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Although pericardial effusions are not uncommon in patients with end-stage renal disease, uremic pericardial effusion (UPE) frequently remains unrecognized in the absence of clinical signs and symptoms. We present a case of post-living donor renal transplantation delayed graft function due to asymptomatic undiagnosed chronic nontamponade UPE. The patient developed dramatic intraoperative severe hypotension, electrolyte abnormalities, and atrial fibrillation. Prolonged intraoperative hypotension and allograft hypoperfusion caused mild acute tubular necrosis and postoperative delayed graft function that required 2 weeks to recover. The combination of chronic UPE, even without tamponade, hypotension, and atrial fibrillation could lead to significant hemodynamic instability during renal transplantation. More careful immediate pretransplantation cardiac evaluation and avoidance of intraoperative hypotension could prevent these serious consequences of silent UPE.s.

International audience

A method for estimating the instantaneous heart rate (HR) using the morphological features of one electrocardiogram (ECG) cycle (beat) at a time is proposed. This work is not aimed at introducing an alternative way for HR estimation, but rather illustrates the utility of model-based ECG analysis in online individualized monitoring of the heart function. The HR estimation problem is reduced to fitting one parameter, whose value is related to the nine parameters of a realistic nonlinear model of the ECG and estimated from data by nonlinear least-squares optimization. The method feasibility is evaluated on synthetic ECG signals as well as signals acquired from MIT-BIH databases at Physionet website. Moreover, the performance of the method was tested under realistic free-moving conditions using a wearable ECG and HR monitor with encouraging results.

This abstract was withdrawn by the authors. Citation Format: Veitch ZW, Bedard P, Tang PA, Conway JL, Ribnikar D, Albaba H, King K, Lupichuk S, Cescon D. Withdrawn [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P6-17-29.

A novel model-based method for patient-specific detection of deformed electrocardiogram (ECG) beats is proposed and tested. Five parameters of a patient-specific nonlinear ECG model are estimated f ...

The increasing urbanization of mountainous areas increased the risk imposed on residential buildings and infrastructure. In Switzerland, shallow landslides and hillslope debris flows are responsible every year for high infrastructure damage, blocking of important highways, evacuations and deaths. Up till now, the assessment of these processes has been mainly based on the experience of experts, especially in the assessment of their run-out extent and expected damage. In this research we present a new computationally efficient Discrete Element Model (DEM) which has been developed for the aim of simulating the run-out of hillslope debris flows.YADE-DEM open source code has been extended and an elasto-plastic adhesive contact law have been implemented, which partially account for the presence of the fluid composed of water and find material. This is achieved through the adhesive aspect of the contact law, which would indirectly take the presence of such fluid into account, as this fluid would increase the cohesion of the flowing mass. A parametric study has been carried out to define the most sensitive model parameters, which were found to be the microscopic basal friction angle (Φb) and the ratio between stiffness parameters (loading and unloading) of the flowing particles . Data of full-scale experiments of hillslope debris flows were used to compare the flow kinematics with the model’s prediction. A good agreement between the model and experiments was observed concerning the mean front velocity (average margin of error of 8%) and the maximum applied pressure (average margin of error of 5%), with less agreement of the flow height (average margin of error of 13%). Detailed comparisons of pressure evolution between different selected experiments and simulations revealed the model’s capability of reproducing observed pressure curves, especially during the primary loading phase, leading to maximum pressure.In order to test the model’s prediction of run-out distance of hillslope debris flow, hundreds of past hillslope debris flow events in the Swiss Alps were analyzed and 30 cases were selected representing different situations (i.e. different release volumes, slopes and forest cover). Due to the discrete nature of results in YADE, a GIS algorithm was developed in order to create envelopes representing the temporal evolution of the simulated propagating processes, which were compared to the those of the historical events. Results of the comparison revealed that, with the calibration of the two sensitive parameters in YADE, a fair to very good agreement was observed between the envelopes of the model and those of historical events for 87% of the tested cases. Difficulties in reproducing the envelopes of the rest of the cases are linked to the uncertainties in the mapping of the envelopes of past events, the role of the forest which is not taken into account in the model, and the lack of direct representation of fluid in the model.

Date of Conference: 10-12 July 2019 Conference name:American Control Conference (ACC) This paper describes a stochastic modeling approach for predicting driver responses in highway traffic. Different from existing approaches in the literature, the proposed modeling framework allows simultaneous decision making for multiple drivers (>100), in a computationally feasible manner, instead of modeling the decisions of an ego driver and assuming a predetermined driving pattern for other drivers in a given scenario. This is achieved by a unique combination of hierarchical game theory, which is used to model strategic decision making, and stochastic reinforcement learning, which is employed to model multi-move decision making. The proposed approach can be utilized to create high fidelity traffic simulators, which can be used to facilitate the validation of autonomous driving control algorithms by providing a safe and relatively fast environment for initial assessment and tuning. What makes the proposed approach appealing especially for autonomous driving research is that the driver models are strategic, meaning that their responses are based on predicted actions of other intelligent agents in the traffic scenario, where these agents can be human drivers or autonomous vehicles. Therefore, these models can be used to create traffic models with multiple human-machine interactions. To evaluate the fidelity of the framework, created stochastic driver models are compared with real driving patterns, processed from the traffic data collected by US Federal Highway Administration on US101 (Hollywood Freeway) on June 15th, 2005.

Journal of Global Archaeology, 2020, Dieses Paper fasst die Ergebnisse der Surveyfunde zusammen, die von 1998 bis 2007 von der Kommission für Archäologie Auβereuropäischer Kulturen des Deutschen Archäologischen Instituts und des Institut National des Sciences de l'Archéologie et du Patrimoine in Ammorene I und Ammorene II durchgeführt wurden. Die stark gestörten Fundstellen liegen in 8 km Entfernung zum Mittelmeer, in der Nähe von Nador. Sie verfügen über lithische Rohstoffquellen, die weniger als 3 km entfernt sind und von den Bewohnern beider Fundstätten genutzt wurden. Die lithische Analyse zeigt, dass über 50% der modifizierten Stücke, die von jeder Assemblage gesammelt wurden, proto-biface oder biface sind. Artefakte aus den Mittel- und Spätacheuléen sind an jeder Fundstelle vorhanden, obwohl die Assemblagen bei Ammorene II technisch-morphologisch etwas älter als die Lithologische Sammlung von Ammorene I zu sein scheint. Angesichts der begrenzten Anzahl solch reicher Fundstätten des unteren Paläolithikums in Nordafrika und der Tatsache, dass diese Fundstätten für den Nordosten Marokkos noch seltener sind, trägt die hier vorgestellte Forschung dazu bei, unsere Kenntnisse über das Paläolithikum des Maghreb zu vertiefen., This report summarizes the results of surface collections conducted from 1998 through 2007 by the Kommission für Archäologie Auβereuropäischer Kulturen des Deutschen Archäologischen Instituts and the Institut National des Sciences de l’Archéologie et du Patrimoine at Ammorene I and Ammorene II. The heavily disturbed sites are located within eight kilometers of the Mediterranean Sea, near Nador, and have lithic raw material sources located less than three kilometers away, which were utilized by the inhabitants at both sites. Lithic analysis reveals that over 50% of the modified pieces collected from each assemblage are proto-bifaces or bifaces. Middle and Late Acheulean artifacts are present at each site although, techno-morphologically, the assemblage at Ammorene II may slightly predate Ammorene I’s lithic collection. Given the limited number of such rich Lower Paleolithic sites in North Africa, coupled with the fact that these sites are even more of a rarity for northeastern Morocco, the research presented here aids in furthering our knowledge of the Maghrebian Paleolithic.

In this thesis, model-based analysis approach is considered as a possible solution towards a patient-specific point-of-care device for the purpose of electrocardiogram monitoring. Two novel methods are proposed, tested, and quantitatively evaluated. First, a method for estimating the instantaneous heart rate using the morphologicalfeatures of one electrocardiogram beat at a time is proposed. This work is not aimed at introducing an alternative way for heart rate estimation, but rather illustrates the utility of model-basedelectrocardiogram analysis in online individualized monitoring ofthe heart function. The heart rate estimation problem is reduced to fitting one parameter, whose value is related to the nine parameters of a realistic nonlinear model of the electrocardiogram and estimated from data by nonlinear least-squares optimization. The method feasibility is evaluated on synthetic electrocardiogram signals as well as signals acquired from MIT-BIH databases at Physionet website. Moreover, the performance of the method was tested under realistic free-moving conditions using a wearable electrocardiogram and heart monitor with encouraging results. Second, a model-based method for patient-specific detection of deformed electrocardiogram beats is proposed. Five parameters of a patient-specific nonlinear electrocardiogram model are estimated from data by nonlinear least-squares optimization. The normal variability of the model parameters is captured by estimated probability density functions. A binary classifier, based on stochastic anomaly detection methods, along with a pre-tuned classification threshold, is employed for detecting the abnormal electrocardiogram beats. The utility of the proposed approach is tested by validating it on annotated arrhythmia data recorded underclinical conditions.

With the increasing availability and clinical use of exome and whole-genome sequencing, reverse phenotyping is now becoming common practice in clinical genetics. Here, we report a patient identified through the Wellcome Trust Deciphering Developmental Disorders study who has homozygous pathogenic variants in CC2D2A and a de-novo heterozygous pathogenic variant in KIDINS220. He presents with developmental delay, intellectual disability, and oculomotor apraxia. Reverse phenotyping has demonstrated that he likely has a composite phenotype with contributions from both variants. The patient is much more mildly affected than those with Joubert Syndrome or Spastic paraplegia, intellectual disability, nystagmus, and obesity, the conditions associated with CC2D2A and KIDINS220 respectively, and therefore, contributes to the phenotypic variability associated with the two conditions.

The anticipated technological advancement of 5th Generation (5G) network is the ability to apply intelligence directly to network’s edge, in the form of virtual network appliances through the archetypes of Network Functions Virtualisation (NFV) and Edge Cloud Computing.The adoption and use of innovative technologies, such as Software Defined Networking (SDN) and NFV is the key to making 5G networks more promising. However, implementing these technologies yield to the imaging of new security challenges. A Cloud-Enabled Small Cell (CESC) provides multi-operator platform to integrates and execute at the virtualised environment. Providing services to multiple operators/tenants to access technologies and protocols in unified network architecture requires well-define security approach in order to deliver secured data communication, privacy and integrity. The CESC security requirement analysis was carried out using Secure Tropos (SecTro) methodology. The paper will thoroughly examine the CESC security challenges and provide possible solutions to mitigate those challenges.

With advances in genetic testing and improved access to such advances, whole exome sequencing is becoming a first-line investigation in clinical work-up of children with developmental delay/intellectual disability (ID). As a result, the need to understand the importance of genetic variants and its effect on the clinical phenotype is increasing. Here, we report on the largest cohort of patients with HNRNPU variants. These 21 patients follow on from the previous study published by Yates et al. in 2017 from our group predominantly identified from the Deciphering Developmental Disorders study that reported seven patients with HNRNPU variants. All the probands reported here have a de novo loss-of-function variant. These probands have craniofacial dysmorphic features, in the majority including widely spaced teeth, microcephaly, high arched eyebrows, and palpebral fissure abnormalities. Many of the patients in the group also have moderate to severe ID and seizures that tend to start in early childhood. This series has allowed us to define a novel neurodevelopmental syndrome, with a likely mechanism of haploinsufficiency, and expand substantially on already published literature on HNRNPU-related neurodevelopmental syndrome.

Predicting the outcomes of integrating Unmanned Aerial Systems (UAS) into the National Airspace System (NAS) is a complex problem which is required to be addressed by simulation studies before allowing the routine access of UAS into the NAS. This paper focuses on providing a 3-dimensional (3D) simulation framework using a game theoretical methodology to evaluate integration concepts using scenarios where manned and unmanned air vehicles co-exist. In the proposed method, human pilot interactive decision making process is incorporated into airspace models which can fill the gap in the literature where the pilot behavior is generally assumed to be known a priori. The proposed human pilot behavior is modeled using dynamic level-k reasoning concept and approximate reinforcement learning. The level-k reasoning concept is a notion in game theory and is based on the assumption that humans have various levels of decision making. In the conventional "static" approach, each agent makes assumptions about his or her opponents and chooses his or her actions accordingly. On the other hand, in the dynamic level-k reasoning, agents can update their beliefs about their opponents and revise their level-k rule. In this study, Neural Fitted Q Iteration, which is an approximate reinforcement learning method, is used to model time-extended decisions of pilots with 3D maneuvers. An analysis of UAS integration is conducted using an example 3D scenario in the presence of manned aircraft and fully autonomous UAS equipped with sense and avoid algorithms., Added 'Acknowledgement' Section

Myopericarditis is a rare but well-documented clinical presentation of primary Toxoplasma gondii infection in immunocompetent patients. Here, early detection of Toxoplasma DNA in the peripheral blood by PCR allowed the diagnosis of acute toxoplasmosis while serological tests were negative. Additional serological evaluations 2 weeks later confirmed the diagnosis and showed that cardiac manifestations occurred before seroconversion. This highlights the importance of a second serological control in the case of a suspected active infection. Overall, we show here that PCR testing for Toxoplasma is a sensitive and straightforward alternative to serological examinations. Keywords: Acute toxoplasmosis, Myopericarditis, Immunocompetent, Toxoplasma gondii, PCR, Second serological control, Molecular diagnosis

Objectives To evaluate long-term clinical outcomes of the Absorb bioresorbable vascular scaffold (BVS) system (Abbott Vascular) in an all-comers Middle East population. Methods This prospective registry study included an initial set of patients with coronary lesions treated using Absorb BVS. Patients were followed for target vessel failure (TVF) including cardiac death, target vessel myocardial infarction (MI), and target lesion revascularization. Results A total of 217 patients (age, 55 ± 11 years; male, 169) with 300 treated lesions were included (median follow-up, 36 months [range, 26–41 months]; complete follow-up, 201 patients). Diabetes mellitus and acute coronary syndrome were present in 50% and 57% of patients, respectively. TVF rate was 32/201 (15.9%), including cardiac death in 10 (5%), target vessel MI in 13 (6.5%), and target lesion revascularization in 22 patients (10.9%). Definite or probable device thrombosis occurred in 11/201 patients (5.5%). TVF was associated with heart failure, worse ejection fraction, multi-vessel BVS, multi BVS in lesion, and total BVS length >50 mm. Conclusions Long-term outcome following Absorb BVS implantation in a population with high prevalence of high-risk and complex patients is acceptable, but heart failure, worse ejection fraction, and multi-vessel or long BVS implantation were associated with worse outcomes.

Yenilenebilir enerji, dünyenın her yerindeki ülkelerin temel hedefidir. Küresel ısınma sorunu düyada her geçen gün büyüyor. Şirketler, zararlı emisyonları sınırlandırmak ve mümkün olduğunca azaltmak için yenilenebilir enerji yatırımlarına hız veriyorlar.Bu tez Türkiye'deki yenilenebilir enerji ve yenilenebilir enerji kaynaklarına odaklanmıştır. Bu çalımada güneş ve rüzgar enerjisinin verimli kullanımını sağlayacak bir sistem tasarlanmıştır. Bazı durumlarda, elektrik şebekesine bağlı olmayan tesislerin elektrik enerjisi talebi karşılanmalıır. Bu amaçla, çift yönlü dönüştürücü, piller ve yedek dizel jeneratörlerinin yanı sıra, güneş (PV) panellerinden ve rüzgar türbini jeneratörlerinden oluşan hibrit bir enerji sistemi kullanılabilir. Araştırma için Ankara Çubuk ve İzmir Urla bölgeleri seçildi. Elektrik Yenilenebilir Hibrit Optimizasyon Modeli (HOMER) programı bölgenin boylam ve enlem değerlerini girdikten sonra NASA yüzey meteorolojisi ve güneş enerjisi veri tabanınından aldığı güneş radyasyonu ve rüzgar hızı değerlerini kullanabilmektedir. Yazılım önerilen hibrit enerji sistemini bütün imkan ve bileşenlerle birlikte simüle etmekte ve en iyi sonucu önermektedir. En iyi sonuç, hibrit enerji sisteminde kullanılacak rüzgar türbini jeneratörlerinin özellikleri yanında, PV panellerinin enerji değeri ile gösterilmektedir.Simülasyon sonuçlarına göre, Çubuk / Ankara ve Urla / İzmir için iki hibrit enerji sistemi ele alındı. Urla için, ilk sistem 800 kW'lık PV paneller, 250 kW'lık bir rüzgar türbini ve bir dizel jeneratör içerirken, ikinci sistem, PV panelleri için 1,300 kW'lık PV paneller ile her biri 250 kW'lık üç rüzgar türbininden oluşmaktadır. İkinci sistem daha pahalı olmasına ragmen dizel jeneratör içermediğinden çevreye zararı daha azdır. The renewable energy is being the main aim for the countries all over the world. The global warming issue is getting more dangerous on our earth. The companies are aiming now to use the renewable energy to limit the harmful emissions and reduce it as much as possible.This thesis focused on the renewable energy and its resources in Turkey. The infinite value of solar radiation and wind speed are the purpose of this study because it can produce a clean energy by using a hybrid energy system which consists of PhotoVoltaic (PV) panels and wind turbine generators, besides the use of bidirectional converter, batteries and a back-up diesel generator, in some cases, to cover the electrical load demand. The selected areas were Cubuk in Ankara and Urla in Izmir. According to the known Hybrid Optimization Model for Electrical Renewable (HOMER) program, the solar radiation and wind speed values will be taken by using the tool of NASA surface meteorology and solar energy database after entering the longitude and latitude values of the areas. The software will implement the proposed hybrid energy system, with all the possibilities and components, and will suggest the top result. The top result will be shown according to the PV panels, besides the quantity of the wind turbine generators which will being used in the hybrid energy system.The simulation results of HOMER software suggested two hybrid energy systems for Cubuk / Ankara and Urla / Izmir. For Urla, the first hybrid system includes 800 kW PV panels, one 250 kW wind turbine generator and one diesel generator. The second hybrid system consists of 1,300 kW PV panels and three wind turbine generators of 250 kW each, without the needy of using the diesel generator, which means that the second hybrid system is producing a clean energy 100%. 108

This paper presents a Discrete Element-based elasto-plastic-adhesive model which is adapted and tested for producing hillslope debris flows. The numerical model produces three phases of particle contacts: elastic, plastic and adhesion. The model capabilities of simulating different types of cohesive granular flows were tested with different ranges of flow velocities and heights. The basic model parameters, being the basal friction (ϕb) and normal restitution coefficient (ϵn), were calibrated using field experiments of hillslope debris flows impacting two sensors. Simulations of 50 m3 of material were carried out on a channelized surface that is 41 m long and 8 m wide. The calibration process was based on measurements of flow height, flow velocity and the pressure applied to a sensor. Results of the numerical model matched well those of the field data in terms of pressure and flow velocity while less agreement was observed for flow height. Those discrepancies in results were due in part to the deposition of material in the field test which are not reproducible in the model. A parametric study was conducted to further investigate that effect of model parameters and inclination angle on flow height, velocity and pressure. Results of best-fit model parameters against selected experimental tests suggested that a link might exist between the model parameters ϕb and ϵn and the initial conditions of the tested granular material (bulk density and water and fine contents). The good performance of the model against the full-scale field experiments encourages further investigation by conducting lab-scale experiments with detailed variation of water and fine content to better understand their link to the model's parameters.