A Huffman code LSB based image steganography technique using multi-level encryption and achromatic component of an image.

In the recent couple of years, due to the accelerated popularity of the internet, various organizations such as government offices, military, private companies, etc. use different transferring methods for exchanging their information. The Internet has various benefits and some demerits, but the primary bad mark is security of information transmission over an unreliable network, and widely uses of images. So, Steganography is the state of the art of implanting a message in the cover objects, that nobody can suspect or identify it. Therefore, in the field of cover steganography, it is very critical to track down a mechanism for concealing data by utilizing different blends of compression strategies. Amplifying the payload limit, and robustness, and working on the visual quality are the vital factors of this research to make a reliable mechanism. Different cover steganography research strategies have been recommended, and each adores its benefits and impediments but there is a need to foster some better cover steganography implements to accomplish dependability between the essential model of cover steganography. To handle these issues, in this paper we proposed a method in view of Huffman code, Least Significant Bits (LSB) based cover steganography utilizing Multi-Level Encryption (MLE) and colorless part (HC-LSBIS-MLE-AC) of the picture. It also used different substitution and flicking concepts, MLE, Magic matrix, and achromatic concepts for proving the proficiency, and significance of the method. The algorithm was also statistically investigated based on some Statistical Assessment Metrics (SAM) such as Mean Square Error (MSE), Peak Signal Noise Ratio (PSNR), Normalized Cross Correlation (NCC), Structural Similarity Index Metric (SSIM), etc. and different perspectives. The observational outcomes show the likelihood of the proposed algorithm and the capacity to give unwavering quality between security, payload, perception, computation, and temper protection.

Assessing and Addressing Social Determinants of Cardiovascular Health: JACC State-of-the-Art Review.

Social determinants of health (SDOH) are the social conditions in which people are born, live, and work. SDOH offers a more inclusive view of how environment, geographic location, neighborhoods, access to health care, nutrition, socioeconomics, and so on are critical in cardiovascular morbidity and mortality. SDOH will continue to increase in relevance and integration of patient management, thus, applying the information herein to clinical and health systems will become increasingly commonplace. This state-of-the-art review covers the 5 domains of SDOH, including economic stability, education, health care access and quality, social and community context, and neighborhood and built environment. Recognizing and addressing SDOH is an important step toward achieving equity in cardiovascular care. We discuss each SDOH within the context of cardiovascular disease, how they can be assessed by clinicians and within health care systems, and key strategies for clinicians and health care systems to address these SDOH. Summaries of these tools and key strategies are provided.

Phytochemical Investigation and Therapeutical Potential of Cotinus coggygria Scop. in Alloxan-Induced Diabetic Mice.

Plants are a significant source for the development of new phytomedicines due to their great clinical benefits, efficiency, cost-effectiveness, fewer side effects, and more affordable therapies. Numerous plants used in traditional treatments, such as Cotinus coggygria Scop., have been effective in the treatment of diabetes mellitus (DM). Therefore, the study is aimed at assessing the phytochemical, antioxidant, and antidiabetic properties of C. coggygria. The hypoglycemic and hypolipidemic activity was evaluated in Swiss male Albino mice by administering an oral dose of 150-250 mg/kg of C. coggygria extracts in alloxan-induced diabetic mice for 15 days. The antioxidant activity and phytochemical composition of the extracts were assessed by using α, α diphenyl-ß-picrylhydrazyl (DPPH) and hydrogen peroxide scavenging assays and through standard chemical procedures. The effects of extracts on blood glucose, body weight, lipid profile, and biochemical parameters like total cholesterol (TC), triglyceride (TG), low-density lipids (LDL), high-density lipids (HDL), plasma insulin, liver glycogen, aspartate aminotransferase (AST), alanine aminotransferase (ALT), alkaline phosphatase (ALP), urea, and creatinine were determined according to standard procedures. The activities of antioxidant enzymes such as superoxide-dismutase (SOD), peroxidase (POD), and catalase (CAT) were also analyzed spectrophotometrically. The hypoglycemic and hypolipidemic effects with chloroform extracts of 250 mg/kg were found significant in the treatment of diabetes in alloxanised mice compared to the diabetic group. The haematological parameters such as TC, TG, HDL, LDL, creatinine, urea, AST, ALT, and ALP were significantly improved (p < 0.01) by the chloroform extract of 250 mg/kg compared to the diabetic group. Treatment for 15 days showed significant elevation (p < 0.01) of antioxidant enzymes. Fourier-transform infrared spectroscopic (FTIR) and gas chromatography-mass spectrometry (GC-MS), column chromatography (CC), and nuclear magnetic resonance (NMR) analyses tentatively identified different phytoconstitutents and metabolites in C. coggygria leaves, which have been reported to possess antihyperglycemic properties. In conclusion, the chloroform extract of 250 mg/kg of C. coggygria possesses significant hypoglycemic and hypolipidemic potential which may prove the claimed use of the plant in amelioration of diabetes and associated complications in folkloric medicine. Additional studies are required for the purification, characterization, and structural elucidation of bioactive compounds.

Phytochemical Screening and Antidiabetic, Antihyperlipidemic, and Antioxidant Effects of Leptopus Cordifolius Decne. In Diabetic Mice.

Plants are well known in traditional herbal medicines for their hypoglycemic and hypolipidemic activities and are often used due to their accessibility, affordability, and corollary effects. Leptopus cordifolius has been reported to control diabetes in folkloric medicine, but no known scientific research has been conducted to assess the plausibility of this assertion. Therefore, the current study is aimed to investigate the antidiabetic and hypolipidemic effects of Leptopus cordifolius leaves in alloxan-induced diabetic mice. The antidiabetic and antihyperlipidemic evaluation was conducted in Swiss albino mice at doses of 150-250°mg/kg for 15°days. The blood glucose, total cholesterol, triglyceride, LDL, HDL, creatinine, ALP, SGPT, and SGOT levels were estimated according to standard procedures. Phytochemicals of leaves were analyzed using GC-MS analysis. Enzymatic antioxidant activity of the plant was investigated spectrophotometrically by carrying out superoxide dismutase, peroxidase, and catalase assays. The membrane stabilization potential of L. cordifolius leaf extracts was carried out using an in vitro haemolytic assay. The results revealed a dose response effect with the methanolic extract of L. cordifolius which had significant antihyperglycemic effects at 150-250°mg/kg in alloxan treated mice, although less than the positive control (glibenclamide). Hyperlipidemic activity was significant at 250 mg/kg. The biochemical parameters, such as total cholesterol, triglyceride, LDL, HDL, creatinine, ALP, SGPT, and SGOT, were significantly improved (p < 0.01) by the methanolic extract of 250 mg/kg compared to the diabetic group. Treatment for 15 days showed significant elevation (p < 0.01) of antioxidant enzymes. GC-MS analysis provided tentative identifications of 52 compounds in the methanolic extract of L. cordifolius, of which 12 compounds have reported antidiabetic activity. In conclusion, methanolic extract of L. cordifolius of 150 and 250°mg/kg body weight showed significant antidiabetic and antihyperlipidemic activities in alloxan-induced diabetic mice and, with further work, has the potential to be used to manage blood glucose and cholesterol levels.

South Asian Cardiovascular Disease & Cancer Risk: Genetics & Pathophysiology.

South Asians (SAs) are at heightened risk for cardiovascular disease as compared to other ethnic groups, facing premature and more severe coronary artery disease, and decreased insulin sensitivity. This disease burden can only be partially explained by conventional risk factors, suggesting the need for a specific cardiovascular risk profile for SAs. Current research, as explored through a comprehensive literature review, suggests the existence of population specific genetic risk factors such as lipoprotein(a), as well as population specific gene modulating factors. This review catalogues the available research on cardiovascular disease and genetics, anthropometry, and pathophysiology, and cancer genetics among SAs, with a geographical focus on the U.S. A tailored risk profile will hinge upon population customized classification and treatment guidelines, informed by continued research.

The Role of Vascular Imaging in Guiding Routine Percutaneous Coronary Interventions: A Meta-Analysis of Bare Metal Stent and Drug-Eluting Stent Trials.

BACKGROUND: The routine use of vascular imaging including intravascular ultrasound (IVUS) and optical coherence tomography (OCT) in guiding percutaneous coronary interventions (PCI) is still controversial especially when using drug-eluting stents. A meta-analysis of trials using bare metal stents was previously published. METHODS: We conducted a meta-analysis of available published trials that compared imaging-guided PCI and angiography-guided PCI in patients undergoing routine PCI only. Trials that enrolled patients with acute coronary syndrome were excluded to decrease heterogeneity. We aimed to study both drug-eluting stents (DES) as well as bare metal stents (BMS). We identified seven randomized controlled trials on IVUS-guided bare metal stents. We also identified three randomized controlled trials on IVUS-guided drug-eluting stents. To improve the power of the drug-eluting stent data, we identified, and included, nine registries that compared IVUS-guided PCI to angiography-guided PCI in the drug-eluting stent era. Nonrandomized registries that included BMS only were excluded as there are multiple previous meta-analyses that studied these patients. Finally, we identified one registry that compared OCT-guided PCI to angiography-guided PCI using either a BMS or a DES. A total of 14,197 patients were studied overall. The meta-analysis was conducted using a random effect model. RESULTS: Imaging guidance was associated with a significantly larger postintervention minimal luminal diameter (SMD: 0.289. 95% CI: 0.213-0.365. P < 0.01). Imaging-guided stenting was associated with a significant decrease in the major adverse cardiac events (MACE) in the DES patients (odds ratio: 0.810. 95% CI: 0.719-0.912. P < 0.01) and combined DES and BMS patients (odds ratio: 0.782. 95% CI: 0.686-0.890. P < 0.01). Imaging guidance was associated with significantly lower events of death from all causes in DES patients (odds ratio: 0.654. 95% CI: 0.468-0.916. P < 0.01) and in the combined DES and BMS patients (odds ratio: 0.727. 95% CI: 0.540-0.980. P < 0.01). The risk of myocardial infarction (MI) was significantly lower with imaging guidance in both, DES patients (odds ratio: 0.551. 95% CI: 0.363-0.837. P < 0.01) and combined DES and BMS patients (odds ratio: 0.589. 95% CI: 0.425-0.816. P < 0.01). This may, in part, be explained by the significantly lower risk of stent thrombosis in imaging-guided DES patients (odds ratio: 0.651. 95% CI: 0.499-0.850. P < 0.01) and combined DES and BMS patients (odds ratio: 0.665. 95% CI: 0.513-0.862. P < 0.01). Patients who received a DES showed no difference between imaging guidance and angiography guidance in repeated target lesion revascularization, while the analysis of BMS alone and the DES and BMS combined showed significant superiority of the imaging-guided PCI group. CONCLUSION: Imaging-guided PCI significantly lowered the risk of death, MI, stent thrombosis, and the combined MACE in DES-implanted patients and all stented patients (DES or BMS). However, imaging guidance had no significant effect on repeated target vessel or target lesion revascularization in patients who received DES, likely due to the effect of the drug in the stent.

Impact of kissing balloon inflation on the main vessel stent volume, area, and symmetry after side-branch dilation in patients with coronary bifurcation lesions: a serial volumetric intravascular ultrasound study.

OBJECTIVES: Intravascular ultrasound (IVUS) was performed to investigate the impact of kissing balloon inflation (KBI) on the main vessel (MV) stent volume, area, and symmetry after side-branch (SB) dilation in patients with coronary bifurcation lesions (CBL). BACKGROUND: It remains controversial whether KBI would restore the MV stent area and symmetry loss after SB dilation. METHODS: A total of 88 serial IVUS examinations of the MV were performed after MV angioplasty, MV stenting, SB dilation, and KBI in 22 patients with CBL. The MV stent was divided into proximal, bifurcation, and distal segments; the stent volume index (SVI), minimal stent area (MSA), stent symmetry index (SSI), and external elastic membrane (EEM) volume index were measured in 198 stent segments and compared after MV stenting, SB dilation, and KBI. RESULTS: In the bifurcation segment, SVI, MSA, and SSI were significantly smaller after SB dilation than after MV stenting and KBI (SVI was 6.10 ± 1.50 mm(3)/mm vs. 6.68 ± 1.60 mm(3)/mm and 6.57 ± 1.60 mm(3)/mm, respectively, p < 0.05; MSA was 5.15 ± 1.30 mm(2) vs. 6.08 ± 1.40 mm(2) and 5.86 ± 1.50 mm(2), respectively, p < 0.05; and SSI was 0.78 ± 0.02 mm(2) vs. 0.87 ± 0.03 mm(2) and 0.84 ± 0.03 mm(2), respectively, p < 0.05). KBI restored the MV SVI, MSA, and SSI after SB dilation. In the proximal segment, SVI, MSA, and EEM volume index were significantly larger, but SSI was smaller after KBI than after MV stenting and SB dilation. In the distal segment, neither SB dilation nor KBI had a significant impact on the MV stent volume or symmetry. CONCLUSIONS: This is the first comprehensive volumetric IVUS analysis of CBL, to our knowledge, demonstrating that KBI restores the MV stent volume, area, and symmetry loss after SB dilation in the bifurcation segment, and induces asymmetric stent expansion in the proximal segment.

Spontaneous right coronary artery dissection possibly associated with clonidine transdermal patch.

We report on a 44-year-old female who developed spontaneous right coronary artery dissection associated with the use of a clonidine transdermal patch. The lesion was successfully treated with percutaneous coronary intervention with placement of three bare metal stents. The patient had an uneventful recovery. To our knowledge, this is the first reported case of spontaneous coronary artery dissection associated with clonidine effect.

Spontaneous left main coronary artery dissection complicated by pseudoaneurysm formation in pregnancy: role of CT coronary angiography.

We report a case of a 26-year-old female, who presented at 34 weeks of an uncomplicated pregnancy with an acute ST elevation anterior wall myocardial infarction. Cardiac catheterization suggested a left main coronary artery dissection with pseudoaneurysm formation. The patient's course was complicated by congestive heart failure. She was initially managed conservatively by a multidisciplinary team including heart failure specialists, obstetricians, and cardiovascular surgeons. 4 days after admission, her LMC was imaged by dual-source 64 slice Cardiac computed tomography, coronary dissection was identified extending to the lumen, and the presence of pseudoaneurysm was confirmed. She underwent subsequently a staged procedure, which included placement of an intra-aortic balloon pump, cesarean section, and coronary artery bypass grafting. This case illustrates the utility of coronary artery CT imaging to assess the complexity and stability of coronary artery dissections, thereby helping to determine the need for, and timing of revascularization procedures.