In patients with heart failure, the evaluation of left ventricular (LV) diastolic function is vital, offering crucial insights into hemodynamic impact and prognostic accuracy. Echocardiography stands as the primary imaging modality for diastolic function assessment, and using it effectively requires a profound understanding of the underlying pathology. This review covers four main topics: first, the fundamental driving forces behind each phase of normal diastolic dynamics, along with the physiological basis of two widely used echocardiographic assessment parameters, E/e' and mitral annulus early diastolic velocity (e'); second, the intricate functional relationship between the left atrium and LV in patients with varying degrees of LV diastolic dysfunction (LVDD); third, the role of stress echocardiography in diagnosing LVDD and the significance of parameter changes in this context; and fourth, the clinical utility of evaluating diastolic function from echocardiography images across diverse cardiovascular care areas.

To secure logic circuits against the illegal copying the insertion of the so-called key bit inputs using XOR/XNOR gates has been proposed in . The inserted gates modify (lock) the behavior of the original circuit and only the correct choice of the secret key bits guarantees the equivalent behaviour of the locked circuit to the original circuit. To break this kind of security, i.e. to find the secret key bits, there was a SAT solver based attack proposed in . The aim of this work is to experimentally verify this attack on several locked circuits with various number of primary inputs and outputs and with various number of gates. Except for the random placement of the key gates we evaluate also the positioning with chaining elimination. The obtained and presented results show that we were able to unlock 10 of 11 circuits within few minutes on a common PC.

Previous high throughput screening studies indicated trans-eQTLs tend to be tissue specific. In this study, I probed if this feature can be used to identify tissue-specific gene regulatory networks. eQTL data (P<5e-8) for 16,259 genes were identified and their summary association statistics were obtained from the eQTLGene database. Next, eQTLs that display both cis and trans regulatory effects were selected and the association between their corresponding genes were examined using Mendelian randomization. A total of 169 genes that exerted trans-regulatory impacts on 692 genes were identified. 90% of the genes (N=749) aggregated into a gene regulatory network significantly enriched in hemo-immune processes. The robustness of finding was confirmed through simulation. The identified network displayed the scale-free topology. This provided the reason to examine the association of the network’s hub genes with the phenome. The outcome of analyses revealed GSDMB and ORMDL3 impact several disorders of immune origin and ALDH2 overexpression contributes to obesity. This study reports trans-eQTLs can be used to identify tissue-specific gene regulatory networks and describes a workflow to achieve this purpose. The network identified in this study showed scale-free topology indicating the hub genes of a GRN could be targeted to prevent disease outcomes.

Researchers have asserted that, as patients rely on external powerful sources to control their disorders, in addition to their own internal powers and virtues, examining their coping mechanisms can lead to a better understanding of the initiation and progression of chronic diseases and uncover potential opportunities to balance and enhance their psycho-spiritual well-being and possibly their treatment and recovery. This review serves as a user’s manual for investigators who choose to use the CSI-SF to conduct their research on coping behaviors. The CSI-SF that measures four coping strategies based on 16 items was first assessed using the Jackson Heart Study (JHS) cohort in 2007. The reliability and construct validity of the CSI-SF was also later assessed among hemodialysis patients across 13 countries. In this study, the CSI-SF was assessed to be a reliable and valid instrument for measuring coping strategies. The CSI-SF serves the purpose of developing an inner voice that can assist with understanding how people cope with everyday life. The information gathered from administration of the CSI-SF can inform investigators about environmental cues and triggers that can also impact individual health.

Following the era of GWAS studies, efforts are being made to identify genes underlying complex traits by merging eQTL and GWAS data and assessing the colocalization of eQTLs and GWAS signals. A problem that sometimes occurs in this context is the observation of association between several genes in a genomic region with a trait. This happens because genes in a region could be under the regulatory impact of common elements and coexpress. As such, computational approaches that rely on cis-eQTL information can not exactly pinpoint the causal gene. Here, I report an alternative solution, based on trans-eQTLs to test the association between a gene and a trait. Through the analyses applied to adjacent genes that coexpress and concordantly impact blood traits, I provide evidence that trans-eQTLs can resolve the problem of coexpression-causality without the interference of shared cis-regulatory SNPs.

This paper aims to address the exponential stability and stabilization problems for a class of delayed nonlinear Markov jump systems under randomly occurring Denial-of-Service (DoS) attack and packet loss. Firstly, the stochastic characteristics of DoS attack and packet loss are depicted by the attack success rate and packet loss rate. Secondly, a Period Observation Window (POW) method and a hybrid-input strategy are proposed to compensate for the impact of DoS attack and packet loss on the system. Thirdly, A Dynamic Event-triggered Mechanism (DETM) is introduced to save more network resources and ensure the security and reliability of systems. Then, by constructing a general common Lyapunov functional and combining with the DETM and other inequality analysis techniques, the less conservative stability and stabilization criteria for the underlying systems are derived. In the end, the effectiveness of our result is verified through a numerical example.

Ambulatory heart rate (HR) monitors that acquire electrocardiogram (ECG) or/and photoplethysmographm (PPG) signals from the torso, wrists, or ears are notably less accurate in tasks associated with high levels of movement compared to clinical measurements. However, reliable estimation of HR can be obtained through data fusion from different sensors. These methods are especially suitable for multimodal hearable devices, where heart rate can be tracked from different modalities, including electrical ECG, optical PPG, and sounds (heart tones). Combined information from different modalities can compensate for single source limitations. In this paper, we evaluate the possible application of data fusion methods in hearables. We assess data fusion for heart rate estimation from simultaneous in-ear ECG and in-ear PPG, recorded on eight subjects while performing 5-minute sitting and walking tasks. Our findings show that data fusion methods provide a similar level of mean absolute error as the best single-source heart rate estimation but with much lower intra-subject variability, especially during walking activities. We conclude that data fusion methods provide more robust HR estimation than a single cardiovascular signal. These methods can enhance the performance of wearable devices, especially multimodal hearables, in heart rate tracking during physical activity.

Heart failure is a prevalent cardiovascular condition with significant health implications, necessitating effective diagnostic strategies for timely intervention. This study explores the potential of continuous monitoring of non-invasive signals, specifically integrating Photoplethysmogram (PPG) and Electrocardiogram (ECG), for enhancing early detection and diagnosis of heart failure. Leveraging a dataset from the MIMIC-III database, encompassing 682 heart failure patients and 954 controls. Feature selection techniques were used to systematically select key features which were identified for their clinical relevance and significance in capturing cardiovascular dynamics and to reduce computational complexity and to decrease the chance of overfitting the ML algorithms. These features are then utilized to train and evaluate machine learning algorithms, resulting in a model with an impressive accuracy of 98%, sensitivity of 97.60%, specificity of 96.90%, and precision of 97.20%. The integrated approach outperforms single-signal strategies, showcas-ng its potential for early, precise, and non-invasive heart failure diagnosis. Furthermore, the study underscores the significance of continuous monitoring through wearables, emphasizing the benefits of integrating multiple signals for a comprehensive evaluation of cardiovascular health. The proposed approach holds promise for implementation in hardware systems to enable continuous monitoring, aiding in early detection and prevention of critical health conditions.

Background We aimed to evaluate the effectiveness of the ALRYNGO channel-type video laryngoscope with an AI-based glottis guidance system in senior emergency medicine residents for endotracheal intubation. Methods We enrolled twenty patients would be adequate for each device (direct laryngoscope, Pentax-AWS, and ALRYNGO). Before intubation, six senior residents wore a personal protective equipment. To randomize the device in this clinical study, a sealed envelope containing a device-specific identification card was utilized. When intubation began, the person who measured the intubation time divided the total intubation time into three-time intervals. The primary outcome was the intubation time. The secondary outcomes were the glottis view using the Cormack-Lehane grade (C-L grade) and the glottis guidance performance of ALRYNGO’s artificial intelligence. Results In Pentax-AWS and ALRYNGO, all intubations were successful, but the intubation time was longer than with the direct laryngoscope. And among the three, the ALRYNGO and Pentax-AWS had the highest frequency of C-L grade I (easiest intubation) at 80%, and the direct laryngoscope had the lowest frequency of 10%. Conclusions Even if healthcare professionals without experience with the channel-type video laryngoscope improve their performance on airway mannequins after training, their intubation performance may differ when applied to actual patients.

Heart failure is a global major healthcare problem with millions of hospitalizations annually and with a very high mortality. There is an increased interest in finding new and reliable biomarkers for the diagnostication, prognostication and therapeutical guidance of patients hospitalized for acute heart failure. There is data to sustain the role of CA 125, a worldwide used marker of ovarian cancer, in patients with heart failure. Several studies have shown links between CA 125 levels and congestion seen in acute heart failure, high mortality and readmission rates at 6 months follow up after discharge from acute heart failure and also a role of CA 125 in the guidance of heart failure therapy. There are also clinical trials that showed that several particularities of CA 125 make it even better than NTpro BNP ( a classical and more utilised marker of heart failure) in several scenarios of acute heart failure.

Systemic inflammation and coronary microvascular endothelial dysfunction are essential pathophysiological factors in heart failure with preserved ejection fraction (HFpEF) that support the use of statins. The pleiotropic properties of statins, such as anti-inflammatory, antihypertrophic, antifibrotic, and antioxidant effects, are generally accepted and may be beneficial in HF, especially in HFpEF. Numerous observational clinical trials have consistently shown a beneficial prognostic effect of statins in patients with HFpEF, while the results of two larger trials in patients with HFrEF have been controversial. Such differences may be related to a more pronounced impact of the pleiotropic properties of statins on the pathophysiology of HFpEF and pro-inflammatory comorbidities (arterial hypertension, diabetes mellitus, obesity, chronic kidney disease) that are more common in HFpEF. This review discusses the potential mechanisms of statin action that may be beneficial for patients with HFpEF, as well as clinical trials that have evaluated the statin effects on left ventricular diastolic function and clinical outcomes in patients with HFpEF.

Background and Objectives: High job strain is worsening the outcome in coronary artery disease, CAD. Severe dissatisfaction on workplace, imbalance between high demands , and low rewards, are affecting the quality of life, and diminishing the duration of life, especially in CAD patients. Our study included two samples : CAD patients (experimental group), and without CAD patients, but with traditional risk factors (control group). The main objective of the study was the role played by high sensitivity C reactive protein, hs CRP, and microalbuminuria, as mediators of job strain and CAD relationship. Secondary objectives were the following: identification of the most vulnerable patients( with significant job strain) and intervention towards this category, for cardiovascular events prevention (primary or secondary). Materials and Methods: The utilized methods were the following : clinical exam; electrocardiogram; echocardiogram; non contrast enhanced computed chest tomography; laboratory findings ( lipid profile, glycemia, hs CRP, microalbuminuria); type D scale, DS 14; depression questionnaire, PHQ-9; and satisfaction with work scale, SWWS. Results: The highest values for hs CRP and microalbuminuria were noticed in patients with the lowest Likert score, for both samples CAD, and without CAD patients. The highest job strain was noticed in females. More than half of CAD patients ,with low Likert scores, revealed myocardial infarction. Conclusions: Microalbuminuria and hs CRP were statistical significant in the study as intercessors, in job strain and CAD relationship. The most vulnerable patients for vascular events were females, in both groups : CAD and “CAD waiting desk”. In CAD sample, the vascular vulnerability was also increased by high job strain.

This report covers the analysis of Intrusion Detection Systems nowadays. Therefore, it focuses on the IDS classification, which includes not only a well-known explanation of Network/Host-Based IDS type but also cloud-based solutions. The paper explores ways of intrusion detection, providing examples of the best detecting tools (OSSEC, Snort or Bro (ZEEK)). Another aspect covered in this report is the juxtaposition of three systems: IDS, IPS and IRS and their response. Finally, there will be presented Intrusion Detection Systems' evasion techniques and challenges, followed by critical conclusions.

Background: In this investigation, we explored the effects of pharmacological cholinergic stimulation on cardiac function and renal inflammation following acute myocardial infarction (AMI) in spontaneously hypertensive rats (SHRs). Methods: Adult male SHRs were randomized into three experimental groups: sham-operated; AMI+Veh (infarcted, treated with vehicle); and AMI+PY (infarcted, treated with the cholinesterase inhibitor pyridostigmine bromide (PY) - 40 mg/kg, once daily for seven days). Rats were euthanized 7 or 30 days post-surgery. Clinical parameters were assessed on the day before euthanasia. Subsequent to euthanasia, blood samples were collected and renal tissues were harvested for histological and gene expression analyses aimed to evaluate inflammation and injury. Results: Seven days post-surgery, the AMI+PY group demonstrated improvements in left ventricular diastolic function and autonomic regulation, and a reduction in renal macrophage infiltration compared to the AMI+Veh group. Furthermore, there was a notable downregulation of pro-inflammatory gene expression and an upregulation of anti-inflammatory gene expression. Analysis 30 days post-surgery showed that PY treatment had a sustained positive effect on renal gene expression, correlated with a decrease in biomarkers indicative of subclinical kidney injury. Conclusion: Short-term cholinergic stimulation with PY provides both cardiac and renal protection by mitigating the inflammatory response after AMI.

Heart failure (HF) is a growing issue in developed countries and most patients present with a reduced ejection fraction. This condition significantly impairs quality of life and represents a threat not only for patients, but also for the entire healthcare system due to its high management cost. In the last decade, new medical treatments and devices have been developed to reduce HF hospitalizations and improve prognosis, while reducing the overall mortality rate. Medical therapy does not achieve the same results in all patients and, whenever it fails, technology comes in handy: novel devices for the management of HF have reduced symptoms. They have also improved the treatment of fluid retention and life threatening arrhythmias. The present review article gives to the readers a comprehensive overview of the most recent and important findings that need to be considered in HF with reduced ejection fraction patients. Both novel medical treatments and devices have been presented and discussed.

Aspalathin (ASP) can protect H9c2 cardiomyocytes against high glucose (HG)-induced shifts in myocardial substrate preference, oxidative stress and apoptosis. While the protective mechanism of aspalathin remains unknown, nuclear factor (erythroid-derived 2)-like 2 (Nrf2) has emerged as a key factor for intracellular responses against oxidative stress. Therefore, we hypothesized that aspalathin protects the myocardium against hyperglycemia-induced oxidative damage by up-regulating Nrf2 expression in H9c2 cardiomyocytes and diabetic (db/db) mice. Using an oxidative stress RT2 Profiler PCR array, ASP at a dose of 1 µM was demonstrated to protect H9c2 cardiomyocytes against HG-induced oxidative stress, but silencing of Nrf2 abolished this protective response of ASP and exacerbated cardiomyocyte apoptosis. Db/db mice and their non-diabetic (db/+) littermate controls were subsequently treated daily for 6 weeks with either a low (13 mg/kg) or high (130 mg/kg) ASP dose. Compared to nondiabetic mice the db/db mice presented increased cardiac remodeling and enlarged left ventricular wall that occurred concomitant to enhanced oxidative stress. Daily treatment of mice with ASP at a dose of 130 mg/kg for 6 weeks was more effective at reversing complications than both a low dose ASP or metformin, eliciting enhanced expression of Nrf2 and its downstream antioxidant genes. These results indicate that ASP maintains cellular homeostasis and protects the myocardium against hyperglycemia-induced stress through activation of Nrf2 and its downstream target genes.

This review aims to explore the intricate relationship between epigenetic mechanisms, stress, and affective disorders, focusing on how early life experiences and coping mechanisms contribute to susceptibility to mood disorders. Epigenetic factors play a crucial role in regulating gene expression without altering the DNA (deoxyribonucleic acid) sequence, and recent research has revealed associations between epigenetic changes and maladaptive responses to stress or psychiatric disorders. A scoping review of 33 studies employing the PRISMA-S (Preferred Reporting Items for Systematic Reviews and Meta-Analyses – Statement) guidelines investigates the role of stress-induced epigenetic mechanisms and coping strategies in affective disorders' occurrence, development, and progression. The analysis encompasses various stress factors, including childhood trauma, work-related stress, and dietary deficiencies, alongside epigenetic changes such as DNA methylation and altered gene expression. Findings indicate that specific stress-related genes frequently exhibit epigenetic changes associated with affective disorders. Moreover, the review examines coping mechanisms in patients with bipolar disorder and major depressive disorder, revealing mixed associations between coping strategies and symptom severity. While active coping is correlated with better outcomes, emotion-focused coping may exacerbate depressive or manic episodes. Overall, this review underscores the complex interplay between genetic predisposition, environmental stressors, coping mechanisms, and affective disorders. Understanding these interactions is essential for developing targeted interventions and personalized treatment strategies for individuals with mood disorders. However, further research is needed to elucidate specific genomic loci involved in affective disorders and the clinical implications of coping strategies in therapeutic settings.

Synchronous electrical cardioversion is a relatively common procedure in the emergency department (ED), often performed for unstable supraventricular tachycardia (SVT) or unstable ventricular tachycardia (VT). However, it is also used for stable cases resistant to drug therapy, which carry a risk of deterioration. In addition to the inherent risks linked with procedural sedation, there is a possibility of malignant arrhythmias or bradycardia, which could potentially result in cardiac arrest following this procedure. Here, we present a case of complete heart block unresponsive to transcutaneous pacing and positive inotropic and chronotropic drugs for 90 minutes, resulting in multiple cardiac arrests. The repositioning of the transcutaneous cardio-stimulation electrodes, one of them placed in the left latero-sternal position and the other at the level of the apex, led to immediate stabilization of the patient. Extubation of the patient was performed the following day, while full recovery and discharge within 7 days, after insertion of a permanent pacemaker.

Congenital heart disease (CHD) is a prevalent congenital disorder diagnosed with high frequency, affecting approximately 0.8% to 1.2% of all live births. Research has demonstrated that the use of pulse oximetry and clinical examination as a screening tool for CHD diagnosis has proven extremely valuable. We conducted a retrospective longitudinal study over a 3-year period that involved screening 1188 newborns admitted to the NICU during the first 72 hours of life within this timeframe. 201 newborns were diagnosed with CHD. Almost all (n=198) had a positive screening test during the 72-hour period, while 3 had a negative screening test, but were later diagnosed using echocardiography. The prevalence rate was 16.67%. A confusion matrix was constructed with 198 true positives (TP), 3 false negatives (FN), no false positives (FP), and 987 true negatives (TN). The sensitivity of the screening test was 98.51%, while the specificity 100%, with no false positives. In our study, a total of 9 deaths occurred. Using the Kaplan-Meier method, the survival probability appeared to be slightly above 0.9 (95.5%), indicating that almost all patients survived past 72 hours after being diagnosed with CHD. Pulse oximetry is an effective, low cost and easy-to-use method and a useful tool to assess and lead to the diagnosis of CHD.

In recent years, wireless networks have undoubtedly become a convenient way to connect to the Internet and provide connection to everyone in any corner of the world. In fact, in this era, people are connected to the internet almost everyday and wireless networks give us this privilege in a seamless manner. A wireless network normally consists of access points and nodes where the access points are responsible to amplify the wireless signals, while the nodes are the gadgets that are receiving these signals. However, with such great convenience provided, many challenges are also faced by the users and stakeholders. With no physical connection to devices, wireless networks are evidently more vulnerable to invisible cyber attacks. In this research paper, it the security issues that cause issues in the wireless networks are discussed. Furthermore, an analytical review of privacy challenges found in these networks is performed; these challenges are segregated into security issues and privacy issues. The paper will then present the methods used in conducting a survey and gathering the research results along with further discussion on the results obtained through this study. Finally, a suitable solution is proposed to prevent and overcome the intrusions faced in terms of security and privacy in wireless network scenarios through detection and response mechanism for mitigation of the problems.

Recently, with the rapid advancement of technology, Internet of Things (IoT‏‏‏‏) security has become more efficient and more complex, especially for resource-limited devices such as embedded devices, wireless sensors and radio frequency identification tags (RFID). Lightweight block ciphers (LBCs) provide security for these technologies to protect them against adversaries, but the need for low power consumption in LBCs is one of the most important challenges for IoT‏ technologies. Furthermore, these LBCs are subject to multiple attacks and side channel attacks (SCAs) are among the mentioned threats to these cryptosystems. A type of SCA is correlation power analysis (CPA) in which the attacker tries to reach the key using the relationship between the power consumption of the chip during the algorithm running, data processing, and operations. In this article, a CPA attack is designed to discover master key of the Midori-64 block cipher. According to the proposed method, an attack is done to the first round S-boxes to get half of the key bits. Then, the second round S-boxes were attacked to other half of key bits just use 300 plain text samples. Finally, the most important physical attacks performed on the Midori, are compared to our proposed CPA attack.

Background and Objectives: Wilson disease (WD) is a disorder of copper metabolism caused by genetic muta-tions in the ATP7B gene which lead to the accumulation of copper in the body. The aim of the present study is to investigate the severity of WD in patients in Romania. Materials and Methods: This study was conducted us-ing an online questionnaire consisting of 32 questions in a group of patients suffering from Wilson disease. Results: The study included 67 people aged 7 to 56 with WD. The most common symptoms of the participants were hepatic and neurological in 22 cases (32.8%). The most common neurological symptom in the assessed cases was muscle stiffness (49.5%), followed by tremor (45%), and speech disorders (40.5%). The Kay-ser-Fleischer ring was present in 50.7% of the participants. The most commonly used drug treatment in the participants was D-penicillamine (77.61%). Conclusions: The severity of WD is based on many aspects, the most important being early diagnosis and access to treatment throughout the year. The prognosis is favorable with early diagnosis and treatment, but it is crucial to diagnose individuals before they develop major symp-toms. Therefore, advances in WD screening can lead to an earlier diagnosis and better results.

Mobile Ad hoc Networks (MANETs) play an important role in the technological era by enabling wireless communication in dynamic and infrastructure-free contexts. Because of Manet’s unique qualities and decentralized nature, MANETs are subject to many attacks such as the Blackhole attack, grey hole attack, Byzantine attack, Wormhole attack, and Sybil attack. Sybil attacks pose a substantial risk to MANETs. A Sybil attack occurs when a malicious node impersonates many identities inside the network, resulting in the creation of multiple suspicious nodes that appear as independent entities. This study presents a thorough analysis of the literature on the detection of Sybil attacks on MANETs. To find gaps in the literature, current surveys are also looked at. Also taken into consideration are several contemporary systems built on distinct techniques. In terms of throughput, detection rate, low energy consumption, packet delivery ratio, and end-to-end latency, some recent methods-based approaches are also evaluated severely. To address the stated state-of-the-art issues in Sybil attack detection, this paper suggests ML-based strategies as the most suitable answer. Machine learning has huge potential for effective wireless network management. According to the researcher, this is the first comprehensive assessment of ML-based techniques for Sybil attack detection in wireless networks. Finally, we considered the unsolved issues in Sybil assault detection in wireless networks.

Currently, face recognition technologies are the most widely used methods for verifying 1an individual’s identity. Nevertheless, it has increased in popularity, raising concerns about face spoofing attacks, in which a photo or video of an authorized person’s face is used to get access to services. Based on a combination of Background Subtraction (BS) and Convolutional Neural Networks (CNN), as well as an ensemble of classifiers, we propose an efficient and more robust face spoof detection algorithm. This algorithm includes a Fully Connected (FC) classifier with a Majority Vote (MV) algorithm, which uses different face spoof attacks (e.g., printed photo and replayed video). By including a majority vote to determine whether the input video is genuine or not, the proposed method significantly enhances the performance of the Face Anti-Spoofing (FAS) system. For evaluation, we considered the MSU MFSD, REPLAY-ATTACK, and CASIA-FASD databases. The obtained results by our proposed approach are better than those obtained by state of the art methods. On the REPLAY-ATTACK database, we were able to attain a Half Total Error Rate (HTER) of 0.62% and an Equal Error Rate (EER) of 0.58%. It was possible to attain an EER of 0% on both the CASIA-FASD and the MSU FAS databases.

The danger is still very large from cross site scripting attacks. When designing web applications We must follow as much as we can prevention rules and don’t leave any loophole to our programs. Experience is a great factor for programmers to know these attacks and for a trainee programmer is a difficult task to spot all the weak points. In this article we present a tutorial on launching an XSS attack and also we propose simple solutions.

IoTs and WSNs utilize their connectivity to enable solutions supporting a spectrum of industries in different and volatile environments. To effectively enhance the security and quality of service of networks, empirical research should take into account a variety of factors and be structured in a replicable manner. This will not only ensure scalability but also enable verification of conclusions, leading to more constructive outcomes. Cooja offers limited performance analysis capabilities of simulations, which are often extracted and calculated manually. In this paper, we introduce a framework and a toolkit that enable researchers to conduct structured and conclusive experiments considering different factors and metrics, experiment design to results analysis. Besides, this tool summarizes multiple network metrics and allows multiple scenarios. As proof of concept, this paper studies the flooding attacks on IoT and illustrates their impact on the network, leveraging the proposed framework and tools.

Recently, there has been growing interest in using smart eHealth systems to manage asthma. However, limitations still exist in providing smart services and accurate predictions tailored to individual patients’ needs. This study aims to develop an adaptive ubiquitous computing framework that leverages different bio-signals and spatial data to provide personalized asthma attack prediction and safe route recommendations. We proposed a smart eHealth framework consisting of multiple layers that employ telemonitoring application, environmental sensors, and advanced machine-learning algorithms to deliver smart services to the user. The proposed smart eHealth system predicts asthma attacks and uses spatial data to provide a safe route that drives the patient away from any asthma trigger. Additionally, the framework incorporates an adaptation layer that continuously updates the system based on real-time environmental data and daily bio-signals reported by the user. The developed telemonitoring application collected a dataset containing 665 records used to train the prediction models. The testing result demonstrates a remarkable 98% accuracy in predicting asthma attacks with a recall of 96%. The eHealth system was tested online by ten asthma patients, and its accuracy achieved 94% of accuracy and a recall of 95.2% in generating safe routes for asthma patients, ensuring a safer and asthma-trigger-free experience. The test shows that 89% of patients were satisfied with the safer recommended route than their usual one. This research contributes to enhancing the capabilities of smart healthcare systems in managing asthma and improving patient outcomes. The adaptive feature of the proposed eHealth system ensures that the predictions and recommendations remain relevant and personalized to the current conditions and needs of the individual.

Aim: To investigate the effects of intensive physical exercise on retinal microvascular regulation in healthy volunteers by the adaptive optics retinal camera measurement. Methods: We included healthy volunteers (11 men and 14 women) aged 20.6± 0.9. Heart rate (HR) and systolic and diastolic blood pressure (SBP, DBP) were recorded before and after a submaximal physical exertion of continuously riding a training ergometer. The superior temporal retinal artery measurements were captured using the adaptive optics (AO) camera rtx1TM (Imagine Eyes, Orsay, France) without pupil dilatation. We compared measures of vessel diameter (VD), lumen diameter (LD), two walls (Wall 1, 2), wall-to-lumen ratio (WLR), and wall cross-sectional analysis (WCSA) before and immediately after the cessation of exercise. Results: Cardiovascular parameters: After exercise, SBP, DBP and HR changed significantly from 130.2±13.2 to 159.7±15.6 mm Hg, 81.2±6.3 to 77.1±8.2 mm Hg and 80.8±16.1 to 175.0±6.2 bpm, respectively (p < 0.002). Retinal microcirculation analysis: Before the exercise, the mean LD was 96.0±6.8, VD 118.5±8.3, WLR 0.234±0.02, WCSA 3802.8±577.6. The mean LD and Wall 1 did not change significantly after exercise but slightly decreased. The VD, Wall 2, WLR and WCSA decreased significantly (p

Environmental contamination has exposed humans to various metal agents, including mercury. It has been determined that mercury is not only harmful to the health of vulnerable populations such as pregnant women and children, but is also toxic to ordinary adults in various ways. For many years, mercury was used in a wide variety of human activities. Nowadays, the exposure to this metal from both natural and artificial sources is significantly increasing. Recent studies suggest that chronic exposure, even to low concentration levels of mercury, can cause cardiovascular, reproductive and developmental toxicity, neurotoxicity, nephrotoxicity, immunotoxicity, and carcinogenicity. Possible biological effects of mercury, including the relationship between mercury toxicity and diseases of the cardiovascular system, such as hypertension, coronary heart disease and myocardial infarction, are being studied. As heart rhythm and function are under autonomic nervous system control, it has been hypothesized that the neurotoxic effects of mercury might also impact cardiac autonomic function. Mercury exposure could have a long-lasting effect on cardiac parasympathetic activity and some evidence show that mercury exposure might affect heart rate variability, particularly early exposures in children. The mechanism by which mercury produces toxic effects on the cardiovascular system is not fully elucidated, but this mechanism is believed to involve an increase in oxidative stress. The exposure to mercury increases the production of free radicals, potentially because of the role of mercury in the Fenton reaction and a reduction in the activity of antioxidant enzymes, such as glutathione peroxidase. In this review we report an overview on the toxicity of mercury and focus our attention on the toxic effects on the cardiovascular system.

The presence of wireless communication grows undeniably more prevalent each year. Since the introduction of the IEEE 802.11 standard for Wireless Local Area Networks (WLAN) in 1997, technologies have progressed to provide wireless accessibility to industries and consumers with growing ease and convenience. As the usage of personal devices, such as phones and watches, that connect to the Internet through Wi-Fi increases, wireless attacks on users are becoming more critical. This paper provides a novel attack model to offer an organized and comprehensive view of the possible attacks on WiFi latest security standards. All exiting attacks will be investigated, with emphasis on more recent attacks, such as the KRACK and PMKID Dictionary attacks. This paper will then analyze the technology offered in the new Wi-Fi Protected Access III (WPA3) security scheme and provide a comprehensive security analysis and discussion to determine whether it has addressed the vulnerabilities of its predecessor. An interesting finding of this paper is that WPA3 still lacks to address all the issues existed in WPA2 and explore other mitigations for future research.

With the latest advances in information and communication technologies, greater amounts of sensitive user and corporate information are constantly shared across the network making it susceptible to an attack that can compromise data confidentiality, integrity and availability. Intrusion Detection Systems (IDS) are important security mechanisms that can perform a timely detection of malicious events through the inspection of network traffic or host-based logs. Throughout the years, many machine learning techniques have proven to be successful at conducting anomaly detection but only a few considered the sequential nature of data. This work proposes a sequential approach and evaluates the performance of a Random Forest (RF), a Multi-Layer Perceptron (MLP) and a Long-Short Term Memory (LSTM) on the CIDDS-001 dataset. The resulting performance measures of this particular approach are compared with the ones obtained from a more traditional one, that only considers individual flow information, in order to determine which methodology best suits the concerned scenario. The experimental outcomes lead to believe that anomaly detection can be better addressed from a sequential perspective and that the LSTM is a very reliable model for acquiring sequential patterns in network traffic data, achieving an accuracy of 99.94% and a f1-score of 91.66%.

Investigating the network response to node removal and the efficacy of the node removal strategies are related and fundamental questions in network science. Research studies proposed many node centralities based on the network structure ranking node to remove. The random walk (RW) on networks describes a stochastic process in which a walker travels among nodes. RW can be a model of transport, diffusion, and search on networks, and an essential tool for studying the importance of network nodes. In this manuscript, we propose four new measures of node centrality based on RW. Then, we compare the efficacy of the new RW node removal strategies to network dismantle with effective node removal strategies from the literature, such as betweenness and closeness node removal over synthetic and real-world networks. We evaluate the network dismantle along node removal using the size of the largest connected component (LCC). We find that, hence the betweenness nodes attack is the best strategy overall, the new node removal strategies based on RW show the highest efficacy in peculiar network topology. Specifically, RW strategies based on covering times emerge as the most effective strategy on a synthetic lattice network and two real-world road networks. Our results may be useful in selecting the best node attack strategies in a specific class of networks and in building more robust network structures.

The present study evaluates the response to betahistine in patients who presented vestibular drops attacks in the context of Ménière's disease (MD) and the factors that can predict an unfavorable response to it. A total of 43 patients were analyzed, out of which 33 were diagnosed with MD. It is a descriptive, cross-sectional study with retrospective data collection. Data as regards age, accompanying symptoms, etiological diagnosis and response to MD treatment were collected. A statistical analysis was carried out, and we found that the disease evolution time and specific alterations in the vestibulospinal and oculomotor physical examination present an unfavorable response to betahistine, as opposed to the use of intratympanic gentamicin, with which symptomatic control is achieved in 100% of the cases.

In addition to identifying and prosecuting cyber attackers, attack attribution activities can provide valuable information guiding the defenders’ security procedures and giving them greater confidence in incident response and remediation. However, technical analysis involved in cyberattack attribution requires high skills, experience, access to up-to-date Cyber Threat Intelligence, and significant investigators’ effort. Attribution results are not always reliable, and skilful attackers often work hard to cover their traces and mislead or confuse investigators. In this article, we present a tool designed to support technical attack attribution and implemented as a machine learning model extending the OpenCTI platform. We also discuss the tool’s performance in the investigation of a recent cyberattack.

The development of wireless sensor networks (WSNs) technology comes with inherent limitations and vulnerabilities that make it exploitable by intruders. The fundamental goal of this article is to solve security problems related to black hole attacks, which interfere with the proper performance of the network and can lead to data leakage and loss. The proposed solution in this article is to apply IDS to a WSN for the first time. We also used the NS2.35 simulator to compare the three routing protocols, AODV, AODV under Hacker Node (HNAODV), and the proposed solution (IDSHNAODV) in the WSN model to reduce the effects of black hole attacks.

Shark unprovoked attacks consist of fatal and non-fatal cases. Numerous cases have been reported involving shark species from Carcharhinus melanopterus with length of 145.5 cm to half-ton Carcharodon carcharias. Currently there are more (P < 0.05) unprovoked non-fatal cases with the average is 28.46 cases/shark species (95%CI: 3.86-53.1) than unprovoked fatal cases, which the average is 5.12 cases /shark species (95%CI: -0.075-10.3). Hence this paper seeks to select the best shark size model that correlates with the unprovoked fatal and non-fatal cases. The studied sharks consist of 24 shark species with the average length is 268.18 cm (95%CI: 230-306 cm) and the average weight is 225.42 kg (95%CI: 128-323 kg). Based on the model and as described by low values of AIC and the highest values of R² and adjusted R² , shark weight followed by combinations of shark weight and length produced unprovoked fatal and non-fatal cases best models. The model for explaining unprovoked fatal cases is the shark weight with high numbers of cases observed in large size shark (weight⁓fatal cases, AIC = 165.359, R² = 0.72, Adj. R = 0.71). While for non-fatal cases, the best model is also the shark weight (weight⁓non fatal cases, AIC = 246.93, R² = 0.63, Adj. R = 0.59).

Pregnancy is a complex biological process which is associated with significant metabolic and hemodynamic changes of the maternal body which allow a normal fetal growth. The inability to adapt to these changes can affect the cardiovascular health. During pregnancy, women may experience mood swings, anxiety and emotional ambivalence. These symptoms can lead to stress and have a negative impact on the mental well-being of expectant mothers. It is crucial to know the aspects that can influence the development of cardiovascular problems among pregnant women in order to manage these cases properly. The current narrative review explores and summarizes the evidence regarding the impact of stress and anxiety on cardiovascular health in pregnant women. Understanding the physiological adaptations that the body undergoes throughout pregnancy is crucial for educating and supporting individuals as well as healthcare professionals. This enables them to recognize any risk factors or pathological conditions that may exacerbate pregnant women's health. In order to reduce maternal morbidity and mortality from cardiovascular disease, a psychological and cardiovascular risk factor screening that is done either before or during pregnancy may be able to identify situations that call for particular medical and/or psychological therapies.

Growing interest has accrued in the co-existence of cardiac amyloidosis and valvular heart disease. Amyloid infiltration from either transthyretin (ATTR) or light chain (AL) origin may affect any structure of the heart, including the valves. Recent literature has mainly focused on aortic stenosis and cardiac amyloidosis, improving our understanding of epidemiology, diagnosis, treatment and prognosis of this dual pathology. Even though of high clinical relevance, data on mitral/tricuspid regurgitation and cardiac amyloidosis is rather scarce and mostly limited to case reports and small cases series. It is the aim of this review article to summarize the current evidence of concomitant valvular heart disease and cardiac amyloidosis including epidemiology, diagnostic approaches, screening possibilities, therapeutic management, and prognostic implications.

Brain hemispheres develop rather symmetrically except in the case of pathology or intense training. As school experience is a form of training, the current study tested the influence of pedagogy on morphological development through the cortical thickness (CTh) asymmetry index (AI). First, we compared CTh AI of 111 students aged 4 to 18 with 77 adults aged > 20. Second, we investigated CTh AI in the students, as a function of schooling background (Montessori or traditional). At the whole-brain level, CTh AI was not different between the adult and student groups, even when controlling for age. However, the pedagogical experience was found to impact CTh AI in the temporal lobe, within the parahippocampal (PHC) region. The PHC has a functional lateralization, with the right PHC having a stronger involvement in spatiotemporal context encoding, while the left PHC is involved in semantic encoding. We observed CTh asymmetry toward the left PHC for participants enrolled in Montessori schools and toward the right for participants enrolled in traditional schools. As these participants were matched on age, intelligence, home life, and socioeconomic conditions, we interpret this effect found in memory-related brain regions to reflect differences in learning strategies. Pedagogy modulates how new concepts are encoded, with possible long-term effects on knowledge transfer.

The violation of data integrity in automotive Cyber-Physical Systems (CPS) may lead to dangerous situations for drivers and pedestrians in terms of safety. In particular, cyber-attacks on the sensor could easily degrade data accuracy and consistency over any other attack, we investigate attack detection and identification based on a deep learning technology on wheel speed sensors of automotive CPS. For faster recovery of a physical system with detection of the cyber-attacks, estimation of a specific value is conducted to substitute false data. To the best of our knowledge, there has not been a case of joining sensor attack detection and vehicle speed estimation in existing literatures. In this work, we design a novel method to combine attack detection and identification, vehicle speed estimation of wheel speed sensors to improve the safety of CPS even under the attacks. First, we define states of the sensors based on the cases of attacks that can occur in the sensors. Second, Recurrent Neural Network (RNN) is applied to detect and identify wheel speed sensor attacks. Third, in order to estimate the vehicle speeds accurately, we employ Weighted Average (WA), as one of the fusion algorithms, in order to assign a different weight to each sensor. Since environment uncertainty while driving has an impact on different characteristics of vehicles and cause performance degradation, the recovery mechanism needs the ability adaptive to changing environments. Therefore, we estimate the vehicle speeds after assigning a different weight to each sensor depending on driving situations classified by analyzing driving data. Experiments including training, validation, and test are carried out with actual measurements obtained while driving on the real road. In case of the fault detection and identification, classification accuracy is evaluated. Mean Squared Error (MSE) is calculated to verify that the speed is estimated accurately. The classification accuracy about test additive attack data is 99.4978%. MSE of our proposed speed estimation algorithm is 1.7786. It is about 0.2 lower than MSEs of other algorithms. We demonstrate that our system maintains data integrity well and is safe relatively in comparison with systems which apply other algorithms.

Analyzing network robustness against random failures or malicious attacks is a critical research issue in network science as it helps to enhance the robustness of beneficial networks or efficiently disintegrate harmful networks. Most studies commonly neglect the impact of the attack success rate (ASR) and assume that attacks on the network will always be successful. However, in real-world scenarios, an attack may not always succeed. This paper proposes a novel robustness measure called Robustness-ASR (RASR), which utilizes mathematical expectations to assess network robustness when considering the ASR of each node. To efficiently compute the RASR for large-scale networks, a parallel algorithm named PRQMC is presented, which leverages randomized quasi-Monte Carlo integration to approximate the RASR with a faster convergence rate. Additionally, a new attack strategy named HBnnsAGP is introduced to better assess the lower bound of network RASR. Finally, the experimental results on 6 representative real-world complex networks demonstrate the effectiveness of the proposed methods compared with the state-of-the-art baselines.

Cloud robot is becoming popular and security of cloud robot is important. However, the researches of cloud robot safety are a few. This work develops a security policy to defense DDoS attack of cloud robot. In this policy, complex, but accurate calculation models are deployed on the cloud, simple but efficient calculation models are deployed on the robot. In the cloud, there are master server and standby server. The master server transfers parameters of complex but accurate models to the standby server periodically and the master executes the start-stop backup policy. Specifically, this work proposes and proves an algorithm to dynamically adjust the interval of parameter transfer. According to a PDRA feature of Netflow, when DDoS attacks, the master server sends warning signals to the robot and standby server. The robot runs local models to avoid stopping work until it is connected to the standby server. Then, standby server provides service to the robot until the master server recover. Finally, this work implemented a gesture recognition cloud robot based on convolutional neural network, hidden Markov model and PDRA feature of Netflow to verify the policy. Experiment shows that the security policy to defense DDoS attack for cloud robot is effective.

Seeds play a vital role in the perpetuation of plant species, both in natural environments and agriculture. However, they often face challenges from biotic stresses, such as seedborne pathogenic fungi. The transgenerational transmission of these seedborne fungi, along with their dissemination during seed commercialization, can contribute to the emergence of global epidemic diseases, resulting in substantial economic losses. One such pathogenic fungus is Alternaria brassicicola, responsible for causing black spot disease in Brassicaceae. This necrotrophic seedborne fungus negatively impacts plant development, consequently affecting crop production and seed quality. To gain a deeper understanding of the interaction between seeds and necrotrophic fungi, the Arabidopsis thaliana/Alternaria brassicicola model pathosystem has been extensively studied. Recent transcriptomic and genetic studies revealed a distinctive immune response of seeds against this pathogen, divergent from the immune response described in the plant vegetative phase. In germinating seeds and seedlings, the necrotrophic fungus seems to induce susceptible response [1]. It was observed at the RNA level that to the detriment of jasmonic acid pathway, Alternaria induced the salicylic acid and glucosinolate (GSL) pathways. Genetic evidence identified that seedling necrosis, potentially beneficial to the growth of the necrotrophic agent, is hypersensitive response mediated by GSL pathway. Transmission of necrotrophic fungal from seed to seedling unveils novel regulations of the immune response, that would illustrate a trade-off between seedling establishment and fungal infection. This knowledge is promising to sustainably ensure the sanitary quality of crops.

Due to the advancement and availability of internet in present age, device tend to become wireless as well. Mobile ad-hoc network is a wireless environment that consist of advanced agility of nodes and does not contain on any central administrative authority. As it does not contain any central administrative authority so being wireless environment, the network is vulnerable to security threats and suffers in performance as well. Security of MANET is the core issue in this era, meanwhile the data is sent over untrustworthy network. Several techniques were proposed to secure data over Mobile Adhoc Network though cryptography that is one of the most reliable techniques to protect data. In our proposed methodology a Secure Cryptographic technique for Mobile Adhoc Networks (SCTMA) we proposed A Collusion attack prevention (CAP) scheme with ElGamal key generator along with DNA encryption Algorithm is used to make it more secure. The proposed scheme protects the network against collusion attacks and improves the performance as well. Performance analysis will be measured on the basis of key generation time, response time, encryption time and decryption time. The proposed scheme also protects the network against collusion attacks.

The ability of deep learning to process vast data and uncover concealed malicious patterns has spurred the adoption of deep learning methods within the cybersecurity domain. Nonetheless, a notable hurdle confronting cybersecurity researchers today is the acquisition of a sufficiently large dataset to train deep learning models effectively. Privacy and security concerns associated with using real-world organization data have made cybersecurity researchers seek alternative strategies, notably focusing on generating synthetic data. Generative Adversarial Networks (GANs) have emerged as a prominent solution, lauded for their capacity to generate synthetic data spanning diverse domains. Despite their widespread use, the efficacy of GANs in generating realistic cyber attack data remains a subject requiring thorough investigation. Moreover, the proficiency of deep learning models trained on such synthetic data to accurately discern real-world attacks and anomalies poses an additional challenge that demands exploration. This paper delves into essential aspects of generative learning, scrutinizing their data generation capabilities, and conducts a comprehensive review to address the above questions. Through this exploration, we aim to shed light on the potential of synthetic data in fortifying deep learning models for robust cybersecurity applications.

Attack investigation is an important research field in forensics analysis. Many existing supervised attack investigation methods rely on well-labeled data for effective training. While the unsupervised approach based on BERT can mitigate the issues, the high degree of similarity between certain real-world attack and normal behaviors makes it challenging to accurately identify disguised attacks. This paper proposes ConLBS, an attack investigation approach that combines the contrastive learning framework and multi-layer Transformer network to realize the classification of behavior sequences. Specifically, ConLBS constructs behavior sequences describing behavior patterns from audit logs, and a novel lemmatization strategy is proposed to map the semantics to the attack pattern layer. Four different augmentation strategies are explored to enhance the differentiation between attack and normal behavior sequences. Moreover, ConLBS can perform unsupervised representation learning on unlabeled sequences, and can be trained either supervised or unsupervised depending on the availability of labeled data. The performance of ConLBS is evaluated in two public datasets. The results show that ConLBS can effectively identify at-tack behavior sequences in the cases of unlabeled data or less labeled data to realize attack investigation, and achieve the superior effectiveness compared to existing methods and models.

Background: The adoption of self-care behaviors among patients with congestive heart failure (CHF) is essential for the management of their health condition. However, there is a lack of tools for estimating self-care in CHF patients. We aim to develop and validate the Hippocratic heart failure self-care scale (HHFSCS). Methods: the scale includes 22 items which are reviewed by a committee of experts. Individuals indicate the frequency at which they follow each self-behavior on a five-point Likert scale. Adult patients with CHF (n=250) from a General Hospital, in Athens, were participated in the study from June 2020 to March 2021. Reliability coefficients and Explanatory Factor Analysis (EFA), using a Varimax rotation and the Principal Components Method were used to assess the psychometric measurements. Results: The Cronbach’s alpha coefficient of the HHFSCS was 0.807. The exploratory factor analysis identified two domains that accounted for 88.44% of the variance of the scale items; however, each sub-scale could not be used as an independent scale. Finally, the test-retest showed a significant strong correlation (r=0.973, p&lt;0.001). Conclusions: The HHFSCS is a reliable and valid tool for assessing self-behaviors in CHF patients. Health professionals can use it in their clinical practice to improve the management of patient’s health conditions.

Heart failure (HF) has become a public health problem, but exact pathophysiology is still unknown. Western diet characterised with high sugar, high fat, red meat and processed meat, eggs, fried foods and sweetened beverages, may cause oxidative stress and inflammation, leading to oxidative dysfunction and adverse effects on cardiac-ultra-structure. However, only little is known about oxidative function of the of the myocardium and how oxidative dysfunction predispose Ca-overloading resulting in to physio-pathological remodelling leading to HF. Antioxidants such as flavonoids and polyphenolics, omega-3 fatty acids, vitamins, minerals as well as essential and nonessential amino acids that are rich in Indo-Mediterranean type of diets, may have protective roles in maintaining oxidative functions of the heart. The cardiac cells use fatty acids and glucose for the metabolic functions depending upon physiological and metabolic requirements. Apart from glucotoxicity, lipotoxicity is also damaging to cardiac cells which worsen in presence of deficiency of endogenous antioxidants and lower exogenous antioxidants in the diet. There is increased production of ceramide, advanced glycation end products (AGE) and triamino-methyl-N-oxide (TMAO) due to high sugar and high fat diets, leading to oxidative dysfunction and Ca-overloading. The biological changes may begin with physiological remodelling to pathological remodelling due to oxidative damages. High fat diet in combination with inducible nitric oxide synthase (NOSi) via N-arginine methyl ester has been found to preserve ejection fraction in a mouse model of HF. It is possible that increased supplementation of High Exogenous Antioxidant Restorative Treatment (HEART) diet; polyphenolics and flavonoids, vitamins, minerals, arginine, with omega-3 fatty acids, and cessation of red meat and egg may further improve the oxidative function of cardiac cells, resulting in the prevention and improvement in the earliest of the Six Stages of HF. Cohort studies and randomised, controlled trials would be necessary for demonstration of the role of HEART diet in the management of HF.

Angiogenesis is a critical physiological response to ischemia but becomes pathological when dysregulated and driven excessively by inflammation. We recently identified a novel angiogenic role for tripartite-motif-containing protein 2 (TRIM2) whereby lentiviral shRNA-mediated TRIM2 knockdown impaired endothelial angiogenic functions in vitro. This study sought to determine whether these effects could be translated in vivo and to determine the molecular mechanisms involved. CRISPR/Cas9-generated Trim2–/– mice that underwent a periarterial collar model of inflammation-induced angiogenesis exhibited significantly less adventitial macrophage infiltration relative to wildtype (WT) littermates, concomitant with decreased mRNA expression of macrophage marker Cd68 and reduced adventitial proliferating neovessels. Mechanistically, TRIM2 knockdown in endothelial cells in vitro attenuated inflammation-driven induction of critical angiogenic mediators, including nuclear HIF-1α, and curbed the phosphorylation of downstream effector eNOS. Conversely, in a hindlimb ischemia model of hypoxia-mediated angiogenesis, there were no differences in blood flow reperfusion to the ischemic hindlimbs of Trim2–/– and WT mice despite a decrease in proliferating neovessels and arterioles. TRIM2 knockdown in vitro attenuated hypoxia-driven induction of nuclear HIF-1α but had no further downstream effects on other angiogenic proteins. Our study has implications for understanding the role of TRIM2 in the regulation of angiogenesis in both pathophysiological contexts.

Cardiovascular disease is the leading cause of death worldwide. A key factor in assessing the risk of cardiovascular disease is left ventricular functional evaluation. Left ventricular (LV) systolic function is evaluated by measuring the left ventricular ejection fraction (LVEF) using echocardiography data. Therefore, quick and accurate left ventricle segmentation is important for estimating the LVEF. However, it is difficult to accurately segment the left ventricle due to changes in the shape and area of the left ventricle during cardiac cycles. In this study, we proposed a framework that considers changes in the shape and area of the left ventricle during the cardiac cycle by applying the convolutional long short-term memory (CLSTM) approach. In addition, we evaluated the left ventricular segmentation and multidimensional quantification of the proposed system in comparison to manual and automated segmentation methods. In addition, to assess the validity of CLSTM, the values of multi-dimensional quantification metrics were compared and analyzed using graphs and Bland–Altman plots on a frame-by-frame basis. We demonstrated that the CLSTM method effectively segments the left ventricle by considering the LV activity. In conclusion, we demonstrated that LV segmentation based on our framework may be utilized to accurately estimate LVEF values.

We have developed deep learning models for automatic identification of the maternal heart rate (MHR) and, more generally, false signals (FSs) on fetal heart rate (FHR) recordings. The models can be used to preprocess FHR data prior to automated analysis or as a clinical alert system to assist the practitioner. Three models were developed and used to detect (i) FSs on the MHR channel (the FSMHR model), (ii) the MHR and FSs on the Doppler FHR sensor (the FSDop model), and (iii) FSs on the scalp ECG channel (the FSScalp model). The FSDop model was the most useful because FSs are far more frequent on the Doppler FHR channel. All three models were based on a multilayer, symmetric, GRU and were trained on data recorded during the first and second stages of delivery. The FSMHR and FSDop models were also trained on antepartum recordings. The training dataset contained 1030 expert-annotated periods (mean duration: 36 min) from 635 recordings. In an initial evaluation of routine clinical practice, 30 fully annotated recordings for each sensor type (mean duration: 5 h for MHR and Doppler sensors, and 3 h for the scalp ECG sensor) were analyzed. The sensitivity, positive predictive value (PPV) and accuracy were respectively 62.20%, 87.1% and 99.90% for the FSMHR model, 93.1%, 95.6% and 99.68% for the FSDop model, and 44.6%, 87.2% and 99.93% for the FSScalp model. We built a second test dataset with a more solid ground truth by selecting 45 periods (lasting 20 min, on average) on which the Doppler FHR and scalp ECG signals were recorded simultaneously. Using scalp ECG data, the experts estimated the true FHR value more reliably and thus annotated the Doppler FHR channel more precisely. The models achieved a sensitivity of 53.3%, a PPV of 62.4%, and an accuracy of 97.29%. In comparison, two experts (blinded to the scalp ECG data) respectively achieved a sensitivity of 15.7%, a PPV of 74.3%, and an accuracy of 96.91% and a sensitivity of 60.7%, a PPV of 83.5% and an accuracy of 98.24%. Hence, the models performed at expert level (better than one expert and worse than the other), although a well-trained expert with good knowledge of FSs could probably do better in some cases. The models and datasets have been included in the Fetal Heart Rate Morphological Analysis open-source MATLAB toolbox and can be used freely for research purposes.

Recently, methods to detect DoS and spoofing attacks that occur on in-vehicle networks using CAN Protocol are being studied through deep learning models such as CNN, RNN, and LSTM. These studies have produced significant results in the field of In-Vehicle Network attack detection using deep learning models. In addition, significant results are being achieved through research on applying time series-based deep learning models such as LSTM to detect DoS attacks and replay attacks occurring in in-drone networks by expanding them to drones using the UAVCAN protocol. In this paper, we conducted an experiment to detect in-drone network attacks through non-time series analysis using machine learning models and deep learning models, and through appropriate learning for each attack type, it can also be analyzed through non-time series analysis. The results showed that it was possible to detect attacks.

Smart grid capabilities have grown significantly in recent years. The smart grid provides advanced real-time handling of faults, advanced automatic control for efficient electricity transmission, monitoring and collection of the electrical system's capacity, and communication for information sharing. Unfortunately, its exposure to public networks makes it increasingly vulnerable to privacy breaches, vulnerabilities, and cyber-attacks. Cyber security threats and vulnerabilities in smart grid networks have become a primary concern that needs to be addressed before deploying a smart grid. Furthermore, the wide range of protocols increases the attack surface of a smart grid. This study focuses on the vulnerability of Modbus, which is regarded as one of the most prevalent protocols in smart grid communication networks. This paper presents preliminary findings of analyzing cyber-attacks against the Modbus protocol using a virtual testbed to investigate its effects on the smart grid network protocol. The concept incorporates an emulated Modbus/TCP network environment built from open-source software components that imitate fundamental industrial control features of the smart grid. Finally, we analyze the cycle of a cyber-attack leading through Reconnaissance to a DoS attack on the Modbus/TCP protocol and propose improvements to the test bed for protocol attack detection and mitigation.

Chronic kidney disease (CKD) and cardiovascular disease (CVD) are highly prevalent conditions, each significantly contributing to the global burden of morbidity and mortality. CVD and CKD share a great number of common risk factor, such as hypertension, diabetes, obesity, and smoking among others. Their relationship extends beyond these factors, encompassing intricate interplay between the two systems. Within this complex network of pathophysiological processes, vitamin D has emerged as a potential linchpin, exerting influence over diverse physiological pathways implicated in both CKD and CVD. In recent years, scientific exploration has unveiled a close connection between these two prevalent conditions and vitamin D, a crucial hormone traditionally recognized for its role in bone health. This article aims to provide an extensive review of vitamin D's multifaceted and expanding actions concerning its involvement in CKD and CVD.

The effects of the ferrocenyl moiety to enhance the nucleophilicity of the carbonyl group, situated at its adjacent position, have been explored in a series of α-ferrocenyl ketocarboxylic acids. In the presence of trifluoroacetic anhydride, 3-ferrocenoylpropionic acid and 4-ferrocenoylbutyric acid gave 5-ferrocenyl-4-trifluoroacetyl-2(3H)-furanone and 6-ferrocenyl-5-trifluoroacetyl-3,4-dihydropyran-2-one, respectively. Under similar reaction conditions, 2-ferrocenylcarbonylbenzoic acid, a keto carboxylic acid without a β-hydrogen, gave a dimerized lactone, 3,3’-diferrocenyl-3,3’-diphthalide possibly due to radical coupling. The nucleophilic attack of carbonyl oxygen, activated by the ferrocenyl moiety, to the carboxylic carbon, is assumed to be the crucial mechanistic step in forming these lactones. When the carbonyl group was reduced to an alcohol to break its conjugation with the ferrocenyl moiety, saturated lactones were isolated after the acidic workup. These results indicate that the α-ferrocenyl carbinols readily undergo solvolysis under acidic conditions, giving ferrocenylcarbenium ions, which are attacked by the carboxy oxygen to give lactones.

Injuries to humans caused by wild animals, particularly bears, are rarely mentioned in the literature. The frequency of such injuries is high in Siberia, which is a territory surrounded by dense forests and is a habitat of brown bears. Only for the last 4 months (September - December) 4 episodes of bear attacks on humans were registered in Khakassia, Russia. We present a clinical case of rehabilitating a patient after a bear attack for multiple fragmentary fracture of the facial skeleton with displacement of bone fragments, subcutaneous emphysema of soft tissues of the face, parietal and right occipital regions, and paranasal sinus hemorrhage on the left side. The nature of the injury was enhanced by the trauma to the upper extremity, with which the patient defended himself against the animal. In addition to the damage to the face, the bear tried to open the cranium, which was evidenced by 4 furrows from the canines, 2 on the frontal and 2 on the occipital bones of the skull. The complex treatment of the patient included both maxillofacial and reconstructive surgery, and at the stage of outpatient treatment the formation of normotrophic scars with the help of neodymium laser and injections of heterogeneous composition consisting of micro-particles of "cross-linked" collagen of animal origin, placed in a gel identical to the natural extracellular matrix.

Although deep learning has received extensive attention and achieved excellent performances in various of scenarios, it suffers from adversarial examples to some extent. Especially, physical attack poses more threats than digital attack. However, existing researches pay less attention to physical attack of object detection in remote sensing images (RSIs). In this work, we systematically analyze the universal adversarial patch attack for multi-scale objects in the remote sensing field. There are two challenges for adversarial attack in RSIs. On one hand, the number of objects in remote sensing images is more than that of natural images. Therefore, it is difficult for adversarial patch to show adversarial effect on all objects when attacking a detector of RSIs. On the other hand, the wide range of height of photography platform causes that the size of objects diverse a lot, which brings challenges for generating universal adversarial perturbation for multi-scale objects. To this end, we propose an adversarial attack method on object detection for remote sensing data. One of the key ideas of the proposed method is the novel optimization of adversarial patch. We aim to attack as many objects as possible by formulating a joint optimization problem. Besides, we raise a scale factor to generate a universal adversarial patch that adapts to multi-scale objects, which ensures the adversarial patch is valid for multi-scale objects in the real world. Extensive experiments demonstrate the superiority of our method against state-of-the-art methods on YOLO-v3 and YOLO-v5. In addition, we also validate the effectiveness of our method in real-world applications.

Corona Virus Infectious Disease (COVID-19) is newly emerging infectious disease. This disease is known to the globe in early 2019. Poor status of mental health is often caused by unemployment, ongoing socio-economic condition. Poor mental health may even accelerate the process of panic attack. It has been happening rapidly during COVID-19. It has a great effect on human health. This paper utilizes multiple related factors those have impact on causing panic attack. Recurrent Neural Network (RNN) based framework is utilized in this paper that assembles multiple RNN layers along with other parameters into a single platform. This method is implemented by capturing interfering factors and predicts panic attack tendency of people during COVID-19. Early prediction of panic attacks may assist in saving life from unwanted circumstances.

A new attack against the Kirchhoff-Law-Johnson-Noise (KLJN) key distribution system is introduced. The attack is based on 1) Utilizing the dc-voltage-source - which we put at Alice’s end in our mathematical modeling of the attack-that could exist due to errors, imbalances, Electromagnetic interference and etc.2) On studying the number of samples per bit in the security key that the measured Alice/Bob voltages exceeds or falls below a threshold voltage, respectively. The threshold voltage is the average between dc voltages across low and high resistors- generated by a dc-voltage source. We count the number of samples the voltage at Bob’s end (containing both the noise and dc components) exceeds the threshold voltage and how many times it falls below the threshold to judge whether the resistor can be guessed as low or high for every cycle. Also for a pre-specified key-length we count the number of high resistance estimations per bit –at Bob’s end-according to the previous criterion and the non-successful estimations per bit to judge the final guessed resistor value at Alice’s end and Bob’s end, where if we have more bits with most of its measured samples are above the threshold voltage then we will predict Bob’s resistance as high resistance, otherwise we predict Bob’s resistance to be low resistance. The Simulation was conducted and the attack proved that it is successful unless the temperature increased dramatically to ranges more than a threshold temperature ~ Kelvin that increases when the number of samples per bit increases.

Tumor to stroma ratio is a highly debated prognostic factor in the management of several solid tumors and there is no universal agreement on its practicality. In our study we proposed to confirm or dismiss the hypothesis that a simple measurement of stroma quantity is an easy-to-use and strong prognostic tool. We have included 74 consecutive patients with colorectal cancer who underwent primary curative abdominal surgery. The tumors have been grouped into stroma-poor (stroma &lt;10%), medium-stroma (between 10 and 50%) and stroma-rich (over 50%). The proportion of tumor stroma ranged from 5% to 70% with a median of 25%. Very few, only 6.8% of patients had stroma-rich tumors, 4% stroma-poor tumors and 89.2%tumors with a medium quantity of stroma. The proportion of stroma, at any cut-off, had no statistically significant influence on the disease specific survival. This can be explained by the low proportion of stroma-rich tumors in our patient group and the inverse correlation of stroma proportion with tumor grade. The real-life proportion of stroma-rich tumors and the complex nature of the stroma-tumor interaction has to be further elucidated.

Since the outbreak of the COVID-19 pandemic, patients infected with COVID-19 may experience abnormal heart rates, posing potential health risks. This study proposes a non-contact method for measuring heart rate (HR) and heart rate variability (HRV) to effectively reduce the risk of infection and assist healthcare professionals in more accurate diagnosis and treatment. In this study, except for the different image acquisition method, other research processes and methods are similar to the research methods in [15]. The image acquisition method is changed from forehead image to palm image. The new non-contact measurement performance of the proposed method can effectively not only avoid infection concerns but also obtain heart rate and HRV quickly and conveniently, providing higher accuracy for physiological parameters, root mean square error (RMSE), and mean absolute percentage error (MAPE) compared to those in recently published papers.

As cardiovascular diseases continue to be a leading cause of mortality, recent-ly, wearable devices for monitoring cardiac activity have gained much interest among medical community. This paper introduces an innovative ECG monitoring system based on a single – lead ECG machine enhanced with machine learning methods. The system only processes and analyses the ECG data, but also predict potential heart disease at an early stage. The wearable device was built on the ADS1298 and a microcontroller STM32L151xD. A server module based on REST API architecture style was designed to fa-cilitate interaction with web-based segment of the system. The module is responsible for receiving data in real time from microcontroller and their deliver to web – based segment. Algorithms for analyzing ECG signals have been developed, including band filter artifact removal, K-means clustering for signal segmentation, and PQRST analysis. Machine leaning methods as Isolation Forest have been employed for ECG anomaly detection. Moreover, a comparative analysis with various machine learning methods, including lo-gistic regression, random forest, SVM, XGBoost, decision forest and, CNNs was conducted to predict cardiovascular diseases. Convoluted Neural Networks (CNN) showed an accu-racy of 0.926, proving high effectiveness in ECG data process.

Neonatal electronic cardiac monitoring in labor and delivery room (DR-ECG) is shown to be sustained at a tertiary care regional perinatal center despite COVID-19 and other complex organizational challenges. In this contemporary cohort, initial increase in chest compressions at birth associated with the introduction of DR-ECG monitoring was mitigated by focused educational interventions on effective ventilation with no difference in neonatal mortality. DR-ECG may help our understanding of human and system factors, identify potential better practices for optimal resuscitation team performance and assess impact of targeted training initiatives on clinical outcomes.

The thermocontextual interpretation (TCI) establishes a system’s exergy, entropic energy, and thermal entropy as thermocontextual properties of state, defined with respect to its positive temperature surroundings. This work extends previous applications of the TCI to irreversible and statistical transitions. The TCI defines statistical entropy as a transactional process of derandomization and transition to a negative-entropy state. Statistical measurements of a confined quantum particle’s position are detailed in terms of reversible processes of instantiation and actualization. The TCI then formalizes the MaxEnt as a fundamental physical principle. We apply MaxEnt and statistical entropy measurements to the double-slit experiment. Particles passing through parallel slits record a wave interference pattern, but a “which-slit” detector eliminates wave interference. Richard Feynman called the double-slit experiment the only mystery, at the heart of quantum mechanics. The TCI offers a simple explanation. The which-slit detector breaks the system’s symmetry, enabling particles to pass through one slit or the other, and MaxEnt selects the asymmetrical transition, which has no wave interference and a higher statistical entropy.

Myocardium transcriptomes of mouse left and right atria and ventricles were profiled separately to identify the differences that might be responsible for the distinct functional roles of the four heart chambers. In total, 16,886 distinct unigenes have been quantified in all 16 samples collected from four adult male mice from the same litter. 15.76% of the quantified genes on the left and 16.5% on the right exhibited differential expression between the corresponding atrium and ventricle of the same side, while 5.8% in atria and 1.2% in ventricles were differently expressed between the left and the right. Beyond the differentially expressed genes, the study revealed distinct expression control and coordination of ion channels and genes within the cardiac muscle contraction, oxidative phosphorylation, glycolysis/glucogenesis, calcium and adrenergic signaling pathways. Interestingly, while expression of Ank2 (encoding ankyrin-B) oscillates in phase with all its binding partners in the left ventricle, the percentage of synergistically expressed partners of Ank2 is 15% and 37% in the left and right atria and 74% in the right ventricle. The analysis revealed also the high interventricular synchrony of the expression of ion channels.

Cardiac dynamics are traditionally linked to a left ventricle, right ventricle and septum morphology, a topography that differs from the heart’s 5-century-old anatomic description of containing a helix and circumferential wrap architectural configuration. Torrent Guasp’s helical ventricular myocardial band (HVMB) defines this anatomy and its structure, explains why the heart’s 6 dynamic actions of narrowing, shortening, lengthening, widening, twisting and uncoiling happen. This database raises questions about deductions behind “accepted cardiac mechanics”, and its functional aspects will challenge and overturn them. These suppositions include the LV, RV, and septum description, timing of mitral valve opening, isovolumic relaxation period, reasons for torsion/twisting, untwisting, reasons for longitudinal and circumferential strain, echocardiographic sub segmentation, resynchronization, RV function dynamics, and diastolic dysfunction’s cause and unrecognized septum impairment. Torrent Guasp’s revolutionary contributions may alter future understanding of the diagnosis and treatment of cardiac disease.

The rapid evolution of technology has given rise to a connected world, where billions of devices interact seamlessly, forming what is known as the Internet of Things (IoT). While IoT offers incredible convenience and efficiency, it presents a significant challenge in cybersecurity and is characterized by various power, capacity, and computational process limitations. Machine learning techniques are employed within Intrusion Detection Systems (IDS) to enhance their capabilities in identifying and responding to security threats. The key features selected to improve IDS efficiency and reduce dataset size, thereby decreasing the time required for attack detection, are drawn from the extensive network dataset. This paper introduces an enhanced feature selection method designed to reduce the computational overhead on IoT resources while simultaneously strengthening intrusion detection capabilities within the IoT environment. Experimental results based on the InSDN dataset demonstrate that our proposed methodology achieves the highest accuracy with the fewest number of features and low computational cost. Specifically, we attain a 99.99% accuracy with 11 features and a computational time of 0.8599 seconds.

The global burden of bacterial resistance remains one of the most serious public health concerns. Infections caused by multiresistant (MDR) bacteria in critically ill patients require immediate empirical treatment, which may not only be ineffective due to the resistance of MDR bacteria to multiple classes of antibiotics, but may also contribute to the selection and spread of antimicrobial resistance. Both the WHO and the ECDC consider carbapenem-resistant Enterobacteriaceae (CRE), carbapenem-resistant Pseudomonas aeruginosa (CRPA) and carbapenem-resistant Acinetobacter baumannii (CRAB) to be the highest priority. The ability to form biofilm and the acquisition of multiple drug resistance, in particular to carbapenems, have made these pathogens particularly difficult to treat. They are a growing cause of healthcare-associated infections and a significant threat to public health, associated with a high mortality rate. Moreover, co-colonization with these pathogens in critically ill patients was found to be a significant predictor for in-hospital mortality. Importantly, they have the potential to spread resistance using mobile genetic elements. Given the current situation, it is clear that finding new ways to combat antimicrobial resistance can no longer be delayed. The aim of this review was to evaluate the literature on how these pathogens contribute to the global burden of AMR. The review also highlights the importance of the rational use of antibiotics and the need to implement antimicrobial stewardship principles to prevent the transmission of drug-resistant organisms in healthcare settings. Finally, the review discusses the advantages and limitations of alternative therapies for the treatment of infections caused by these "titans" of antibiotic resistance.

The major threats to the sustainable supply of forest tree products are adverse climate, pests and diseases. Climate change, exemplified by increased drought, poses a unique threat to global forest health. This is attributed to the unpredictable behavior of forest pathosystems, which can favor fungal pathogens over the host under persistent drought stress conditions in the future. Currently, the effects of drought on tree resistance against pathogens are hypothetical, thus research is needed to identify these correlations. Norway spruce (Picea abies) is one of the most economically important tree species in Europe, and is considered highly vulnerable to changes in climate. Dedicated experiments to investigate how disturbances will affect the Norway spruce - Heterobasidion sp. pathosystem are important, in order to develop different strategies to limit the spread of H. annosum s.l. under the predicted climate change. Here, we report a transcriptional study to compare Norway spruce gene expressions to evaluate the effects of water availability and the infection of Heterobasidion parviporum. We performed inoculation studies of three-year-old saplings in a greenhouse (purchased from a nursery). Norway spruce saplings were treated in either high (+) or low (-) water groups: high water group received double the water amount than the low water group. RNA was extracted and sequenced. Similarly, we quantified gene expression levels of candidate genes in biotic stress and jasmonic acid (JA) signaling pathways using qRT-PCR, through which we discovered a unique preferential defense response of H. parviporum-infected Norway spruce under drought stress at the molecular level. Disturbances related to water availability, especially low water conditions can have negative effects on the tree host and benefit the infection ability of the pathogens in the host. From our RNA-seq analysis, 114 differentially expressed gene regions were identified between high (+) and low (-) water groups under pathogen attack. None of these gene pathways were identified to be differentially expressed from both non-treated and mock-control treatments between high (+) and low (-) water groups. Finally, only four genes were found to be associated with drought in all treatments.

This paper outlines a tool developed with the purpose of creating a simple configurable emulated network environment that can be used in cyber defence exercises. Research has been conducted into the various related subject areas: cyber defence exercises, network threats, network emulation, network traffic replay, network topologies, and common network services. From this research a requirements specification was produced to encapsulate the features required to create this tool. A network, containing many of the aspects researched, was designed and implemented using Netkit-NG to act as a blueprint for the tool and to further knowledge in the construction of an emulated network. Following this the tool was developed and tested to ensure requirements were met.

Transient receptor potential canonical (TRPC) channels are ubiquitously expressed in excitable and non-excitable cardiac cells where they sense and respond to a wide variety of physical and chemical stimuli. As other TRP, TRPC may form homo or heterotetrameric ion channel, and they can associate with other membrane receptors and ion channels to regulate intracellular calcium concentration. Dysfunctions of TRPC channels are involved in many types of cardiovascular diseases. Significant increase of the expression of different TRPC isoforms has been observed in different animal model of heart infarcts, and in vitro experimental model of ischemia and reperfusion. TRPC-mediated increase of the intracellular Ca²⁺ concentration seems required for the activation of signaling pathway that plays minor roles in the healthy heart, but they are more relevant for cardiac responses to ischemia, such as the activation of different factors of transcription and cardiac hypertrophy, fibrosis, and angiogenesis. In this review, we will highlight the current knowledge regarding TRPC implication in different cellular processes related to ischemia and reperfusion, and to heart infarction.

The ever-evolving ways attacker continues to im prove their phishing techniques to bypass existing state-of-the-art phishing detection methods pose a mountain of challenges to researchers in both industry and academia research due to the inability of current approaches to detect complex phishing attack. Thus, current anti-phishing methods remain vulnerable to complex phishing because of the increasingly sophistication tactics adopted by attacker coupled with the rate at which new tactics are being developed to evade detection. In this research, we proposed an adaptable framework that combines Deep learning and Randon Forest to read images, synthesize speech from deep-fake videos, and natural language processing at various predictions layered to significantly increase the performance of machine learning models for phishing attack detection.

In cotton cultivars, an insect that causes irreversible damage is the Spodoptera frugiperda, known as the fall armyworm. Since the visual detection of plants is a burdensome task for human inspection, the spectral information related to plant damage, registered on a spectral scale, can be useful. These measurements, associated with machine learning techniques, produce useful information for a rapid and non-invasive inspection method development. To contribute to this gap fulfillment, this paper proposes a machine learning framework to model the spectral response of cotton plants under the attack of the fall armyworm. Additionally, a theoretical model is presented, built from the results of the machine learning analysis, to infer this damage with up-to-date orbital sensors. The data was composed of the reflectance measurements collected at a cotton field with control plants and plants submitted to Spodoptera frugiperda damage. Their spectral response was recorded with a hand-held spectroradiometer ranging from 350 to 2,500 nm, for eight consecutive days. Different machine learning models were evaluated and the overall best model was defined by accuracies comparisons on a testing-set. A ranking approach was adopted based on the model accuracy, returning the most contributive wavelengths for the classification. Sequentially, an unsupervised neural network (Self-Organizing Map - SOM) was implemented to reduce data-dimensionality and assist in the definition of important spectral regions. The regions were associated with the spectral bands of the two sensors (OLI and MSI) and a theoretical model using a band simulation process with the overall best machine learning model was proposed. The results indicated that the Random Forest (RF) algorithm is the most suitable to predict cotton-plants damaged by insects and that the last day of analysis (8th day) was better to separate it, with F-measure equals 0.912. The ranking approach combined with the SOM method indicated the spectral regions at the red to near-infrared (650 to 1,350 nm) and shortwave infrared (1,570 to 1,640 nm) as the most important regions to the analysis. The proposed theoretical model simulated with the OLI and MSI sensor-bands returned an F-Measure of 0.865 and 0.886, respectively. In conclusion, this framework can be used to map cotton-plants under insect-attack. The theoretical model presents high accuracy to infer the insect-damaged on cotton plants based on multispectral bands from other sensors, being a useful tool for future research that intends to evaluate it in other areas and at different field scales.

Cirrhosis is a chronic disease with multiple etiologies, multiple manifestations, and multi-organ involvement. Affects about 200 million people worldwide. Its main complication is Portal hypertension (PHT). Cirrhotic cardiomyopathy is a consequence of PHT, with heart failure (HF) being the main manifestation. On the other hand, for people with cardiopathy due to other reasons beyond cirrhosis, the presence of the last could act as a trigger to acute HF. Finally, when HF and cirrhosis coexist, the renal system suffers the most, originating from type-5 cardio-renal syndrome, a complex entity with many challenges in diagnosis and treatment. This entity was recently defined and there is a lack of data on the epidemiology of this syndrome. A 77-year-old woman, with cardiovascular risk factors; heart failure with reduced ejection fraction (HFrEF), secondary ischemic and valvular cardiopathy, chronic Kidney disease (CKD), and stable decompensated cirrhosis, went to the emergency department after progressive abdominal perimeter augmentation, legs’ edema and hematochezia. It was assumed acute decompensated cirrhosis and acute decompensated chronic kidney disease, had triggered digestive bleeding and the patient stayed hospitalized. Intravenous diuretic therapy was started but, the ascites and kidney function got worse, the Nt pro-BNP grew until 1125000 pg/ml, and a transthoracic echocardiography showed important signs of congestion, isolated right ventricular dysfunction, with normal cardiac output. After teamwork’s discussion, a type-5 cardio-renal syndrome was assumed deciding not to act on tricuspid regurgitation due to the maladaptive RV remodeling. Hepatorenal syndrome treatment was begun (oral terlipressin and intravenous albumin), followed by decongestion therapy, resulting in a marked improvement in clinical presentation. The kidney, heart, and liver recovered to these basal states. With this clinical case, the authors want to show how multidisciplinary management is important to face tricuspid regurgitation and right ventricular dysfunction.

Although acute heart failure (AHF) is a common disease associated with significant symptoms, morbidity and mortality, the diagnosis, risk stratification and treatment of patients with hypertensive acute heart failure (H-AHF) still remain a challenge in modern medicine. Despite great progress in diagnostic and therapeutic modalities, this disease is still accompanied by a high rate of both in-hospital (from 3.8% to 11%) and one-year mortality (from 20% to 36%). Considering the high rate of re-hospitalization (22% to 30% in the first three months), the treatment of this disease represents a major financial blow to the health system of each country. This disease is characterized by heterogeneity in precipitating factors, clinical presentation, therapeutic modalities and prognosis. Since heart decompensation usually occurs quickly (within a few hours) in patients with H-AHF, establishing a rapid diagnosis is of vital importance. In addition to establishing the diagnosis of heart failure itself, it is necessary to see the underlying cause that led to it, especially if it is de novo heart failure. Given that hypertension is a precipitating factor of AHF and in up to 11% of AHF patients, strict control of arterial blood pressure is necessary until target values are reached in order to prevent the occurrence of H-AHF, which is still accompanied by a high rate of both early and long-term mortality.

(1)Background:The purpose of the study was conducted to investigate the recovery of heart rate according to the performance level and rest interval conditions during 65%1RM bench press exercise;(2)Methods:The subjects of this study were eight healthy male college studentsin their 20 (years) attending University C. 1RM was measured before theexperiment, and the exercise sequence of six rest intervals (30sec, 1, 2, 3, 4,5min) was randomly selected and cross-distribution experiment. The experimental measurement was conducted a total of six times according to the rest interval condition (six conditions) once every 3 days to minimize the learning effect. The data was verified with repeated measures Two-way ANOVA and Contrast's repeated method was applied for post-comparison;(3)Results: First, the amount of exercise and the number of repetitions statistically substantially dropped (p&lt;.001) as the number of sets rose, and a greater decline was shown when the rest periods got shorter. Second, the heart rate after exercise was increased significantly (p&lt;.01) as the set progressed in the long rest interval conditions (4, 5min), and the heart rate after rest was increased statistically significantly (p&lt;,05) as the set progressed in the short rest interval conditions (30sec, 1min). Third, the heart rate recovery rate (%) was able to perform more repetitions than in the short rest interval condition due to the relatively high physiological recovery of the neuromuscular and circulatory system under the long rest interval condition;(4)Conclusions: Therefore, according to the rest conditionduring the 65%1RM bench press exercise conducted in this study, the restinterval condition of 2~3min may be effective in improving muscular endurance,and the rest interval condition of 4~5min may be effective in improving muscular hypertrophy. As a result of this study, there was a significant difference in exercise performance (repetition) and physiological recovery depending on the rest interval condition according to the set progress during the same intensity resistance exercise. Through this, it is judged that it is possible to adjust the amount of exercise appropriate for the purpose of training by adjusting not only the intensity during resistance exercise but also the rest interval between sets.

In order to overcome the disadvantages of existing treatments in heart valve tissue engineering, decellularization studies are carried out. The main purpose of decellularization is to eliminate the immunogenicity of biologically derived grafts and to obtain a scaffold that allows recellularization while preserving the natural tissue architecture. SD and SDS are detergent derivatives frequently used in decellularization studies. The aim of our study is to decellularize the pulmonary heart valves of young Merino sheep by using low-density SDS and SD detergents together, and then to perform their detailed characterization to determine whether they are suitable for clinical studies. Pulmonary heart valves of 4-6 month old sheep were decellularized in detergent solution for 24 hours. The amount of residual DNA was measured to determine the efficiency of decellularization. Then, the effect of decellularization on the ECM by histological staining was examined. In addition, the samples were visualized by SEM to determine the surface morphologies of the scaffolds. Uniaxial tensile test was performed to examine the effect of decellularization on biomechanical properties. The results showed DNA removal of 94% and 98% from the decellularized leaflet and artery portions after decellularization relative to the control group. No cell nuclei were found in histological staining and it was observed that the 3-layer leaflet structure was preserved. As a result of the tensile test, it was determined that there was no statistically significant difference between the control and decellularized groups in the UTS and elasticity modulus, and the biomechanical properties did not change. In conclusion, we suggest that the pulmonary valves of decellularized young Merino sheep can be used as a initial matrix in heart valve tissue engineering studies.

The Internet of Things (IoT) has a growing presence in society's daily lives. These lightweight devices can be easily deployed and maintained, enabling extensive adoption in different environments. Furthermore, one of the most promising areas for using IoT devices is healthcare, comprising devices referred to as the Internet of Medical Things (IoMT). Several examples of healthcare services are supported by IoMT devices, e.g., continuous health monitoring. Conversely, there is an increasing concern with the cybersecurity aspects of these devices, and several attacks against IoT infrastructures have been launched in the past few years. These cybersecurity concerns also apply to healthcare applications, where the tradeoff between the benefits and security of IoMT devices must be observed. Given the complexity and amount of data IoMT network traffic generates, advanced methods become especially useful in these environments. Although Machine Learning (ML) brings various techniques and solutions to improve cyberattack detection, prevention, and mitigation, essential features are not addressed in the current state-of-the-art benchmark dataset contributions. Thereupon, the main goal of this research is to propose a realistic benchmark dataset to enable the development and evaluation of IoMT security solutions. In order to accomplish this, 18 attacks were executed against an IoMT testbed composed of 40 IoMT devices (25 real devices and 15 simulated devices), considering the plurality of protocols used in healthcare (e.g., Wi-Fi, MQTT, and Bluetooth). These attacks are categorized into five classes: DDoS, DoS, Recon, MQTT, and spoofing. This effort aims to establish a baseline complementary to the state-of-the-art contributions. The outcome supports researchers in investigating and developing new solutions to make healthcare systems more secure using different mechanisms (e.g., machine learning - ML). This research goes beyond merely conducting attacks on IoMT devices. We also attempt to capture the lifecycle of these devices in different vital phases, from the moment they join the network until they leave, which is called profiling. Profiling allows the different classifiers to identify anomalies of each device individually in the healthcare network. The CICIoMT2024 dataset has been published on CIC's dataset page, making it available for other researchers to use.

An event-based dynamic output feedback control (DOFC) strategy for unmanned marine vehicle (UMV) systems is concerned. The whole UMV systems are composed of an UMV closed-loop system, a land-based control unit and the communication network. To increase the effectiveness of data transmission in the network channel and better enable the control unit against attack, an adaptive event-triggered mechanism (AETM) is applied. Moreover, a quantizer is installed between the sampler and the control unit. The quantizer further reduces the communication burden. The occurrence of aperiodic denial-of-service (DoS) attack is considered in the channel from the control unit to the UMV system. Sufficient criterion for ensuring global exponential stability of system with an expected H∞ disturbance attenuation index is obtained. Co-design of the dynamic output feedback controller and the AETM is derived. The effectiveness of the proposed approach is verified in the given illustrative simulation. The simulation results indicate that the reduction percentages of yaw angle amplitudes and yaw velocity accumulative error of the UMV system with the control strategy proposed in this paper are 43.2%and 45.9%, respectively, which are 0.3% and 5.8% improvement in both metrics compared to the previously published work.

Extracellular vesicles (EVs) are emerging mediators of intracellular and inter-organ communications in cardiovascular diseases (CVDs), especially in the pathogenesis of heart failure through the transference of EV-containing bioactive substances. microRNAs (miRNAs) are contained in EV cargo and are involved in the progression of heart failure. Over the past several years, a growing body of evidence has suggested that the biogenesis of miRNAs and EVs are tightly regulated, and the sorting of miRNAs into EVs is highly selective and tightly controlled. Extracellular miRNAs, in particular circulating EV-miRNAs, have shown promising potential as prognostic and diagnostic biomarkers for heart failure and as therapeutic targets. In this review, we summarize the latest progress concerning the role of EV-miRNAs in HF and their application in a therapeutic strategy development for heart failure.

A strategy to reduce qualitative and quantitative losses in crop-yields refers to early and accurate detection of insect-damage caused in plants. Remote sensing systems like hyperspectral proximal sensors are a promising strategy for managing crops. In this aspect, machine learning predictions associated with clustering techniques may be an interesting approach mainly because of its robustness to evaluate high dimensional data. In this paper, we model the spectral response of insect-herbivory-damage in maize plants and propose an approach based on machine learning and a clustering method to predict whether the plant is herbivore-attacked or not using leaf reflectance measurements. We differentiate insect-type damage based on the spectral response and indicate the most contributive wavelengths to perform it. For this, we used a maize experiment in semi-field conditions. The maize plants were submitted to three different treatments: control (health plants); plants submitted to Spodoptera frugiperda herbivory-damage, and; plants submitted to Dichelops melacanthus herbivory-damage. The leaf spectral response of all plants (controlled and submitted to herbivory) was measured with a FieldSpec 3.0 Spectroradiometer from 350 to 2500 nm for eight consecutive days. We evaluated the performance of different learners like random forest (RF), support vector machine (SVM), extreme gradient boost (XGB), neural networks (MLP), and measured the impact of a day-by-day analysis into the prediction. We proposed a novel framework with a ranking strategy, based on the accuracy returned by predictions, and a clusterization method based on a self-organizing map (SOM) to identify important regions in the reflectance measurement. Our results indicated that the RF-based framework algorithm is the overall best learner to deal with this type of data. After the 5th day of analysis, the accuracy of the algorithm improved substantially. It separated the three treatments into different groups with an F-measure equal to 0.967, 0.917, and 0.881, respectively. We also verified that the most contributive spectral regions are situated in the near-infrared domain. We conclude that the proposed approach with machine learning methods is adequate to monitor herbivory-damage of S. frugiperda and stink bugs like Dichelops melacanthus in maize, differentiating the types of insect-attack early on. We also demonstrate that the framework proposed for the analysis of the most contributive wavelengths is suitable to highlight spectral regions of interest.

Congestion not only represents a cardinal sign of heart failure but is also now recognized as the primary cause for hospital admissions, rehospitalizations, and mortality among patients with acute heart failure. Congestion can manifest through various heart failure phenotypes in acute settings: volume overload, volume redistribution, or both. Recognizing the congestion phenotype is paramount, as it implies different therapeutic strategies for decongestion. Complete decongestion is hardly achieved among patients with acute heart failure, as more than half still have residual congestion at discharge. Residual congestion is one of the strongest predictors of future cardiovascular events and poor outcomes. Through this review, we try to provide a better understanding of the congestion phenomenon among patients with acute heart failure by highlighting insights into the pathophysiology mechanisms behind congestion and new diagnostic and management tools to achieve and maintain efficient decongestion.

Transient Receptor Potential Vanilloid 4 (TRPV4) channel is a non-selective cation channel, mostly permeable to calcium (Ca2+), which participates to intracellular Ca2+ handling in cardiac cells. It is widely expressed through the body and is activated by a large spectrum of physico-chemical stimuli, conferring it a role in a variety of sensorial and physiological functions. With-in the cardiovascular system, TRPV4 expression was reported in cardiomyocytes, endothelial cells (ECs) and smooth muscle cells (SMCs) where it modulates mitochondrial activity, Ca2+ ho-meostasis, cardiomyocytes electrical activity and contractility, cardiac embryonic development, fibroblast proliferation but also vascular permeability, dilatation and constriction. On the other hand, TRPV4 channels participate in several cardiac pathological processes such as development of cardiac fibrosis, hypertrophy, ischemia-reperfusion injuries, heart failure, myocardial infarc-tion, and arrhythmia. In this manuscript, we provide an overview of TRPV4 channel implica-tions in cardiac physiology and discuss the potential of TRPV4 channel as therapeutic target against cardiovascular diseases.

Diesel, gas oil, whole crudes, and bitumen samples were subjected to sulfoxidation, and then subjected to hydroxide attack in the presence of ethylene or propylene glycol. The resultant oils were analyzed by XRF for total sulfur and XANES spectroscopy for sulfur speciation at each stage. The combination of these analyses gave the total amount of sulfur as organic sulfide, sulfoxide, and sulfone at each stage of treatment so as to determine the effectiveness of the desulfonylation for sulfur compounds of different oxidation states.

Metabolic syndrome, diabetes and ischemic heart disease are among the leading causes of death and disability in Western countries. Diabetic cardiomyopathy is responsible for the most severe signs and symptoms. An important strategy for reducing the incidence of cardiovascular disease is regular exercise. Remote ischemic conditioning has some similarity with exercise, and can be induced by short periods of ischemia and reperfusion of a limb, and it can be performed in people who cannot exercise. There is abundant evidence that exercise is beneficial in diabetes and ischemic heart disease, but there is a need to elucidate the specific cardiovascular effects of emerging and unconventional forms of exercise in people with diabetes. Also, remote ischemic conditioning may be considered among the options to induce beneficial effects in these patients. The characteristics and interactions of diabetes and ischemic heart disease, and the known effects of exercise and remote ischemic conditioning in the presence of metabolic syndrome and diabetes, are analyzed in this brief review.

The thyroid-heart relationship has a long and articulated history of its own, a history that en-compasses physiological and pathophysiological knowledge, the latter particularly in the context of cardiac diseases such as heart failure, arrhythmias and ischaemic heart disease. In recent years, molecular biology studies, in an experimental context, have highlighted the extraordinary dialogue that exists among the two systems in the field of cardioprotection, being an extremely important area for the treatment of cardiac diseases in both acute and chronic phases. In addi-tion, in the last few years, several studies have been carried out on the prognostic impact of al-terations in thyroid function, including subclinical ones, in heart disease, in particular in heart failure and acute myocardial infarction, with evidence of a negative prognostic impact of these and therefore with the suggestion to treat these alterations in order to prevent cardiac events, such as death. This review provides a comprehensive summary of the heart-thyroid relation-ship.

CKD in HF patients is very common condition, their dysfunction is closely linked and influence each other, so their management required multidisciplinary and personalized approaches. The diagnosis of HF and CDK relies on signs and symptoms. Several tools, such as blood-based biomarkers and echography help us to clarify and discriminate the main characteristics of these patients. Evidence in improving survival due to new drug-employment in HF, has increasingly challenged physicians to manage patients with multiple diseases, especially in patients with CKD. The difficulty is in the safe administration of these drugs in patients with HF and CKD. Knowing up to which values ​​of creatinine or renal clearance any drug can be administered is fundamental. We wanted to summarize, on this sizable and complex topic, the experiences of various prior study to get clearer ideas and a more precise reference about the assessment and management of HF and CKD.

Maximal heart rate (HRmax) is a widely used measure of cardiorespiratory fitness. Prediction of HRmax is an alternative to cardiopulmonary exercise testing (CPET), but its accuracy among endurance athletes (EA) requires evaluation. This study aimed to externally validate HRmax prediction models in the EA independently for running and cycling CPET. 4043 runners (age=33.58 (8.12) years; 83.53% males; BMI=23.66 (2.54) kg·m−2) and 1026 cyclists (age=36.88 (9.03) years; 89.67% males; BMI=24.04 (2.65) kg·m−2) underwent maximum CPET. Student t-test, mean absolute percentage error (MAPE), mean absolute error (MAE), and root mean square error (RMSE) were applied to externally validate 8 running and 5 cycling HRmax equations. HRmax was 184.60 (9.79) beats·min−1 and 182.66 (10.28) beats·min−1 respectively for running and cycling, p=0.001. Measured and predicted HRmax differed significantly (p=0.001) for 9 of 13 (69.23%) models. HRmax was overestimated by 8 (61.54%) and underestimated by 5 (38.46%) formulae. Overestimated HRmax ranged 0.08-4.94 beats·min−1 and underestimated HRmax ranged 0.03-4.90 beats·min−1. MAE and RMSE were 0.18-4.94 beats·min−1 and 9.13-10.47, respectively. MAPE ranged 3.95-4.69%. Prediction models do not allow for accurate estimation of HRmax. HRmax was more often underestimated than overestimated. Predicted HRmax can be implemented for EA as a supplemental method but CPET is the preferable approach.

During the 90 days following hospitalization for acute heart failure, ejection fraction and type of discharge medications have been shown in clinical trials to have little effect on mortality. We examined the recent literature addressing brain-related etiologies of sudden death following heart failure. Two mechanisms of sudden unexpected death have been suggested to possibly result from 4 significant influences on pathophysiology in the brain. The two causes of death are severe cardiac arrhythmia, and neurogenic pulmonary edema. They are both mediated through the brainstem autonomic nuclei generally, and executed specifically through the dorsal motor nucleus of the vagus nerve. The four significant influences on pathophysiology in the brainstem autonomic nuclei are: 1) Hyper-stimulation of neurons in the solitary tract nucleus, increasing their metabolic requirements; 2) Inadequate blood flow at a vascular watershed terminus; 3) Additionally decreased blood flow following vasoconstriction related to relative hyperventilation and decreased pCO2 levels; 4) Gravitational ischemia in the brain—caused by the weight of the brain mass sitting above the brainstem. Changes in head tilt release gravitational ischemia in the brain. There is no specific head position (relative to gravity) that is considered favorable or unfavorable for an extended period of time (i.e. more than 24 hours). Even a small degree of head elevation, used in managing pulmonary congestion, may increase gravitational ischemia in the posterior fossa and brainstem. In this paper we suggest a new and important research avenue for intervening in cardiac arrhythmias, and preventing their occurrence, through the non-invasive use of head-tilting, and other head repositioning maneuvers. This could potentially help many geriatric patients with heart failure, who have decreased mobility in bed, and who tend to stay in one position longer, thereby increasing gravitational ischemia in the brain.

Chronic heart failure (CHF) results when heart cannot constantly supply the body tissues with oxygen and required nutrients, and it can be categorized as heart failure (HF) with preserved ejection fraction (HFpEF), and HF with reduced ejection fraction (HFrEF). There are different causes and mechanisms of the HF pathogenesis; however, the inflammation can be regarded as one of the factors promoting both HFrEF and HFpEF. Monocytes, a subgroup of leucocytes, are known as cellular mediators in response to cardiovascular injury and are closely related to inflammatory reactions. These cells are a vital component of the immune system and are the source of macrophages, which participate in cardiac tissue repair after injury. However, the monocytes are not homogenous as thought, and thus can present different functions under different cardiovascular disease conditions. In addition, there is still an open question whether the functions of monocytes and macrophages should be regarded as a cause or a consequence in CHF development. Therefore, our aim was to summarize the current studies on the function of various monocyte subsets in CHF with a focus on the role of a certain monocyte subset in HFpEF and HFrEF patients, and the relation to inflammatory markers.

miRNAs have recently attracted investigators' interest as regulators of valvular diseases pathogenesis, diagnostic biomarkers, and therapeutical targets. Evidence from in-vivo and in-vitro studies demonstrated stimulatory or inhibitory roles in mitral valve prolapse development, aortic leaflet fusion, and calcification pathways, specifically osteoblastic differentiation and transcription factors modulation. Tissue expression assessment and comparison between physiological and pathological phenotypes of different disease entities, including mitral valve prolapse and mitral chordae tendineae rupture, emerged as the best strategies to address miRNAs over or under-representation and thus, their impact on pathogeneses. In this review, we discuss the fundamental intra- and intercellular signals regulated by miRNAs leading to defects in mitral and aortic valves, congenital heart diseases, and the possible therapeutic strategies targeting them. These miRNAs inhibitors comprise of antisense oligonucleotides and sponge vectors. The miRNA mimics, miRNA expression vectors, and small molecules are instead possible practical strategies to increase specific miRNA activity. Advantages and technical limitations of these new drugs, including instability and complex pharmacokinetics, are also presented. Novel delivery strategies, such as nanoparticles and liposomes, are described to improve knowledge on future personalized treatment directions.

Coronavirus Disease 2019 (COVID-19) is the pandemic challenge of the last year. Cardiovascular involvement is one of the main characteristics of this disease. Due to endothelial damage, consequent phlogosis may increase a thrombosis risk. Cardiac injury may occur in different ways. However, an ischemic involvement of the cardiovascular system is rarely implied. In this regard, direct and indirect effects of COVID-19 are described. Nonetheless, the possible evaluation of the cardiovascular system may require different modalities. The cardiovascular evaluation may be different in emergency compared to critical care, requiring different tools for each setting. The aim of this review is to explore these modalities according to the different involvement of the cardiovascular system..

Preeclampsia is a multifactorial cardiovascular disorder diagnosed after 20 weeks of gestation that is the leading cause of death for both mothers and babies in pregnancy. The pathophysiology remains poorly understood due to variability and unpredictability of disease manifestation when studied in animal models. After preeclampsia, both mothers and offspring have a higher risk of cardiovascular disease (CVD) including myocardial infarction or heart attack and heart failure (HF). Myocardial infarction is an acute myocardial damage that can be treated through reperfusion, however, that therapeutic approach leads to ischemic/reperfusion injury (IRI) often leading to HF. In this review, we compared the current in vivo, in vitro and ex vivo model systems used to study preeclampsia, IRI and HF. Future studies aiming at evaluating CVD in preeclampsia patients could benefit from novel models that better mimic the complex scenario described in this article.

Hedgehog (Hh) proteins are prototypical morphogens known to regulate epithelial/mesenchymal interactions during embryonic development. In addition to its pivotal role in embryogenesis, the Hh signaling pathway may be recapitulated in post-natal life in a number of physiological and pathological conditions, including ischemia. This review highlights the involvement of Hh signaling in ischemic tissue regeneration and angiogenesis, with particular attention to the heart, the brain, and the skeletal muscle. Updated information on the potential role of the Hh pathway as a therapeutic target in ischemic condition is also presented.

Keywords: olfactory rehabilitation; chronic pain; fMRI;

The keyless systems have replaced the old fashion methods of inserting physical keys in the keyhole to, i.e., unlock the door, because they are inconvenient and easy to be exploited by the threat actors. Keyless systems use the technology of radio frequency (RF) as an interface to transmit signals from the key fob to the vehicle. However, Keyless systems are susceptible to being compromised by a thread actor who intercepts the transmitted signal and performs a reply attack. In this paper, we propose a transfer learning-based model to identify the replay attacks launched against remote keyless controlled vehicles. Specifically, the system makes use of a pre-trained ResNet50 deep neural network to predict the wireless remote signals used to lock or unlock doors of a remote-controlled vehicle system remotely. The signals are finally classified into three classes: real signal, fake signal high gain, and fake signal low gain. We have trained our model with 100 epochs (3800 iterations) on a KeFRA 2022 dataset, a modern dataset. The model has recorded a final validation accuracy of 99.71% and a final validation loss of 0.29% at a low inferencing time of 50 ms for the model-based SGD solver. The experimental evaluation revealed the supremacy of the proposed model.

Background: the study aimed at comparing the prognostic importance of Heart Rate (HR) and of QT corrected (QTc) according to Fridericia, Framingham and Bazett methods, in a large non-selected population. Methods: the analysis of digital Electrocardiograms archived from 2008 to 2022 in the metropolitan area of Modena, Italy, was made. The population under study was divided into three age-groups and survival analysis was performed. Results: 131.627 patients were enrolled and during the follow-up (mean 1641.4 days), all-cause mortality was 8.9%. Both HR and QTc were associated with mortality. All-cause mortality significantly increased from HR values greater than 81 BPM and from QTc values greater than 440 msec in young subjects and 455 msec in old subjects (values of the 75th percentiles/optimal operating point). Cox analysis confirmed the better prognostic value of Bazett’s QTc and of HR in the whole population and in the three age-groups. Conclusion: Bazett’s method performed better than other methods but unexpectedly HR had the same or a better correlation with all-cause mortality. Since HR is simple and readily available, its evaluation should be improved. However, reference values for QTc and for HR are difficult to define causing many confounding factors and further population-study are required.

Heart failure is a leading cause of death among people worldwide. The cost of treatment can be prohibitive, and early prediction of heart failure would reduce treatment costs to patients and hospitals. Improved prediction of readmission would also be of great help hospital, allowing them to better manage their treatment programs and budgets. This systematic review aims to summarize recent studies of predictive analytics models that have been constructed to predict heart failure and readmission. Some of these models use a statistical approach and others a machine learning approach. Electronic patient health records, including demography, physical and clinical values, and laboratory findings are used to design and build predictive models. Predictive analytics with good performance have become essential for clinicians and specialists. Choosing a suitable machine learning algorithm and data preprocessing technique will improve predictive model performance, including data imputation and class imbalance.

BackgroundHeart failure is a life-threatening disease affecting millions worldwide. Tolvaptan is the first FDA-approved orally active nonpeptide vasopressin 2 receptor antagonist to be used in hypervolemic hyponatremia, heart failure, cirrhosis, etc. In clinical trials, tolvaptan impacts short-term in increasing water excretion, and restoring Na+ and dyspnoea. Aims & ObjectivesThe objective is to analyze the outcomes of tolvaptan in existing cases of heart failure. MethodologyWe conducted a database search of the MEDLINE, Embase, and Cochrane Central Register of Controlled Trials and RCTs till 1st September 2019 were included following PRISMA guidelines after being matched with inclusion and exclusion criteria. 21 RCTs were included with 7,357 patients receiving tolvaptan and 7,273 patients being the control group. We used the MESH strings such as 'tolvaptan', 'vasopressin V2 receptor blocker', 'acute heart failure', and 'acute decompensated heart failure'. ResultsMeta-analysis showed that Tolvaptan was associated with a significant reduction in edema (RR = 1.05, 95% CI = 1.019-1.081, p=0.001) and significant body weight reduction (Control-SMD = -0.489, 95% CI =-0.637 to -0.342, p<0.001)&(Placebo-SMD = -0.425, 95% CI = -0.425 to -0.382, p<0.001) It shows significant decrease in serum sodium levels (SMD = 0.678, 95% CI = 0.609 to 0.748, p<0.001). There was no significant decrease in all-cause mortality (Control-RR = 0.855, 95% CI 0.470 to 1.555, p=0.607)(Placebo-RR= 0.972, 95% CI = 0.879-1.074, p=0.575). Results for Worsening renal function in heart failure (Placebo-RR = 0.798 95% CI 0.619 to 1.028, p=0.081)(Control-RR = 1.349, 95% CI=0.927-1.964, p=0.118). ConclusionAlthough tolvaptan may significantly reduce edema, congestive symptoms and decreased body weight, it has no impact on all-cause mortality and worsening renal function in heart failure.

Non-invasive heart rate (HR) monitoring is important in clinical settings as it plays a critical role in diagnosing a range of health conditions and assessing well-being. Presently, the gold standards for HR measurement are all based on sensors which require skin contact. Apart from inconvenience, contact sensors have proven problematic in certain scenarios – they cannot be used when mechanical isolation of the patient is imperative (burn victims, patients with shaky hands and feet), cause skin damage to premature babies in the ICU and increase the risk of spreading infections. Non-contact HR monitoring using a camera has been recently shown to be a viable alternative. It is now possible to record cardiac-synchronous blood volume variations from facial videos of human subjects under ambient lighting. These variations produce corresponding changes in skin reflectance which can be extracted as a raw reflectance photoplethysmography (rPPG) signal and processed to reveal HR. In this project, an algorithmic framework for webcam-based HR detection was successfully implemented in MATLAB. The investigation was based on 100 self-captured videos (dark-skinned subject) and 48 videos (from 12 subjects, all but one fair-skinned) obtained from COHFACE – an online database of facial videos and corresponding physiological signals. While the performance metrics (mean error, SNR) of the rPPG signals obtained from the self-captured videos were poor (best case mean error of 22%), they were good enough to demonstrate the success of the implementation. The poor results were primarily imputed to skin tone as rPPG SNR is known to be particularly low for dark tones. The results of the COHFACE videos were far superior, with mean error ranging from 3% to 15% (among 8 different rPPG signals) and 0% to 9% under ambient and dedicated lighting, respectively. This investigation sets the foundation for future research directed at optimizing rPPG performance metrics for dark-skinned subjects.