Discovery of dual-action phenolic 4-arylidene-isoquinolinones with antioxidant and α-glucosidase inhibition activities.

A multicomponent-derived synthesis of arylidene isoquinolinones decorated with phenolic moieties is described. The series demonstrated good DPPH trapping and, in the case of sinapic acid-containing analogs, excellent activity against lipoperoxidation; EPR also demonstrated that one derivative scavenged hydroxyl radicals. In addition, some compounds showed excellent inhibition of α-glucosidase activity and, according to both Lineweaver-Burk plots and molecular docking, they act as non-competitive or mixed inhibitors. In vitro assay also demonstrated that two compounds significantly reduced the plasma glucose levels after sucrose administration. In summary, the studied isoquinolinones become novel compounds with dual action (antioxidant and α-glucosidase inhibition) against diabetes and related metabolic diseases, whose optimization would lead to more potent candidates.

Unraveling motor imagery brain patterns using explainable artificial intelligence based on Shapley values.

BACKGROUND AND OBJECTIVE: Motor imagery (MI) based brain-computer interfaces (BCIs) are widely used in rehabilitation due to the close relationship that exists between MI and motor execution (ME). However, the underlying brain mechanisms of MI remain not well understood. Most MI-BCIs use the sensorimotor rhythms elicited in the primary motor cortex (M1) and somatosensory cortex (S1), which consist of an event-related desynchronization followed by an event-related synchronization. Consequently, this has resulted in systems that only record signals around M1 and S1. However, MI could involve a more complex network including sensory, association, and motor areas. In this study, we hypothesize that the superior accuracies achieved by new deep learning (DL) models applied to MI decoding rely on focusing on a broader MI activation of the brain. Parallel to the success of DL, the field of explainable artificial intelligence (XAI) has seen continuous development to provide explanations for DL networks success. The goal of this study is to use XAI in combination with DL to extract information about MI brain activation patterns from non-invasive electroencephalography (EEG) signals. METHODS: We applied an adaptation of Shapley additive explanations (SHAP) to EEGSym, a state-of-the-art DL network with exceptional transfer learning capabilities for inter-subject MI classification. We obtained the SHAP values from two public databases comprising 171 users generating left and right hand MI instances with and without real-time feedback. RESULTS: We found that EEGSym based most of its prediction on the signal of the frontal electrodes, i.e. F7 and F8, and on the first 1500 ms of the analyzed imagination period. We also found that MI involves a broad network not only based on M1 and S1, but also on the prefrontal cortex (PFC) and the posterior parietal cortex (PPC). We further applied this knowledge to select a 8-electrode configuration that reached inter-subject accuracies of 86.5% ± 10.6% on the Physionet dataset and 88.7% ± 7.0% on the Carnegie Mellon University's dataset. CONCLUSION: Our results demonstrate the potential of combining DL and SHAP-based XAI to unravel the brain network involved in producing MI. Furthermore, SHAP values can optimize the requirements for out-of-laboratory BCI applications involving real users.

Synthesis, antibiofilm activity and molecular docking of N-acylhomoserine lactones containing cinammic moieties.

We prepared a series of cinnamoyl-containing furanones by an affordable and short synthesis. The nineteen compounds hold a variety of substituents including electron-donating, electron-withdrawing, bulky and meta-substituted phenyls, as well as heterocyclic rings. Compounds showed antibiofilm activity in S. aureus, K. pneumoniae and, more pronounced, against P. aeruginosa. The disruption of quorum sensing (QS) was tested using the violacein test and molecular docking predicted the antagonism of LasR as a plausible mechanism of action. The trimethoxylated and diene derivatives showed the best antibiofilm and anti-QS properties, thus becoming candidates for further modifications.

Embodied strategies for public speaking anxiety: evaluation of the Corp-Oral program.

Background: Public speaking is an indispensable skill that can profoundly influence success in both professional and personal spheres. Regrettably, managing anxiety during a speech poses a significant challenge for many of the population. This research assessed the impacts of a Corp-Oral program, designed to manage public speaking anxiety in university students, based on, body awareness, embodied message techniques, simulation, embodied visualization, body transformation, and gesture enhancement. Methods: Thirty-six students (61% women; Mage = 20.22, SD = 1.23 years) were randomly assigned to either an experimental group (n = 18), which underwent the Corp-Oral program, or a control group (n = 18). Self-perceived anxiety, heart rate, and electroencephalography were measured in a pre-test and a post-test. Results: The study reveals that the Corp-Oral program significantly (p < 0.005) reduced both physiological responses (heart rate) and self-reported measures of anxiety. The alteration was more noticeable in self-reported anxiety measures (a decrease of 33.217%) than in heart rate (a decrease of 4.659%). During the speech, the experimental group exhibited increased cortical activation in areas related to emotional regulation, consciousness, sensorimotor integration, and movement control. A significant increase in frontal alpha asymmetry was observed for the experimental group in the post-test, but there were no significant variations in the theta/beta ratio. Conclusion: These findings underline the benefit of managing public speaking anxiety not merely by reducing it but by channeling it through embodied strategies. These strategies could lead to greater action awareness that would cushion the physiological effect of the anxiety response and help generate a better self-perception of the anxiety state.

Assessing the Potential of Brain-Computer Interface Multiplayer Video Games using c-VEPs: A Pilot Study.

Video games have become a common and widespread form of entertainment, while non-invasive brain-computer interfaces (BCI) are emerging as potential alternative communication technologies. Combining BCIs and video games can enhance the gaming experience and make it accessible to motor-disabled individuals. Recently, code-modulated visual evoked potentials (c-VEP) have been proposed as a novel control signal able to achieve high performance with short calibration times. However, there are still no video games that use c-VEPs as a control signal. The aim of this pilot study is to develop an implementation of the 'Connect 4' multiplayer video game using a c-VEP-based BCI and test it with 10 healthy users. Participants were paired to compete in matches and carried out individual tasks. The results showed that the participants were able to control the game with an average accuracy of 94.10% and a selection time of 5.25 seconds per command, outperforming previous approaches. This suggests that the proposed video game is feasible and c-VEPs can provide smooth BCI control.

Nonparametric Early Stopping Detection for c-VEP-based Brain-Computer Interfaces: A Pilot Study.

Brain-computer interface (BCI) systems based on code-modulated visual evoked potentials (c-VEP) stand out for achieving excellent command selection accuracies with very short calibration times. One of the natural steps to democratize their use in plug-and-play environments is to develop early stopping algorithms. These methods allow real-time detection of the minimum number of code repetitions needed to provide reliable selections. However, such techniques are scarce in the current state-of-the-art for c-VEP-based BCI systems based on the classical circular shifting paradigm. Here, a novel nonparametric early stopping method is proposed, which approximates the distribution of unattended commands to a normal distribution and issues a selection when the correlation of the command is considered an outlier. The proposal has been evaluated offline with 15 healthy users, achieving an average accuracy of 97.08% and a speed of 1.37 s/command. Likewise, the algorithm has also been evaluated with an additional user in an online way, as a proof of concept to validate its technical feasibility, achieving an average accuracy of 96.88% with a speed of 1.67 s/command. These results suggest that the real time application of the proposed algorithm is feasible, significantly reducing the required selection time without compromising accuracy.

Third National Registry of Cardiac Rehabilitation Programs in Mexico (RENAPREC III-2022) / Tercer Registro Nacional de Programas de Rehabilitación Cardiaca en México (RENAPREC III-2022)

Abstract Introduction: In Mexico, cardiac rehabilitation (CR) as an interdisciplinary intervention with therapeutic impact in patients with heart disease is growing. There is the need to know actual conditions of CR in our country. Objectives: The objective of this National Registry is to follow-up those existing and new CR units in Mexico through the comparison between the two previous registries, RENAPREC-2009 and RENAPREC II-2015 studies. This is a descriptive study focused on diverse CR activities such as assistance training, and certification of health professionals, barriers, reference, population attended, interdisciplinarity, permanence over time, growth prospects, regulations, post-pandemic condition, integrative characteristics, and scientific research. Results: Data were collected from 45 CR centers in the 32 states, 75.5% are private practice units, 67% are new, 33% were part of RENAPREC II-2015, and 17 have continued since 2009. With a better distribution of CR units along the territory, the median reference of candidates for CR programs is 9% with a significant reduction into tiempo of enrollment to Phase II admission (19 ± 11 days). Regarding to previous registries, the coverance of Phases I, II, and III is 71%, 100%, and 93%, respectively; and a coverance increases in evaluation, risk stratification, and prescription, more comprehensive attendance and prevention strategies. Conclusions: CR in Mexico has grown in the past 7 years. Even there is still low reference and heterogeneity in specific processes, there are strengths such as interdisciplinarity, scientific professionalization of specialists, national diversification, and an official society that are consolidated over time.

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Influence of spatial frequency in visual stimuli for cVEP-based BCIs: evaluation of performance and user experience.

Code-modulated visual evoked potentials (c-VEPs) are an innovative control signal utilized in brain-computer interfaces (BCIs) with promising performance. Prior studies on steady-state visual evoked potentials (SSVEPs) have indicated that the spatial frequency of checkerboard-like stimuli influences both performance and user experience. Spatial frequency refers to the dimensions of the individual squares comprising the visual stimulus, quantified in cycles (i.e., number of black-white squares pairs) per degree of visual angle. However, the specific effects of this parameter on c-VEP-based BCIs remain unexplored. Therefore, the objective of this study is to investigate the role of spatial frequency of checkerboard-like visual stimuli in a c-VEP-based BCI. Sixteen participants evaluated selection matrices with eight spatial frequencies: C001 (0 c/°, 1×1 squares), C002 (0.15 c/°, 2×2 squares), C004 (0.3 c/°, 4×4 squares), C008 (0.6 c/°, 8×8 squares), C016 (1.2 c/°, 16×16 squares), C032 (2.4 c/°, 32×32 squares), C064 (4.79 c/°, 64×64 squares), and C128 (9.58 c/°, 128×128 squares). These conditions were tested in an online spelling task, which consisted of 18 trials each conducted on a 3×3 command interface. In addition to accuracy and information transfer rate (ITR), subjective measures regarding comfort, ocular irritation, and satisfaction were collected. Significant differences in performance and comfort were observed based on different stimulus spatial frequencies. Although all conditions achieved mean accuracy over 95% after 2.1 s of trial duration, C016 stood out in terms user experience. The proposed condition not only achieved a mean accuracy of 96.53% and 164.54 bits/min with a trial duration of 1.05s, but also was reported to be significantly more comfortable than the traditional C001 stimulus. Since both features are key for BCI development, higher spatial frequencies than the classical black-to-white stimulus might be more adequate for c-VEP systems. Hence, we assert that the spatial frequency should be carefully considered in the development of future applications for c-VEP-based BCIs.

Combining brain-computer interfaces and multiplayer video games: an application based on c-VEPs.

Introduction and objective: Video games are crucial to the entertainment industry, nonetheless they can be challenging to access for those with severe motor disabilities. Brain-computer interfaces (BCI) systems have the potential to help these individuals by allowing them to control video games using their brain signals. Furthermore, multiplayer BCI-based video games may provide valuable insights into how competitiveness or motivation affects the control of these interfaces. Despite the recent advancement in the development of code-modulated visual evoked potentials (c-VEPs) as control signals for high-performance BCIs, to the best of our knowledge, no studies have been conducted to develop a BCI-driven video game utilizing c-VEPs. However, c-VEPs could enhance user experience as an alternative method. Thus, the main goal of this work was to design, develop, and evaluate a version of the well-known 'Connect 4' video game using a c-VEP-based BCI, allowing 2 users to compete by aligning 4 same-colored coins vertically, horizontally or diagonally. Methods: The proposed application consists of a multiplayer video game controlled by a real-time BCI system processing 2 electroencephalograms (EEGs) sequentially. To detect user intention, columns in which the coin can be placed was encoded with shifted versions of a pseudorandom binary code, following a traditional circular shifting c-VEP paradigm. To analyze the usability of our application, the experimental protocol comprised an evaluation session by 22 healthy users. Firstly, each user had to perform individual tasks. Afterward, users were matched and the application was used in competitive mode. This was done to assess the accuracy and speed of selection. On the other hand, qualitative data on satisfaction and usability were collected through questionnaires. Results: The average accuracy achieved was 93.74% ± 1.71%, using 5.25 seconds per selection. The questionnaires showed that users felt a minimal workload. Likewise, high satisfaction values were obtained, highlighting that the application was intuitive and responds quickly and smoothly. Conclusions: This c-VEP based multiplayer video game has reached suitable performance on 22 users, supported by high motivation and minimal workload. Consequently, compared to other versions of "Connect 4" that utilized different control signals, this version has exhibited superior performance.

Methemoglobinemia in Hemodialysis Patients due to Acute Chlorine Intoxication: A Case Series Calling Attention on an Old Problem.

INTRODUCTION: Hemodialysis uses municipal water that must be strictly purified and sterilized to be used for that procedure. Large amounts of decontaminants are often used, such as chlorine, and if these compounds are not subsequently removed they can be transferred to the blood of patients causing complications including methemoglobinemia. METHODS: In this case series study, dialysis patients in one unit were evaluated. We reviewed clinical characteristics and laboratory findings obtained on the day when the water supply was disinfected with chlorine, with the aim to quantify methemoglobin concentrations. Our objective was to characterize the clinical presentation and management of patients who presented with methemoglobinemia on a specific index day. We also reviewed reported cases in the literature regarding this underreported complication. RESULTS: Eight patients who presented with chlorine intoxication were evaluated. The methemoglobin concentrations were between 1.3% and 7.9% (reference value 0-1%). We believe this to be caused by water containing 0.78 mg/L of total chlorine. Seven patients presented with cyanosis, 4 with dizziness, 6 with dark brown blood, 4 with dyspnea, and 4 with headache and hemolytic anemia. Subjects were treated with supplemental oxygen, methylene blue, intravenous vitamin C, blood transfusions, and increased doses of erythropoietin. No patient died, and all continued with their usual hemodialysis sessions. CONCLUSION: Acute chlorine intoxication transferred by the water used during hemodialysis sessions can present with methemoglobinemia accompanied by cyanosis, oxygen desaturation, and hemolytic anemia. Chlorine levels should be carefully monitored in the water used for hemodialysis treatment.

A regioselective synthesis of 3,4-diaryl-1H-pyrazoles through a 1,3-dipolar cycloaddition of tosylhydrazones and nitroalkenes.

A procedure for the selective synthesis of 3,4-diaryl-1H-pyrazoles through a 1,3-dipolar cycloaddition is reported. The transformation occurred under mild conditions using affordable tosylhydrazones and nitroalkenes commencing from benzaldehydes/heteroaromatic aldehydes as starting materials. Due to the versatility of this protocol, we prepared a vast collection of 3,4-diaryl-1H-pyrazoles, which included the incorporation of heterocyclic rings at the pyrazole core. Two-dimensional NMR techniques (2D-NOESY and HMBC) confirmed the regioselectivity of the transformation and correlated well with DFT calculations. Accordingly, the analysis of the transition states indicated that the 3,4-diaryl product corresponded to the product with the lowest activation energy and led to the most stable product. Finally, the series was evaluated against three cancer cell lines, with compound 8f being the most remarkable analog in terms of activity and extraordinary selectivity towards PC-3 compared to the other cell lines (including COS-7).

A Real-Time FPGA-Based Metaheuristic Processor to Efficiently Simulate a New Variant of the PSO Algorithm.

Nowadays, high-performance audio communication devices demand superior audio quality. To improve the audio quality, several authors have developed acoustic echo cancellers based on particle swarm optimization algorithms (PSO). However, its performance is reduced significantly since the PSO algorithm suffers from premature convergence. To overcome this issue, we propose a new variant of the PSO algorithm based on the Markovian switching technique. Furthermore, the proposed algorithm has a mechanism to dynamically adjust the population size over the filtering process. In this way, the proposed algorithm exhibits great performance by reducing its computational cost significantly. To adequately implement the proposed algorithm in a Stratix IV GX EP4SGX530 FPGA, we present for the first time, the development of a parallel metaheuristic processor, in which each processing core simulates the different number of particles by using the time-multiplexing technique. In this way, the variation of the size of the population can be effective. Therefore, the properties of the proposed algorithm along with the proposed parallel hardware architecture potentially allow the development of high-performance acoustic echo canceller (AEC) systems.

[Third National Registry of Cardiac Rehabilitation Programs in Mexico (RENAPREC III-2022)]. / Tercer Registro Nacional de Programas de Rehabilitación Cardiaca en México (RENAPREC III-2022).

Introduction: In Mexico, cardiac rehabilitation (CR) as an interdisciplinary intervention with therapeutic impact in patients with heart disease is growing. There is the need to know actual conditions of CR in our country. Objectives: The objective of this National Registry is to follow-up those existing and new CR units in Mexico through the comparison between the two previous registries, RENAPREC-2009 and RENAPREC II-2015 studies. This is a descriptive study focused on diverse CR activities such as assistance training, and certification of health professionals, barriers, reference, population attended, interdisciplinarity, permanence over time, growth prospects, regulations, post-pandemic condition, integrative characteristics, and scientific research. Results: Data were collected from 45 CR centers in the 32 states, 75.5% are private practice units, 67% are new, 33% were part of RENAPREC II-2015, and 17 have continued since 2009. With a better distribution of CR units along the territory, the median reference of candidates for CR programs is 9% with a significant reduction into tiempo of enrollment to Phase II admission (19 ± 11 days). Regarding to previous registries, the coverance of Phases I, II, and III is 71%, 100%, and 93%, respectively; and a coverance increases in evaluation, risk stratification, and prescription, more comprehensive attendance and prevention strategies. Conclusions: CR in Mexico has grown in the past 7 years. Even there is still low reference and heterogeneity in specific processes, there are strengths such as interdisciplinarity, scientific professionalization of specialists, national diversification, and an official society that are consolidated over time.

Introducción: En México, la Rehabilitación Cardíaca (RC) como intervención interdisciplinaria con impacto terapéutico en paciente con cardiopatía está en crecimiento. Existe la necesidad de conocer las condiciones actuales de la RC en nuestro país. Objetivo: El objetivo de este Registro es dar seguimiento comparativo de las unidades nuevas y existentes entre los registros anteriores, RENAPREC-2009 y RENAPREC II-2015. Se trata de un estudio descriptivo centrado en diversas actividades de la RC: formación asistencial y certificación de sus profesionales, barreras, referencia, población atendida, interdisciplinariedad, permanencia en el tiempo, perspectivas de crecimiento, normativa, condición pospandemia, características integradoras e investigación. Resultados: Se recolectaron datos de 45 centros en los 32 estados, 67% son nuevos 75.5% son de práctica privada, 33% fueron parte de RENAPREC II-2015 y 17 desde 2009. Con una mejor distribución de las unidades de RC a lo largo del territorio, la mediana de referencia de pacientes candidatos a RC es ahora del 9% con reducción significativa del tiempo de admisión a Fase II (19 ± 11 días). Respecto a registros anteriores las coberturas de las Fases I, II y III son del 71%, 100% y 93%, respectivamente; con un aumento de la cobertura en evaluación, estratificación de riesgo y prescripción, atención más integral y estrategias de prevención. Conclusiones: La RC en México ha crecido en los últimos 7 años. Si bien aún existe baja referencia y heterogeneidad en procesos específicos, existen fortalezas como la interdisciplinariedad, la profesionalización científica de los especialistas, la diversificación nacional y una sociedad oficial que se consolida en el tiempo.

ITACA: An open-source framework for Neurofeedback based on Brain-Computer Interfaces.

BACKGROUND AND OBJECTIVE: Neurofeedback (NF) is a paradigm that allows users to self-modulate patterns of brain activity. It is implemented with a closed-loop brain-computer interface (BCI) system that analyzes the user's brain activity in real-time and provides continuous feedback. This paradigm is of great interest due to its potential as a non-pharmacological and non-invasive alternative to treat non-degenerative brain disorders. Nevertheless, currently available NF frameworks have several limitations, such as the lack of a wide variety of real-time analysis metrics or overly simple training scenarios that may negatively affect user performance. To overcome these limitations, this work proposes ITACA: a novel open-source framework for the design, implementation and evaluation of NF training paradigms. METHODS: ITACA is designed to be easy-to-use, flexible and attractive. Specifically, ITACA includes three different gamified training scenarios with a choice of five brain activity metrics as real-time feedback. Among them, novel metrics based on functional connectivity and network theory stand out. It is complemented with five different computerized versions of widespread cognitive assessment tests. To validate the proposed framework, a computational efficiency analysis and an NF training protocol focused on frontal-medial theta modulation were conducted. RESULTS: Efficiency analysis proved that all implemented metrics allow an optimal feedback update rate for conducting NF sessions. Furthermore, conducted NF protocol yielded results that support the use of ITACA in NF research studies. CONCLUSIONS: ITACA implements a wide variety of features for designing, conducting and evaluating NF studies with the goal of helping researchers expand the current state-of-the-art in NF training.

MEDUSA©: A novel Python-based software ecosystem to accelerate brain-computer interface and cognitive neuroscience research.

BACKGROUND AND OBJECTIVE: Neurotechnologies have great potential to transform our society in ways that are yet to be uncovered. The rate of development in this field has increased significantly in recent years, but there are still barriers that need to be overcome before bringing neurotechnologies to the general public. One of these barriers is the difficulty of performing experiments that require complex software, such as brain-computer interfaces (BCI) or cognitive neuroscience experiments. Current platforms have limitations in terms of functionality and flexibility to meet the needs of researchers, who often need to implement new experimentation settings. This work was aimed to propose a novel software ecosystem, called MEDUSA©, to overcome these limitations. METHODS: We followed strict development practices to optimize MEDUSA© for research in BCI and cognitive neuroscience, making special emphasis in the modularity, flexibility and scalability of our solution. Moreover, it was implemented in Python, an open-source programming language that reduces the development cost by taking advantage from its high-level syntax and large number of community packages. RESULTS: MEDUSA© provides a complete suite of signal processing functions, including several deep learning architectures or connectivity analysis, and ready-to-use BCI and neuroscience experiments, making it one of the most complete solutions nowadays. We also put special effort in providing tools to facilitate the development of custom experiments, which can be easily shared with the community through an app market available in our website to promote reproducibility. CONCLUSIONS: MEDUSA© is a novel software ecosystem for modern BCI and neurotechnology experimentation that provides state-of-the-art tools and encourages the participation of the community to make a difference for the progress of these fields. Visit the official website at https://www.medusabci.com/ to know more about this project.

Transcatheter aortic valve replacement in pure native aortic regurgitation: when off-label indications match the patient's requirements / TAVI en IA pura de válvula nativa: cuando indicaciones fuera de guías cumplen los requerimientos del paciente

Abstract Objective: In recent years, transcatheter aortic valve replace (TAVR) has revolutionized the interventional treatment of aortic stenosis, however, only scarce evidence considers it as treatment for Aortic Regurgitation (AR). At present, the treatment of Pure AR of Native Valve with TAVR does not fall within the recommendations of international guidelines, as it poses multiple challenges with immediate and long-term variable and unpredictable results. The objective of this paper is to present the case of a patient with prohibitive operative risk that benefited of TAVR treatment for AR. Materials and methods: We present the case of a 79-year-old male patient who has severe Pure Native Aortic Valve Regurgitation, considered inoperable. Based on the heart team's decision, TAVR was planned with the use of an Edwards SAPIEN 3 valve. After TAVR, the patient developed complete heart block and a pacemaker was implanted. He improved to NYHA II functional class. At 15-month follow-up, he suffered intracranial hemorrhage and passed away. Results and Conclusions: Management of patients with severe symptomatic AR with high surgical risk continues to be a special challenge. They have high mortality if left untreated with valvular change, despite medical treatment. Even though it is strictly off-label, TAVR might be a reasonable solution for a select type of patients who are considered inoperable due to surgical high mortality risk.

Resumen Objetivo: En años recientes, el reemplazo valvular aórtico vía percutánea (TAVI) ha revolucionado el tratamiento de los pacientes con estenosis aórtica, sin embargo, poca evidencia la considera como opción de tratamiento en pacientes con insuficiencia aórtica (IA), especialmente en pacientes con Insuficiencia Aórtica Pura de Válvula Nativa (IAPVN), dado que esta patología confiere múltiples retos con resultados muy variables tanto a corto como a largo plazo. Dada su alta mortalidad en caso de permanecer sin tratamiento, la primera opción de tratamiento es la cirugía de cambio valvular. Material y Métodos: Presentamos el caso de un masculino de 79 años con IAPVN grave considerado inoperable dadas las comorbilidades. De acuerdo con la decisión del equipo de Cardiología, se decidió realizar TAVI con la colocación de una Válvula Edwards SAPIEN 3. El paciente desarrolló bloqueo AV completo como única complicación y se colocó marcapasos permanente. Permaneció en clase funcional NYHA II. A los 15 meses de seguimiento presentó hemorragia intracraneal y falleció. Resultados y Conclusiones: El manejo de los pacientes con IAPVN grave sintomática con riesgo quirúrgico alto sigue siendo un reto especial. Tienen alta mortalidad si no se realiza cambio valvular a pesar de tratamiento médico. A pesar de que no se recomienda en las guías actuales, la TAVI puede ser una opción razonable para un grupo muy selecto de pacientes que son considerados inoperables.

Transcatheter aortic valve replacement in pure native aortic regurgitation: when off-label indications match the patient's requirements.

OBJECTIVE: In recent years, transcatheter aortic valve replace (TAVR) has revolutionized the interventional treatment of aortic stenosis, however, only scarce evidence considers it as treatment for Aortic Regurgitation (AR). At present, the treatment of Pure AR of Native Valve with TAVR does not fall within the recommendations of international guidelines, as it poses multiple challenges with immediate and long-term variable and unpredictable results. The objective of this paper is to present the case of a patient with prohibitive operative risk that benefited of TAVR treatment for AR. MATERIALS AND METHODS: We present the case of a 79-year-old male patient who has severe Pure Native Aortic Valve Regurgitation, considered inoperable. Based on the heart team's decision, TAVR was planned with the use of an Edwards SAPIEN 3 valve. After TAVR, the patient developed complete heart block and a pacemaker was implanted. He improved to NYHA II functional class. At 15-month follow-up, he suffered intracranial hemorrhage and passed away. RESULTS AND CONCLUSIONS: Management of patients with severe symptomatic AR with high surgical risk continues to be a special challenge. They have high mortality if left untreated with valvular change, despite medical treatment. Even though it is strictly off-label, TAVR might be a reasonable solution for a select type of patients who are considered inoperable due to surgical high mortality risk.

OBJETIVO: En años recientes, el reemplazo valvular aórtico vía percutánea (TAVI) ha revolucionado el tratamiento de los pacientes con estenosis aórtica, sin embargo, poca evidencia la considera como opción de tratamiento en pacientes con insuficiencia aórtica (IA), especialmente en pacientes con Insuficiencia Aórtica Pura de Válvula Nativa (IAPVN), dado que esta patología confiere múltiples retos con resultados muy variables tanto a corto como a largo plazo. Dada su alta mortalidad en caso de permanecer sin tratamiento, la primera opción de tratamiento es la cirugía de cambio valvular. MATERIAL Y MÉTODOS: Presentamos el caso de un masculino de 79 años con IAPVN grave considerado inoperable dadas las comorbilidades. De acuerdo con la decisión del equipo de Cardiología, se decidió realizar TAVI con la colocación de una Válvula Edwards SAPIEN 3. El paciente desarrolló bloqueo AV completo como única complicación y se colocó marcapasos permanente. Permaneció en clase funcional NYHA II. A los 15 meses de seguimiento presentó hemorragia intracraneal y falleció. RESULTADOS Y CONCLUSIONES: El manejo de los pacientes con IAPVN grave sintomática con riesgo quirúrgico alto sigue siendo un reto especial. Tienen alta mortalidad si no se realiza cambio valvular a pesar de tratamiento médico. A pesar de que no se recomienda en las guías actuales, la TAVI puede ser una opción razonable para un grupo muy selecto de pacientes que son considerados inoperables.

Confidentiality in medical images through a genetic-based steganography algorithm in artificial intelligence.

Nowadays, image steganography has an important role in hiding information in advanced applications, such as medical image communication, confidential communication and secret data storing, protection of data alteration, access control system for digital content distribution and media database systems. In these applications, one of the most important aspects is to hide information in a cover image whithout suffering any alteration. Currently, all existing approaches used to hide a secret message in a cover image produce some level of distortion in this image. Although these levels of distortion present acceptable PSNR values, this causes minimal visual degradation that can be detected by steganalysis techniques. In this work, we propose a steganographic method based on a genetic algorithm to improve the PSNR level reduction. To achieve this aim, the proposed algorithm requires a private key composed of two values. The first value serves as a seed to generate the random values required on the genetic algorithm, and the second value represents the sequence of bit locations of the secret medical image within the cover image. At least the seed must be shared by a secure communication channel. The results demonstrate that the proposed method exhibits higher capacity in terms of PNSR level compared with existing works.

A biologically inspired spiking neural P system in selective visual attention for efficient feature extraction from human motion.

Nowadays, human action recognition has become an essential task in health care and other fields. During the last decade, several authors have developed algorithms for human activity detection and recognition by exploiting at the maximum the high-performance computing devices to improve the quality and efficiency of their results. However, in real-time and practical human action recognition applications, the simulation of these algorithms exceed the capacity of current computer systems by considering several factors, such as camera movement, complex scene and occlusion. One potential solution to decrease the computational complexity in the human action detection and recognition can be found in the nature of the human visual perception. Specifically, this process is called selective visual attention. Inspired by this neural phenomena, we propose for the first time a spiking neural P system for efficient feature extraction from human motion. Specifically, we propose this neural structure to carry out a pre-processing stage since many studies have revealed that an analysis of visual information of the human brain proceeds in a sequence of operations, in which each one is applied to a specific location or locations. In this way, this specialized processing have allowed to focus the recognition of the objects in a simpler manner. To create a compact and high speed spiking neural P system, we use their cutting-edge variants, such as rules on the synapses, communication on request and astrocyte-like control. Our results have demonstrated that the use of the proposed neural P system increases significantly the performance of low-computational complexity neural classifiers up to more 97% in the human action recognition.