Continuous bronchoscopy during exercise in a pediatric patient: A case report
Bibliographic record
Abstract
Exercise-induced respiratory symptoms limit physical activity and sport performance in adolescents. Etiologies include exercise-induced bronchoconstriction, laryngeal obstruction, dysfunctional breathing, and in rarer cases, large airway obstruction and cardiac pathologies. Accurate diagnosis requires assessment during exercise that elicits the symptoms patients experience in the field. This is particularly important considering that misdiagnosis with asthma is common among those with laryngeal obstruction and leads to ineffective treatment and increased financial burden for patients and families. Continuous laryngoscopy is the gold standard for the evaluation of intermittent upper airway obstruction during exercise. Researchers recently established the feasibility of continuous bronchoscopy during exercise to assess the large airway in adults. We present the case of a 13-year-old female patient reporting dyspnea, chest tightness, and wheezing during exercise. A double aortic arch causing mild fixed tracheal compression did not appear to explain her symptoms. Vascular rings can cause tracheomalacia, another possible source of intermittent obstruction during exercise. We performed continuous bronchoscopy during exercise following continuous laryngoscopy during a cardiopulmonary exercise test. We found exercise-induced laryngeal obstruction and ruled out tracheomalacia and other potential causes. To our knowledge, this was the first continuous bronchoscopy during exercise performed in a pediatric patient worldwide.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.004 |
| Meta-epidemiology (narrow) | 0.002 | 0.002 |
| Meta-epidemiology (broad) | 0.002 | 0.001 |
| Bibliometrics | 0.003 | 0.002 |
| Science and technology studies | 0.003 | 0.002 |
| Scholarly communication | 0.002 | 0.004 |
| Open science | 0.002 | 0.002 |
| Research integrity | 0.007 | 0.006 |
| Insufficient payload (model declined to judge) | 0.002 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".