[Extensive cardiac thombosis in a patient with disseminated intravascular coagulation]. / Thrombose extensive intracardiaque dans un contexte de coagulation intravasculaire disséminée.

Disseminated intravascular coagulation is a syndrome characterized by thrombin and fibrin generation which is associated with organ failure and death. Intracardiac thrombus may occur and further deteriorate prognosis. We report the case of a patient with massive intraventricular thrombus revealed by an acute ischemia of the upper left limb in a context of pulmonary adenocarcinoma complicated by a disseminated intravascular coagulation. We describe the diagnostic modalities and the fatal evolution.

[Acute myocarditis in a patient with dengue infection]. / Myocardite aiguë induite par la dengue.

Dengue is a febrile viral illness transmitted by Aedes Aegypti mosquito with growing incidence, it could be associated with cardiovascular complication mediated by inflammation and notably acute myocarditis. We report the case of a 36-year old woman admitted in cardiology department with initial diagnosis of acute coronary syndrome and ultimately diagnosed to have an acute myocarditis induced by dengue infection; we describe diagnostic modalities and clinical evolution.

An efficient antenna system with improved radiation for multi-standard/multi-mode 5G cellular communications.

This paper introduces a multi-input multiple-output (MIMO) antenna array system that provides improved radiation diversity for multi-standard/multi-mode 5G communications. The introduced MIMO design contains four pairs of miniaturized self-complementary antennas (SCAs) fed by pairs of independently coupled structures which are symmetrically located at the edge corners of the smartphone mainboard with an overall size of 75 × 150 (mm2). Hence, in total, the design incorporates four pairs of horizontally and vertically polarized resonators. The elements have compact profiles and resonate at 3.6 GHz, the main candidate bands of the sub-6 GHz 5G spectrum. In addition, despite the absence of decoupling structures, adjacent elements demonstrate high isolation. To the best of the authors' knowledge, it is the first type of smartphone antenna design using dual-polarized self-complementary antennas that could possess anti-interference and diversity properties. In addition to exhibiting desirable radiation coverage, the presented smartphone antenna also supports dual polarizations on different sides of the printed circuit board (PCB). It also exhibits good isolation, high-gain patterns, improved radiation coverage, low ECC/TARC, and sufficient channel capacity. The introduced antenna design was manufactured on a standard smartphone board and its main characteristics were experimentally measured. Simulations and measurement results are generally in good agreement with each other. Moreover, the presented antenna system delivers low SAR with adequate efficiency when it comes to the appearance of the user. Hence, the design could be adapted to 5G hand-portable devices. As an additional feature, a new ultra-compact phased array millimeter-wave antenna with super-wide bandwidth and end-fire radiation is being introduced for integration into the MIMO antenna systems. As a result, the proposed antenna system design with improved radiation and multi-standard operation is a good candidate for future multi-mode 5G cellular applications.

New Method to Implement and Analysis of Medical System in Real Time.

The use of information technology and technological medical devices has contributed significantly to the transformation of healthcare. Despite that, many problems have arisen in diagnosing or predicting diseases, either as a result of human errors or lack of accuracy of measurements. Therefore, this paper aims to provide an integrated health monitoring system to measure vital parameters and diagnose or predict disease. Through this work, the percentage of various gases in the blood through breathing is determined, vital parameters are measured and their effect on feelings is analyzed. A supervised learning model is configured to predict and diagnose based on biometric measurements. All results were compared with the results of the Omron device as a reference device. The results proved that the proposed design overcame many problems as it contributed to expanding the database of vital parameters and providing analysis on the effect of emotions on vital indicators. The accuracy of the measurements also reached 98.8% and the accuracy of diagnosing COVID-19 was 64%. The work also presents a user interface model for clinicians as well as for smartphones using the Internet of things.

Slotted E-Shaped Meta-Material Decoupling Slab for Densely Packed MIMO Antenna Arrays.

In contemporary wireless communication systems, the multiple-input and multiple-output systems are extensively utilized due to their enhanced spectral efficiency and diversity. Densely packed antenna arrays play an important role in such systems to enhance their spatial diversity, array gain, and beam scanning capabilities. In this article, a slotted meta-material decoupling slab (S-MTM-DS) with dual reflexes slotted E-shapes and an inductive stub is proposed. Its function was validated when located between two microstrip patch antenna elements to reduce the inter-element spacing, the mutual coupling, the return losses, and manufacturing costs due to size reduction. A prototype is simply fabricated in a volume of 67.41 × 33.49 × 1.6 mm3 and frequency-span measured from 8.4:11 GHz. At 9.4 GHz frequency, the spaces between the transmitting elements are decreased to 0.57 of the free space wavelength. When the proposed isolation S-MTM-DS is applied, the average isolation among them is measured to be -36 dB, the operational bandwidth is enhanced to be 1.512 GHz, the fractional bandwidth improved to be 16.04%, and the return losses are decreased to be -26.5 dB at 9.4 GHz center frequency. Consequently, the proposed design has the potential to be implemented simply in wireless contemporary communication schemes.

An Intelligent Combined Visual Navigation Brain Model/GPS/MEMS-INS/ADSFCF Method to Develop Vehicle Independent Guidance Solutions.

This paper presents an integrated navigation system that can function more efficiently than an inertial navigation system (INS), the results of which are not precise enough because of drifts caused by accelerometers. The paper's proposed approach depends primarily on integrating micro-electrical-mechanical system (MEMS)-INS smartphone integrated sensors, the Global Positioning System (GPS), and the visual navigation brain model (VNBM) to enhance navigation in bad weather conditions. The recommended integrated navigation model, using an adaptive DFS combined filter, has been well studied and tested under severe climate conditions on reference trajectories. This integrated technique can easily detect and disable less accurate reference sources (GPS or VNBM) and activate a more accurate one. According to the results, the proposed integrated data fusion algorithm offers a reliable solution for errors in the previous strategies. Furthermore, compared to the pure MEMS-INS method, the proposed system reduces navigational errors by approximately 93.76 percent, whereas the conventional centralized Kalman filter technique reduces such errors by 82.23 percent.

Non-Linear Hopped Chaos Parameters-Based Image Encryption Algorithm Using Histogram Equalization.

Multimedia wireless communications have rapidly developed over the years. Accordingly, an increasing demand for more secured media transmission is required to protect multimedia contents. Image encryption schemes have been proposed over the years, but the most secure and reliable schemes are those based on chaotic maps, due to the intrinsic features in such kinds of multimedia contents regarding the pixels' high correlation and data handling capabilities. The novel proposed encryption algorithm introduced in this article is based on a 3D hopping chaotic map instead of fixed chaotic logistic maps. The non-linearity behavior of the proposed algorithm, in terms of both position permutation and value transformation, results in a more secured encryption algorithm due to its non-convergence, non-periodicity, and sensitivity to the applied initial conditions. Several statistical and analytical tests such as entropy, correlation, key sensitivity, key space, peak signal-to-noise ratio, noise attacks, number of pixels changing rate (NPCR), unified average change intensity randomness (UACI), and others tests were applied to measure the strength of the proposed encryption scheme. The obtained results prove that the proposed scheme is very robust against different cryptography attacks compared to similar encryption schemes.

ST-segment elevation myocardial infarction: Management and association with prognosis during the COVID-19 pandemic in France.

BACKGROUND: Systems of care have been challenged to control progression of the COVID-19 pandemic. Whether this has been associated with delayed reperfusion and worse outcomes in French patients with ST-segment elevation myocardial infarction (STEMI) is unknown. AIM: To compare the rate of STEMI admissions, treatment delays, and outcomes between the first peak of the COVID-19 pandemic in France and the equivalent period in 2019. METHODS: In this nationwide French survey, data from consecutive STEMI patients from 65 centres referred for urgent revascularization between 1 March and 31 May 2020, and between 1 March and 31 May 2019, were analysed. The primary outcome was a composite of in-hospital death or non-fatal mechanical complications of acute myocardial infarction. RESULTS: A total of 6306 patients were included. During the pandemic peak, a 13.9±6.6% (P=0.003) decrease in STEMI admissions per week was observed. Delays between symptom onset and percutaneous coronary intervention were longer in 2020 versus 2019 (270 [interquartile range 150-705] vs 245 [140-646]min; P=0.013), driven by the increase in time from symptom onset to first medical contact (121 [60-360] vs 150 [62-420]min; P=0.002). During 2020, a greater number of mechanical complications was observed (0.9% vs 1.7%; P=0.029) leading to a significant difference in the primary outcome (112 patients [5.6%] in 2019 vs 129 [7.6%] in 2020; P=0.018). No significant difference was observed in rates of orotracheal intubation, in-hospital cardiac arrest, ventricular arrhythmias and cardiogenic shock. CONCLUSIONS: During the first peak of the COVID-19 pandemic in France, there was a decrease in STEMI admissions, associated with longer ischaemic time, exclusively driven by an increase in patient-related delays and an increase in mechanical complications. These findings suggest the need to encourage the population to seek medical help in case of symptoms.

A Thrombus on a Journey: A Massive Thrombus in Transit With Cerebral, Coronary, and Pulmonary Embolization.

Impending paradoxical embolism is a biatrial thrombus in transit across a patent foramen ovale. It constitutes a rare clinical condition, possibly associated with multiple embolization and high mortality. We report the exceptional case of a 71-year-old-man presenting a giant impending paradoxical thrombus, complicated with pulmonary, cerebral, and coronary embolization. The patient underwent urgent surgery and was finally discharged without complications.

A Novel Color Image Encryption Algorithm Based on Hyperchaotic Maps and Mitochondrial DNA Sequences.

Multimedia encryption innovation is one of the primary ways of securely and privately guaranteeing the security of media transmission. There are many advantages when utilizing the attributes of chaos, for example, arbitrariness, consistency, ergodicity, and initial condition affectability, for any covert multimedia transmission. Additionally, many more benefits can be introduced with the exceptional space compliance, unique information, and processing capability of real mitochondrial deoxyribonucleic acid (mtDNA). In this article, color image encryption employs a confusion process based on a hybrid chaotic map, first to split each channel of color images into n-clusters; then to create global shuffling over the whole image; and finally, to apply intrapixel shuffling in each cluster, which results in very disordered pixels in the encrypted image. Then, it utilizes the rationale of human mitochondrial genome mtDNA to diffuse the previously confused pixel values. Hypothetical examination and trial results demonstrate that the anticipated scheme exhibits outstanding encryption, as well as successfully opposes chosen/known plain text, statistical, and differential attacks.

A Bijective Image Encryption System Based on Hybrid Chaotic Map Diffusion and DNA Confusion.

Modern multimedia communications technology requirements have raised security standards, which allows for enormous development in security standards. This article presents an innovative symmetric cryptosystem that depends on the hybrid chaotic Lorenz diffusion stage and DNA confusion stage. It involves two identical encryption and decryption algorithms, which simplifies the implementation of transmitting and receiving schemes of images securely as a bijective system. Both schemes utilize two distinctive non-consecutive chaotic diffusion stages and one DNA scrambling stage in between. The generation of the coded secret bit stream employs a hybrid chaotic system, which is employed to encrypt or decrypt the transmitted image and is utilized in the diffusion process to dissipate the redundancy in the original transmitted image statistics. The transmitted image is divided into eight scrambled matrices according to the position of the pixel in every splitting matrix. Each binary matrix is converted using a different conversion rule in the Watson-Crick rules. The DNA confusion stage is applied to increase the complexity of the correlation between the transmitted image and the utilized key. These stages allow the proposed image encryption scheme to be more robust against chosen/known plaintext attacks, differential attacks, cipher image attacks, and information entropy. The system was revealed to be more sensitive against minimal change in the generated secret key. The analysis proves that the system has superior statistical properties, bulkier key space, better plain text sensitivity, and improved key sensitivity compared with former schemes.

Von Willebrand Factor Multimers during Transcatheter Aortic-Valve Replacement.

BACKGROUND: Postprocedural aortic regurgitation occurs in 10 to 20% of patients undergoing transcatheter aortic-valve replacement (TAVR) for aortic stenosis. We hypothesized that assessment of defects in high-molecular-weight (HMW) multimers of von Willebrand factor or point-of-care assessment of hemostasis could be used to monitor aortic regurgitation during TAVR. METHODS: We enrolled 183 patients undergoing TAVR. Patients with aortic regurgitation after the initial implantation, as identified by means of transesophageal echocardiography, underwent additional balloon dilation to correct aortic regurgitation. HMW multimers and the closure time with adenosine diphosphate (CT-ADP), a point-of-care measure of hemostasis, were assessed at baseline and 5 minutes after each step of the procedure. Mortality was evaluated at 1 year. A second cohort (201 patients) was studied to validate the use of CT-ADP in order to identify patients with aortic regurgitation. RESULTS: After the initial implantation, HMW multimers normalized in patients without aortic regurgitation (137 patients). Among the 46 patients with aortic regurgitation, normalization occurred in 20 patients in whom additional balloon dilation was successful but did not occur in the 26 patients with persistent aortic regurgitation. A similar sequence of changes was observed with CT-ADP. A CT-ADP value of more than 180 seconds had sensitivity, specificity, and negative predictive value of 92.3%, 92.4%, and 98.6%, respectively, for aortic regurgitation, with similar results in the validation cohort. Multivariable analyses showed that the values for HMW multimers and CT-ADP at the end of TAVR were each associated with mortality at 1 year. CONCLUSIONS: The presence of HMW-multimer defects and a high value for a point-of-care hemostatic test, the CT-ADP, were each predictive of the presence of aortic regurgitation after TAVR and were associated with higher mortality 1 year after the procedure. (Funded by Lille 2 University and others; ClinicalTrials.gov number, NCT02628509.).