A Deep Learning Approach for Predicting Multiple Sclerosis.

This paper proposes a deep learning model based on an artificial neural network with a single hidden layer for predicting the diagnosis of multiple sclerosis. The hidden layer includes a regularization term that prevents overfitting and reduces the model complexity. The purposed learning model achieved higher prediction accuracy and lower loss than four conventional machine learning techniques. A dimensionality reduction method was used to select the most relevant features from 74 gene expression profiles for training the learning models. The analysis of variance test was performed to identify the statistical difference between the mean of the proposed model and the compared classifiers. The experimental results show the effectiveness of the proposed artificial neural network.

Aumento de pantorrillas con implantes subfascial

Objetivo: El objetivo del presente estudio es analizar las cirugías de aumento de pantorrillas realizadas por el autor principal describiendo características clínicas de los pacientes, tipos de implantes utilizados y detalles de la técnica quirúrgica con bolsillo subfascial. Material y Método: Estudio de tipo observacional retrospectivo de una serie de 19 pacientes que se realizaron aumento de pantorrilla bilateral por motivos estéticos en una clínica privada en el periodo 2009-2018. Resultados: Todos los pacientes consultaron por piernas delgadas de carácter estético y se les realizó aumento gemelar interno con implantes bilaterales subfascial. En 78% de los casos se utilizó implante de base simétrica y 22% implante de base asimétrica. Hubo 2 complicaciones menores. Discusión: Es necesario contar con mayor variedad de implantes que combinen diferentes medidas de longitud, ancho y proyección que se adecuen a las variables anatomías particulares de cada paciente. Conclusiones: La técnica de implantes de silicona en bolsillo subfascial es satisfactoria con pocas complicaciones. Su éxito depende del correcto balance entre bolsillo e implante. Debería existir mayor variedad de implantes ajustables para cada paciente.

Objective: The objective of the present study is to analyze the calf augmentation surgeries performed by the main author, describing patients' clinical characteristics, types of implants used and details of the surgical technique with subfascial pocket. Materials and Method: A retrospective observational study of a series of 19 patients who underwent bilateral calf augmentation for cosmetic reasons in a private clinic in the period 2009-2018. Results: All patients consulted for slim cosmetic legs, an internal calf augmentation was performed with bilateral implants. In 78% of cases, a symmetrical based implant was used and 22% asymmetric based implant. There were 2 minor complications. Discussion: It is necessary to have a greater variety of implants that combine different measures of length, width and projection that are adapted to the variable anatomies of each patient. Conclusions: Subfascial pocket silicone implant technique is satisfactory with good results and few complications. Its success depends on the correct balance between pocket and implant. It seems that there is not yet a variety of adjustable implants for each patient on the market.

Differences in the Visual Performances of Patients with Strabismus, Amblyopia, and Healthy Controls.

The aim of this paper is to use the new definition of amblyopia and to define the overall visual performance of healthy controls (HCs), patients with strabismus (PS), and patients with refractive amblyopia (PRA), based on the interaction of selected visual abilities. METHOD: A total of 398 participants were divided in three groups: HCs, PRA, and PS. Variables such as visual acuity, refractive state, degree of stereopsis, phoria state, magnitude, and type of deviation were analyzed using parametric and non-parametric tests. RESULTS: Binocular visual acuity at near is the unique predictor factor for stereopsis in PRA and PS, while age relates to the amount of binocular visual acuity at near, only for PS with stereopsis. Binocular visual acuity at near and phoria states relate to each other in PRA. Binocular visual acuity at near and far in PS is better than PRA, with no differences in the degree of stereopsis. Stereoblind patients were only found among PS (36%). Only (44.9%) of PS had amblyopia. Exophoria predominated among PRA (69.72%) and HCs (78.87%), while exotropia was the predominant deviation in PS (60.54%). Hyperopia was the predominate refractive error among the groups, HCs (74.65%), PRA (79.82%), and PS (59.85%), followed by astigmatism. INTERPRETATION: HCs perform better than PS and PRA. The visual performance of PS with stereopsis and PRA is similar. Binocular visual acuity at near can predict the degree of stereopsis, and stereoblind patients are exclusively related to strabismus.

Digital Pregnancy Test Powered by an Air-Breathing Paper-Based Microfluidic Fuel Cell Stack Using Human Urine as Fuel.

The direct integration of paper-based microfluidic fuel cells (µFC's) toward creating autonomous lateral flow assays has attracted attention. Here, we show that an air-breathing paper-based µFC could be used as a power supply in pregnancy tests by oxidizing the human urine used for the diagnosis. We present an air-breathing paper-based µFC connected to a pregnancy test, and for the first time, as far as we know, it is powered by human urine without needing any external electrolyte. It uses TiO2-Ni as anode and Pt/C as cathode; the performance shows a maximum value of voltage and current and power densities of ∼0.96 V, 1.00 mA cm-2, and 0.23 mW cm-2, respectively. Furthermore, we present a simple design of a paper-based µFC's stack powered with urine that shows a maximum voltage and maximum current and power densities of ∼1.89 V, 2.77 mA cm-2 and 1.38 mW cm-2, respectively, which powers the display of a pregnancy test allowing to see the analysis results.

Distortion Calculation Method Based on Image Processing for Automobile Lateral Mirrors.

The automobile lateral-view mirrors are the most important visual support for driver safety; therefore, it is important they have robust quality control. Typically, the distortion of a lateral-view mirror is measured using the JIS-D-5705 standard; however, this methodology requires an expert person to perform the measurements and calculations manually, which can induce measurement errors. In this work, a semi-automatic distortion calculation method based on image processing is presented. Distortion calculations of five commercial mirrors from different manufacturers were performed, and a comparative study was carried out between the JIS-D-5705 standard and the proposed method. Experimental results performed according to the JIS-D-5705 standard showed that all mirrors have a distortion lower than 5%, indicating that all meet the standard. On the other hand, the proposed method was able to detect that one of the mirrors presented an important distortion, which was not detected by the methodology proposed in the standard; therefore, that mirror should not meet the standard. Then, it was possible to conclude that the proposed distortion calculation method, based on image processing, has higher robustness and precision than the standard. In addition, an appropriate and effective behavior against changes in scale, resolution, and, unlike the standard, against changes in image rotation was also shown.

Hyperconnected Openings Codified in a Max Tree Structure: An Application for Skull-Stripping in Brain MRI T1.

This article presents two procedures involving a maximal hyperconnected function and a hyperconnected lower leveling to segment the brain in a magnetic resonance imaging T1 weighted using new openings on a max-tree structure. The openings are hyperconnected and are viscous transformations. The first procedure considers finding the higher hyperconnected maximum by using an increasing criterion that plays a central role during segmentation. The second procedure utilizes hyperconnected lower leveling, which acts as a marker, controlling the reconstruction process into the mask. As a result, the proposal allows an efficient segmentation of the brain to be obtained. In total, 38 magnetic resonance T1-weighted images obtained from the Internet Brain Segmentation Repository are segmented. The Jaccard and Dice indices are computed, compared, and validated with the efficiency of the Brain Extraction Tool software and other algorithms provided in the literature.

Changes in the Brain Activity and Visual Performance of Patients with Strabismus and Amblyopia after a Compete Cycle of Light Therapy.

This research assesses the brain activity and visual performance at baseline and after light therapy (LTH), of seventeen patients with strabismus and amblyopia (SA), and eleven healthy controls (HCs) from Querétaro, México. Quantitative electroencephalogram analysis (qEEG) was used to record the brain activity, and clinical metrics such as the visual acuity, angle of deviation, phoria state, stereopsis, and visual fields determined the visual performance. Results showed a constant higher alpha-wave frequency for HCs. Low voltages remained negative for HCs and positive for SA patients across stimulation. After LTH, high voltage increased in SA patients, and decreased in HCs. A second spectral peak, (theta-wave), was exclusively recorded in SA patients, at baseline and after LTH. Positive Spearman correlations for alpha-wave frequency, low and high voltages were only seen in SA patients. Synchronized brain activity was recorded in all SA patients stimulated with filters transmitting light in the blue but not in the red spectrum. Enhancement in the visual performance of SA patients was found, whereas deterioration of the phoria state and a decrease in the amount of stereopsis was seen in HCs. To conclude, only a suffering brain and a visual pathway which needs to be enabled can benefit from LTH.

Analysis of the potential impact of strabismus with and without amblyopia on visual-perceptual and visual-motor skills evaluated using TVPS-3 and VMI-6 tests

Purpose: To investigate the potential impact of strabismus and amblyopia on visual-perceptual skills (VPS) and visual-motor skills (VMS) of patients according to the type of strabismus, visual acuity (VA), state of binocularity, and sex.MethodsThis observational, transverse, prospective study analyzed a sample of 146 children with strabismus (88 male and 58 female) aged 5–15 years from Querétaro, México. To determine the strabismus type, we considered the deviation direction, frequency, binocularity state, and associated and dissociated elements. VPS and VMS were evaluated using the Test of Visual-Perceptual Skills 3rd ed. (TVPS-3) and Visual-Motor Integration Test of Beery 6th ed. (VMI-6).ResultsSex was the main variable associated with the performance of the analyzed patients on TVPS-3 and VMI-6 (p<0.05); boys obtained better scores than girls in all evaluated aspects. Stereopsis was not a determinant of the patients’ performance level but was associated with the far and near angles of deviation in both types of strabismus, esotropia and exotropia. Amblyopia was associated with the spatial relationship (p=0.001) and visual closure abilities (p=0.044). Form constancy skill scores diminished in both types of strabismus (esotropia: p=0.011; exotropia: p=0.004), and VMS were the most affected in patients with strabismus.ConclusionsThe performance of patients with strabismus with and without amblyopia on TVPS-3 and VMI-6 suggests that they adopt a mechanism to compensate for the impact of strabismus on their VPS and VMS. (AU)

Analysis of the potential impact of strabismus with and without amblyopia on visual-perceptual and visual-motor skills evaluated using TVPS-3 and VMI-6 tests.

PURPOSE: To investigate the potential impact of strabismus and amblyopia on visual-perceptual skills (VPS) and visual-motor skills (VMS) of patients according to the type of strabismus, visual acuity (VA), state of binocularity, and sex. METHODS: This observational, transverse, prospective study analyzed a sample of 146 children with strabismus (88 male and 58 female) aged 5-15 years from Querétaro, México. To determine the strabismus type, we considered the deviation direction, frequency, binocularity state, and associated and dissociated elements. VPS and VMS were evaluated using the Test of Visual-Perceptual Skills 3rd ed. (TVPS-3) and Visual-Motor Integration Test of Beery 6th ed. (VMI-6). RESULTS: Sex was the main variable associated with the performance of the analyzed patients on TVPS-3 and VMI-6 (p<0.05); boys obtained better scores than girls in all evaluated aspects. Stereopsis was not a determinant of the patients' performance level but was associated with the far and near angles of deviation in both types of strabismus, esotropia and exotropia. Amblyopia was associated with the spatial relationship (p=0.001) and visual closure abilities (p=0.044). Form constancy skill scores diminished in both types of strabismus (esotropia: p=0.011; exotropia: p=0.004), and VMS were the most affected in patients with strabismus. CONCLUSIONS: The performance of patients with strabismus with and without amblyopia on TVPS-3 and VMI-6 suggests that they adopt a mechanism to compensate for the impact of strabismus on their VPS and VMS.

Fracturas de cadera: satisfacción posquirúrgica al año en adultos mayores atendidos en Méderi-Hospital Universitario Mayor, Bogotá, DC / Hip Fractures: Postsurgical Satisfaction a Year After in Older Adults Treated at Méderi-Hospital Universitario Mayor, Bogotá, DC / Fraturas de quadril: Satisfação pós-cirúrgica no ano seguinte em idosos atendidos em Méderi-Hospital Universitário Mayor, Bogotá, DC

Introducción: el envejecimiento poblacional mundial ha aumentado la incidencia de fracturas de cadera, este cambio genera un alto impacto económico, social y constituye un reto para la salud pública. Este estudio busca evaluar la satisfacción con el manejo posquirúrgico en adultos mayores con fracturas de cadera al año de la intervención y conocer los desenlaces en este tiempo. Materiales y métodos: estudio exploratorio, observacional, descriptivo de corte transversal, mediante encuesta telefónica en adultos de 65 o más años, un año después de intervención quirúrgica por fracturas de cadera en Méderi - Hospital Universitario Mayor, de Bogotá. Se describen variables evaluativas de satisfacción y atención en salud, así como otras relacionadas. Resultados: de 287 pacientes, 116 cumplen los criterios de inclusión y aceptan participar. El rango de edad oscila entre 65 y 99 años, media de 81,3 ± 8,17. Las mujeres y los hombres representan, respectivamente, 76% y 24% de la muestra. Mortalidad anual 28%, por género: 23% mujeres y 43% hombres. 29,3% presenta reingresos hospitalarios, 50% recupera su habilidad para la marcha. 81% considera buena la atención intrahospitalaria por ortopedia. 64% no califica el servicio intrahospitalario por fisioterapia ya que no lo recibe. 70% expresa satisfacción con los servicios ambulatorios de ortopedia y rehabilitación. Conclusiones: estudio novedoso y único que da voz como sujeto activo al paciente para evaluar el sistema de salud, sugiere el grado de dolor como elemento trazador de calidad de vida y obliga a implementar programas y servicios para adultos mayores con fracturas de cadera.

Introduction: World aging increases the incidence of hip fracture in adults over sixty years of age, pathology of economic and social burden being a challenge for public health. This study seeks to assess patient degree of satisfaction with health care services and assess outcomes. Materials and methods: Exploratory, observational, descriptive cross sectional study, with a telephone survey in patients 65 years or older, one year after hip fracture surgical intervention in Méderi - Hospital Universitario Mayor, Bogotá. Results: Of 287 patients 116 met the inclusion-exclusion criteria and accepted to participate. Age ranges between 65 and 99 years with a mean of 81,3 ± 8,17. Women and men represent respectively 76% and 24% of the sample. Mortality a year after is 28%, gender: 23% women and 43% men. 29,3% of the patients reentered the hospital, 50% recovered their previous functional capacity. 81% express as good the inpatient care by orthopedic service. 64% does not grade inpatient care by rehabilitation services because it was not given. 70% are satisfied with the outpatient services of orthopedic and rehabilitation. Conclusions: This study represents a novel and unique approach as it gives voice to the patient allowing assessment of the health services. Suggests the degree of pain as a tracer of quality of life and brings upon compulsory attention to implement health services improvement programs for hip fractures in the elderly.

Introdução: o envelhecimento populacional mundial tem aumentado a incidência de fraturas de quadril, mudanças que gera um alto impacto económico, social e constitui um desafio para a saúde pública. O estudo busca avaliar a satisfação com o manejo pós-cirúrgico em idosos com fraturas de quadril no ano posterior à intervenção e conhecer os desenlaces neste tempo. Materiais e métodos: estudo exploratório, observacional, descritivo, de corte transversal, mediante questionário por telefone em adultos de 65 ou mais anos, um ano após da intervenção cirúrgica por fraturas de quadril em Méderi - Hospital Universitário Mayor, de Bogotá D.C. Descrevem-se variáveis avaliativas de satisfação e atenção em saúde, assim como outras relacionadas. Resultados: de 287 pacientes, 116 cumprem os critérios de inclusão e aceitam participar. O rango de idade oscila entre 65 e 99 anos, média de 81,3 ± 8,17. As mulheres e os homens representam respetivamente 76% e 24% da amostra. Mortalidade anual 28%, por gênero: 23% mulheres e 3% homens. 29,3% apresenta reingressos hospitalários, 50% recupera a sua habilidade para a marcha. 81% considera boa a atenção intra-hospitalar por ortopedia. 64% não qualifica o serviço intra-hospitalar por fisioterapia já que não o recebe. 70% expressa satisfação com os serviços ambulatórios de ortopedia e reabilitação. Conclusões: estudo novo e único que dá voz como sujeito ativo ao paciente para avaliar o sistema de saúde, sugere o grau de dor como elemento traçador de qualidade de vida e obriga a implementar programas e serviços para idosos com fraturas de quadril.

Morphological background detection and enhancement of images with poor lighting.

In this paper, some morphological transformations are used to detect the background in images characterized by poor lighting. Lately, contrast image enhancement has been carried out by the application of two operators based on the Weber's law notion. The first operator employs information from block analysis, while the second transformation utilizes the opening by reconstruction, which is employed to define the multibackground notion. The objective of contrast operators consists in normalizing the grey level of the input image with the purpose of avoiding abrupt changes in intensity among the different regions. Finally, the performance of the proposed operators is illustrated through the processing of images with different backgrounds, the majority of them with poor lighting conditions.

[Dissociated deviation. A strabismus of cortical origin]. / Desviación disociada. Estrabismo de origen cortical.

BACKGROUND: We undertook this study to determine the cortical alterations related to the origin of dissociated deviation. METHODS: This was a prospective, descriptive and observational study that included 10 children with diagnosis of dissociated horizontal deviation, without previous evidence of neuronal damage. Manual, cerebral and ocular dominance were determined, as well as sensorial state and visual perceptual profile. Cortical response to different stimuli was analyzed: luminous, hyperventilation, slow and saccadic movements of pursuit, gaze and stare through cerebral mapping and neurometric EEG. The biochemical composition to the visual cortex by means of magnetic resonance spectroscopy was also investigated. RESULTS: The following alterations were demonstrated: a) neuroelectric: dysynchronic, paroxysms and/or lentification; b) neurometabolic: elevation of lactate, decrease of N-acetylaspartate and loss of the creatine/choline relationship; c) sensorial: suppression and amblyopia; d) perceptual vision: under-yield in visual abilities; e) motor: horizontal and vertical dissociated deviation; f) optometric: hyperopic astigmatism. CONCLUSIONS: The study suggests that dissociated deviation has a cortical origin and is related to epileptogenic disease.

Prevalence of risk factors for HIV infection among Mexican migrants and immigrants: probability survey in the North border of Mexico.

OBJECTIVE: To estimate the prevalence of risk factors for HIV infection among Mexican migrants and immigrants (MMIs) in different geographic contexts, including the sending communities in Mexico, the receiving communities in the United States (US), and the Mexican North border region. MATERIAL AND METHODS: We conducted a probability survey among MMIs traveling through key border crossing sites in the Tijuana (Baja California, Mexico)-San Diego (California, US) border region (N= 1,429). RESULTS: The survey revealed substantial rates of reported sexually transmitted infections, needle-sharing and sexual risk practices in all migration contexts. CONCLUSIONS: The estimated levels of HIV risk call for further binational research and preventive interventions in all key geographic contexts of the migration experience to identify and tackle the different personal, environmental, and structural determinants of HIV risk in each of these contexts.

Prevalence of risk factors for HIV infection among Mexican migrants and immigrants: probability survey in the north border of Mexico

OBJETIVO: Estimar la prevalencia de prácticas de riesgo para la infección por VIH en migrantes mexicanos durante su estancia en distintos contextos geográficos, incluyendo sus comunidades de origen en México, las comunidades de destino en Estados Unidos de América (EUA), y la frontera Norte de México. MATERIAL Y MÉTODOS: Encuesta probabilística de migrantes mexicanos que transitan por la región fronteriza Tijuana (Baja California, México)-San Diego (California, EUA) (N=1 429). RESULTADOS: La encuesta reveló una alta prevalencia de infecciones de transmisión sexual, uso compartido de agujas, y prácticas sexuales de riesgo en todos los contextos geográficos estudiados. CONCLUSIONES: Los niveles de riesgo de infección por VIH estimados para migrantes mexicanos en diferentes contextos geográficos exigen estudios e intervenciones preventivas binacionales que identifiquen y aborden los distintos factores de riesgo personales, ambientales, y estructurales que contribuyen al riesgo de infección por VIH en cada contexto.

HIV infection in mobile populations: the case of Mexican migrants to the United States.

OBJECTIVE: Previous studies have indicated varying rates of HIV infection among labor migrants to the United States of America. Most of these studies have been conducted with convenience samples of farmworkers, thus presenting limited external validity. This study sought to estimate the prevalence of HIV infection and risk factors among Mexican migrants traveling through the border region of Tijuana, Baja California, Mexico, and San Diego, California, United States. This region handles 37% of the migrant flow between Mexico and the United States and represents the natural port of entry for Mexican migrants to California. METHODS: From April to December 2002 a probability survey was conducted at key migrant crossing points in Tijuana. Mexican migrants, including ones with a history of illegal migration to the United States, completed an interview on HIV risk factors (n = 1 429) and an oral HIV antibody test (n = 1,041). RESULTS: Despite reporting risk factors for HIV infection, none of the migrants tested positive for HIV. CONCLUSIONS: Our findings contrast with previous estimates of HIV among labor migrants in the United States that were based on nonprobability samples. Our findings also underline the need for early HIV prevention interventions targeting this population of Mexican migrants.