Impact of cardiac conduction disease in patients with cardiac amyloidosis: A national retrospective cohort study.

BACKGROUND: There is a paucity of data regarding the impact of cardiac conduction disease (CD) on clinical outcomes in patients with cardiac amyloidosis (CA). METHODS: The National Inpatient Sample (NIS) was queried to identify all CA admissions and those with CD using ICD-10 codes from 2016 to 2019. We explored baseline characteristics and used multivariate logistic regression to assess the association between CD and several clinical outcomes during index admission; a p-value of <0.05 was significant. Propensity score matching (PSM) was performed to validate our results. RESULTS: A total of 12,185 patients with CA were identified. Of these, 920 (7.6 %) had CD. The median age of the sample was 72 years (IQR: 64-80). After multivariate adjustment and PSM, the presence of CD in CA was associated with higher odds of ventricular arrhythmias (VA) (aOR = 2.97, 95 % CI 1.78-4.96, p < 0.001), syncope (aOR = 3.44, 95 % CI 1.51-7.83, p = 0.003), and cardiovascular implantable electronic device (CIED) implantation (aOR = 12.86, 95 % CI 5.50-30.04, p < 0.001) but not with sudden cardiac arrest (p = 0.092), acute heart failure (p = 0.060), all-cause in-hospital mortality (p = 0.384), and non-routine discharge in patients admitted for CA (p = 0.271). CONCLUSIONS: Although CD was not associated with all-cause in-hospital mortality, there was a significant association with VAs and syncope. Syncope is associated with worse survival in patients with CA. Further studies that prospectively follow patients are needed to determine the true effect of cardiac CD on mortality in patients with CA.

Periodontal Disease and Nonsurgical Periodontal Therapy on the OHRQoL of the Patient: A Pilot Study of Case Series.

The objective of this prospective study was to assess oral health-related quality of life (OHR-QoL) in patients with periodontitis and nonsurgical periodontal treatment. A prospective, longitudinal case series study was carried out at the University Dental Clinic of the Morales Meseguer Hospital in Murcia. Eighty periodontal patients with periodontitis, aged 22 to 72 years, were included in this study. The Spanish version of the Oral Health Impact Profile 14 (OHIP-14sp) questionnaire was used on two occasions: at the first visit and one month after completing the nonsurgical periodontal treatment. Clinical measurements of probing depth, plaque index and bleeding on probing were performed at baseline and after periodontal therapy. Data were analyzed using Student's t-test and analysis of variance. We found statistically significant differences (p < 0.05) between the pre- and post-treatment in all the dimensions studied except disability. Similarly, statistically significant differences were also found according to the degree or stage of the disease. However, these differences were not observed with respect to the extent of periodontal disease. Periodontal disease has a negative impact on the OHRQoL of periodontal patients, especially in severe stages (III-IV). Basic periodontal treatment can improve the OHRQoL of periodontal patients one month after treatment.

Establishment of reference intervals for complete blood count in times of COVID-19 and vaccination.

Introduction: COVID-19 and vaccination may affect some parameters of the complete blood count (CBC). The aim of this study was to determine reference intervals (RI) of CBC in healthy population with different COVID-19 and vaccination backgrounds and compare them with those established previously. Materials and methods: A cross-sectional study was conducted in donors who attended the Traumatology Hospital "Dr. Victorio de la Fuente Narváez" (HTVFN) from June to September 2021. Reference intervals were established using the non-parametric method on Sysmex XN-1000. For differences between groups with different COVID-19 and vaccination backgrounds, non-parametric tests were used. Results: The RI were established in 156 men and 128 women. Haemoglobin (Hb), haematocrit (Hct), red blood cells (RBC), platelets (Plt), mean platelets volume (MPV), monocytes and relative neutrophils were higher in men than women (P < 0.001). The percentiles of Hb, Hct, RBC, MPV and relative monocytes showed higher values; Plt, white blood cells (WBC), lymphocytes, monocytes, neutrophils, eosinophils and absolute basophils, the 2.5th was higher and the 97.5th was lower; for lymphocytes and relative neutrophils, both percentiles had a trend toward lower values, compared to previous RI. Differences between groups with different COVID-19 and vaccination backgrounds, in lymphocytes (P = 0.038), neutrophils (P = 0.017) and eosinophils (P = 0.018) in men; Hct (P = 0.014), RDW (P = 0.023) in women and MPV (P = 0.001) in both, were not considered pathological. Conclusions: The RI for the CBC were established in a Mestizo-Mexican population with different COVID-19 and vaccination backgrounds, so should be updated and validated in different hospitals close to the HTVFN that use the same analyser.

Study of the Properties of CdS:Al (R = [Al3+]/[Cd2+] = 0.30, 0.40, 0.50) Thin Films Grown by the CBD Method in an Ammonia-Free System.

CdS:Al thin films were fabricated on a glass substrate using the CBD method. The effect of aluminum incorporation on the structural, morphological, vibrational, and optical properties of CdS thin layers was investigated by X-ray diffraction (XRD), Raman spectroscopy (RS), atomic force microscopy (AFM), scanning electron microscopy (SEM), and UV-visible (UV-vis) and photoluminescence (PL) spectroscopies. XRD analysis of deposited thin films confirmed a hexagonal structure with a preferred (002) orientation in all samples. The crystallite size and surface morphology of the films are modified with aluminum content. Raman spectra exhibit fundamental longitudinal optical (LO) vibrational modes and their overtones. Optical properties were studied for each thin film. Here, it was observed that the optical properties of thin films are affected by the incorporation of aluminum into the CdS structure.

Development and validation of anthropometric-based fat-mass prediction equations using air displacement plethysmography in Mexican infants.

BACKGROUND/OBJECTIVES: Fat-mass (FM) assessment since birth using valid methodologies is crucial since excessive adiposity represents a risk factor for adverse metabolic outcomes. AIM: To develop infant FM prediction equations using anthropometry and validate them against air-displacement plethysmography (ADP). SUBJECTS/METHODS: Clinical, anthropometric (weight, length, body-mass index -BMI-, circumferences, and skinfolds), and FM (ADP) data were collected from healthy-term infants at 1 (n = 133), 3 (n = 105), and 6 (n = 101) months enrolled in the OBESO perinatal cohort (Mexico City). FM prediction models were developed in 3 steps: 1) Variable Selection (LASSO regression), 2) Model behavior evaluation (12-fold cross-validation, using Theil-Sen regressions), and 3) Final model evaluation (Bland-Altman plots, Deming regression). RESULTS: Relevant variables in the FM prediction models included BMI, circumferences (waist, thigh, and calf), and skinfolds (waist, triceps, subscapular, thigh, and calf). The R2 of each model was 1 M: 0.54, 3 M: 0.69, 6 M: 0.63. Predicted FM showed high correlation values (r ≥ 0.73, p < 0.001) with FM measured with ADP. There were no significant differences between predicted vs measured FM (1 M: 0.62 vs 0.6; 3 M: 1.2 vs 1.35; 6 M: 1.65 vs 1.76 kg; p > 0.05). Bias were: 1 M -0.021 (95%CI: -0.050 to 0.008), 3 M: 0.014 (95%CI: 0.090-0.195), 6 M: 0.108 (95%CI: 0.046-0.169). CONCLUSION: Anthropometry-based prediction equations are inexpensive and represent a more accessible method to estimate body composition. The proposed equations are useful for evaluating FM in Mexican infants.

How Do Artificial Neural Networks Classify Musical Triads? A Case Study in Eluding Bonini's Paradox.

How might artificial neural networks (ANNs) inform cognitive science? Often cognitive scientists use ANNs but do not examine their internal structures. In this paper, we use ANNs to explore how cognition might represent musical properties. We train ANNs to classify musical chords, and we interpret network structure to determine what representations ANNs discover and use. We find connection weights between input units and hidden units can be described using Fourier phase spaces, a representation studied in musical set theory. We find the total signal coming through these weighted connection weights is a measure of the similarity between two Fourier structures: the structure of the hidden unit's weights and the structure of the stimulus. This is surprising because neither of these Fourier structures is computed by the hidden unit. We then show how output units use such similarity measures to classify chords. However, we also find different types of units-units that use different activation functions-use this similarity measure very differently. This result, combined with other findings, indicates that while our networks are related to the Fourier analysis of musical sets, they do not perform Fourier analyses of the kind usually described in musical set theory. Our results show Fourier representations of music are not limited to musical set theory. Our results also suggest how cognitive psychologists might explore Fourier representations in musical cognition. Critically, such theoretical and empirical implications require researchers to understand how network structure converts stimuli into responses.

Preliminary study of the photodegradation of dyes using amorphous films of ZnO-CuO obtained by photochemical deposition in solid phase.

Here, we propose an original method of photochemical deposition for the synthesis of metal oxides from coordination complexes sensitive to UV light. The method consists of the synthesis of zinc oxide amorphous films doped with different concentrations of copper oxide followed by annealing at 600 °C. The photo-reactivity of the samples was evaluated by the decrease of the FT-IR spectroscopy bands. The films were analyzed by scanning electron microscopy (SEM-EDX) and X-ray diffraction (XRD) to study their morphology and structures, respectively. The results show an amorphous characteristic in the photo-deposits. The optical properties show a gradual decrease of both the optical band gap and the luminescent emissions of the ZnO photo-deposits when CuO doping increases. Both properties allow a shift in absorption towards the visible and a decrease in the rate of recombination of charge carriers. The photocatalytic activity was analyzed using methyl orange and methylene blue as pollutants under a lamp that emulates solar energy. The results show that the photocatalytic activity is favored by the insertion of CuO; 46.6 and 93.0% efficiency in the photodegradation of methyl orange and methylene blue, respectively, were reached at 1.0 mol % of CuO with respect to pure ZnO. These differences in degradation efficiency respond to the chemical stability of the dyes. Finally, the use of appropriate scavengers suggests an oxidative route in the dye degradation mechanism.

Electrical Potentiometry with Intraoral Applications.

Dental implants currently in use are mainly made of titanium or titanium alloys. As these metallic elements are immersed in an electrolytic medium, galvanic currents are produced between them or with other metals present in the mouth. These bimetallic currents have three potentially harmful effects on the patient: micro-discharges, corrosion, and finally, the dispersion of metal ions or their oxides, all of which have been extensively demonstrated in vitro. In this original work, a system for measuring the potentials generated in vivo is developed. Specifically, it is an electrogalvanic measurements system coupled with a periodontal probe that allows measurement of the potentials in the peri-implant sulcus. This device was tested and verified in vitro to guarantee its applicability in vivo. As a conclusion, this system is able to detect galvanic currents in vitro and it can be considered capable of being employed in vivo, so to assess the effects they may cause on dental implants.

Ozone in Patients with Periodontitis: A Clinical and Microbiological Study.

The purpose of this article was to assess the effectiveness of ozone therapy as an adjunct to mechanical therapy in periodontitis patients. Thirty-two patients diagnosed with generalized periodontitis were selected, with a total of 655 teeth examined. Each patient's mouth was divided into four quadrants (the split-mouth model) to be randomly treated with four sessions of gaseous ozone or air. The following clinical variables were recorded: the gingival index, the periodontal clinical attachment loss, the Miller's mobility index and the clinical improvements, as assessed through the visual analog scale (VAS). In addition, the microorganisms were qualitatively compared. After four weeks of treatment, the teeth of the ozone-treated quadrants showed statistically significant reductions in the gingival index and an improvement in the clinical attachment (p < 0.0001). The same treatment also significantly improved mobility by between 70% and 86% compared to the control group (p < 0.0001). Statistically significant differences were also recorded for the VAS (p < 0.0001). In the qualitative study of the subgingival flora, significant differences were observed (p < 0.0001). The overall results of this trial support the view that ozone treatment is effective and well tolerated in cases of generalized chronic periodontitis.

Drug Interactions Affecting Oral Anticoagulant Use.

Oral anticoagulants (OACs) are medications commonly used in patients with atrial fibrillation and other cardiovascular conditions. Both warfarin and direct oral anticoagulants are susceptible to drug-drug interactions (DDIs). DDIs are an important cause of adverse drug reactions and exact a large toll on the health care system. DDI for warfarin mainly involve moderate to strong inhibitors/inducers of cytochrome P450 (CYP) 2C9, which is responsible for the elimination of the more potent S-isomer of warfarin. However, inhibitor/inducers of CYP3A4 and CYP1A2 may also cause DDI with warfarin. Recognition of these precipitating agents along with increased frequency of monitoring when these agents are initiated or discontinued will minimize the impact of warfarin DDI. Direct oral anticoagulants are mainly affected by medications strongly affecting the permeability glycoprotein (P-gp), and to a lesser extent, strong CYP3A4 inhibitors/inducers. Dabigatran and edoxaban are affected by P-gp modulation. Strong inducers of CYP3A4 or P-gp should be avoided in all patients taking direct oral anticoagulant unless previously proven to be otherwise safe. Simultaneous strong CYP3A4 and P-gp inhibitors should be avoided in patients taking apixaban and rivaroxaban. Concomitant antiplatelet/anticoagulant use confers additive risk for bleeding, but their combination is unavoidable in many cases. Minimizing duration of concomitant anticoagulant/antiplatelet therapy as indicated by evidence-based clinical guidelines is the best way to reduce the risk of bleeding.

Geometric Analysis of Signals for Inference of Multiple Faults in Induction Motors.

Multiple fault identification in induction motors is essential in industrial processes due to the high costs that unexpected failures can cause. In real cases, the motor could present multiple faults, influencing systems that classify isolated failures. This paper presents a novel methodology for detecting multiple motor faults based on quaternion signal analysis (QSA). This method couples the measured signals from the motor current and the triaxial accelerometer mounted on the induction motor chassis to the quaternion coefficients. The QSA calculates the quaternion rotation and applies statistics such as mean, variance, kurtosis, skewness, standard deviation, root mean square, and shape factor to obtain their features. After that, four classification algorithms are applied to predict motor states. The results of the QSA method are validated for ten classes: four single classes (healthy condition, unbalanced pulley, bearing fault, and half-broken bar) and six combined classes. The proposed method achieves high accuracy and performance compared to similar works in the state of the art.

Clinical characteristics and risk factors for SARS-CoV-2 infection in pregnant women attending a third level reference center in Mexico City.

BACKGROUND: COVID-19 symptoms vary widely among pregnant women. We aimed to assess the most frequent symptoms amongst pregnant women with SARS-CoV-2 infection in a tertiary hospital in Mexico City. METHODS: A cross-sectional study of pregnant women attending the National Institute of Perinatology in Mexico City was performed. All women who attended the hospital, despite their symptoms, were tested for SARS-CoV-2. A multivariate-age-adjusted logistic regression was used to assess the association between the main outcome and each characteristic of the clinical history. RESULTS: A total of 1880 women were included in the data analysis. Among all women, 30.74% (n = 578) had a positive PCR for SARS-CoV-2 from which 2.7 (n = 50) were symptomatic. Symptoms associated with a positive PCR result were headache (p=.01), dyspnea (p=.043), and myalgia (p=.043). CONCLUSIONS: At universal screening for SARS-CoV-2, one-third of the population had a positive result, while those symptoms associated with a positive PCR were headache, dyspnea, and myalgia.

Primary stability and PES/WES evaluation for immediate implants in the aesthetic zone: a pilot clinical double-blind randomized study.

The use of immediate implants in the aesthetic area is a technique widely used in modern implantology. The characteristics of the patient, the implant, and the surgical procedure used may influence the final results. The aim was to assess whether the implant design affects primary (P.S.) and secondary stability (S.S.), bone level (B.L.), and PES/WES evaluation. Twenty implants with two different designs (n = 10) were immediately placed and randomly located in the upper anterior maxilla with no grafting material. Implant-Stability-Quotient (ISQ), B.L., and Pink-Esthetic-Score/White-Esthetic-Score (PES/WES) were evaluated. Shapiro-Wilk normality test was performed to determine the sample normality, as the data did not follow a normal distribution, the Wilcoxon-Mann-Whitney test was applied (p < 0.05). ISQ was determined at placement (PS): control 59.1 (C.I.54.8-63.3); experimental 62.2(C.I.60.1-64.2) and three months after placement (SS): control 62.2.1 (C.I.53.3-71.0); experimental 67.2(C.I.65.8-68.5). The BL was measured at three months after placement: control 0.38 mm (C.I.- 0.06 to + 0.83); experimental 0.76 mm (C.I.0.33-1.19) and at 12 months post-loading: control 0.07 mm (C.I.- 0.50-0.65); experimental 0.90 mm (C.I.0.38-1.42). PES/WES values were evaluated for the control group: 15 (C.I.12.68-17.32), and for the experimental group 15.20 (C.I.11.99-18.41). No significant differences were shown between both implant designs. A good grade of osseointegration and primary/secondary stability was achieved, as well as proper maintenance of crestal bone and adequate PES/WES scores. The criteria for selection for the ideal patient for immediate implant placement is essential.ClinicalTrials Protocol ID: NCT04343833.

An Efficient Partition-Based Approach to Identify and Scatter Multiple Relevant Spreaders in Complex Networks.

One of the main problems in graph analysis is the correct identification of relevant nodes for spreading processes. Spreaders are crucial for accelerating/hindering information diffusion, increasing product exposure, controlling diseases, rumors, and more. Correct identification of spreaders in graph analysis is a relevant task to optimally use the network structure and ensure a more efficient flow of information. Additionally, network topology has proven to play a relevant role in the spreading processes. In this sense, more of the existing methods based on local, global, or hybrid centrality measures only select relevant nodes based on their ranking values, but they do not intentionally focus on their distribution on the graph. In this paper, we propose a simple yet effective method that takes advantage of the underlying graph topology to guarantee that the selected nodes are not only relevant but also well-scattered. Our proposal also suggests how to define the number of spreaders to select. The approach is composed of two phases: first, graph partitioning; and second, identification and distribution of relevant nodes. We have tested our approach by applying the SIR spreading model over nine real complex networks. The experimental results showed more influential and scattered values for the set of relevant nodes identified by our approach than several reference algorithms, including degree, closeness, Betweenness, VoteRank, HybridRank, and IKS. The results further showed an improvement in the propagation influence value when combining our distribution strategy with classical metrics, such as degree, outperforming computationally more complex strategies. Moreover, our proposal shows a good computational complexity and can be applied to large-scale networks.

Clinical and Surgical Outcomes in Extensive Scalp Reconstruction after Oncologic Resection: A Comparison of Anterolateral Thigh, Latissimus Dorsi and Omental Free Flaps.

Microsurgical scalp reconstruction is indicated in patients with large scalp defects. The aim of this study was to compare the outcomes of scalp reconstruction in oncologic patients reconstructed with latissimus dorsi (LD), anterolateral thigh (ALT), and omental (OM) free flaps. Thirty oncologic patients underwent scalp reconstruction with LD (10), ALT (11), and OM (9) flaps. The length of the vascular pedicle, the operation time, the possibility of a two-team approach, the length of hospital stays, the complications, and the aesthetic results were evaluated. The OM flap was the flap with the shortest vascular pedicle length with a mean of 6.26 ± 0.16 cm, compared to the LD flap, which was 12.34 ± 0.55 cm and the ALT flap with 13.20 ± 0.26 cm (p < 0.05). The average time of surgery was 6.6 ± 0.14 h in patients reconstructed with OM, compared to the LD flap, which was 8.91 ± 0.32 h and the ALT flap with 7.53 ± 0.22 h (p < 0.05). A two-team approach was performed in all patients for OM flaps and ALT flaps, but only in two patients reconstructed with the LD flap (p < 0.001). In patients reconstructed with the OM flap, a very satisfactory or satisfactory result was reported in seven patients (77.8%). Eight patients reported a very unsatisfactory or unsatisfactory result with LD flap (80%) and 10 patients with ALT flap (90.9%) (p = 0.002). The mean hospital stay after surgery was not statistically significant (p > 0.05). As for complications, two patients reconstructed with OM flap, five LT flaps, and two ALT flaps developed complications, not statistically significant (p = 0.235). Omental flap, latissimus dorsi flap, and anterolateral thigh flap fulfill most of the characteristics for complex scalp reconstruction. The decision on which flap to use should be based on clinical aspects of the patients taking into account that the three flaps show similar rates of complications and length of hospital stay. Regarding the aesthetic outcome, OM flap or LD flap should be considered for reconstruction of extensive scalp defects.

Short-Circuited Turn Fault Diagnosis in Transformers by Using Vibration Signals, Statistical Time Features, and Support Vector Machines on FPGA.

One of the most critical devices in an electrical system is the transformer. It is continuously under different electrical and mechanical stresses that can produce failures in its components and other electrical network devices. The short-circuited turns (SCTs) are a common winding failure. This type of fault has been widely studied in literature employing the vibration signals produced in the transformer. Although promising results have been obtained, it is not a trivial task if different severity levels and a common high-level noise are considered. This paper presents a methodology based on statistical time features (STFs) and support vector machines (SVM) to diagnose a transformer under several SCTs conditions. As STFs, 19 indicators from the transformer vibration signals are computed; then, the most discriminant features are selected using the Fisher score analysis, and the linear discriminant analysis is used for dimension reduction. Finally, a support vector machine classifier is employed to carry out the diagnosis in an automatic way. Once the methodology has been developed, it is implemented on a field-programmable gate array (FPGA) to provide a system-on-a-chip solution. A modified transformer capable of emulating different SCTs severities is employed to validate and test the methodology and its FPGA implementation. Results demonstrate the effectiveness of the proposal for diagnosing the transformer condition as an accuracy of 96.82% is obtained.

Prevalence of Depression, Anxiety, and Perceived Stress in Postpartum Mexican Women during the COVID-19 Lockdown.

The COVID-19 lockdown represents a new challenge for mental health researchers and clinical practitioners. This cross-sectional study aimed to investigate the prevalence of depression, anxiety, and perceived stress in postpartum Mexican women. The study included 293, 4-12-week postpartum women over the age of 18. The Edinburgh Postpartum Depression Scale (EPDS), Trait-State Trait Anxiety Inventory (T-STAI), and Ten Perceived Stress Scale (PSS-10), which are all questionnaires validated for the Mexican population, were applied using a web-based online survey. Prevalence and 95% confidence intervals (CIs) were calculated. The mean ± standard deviation (SD) of the maternal age was 29.9 ± 6.3 years; the EPDS score: 11 ± 6, T-STAI score: 41.7 ± 12.3, and PSS-10 score: 17.1 ± 7. The prevalence (95% CI) of the postpartum depression symptoms was 39.2% (34-45%), trait anxiety symptoms were found among 46.1% (32-43%) of the participants, and moderate and high perceived stress were in 58% (52-64) and 10.9% (7.8-15) of the participants, respectively. The prevalence of depressive symptoms, generalized anxiety, and perceived stress was higher among postpartum Mexican women during the COVID-19 outbreak than before the lockdown. Our findings highlight the importance of monitoring perinatal mental health during pandemics and the need to design effective psychologic interventions for these patients.