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Miniaturized thermal infrared (TIR) cameras that measure surface temperature are increasingly available for use with unmanned aerial vehicles (UAVs). However, deriving accurate temperature data from these cameras is non-trivialsince they are highly sensitive to changes in their internal temperature and low-cost models are often not radiometrically calibrated. We present the results of laboratory and field experiments that tested the extent of the temperature-dependency of a non-radiometric FLIR Vue Pro 640. We found that a simple empirical line calibration using at least three ground calibration points was sufficient to convert camera digital numbers to temperature values for images captured during UAV flight. Although the camera performed well under stable laboratory conditions (accuracy ±0.5 °C), the accuracy declined to ±5 °C under the changing ambient conditions experienced during UAV flight. The poor performance resulted from the non-linear relationship between camera output and sensor temperature, which was affected by wind and temperature-drift during flight. The camera’s automated non-uniformity correction (NUC) could not sufficiently correct for these effects. Prominent vignetting was also visible in images captured under both stable and changing ambient conditions. The inconsistencies in camera output over time and across the sensor will affect camera applications based on relative temperature differences as well as user-generated radiometric calibration. Based on our findings, we present a set of best practices for UAV TIR camera sampling to minimize the impacts of the temperature dependency of these systems.

IntroductionVibrotactile positional therapy (PT) devices are a new treatment modality for positional obstructive sleep apnoea (POSA). This review aimed to determine the effect of vibrotactile PT on the Apnoea Hypopnoea Index (AHI) and the percentage of time spent in the supine position (%Tsupine) in patients with POSA, compared with baseline. Secondary aims were to investigate the effect on daytime sleepiness, quality of life and sleep quality.MethodsA systematic review and meta-analysis was performed of randomised controlled trials (RCTs) and cohort studies that investigated the effect of vibrotactile PT in POSA patients. Searches were performed via MEDLINE, CENTRAL and Embase up to 29 October 2022.Results1119 studies were identified, 18 studies met the inclusion criteria (10 RCTs, 8 cohort studies). The use of vibrotactile PT significantly reduced the AHI at follow-up compared with baseline (mean difference (95% CI) −9.19 events/hour (–11.68 to –6.70); p<0.00001). The mean %Tsupine was also significantly reduced (mean difference (95% CI) −32.79% (–38.75% to –26.83%); p<0.00001). The percentage changes in the AHI and %Tsupine were 43% and 70%, respectively. Secondary outcomes were daytime sleepiness, quality of life and sleep indices. These showed minimal change, although follow-up was short.ConclusionVibrotactile PT devices are effective in treating POSA; reducing both AHI and %Tsupine. The effect on sleep quality, daytime sleepiness and disease-specific quality of life was minimal. However, there were limited data and follow-up was often brief, meaning that further research is needed to determine the effect of vibrotactile PT on patient-centred outcomes.PROSPERO registration numberCRD42020188617.

Background: The capacity to diagnose obstructive sleep apnoea (OSA) must be expanded to meet an estimated disease burden of nearly one billion people worldwide. Validated alternatives to the gold standard polysomnography (PSG) will improve access to testing and treatment. This study aimed to evaluate the diagnosis of OSA, using measurements of mandibular movement (MM) combined with automated machine learning analysis, compared to in-home PSG. Methods: 40 suspected OSA underwent single overnight in-home sleep testing with PSG (Nox A1, ResMed, Australia) and simultaneous MM monitoring (Sunrise, Sunrise SA, Belgium). PSG recordings were manually analysed by two expert sleep centres (Grenoble and London); MM analysis was automated. The Obstructive Respiratory Disturbance Index calculated from the MM monitoring (MM-ORDI) was compared to the PSG (PSG-ORDI) using intraclass correlation coefficient and Bland-Altman analysis. Receiver operating characteristic curves (ROC) were constructed to optimise the diagnostic performance of the MM monitor at different PSG-ORDI thresholds (5, 15 and 30 events/hour). Results: 31 patients were included in the analysis (58% men; mean (SD) age: 48 (15) years; BMI: 30.4 (7.6) kg/m2). Good agreement was observed between MM-ORDI and PSG-ORDI (median bias 0.00; 95% CI -23.25 to +9.73 events/hour). However, for patients with no or mild OSA, MM monitoring overestimated disease severity (PSG-ORDI 5-15: MM-ORDI overestimation +3.70 (95% CI -0.53 to +18.32) events/hour). In patients with moderate-severe OSA, there was an underestimation (PSG-ORDI >15: MM-ORDI underestimation -8.70 (95% CI -28.46 to +4.01) events/hour). ROC optimal cut-off values for PSG-ORDI thresholds of 5, 15, 30 events/hour were: 9.53, 12.65 and 24.81 events/hour, respectively. These cut-off values yielded a sensitivity of 88, 100 and 79%, and a specificity of 100, 75, 96%. The positive predictive values were: 100, 80, 95% and the negative predictive values 89, 100, 82%, respectively. Conclusion: The diagnosis of OSA, using MM with machine learning analysis, is comparable to manually scored in-home PSG. Therefore, this novel monitor could be a convenient diagnostic tool that can easily be used in the patients’ own home.

Seagrasses are highly productive, but human nearshore activities have reduced their global distribution by >29% since the twentieth century. In the United States and Canada, the native seagrass Zostera marina (eelgrass) provides habitat for many species and multiple ecosystem services. By supplying spawning surface for fish and substrate for invertebrates, eelgrass creates foraging areas for high densities of migratory birds. Eelgrass beds stabilize sediment, protect adjacent shorelines, improve water quality, and sequester carbon in their underlying substrate. San Francisco Bay (California, USA) is a significant estuary for eelgrass, and recent surveys show that eelgrass beds are in decline. Protecting eelgrass is a conservation priority for federal, state, and local agencies, yet few studies have documented the extent of eelgrass loss due to human impacts such as boat anchoring. The purpose of our study was to provide factual evidence for policy makers by quantifying damage to eelgrass caused by illegal anchor-outs in San Francisco Bay, an issue that has been disputed for decades. Using aerial imagery and GIS analyses, we determined the amount of direct damage to eelgrass caused by anchor-outs. We found that boats damage up to 41% of the eelgrass bed, and each boat may cause up to 0.3 ha of damage. These results can be used to inform decisions about anchor-outs by stakeholders and government agencies. Furthermore, our efficient analytical approach could be implemented in other coastal regions.

Bacterial vaginosis (BV), the overgrowth of diverse anaerobic bacteria in the vagina, is the most common cause of vaginal symptoms worldwide. BV frequently recurs after antibiotic therapy, and the best probiotic treatments only result in transient changes from BV-associated states to “optimal” communities dominated by a single species of Lactobacillus . Therefore, additional treatment strategies are needed to durably alter vaginal microbiota composition for patients with BV. Vaginal microbiota transplantation (VMT), the transfer of vaginal fluid from a healthy person with an optimal vaginal microbiota to a recipient with BV, has been proposed as one such alternative. However, VMT carries potential risks, necessitating strict safety precautions. Here, we present an FDA-approved donor screening protocol and detailed methodology for donation collection, storage, screening, and analysis of VMT material. We find that Lactobacillus viability is maintained for over six months in donated material stored at − 80 °C without glycerol or other cryoprotectants. We further show that species-specific quantitative PCR for L. crispatus and L. iners can be used as a rapid initial screening strategy to identify potential donors with optimal vaginal microbiomes. Together, this work lays the foundation for designing safe, reproducible trials of VMT as a treatment for BV.

Many patients with obstructive sleep apnoea (OSA) remain undiagnosed and thus untreated, and in part this relates to delay in diagnosis. Novel diagnostic strategies may improve access to diagnosis. In a multicentre, randomised study, we evaluated time to treatment decision in patients referred for suspected OSA, comparing a mandibular movement (MM) monitor to respiratory polygraphy, the most commonly used OSA detection method in the UK. Adults with high pre-test probability OSA were recruited from both northern Scotland and London. 40 participants (70 % male, mean±SD age 46.8 ± 12.9 years, BMI 36.9 ± 7.5 kg/m2, ESS 14.9 ± 4.1) wore a MM monitor and respiratory polygraphy simultaneously overnight and were randomised (1:1) to receive their treatment decision based on results from either device. Compared to respiratory polygraphy, MM monitor reduced time to treatment decision by 6 days (median(IQR): 13.5 (7.0–21.5) vs. 19.5 (13.7–35.5) days, P = 0.017) and saved an estimated 29 min of staff time per patient.

BackgroundThe optimal interface for the delivery of home non-invasive ventilation (NIV) to treat chronic respiratory failure has not yet been determined. The aim of this individual participant data (IPD) meta-analysis was to compare the effect of nasal and oronasal masks on treatment efficacy and adherence in patients with COPD and obesity hypoventilation syndrome (OHS).MethodsWe searched Medline and Cochrane Central Register of Controlled Trials for prospective randomised controlled trials (RCTs) of at least 1 month’s duration, published between January 1994 and April 2019, that assessed NIV efficacy in patients with OHS and COPD. The main outcomes were diurnal PaCO2, PaO2 and NIV adherence (PROSPERO CRD42019132398).FindingsOf 1576 articles identified, 34 RCTs met the inclusion criteria and IPD were obtained for 18. Ten RCTs were excluded because only one type of mask was used, or mask data were missing. Data from 8 RCTs, including 290 IPD, underwent meta-analysis. Oronasal masks were used in 86% of cases. There were no differences between oronasal and nasal masks for PaCO2 (0.61 mm Hg (95% CI −2.15 to 3.38); p=0.68), PaO2 (−0.00 mm Hg (95% CI −4.59 to 4.58); p=1) or NIV adherence (0·29 hour/day (95% CI −0.74 to 1.32); p=0.58). There was no interaction between the underlying pathology and the effect of mask type on any outcome.InterpretationOronasal masks are the most used interface for the delivery of home NIV in patients with OHS and COPD; however, there is no difference in the efficacy or tolerance of oronasal or nasal masks.

Background There is some evidence that singing lessons may be of benefit to patients with chronic obstructive pulmonary disease (COPD). It is not clear how much of this benefit is specific to singing and how much relates to the classes being a group activity that addresses social isolation. Methods Patients were randomised to either singing classes or a film club for eight weeks. Response was assessed quantitatively through health status questionnaires, measures of breathing control, exercise capacity and physical activity and qualitatively, through structured interviews with a clinical psychologist. Results The singing group (n=13 mean(SD) FEV 1 44.4(14.4)% predicted) and film group (n=11 FEV 1 63.5(25.5)%predicted) did not differ significantly at baseline. There was a significant difference between the response of the physical component score of the SF-36, favouring the singing group +12.9(19.0) vs -0.25(11.9) (p=0.02), but no difference in response of the mental component score of the SF-36, breathing control measures, exercise capacity or daily physical activity. In the qualitative element, positive effects on physical well-being were reported in the singing group but not the film group. Conclusion Singing classes have an impact on health status distinct from that achieved simply by taking part in a group activity. Trials registration Registration Current Controlled Trials - ISRCTN17544114

Peatlands play an important role in the global carbon cycle as they contain a large soil carbon stock. However, current climate change could potentially shift peatlands from being carbon sinks to carbon sources. Remote sensing methods provide an opportunity to monitor carbon dioxide (CO2) exchange in peatland ecosystems at large scales under these changing conditions. In this study, we developed empirical models of the CO2 balance (net ecosystem exchange, NEE), gross primary production (GPP), and ecosystem respiration (ER) that could be used for upscaling CO2 fluxes with remotely sensed data. Two to three years of eddy covariance (EC) data from five peatlands in Sweden and Finland were compared to modelled NEE, GPP and ER based on vegetation indices from 10 m resolution Sentinel-2 MSI and land surface temperature from 1 km resolution MODIS data. To ensure a precise match between the EC data and the Sentinel-2 observations, a footprint model was applied to derive footprint-weighted daily means of the vegetation indices. Average model parameters for all sites were acquired with a leave-one-out-cross-validation procedure. Both the GPP and the ER models gave high agreement with the EC-derived fluxes (R2 = 0.70 and 0.56, NRMSE = 14% and 15%, respectively). The performance of the NEE model was weaker (average R2 = 0.36 and NRMSE = 13%). Our findings demonstrate that using optical and thermal satellite sensor data is a feasible method for upscaling the GPP and ER of northern boreal peatlands, although further studies are needed to investigate the sources of the unexplained spatial and temporal variation of the CO2 fluxes.

Background: The chronic obstructive pulmonary disease (COPD) assessment test (CAT) is a simple, self-completion questionnaire developed to measure health status in patients with COPD, which is potentially suitable for routine clinical use. Objectives: The purpose of this study was to establish the determinants of the CAT score in routine clinical practice. Methods: Patients attending the clinic completed the CAT score before being seen. Clinical data, including, where available, plethysmographic lung volumes, transfer factor and arterial blood gas analysis, were recorded on a pro forma in the clinic. Results: In 224 patients (36% female), mean forced expiratory volume in 1 s (FEV 1 ) was 40.1% (17.9) of predicted (%pred); CAT score was associated with exacerbation frequency [0–1/year 20.1 (7.6); 2–4/year 23.5 (7.8); >4/year 28.5 (7.3), p < 0.0001; 41/40/19% in each category] and with Medical Research Council (MRC) dyspnoea score (r 2 = 0.26, p < 0.0001) rising approximately 4 points with each grade. FEV 1 %pred had only a weak influence. Using stepwise regression, CAT score = 2.48 + 4.12 [MRC (1–5) dyspnoea score] + 0.08 (FEV 1 %pred) + 1.06 (exacerbation rate/year)] (r 2 = 0.36, p < 0.0001). The CAT score was higher in patients (n = 54) with daily sputum production [25.9 (7.5) vs. 22.2 (8.2); p = 0.004]. Detailed lung function (plethysmography and gas transfer) was available in 151 patients but had little influence on the CAT score. Conclusion: The CAT score is associated with clinically important variables in patients with COPD and enables health status measurement to be performed in routine clinical practice.