Probability Distributions.- Linear Models for Regression.- Linear Models for Classification.- Neural Networks.- Kernel Methods.- Sparse Kernel Machines.- Graphical Models.- Mixture Models and EM.- Approximate Inference.- Sampling Methods.- Continuous Latent Variables.- Sequential Data.- Combining Models.

Pattern Recognition and Machine Learning

Deposits of clastic carbonate-dominated (calciclastic) sedimentary slope systems in the rock record have been identified mostly as linearly-consistent carbonate apron deposits, even though most ancient clastic carbonate slope deposits fit the submarine fan systems better. Calciclastic submarine fans are consequently rarely described and are poorly understood. Subsequently, very little is known especially in mud-dominated calciclastic submarine fan systems. Presented in this study are a sedimentological core and petrographic characterisation of samples from eleven boreholes from the Lower Carboniferous of Bowland Basin (Northwest England) that reveals a >250 m thick calciturbidite complex deposited in a calciclastic submarine fan setting. Seven facies are recognised from core and thin section characterisation and are grouped into three carbonate turbidite sequences. They include: 1) Calciturbidites, comprising mostly of highto low-density, wavy-laminated bioclast-rich facies; 2) low-density densite mudstones which are characterised by planar laminated and unlaminated muddominated facies; and 3) Calcidebrites which are muddy or hyper-concentrated debrisflow deposits occurring as poorly-sorted, chaotic, mud-supported floatstones. These

Phd by thesis

Data Mining Practical Machine Learning Tools and Techniques

The power of feedback.

Emotion and Adaptation

We respond to two themes in the comments by Bainbridge, Gratch, and Nishida: first, the importance of embodiment, and second the issue of what should be explicitly modelled as against what should be dynamically generated. Finally, we briefly respond to the ethical questions raised by Bainbridge.

Reply to Comments by Bainbridge, Gratch, and Nishida

As AI techniques become more widespread in computer games, and the area of synthetic characters matures, avatars in such computer games also tend to gain autonomy and become more clever. However, this autonomy may bring also some change in the interaction between users and game characters. Players may become less in charge of their characters and lose the power of complete motion or behavior control. On the other hand, characters may become more clever exhibiting much more interesting autonomous actions and behaviors. This paper presents, defines and discusses the concept of “influence”, as an alternative to “direct” control of game characters, describing how influence can be achieved in computer games. To illustrate the notion of “influence” we will present a game called FantasyA where players interact with it by influencing the emotions of they semi-autonomous avatars using a tangible interface called SenToy. We show how ”influence” was built into this game, the role of SenToy as an influencing device, and the reactions of the users to this type of control.

http://gaips.inesc-id.pt/component/gaips/publications/showPublicationPdf?pid=100&format=raw

“Tangible Influence”: Towards a New Interaction Paradigm for Computer Games

We report the case of a 63-year-old man with severe hypercalcemia, acute kidney injury, and concomitant diagnosis of germinal center diffuse large B-cell lymphoma (nHL). Hypercalcemia is a common finding in patients with cancer. Multiple mechanisms can lead to hypercalcemia of malignancy, and different malignancies are often associated with a specific mechanism of hypercalcemia. Parathyroid hormone-related protein (PTHrP) and excessive production of 1,25-dihydroxyvitamin D can independently (and rarely, concomitantly) lead to development of hypercalcemia in patients with a variety of malignancies. Literature review of hypercalcemia related with PTHrP and 1,25-dihydroxyvitamin D co-secretion shows that most reported cases are associated with solid tumors and responded to tumor directed therapy. Our case of nHL was associated with increased PTHrP and 1,25-dihydroxyvitamin D making this an unusual presentation.

https://journals.sagepub.com/doi/pdf/10.1177/23993693231159175

Hypercalcemia of malignancy with simultaneous production of parathyroid hormone-related peptide and 1,25-Dihydroxyvitamin D by non-Hodgkin lymphoma: Case report & brief review


 
 
 Onconephrology is a rapidly evolving nephrology subspecialty that focuses on the interaction between cancer and the kidney. Our aim was to describe the clinical activity of a Nephrology Department in a cancer care center, in a 2-year period.
 
 
 
 We retrospectively analyzed the patients observed by the Nephrology Department at our center between 2021 and 2022. Demographic, clinical and laboratory data were collected. The statistical analysis was performed with SPSS software.
 
 
 
 During the 2-year period, there were 26,015 admissions, 636 of which required a Nephrology observation. Sixty-two per cent were female; the mean age was 68 years (SD ±12.4) with a median Charlson Comorbidity Index of 7. Most cancers were from gastrointestinal (24.1%, n = 153) or urologic origins (22.3%, n = 142), 37% had metastatic disease. Hematologic malignancies accounted for 12.1% of patients (n = 77). Nearly 44.5% of patients (n = 283) had chronic kidney disease (CKD), 20.8% (n = 59) of which were on hemodialysis (HD). Urinary tract obstruction (23.3%), cardiovascular risk factors (17.3%) and nephron loss (10.6%) were the most common causes of CKD. The main reasons for admission were renal dysfunction (23.7%; n = 151), infectious complications (23.3%, n = 148) and elective surgery (20.3%; n = 129). Of the patients observed, 40.7% (n = 259) had acute kidney injury (AKI), 23.3% (n = 148) acute-on-chronic kidney disease and 11.8% (n = 75) hydro-electrolytic disorders. Ten patients (1.6%) were evaluated for nephrotic syndrome (NS) or rapidly progressive renal failure (RPRF). Among AKI patients, intrinsic causes were the most prevalent (48.7% of all cases), with sepsis and ischemic and toxic acute tubular necrosis being the most frequent. Pre-renal and post-renal etiologies occurred in 29.7% and 21.6% of cases, respectively. Gynaecological and prostate tumours were the main neoplastic cause of post-renal AKI. There were 5 TMA cases in allogenic stem cell transplanted patients or treated with gemcitabine and six cases of acute interstitial nephritis, the majority immune check-point inhibitors-related. Over 54% (n = 142) of patients presented with AKI stage 3. About 13% (n = 34) needed renal replacement therapy (RRT), mainly continuous or hybrid techniques (58.8%; n = 20), and only 38% (n = 13) recovered renal function. The group of acute-on-chronic CKD patients included mostly stage 3b and 4 CKD. Most of them (54.1%; n = 80) had an intrinsic cause for kidney dysfunction. There was an equal distribution between stages of AKI severity. About 5% (n = 8) needed RRT and only two of those recovered. Hyponatremia was the most common electrolyte disturbance (56%; n = 42), followed by hypercalcemia (17.3%; n = 13). Over 40% of all cases of hyponatremia occurred in patients with metastatic lung cancer, probably related with the high prevalence of SIADH in this population. All but two patients with NS or RPRF underwent kidney biopsy. Among the patients with NS, its etiologies were: focal and segmental glomerulosclerosis secondary to pamidronate (n = 2), podocytopathy related to pazopanib (n = 1), paraneoplastic membranous nephropathy (n = 1), AL amyloidosis (n = 1) and TMA secondary to gemcitabine (n = 1). The causes of RPRF were ANCA-negative small vessel vasculitis, crescentic glomerulonephritis (GN) related to pembrolizumab and TMA. We also followed two patients with acute kidney disease, one with ATN secondary to bisphosphonates therapy and other with paraneoplastic fibrillary glomerulopathy. The median duration of hospitalization was 10 days (IQR 7.0 – 20.8), with median Nephrology follow-up time of 5.5 days (IQR 3.0 – 9.0). The overall mortality rate was 21.5%, and it was even higher on the subgroup with AKI (27.4%; p = 0.03). About 44% (n = 219) of patients were referred to outpatient Nephrology follow-up, at discharge.
 
 
 
 Our data provides a picture of the rich inward activity developed at our cancer center by the nephrology team. The complexity of these patients highlights the importance of a multidisciplinary approach in their management. No surprisingly, there was a high mortality rate, which was even higher in the AKI-patients subset.


https://academic.oup.com/ndt/article-pdf/38/Supplement_1/gfad063c_6045/50594764/gfad063c_6045.pdf

#6045 two-year inpatient activity of a dedicated onconephrology department


 
 
 Malignant hypercalcemia is the most common cause of hypercalcemia, occurring in 30% of cancer patients and rendering a poor prognosis. Most cases have a humoral cause, the majority mediated by parathyroid hormone related peptide (PTHrP), rarely by 1,25-dihydroxyvitamin D3 (1,25(OH)2D) and very rarely by parathyroid hormone (PTH) ectopic production; other cases are due to local osteolysis. In the literature, there are only 5 reported cases of hypercalcemia associated to gastrointestinal stromal tumour (GIST), only 2 of them due to 1,25(OH)2D overproduction.
 
 
 
 Case report.
 
 
 
 Sixty-two years-old male with small bowel GIST diagnosed in 2014, subjected to enterectomy and on tyrosine kinase inhibitor (TKI) since 2017. TKI was changed from imatinib to sunitinib 25mg since August 2020 to the present date due to disease progression with liver metastasis. In March 2022, a PET scan showed no bone or soft tissue metastasis and there was a finding of right ureteral lithiasis with asymptomatic mild pyelocaliceal dilation. The patient had also subclinical hypothyroidism and several episodes of acute kidney injury (AKI) associated with hypercalcemia and hyperphosphatemia managed in outpatient clinic. He did not take any other medication besides the TKI. In April 2022, symptoms of disequilibrium, confusion, asthenia, and anorexia drove the patient to the Oncology Department. At physical examination the patient had an ECOG 3, was disoriented, cachectic and dehydrated, with no other noticeable findings. Blood lab tests showed a serum creatinine (sCr) of 2,86 mg/dL (baseline 1,10 mg/dL, estimated glomerular filtration rate of 72 mL/min/1,73 m2), a corrected serum total calcium (sCa) of 16,6 mg/dL and a normal serum phosphate of 4,0 mg/dL. The patient was admitted in the oncology ward with the collaboration of the nephrology department and was started on fluid therapy with 3000–4000cc NaCl 0,9%/day for a target urinary output of 75–200 mL/h. Hypercalcemia work-up showed low PTH of 8,8 pg/dL (reference range: 12–65 pg/dL). Measurement of PTHrP and 1,25(OH)2D were requested but took longer. After 3 days, despite the improvement of both sCr (2,23 mg/dL) and sCa (13,6 mg/dL), zoledronic acid was started. Results revealed an increased 1,25(OH)2D of 309 pg/dL (reference range: 10,9-79,3 pg/dL) and negative PTHrP. At the 6th day, a clear improvement of analytical (sCr 1,60 mg/dL; sCa 11,9 mg/dL) and clinical status, so the patient was discharged. The diagnosis was GIST 1,25(OH)2D overproduction causing malignant hypercalcemia and prednisolone on 20mg id was started. In June 2022, the patient had tumour progression, presenting lethargic, disoriented, and dehydrated; blood lab results showed AKI (sCr 1,97 mg/dL) and worsening hypercalcemia (sCa 14,7 mg/dL). He was admitted for fluid therapy and bisphosphonates but, even though there was a recovery of the hypercalcemia and renal function, the patient's clinical status got worse and he had a fatal outcome in the following days.
 
 
 
 Malignant hypercalcemia caused by GIST 1,25(OH)2D overproduction is a rare condition. The work-up of an oncological patient with ureteral lithiasis and recurrent hypercalcemia should prompt us to a more in-depth investigation.


/pdf/3154-malignant-hypercalcemia-in-a-case-of-small-bowel-23mp5rem.pdf

Ana Paiva

Papers

Reply to Comments by Bainbridge, Gratch, and Nishida

“Tangible Influence”: Towards a New Interaction Paradigm for Computer Games

Hypercalcemia of malignancy with simultaneous production of parathyroid hormone-related peptide and 1,25-Dihydroxyvitamin D by non-Hodgkin lymphoma: Case report & brief review

#6045 two-year inpatient activity of a dedicated onconephrology department

#3154 malignant hypercalcemia in a case of small bowel gastrointestinal stromal tumour