Causal Triplet: An Open Challenge for Intervention-centric Causal Representation Learning

Recent years have seen a surge of interest in learning high-level causal representations from low-level image pairs under interventions. Yet, existing efforts are largely limited to simple synthetic settings that are far away from real-world problems. In this paper, we present Causal Triplet, a causal representation learning benchmark featuring not only visually more complex scenes, but also two crucial desiderata commonly overlooked in previous works: (i) an actionable counterfactual setting, where only certain object-level variables allow for counterfactual observations whereas others do not; (ii) an interventional downstream task with an emphasis on out-of-distribution robustness from the independent causal mechanisms principle. Through extensive experiments, we find that models built with the knowledge of disentangled or object-centric representations significantly outperform their distributed counterparts. However, recent causal representation learning methods still struggle to identify such latent structures, indicating substantial challenges and opportunities for future work. Our code and datasets will be available at https://sites.google.com/view/causaltriplet.Comment: Conference on Causal Learning and Reasoning (CLeaR) 202

Image retrieval outperforms diffusion models on data augmentation

Many approaches have been proposed to use diffusion models to augment training datasets for downstream tasks, such as classification. However, diffusion models are themselves trained on large datasets, often with noisy annotations, and it remains an open question to which extent these models contribute to downstream classification performance. In particular, it remains unclear if they generalize enough to improve over directly using the additional data of their pre-training process for augmentation. We systematically evaluate a range of existing methods to generate images from diffusion models and study new extensions to assess their benefit for data augmentation. Personalizing diffusion models towards the target data outperforms simpler prompting strategies. However, using the pre-training data of the diffusion model alone, via a simple nearest-neighbor retrieval procedure, leads to even stronger downstream performance. Our study explores the potential of diffusion models in generating new training data, and surprisingly finds that these sophisticated models are not yet able to beat a simple and strong image retrieval baseline on simple downstream vision tasks

Image retrieval outperforms diffusion models on data augmentation

Many approaches have been proposed to use diffusion models to augment training datasets for downstream tasks, such as classification. However, diffusion models are themselves trained on large datasets, often with noisy annotations, and it remains an open question to which extent these models contribute to downstream classification performance. In particular, it remains unclear if they generalize enough to improve over directly using the additional data of their pre-training process for augmentation. We systematically evaluate a range of existing methods to generate images from diffusion models and study new extensions to assess their benefit for data augmentation. Personalizing diffusion models towards the target data outperforms simpler prompting strategies. However, using the pre-training data of the diffusion model alone, via a simple nearest-neighbor retrieval procedure, leads to even stronger downstream performance. Our study explores the potential of diffusion models in generating new training data, and surprisingly finds that these sophisticated models are not yet able to beat a simple and strong image retrieval baseline on simple downstream vision tasks

S1‐Guideline: Microscopically controlled surgery

Microscopically controlled surgery (MCS) comprises various methods allowing histologically proven complete resection of malignant tumors while at the same time sparing the tumor-free tissue in the immediate vicinity as much as possible. All procedures subsumed under MCS have in common the marking of the excised tissue for topographical orientation, which provides an assignment of remaining tumor remnants. Indications for MCS are malignant skin tumors in problem localizations as well as aggressive subtypes of skin tumors. Established indications for MCS include basal cell carcinoma, cutaneous squamous cell carcinoma, Bowen’s disease as well as Bowen’s carcinoma, dermatofibrosarcoma protuberans, melanoma in chronically light-damaged skin as well as acral lentiginous melanoma and Merkel cell carcinoma. For other tumors such as extramammary Paget’s disease and various cutaneous sarcomas, evidence exists that MCS has demonstrated benefits, such as local recurrence rates. In addition, MCS is indicated when it is foreseeable that a complex closure technique is required and complete resection of the tumor must be assured. Various methods of MCS have been described, including 3D histology, horizontal method and Mohs surgery. A close cooperation of qualified surgeons and (dermato)pathologists as well as laboratory staff is essential for the successful application of MCS

Dynamic Up-Regulation of PD-L1 in the Progression of Oral Squamous Cell Carcinoma

The introduction of immune checkpoint inhibition for recurrent and metastatic head and neck cancer has brought a new treatment option for patients suffering from advanced oral cancers without a chance for curation using surgery or radiotherapy. The application of immune checkpoint inhibitors in most cases is based on the expression levels of PD-L1 in the tumor tissue. To date, there is a lack of data on the dynamic regulation of PD-L1 during disease progression. Therefore, this study aimed to evaluate the expression levels of PD-L1 in a large cohort of patients (n = 222) with oral squamous cell carcinoma including primary and recurrent tumors. Semiautomatic digital pathology scoring was used for the assessment of PD-L1 expression levels in primary and recurrent oral squamous cell carcinoma. Survival analysis was performed to evaluate the prognostic significance of the protein expression at different stages of the disease. We found a significant up-regulation of PD-L1 expression from primary disease to recurrent tumors (mean PD-L1 H-scores: primary tumors: 47.1 ± 31.4; recurrent tumors: 103.5 ± 62.8, p < 0.001). In several cases, a shift from low PD-L1 expression in primary tumors to high PD-L1 expression in recurrent tumors was identified. Multivariate Cox regression analysis did not reveal a significantly higher risk of death (p = 0.078) or recurrence (p = 0.926) in patients with higher PD-L1 expression. Our findings indicate that the exclusive analysis of primary tumor tissue prior to the application of checkpoint blockade may lead to the misjudgment of PD-L1 expression in recurrent tumors

Free-Flap Reconstruction in Early-Stage Squamous Cell Carcinoma of the Oral Cavity : A Prospective Monocentric Trial to Evaluate Oncological Outcome and Quality of Life

Surgery is generally accepted as standard treatment in oral cancer, but the reconstructive procedures remain a matter of debate. The aim of this study was to evaluate oncological outcome and quality of life following surgical resection and free-flap reconstruction in patients with early oral squamous cell carcinoma. The presented trial was performed as a prospective, single-center observation study. Inclusion criteria were primary surgery in early-stage oral squamous cell carcinoma with free-flap reconstruction. Endpoints were overall and progression-free survival and quality of life up to 24 months after surgery. Twenty-six patients were included. Overall survival was 100% and progression-free survival was 92.3% in a maximum follow-up time of 21 months. Global quality of life showed no significant alteration after surgery. Patients reported a significant reduction in pain (p = 0.048) and a decreasing impairment of speech one year after surgery (p = 0.021). Free-flap reconstruction is a safe procedure that results in excellent oncological outcome and quality of life. Functional outcome is of high relevance in early-stage tumors of the head and neck and may mostly be affected by reconstructive procedures. Therefore, a prospective evaluation to explore success and the effects of surgical therapy is highly warranted

Life cycle assessment of innovative materials for thermal energy storage in buildings

The politically endorsed reduction of greenhouse gas emissions entails the transformation of thermal energy systems towards renewable energies, especially in the building sector. This comes along with a demand in energy storage, as there is a time offset between energy availability and demand. As sensible heat storages induce major losses and have limited energy density, current water-based solutions are only partially sufficient to meet these demands. Within the project “Speicher-LCA” the environmental performance of a variety of innovative materials available for energy storage in buildings is assessed. The project provides the first extensive comparison of environmental profiles of various thermal energy storage materials, including phase change, thermochemical and sorption materials. The specific performances in the storage cycle are taken into account. All results will be publically accessible through a spreadsheet tool including a comprehensive set of materials, components as well as their integration into different building types. This paper discusses the methodological framework of the study and presents the environmental assessment results for selected materials. It highlights the main challenges in the assessment of innovative storage materials on different system levels which require specific definition of functional units accordingly. The first assessment results on material level for selected phase change (PCM) and thermo-chemical materials (TCM) allow an environmental characterization regarding their potential application in thermal storages. In addition, ranges of required numbers of storage cycles for amortization have been calculated for the non-renewable primary energy demand. For PCMs amortization cycles range between ∼20 to 150 cycles for salt hydrates and up to ∼280 cycles for paraffins. Regarding TCM, energetic amortization of silica gel and zeolite 13x is reached after ∼60 and ∼260 cycles respectively. Since the realization of storage components and systems which can actually be used in real applications will further increase the cycle number required for amortization, these storage materials may thus not be suitable for applications with a low number of cycles over lifetime, such as seasonal storage

Full-Thickness Tumor Resection of Oral Cancer Involving the Facial Skin—Microsurgical Reconstruction of Extensive Defects after Radical Treatment of Advanced Squamous Cell Carcinoma

Advanced tumors of the head and neck are challenging for the treatment specialist due to the need to synergize oncological and functional requirements. Free flap reconstruction has been established as the standard of care for defects following tumor resection. However, depending on the affected anatomic subsite, advanced tumors may impose specific difficulties regarding reconstruction, especially when full-thickness resection is required. This study aimed to evaluate reconstructive strategies and oncological outcomes in patients with full-thickness resection of the oral cavity. A total of 33 patients with extensive defects due to squamous cell carcinoma of the oral cavity were identified. Indications, reconstructive procedures, and clinical outcome were evaluated. Thirty-two patients (97%) presented locally advanced tumors (T3/T4). Complete tumor resection was achieved in 26 patients (78.8%). The anterolateral thigh flap was the most frequently used flap (47.1%), and the primary flap success rate was 84.8%. The cohort demonstrated a good local control rate and moderate overall and progression-free survival rates. Most patients regained full competence regarding oral alimentation and speech. Full-thickness tumor resections of the head and neck area may be necessary due to advanced tumors in critical anatomic areas. In many cases, radical surgical treatment leads to good oncological results. Free flap reconstruction has been shown to be a suitable option for extensive defects in aesthetically challenging regions