COPD exacerbation: Lost in translation

The introduction and acceptance of a standard definition for exacerbations of COPD can be helpful in prompt diagnosis and management of these events. The latest GOLD executive committee recognised this necessity and it has now included a definition of exacerbation in the guidelines for COPD which is an important step forward in the management of the disease. This definition is pragmatic and compromises the different approaches for exacerbation. However, the inclusion of the "healthcare utilisation" approach (".. may warrant a change in regular medication") in the definition may introduce in the diagnosis of exacerbation factors related to the access to health care services which may not be related to the underlying pathophysiologal process which characterizes exacerbations. It should be also noted that the aetiology of COPD exacerbations has not yet been included in the current definition. In this respect, the definition does not acknowledge the fact that many patients with COPD may suffer from additional conditions (i.e. congestive cardiac failure or pulmonary embolism) that can masquerade as exacerbations but they should not be considered as causes of them. The authors therefore suggest that an inclusion of the etiologic factors of COPD exacerbations in the definition. Moreover, COPD exacerbations are characterized by increased airway and systemic inflammation and significant deterioration in lung fuction. These fundamental aspects should be accounted in diagnosis/definition of exacerbations. This could be done by the introduction of a "laboratory" marker in the diagnosis of these acute events. The authors acknowledge that the use of a test or a biomarker in the diagnosis of exacerbations meets certain difficulties related to performing lung function tests or to sampling during exacerbations. However, the introduction of a test that reflects airway or systemic inflammation in the diagnosis of exacerbations might be another step forward in the management of COPD

Relayed-QKD and switched-QKD networks performance comparison considering physical layer QKD limitations

We experimentally evaluate the SKR generation for unoptimized QKD pairs in switched QKD and compare the performance of the switched-QKD with relayed-QKD networks to reveal they perform better for short distances and at large networks.Comment: 3 page

CAR-Net: Clairvoyant Attentive Recurrent Network

We present an interpretable framework for path prediction that leverages dependencies between agents' behaviors and their spatial navigation environment. We exploit two sources of information: the past motion trajectory of the agent of interest and a wide top-view image of the navigation scene. We propose a Clairvoyant Attentive Recurrent Network (CAR-Net) that learns where to look in a large image of the scene when solving the path prediction task. Our method can attend to any area, or combination of areas, within the raw image (e.g., road intersections) when predicting the trajectory of the agent. This allows us to visualize fine-grained semantic elements of navigation scenes that influence the prediction of trajectories. To study the impact of space on agents' trajectories, we build a new dataset made of top-view images of hundreds of scenes (Formula One racing tracks) where agents' behaviors are heavily influenced by known areas in the images (e.g., upcoming turns). CAR-Net successfully attends to these salient regions. Additionally, CAR-Net reaches state-of-the-art accuracy on the standard trajectory forecasting benchmark, Stanford Drone Dataset (SDD). Finally, we show CAR-Net's ability to generalize to unseen scenes.Comment: The 2nd and 3rd authors contributed equall

Behavioral treatment of obesity.

ABSTRACT Behavioral treatment is an approach used to help individuals develop a set of skills to achieve a healthier weight. It is more than helping people to decide what to change; it is helping them identify how to change. The behavior change process is facilitated through the use of self-monitoring, goal setting, and problem solving. Studies suggest that behavioral treatment produces weight loss of 8-10% during the first 6 mo of treatment. Structured approaches such as meal replacements and food provision have been shown to increase the magnitude of weight loss. Most research on behavioral treatment has been conducted in university-based clinic programs. Although such studies are important, they tell us little about the effectiveness of these approaches in settings outside of specialized clinics. Future research might focus more on determining how these behavioral techniques can be best applied in a real-world setting. Am J Clin Nutr 2005; 82(suppl):230S-5S

Minimal dataset for post-registration surveillance of new drugs in hemophilia: communication from the SSC of the ISTH

Clinical epidemiolog

Using a coherent hydrophone array for observing sperm whale range, classification, and shallow-water dive profiles

Sperm whales in the New England continental shelf and slope were passively localized, in both range and bearing, and classified using a single low-frequency (<2500 Hz), densely sampled, towed horizontal coherent hydrophone array system. Whale bearings were estimated using time-domain beamforming that provided high coherent array gain in sperm whale click signal-to-noise ratio. Whale ranges from the receiver array center were estimated using the moving array triangulation technique from a sequence of whale bearing measurements. Multiple concurrently vocalizing sperm whales, in the far-field of the horizontal receiver array, were distinguished and classified based on their horizontal spatial locations and the inter-pulse intervals of their vocalized click signals. The dive profile was estimated for a sperm whale in the shallow waters of the Gulf of Maine with 160 m water-column depth located close to the array's near-field where depth estimation was feasible by employing time difference of arrival of the direct and multiply reflected click signals received on the horizontal array. By accounting for transmission loss modeled using an ocean waveguide-acoustic propagation model, the sperm whale detection range was found to exceed 60 km in low to moderate sea state conditions after coherent array processing.National Science Foundation (U.S.)United States. Office of Naval Researc