Nonlinear State and Parameter Estimation Using Iterated Sigma Point Kalman Filter: Comparative Studies

In this chapter, iterated sigma‐point Kalman filter (ISPKF) methods are used for nonlinear state variable and model parameter estimation. Different conventional state estimation methods, namely the unscented Kalman filter (UKF), the central difference Kalman filter (CDKF), the square‐root unscented Kalman filter (SRUKF), the square‐root central difference Kalman filter (SRCDKF), the iterated unscented Kalman filter (IUKF), the iterated central difference Kalman filter (ICDKF), the iterated square‐root unscented Kalman filter (ISRUKF) and the iterated square‐root central difference Kalman filter (ISRCDKF) are evaluated through a simulation example with two comparative studies in terms of state accuracies, estimation errors and convergence. The state variables are estimated in the first comparative study, from noisy measurements with the several estimation methods. Then, in the next comparative study, both of states and parameters are estimated, and are compared by calculating the estimation root mean square error (RMSE) with the noise‐free data. The impacts of the practical challenges (measurement noise and number of estimated states/parameters) on the performances of the estimation techniques are investigated. The results of both comparative studies reveal that the ISRCDKF method provides better estimation accuracy than the IUKF, ICDKF and ISRUKF. Also the previous methods provide better accuracy than the UKF, CDKF, SRUKF and SRCDKF techniques. The ISRCDKF method provides accuracy over the other different estimation techniques; by iterating maximum a posteriori estimate around the updated state, it re‐linearizes the measurement equation instead of depending on the predicted state. The results also represent that estimating more parameters impacts the estimation accuracy as well as the convergence of the estimated parameters and states. The ISRCDKF provides improved state accuracies than the other techniques even with abrupt changes in estimated states

Case Report: Tracheal infiltration with wheezing revealing Hodgkin's disease [version 2; peer review: 2 approved]

Hodgkin's disease with an initial tracheobronchial involvement is not common. The symptoms might be misleading, resulting in a diagnosis delay. We report the case of a 38-year-old woman with a one-month history of wheezing associated with a dry cough. The physical examination revealed a good general state of health, bilateral wheezing and supra-clavicular lymphadenopathy. The adenopathy biopsy's histopathology revealed Hodgkin lymphoma. The whole body FDG-PET scan was an important tool to assess the diagnosis as well as for the staging. The patient was treated with chemotherapy. Another unusual aspect is the tracheobronchial metastasis confirmed by a bronchial biopsy. Thus, our patient was put on a second-line chemotherapy. She died one year after the initial diagnosis. To conclude, it is an atypical clinical presentation of an Hodgkin lymphoma with a tracheobronchial relapse. It should be considered in the differential diagnosis of asthma or a tracheal tumor

Acute respiratory distress syndrome related to Mycoplasma pneumoniae infection

M. pneumoniae respiratory infection is usually mild and self-limiting. We report a case of acute respiratory distress syndrome (ARDS) due to M. pneumoniae infection in a 60 years old woman. Quick diagnosis was established by multiplex PCR assay for detection of pneumonia-causing bacteria. Outcome was favorable. The factors accounting for the severity of pneumonia caused by M. pneumoniae are discussed

Gonadal dysgenesis and the Mayer-Rokitansky-Kuster-Hauser Syndrome in a girl with a 46, XX karyotype: A case report and review of literature

Mayer-Rokitansky-Kuster-Hauser (MRKH) is a characteristic syndrome in which the Mullerian structures are absent or rudimentary. It is also associated with anomalies of the genitourinary and skeletal systems. Its association with gonadal dysgenesis is extremely rare and appears to be fortuitous, independent of chromosomal anomalies. We report such a case in a 21-year-old girl who presented primary amenorrhea and impuberism. The endocrine study revealed hypergonadotrophic hypogonadism. The karyotype was normal, 46, XX. No chromosome Y was detected at the fluorescence in situ hybridization (FISH) analysis. Internal genitalia could not be identified on the pelvic ultrasound and pelvic magnetic resonance imaging. Laparoscopy disclosed concomitant ovarian dysgenesis and MRKH syndrome. There were no other associated malformations. Hormonal substitution therapy with oral conjugated estrogens was begun. The patient has been under regular follow-up for the last two years and is doing well

Circulating tumour cells as a potential biomarker for lung cancer screening: a prospective cohort study

International audienceBackground Lung cancer screening with low-dose chest CT (LDCT) reduces the mortality of eligible individuals. Bloodsignatures might act as a standalone screening tool, refine the selection of patients at risk, or help to classifyundetermined nodules detected on LDCT. We previously showed that circulating tumour cells (CTCs) could bedetected, using the isolation by size of epithelial tumour cell technique (ISET), long before the cancer was diagnosedradiologically. We aimed to test whether CTCs could be used as a biomarker for lung cancer screening.Methods We did a prospective, multicentre, cohort study in 21 French university centres. Participants had to beeligible for lung cancer screening as per National Lung Screening Trial criteria and have chronic obstructivepulmonary disease with a fixed airflow limitation defined as post-bronchodilator FEV1/FVC ratio of less than 0∙7.Any cancer, other than basocellular skin carcinomas, detected within the previous 5 years was the main exclusioncriterion. Participants had three screening rounds at 1-year intervals (T0 [baseline], T1, and T2), which involved LDCT,clinical examination, and a blood test for CTCs detection. Participants and investigators were masked to the results ofCTC detection, and cytopathologists were masked to clinical and radiological findings. Our primary objective was totest the diagnostic performance of CTC detection using the ISET technique in lung cancer screening, compared withcancers diagnosed by final pathology, or follow up if pathology was unavailable as the gold standard. This studyis registered with ClinicalTrials.gov identifier, number NCT02500693.Findings Between Oct 30, 2015, and Feb 2, 2017, we enrolled 614 participants, predominantly men (437 [71%]), aged65∙1 years (SD 6∙5), and heavy smokers (52∙7 pack-years [SD 21∙5]). 81 (13%) participants dropped out betweenbaseline and T1, and 56 (11%) did between T1 and T2. Nodules were detected on 178 (29%) of 614 baseline LDCTs.19 participants (3%) were diagnosed with a prevalent lung cancer at T0 and 19 were diagnosed with incident lungcancer (15 (3%) of 533 at T1 and four (1%) of 477 at T2). Extrapulmonary cancers were diagnosed in 27 (4%) ofparticipants. Overall 28 (2%) of 1187 blood samples were not analysable. At baseline, the sensitivity of CTC detectionfor lung cancer detection was 26∙3% (95% CI 11∙8–48∙8). ISET was unable to predict lung cancer or extrapulmonarycancer development

Prospective Multicenter Validation of the Detection of ALK Rearrangements of Circulating Tumor Cells for Noninvasive Longitudinal Management of Patients With Advanced NSCLC

International audienceIntroduction: Patients with advanced-stage NSCLC whose tumors harbor an ALK gene rearrangement benefit from treatment with multiple ALK inhibitors (ALKi). Approximately 30% of tumor biopsy samples contain insufficient tissue for successful ALK molecular characterization. This study evaluated the added value of analyzing circulating tumor cells (CTCs) as a surrogate to ALK tissue analysis and as a function of the response to ALKi.Methods: We conducted a multicenter, prospective observational study (NCT02372448) of 203 patients with stage IIIB/IV NSCLC across nine French centers, of whom 81 were ALK positive (immunohistochemistry or fluorescence in situ hybridization [FISH]) and 122 ALK negative on paraffin-embedded tissue specimens. Blood samples were collected at baseline and at 6 and 12 weeks after ALKi initiation or at disease progression. ALK gene rearrangement was evaluated with CTCs using immunocytochemistry and FISH analysis after enrichment using a filtration method.Results: At baseline, there was a high concordance between the detection of an ALK rearrangement in the tumor tissue and in CTCs as determined by immunocytochemistry (sensitivity, 94.4%; specificity 89.4%). The performance was lower for the FISH analysis (sensitivity, 35.6%; specificity, 56.9%). No significant association between the baseline levels or the dynamic change of CTCs and overall survival (hazard ratio = 0.59, 95% confidence interval: 0.24-1.5, p = 0.244) or progression-free survival (hazard ratio = 0.84, 95% confidence interval: 0.44-1.6, p = 0.591) was observed in the patients with ALK-positive NSCLC.Conclusions: CTCs can be used as a complementary tool to a tissue biopsy for the detection of ALK rearrangements. Longitudinal analyses of CTCs revealed promise for real-time patient monitoring and improved delivery of molecularly guided therapy in this population

Efficacy and Safety of Rovalpituzumab Tesirine Compared With Topotecan as Second-Line Therapy in DLL3-High SCLC: Results From the Phase 3 TAHOE Study

International audienc