Validity and reliability of grade scoring in the diagnosis of exercise-induced laryngeal obstruction

The current gold-standard method for diagnosing exercise-induced laryngeal obstruction (EILO) is continuous laryngoscopy during exercise (CLE), with severity classified by a visual grade scoring system. We evaluated the precision of this approach, by evaluating test–retest reliability of CLE and both inter- and intra-rater variability. In this prospective case–control study, subjects completed four consecutive treadmill CLE tests under identical conditions. Laryngoscopic video recordings were anonymised and graded by three expert raters. 2 months following initial scoring, videos were re-randomised and rating repeated to assess intra-rater agreement. 20 subjects (16 cases and four controls) completed four CLE tests. The time to exhaustion increased by 30 s (95% CI 0.02–57.8, p<0.05) in the second CLE compared with the first test, but remained identical in the subsequent tests. Only one-third of subjects retained their initial diagnosis in the subsequent three tests. Inter-rater agreement on grade scores (weighted Cohen's ϰ) was 0.16–0.45, while intra-rater agreement ranged from 0.30 to 0.67. The CLE test is key in the diagnostic assessment of patients with EILO. However, the widely adopted visual grade scoring system does not appear to be a robust means for reliably classifying severity of EILO

Analysis of Coastal Areas Using SAR Images: A Case Study of the Dutch Wadden Sea Region

The increased availability of civil synthetic aperture radar (SAR) satellite images with different resolution allows us to compare the imaging capabilities of these instruments, to assess the quality of the available data and to investigate different areas (e.g., the Wadden Sea region). In our investigation, we propose to explore the content of TerraSAR-X and Sentinel-1A satellite images via a data mining approach in which the main steps are patch tiling, feature extraction, classification, semantic annotation and visual-statistical analytics. Once all the extracted categories are mapped and quantified, then the next step is to interpret them from an environmental point of view. The objective of our study is the application of semi-automated SAR image interpretation. Its novelty is the automated multiclass categorisation of coastal areas. We found out that the north-west of the Netherlands can be interpreted routinely as land surfaces by our satellite image analyses, while for the Wadden Sea, we can discriminate the different water levels and their impact on the visibility of the tidal flats. This necessitates a selection of time series data spanning a full tidal cycle

Gauge Bundles and Born-Infeld on the Noncommutative Torus

In this paper, we describe non-abelian gauge bundles with magnetic and electric fluxes on higher dimensional noncommutative tori. We give an explicit construction of a large class of bundles with nonzero magnetic 't Hooft fluxes. We discuss Morita equivalence between these bundles. The action of the duality is worked out in detail for the four-torus. As an application, we discuss Born-Infeld on this torus, as a description of compactified string theory. We show that the resulting theory, including the fluctuations, is manifestly invariant under the T-duality group SO(4,4;Z). The U-duality invariant BPS mass-formula is discussed shortly. We comment on a discrepancy of this result with that of a recent calculation.Comment: 22 pages, LaTeX2e. Small errors correcte

Lung transplantation for acute respiratory distress syndrome:A multicenter experience

Acute respiratory distress syndrome (ARDS) is a rapidly progressive lung disease with a high mortality rate. Although lung transplantation (LTx) is a well-established treatment for a variety of chronic pulmonary diseases, LTx for acute lung failure (due to ARDS) remains controversial. We reviewed posttransplant outcome of ARDS patients from three high-volume European transplant centers. Demographics and clinical data were collected and analyzed. Viral infection was the main reason for ARDS (n = 7/13, 53.8%). All patients were admitted to ICU and required mechanical ventilation, 11/13 were supported with ECMO at the time of listing. They were granted a median LAS of 76 (IQR 50-85) and waited for a median of 3 days (IQR 1.5-14). Postoperatively, median length of mechanical ventilation was 33 days (IQR 17-52.5), median length of ICU and hospital stay were 39 days (IQR 19.5-58.5) and 54 days (IQR 43.5-127). Prolongation of peripheral postoperative ECMO was required in 7/13 (53.8%) patients with a median duration of 2 days (IQR 2-7). 30-day mortality was 7.7%, 1 and 5-year survival rates were calculated as 71.6% and 54.2%, respectively. Given the lack of alternative treatment options, the herein presented results support the concept of offering live-saving LTx to carefully selected ARDS patients

Analysis of Protected Areas: The Use of Satellite Images for Data Mining within ECOPOTENTIAL

The EU-funded ECOPOTENTIAL project shall demonstrate, among others, the application potential of satellite images for detailed ecological studies of environmental and ecological protected areas within pre-defined bio-geographical regions of Europe. These studies aim at the corroboration of essential variables for the monitoring of protected areas in Europe. The innovative character of our project is a systematic assessment of how to exploit SAR satellite images in combination with multispectral optical satellite images and/or local in-situ measurements. The results of the project shall demonstrate the scientific gain when combining SAR image data with optical instrument data. While standard products of Sentinel-2 and WorldView-2 provide a sound basis for multispectral analysis and interpretation of vegetated areas, any additional information contained in SAR images (of TerraSAR-X and Sentinel-1) can improve the classification results and the analysis of time series data. We estimate that about 10 essential protected area variables (out of 93 envisaged variables) can be extracted from these images