Secure Vehicular Communication Systems: Implementation, Performance, and Research Challenges

Vehicular Communication (VC) systems are on the verge of practical deployment. Nonetheless, their security and privacy protection is one of the problems that have been addressed only recently. In order to show the feasibility of secure VC, certain implementations are required. In [1] we discuss the design of a VC security system that has emerged as a result of the European SeVeCom project. In this second paper, we discuss various issues related to the implementation and deployment aspects of secure VC systems. Moreover, we provide an outlook on open security research issues that will arise as VC systems develop from today's simple prototypes to full-fledged systems

Diagnostic accuracy of a clinical diagnosis of idiopathic pulmonary fibrosis: An international case-cohort study

We conducted an international study of idiopathic pulmonary fibrosis (IPF) diagnosis among a large group of physicians and compared their diagnostic performance to a panel of IPF experts. A total of 1141 respiratory physicians and 34 IPF experts participated. Participants evaluated 60 cases of interstitial lung disease (ILD) without interdisciplinary consultation. Diagnostic agreement was measured using the weighted kappa coefficient (\u3baw). Prognostic discrimination between IPF and other ILDs was used to validate diagnostic accuracy for first-choice diagnoses of IPF and were compared using the Cindex. A total of 404 physicians completed the study. Agreement for IPF diagnosis was higher among expert physicians (\u3baw=0.65, IQR 0.53-0.72, p20 years of experience (C-index=0.72, IQR 0.0-0.73, p=0.229) and non-university hospital physicians with more than 20 years of experience, attending weekly MDT meetings (C-index=0.72, IQR 0.70-0.72, p=0.052), did not differ significantly (p=0.229 and p=0.052 respectively) from the expert panel (C-index=0.74 IQR 0.72-0.75). Experienced respiratory physicians at university-based institutions diagnose IPF with similar prognostic accuracy to IPF experts. Regular MDT meeting attendance improves the prognostic accuracy of experienced non-university practitioners to levels achieved by IPF experts

Progressive apraxia of speech presenting as isolated disorder of speech articulation and prosody : a case report

Apraxia of speech (AOS) is a rare disorder of motor speech programming, and few case reports have included sufficient description of both clinical findings and lesion localization. We report a case with an isolated progressive speech articulation deficit and brain involvement restricted to the left superior frontal gyrus. This case suggests that slowly progressive AOS may be a clinical disorder distinct from primary progressive aphasia, and that it can occur without language disorders or bucco-facial apraxia. Our findings highlight the importance of the left hemisphere in speech articulatory deficits and suggest that the left superior frontal gyrus plays a crucial role in specific articulatory processes.7 page(s

An integrated clinicoradiological staging system for pulmonary sarcoidosis: a case-cohort study

SummaryBackgroundMortality in pulmonary sarcoidosis is highly variable and a reliable prognostic algorithm for disease staging and for guiding management decisions is needed. The objective of this study is to derive and test a staging system for determining prognosis in pulmonary sarcoidosis.MethodsWe identified the prognostic value of high-resolution computed tomography (HRCT) patterns and pulmonary function tests, including the composite physiological index (CPI) in patients with pulmonary sarcoidosis. We integrated prognostic physiological and HRCT variables to form a clinical staging algorithm predictive of mortality in a test cohort. The staging system was externally validated in a separate cohort by the same methods of discrimination used in the primary analysis and tested for clinical applicability by four test observers.FindingsThe test cohort included 251 patients with pulmonary sarcoidosis in the study referred to the Sarcoidosis clinic at the Royal Brompton Hospital, UK, between Jan 1, 2000, and June 30, 2010. The CPI was the strongest predictor of mortality (HR 1·04, 95% CI 1·02–1·06, p<0·0001) in the test cohort. An optimal CPI threshold of 40 units was identified (HR 4·24, 2·84–6·33, p<0·0001). The CPI40, main pulmonary artery diameter to ascending aorta diameter ratio (MPAD/AAD), and an extent of fibrosis threshold of 20% were combined to form a staging algorithm. When assessed in the validation cohort (n=252), this staging system was strikingly more predictive of mortality than any individual variable alone (HR 5·89, 2·68–10·08, p<0·0001). The staging system was successfully applied to the test and validation cohorts combined, by two radiologists and two physicians.InterpretationA clear prognostic separation of patients with pulmonary sarcoidosis is provided by a simple staging system integrating the CPI and two HRCT variables.FundingNational Institute of Health Research Respiratory Disease Biomedical Unit at the Royal Brompton and Harefield NHS Foundation Trust and Imperial College London