evaluated with the Technology-Activities of Daily Living Questionnaire (T-ADLQ) in 33 patients with AD and 30 controls. ADL were divided in BADL, IADL, and a-ADL. The three domain subscores were covaried against gray matter atrophy via voxel-based morphometry. RESULTS: Our results showed that three domain subscores of ADL correlate with several brain structures, with a varying degree of overlap between them. BADL score correlated mostly with frontal atrophy, IADL with more widespread frontal, temporal and occipital atrophy and a-ADL with occipital and temporal atrophy. Finally, ICT subscale was associated with atrophy in the precuneus. CONCLUSIONS: The association between ADL domains and neurodegeneration in AD follows a traceable neuropathological pathway which involves different neural networks. This the first evidence of ADL phenotypes in AD characterised by specific patterns of functional decline and well-defined neuropathological changes. The identification of such phenotypes can yield functional biomarkers for dementias such as AD.

Time of Day and a Ketogenic Diet Influence Susceptibility to SUDEP in Scn1a R1407X/+ Mice.

Sudden unexpected death in epilepsy (SUDEP) is a major cause of mortality in patients with drug-resistant epilepsy. Most SUDEP cases occur in bed at night and are preceded by a generalized tonic-clonic seizure (GTCS). Dravet syndrome (DS) is a severe childhood-onset epilepsy commonly caused by mutations in the SCN1A gene. Affected individuals suffer from refractory seizures and an increased risk of SUDEP. Here, we demonstrate that mice with the Scn1a R1407X/+ loss-of-function mutation (DS) experience more spontaneous seizures and SUDEP during the early night. We also evaluate effects of long-term ketogenic diet (KD) treatment on mortality and seizure frequency. DS mice showed high premature mortality (44% survival by P60) that was associated with increased spontaneous GTCSs 1-2 days prior to SUDEP. KD treated mice had a significant reduction in mortality (86% survival by P60) compared to mice fed a control diet. Interestingly, increased survival was not associated with a decrease in seizure frequency. Further studies are needed to determine how KD confers protection from SUDEP. Moreover, our findings implicate time of day as a factor influencing the occurrence of seizures and SUDEP. DS mice, though nocturnal, are more likely to have SUDEP at night, suggesting that the increased incidence of SUDEP at night in may not be solely due to sleep.

Sistema de biofeedback para rehabilitación de marcha asistida por un exoesqueleto / Biofeedback System for Exoskeletqn Assisted Gait Rehabilitation / Sistema de biofeedback para reabilitação de marcha assistida por um exoesqueleto

Resumen Los robots proporcionan nuevas formas de terapia para pacientes con desórdenes neurológicos. Las terapias de marcha asistidas con exoesqueletos pueden incrementar la duración y la intensidad de los entrenamientos para los pacientes y reducir el esfuerzo físico del terapeuta. Sin embargo, el uso de estos dispositivos para el entrenamiento de la marcha limita la interacción física entre el terapeuta y el paciente, en comparación con la terapia manual. Una apropiada realimentación de las funciones corporales y biomecánicas en la interacción con el sistema robótico facilita la evaluación del desempeño del paciente, motivándolo en el reaprendizaje de la marcha con resultados superiores. Este artículo presenta el diseño de una interfaz de usuario para un exoesqueleto de miembros inferiores para asistencia en la marcha y en terapias de rehabilitación. Se consideraron aspectos técnicos y clínicos para proporcionar ventajas del exoesqueleto durante las terapias, estableciendo una herramienta de apoyo para la configuración, monitoreo y registro de los parámetros involucrados. Se propuso un esquema de realimentación sensorial para el paciente acerca de la actividad muscular, la presión ejercida en diferentes puntos de los pies y algunas variables biomecánicas. Finalmente, se valida la herramienta con sujetos sanos por medio de un test de usabilidad propuesto.

Abstract The inclusion of robots in rehabilitation allow advantages for generate newer therapies in neurologic disorder patients. Assistive gait therapies using robots, like exoskeletons, allow increase the time and intensity training for patients while the strenuous labor of therapist is reduced. However, the physic interaction between therapist and patient in training with robots is limited, in relation to the traditional manual therapy. An appropriated feedback of biological and biomechanics functions in the robot interaction during training provides an easier performance evaluation of the patient for the therapist. Further, biofeedback gives a motivation to the patient and encourages him for gait relearning with higher effects than conventional. This paper presents a user interface design for a lower limb exoskeleton for human gait assistance in rehabilitation. Clinical and technical criteria for increasing the advantages of the exoskeleton in therapy were considered. A biofeedback scheme about muscle activity, plantar pressure and some biomechanics variables, for the patient is proposed. Finally, a validation for this tool with healthy subjects by a usability test was carried out.

Resumo A inclusão de robôs na reabilitação fornecem vantagens que promovem novas formas de terapia em pacientes com desordens neurológicas. Terapias de marcha assistidas por exoesqueletos permitem o aumento da duração e da intensidade dos exercícios com os pacientes, reduzindo o esforço físico dos terapeutas. Não entanto, o uso desses dispositivos para o treino da marcha limita a interação física entre o terapeuta e paciente, em comparação com a terapia manual. Uma apropriada realimentação das funções corporais e biomecânicas na interação com o sistema robótico facilita a avaliação do progresso do paciente, motiva e incentiva ao paciente na reaprendizagem da marcha gerando efeitos superiores aos convencionais. Neste artigo apresenta-se o desenho de uma interface de usuário para um exoesqueleto de membros inferiores para assistência na marcha e nas terapias de reabilitação. São considerados aspectos técnicos e clínicos para fornecer maiores vantagens do exoesqueleto durante as terapias, estabelecendo uma ferramenta de suporte para configuração, monitoramento e registro dos parâmetros envolvidos. Foi proposto um sistema de realimentação sensorial para o paciente sobre a atividade muscular, a pressão em diferentes pontos dos pés e algumas variáveis biomecânicas. Finalmente, é apresentada a ferramenta de validação para indivíduos saudáveis utilizando um teste de usabilidade proposto.

Monitoreo ambulatorio y generación de alertas tempranas ante anomalías cardiacas usando dispositivos móviles / Ambulatory monitoring and early warning generation of cardiac anomalies using mobile devices / Monitoramento ambulatorial e geração de aviso prévio de anomalias cardíacas usando dispositivos móveis

Resumen En este artículo se presenta un sistema portátil para el monitoreo ambulatorio del ritmo cardiaco y la detección temprana de las arritmias cardiacas de mayor riesgo. El sistema consta de un sensor con tres electrodos superficiales para la captura de la señal ECG, la cual se transmite vía Bluetooth a un dispositivo móvil con Android, en donde se realiza el análisis de la señal capturada durante lapsos de 5 s. El sistema propuesto distingue entre Ritmo Normal [Ritmo Sinusal - RS), Taquicardia Ventricular [TV), Fibrilación Ventricular [FV) y Asistolia, con una precisión del 100%, 55%, 75% y 90% respectivamente. Sin embargo, el sistema puede recuperarse de los errores rápidamente en el análisis de la trama subsecuente. Este trabajo se centra en el uso de dispositivos móviles de uso cotidiano, multitarea y de fácil acceso, implementando algoritmos en el dominio del tiempo para la extracción de parámetros, los cuales son idóneos para ser usados en aplicaciones móviles principalmente por su baja carga computacional y posibilidad de ejecución en tiempo real, permitiendo la detección de anomalías cardiacas de forma automática y rápida sin la necesidad de una supervisión constante por parte de un especialista para el análisis preliminar.

Abstract This paper presents a portable system for ambulatory heart rate monitoring and early detection of cardiac arrhythmias at high risk. The system consists of a sensor with three surface electrodes to capture the ECG signal, which is transmitted via bluetooth to a mobile device with Android, where the analysis is performed of the acquired signal during a time of 5 s. The proposed system distinguishes between Normal Rhythm [Rhythm Sinus - RS), Ventricular Tachycardia [VT), Ventricular Fibrillation [VF) and Asystole with an accuracy of 100%, 55%, 75% and 90% respectively. However, the system can quickly recover from errors in the subsequent analysis frame. This work focuses on using regular mobile devices which have multitasking and easy access characteristics, implementing algorithms in time domain for extracting parameters that are suitable to use in mobile applications, mainly because of their low computational load and possibility of execution in real time, allowing the detection of cardiac abnormalities automatically and quickly without the need of constant supervision by a specialist for preliminary analysis.

Resumo Neste artigo se apresenta um sistema portátil para o monitoramento da freqüência cardíaca ambulatorial e detecção precoce das arritmias cardíacas de mais risco. O sistema possui um sensor com três eletrodos superficiais para pegar o sinal ECG, o qual é transmitido via Bluetooth para um dispositivo móvel com Android, onde se faz a análise do sinal capturado durante um período de 5 s. O sistema proposto distingue entre Normal Ritmo [Ritmo Sinusal - RS), Taquicardia Ventricular [TV), Fibrilação Ventricular [FV) e Assistolia, com uma precisão do 100%, 55%, 75% e 90%, respectivamente. Porém, o sistema pode - se recuperar rapidamente dos erros na análise do quadro subsequente. Este trabalho centra-se no uso de dispositivos móveis de utilização diária, multitarefa e utilização acessível, implementação de algoritmos no domínio do tempo para a extração de parâmetros que são adequados para utilização em aplicações móveis, principalmente pela baixa carga computacional e possibilidade de execução em tempo real, permitindo a detecção de anormalidades cardíacas numa forma automática e rápida sem a necessidade de um controlo constante por um especialista para análise preliminar.

Severe peri-ictal respiratory dysfunction is common in Dravet syndrome.

Dravet syndrome (DS) is a severe childhood-onset epilepsy commonly due to mutations of the sodium channel gene SCN1A. Patients with DS have a high risk of sudden unexplained death in epilepsy (SUDEP), widely believed to be due to cardiac mechanisms. Here we show that patients with DS commonly have peri-ictal respiratory dysfunction. One patient had severe and prolonged postictal hypoventilation during video EEG monitoring and died later of SUDEP. Mice with an Scn1aR1407X/+ loss-of-function mutation were monitored and died after spontaneous and heat-induced seizures due to central apnea followed by progressive bradycardia. Death could be prevented with mechanical ventilation after seizures were induced by hyperthermia or maximal electroshock. Muscarinic receptor antagonists did not prevent bradycardia or death when given at doses selective for peripheral parasympathetic blockade, whereas apnea, bradycardia, and death were prevented by the same drugs given at doses high enough to cross the blood-brain barrier. When given via intracerebroventricular infusion at a very low dose, a muscarinic receptor antagonist prevented apnea, bradycardia, and death. We conclude that SUDEP in patients with DS can result from primary central apnea, which can cause bradycardia, presumably via a direct effect of hypoxemia on cardiac muscle.

Neuroanatomical Comparison of the "Word" and "Picture" Versions of the Free and Cued Selective Reminding Test in Alzheimer's Disease.

Episodic memory tests with cued recall, such as the Free and Cued Selective Reminding Test (FCSRT), allow for the delineation of hippocampal and prefrontal atrophy contributions to memory performance in Alzheimer's disease (AD). Both Word and Picture versions of the test exist but show different profiles, with the Picture version usually scoring higher across different cohorts. One possible explanation for this divergent performance between the different modality versions of the test might be that they rely on different sets of neural correlates. The current study explores this by contrasting the neural correlates of the Word and Picture versions of the FCSRT with voxel-based morphometry (VBM) in AD and healthy subjects. We predicted that the Picture version would be associated with different cortical regions than the Word version, which might be more hippocampal-centric. When comparing 35 AD patients and 34 controls, AD patients exhibited impairments on both versions of the FCSRT and both groups performed higher in the Picture version. A region of interest analysis based on prior work revealed significant correlations between free recall of either version with atrophy of the temporal pole and hippocampal regions. Thus, contrary to expectations, performance on both the Word and the Picture version of the FCSRT is associated with largely overlapping networks. Free recall is associated with hippocampal volume and might be properly considered as an indicator of hippocampal structural integrity.

Identificación de la delimitación administrativa de la malaria usando redes neuronales artificiales / Boundary Delimitiation of Malaria using Artificial Neural Networks / Identificação da Delimitação Administrativa da Malária usando Redes Neurais Artificiais

Resumen La metodología de clustering fue utilizada para agrupar tres barrios en Quibdó teniendo en cuenta factores que favorecen el desarrollo de la malaria. Los mapas auto-organizados de Kohonen fueron utilizados para el análisis de las características más significativas en la clasificación. Los clusters detectados fueron comparados con la clasificación geográfica de las casas, encontrando, que los mapas auto-organizados de Kohonen clasifican las casas por las condiciones ambientales propicias para el desarrollo del mosquito más que por la clasificación administrativa de la ciudad.

Resumo A Metodologia de Clustering foi usada para agrupar três bairros em Quibdo, Colômbia, levando em consideração fatores que favorecem o desenvolvimento da malária. Mapas auto-organizados de Kohonen foram utilizados para a análise das características mais significativas no agrupamento. Os Clusters detectados foram comparados com o agrupamento geo-gráfico de casas, mostrando que os mapas auto-organizados de Kohonen agrupam as casas pelas condições ambientais favoráveis ao desenvolvimento do mosquito e não pelo agrupamento administrativo da cidade.

Abstract Clustering methodology was used to group three neighborhoods in Quibdo taking into account factors that favor the development of malaria. The Kohonen self-organizing maps were used for the analysis of the most significant features in the standings. The detected clusters were compared with the geographical classification of houses, finding that the Kohonen self-organizing maps households classified by environmental conditions conducive to development rather than the administrative classification of the city.

Aplicación de tecnologías de rehabilitación robótica en niños con lesión del miembro superior / Application of robotics rehabilitation technologies in children with upper limb disabilities

RESUMEN Las lesiones de miembro superior ocasionan un profundo impacto en la calidad de vida del paciente. Es bien conocido que para la recuperación del paciente, debe permitírsele jugar un papel activo en su proceso de rehabilitación. Por esta razón, las nuevas tecnologías como la robótica, se están implementando para abordar este problema; tal como lo presentan las múltiples investigaciones reportadas en la literatura. En este artículo, se documentó una revisión de la literatura sobre dispositivos y sistemas robóticos para rehabilitación del miembro superior en niños, lo que incluyó algunos que aún se encuentran en fase de desarrollo, con el fin de ofrecer un panorama global sobre los diseños y soluciones que faciliten el avance de nuevos dispositivos. Para facilidad del lector, este documento se distribuyó en marco teórico, metodología, resultados y discusión, proyecciones de la ingeniería de rehabilitación y conclusiones.

ABSTRACT Upper limb injuries cause a profound impact on patient's quality of life. It is well known that for the recovery of the patient, should be allowed to play an active role in their rehabilitation process. For this reason, new technologies such as robotics, are being implemented to address this problem; as presented by the multiple investigations reported in the literature. In this article, the review of devices and robotic systems for rehabilitation of the upper limb in children was documented, including some that are still under development, in order to provide a comprehensive overview of the designs and solutions to facilitate the development of new devices. For convenience of the reader, this document was distributed into theoretical framework, methodology, results and discussion, projections rehabilitation engineering and conclusions.