Continuous reach-to-grasp motion recognition based on an extreme learning machine algorithm using sEMG signals.

Recognizing user intention in reach-to-grasp motions is a critical challenge in rehabilitation engineering. To address this, a Machine Learning (ML) algorithm based on the Extreme Learning Machine (ELM) was developed for identifying motor actions using surface Electromyography (sEMG) during continuous reach-to-grasp movements, involving multiple Degrees of Freedom (DoFs). This study explores feature extraction methods based on time domain and autoregressive models to evaluate ELM performance under different conditions. The experimental setup encompassed variations in neuron size, time windows, validation with each muscle, increase in the number of features, comparison with five conventional ML-based classifiers, inter-subjects variability, and temporal dynamic response. To evaluate the efficacy of the proposed ELM-based method, an openly available sEMG dataset containing data from 12 participants was used. Results highlight the method's performance, achieving Accuracy above 85%, F-score above 90%, Recall above 85%, Area Under the Curve of approximately 84% and compilation times (computational cost) of less than 1 ms. These metrics significantly outperform standard methods (p < 0.05). Additionally, specific trends were found in increasing and decreasing performance in identifying specific tasks, as well as variations in the continuous transitions in the temporal dynamics response. Thus, the ELM-based method effectively identifies continuous reach-to-grasp motions through myoelectric data. These findings hold promise for practical applications. The method's success prompts future research into implementing it for more reliable and effective Human-Machine Interface (HMI) control. This can revolutionize real-time upper limb rehabilitation, enabling natural and complex Activities of Daily Living (ADLs) like object manipulation. The robust results encourages further research and innovative solutions to improve people's quality of life through more effective interventions.

The Need and Opportunity to Update the Inventory of Plant Pathogenic Fungi and Oomycetes in Mexico.

Mexico generates specific phytosanitary regulations for each product and origin to prevent the entry of quarantine pests and/or delay their spread within the national territory, including fungi and oomycetes. Phytosanitary regulations are established based on available information on the presence or absence of these pathogens in the country; however, the compilation and precise analysis of reports is a challenging task due to many publications lacking scientific rigor in determining the presence of a taxon of phytosanitary interest in the country. This review evaluated various studies reporting the presence of plant pathogenic fungi and oomycetes in Mexico and concluded that some lists of diseases and phytopathogenic organisms lack technical-scientific basis. Thus, it highlights the need and presents an excellent opportunity to establish a National Collection of Fungal Cultures and a National Herbarium for obligate parasites, as well as to generate a National Database of Phytopathogenic Fungi and Oomycetes present in Mexico, supported by the combination of morphological, molecular, epidemiological, pathogenicity, symptom, and micrograph data. If realized, this would have a direct impact on many future applications related to various topics, including quarantines, risk analysis, biodiversity studies, and monitoring of fungicide resistance, among others.

Unearthing the soil-borne microbiome of land plants.

Plant-soil biodiversity interactions are fundamental for the functioning of terrestrial ecosystems. Yet, the existence of a set of globally distributed topsoil microbial and small invertebrate organisms consistently associated with land plants (i.e., their consistent soil-borne microbiome), together with the environmental preferences and functional capabilities of these organisms, remains unknown. We conducted a standardized field survey under 150 species of land plants, including 58 species of bryophytes and 92 of vascular plants, across 124 locations from all continents. We found that, despite the immense biodiversity of soil organisms, the land plants evaluated only shared a small fraction (less than 1%) of all microbial and invertebrate taxa that were present across contrasting climatic and soil conditions and vegetation types. These consistent taxa were dominated by generalist decomposers and phagotrophs and their presence was positively correlated with the abundance of functional genes linked to mineralization. Finally, we showed that crossing environmental thresholds in aridity (aridity index of 0.65, i.e., the transition from mesic to dry ecosystems), soil pH (5.5; i.e., the transition from acidic to strongly acidic soils), and carbon (less than 2%, the lower limit of fertile soils) can result in drastic disruptions in the associations between land plants and soil organisms, with potential implications for the delivery of soil ecosystem processes under ongoing global environmental change.

Identifying Strategies for Effective Biodiversity Preservation and Species Status of Chilean Amphibians.

Resources are limited in global biodiversity conservation efforts, which emphasizes the significance of setting conservation priorities. Using standardized criteria, we evaluated 58 amphibian species in Chile to determine their conservation priority (CP). Species with insufficient historical data had their values marked as missing. With a median value of p = 1.67, the results demonstrated CP values ranging from p = 0.48 to p = 3.0, classifying species into priority and non-priority groups. Four levels were established for the priority categories: no priority, low priority, medium priority, and high priority. Additionally, the Telmatobiidae and Alsodidae families were identified as two more priority families. Notably, the species with the highest priority were found to be T. halli, T. fronteriensis, T. philippii, T. chusmisensis, A. pehuenche, and Alsodes tumultuosus, where T. philippii and T. fronteriensis have equal priority for conservation at the national level according to the conservation priority analysis. Eight priority families-the Alsodidae, Batrachylidae, Bufonidae, Ceratophryidae, Leptodactylidae, Rhinodermatidae, and Telmatobiidae-were determined, and 14 species-or 24% of the species examined-need further study. Based on the conservation priority analysis, the species T. fronteriensis and T. philippii share the highest priority for conservation at the national level (p = 2.50). With 70% of the amphibians under study being threatened mainly by habitat loss, pollution, and emerging diseases, the creation of conservation categories made the threat assessment process easier. Due to a lack of information on geographic distribution and abundance, quantitatively classifying amphibians in Chile remains difficult. The analysis of conservation priorities and potential extinction threats informs appropriate management strategies.

Evaluation of temporal, spatial and spectral filtering in CSP-based methods for decoding pedaling-based motor tasks using EEG signals.

Stroke is a neurological syndrome that usually causes a loss of voluntary control of lower/upper body movements, making it difficult for affected individuals to perform Activities of Daily Living (ADLs). Brain-Computer Interfaces (BCIs) combined with robotic systems, such as Motorized Mini Exercise Bikes (MMEB), have enabled the rehabilitation of people with disabilities by decoding their actions and executing a motor task. However, Electroencephalography (EEG)-based BCIs are affected by the presence of physiological and non-physiological artifacts. Thus, movement discrimination using EEG become challenging, even in pedaling tasks, which have not been well explored in the literature. In this study, Common Spatial Patterns (CSP)-based methods were proposed to classify pedaling motor tasks. To address this, Filter Bank Common Spatial Patterns (FBCSP) and Filter Bank Common Spatial-Spectral Patterns (FBCSSP) were implemented with different spatial filtering configurations by varying the time segment with different filter bank combinations for the three methods to decode pedaling tasks. An in-house EEG dataset during pedaling tasks was registered for 8 participants. As results, the best configuration corresponds to a filter bank with two filters (8-19 Hz and 19-30 Hz) using a time window between 1.5 and 2.5 s after the cue and implementing two spatial filters, which provide accuracy of approximately 0.81, False Positive Rates lower than 0.19, andKappaindex of 0.61. This work implies that EEG oscillatory patterns during pedaling can be accurately classified using machine learning. Therefore, our method can be applied in the rehabilitation context, such as MMEB-based BCIs, in the future.

Detection, Characterization and Sequencing of BTV Serotypes Circulating in Cuba in 2022.

In Cuba, despite a high sero-prevalence of bluetongue virus (BTV), circulating serotypes remain unknown. The aim of this study was to identify circulating BTV serotypes in farms throughout the western region of Cuba. Blood samples were collected from 200 young cattle and sheep between May and July 2022 for virological analyses (PCR, viral isolation and virus neutralization) and genome sequencing. The results confirmed viral circulation, with viro-prevalence of 25% for BTV. The virus was isolated from 18 blood samples and twelve BTV serotypes were identified by sequencing RT-PCR products targeting the segment 2 of the BTV genome (BTV-1, 2, 3, 6, 10, 12, 13, 17, 18, 19, 22 and 24). Finally, the full genome sequences of 17 Cuban BTV isolates were recovered using a Sequence Independent Single Primer Amplification (SISPA) approach combined to MinION Oxford Nanopore sequencing technology. All together, these results highlight the co-circulation of a wide diversity of BTV serotypes in a quite restricted area and emphasize the need for entomological and livestock surveillance, particularly in light of recent changes in the global distribution and nature of BTV infections.

Porous carbonaceous materials simultaneously dispersing N, Fe and Co as bifunctional catalysts for the ORR and OER: electrochemical performance in a prototype of a Zn-air battery.

Infiltration of the mesoporous structure of SBA-15 silica as a hard template with phenanthroline complexes of Fe3+ and Co2+ allowed the simultaneous dispersion of nitrogen, iron and cobalt species on the surface of the obtained carbonaceous CMK-3 silica replica, with potential as bifunctional heterogeneous catalysts for the cathodic oxygen reduction and evolution reactions (ORR and OER). The textural properties and mesopore structure depended on the composition of the material. The carbonaceous FeCoNCMK-3 (1/1), obtained with an Fe/Co molar ratio of 1/1, exhibited an ordered cylindrical mesoporous structure with a high mesopore volume, a rather homogeneous composition in terms of total and surface concentrations of iron and cobalt, and a balanced presence of pyridinic-, pyrrolic- and graphitic-N species. FeCoNCMK-3 (1/1) could improve the ORR kinetics by adsorption and reduction of O2 through the 4-electron mechanism with a current density of -17.37 mA cm-2, Eonset of 1.13 V vs. RHE and E1/2 of 0.75 V when compared to metal-free, monometallic or bimetallic electrocatalysts with a higher amount of cobalt than that of iron. In addition, FeCoNCMK-3 (1/1) exhibited activity for the OER, presenting lower values of Eonset (1.52 V), Ej10 (1.78 V) and the Tafel slope (76.3 mV dec-1) with respect to other catalysts. When evaluated as a cathode in a prototype of a Zn-air battery, FeCoNCMK-3 (1/1) exhibited a high open circuit voltage of 1.41 V, a peak power density of 66.84 mW cm-2, a large specific capacity of 818.88 mA h gZn-1, and cycling for 20 h but with deactivation upon cycling.

Analysis of the Extent of Liver Oncological Extended Resection for Incidental Gallbladder Cancer: How Much Is Too Much?

BACKGROUND: Liver resection is pivotal in treating incidental gallbladder cancer (IGBC). However, the adequate volume of liver resection remains controversial. METHODS: A cross-sectional retrospective analysis was performed on resected IGBC patients between 1999 and 2018. Morbidity was evaluated according to the Clavien-Dindo classification. The theoretical volume of a 2-cm and 1.5-cm wedge liver resection was calculated (105 cm3 and 77.5 cm3, respectively) and used as reference. Overall survival (OS) was estimated using Kaplan-Meier and Cox regression analyses. RESULTS: Among 111 patients re-resected for IGBC, 84 provided sufficient data to calculate liver resection volume. Patients with a resection volume ≥ 105 cm3 had a higher rate of overall morbidity (P = 0.001) and length of stay (P = 0.012), with no difference in mortality. There was no significant difference in OS according to residual cancer or T-category. A resection volume ≥ 77.5 cm3 was more frequent in T ≥ 3 than in T1-2 patients (P = 0.026), and residual cancer was higher (P = 0.041) among patients with ≥ 77.5 cm3 resected. Cox multivariate regression showed that residual cancer (HR = 11.47, P < 0.001), perineural/lymphovascular invasion (HR = 2.48, P = 0.021), and Clavien-Dindo ≥ IIIa morbidity (HR = 5.03, P = 0.003) predict worse OS, but not liver volume resection. CONCLUSION: There are no significant differences in OS based on resected liver volume of IGBC, when R0 is achieved. There is a significant difference in morbidity and length of stay when liver wedges are ≥ 105 cm3, which is lost when analyzed by Clavien-Dindo ≥ IIIa. A 77.5-105 cm3 resection is indicated in ≥ T3 patients, minimizing morbidity risk, while addressing concerns of overall survival.

Genetic control underlying the flowering-drought tolerance trade-off in the Antarctic plant Colobanthus quitensis.

Plants inhabiting environments with stressful conditions often exhibit a low number of flowers, which can be attributed to the energetic cost associated with reproduction. One of the most stressful environments for plants is the Antarctic continent, characterized by limited soil water availability and low temperatures. Induction of dehydrins like those from the COR gene family and auxin transcriptional response repressor genes (IAAs), which are involved in floral repression, has been described in response to water stress. Here, we investigated the relationship between the water deficit-induced stress response and the number of flowers in Colobanthus quitensis plants collected from populations along a latitudinal gradient. The expression levels of COR47 and IAA12 genes in response to water deficit were found to be associated with the number of flowers. The relationship was observed both in the field and growth chambers. Watering the plants in the growth chambers alleviated the stress and stimualted flowering, thereby eliminating the trade-off observed in the field. Our study provides a mechanistic understanding of the ecological constraints on plant reproduction along a water availability gradient. However, further experiments are needed to elucidate the primary role of water availability in regulating resource allocation to reproduction in plants inhibiting extreme environments.

EEG motor imagery classification using deep learning approaches in naïve BCI users.

Motor Imagery (MI)-Brain Computer-Interfaces (BCI) illiteracy defines that not all subjects can achieve a good performance in MI-BCI systems due to different factors related to the fatigue, substance consumption, concentration, and experience in the use. To reduce the effects of lack of experience in the use of BCI systems (naïve users), this paper presents the implementation of three Deep Learning (DL) methods with the hypothesis that the performance of BCI systems could be improved compared with baseline methods in the evaluation of naïve BCI users. The methods proposed here are based on Convolutional Neural Network (CNN), Long Short-Term Memory (LSTM)/Bidirectional Long Short-Term Memory (BiLSTM), and a combination of CNN and LSTM used for upper limb MI signal discrimination on a dataset of 25 naïve BCI users. The results were compared with three widely used baseline methods based on the Common Spatial Pattern (CSP), Filter Bank Common Spatial Pattern (FBCSP), and Filter Bank Common Spatial-Spectral Pattern (FBCSSP), in different temporal window configurations. As results, the LSTM-BiLSTM-based approach presented the best performance, according to the evaluation metrics of Accuracy, F-score, Recall, Specificity, Precision, and ITR, with a mean performance of 80% (maximum 95%) and ITR of 10 bits/min using a temporal window of 1.5 s. The DL Methods represent a significant increase of 32% compared with the baseline methods (p< 0.05). Thus, with the outcomes of this study, it is expected to increase the controllability, usability, and reliability of the use of robotic devices in naïve BCI users.

Genetic Diversity, Morphometric Characterization, and Conservation Reassessment of the Critically Endangered Freshwater Snail, Heleobia atacamensis, in the Atacama Saltpan, Northern Chile.

Evaporitic ecosystems of the Atacama Desert contain a rich endemic fauna, including mollusk species. A recent study performed in the freshwater snail Heleobia atacamensis, endemic to the Atacama Saltpan, revealed a strong interdependence of genetic patterns with climatic fluctuations and landscape physiography. The species is currently listed as Critically Endangered at regional scale and as Data Deficient on the International Union for Conservation of Nature (IUCN) Red List. Here, we studied genetic diversity and demographic history of several populations of the species occurring on a connectivity gradient, including snails from new peripherical localities (Peine and Tilomonte), which were compared with topotype specimens. In addition, we reassessed the conservation status using the IUCN Red List categories and criteria considering species-specific idiosyncrasy. Phylogenetic and phylogeographical analyses indicated that snails from Peine and Tilomonte belong to H. atacamensis. We discovered significant differentiation in shell morphology, which was generally greater in geographically isolated populations. We also inferred six genetic clusters and a demographic expansion congruent with the wet periods that occurred at the end of the Pleistocene. Considering the highest risk category obtained, H. atacamensis was reassessed as Endangered at regional scale. Future conservation plans should consider the genetic assemblages as conservation units.

Lower-limb kinematic reconstruction during pedaling tasks from EEG signals using Unscented Kalman filter.

Kinematic reconstruction of lower-limb movements using electroencephalography (EEG) has been used in several rehabilitation systems. However, the nonlinear relationship between neural activity and limb movement may challenge decoders in real-time Brain-Computer Interface (BCI) applications. This paper proposes a nonlinear neural decoder using an Unscented Kalman Filter (UKF) to infer lower-limb kinematics from EEG signals during pedaling. The results demonstrated maximum decoding accuracy using slow cortical potentials in the delta band (0.1-4 Hz) of 0.33 for Pearson's r-value and 8 for the signal-to-noise ratio (SNR). This leaves an open door to the development of closed-loop EEG-based BCI systems for kinematic monitoring during pedaling rehabilitation tasks.

Lichen planus associated with secukinumab treatment for plaque psoriasis.

Secukinumab and ixekizumab are IL17A inhibitors most commonly used to treat psoriasis. Common side effects include upper respiratory tract infections, injection site reactions, and mucocutaneous candidiasis. Recently, these medications have been reported to trigger lichen planus and lichenoid reactions have also been reported as an emerging side effect of biologics, especially tumor necrosis factor inhibitors. Herein, we report a patient with lichen planus that appeared after initiation of secukinumab for the treatment of psoriasis.

Electromagnetic fields disrupt the pollination service by honeybees.

We assessed the effect that electromagnetic field (EMF) exerts on honeybees' pollination efficiency using field and laboratory experiments. First, we measured levels of gene and protein expression in metabolic pathways involved in stress and behavioral responses elicited by EMF. Second, we assessed the effect of EMF on honeybee behavior and seed production by the honeybee-pollinated California poppy and, lastly, by measuring the consequences of pollination failure on plants' community richness and abundance. EMF exposure exerted strong physiological stress on honeybees as shown by the enhanced expression of heat-shock proteins and genes involved in antioxidant activity and affected the expression levels of behavior-related genes. Moreover, California poppy individuals growing near EMF received fewer honeybee visits and produced fewer seeds than plants growing far from EMF. Last, we found a hump-shaped relationship between EMF and plant species richness and plant abundance. Our study provides conclusive evidence of detrimental impacts of EMF on honeybee's pollination behavior, leading to negative effects on plant community.

Soil contamination in nearby natural areas mirrors that in urban greenspaces worldwide.

Soil contamination is one of the main threats to ecosystem health and sustainability. Yet little is known about the extent to which soil contaminants differ between urban greenspaces and natural ecosystems. Here we show that urban greenspaces and adjacent natural areas (i.e., natural/semi-natural ecosystems) shared similar levels of multiple soil contaminants (metal(loid)s, pesticides, microplastics, and antibiotic resistance genes) across the globe. We reveal that human influence explained many forms of soil contamination worldwide. Socio-economic factors were integral to explaining the occurrence of soil contaminants worldwide. We further show that increased levels of multiple soil contaminants were linked with changes in microbial traits including genes associated with environmental stress resistance, nutrient cycling, and pathogenesis. Taken together, our work demonstrates that human-driven soil contamination in nearby natural areas mirrors that in urban greenspaces globally, and highlights that soil contaminants have the potential to cause dire consequences for ecosystem sustainability and human wellbeing.

Distribution, conservation status and proposed measures for preservation of Radiodiscus microgastropods in Chile.

The genus Radiodiscus includes minute terrestrial snails occurring throughout the American continent. We assessed the conservation status of eight poorly known Chilean Radiodiscus species using the International Union for Conservation of Nature (IUCN) and NatureServe categories and criteria. Under the IUCN guidelines the species were assessed using the Criterion B of geographic range, which considers the extent of occurrence (EOO) and area of occupancy (AOO) as subcriteria. For NatureServe we used these two parameters plus the number of occurrences, ecological viability, and threats. Considering species rarity and possible sampling bias, we also used ecological niche modeling to determine climate and environmental tolerances and predict potential species distributions analyzing bioclimatic and geographical layers. Radiodiscus australis, R. coarctatus and R. quillajicola were listed as Critically Endangered by IUCN and NatureServe standards; R. coppingeri, R. flammulatus, R. magellanicus and R. villarricensis as Endangered by both methods; while R. riochicoensis as Endangered by IUCN standards and Vulnerable by NatureServe standards. Niche modeling results indicated that Radiodiscus species respond to different environmental conditions and that the predicted distribution areas contain suitable habitats beyond the current ranges, which may be helpful for future management plans. Nature-based sport tourism, forestry activities, urbanization, roads, pollution, mining, forest fires, livestock, volcanism, tsunamis, soil erosion and introduced species are among the major threats affecting these snails. Based on the low number of occurrences and the threats identified, the most at-risk species are R. coarctatus and R. quillajicola (one record), R. australis (two records) and R. villarricensis (three records); the latter two lacking occurrences within protected areas. Compiling our findings, we propose a list of actions to preserve Chilean Radiodiscus species.

Hypopigmentation in mantled howler monkeys Alouatta palliata (gray 1849): First documented cases of whole-body leucism in South America.

The existence of hypopigmentation like leucism is the result of genetic anomalies that might be enhanced by external factors such as pollution. This anomaly may reduce survival rates. Leucism has been recorded in wildlife, but overall, it is considered very rare. There have been few records of mantled howler monkeys with leucism in Mexico and Costa Rica, but whole-body leucism in howler monkeys from South America was unknown. In this article, we report for the first-time documented cases of whole-body leucism in young individuals of mantled howler monkeys Alouatta palliata in an isolated remanent of tropical dry forest in southwestern Ecuador known as Cerro Blanco Protective Forest. In total, we found two juvenile individuals with leucism in October 2021. The report of howler monkeys with whole-body leucism may be caused by two processes: inbreeding because of isolated populations, environmental pressure caused by pollution, or the interaction of both. Our findings also reveal that hypopigmentation is becoming more frequent in howler monkey populations along its distributional range. Therefore, it is important to promote research in this field to disentangle the causes of hypopigmentation and to consider a regional management strategy for the species.

La existencia de afecciones que causan hipopigmentación, como el leucismo, son el resultado de anomalías genéticas que pueden verse potenciadas por factores externos como la contaminación. Estas anomalías puedes reducir las tasas de supervivencia. Se ha registrado leucismo en la vida silvestre, pero en general, se considera muy raro. En México y Costa Rica se ha reportado la existencia de casos aislados de monos aulladores de manto con leucismo, pero se desconocía el leucismo de cuerpo completo en monos aulladores para América del Sur. En este artículo, reportamos por primera vez casos documentados de leucismo en todo el cuerpo en individuos juveniles de monos aulladores de manto Alouatta palliata en un remanente aislado de bosque seco tropical en el suroeste de Ecuador conocido como Bosque Protector Cerro Blanco. En total, encontramos dos individuos juveniles con leucismo en octubre de 2021. Este reporte de monos aulladores con leucismo en todo el cuerpo puede ser causado por dos procesos: apareamiento dentro de individuos de la misma población causado por el aislamiento, la presión ambiental causada por la contaminación o la interacción de ambos. Nuestros hallazgos también revelan que la hipopigmentación es cada vez más frecuente en las poblaciones de monos aulladores a lo largo de su rango de distribución. Por lo tanto, es importante promover la investigación en este campo para determinar las causas de la hipopigmentación y considerar una estrategia de manejo regional para la especie. Palabras clave: aberraciones cromáticas, pérdida de conectividad, anomalías genéticas, endogamia, cambio de pigmentación en primates por contaminación, Bosque Seco del Pacífico Ecuatorial.

The global distribution and environmental drivers of the soil antibiotic resistome.

BACKGROUND: Little is known about the global distribution and environmental drivers of key microbial functional traits such as antibiotic resistance genes (ARGs). Soils are one of Earth's largest reservoirs of ARGs, which are integral for soil microbial competition, and have potential implications for plant and human health. Yet, their diversity and global patterns remain poorly described. Here, we analyzed 285 ARGs in soils from 1012 sites across all continents and created the first global atlas with the distributions of topsoil ARGs. RESULTS: We show that ARGs peaked in high latitude cold and boreal forests. Climatic seasonality and mobile genetic elements, associated with the transmission of antibiotic resistance, were also key drivers of their global distribution. Dominant ARGs were mainly related to multidrug resistance genes and efflux pump machineries. We further pinpointed the global hotspots of the diversity and proportions of soil ARGs. CONCLUSIONS: Together, our work provides the foundation for a better understanding of the ecology and global distribution of the environmental soil antibiotic resistome. Video Abstract.

Disección Aórtica Tipo A como diagnóstico diferencial potencialmente letal de dolor torácico: revisión de casos / Type A Aortic Dissection as a potentially lethal differential diagnosis of chest pain: case Review

Chest pain (CP) is a frequent reason for consultation in emergency departments (ED). It responds to a broad spectrum of pathologies, ranging from banal causes to severe conditions with high mortality. The clinician must be able to distinguish prompt when CP is due to severe pathology and thus make a timely intervention for the patient's benefit. Acute Aortic Syndrome (AAS) is one of the potentially fatal causes of CP. Within this syndrome, we find aortic dissection (AD), intramural hematoma and atherosclerotic penetrating ulcer. AD is the most frequent presentation of AAS. Although it is not a common condition, its high lethality and low suspicion make it of particular interest as a differential diagnosis of CP. The following are two clinical cases of AD of the ascending aortic treated at the Hospital Regional de Talca (HRT) to analyse the clinical characteristics that help to differentiate this condition, the main electrocardiographic and imaging findings, as well as some of its complications and management.