Abstract In the realm of modern cardiology, the integration of computer-interpreted electrocardiograms (CI-ECGs) has marked the beginning of a new era of diagnostic precision and efficiency. Contemporary electrocardiogram (ECG) integration systems, applying algorithms and artificial intelligence, have modernized the interpretation of heart rhythms and cardiac morphology. Due to their ability to rapidly analyze and interpret ECG recordings CI-ECGs have already profoundly impacted clinical practice. This review explores the evolution of computer interpreted ECG technology, evaluates the pros and cons of current automatic reporting systems, analyzes the growing role of artificial intelligence on ECG interpretation technologies, and discusses emerging applications that may have transformative effects on patient outcomes. Emphasis is placed on the role of ECGs in the automatic diagnosis of occlusion myocardial infarctions (OMI). AI models enhance accuracy and efficiency in ECG interpretation, offering insights into cardiac function and aiding timely detection of concerning patterns for accurate clinical diagnoses. The shift to AI-driven diagnostics has emphasized the importance of data in the realm of cardiology by improving patient care. The integration of novel AI models in ECG analysis has created a promising future for ECG diagnostics through a synergistic fusion of feature-based machine learning models, deep learning approaches, and clinical acumen. Overall, CI-ECGs have transformed cardiology practice, offering rapid, accurate, and standardized analyses. These systems reduce interpretation time significantly, allowing for quick identification of abnormalities. However, sole reliance on automated interpretations may overlook nuanced findings, risking diagnostic errors. Therefore, a balanced approach in integrating automated analysis with clinical judgment is necessary. computerinterpreted CIECGs CI (CI-ECGs (ECG morphology practice technology technologies outcomes OMI. OMI . (OMI) diagnoses AIdriven driven care featurebased feature based approaches acumen Overall rapid analyses significantly abnormalities However findings errors Therefore necessary (OMI

Resumo Embora o modelo existente de classificação do infarto agudo do miocárdio (IAM) em IAMCSST e IAMSSST tenha sido benéfico, considera-se hoje que ele falha em abordar a complexidade das síndromes coronarianas agudas. O estudo tem como objetivo examinar o atual paradigma IAMCSST-IAMSSST e defender um modelo mais detalhado, chamado de oclusão coronariana aguda (OCA) e Ausência de Oclusão Coronária Aguda (NOCA), para um diagnóstico e um manejo do IAM mais precisos. Realizou-se uma análise abrangente da literatura médica existente, com foco nas limitações do modelo IAMCSST-IAMSSST. O estudo também descreve uma nova abordagem diagnóstica para pacientes apresentando do torácica nos departamentos de emergência. O modelo IAMCSST-IAMSSST tradicional falha em prover um diagnóstico preciso e um tratamento efetivo, principalmente na identificação de oclusões da artéria coronária. O modelo OCA-NOCA é mais preciso em termos anatômicos e fisiológicos, e apoiado por pesquisa clínica extensa e opiniões de especialistas. Ele destaca a necessidade de rápida realização de eletrocardiogramas (ECGs) e terapias de reperfusão para casos suspeitos de OCA, visando melhorar os desfechos dos pacientes. O modelo OCA-NOCA abre um novo caminho para pesquisas e aplicações clínicas futuras. Ele defende um entendimento mais abrangente dos mecanismos subjacentes das síndromes coronarianas agudas, levando a planos individualizados de tratamentos. Espera-se que essa nova abordagem incite novos debates e pesquisas acadêmicas, principalmente na área de cardiologia no Brasil, com o objetivo de aumentar a precisão diagnóstica e a eficácia do tratamento de pacientes com IAM. (IAM benéfico considerase considera se agudas IAMCSSTIAMSSST detalhado OCA (OCA NOCA, NOCA , (NOCA) precisos Realizouse Realizou IAMCSSTIAMSSST. IAMSSST. emergência efetivo coronária OCANOCA fisiológicos especialistas ECGs (ECGs futuras tratamentos Esperase Espera acadêmicas Brasil (NOCA

Abstract Although the existing framework for classifying acute myocardial infarction (AMI) into STEMI and NSTEMI has been beneficial, it is now considered to be falling short in addressing the complexity of acute coronary syndromes. The study aims to scrutinize the current STEMI-NSTEMI paradigm and advocate for a more nuanced framework, termed as occlusion myocardial infarction (OMI) and non-occlusion myocardial infarction (NOMI), for a more accurate diagnosis and management of AMI. A comprehensive analysis of existing medical literature was conducted, with a focus on the limitations of the STEMI-NSTEMI model. The study also outlines a new diagnostic approach for patients presenting with chest pain in emergency settings. The traditional STEMI-NSTEMI model falls short in diagnostic precision and effective treatment, especially in identifying acute coronary artery occlusions. The OMI-NOMI framework offers a more anatomically and physiologically accurate model, backed by a wealth of clinical research and expert opinion. It underscores the need for quick ECG assessments and immediate reperfusion therapies for suspected OMI cases, aiming to improve patient outcomes. The OMI-NOMI framework offers a new avenue for future research and clinical application. It advocates for a more comprehensive understanding of the underlying mechanisms of acute coronary syndromes, leading to individualized treatment plans. This novel approach is expected to ignite further scholarly debate and research, particularly in the Brazilian cardiology sector, with the goal of enhancing diagnostic accuracy and treatment effectiveness in AMI patients. (AMI beneficial syndromes STEMINSTEMI (OMI nonocclusion non NOMI, NOMI , (NOMI) conducted settings occlusions OMINOMI opinion cases outcomes application plans sector (NOMI

A key phrase in working with horses, "bringing up life" is taken in its literal sense of moving expressively and energetically in order to animate the movements of the horses. The phrase also points to both what the radical phenomenologist Michel Henry referred to as the auto-affectivity of life and the vital powers of an essential hetero-affectivity. "Bringing up life" is the kinetic, kinaesthetic, affective expression of this fundamental impression that life is shared with other animate beings and that it is all the more powerfully felt for being so. Working with horses - in spite of all the human conceits that groundwork, liberty training, and the riding disciplines hold -can thus reveal what it means to "bring up life" as more than a topic of very practical interest and specific phenomenological description. Through the impressional investigation of this expression we may well begin to feel our way toward more life-affirming, life-enhancing interactions with others of our own and many other animal kinds.

Extreme wet and dry years (± 1 standard deviation, respectively), as well as the top 95 percentile (P95) of daily precipitation events, derived from tropical cyclone (TC) and non-tropical cyclone (NTC) rainfall, were analyzed in coastal river basins in Southern Oaxaca, Mexico (Río Verde, Río Tehuantepec, and the Southern Coast). The study is based on daily precipitation records from 47 quality-controlled stations for the 1961 to 1990 period and TC data for the Eastern Tropical Pacific (EPAC). The aim of this study was to evaluate extreme (dry and wet) trends in the annual contribution of daily P95 precipitation events and to determine the relationship of summer precipitation with El Niño Southern Oscillation (ENSO) and the Pacifical Decadal Oscillation (PDO). A regionalization based on a rotated principal component analysis (PCA) was used to produce four precipitation regions in the coastal river basins. A significant negative correlation (significance at the 95% level) was only found with ONI in rainfall Region 3, nearest to the Gulf of Tehuantepec. Wet years, mainly linked to TC-derived P95 precipitation events, were associated with SST anomalies (≥-0.6°C) similar to weak La Niña and Neutral cool conditions, while dry years were associated with SST positive anomalies similar to Neutral warm conditions (≤-0.5°C). The largest contribution of extreme P95 precipitation derived from TCs to the annual precipitation was observed in Region 3. A significant upward trend in the contribution of TC-derived precipitation to the annual precipitation was found only in Region 1, low Río Verde.

Se realizó un estudio sobre eventos extremos de sequía y humedad (± 1 desviación estándar), así como eventos de precipitación diaria mayores al percentil 95 (P95), asociados a tormentas tropicales y otros eventos, en tres cuencas hidrológicas costeras del sur de Oaxaca (Río Verde, Río Tehuantepec y la costa del sur de Oaxaca). El estudio está basado en registros de precipitación diaria de 47 estaciones bajo control de calidad durante el periodo de 1961-1990, con datos de tormentas tropicales para el Pacífico Oriental Tropical. El objetivo de este estudio fue evaluar eventos extremos (húmedos y secos), las tendencias de la contribución anual de la precipitación derivada del P95 y la relación de la precipitación de verano con El Niño-Oscilación del Sur y la Oscilación Decadal del Pacífico. Se realizó una regionalización basada en un análisis de componentes principales lo cual dió por resultado cuatro regiones de precipitación. Una correlación negativa significativa (al 95 % de confianza) fue encontrada sólo con el índice ONI en la región 3, la más cercana al Golfo de Tehuantepec. Los años húmedos ligados a eventos del P95 asociados con tormentas tropicales, fueron relacionados con anomalías negativas (≥-0.6°C) similares a condiciones de La Niña débil y neutrales. Mientras que los años secos fueron relacionados con anomalías positivas similares a condiciones neutrales (≤-0.5°C) . La mayor contribución de precipitación del P95, asociada con tormentas tropicales, fue observada en la región 3. Sólo se encontró una tendencia positiva de esta contribución en la región 1: el bajo Río Verde.