Comprehensive analysis of right fascicular and right bundle branch blocks: A multi-center study.

Electrocardiographic patterns of right bundle branch and fascicular blocks were comprehensively analyzed in a two-phase study. The research aimed to address the scarcity of literature and the absence of standardized diagnostic criteria for these conditions. It revealed a weak correlation between the cardiac axis and age and highlighted the high misdiagnosis rate of these blocks. Furthermore, it discussed the challenges in fulfilling existing diagnostic criteria. The study emphasizes the need for a more precise understanding of right ventricular conduction disorders and the importance of developing robust diagnostic criteria.

Heart Rate Variability to Automatically Identify Hyperbaric States Considering Respiratory Component.

This study's primary objective was to identify individuals whose physiological responses deviated from the rest of the study population by automatically monitoring atmospheric pressure levels to which they are exposed and using parameters derived from their heart rate variability (HRV). To achieve this, 28 volunteers were placed in a dry hyperbaric chamber, where they experienced varying pressures from 1 to 5 atmospheres, with five sequential stops lasting five minutes each at different atmospheric pressures. The HRV was dissected into two components: the respiratory component, which is linked to respiration; and the residual component, which is influenced by factors beyond respiration. Nine parameters were assessed, including the respiratory rate, four classic HRV temporal parameters, and four frequency parameters. A k-nearest neighbors classifier based on cosine distance successfully identified the atmospheric pressures to which the subjects were exposed to. The classifier achieved an 88.5% accuracy rate in distinguishing between the 5 atm and 3 atm stages using only four features: respiratory rate, heart rate, and two frequency parameters associated with the subjects' sympathetic responses. Furthermore, the study identified 6 out of 28 subjects as having atypical responses across all pressure levels when compared to the majority. Interestingly, two of these subjects stood out in terms of gender and having less prior diving experience, but they still exhibited normal responses to immersion. This suggests the potential for establishing distinct safety protocols for divers based on their previous experience and gender.

Right fascicular blocks: A case series and a comprehensive electrocardiographic analysis.

The main trunk of the right bundle branch divides into an anterior, middle (lateral) and posterior fascicle. This article describes the right anterior and posterior fascicular block. They present a diagnostic challenge and are often overlooked during diagnostic processes. The studied patients were young adults whose electrocardiographic tracings were registered at the Mexican Faculty of Medicine of La Salle University. The presence of delayed R-peak time in aVR and V1, along with the described ventricular complex morphologies, and a right or left deviation of the cardiac axis exceeding +60°, may be suggestive of right fascicular blocks.

Enhancing Safety in Hyperbaric Environments through Analysis of Autonomic Nervous System Responses: A Comparison of Dry and Humid Conditions.

Diving can have significant cardiovascular effects on the human body and increase the risk of developing cardiac health issues. This study aimed to investigate the autonomic nervous system (ANS) responses of healthy individuals during simulated dives in hyperbaric chambers and explore the effects of the humid environment on these responses. Electrocardiographic- and heart-rate-variability (HRV)-derived indices were analyzed, and their statistical ranges were compared at different depths during simulated immersions under dry and humid conditions. The results showed that humidity significantly affected the ANS responses of the subjects, leading to reduced parasympathetic activity and increased sympathetic dominance. The power of the high-frequency band of the HRV after removing the influence of respiration, PHF⟂¯, and the number of pairs of successive normal-to-normal intervals that differ by more than 50 ms divided by the total number of normal-to-normal intervals, pNN50¯, indices were found to be the most informative in distinguishing the ANS responses of subjects between the two datasets. Additionally, the statistical ranges of the HRV indices were calculated, and the classification of subjects as "normal" or "abnormal" was determined based on these ranges. The results showed that the ranges were effective at identifying abnormal ANS responses, indicating the potential use of these ranges as a reference for monitoring the activity of divers and avoiding future immersions if many indices are out of the normal ranges. The bagging method was also used to include some variability in the datasets' ranges, and the classification results showed that the ranges computed without proper bagging represent reality and its associated variability. Overall, this study provides valuable insights into the ANS responses of healthy individuals during simulated dives in hyperbaric chambers and the effects of humidity on these responses.

Increased incidence of high-lethality suicide attempts after the declaration of the state of alarm due to the COVID-19 pandemic in Salamanca: A real-world observational study.

The coronavirus pandemic has led to people getting involved in harmful behaviors. In our observational study, we assessed 241 patients with suicidal thoughts or behaviors in the emergency room before, during, and after the lockdown, from January to July 2020. After the lockdown, retired patients made higher-lethality attempts, and consultations related to suicide were less frequent, but active suicidal behaviors were more frequent. Men tended to use more lethal methods, and women made more suicidal gestures and had more suicide-related consultations. We observed an increase in the lethality of the attempts after the declaration of the state of alarm.

Photoplethysmographic Waveform and Pulse Rate Variability Analysis in Hyperbaric Environments.

The main aim of this work is to identify alterations in the morphology of the pulse photoplethysmogram (PPG) signal, due to the exposure of the subjects to a hyperbaric environment. Additionally, their Pulse Rate Variability (PRV) is analysed to characterise the response of their Autonomic Nervous System (ANS). To do that, 28 volunteers are introduced into a hyperbaric chamber and five sequential stages with different atmospheric pressures from 1 atm to 5 atm are performed. In this work, nineteen morphological parameters of the PPG signal are analysed: the pulse amplitude; eight parameters related to pulse width; eight parameters related to pulse area; and the two two pulse slopes. Also, classical time and frequency parameters of PRV are computed. Notable widening of the pulses width is observed in the stages analysed. The PPG area increases with pressure, with no significant changes when the initial pressure is recovered. These changes in PPG waveform may be caused by an increase in the systemic vascular resistance as a consequence of of vasoconstriction in the extremities, suggesting a sympathetic activation. However, the PRV results show an augmented parasympathetic activity and a reduction in the parameters that characterise the sympathetic response. So, only a sympathetic activation is detected in the peripheral region, as reflected by PPG morphology. The information regarding the ANS and the cardiovascular response that can be extracted from the PPG signal, as well as its compatibility with wet conditions make this signal the most suitable for studying the physiological response in hyperbaric environments.

Fish Granzyme A Shows a Greater Role Than Granzyme B in Fish Innate Cell-Mediated Cytotoxicity.

Granzymes (Gzm) are serine proteases, contained into the secretory granules of cytotoxic cells, responsible for the cell-mediated cytotoxicity (CMC) against tumor cells and intracellular pathogens such as virus and bacteria. In fish, they have received little attention to their existence, classification or functional characterization. Therefore, we aimed to identify and evaluate their functional and transcriptomic relevance in the innate CMC activity of two relevant teleost fish species, gilthead seabream and European sea bass. Afterwards, we wanted to focus on their regulation upon nodavirus (NNV) infection, a virus that causes great mortalities to sea bass specimens while seabream is resistant. In this study, we have identified genes encoding GzmA and GzmB in both seabream and sea bass, as well as GzmM in seabream, which showed good phylogenetic relation to their mammalian orthologs. In addition, we found enzymatic activity related to tryptase (GzmA and/or GzmK), aspartase (GzmB), metase (GzmM), or chymase (GzmH) in resting head-kidney leucocytes (HKLs), with the following order of activity: GzmA/K ~ GzmM >> GzmH >>> GzmB. In addition, during innate CMC assays consisting on HKLs exposed to either mock- or NNV-infected target cells, though all the granzyme transcripts were increased only the tryptase activity did. Thus, our data suggest a high functional activity of GzmA/K in the innate CMC and a marginal one for GzmB. Moreover, GzmB activity was detected into target cells during the CMC assays. However, the percentage of target cells with GzmB activity after the CMC assays was about 10-fold lower than the death target cells, demonstrating that GzmB is not the main inductor of cell death. Moreover, in in vivo infection with NNV, gzm transcription is differently regulated depending on the fish species, genes and tissues. However, the immunohistochemistry study revealed an increased number of GzmB stained cells and areas in the brain of seabream after NNV infection, which was mainly associated with the lesions detected. Further studies are needed to ascertain the molecular nature, biological function and implication of fish granzymes in the CMC activity, and in the antiviral defense in particular.

Autonomic Nervous System Measurement in Hyperbaric Environments Using ECG and PPG Signals.

The main aim of this paper was to characterize the Autonomic Nervous System response in hyperbaric environments using electrocardiogram (ECG) and pulse-photoplethysmogram (PPG) signals. To that end, 26 subjects were introduced into a hyperbaric chamber and five stages with different atmospheric pressures (1 atm; descent to 3 and 5 atm; ascent to 3 and 1 atm) were recorded. Respiratory information was extracted from the ECG and PPG signals and a combined respiratory rate was studied. This information was also used to analyze Heart Rate Variability (HRV) and Pulse Rate Variability (PRV). The database was cleaned by eliminating those cases where the respiratory rate dropped into the low frequency band (LF: 0.04-0.15 Hz) and those in which there was a discrepancy between the respiratory rates estimated using the ECG and PPG signals. Classical temporal and frequency indices were calculated in such cases. The ECG results showed a time-related dependency, with the heart rate and sympathetic markers (normalized power in LF and LF/HF ratio) decreasing as more time was spent inside the hyperbaric environment. A dependence between the atmospheric pressure and the parasympathetic response, as reflected in the high-frequency band power (HF: 0.15-0.40 Hz), was also found, with power increasing with atmospheric pressure. The combined respiratory rate also reached a maximum in the deepest stage; thus, highlighting a significant difference between this stage and the first one. The PPG data gave similar findings and also allowed the oxygen saturation to be computed; therefore, we propose the use of this signal for future studies in hyperbaric environments.

3D Digitization and Prototyping of the Skull for Practical Use in the Teaching of Human Anatomy.

The creation of new rapid prototyping techniques, low cost 3D printers as well as the creation of new software for these techniques have allowed the creation of 3D models of bones making their application possible in the field of teaching anatomy in the faculties of Health Sciences. The 3D model of cranium created in the present work, at full scale, present accurate reliefs and anatomical details that are easily identifiable by undergraduate students in their use for the study of human anatomy. In this article, the process of scanning the skull and the subsequent treatment of these images with specific software until the generation of 3D model using 3D printer has been reported.

Hiperplasia epidérmica verrugosa en un paciente trasplantado renal / Epidermal hyperplasia in a transplant recipient

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Ontogeny of the endocrine pancreatic cells of the gilthead sea bream, Sparus aurata (Teleost).

The development of the gilthead sea bream, Sparus aurata, endocrine pancreas was studied from hatching to 114 days, using immunocytochemical techniques. Bonito insulin (INS)-, synthetic somatostatin-14 (SS-14)-, salmon somatostatin-25 (SS-25)-, mammalian somatostatin-28 (1-12) (SS-28)-, porcine glucagon (GLU)-, glucagon-like peptide-1 (1-19) (GLP-1)-, synthetic porcine peptide tyrosine tyrosine (PYY)-, and neuropeptide Y (NPY)-like immunoreactivities were demonstrated. The different types of endocrine cells appear at distinct stages of development and differ in their arrangement. The coexistence of INS and SS-25 immunoreactivities was demonstrated in the cells of one strand or primordial cord and a primordial islet that appeared close to the dorsal epithelium of the anterior region of the undifferentiated gut or next to the gut at hatching and one day after hatching, respectively. INS- and SS-25- immunoreactive (ir) cells were located in the core and at the periphery of the single islet found in 2-day-old larvae, while SS-28-ir cells were found in the single islet in 4- to 11-day-old larvae. GLU/GLP-1-ir cells were located next to the outer SS-25-ir cells in the single islet of 12- and 16-day-old larvae. SS-14/SS-25- and SS-14/SS-28-ir cells were detected in the outer region and in the inner area of the single islet, respectively, in 17- to 23-day-old larvae. One big islet and several small islets and isolated or clustered cells next to the pancreatic duct were present in 24- and 25-day-old larvae. The islets were similar in cell composition to the single islet seen in the previous stage, while the isolated and grouped cells showed the coexistence of INS and diverse SSs immunoreactivities. Nerve fibers showing PYY immunoreactivity were identified in the islets from 17 days onwards. In 30- to 44-day-old larvae, GLU and NPY immunoreactivities coexisted in a few cells at the periphery of some small islets. PYY-ir cells were first detected at day 51. One big islet, several intermediate islets and numerous small islets were present from 51-day-old-larvae to juveniles. GLU was colocalized with PYY and NPY in a few cells in a small peripheral area in the big islet and a few intermediate islets. The outer region of small islets and other intermediate islets showed the complete coexistence of GLU, PYY, and NPY.