Local and Global Information in Obstacle Detection on Railway Tracks

Reliable obstacle detection on railways could help prevent collisions that result in injuries and potentially damage or derail the train. Unfortunately, generic object detectors do not have enough classes to account for all possible scenarios, and datasets featuring objects on railways are challenging to obtain. We propose utilizing a shallow network to learn railway segmentation from normal railway images. The limited receptive field of the network prevents overconfident predictions and allows the network to focus on the locally very distinct and repetitive patterns of the railway environment. Additionally, we explore the controlled inclusion of global information by learning to hallucinate obstacle-free images. We evaluate our method on a custom dataset featuring railway images with artificially augmented obstacles. Our proposed method outperforms other learning-based baseline methods

Sentinel-1 detects firn aquifers in the Greenland ice sheet

Firn aquifers in Greenland store liquid water within the upper ice sheet and impact the hydrological system. Their location and area have been estimated with airborne radar sounder surveys (Operation IceBridge, OIB). However, the OIB coverage is limited to narrow flight lines, offering an incomplete view. Here, we show the ability of satellite radar measurements from Sentinel-1 to map firn aquifers across all of Greenland at 1 km(2) resolution. The detection of aquifers relies on a delay in the freezing of meltwater within the firn above the water table, causing a distinctive pattern in the radar backscatter. The Sentinel-1 aquifer locations are in very good agreement with those detected along the OIB flight lines (Cohen's kappa = 0.84). The total aquifer area is estimated at 54,800 km(2). With continuity of Sentinel-1 ensured until 2030, our study lays a foundation for monitoring the future response of firn aquifers to climate change

A first-in-human, randomized, controlled, subject- and reviewer-blinded multicenter study of Actamax™ Adhesion Barrier

Purpose: Post-surgical adhesions remain a significant concern following abdominopelvic surgery. This study was to assess safety, manageability and explore preliminary efficacy of applying a degradable hydrogel adhesion barrier to areas of surgical trauma following gynecologic laparoscopic abdominopelvic surgery. Methods: This first-in-human, prospective, randomized, multicenter, subject- and reviewer-blinded clinical study was conducted in 78 premenopausal women (18–46 years) wishing to maintain fertility and undergoing gynecologic laparoscopic abdominopelvic surgery with planned clinically indicated second-look laparoscopy (SLL) at 4–12 weeks. The first two patients of each surgeon received hydrogel, up to 30 mL sprayed over all sites of surgical trauma, and were assessed for safety and application only (n = 12). Subsequent subjects (n = 66) were randomized 1:1 to receive either hydrogel (Treatment, n = 35) or not (Control, n = 31); 63 completed the SLL. Results: No adverse event was assessed as serious, or possibly device related. None was severe or fatal. Adverse events were reported for 17 treated subjects (17/47, 36.2%) and 13 Controls (13/31, 41.9%). For 95.7% of treated subjects, surgeons found the device “easy” or “very easy” to use; in 54.5%, some residual material was evident at SLL. For 63 randomized subjects who completed the SLL, adjusted between-group difference in the change from baseline adhesion score demonstrated a 41.4% reduction for Treatment compared with Controls (p = 0.017), with a 49.5% reduction (p = 0.008) among myomectomy subjects (n = 34). Conclusion: Spray application of a degradable hydrogel adhesion barrier during gynecologic laparoscopic abdominopelvic surgery was performed easily and safely, without evidence of clinically significant adverse outcomes. Data suggest the hydrogel was effective in reducing postoperative adhesion development, particularly following myomectomy

Sterben und Erben in der digitalen Welt. von der Tabuisierung zur Sensibilisierung. Crossing Borders

Immer mehr Menschen verfügen über Social-Media-Profile und hinterlassen immer mehr Daten und Spuren im Internet. Doch was passiert im Todesfall? Profile zu löschen oder Zugriff auf Daten zu erlangen, ist für Angehörige kompliziert oder unmöglich. Dieser Ergebnisbericht eines interdisziplinären Forschungsprojekts zeichnet ein differenzierteres Bild der grundlegenden Problematik, der unterschiedlichen Interessensgruppen und Spannungsfelder sowie der erb- und persönlichkeitsrechtlichen Fragestellungen im Umgang mit dem digitalen Nachlass. Auf dieser Grundlage wird ein erweiterter Lösungsraum für den digitalen Nachlass vorgeschlagen, der nicht nur das Pionierfeld digitale Nachlassplanung und Willensvollstreckung präzisiert, sondern auch die Sicherstellung der Datenherrschaft zu Lebzeiten, das "Recht auf Vergessen" sowie den Bedarf an Beratung und Sensibilisierung der Internetnutzerschaft und der Plattformbetreiber einbezieht. Zielpublikum: Nutzerinnen und Nutzer von Social Medi

Clinical aspects of Mayer-Rokitansky-Kuester-Hauser syndrome: recommendations for clinical diagnosis and staging

BACKGROUND: The Mayer-Rokitansky-Kuester-Hauser (MRKH) syndrome is a malformation of the female genitals (occurring in one in 4000 female live births) as a result of interrupted embryonic development of the Müllerian (paramesonephric) ducts. This retrospective study examined the issue of associated malformations, subtyping, and the frequency distribution of subtypes in MRKH syndrome. METHODS: Fifty-three MRKH patients were investigated using a newly developed standardized questionnaire. Together with the results of clinical and diagnostic examinations, the patients were classified into the three recognized subtypes [typical, atypical and MURCS (Müllerian duct aplasia, renal aplasia, and cervicothoracic somite dysplasia)]. RESULTS: The typical form was diagnosed in 25 patients (47%), the atypical form in 11 patients (21%), and the most marked form—the MURCS type—in 17 patients (32%). Associated malformations were notably frequent among the patients. Malformations of the renal system were the most frequent type of accompanying malformation, with 23 different malformations in 19 patients, followed by 18 different skeletal changes in 15 patients. CONCLUSIONS: In accordance with the literature, this study shows that associated malformations are present in more than a third of cases. Therefore, new basic guidelines for standard diagnostic classification involving patients with suspected MRKH are presente

Certification of breast centres in Germany: proof of concept for a prototypical example of quality assurance in multidisciplinary cancer care

<p>Abstract</p> <p>Background</p> <p>The main study objectives were: to develop a set of requirements of comprehensive breast centres; to establish a nationwide voluntary certification programme for breast centres based on such requirements, a certified quality management system (QMS), and scheduled independent, external audits and periodic recertification; and to demonstrate the general acceptance of such a certification programme with a view to introducing similar certification programmes for other major cancers.</p> <p>Methods</p> <p>Breast centres introduced a QMS and voluntarily participated in an external certification procedure based on guideline-derived Requirements of Breast Centres specifically developed for the application procedure, all subsequent audits and recertification. All data (numbers of pending and successful applications, sites/centre, etc.) were collected by a newly founded, independent organisation for certification of cancer services delivery. Data analysis was descriptive.</p> <p>Results</p> <p>Requirements of Breast Centres were developed by the German Cancer Society (DKG), the German Society of Senology (DGS) and other relevant specialist medical societies in the form of a questionnaire comprising 185 essential items based on evidence-based guidelines and the European Society of Breast Cancer Specialists' (EUSOMA) requirements of specialist breast units. From late 2002 to mid 2008, the number of participating breast centres rose from 1 to 175. As of mid 2008, 77% of an estimated 50,000 new breast cancers in Germany were diagnosed and treated at certified breast centres, 78% of which were single-site centres.</p> <p>Conclusion</p> <p>Nationwide voluntary certification of breast centres is feasible and well accepted in Germany. Dual certification of breast centres that involves certification of breast services to guideline-derived requirements in conjunction with independent certification of a mandatory QMS can serve as a model for other multidisciplinary site-specific cancer centres.</p

Dihydropyrimidine Dehydrogenase Testing prior to Treatment with 5-Fluorouracil, Capecitabine, and Tegafur: A Consensus Paper

Background: 5-Fluorouracil (FU) is one of the most commonly used cytostatic drugs in the systemic treatment of cancer. Treatment with FU may cause severe or life-threatening side effects and the treatment-related mortality rate is 0.2–1.0%. Summary: Among other risk factors associated with increased toxicity, a genetic deficiency in dihydropyrimidine dehydrogenase (DPD), an enzyme responsible for the metabolism of FU, is well known. This is due to variants in the DPD gene (DPYD). Up to 9% of European patients carry a DPD gene variant that decreases enzyme activity, and DPD is completely lacking in approximately 0.5% of patients. Here we describe the clinical and genetic background and summarize recommendations for the genetic testing and tailoring of treatment with 5-FU derivatives. The statement was developed as a consensus statement organized by the German Society for Hematology and Medical Oncology in cooperation with 13 medical associations from Austria, Germany, and Switzerland. Key Messages: (i) Patients should be tested for the 4 most common genetic DPYD variants before treatment with drugs containing FU. (ii) Testing forms the basis for a differentiated, risk-adapted algorithm with recommendations for treatment with FU-containing drugs. (iii) Testing may optionally be supplemented by therapeutic drug monitorin