Search

Background and Objectives: Neurodevelopmental disorders (NDDs), including developmental delay (DD), autism spectrum disorder (ASD), intellectual disability (ID), attention-deficit/hyperactivity disorder (ADHD), and specific learning disorders, affect 15% of children and adolescents worldwide. Advances in next-generation sequencing, particularly whole exome sequencing (WES), have improved the understanding of NDD genetics. Methodology: This study analyzed 3244 patients undergoing WES (single, duo, trio analyses), with 1028 meeting inclusion criteria (67% male; aged 0–50 years). Results: Pathogenic (P) or likely pathogenic (LP) variants were identified in 190 patients, achieving a diagnostic yield of 13.4% (singleton), 14% (duo), and 21.2% (trio). A total of 207 P/LP variants were identified in NDD-associated genes: 38% were missense (48 de novo), 29% frameshift (26 de novo), 21% nonsense (14 de novo), 11% splicing site (14 de novo), and 1% inframe (1 de novo). De novo variants accounted for 49.8% of cases, with 86 novels de novo variants and 27 novel non de novo variants unreported in databases like ClinVar or scientific literature. Conclusions: This is the largest study on WES in Colombian children with NDDs and one of the largest in Latino populations. It highlights WES as a cost-effective first-tier diagnostic tool in low-income settings, reducing diagnostic timelines and improving clinical care. These findings underscore the feasibility of implementing WES in underserved populations and contribute significantly to understanding NDD genetics, identifying novel variants with potential for further research and clinical applications.

BackgroundOf the 1.6 million transgender and gender-diverse (TGD) people in the United States, approximately 700,000 are youth aged 13-24 years. Many factors make it difficult for TGD young people to identify resources for support and information related to gender identity and medical transition. These range from lack of knowledge to concerns about personal safety in the setting of increased antitransgender violence and legislative limitations on transgender rights. Web-based resources may be able to address some of the barriers to finding information and support, but youth may have difficulty finding relevant content or have concerns about the quality and content of information they find on the internet. ObjectiveWe aim to understand ways TGD young adults look for web-based information about gender and health. MethodsIn August 2022, 102 young adults completed a 1-time survey including closed- and open-ended responses. Individuals were recruited through the Prolific platform. Eligibility was restricted to people between the ages of 18-25 years who identified as transgender and were residents of the United States. The initial goal was to recruit 50 White individuals and 50 individuals who identified as Black, indigenous, or people of color. In total, 102 people were eventually enrolled. ResultsYoung adults reported looking on the internet for information about a broad range of topics related to both medical- and social-gender affirmation. Most participants preferred to obtain information via personal stories. Participants expressed a strong preference for obtaining information from other trans people. ConclusionsThere is a need for accessible, expert-informed information for TGD youth, particularly more information generated for the transgender community by members of the community.

Introducción Los protocolos de manejo de anemia perioperatoria mejoran el cuidado del paciente y disminuyen los costos en salud. El objetivo de este estudio fue identificar el efecto de dicho programa en pacientes sometidos a reemplazo total de cadera (RTC) o rodilla (RTR), en la tasa de transfusiones, tiempo de estadía hospitalaria y eventos adversos. Métodos Se realizó un estudio observacional retrospectivo, incluyendo pacientes sometidos a RTC o RTR primarios. El programa abarcó la valoración preoperatoria, el uso de 2 dosis de ácido tranexámico, la aplicación de transfusiones restringidas, y el uso de hierro suplementario. Se compararon los resultados entre pacientes pre y post implementación del protocolo. Resultados Se incluyeron 179 pacientes (80 RTR y 99 RTC) pre protocolo entre enero y diciembre 2014 (grupo A) y 187 casos (103 RTR y 84 RTC) post protocolo entre enero y noviembre 2016 (grupo B). En el grupo A, la caida de hemoglobina fue mayor que en el grupo B en RTR (5,1±1,2 vs. 4,2±1,2 g/dl; p

A whole-exome capture and next-generation sequencing was applied to an 11 y/o patient with a clinical history of congenital hypotonia, generalized motor and cognitive neurodevelopmental delay, and severe cognitive deficit, and without any identifiable Syndromic pattern, and to her parents, we disclosed a de novo heterozygous pathogenic mutation, c.697_699del p.Phe233del (rs786204835)(ACMG classification PS2, PM1, PM2, PP5), harbored in the PURA gene (MIM*600473) (5q31.3), associated with Autosomal Dominant Mental Retardation 31 (MIM # 616158). We used the significant improvement in the accuracy of protein structure prediction recently implemented in AlphaFold that incorporates novel neural network architectures and training procedures based on the evolutionary, physical, and geometric constraints of protein structures. The wild-type (WT) sequence and the mutated sequence, missing the Phe233, were reconstructed. The predicted local Distance Difference Test (lDDT) for the PURAwt and the PURA–Phe233del showed that the occurrence of the Phe233del affects between 220–320 amino acids. The distortion in the PURA structural conformation in the ~5 Å surrounding area after the p.Phe233del produces a conspicuous disruption of the repeat III, where the DNA and RNA helix unwinding capability occurs. PURA Protein–DNA docking corroborated these results in an in silico analysis that showed a loss of the contact of the PURA–Phe233del III repeat domain model with the DNA. Together, (i) the energetic and stereochemical, (ii) the hydropathic indexes and polarity surfaces, and (iii) the hybrid Quantum Mechanics–Molecular Mechanics (QM–MM) analyses of the PURA molecular models demarcate, at the atomic resolution, the specific surrounding region affected by these mutations and pave the way for future cell-based functional analysis. To the best of our knowledge, this is the first report of a de novo mutation underpinning a PURA syndrome in a Latin American patient and highlights the importance of predicting the molecular effects in protein structure using artificial intelligence algorithms and molecular and atomic resolution stereochemical analyses.

This paper analyses the environment of open data and its perception by Mexicans based on the National Survey on Access to Public Information and Protection of Personal Data (ENAID 2016), and the Survey on Public Perception of Science and Technology (ENPECYT 2015). The literature review was focused on how the open data age represents a new social paradigm that has revolutionized the way that people and organizations obtain, analyse and use large amounts of information to make decisions. Mexico has mechanisms and platforms for access to open data, however, its use and contribution to real innovation is unknown. This work focuses on this problem, the data reflect important weaknesses in the perception of open data implementation as well as little interest in innovation and ignorance about it.

Objective. To determine the prevalence of dry eye symp­toms (DES) and associated risk factors among adults in Tlax­cala, Mexico. Materials and methods. A cross-sectional population-based study that included 1 508 individuals aged ≥50 years who answered the Dry Eye Questionnaire (DEQ- 5), with a score ranging between 0 and 22; the following categories were defined: no DES (

Objective. To evaluate cardiovascular risk, metabolic profile, low urinary tract symptoms (LUTS), and sexual function in patients with nonfunctional pituitary macroadenoma (NFPMA) and hypogonadotropic hypogonadism with testosterone therapy (TTh). Methods. A retrospective clinical study at a tertiary care center was performed in 101 men with NFPMA, HH, and TTh; metabolic profile, cardiovascular risk, International Prostate Symptoms Score (IPSS), and International Index of Erectile Function 5 (IIEF-5) scores were evaluated before initiation of TTh and at the last checkup with TTh. Results. Age was 49.3 ± 8.8 years; T before TTh was 195 ng/mL (101–259) vs. 574 (423–774) at the last checkup. The time of TTh administration was 34 months (12–72). An increase in triglyceride levels (200 (153–294) vs. 174 (134–233) mg/dL; p=0.03), dyslipidemia (40% vs. 52%; p=0.03), and MetS (25% vs. 34%; p=0.05) was corroborated. A statistical difference in the Globorisk score and cardiovascular (CV) risk stratification was not found. IIEF-5 score was 15.5 ± 6.5 vs. 17.8 ± 5.3 (p=0.11). An improvement in penetration quality (2.0 ± 1.5 vs. 2.6 ± 1.3; p=0.05), erection after penetration (1.8 ± 1.2 vs. 2.5 ± 1.6; p=0.02), completion of intercourse (1.8 ± 1.2 vs. 2.4 ± 1.3; p=0.03), and satisfaction of sexual intercourse (1.8 ± 1.3 vs. 2.5 ± 1.5; p=0.01) was evidenced. IPSS score was 6 (IQR 2–10) vs. 7 (IQR 4–12); p=0.30. A lower rate of intermittency (14% vs. 3%; p=0.02), urgency (39% vs. 16%; p=0.01), and episodes of nocturia (18% vs. 4%; p=0.02) was found. An increase of hematocrit (44.1 ± 4.4 vs. 47.3 ± 4.4%; p=0.001), hemoglobin (14.9 ± 1.4 vs. 15.9 ± 1.4 g/dL; p=0.001), and prostatic specific antigen (0.59 (0.43–1.19) vs. 0.82 (0.45–1.4) ng/mL; p=0.02) was evidenced during TTh. Conclusion. TTh in young men with NFPMA improves LUTS, sexual function, and some metabolic parameters, and it is relatively safe in the prostatic context.

Background: Cultural competence training in residency is important to improve learners’ confidence in cross-cultural encounters. Recognition of cultural diversity and avoidance of cultural stereotypes are essential for health care providers. Methods: We developed a multimethod approach for cross-cultural training of Internal Medicine residents and evaluated participants’ preparedness for cultural encounters. The multimethod approach included (1) a conference series, (2) a webinar with a national expert, (3) small group sessions, (4) a multicultural social gathering, (5) a Grand Rounds presentation on cross-cultural training, and (6) an interactive, online case-based program. Results: The program had 35 participants, 28 of whom responded to the survey. Of those, 16 were white (62%), and residents comprised 71% of respondents (n=25). Following training, 89% of participants were more comfortable obtaining a social history. However, prior to the course only 27% were comfortable caring for patients who distrust the US system and 35% could identify religious beliefs and customs which impact care. Most (71%) believed that the training would help them give better care for patients from different cultures, and 63% felt more comfortable negotiating a treatment plan following the course. Conclusions: Multimethod training may improve learners’ confidence and comfort with cross-cultural encounters, as well as lay the foundation for ongoing learning. Follow-up is needed to assess whether residents’ perceived comfort will translate into improved patient outcomes.

Multidrug-resistant tuberculosis (MDR-TB), resistance to at least isoniazid and rifampin, is a worldwide problem.To develop a clinical prediction rule to stratify risk for MDR-TB among patients with pulmonary tuberculosis.Derivation and internal validation of the rule among adult patients prospectively recruited from 37 health centers (Perú), either a) presenting with a positive acid-fast bacillus smear, or b) had failed therapy or had a relapse within the first 12 months.Among 964 patients, 82 had MDR-TB (prevalence, 8.5%). Variables included were MDR-TB contact within the family, previous tuberculosis, cavitary radiologic pattern, and abnormal lung exam. The area under the receiver-operating curve (AUROC) was 0.76. Selecting a cut-off score of one or greater resulted in a sensitivity of 72.6%, specificity of 62.8%, likelihood ratio (LR) positive of 1.95, and LR negative of 0.44. Similarly, selecting a cut-off score of two or greater resulted in a sensitivity of 60.8%, specificity of 87.5%, LR positive of 4.85, and LR negative of 0.45. Finally, selecting a cut-off score of three or greater resulted in a sensitivity of 45.1%, specificity of 95.3%, LR positive of 9.56, and LR negative of 0.58.A simple clinical prediction rule at presentation can stratify risk for MDR-TB. If further validated, the rule could be used for management decisions in resource-limited areas.

Abstract Designing a cultural competence curriculum is inherently complex. Many elements are needed, and multiple frameworks exist. We used a novel approach to identify and prioritize elements to include in a cultural competence curriculum to address disparities in cardiovascular disease. First, we used the Nominal Group Technique (NGT) to generate and prioritize a list of ideas to include in the curriculum. NGT is a structured small-group process that fosters creativity and equal participation of participants. We conducted four NGT sessions and elicited responses to the question “What sorts of things could be included in a curriculum that focuses on cultural competence training for physicians?” Participants in the NGT sessions were nine medical students, seven medicine residents, seven practicing physicians, and seven disparities researchers. To organize the ideas generated, we then asked 45 educators and researchers to group and rank the ideas based on their own perceptions of importance. Finally, to produce homogeneous groupings of elements based on the ideas grouped and ranked, we used multidimensional scaling (MDS) and hierarchical cluster analysis. The NGT sessions generated 61 ideas, 29 of which were selected by at least two participants. We observed five clusters of related issues within the multidimensional space (asterisks indicate the NGT groups' top-rated ideas): (1) patients' cultural background (provide information on cultures,∗ habits, customs, values), (2) impact on health care and health behavior (include factors influencing health services, folk remedies, diet), (3) differences in therapies and health disparities (provide pharmacological therapies, reasons for cardiovascular disparities), (4) awareness of approaches to multicultural care (increase awareness of own biases,∗ stereotype avoidance), and (5) resources to manage cultural diversity (provide resources for patients and their families to comprehend instructions,∗ provide questions to permit taking a cultural history,∗ language translation guide and available services, community resources). The MDS showed good fit of the dimensions (Stress = .074; R2 = .97). Our cognitive mapping approach allowed us to use input from various stakeholders and generate critical domains to guide the development of the new curriculum. This curriculum is composed of online cultural competence training modules. Users can learn effective cross-cultural approaches to care for African American patients with cardiovascular disease, especially hypertension. Videos with real patient scenarios and case-based modules increase learners' awareness. This project has been completely funded by a grant from the National Institutes of Health (NIH) through the National Heart Lung and Blood Institute (NHLBI).

La Inmunodeficiencia Severa Combinada (IDSC) es una enfermedadde origen genético, que se puede heredar de forma autosómicarecesiva o ligada al cromosoma X. La IDSC se caracteriza por undefecto en el número y la diferenciación de los linfocitos T y NK. Losindividuos afectados desarrollan diarrea crónica, infecciones persistentes y severas como neumonía, septicemia e infecciones fúngicas.Estos pacientes presentan retardo en el crecimiento y pueden morir atemprana edad si no se realiza una terapia de corrección genética o untrasplante de células hematopoyéticas. Las mutaciones responsablesde la IDSC comprometen principalmente el gen de la cadena gamacomún (γc) y la proteína Jak3 que son proteínas fundamentales en latransducción de señales de los receptores para varias citoquinas esenciales en la diferenciación y activación de células del sistema inmune, las cuales incluyen IL-2, IL-4, IL-7, IL-9 e IL-15 (1,2).

La respuesta inmune contra microorganismos intracelulares,como el Mycobacterium dependen de la inmunidad mediada porcélulas (IMC). El principal mecanismo efector de la IMC es la activación del macrófago infectado por medio de citoquinas producidas por células Th1, particularmente el IFNγ. Recientemente se identificó la deficiencia del receptor de IFN gama (IFNγR) en humanos como un desorden autosómico recesivo, que conduce a un defecto en la expresión o función del IFNgR. Esta deficiencia se caracteriza por aumento de la severidad y cronicidad de las infecciones intracelulares, especialmente en aquellos casos donde el macrófago es la principal célula efectora (1,2).

Abstract Controlled coupling between distant particles is a key requirement for the implementation of quantum information technologies. A promising platform are hybrid systems of semiconducting quantum dots coupled to superconducting islands, where the tunability of the dots is combined with the macroscopic coherence of the islands to produce states with non-local correlations, e.g. in Cooper pair splitters. Electrons in hybrid quantum dots are typically not amenable to long-distance spin alignment as they tend to be screened into a localized singlet state by bound superconducting quasiparticles. However, two quasiparticles coming from different superconductors can overscreen the quantum dot into a doublet state, leading to ferromagnetic correlations between the superconducting islands. We present experimental evidence of a stabilized overscreened state, implying correlated quasiparticles over a micrometer distance. We propose alternating chains of quantum dots and superconducting islands as a novel platform for controllable large-scale spin coupling.

Exposure to Electromagnetic Fields (EMF) is one of the main concerns on current mobile wireless deployments, due to the use of active antenna systems and the increase of users connected simultaneously to these systems. In this paper, we evaluate the achievable rate resulting from simultaneous connections from multiple users, along with the signal-to-noise ratio (i.e., SNR), considering existing regulatory constraints on EMF, which is the subject of limitations in several countries. Our approach considers a random deployment of several base stations, according to a Poisson point process, and focuses on exploring the convexity of the achievable rate, as it will increase together with the number of antennas, and decrease with the overhead when a higher number of antennas is used. This article also studies the effects of the placement of new base stations on the overall EMF exposure, ensuring compliance with the current EMF limitations. Results show that due to the narrowness of the beam, the blockage can considerably affect the SNR received. Although several configurations are available from an operator perspective, some flexibility is allowed and the EMF exposure does not affect the average performance dramatically.

The estimation of Electromagnetic Field (EMF) exposure is critical for evaluating the potential health risks associated with wireless network implementation. With the advent of new communication technologies, such as 5G and 6G, new methodologies are required. Indeed, higher frequency ranges are being studied, necessitating an increased number of base stations for service provision. In this paper, we introduce a novel methodology for EMF estimation in 5G mobile networks. We also evaluate common scenarios that mobile network operators frequently encounter, resulting in additional exposure, such as interference, overpropagation, and the presence of other users. Our approach is validated through a combination of simulated values and real data collected from sensors deployed in the field. Finally, a digital twin approach is proposed to combine the simulated values with the real data obtained from radio frequency sensors. The scenario is deployed in Belval, Luxembourg.

Introduction: chronic kidney disease is an aggravating condition for the public health system. The detection and timely monitoring of the triggering and progression factors of the disease are a priority in each health system. Objective: to characterize chronic kidney disease in patients with type 2 diabetes mellitus with poor metabolic control. Method: a descriptive, cross-sectional study was carried out on patients with type 2 diabetes mellitus who entered the chronic kidney disease program of the Hospital “Dr. Miguel Enríquez” from October 2021 to January 2023. The population was made up of 175 patients; the sample selected was of 74 patients, who met the inclusion criteria after signing the informed consent. Results: there was a predominance of chronic kidney disease in young patients (64% in 18 to 49 years olds); likewise, the female sex represented a 65.3%; and a duration of type 2 diabetes mellitus of 1 to 5 years in 49.3%; the most frequent comorbidities were: dyslipidemia, arterial hypertension and heart failure with a prevalence of 89.3%, 79.3% and 41.3% respectively. The predominant kidney damage stage was grade 2 in a 20.0%; 4% of patients required renal replacement treatment. Conclusions: kidney disease usually progresses more in women and in patients with multiple cardiovascular risk factors. Inadequate glycemic control is associated with the progression of kidney disease. Damage to kidney function largely depends on metabolic control.

Background Recurrence after atrial fibrillation (AF) ablation remains common. We evaluated the association between recurrence and levels of biomarkers of cardiac remodeling, and their ability to improve recurrence prediction when added to a clinical prediction model. Methods and Results Blood samples collected before de novo catheter ablation were analyzed. Levels of bone morphogenetic protein‐10, angiopoietin‐2, fibroblast growth factor‐23, insulin‐like growth factor‐binding protein‐7, myosin‐binding protein C3, growth differentiation factor‐15, interleukin‐6, N‐terminal pro‐brain natriuretic peptide, and high‐sensitivity troponin T were measured. Recurrence was defined as ≥30 seconds of an atrial arrhythmia 3 to 12 months postablation. Multivariable logistic regression was performed using biomarker levels along with clinical covariates: APPLE score (Age >65 years, Persistent AF, imPaired eGFR [

Abstract At present, facial recognition entertains great importance in performing authentication processes, because it prevents unauthorized access to devices and places. Additionally, it allows for the identification of persons. Henceforth, this paper proposes a novel texture descriptor called Cyclical Chroma and a new classification technique, which takes in consideration the sub‐pixel values of 0–255 for each RGB (Red, Green, Blue) channel that conforms the image. To verify the effectiveness of the proposed techniques, tests were performed with a database of images in a controlled environment and in one under uncontrolled conditions; additionally, Cyclical Chroma was tested with a different classifier, denominated the Multiclass Classifier, and the results were compared against other descriptors, including GLCM, SHDH, LQP, and CCR, demonstrating the effectiveness of the proposed techniques with 100% efficiency with controlled images and 78% effectiveness under uncontrolled conditions prior to the application of an equalization technique, increasing the efficiency to 100%.

Considering electromagnetic field (EMF) exposure from the radio frequency (RF) domain has always been critical in deploying new cellular network technologies. European countries implement strict limits to ensure that a radiating element such as a cellular antenna cannot exceed a certain threshold in the vicinity of urban or densely populated areas. Before 5G, these limits could easily be managed with calculation methods during the network planning phase, i.e., before the physical installation of antennas. These previous-generation transmitters act statically, and it is usually simple to respect EMF limit values while ensuring adequate quality performance for end-users. Current active antenna systems benefit from Massive MIMO (Multiple Input, Multiple Output) technologies with Time Division Duplex (TDD) and precise beamforming. These technologies employed by 5G enable antennas to behave dynamically in time and space, depending on the distribution of users and the applications targeted. This new dynamic behaviour, together with larger antenna arrays, makes the estimation of RF-EMF exposure more complex, usually leading to overestimations. The only solution to lower this exposure and to make an installation compliant is to lower the output power, which potentially limits the performance of current 5G networks. In the future, as new frequencies and multiple deployment points emerge, this exposure overestimation, associated to strict regulations, could drastically restrict or even prevent the deployment of communication technologies (5G Advanced, 6G). This survey provides an overview of this broad area, looking at the global and European regulatory frameworks and then taking the case of Luxembourg, which has lower limits than most EU countries. It then references the main EMF exposure estimation methods available in the literature applied for 4G and prior generations before focusing on potential and not yet standardised approaches for 5G. The perspective is then changed to discuss the issues related to network planning and the interest in using optimisation approaches. Finally, the survey concludes by summarising the gaps and opportunities related to EMF-aware network planning solutions.

The fate of Yu-Shiba-Rusinov states in the presence of a strong Coulomb repulsion in a superconductor remains unknown. Here, the authors couple a quantum dot to a superconducting island with a tunable Coulomb repulsion, where they find a singlet many-body state which, by a strong Coulomb repulsion, changes to a two-body state.

Abstract Little–Parks oscillations of a hollow superconducting cylinder are of interest for flux-driven topological superconductivity in single Rashba nanowires. The oscillations are typically symmetric in the orientation of the applied magnetic flux. Using double InAs nanowires coated by an epitaxial superconducting Al shell which, despite the non-centro-symmetric geometry, behaves effectively as one hollow cylinder, we demonstrate that a small misalignment of the applied parallel field with respect to the axis of the nanowires can produce field-asymmetric Little–Parks oscillations. These are revealed by the simultaneous application of a magnetic field perpendicular to the misaligned parallel field direction. The asymmetry occurs in both the destructive regime, in which superconductivity is destroyed for half-integer quanta of flux through the shell, and in the non-destructive regime, where superconductivity is depressed but not fully destroyed at these flux values.

El artículo es fruto de la investigación adelantada en el corregimiento de Obonuco, municipio de Pasto, en los años 2016 y 2017. Entre los objetivos está identificar las características económicas y sociales que inciden en el emprendimiento empresarial y social; con énfasis, debido a las características del contexto, hacia el emprendimiento social. Los hallazgos muestran que en esta comunidad ha sido difícil adelantar emprendimientos empresariales, lo cual motivó al grupo de investigación para indagar sobre las causas, y encontró que estas residen en las características sociales y culturales de sus habitantes, quienes poseen raíces indígenas reconocidas en un cabildo. Sin embargo, estas no se aprovechan debidamente para impulsar el emprendimiento social, debido a varias circunstancias relacionadas con factores políticos, económicos, educativos y culturales. Al contrastar la teoría con los resultados, se evidenció la escasa capacidad de asociación para cualquier tipo de emprendimiento, lo cual es condición esencial para que el emprendimiento social sea exitoso.

Superimposed training (ST) is a semiblind channel estimation technique, proposed for orthogonal frequency division multiplexing (OFDM), where training sequences are added to data symbols, avoiding the use of dedicated pilot-subcarriers, and increasing the available bandwidth compared with pilot symbol assisted modulation (PSAM). Filter bank multicarrier offset quadrature amplitude modulation (FBMC-OQAM) is a promising waveform technique considered to replace the OFDM, which takes advantage of well-designed filters to avoid the use of cyclic prefix and reduce the out-band-emissions. In this paper, we provide the expressions of the average channel capacity of the FBMC-OQAM combined with either PSAM or ST schemes, considering imperfect channel estimation and the presence of the pilot sequences. In order to compute the capacity expression of our proposal, ST-FBMC-OQAM, we analyze the channel estimation error and its variance. The average channel capacity is deduced considering the noise, data interference from ST, and the intrinsic self-interference of the FBMC-OQAM. Additionally, to maximize the average channel capacity, the optimal value of data power allocation is also obtained. The simulation results confirm the validity of the capacity analysis and demonstrate the superiority of the ST-FBMC-OQAM over existing proposals.

The antilock braking system (ABS) is a mechatronic system that helps a driver maintain the maneuverability of a vehicle while braking by preventing wheel lock-ups. However, the design of high-performance controllers for this type of system is complicated because of its highly nonlinear dynamics. The problem becomes even more difficult to resolve when uncertainties in the parameters appear in its dynamics. In this paper, an ABS laboratory setup mimicking a quarter car model is considered. A modified high-order sliding mode (HOSM) controller using a proportional-integral-differential (PID) control as a sliding surface was designed. This controller provides a reference value of a tire slip. The proposed controller uses a tracking error to define the slip surface through the PID controller structure, and the modified HOSM controller holds the system on the previously designed slip surface. The closed-loop system stability has been proven in the sense of Lyapunov. Finally, the ABS laboratory setup allows for experimentally checking the performance of the modified HOSM controller using a PID-sliding surface, showing a considerable increase in the efficiency of the control system compared with a PID-like controller.

In this work, steganography is implemented in photographs captured by an unmanned aerial vehicle (drone), with the purpose of adding an identifier that indicates which device they are taken from so it works for the recovery of the origin. In the system, a new technique that modifies the least significant bit (LSB) is applied, using a mathematical model to generate the chaotic orbits, one of the parts selects the RGB channel (Red, Green or Blue) where the LSB is changed and the other is implemented to calculate the random position of the sub pixel to be modified in the selected channel. In addition, a comparison between the bit to be hidden and the LSB of the pixel of the image is performed to verify if it is not necessary to modify it, which lessens the alterations in the container image. It is a tool to capture photos remotely with the Ar.Drone 2.0, with the features needed to perform an analysis that uses correlation diagrams and histograms to verify if the integrity of the message is guaranteed or if changes in the stego-image are visible to the naked eye. On the other hand, a test was done on the Baboon image to compare the robustness of the proposed system with other investigations, evaluating the correlation, contrast, energy, homogeneity, MSE, PSNR and quality index. The results generated were compared with the work of other authors concluding our system provides greater security, integrity, high sensitivity to the keys, it is not linked to a single chaotic system and can be applied to hide imperceptibly all kinds of information, in: radiographs, videos, files, official documents, and other types of containers.

We characterize parallel double quantum dot Josephson junctions based on closely spaced double nanowires bridged by in-situ deposited superconductors. The parallel double dot behavior occurs despite the proximity of the two nanowires and the potential risk of nanowire clamping during growth. By tuning the charge filling and lead couplings, we map out the parallel double quantum dot Yu-Shiba-Rusinov phase diagram. Our quasi-independent two-wire hybrids show promise for the realization of exotic topological phases.

This article presents an alternative for resolving the existing vulnerability of systems that implement masking by means of chaotic synchronization. This system avoids detection of the parameters used as the cipher key by an attacker on implementing encryption by means of synchronized chaotic-phase masks of the Rössler oscillator, for encoding and establishing synchronization among transmitterreceiver devices. In addition, it employs two ciphering keys: the first, with a recommended length of 2,048 characters, and the second, which is used as an initial value. Both keys are employed for continual modification of one of the oscillator’s parameters. This strengthens the security system and avoiding an attacker from obtaining the oscillator’s parametric values by calculating the least average synchronization error. The use of the system developed provides a cipher, which is resistant to statistical attacks. In addition, our system validates the data of the transmitter device (username, password, etc.) in order to authorize transmission.

Se presenta el desarrollo de un dispositivo analógico, para mod ular y registrar de manera inalámbrica las doce derivaciones ca rdiacas con una PC. El sistema que ha sido desarrollado con componentes de bajo costo, contiene una sola etapa de acondicionamiento de señ ales, una etapa de modulación de las señales en AM con transmisión/re cepción en FM, más un medio de selección de las derivaciones de manera remota, basado en la transmisión/decodificación de tonos audibles de doble frecuencia. El dispositivo ha sido probado e n un grupo de voluntarios de manera simultánea empleando un electroc ardiógrafo de marca con el fin de evaluar su funcionamiento. Lo s resultados experimentales indican que el sistema es una herrami enta capaz de conducir estudios de vectorcardiografía con una incertidumbre máxima del 20 % en la medición de la orientación del eje cardiaco.

Los neuroblastomas son una forma de cáncer infantil que se diagnostica comúnmente en el primer año de edad. Estos tumores, derivados de la cresta neural, se localizan en las glándulas suprarrenales o en territorio extrarrenal, que tienen características clínicas y biológicas curiosas pues existen desde casos con remisión espontánea hasta otros con progresión tumoral, escasa respuesta terapéutica y la muerte del paciente. Se presentó un caso de una paciente femenina de cuatro meses de edad que fue atendida en el Hospital Pediátrico Universitario de Holguín; fue remitida de su área de salud por presentar como hallazgo ultrasonográfico una masa sólida de 38 x 36 mm de bordes bien definidos en el borde superior del riñón izquierdo; exámenes de laboratorio negativos. Se realizó resección del tumor con adecuada evolución postquirúrgica. La biopsia informó neuroblastoma suprarrenal izquierdo, indiferenciado, de pobre estroma e histología desfavorable que medía 5 x 4 cm de diámetro e infiltraba algunas áreas de la cápsula. Palabras clave: neuroblastoma, neuroblastoma suprarrenal, lactante

Se presenta el desarrollo de un dispositivo para soldar compone ntes electrónicos, el cual funciona a base de campos magnéticos alternos. El dispositivo ha sido diseñado para trabajar sin cableado. El nuevo soldador se compone de un inversor resonante capaz de gen erar campos magnéticos alternos de 250 kHz en el centro de una bobin a de 11 espiras. El elemento calefactor es una pequeña pieza ci líndrica de acero inoxidable magnético con un núcleo concéntrico de cobr e, el cual se encuentra unido a una punta reemplazable para cau tín comercial. Adicionalmente hemos determinado el factor de potenc ia y la eficiencia en la transferencia de energía con un máximo de consumo de potencia de 134 Watts. El dispositivo representa una buena herramienta adecuada para la realización de tarjetas imp resas para circuitos o tareas de electrónica.

BACKGROUND:Atrial fibrillation (AF) is a mechanistically heterogeneous disorder, and the ability to identify sub-phenotypes ("endophenotypes") of AF would assist in the delivery of personalized medicine. We used the clinical response to pulmonary vein isolation (PVI) to identify a sub-group of patients with non-PV mediated AF and sought to define the clinical associations. METHODS:Subjects enrolled in the Vanderbilt AF Ablation Registry who underwent a repeat AF ablation due to arrhythmia recurrence were analyzed on the basis of PV reconnection. Subjects who had no PV reconnection were defined as "non-PV mediated AF". A comparison group of subjects were identified who had AF that was treated with PVI-only and experienced no arrhythmia recurrence >12 months. They were considered a group enriched for "PV-mediated AF". Univariate and multivariable binary logistic regression analysis was performed to investigate clinical associations between the PV and non-PV mediated AF groups. RESULTS:Two hundred and twenty nine subjects underwent repeat AF ablation and thirty three (14%) had no PV reconnection. They were compared with 91 subjects identified as having PV-mediated AF. Subjects with non-PV mediated AF were older (64 years [IQR 60,71] vs. 60 [52,67], P = 0.01), more likely to have non-paroxysmal AF (82% [N = 27] vs. 35% [N = 32], P

This document explores the possibility to link to foreign lan - guage teaching practice in the classroom, two streams of theo - retical elements set by late research on neurosciences about the cognitive processes underling learning, and the elements from sociolinguistics dealing with languages in contact. The objective of the paper is to consider those elements as an en - riching source for didactics and as an alternative to practice based on recipe -like activities well designed to different settings. Reflective teaching is presented though, as the empirical tool to make language education a real part of praxeology, in which effective teaching is connected to meaningful and contextualized didactics.

Resumen: La privacidad es un concepto muy relativo y sujeto al sentimiento de seguridad que tenga un usuario. Aunque es común estudiar la percepción de privacidad de los usuarios de Internet, casi nada se ha discutido sobre este derecho en Ecuador. Por ello, tampoco se han puesto de manifiesto algunos riesgos a la privacidad de los usuarios que están latentes en el contexto nacional. Ya que la administración pública en Ecuador experimenta una explosiva integración al “gobierno en línea” en la que se gestiona información de los ciudadanos, resulta crucial estudiar la privacidad de estos datos desde su perspectiva local y en el marco de los riesgos latentes que dicha privacidad enfrenta. Se realizó un estudio de percepción de privacidad mediante una encuesta para determinar, entre otras cosas, qué información es considerada sensible por los usuarios. Además, se hizo un análisis experimental no intrusivo de algunos servicios de información ecuatorianos en Internet, para determinar si la percepción de los usuarios concurre con los riesgos de su privacidad en Internet. Se encontró que los usuarios están claramente conscientes de las amenazas a su intimidad en línea. Lamentablemente, la información que consideran “no sensible” podría permitirle a un atacante obtener información que los usuarios consideran “muy sensible”, con lo que la conciencia inicial que muestran no resultaría suficiente para proteger su privacidad.Abstract: Privacy is a very relative concept subject to the user’s feeling about security. Although it is common to study the privacy perception of Internet users, little has been discussed about that in Ecuador. Thus, the risks of user privacy in the local context have not been highlighted. Since public administration in Ecuador suffers an explosive integration into the e-government where information on citizens is managed, it is crucial to study these data privacy from a local view and within the framework of the underlying risks that such privacy faces. We performed a study of privacy perception by means of a poll which helped us to determine how concerned users are about some types of information. Moreover, we did an experimental nonintrusive analysis of some Ecuadorian information services available on Internet in order to find if the users’ perceptions match their privacy risk on Internet. We found that users are aware of the threats to their privacy online. Sadly, the data they find “non sensible” could allow an attacker to get information that users find “very sensible”, so the initial awareness they show may not be enough to protect their privacy.

Resumen: La telefonía es un servicio que se usa muy ampliamente todavía, ya que con éste han crecido las últimas generaciones de personas. La integración de la telefonía con Internet y la posibilidad de implementarla a nivel de software le ha dado a este servicio una flexibilidad asombrosa para el despliegue de sistemas de comunicación de voz. Además, gracias al desarrollo de código abierto, un sistema PBX puede instalarse ahora en casi cualquier dispositivo de cómputo. Este es el caso de la placa Raspberry Pi, una plataforma de cómputo pequeña y de muy bajo costo que actualmente está siendo usada para distintas aplicaciones en entornos domésticos, y que es compatible con sistemas operativos basados en Linux. Así, el objetivo de este artículo es evaluar el rendimiento de un sistema de Telefonía IP basado en la plataforma Raspberry Pi de acuerdo a parámetros objetivos como uso de CPU, uso de memoria RAM, tiempos de respuesta de llamada y llamadas fallidas. Sin embargo, se toman en cuenta también parámetros objetivos de evaluación, mediante la realización del test MOS, con el fin de medir la percepción del usuario sobre el servicio telefónico en un entorno específico utilizando la plataforma mencionada. Encontramos que la plataforma Raspberry Pi puede soportar varias llamadas concurrentes sin que se sobrecarguen sus recursos pero que, en determinado punto, los tiempos de respuesta se incrementan significativamente, así como el número de llamadas fallidas. Considerando el costo reducido de la placa debido a la no utilización de licenciamiento a nivel se software o hardware y tomando en cuenta el rendimiento obtenido con diferentes valores de carga, se evidencia como una interesante opción para pequeñas y medianas empresas, así como para entornos domésticos de aplicación. Abstract: Telephony is still heavily used since it is a service with which people are very familiar. Its integration to Internet and its implementation at the software level have given this service an amazing flexibility when deploying voice communication systems. Moreover, thanks to the open source development, a PBX service can now be installed in almost every computing device. That is the case of Raspberry Pi low-sized and very cheap computing platform that is being employed to provide network services for SOHO environments, and which is compatible with Linux based operating systems. The aim of this paper is to assess the performance of a Raspberry Pi based IP telephony service in terms of objective parameters such as CPU and RAM usage, call response times, and failed calls. However, subjective parameters, in terms of user perception about the service, were also taken into account by applying the test MOS in a specific test environment. We found that the codec selection and the simultaneous number of calls determine the overloading point of the platform (in terms of CPU usage) which was evidenced by longer response times and failed calls. Considering the reduced cost of the board, since no hardware or software licenses are required, and taking into account the performance obtained from the system with different load levels, this is a very interesting option for small and medium companies, and also for domestic application environments.

This document explores the possibility to link to foreign lan - guage teaching practice in the classroom, two streams of theo - retical elements set by late research on neurosciences about the cognitive processes underling learning, and the elements from sociolinguistics dealing with languages in contact. The objective of the paper is to consider those elements as an en - riching source for didactics and as an alternative to practice based on recipe -like activities well designed to different settings. Reflective teaching is presented though, as the empirical tool to make language education a real part of praxeology, in which effective teaching is connected to meaningful and contextualized didactics.

Resumen: Los sistemas P2P y los ISPs dependen entre sí para poder ofrecer la mejor experiencia de acceso a contenido al usuario final. Sin embargo, los sistemas P2P no poseen información sobre lo que está pasando en las redes subyacentes, de manera que estos sistemas tienen que cooperar con los ISPs para superar la ineficiencia inherente del enrutamiento P2P. Al parecer esta cooperación tiene que ver con un objetivo principal: localizar tráfico en las redes de los ISPs para aprovechar las características demográficas de distribución de contenido. Este trabajo trata de resumir algunos enfoques, aplicados a las redes P2P más populares, que intentan aprovechar los beneficios de las características demográficas del tráfico P2P, por medio de caching , modificaciones en los protocolos P2P, servicios intermedios gestionados por el ISP, e incluso acuerdos de peering entre ISPs locales. Abstract: P2P systems and ISPs depend on each other to give the best accessing content experience for the end user. However, P2P systems have not information about what is happening in the underlay networks, so these systems have to cooperate with ISPs in order to overcome the inherent inefficiency of P2P routing. It seems that this cooperation has to do with a main objective: localizing traffic within the ISPs networks to take advantage of content distribution demographic characteristics. This work summarizes some approaches, applied to the most popular P2P networks, which try to explode the benefits of demographic characteristics of P2P traffic, by means of caching, modifications on the P2P protocols, intermediate services managed by the ISP and even peering agreements between local ISPs.