Deep Convolutional Neural Networks as strong gravitational lens detectors

Future large-scale surveys with high resolution imaging will provide us with a few $10^5$ new strong galaxy-scale lenses. These strong lensing systems however will be contained in large data amounts which are beyond the capacity of human experts to visually classify in a unbiased way. We present a new strong gravitational lens finder based on convolutional neural networks (CNNs). The method was applied to the Strong Lensing challenge organised by the Bologna Lens Factory. It achieved first and third place respectively on the space-based data-set and the ground-based data-set. The goal was to find a fully automated lens finder for ground-based and space-based surveys which minimizes human inspect. We compare the results of our CNN architecture and three new variations ("invariant" "views" and "residual") on the simulated data of the challenge. Each method has been trained separately 5 times on 17 000 simulated images, cross-validated using 3 000 images and then applied to a 100 000 image test set. We used two different metrics for evaluation, the area under the receiver operating characteristic curve (AUC) score and the recall with no false positive ($\mathrm{Recall}_{\mathrm{0FP}}$). For ground based data our best method achieved an AUC score of $0.977$ and a $\mathrm{Recall}_{\mathrm{0FP}}$ of $0.50$. For space-based data our best method achieved an AUC score of $0.940$ and a $\mathrm{Recall}_{\mathrm{0FP}}$ of $0.32$. On space-based data adding dihedral invariance to the CNN architecture diminished the overall score but achieved a higher no contamination recall. We found that using committees of 5 CNNs produce the best recall at zero contamination and consistenly score better AUC than a single CNN. We found that for every variation of our CNN lensfinder, we achieve AUC scores close to $1$ within $6\%$.Comment: 9 pages, accepted to A&

Ground-penetrating radar insight into a coastal aquifer: the freshwater lens of Borkum Island

Freshwater lenses, as important resource for drinking water, are sensitive to climate changes and sea level rise. To simulate this impact on the groundwater systems, hydraulic subsurface models have to be designed. Geophysical techniques can provide information for generating realistic models. The aim of our work is to show how ground-penetrating radar (GPR) investigations can contribute to such hydrological simulations. In the pilot area, Borkum island, GPR was used to map the shape of the groundwater table (GWT) and to characterise the aquifer. In total, 20 km of constant offset (CO) profiles were measured with centre frequencies of 80 and 200 MHz. Wave velocities were determined by common midpoint (CMP) measurements and vertical radar profiling (VRP) in a monitoring well. The 80 MHz CO data show a clear reflection at the groundwater table, whereas the reflection is weaker for the 200 MHz data. After correcting the GPR water tables for the capillary rise, they are in good accordance with the pressure heads of the observation wells in the area. In the centre of the island, the groundwater table is found up to 3.5 m above sea level, however it is lower towards the coastline and marshland. Some local depressions are observed in the region of dune valleys and around pumping stations of the local water supplier. GPR also reveals details within the sediments and highly-permeable aeolian sands can be distinguished from less-permeable marine sediments. Further, a silt loam layer below the water table could be mapped on a large area. The reflection characteristics indicates scattered erosion channels in this layer that cause it to be an aquitard with some leakage. GPR provides a high resolution map of the groundwater table and insight into the stratigraphy of the sediments and their hydraulic properties. This is valuable complementary information to the observation of sparsely distributed monitoring wells as input to hydraulic simulation

Ground-penetrating radar insight into a coastal aquifer: The freshwater lens of Borkum Island

Freshwater lenses, as important resource for drinking water, are sensitive to climate changes and sea level rise. To simulate this impact on the groundwater systems, hydraulic subsurface models have to be designed. Geophysical techniques can provide information for generating realistic models. The aim of our work is to show how groundpenetrating radar (GPR) investigations can contribute to such hydrological simulations. In the pilot area, Borkum island, GPR was used to map the shape of the groundwater table (GWT) and to characterise the aquifer. In total, 20 km of constant offset (CO) profiles were measured with centre frequencies of 80 and 200 MHz. Wave velocities were determined by common midpoint (CMP) measurements and vertical radar profiling (VRP) in a monitoring well. The 80MHz CO data show a clear reflection at the groundwater table, whereas the reflection is weaker for the 200MHz data. After correcting the GPR water tables for the capillary rise, they are in good accordance with the pressure heads of the observation wells in the area. In the centre of the island, the groundwater table is found up to 3.5m above sea level, however it is lower towards the coastline and marshland. Some local depressions are observed in the region of dune valleys and around pumping stations of the local water supplier. GPR also reveals details within the sediments and highly-permeable aeolian sands can be distinguished from less-permeable marine sediments. Further, a silt loam layer below the water table could be mapped on a large area. The reflection characteristics indicates scattered erosion channels in this layer that cause it to be an aquitard with some leakage. GPR provides a high resolution map of the groundwater table and insight into the stratigraphy of the sediments and their hydraulic properties. This is valuable complementary information to the observation of sparsely distributed monitoring wells as input to hydraulic simulation

Acute painful diabetic neuropathy: an uncommon, remittent type of acute distal small fibre neuropathy.

INTRODUCTION: Acute painful diabetic neuropathy (APDN) is a distinctive diabetic polyneuropathy and consists of two subtypes: treatment-induced neuropathy (TIN) and diabetic neuropathic cachexia (DNC). The characteristics of APDN are (1.) the small-fibre involvement, (2.) occurrence paradoxically after short-term achievement of good glycaemia control, (3.) intense pain sensation and (4.) eventual recovery. In the face of current recommendations to achieve quickly glycaemic targets, it appears necessary to recognise and understand this neuropathy. METHODS AND RESULTS: Over 2009 to 2012, we reported four cases of APDN. Four patients (three males and one female) were identified and had a mean age at onset of TIN of 47.7 years (±6.99 years). Mean baseline HbA1c was 14.2% (±1.42) and 7.0% (±3.60) after treatment. Mean estimated time to correct HbA1c was 4.5 months (±3.82 months). Three patients presented with a mean time to symptom resolution of 12.7 months (±1.15 months). One patient had an initial normal electroneuromyogram (ENMG) despite the presence of neuropathic symptoms, and a second abnormal ENMG showing axonal and myelin neuropathy. One patient had a peroneal nerve biopsy showing loss of large myelinated fibres as well as unmyelinated fibres, and signs of microangiopathy. CONCLUSIONS: According to the current recommendations of promptly achieving glycaemic targets, it appears necessary to recognise and understand this neuropathy. Based on our observations and data from the literature we propose an algorithmic approach for differential diagnosis and therapeutic management of APDN patients

Late onset tacrolimus-induced life-threatening polyneuropathy in a kidney transplant recipient patient

A 59-year-old kidney recipient was diagnosed with a late onset of severe chronic inflammatory demyelinating polyradiculoneuropathy and almost fully recovered after stopping tacrolimus and one course of intravenous immunoglobulin treatment. Unique features of this patient are the unusually long time lapse between initiation of tacrolimus and the adverse effect (10 years), a strong causality link and several arguments pointing toward an inflammatory etiology. When facing new neurological signs and symptoms in graft recipients, it is important to bear in mind the possibility of a drug-induced adverse event. Discontinuation of the suspect drug and immunomodulation are useful treatment options

SARS-CoV-2 and Guillain-Barré syndrome: AIDP variant with a favourable outcome.

The spectrum of COVID-19, caused by severe acute respiratory syndrome coronavirus 2 infection (SARS-CoV-2), includes different neurologic manifestations of the central and peripheral nervous system. From March through April 2020, in two university hospitals located in western Switzerland, we examined three patients with Guillain-Barré syndrome (GBS) following SARS-CoV-2. These cases were characterized by a primary demyelinating electrophysiological pattern (Acute inflammatory demyelinating polyneuropathy or AIDP) and a less severe disease course compared to recently published case series. Clinical improvement was observed in all patients at week five. One patient was discharged from hospital after full recovery with persistence of minor neurological signs (areflexia). Two of the three patients remained hospitalized: one was able to walk and the other could stand up with assistance. We report three cases of typical GBS (AIDP) occurring after SARS-CoV-2 infection and presenting with a favourable clinical course. Given the interval between COVID-19-related symptoms and neurological manifestations (mean of 15 days) we postulate a secondary immune-mediated mechanism rather than direct viral damage

Update of the Swiss guidelines on post-treatment Lyme disease syndrome.

Lyme borreliosis is caused by Borrelia burgdorferi sensu lato infection, which responds well to antibiotic therapy in the overwhelming majority of cases. However, despite adequate antibiotic treatment some patients report persisting symptoms which are commonly summarised as post-treatment Lyme disease syndrome (PTLDS). In 2005, the Swiss Society of Infectious Diseases published a case definition for PTLDS. We aimed to review the scientific literature with a special emphasis on the last 10 years, questioning whether the definitions from 2005 are still valid in the light of current knowledge. Furthermore, we describe the clinical history of infection with Borrelia burgdorferi sensu lato, the estimated prevalence of PTLDS, the possible pathogenesis of PTLDS, and treatment options with an emphasis on clinical studies. In summary, we were unable to find a scientific reason for modification of the PTLDS definitions published in 2005. Thus, the diagnostic criteria remain unchanged, namely documented clinical and laboratory evidence of previous infection with B. burgdorferi, a completed course of appropriate antibiotic therapy, symptoms including fatigue, arthralgia, myalgia, cognitive dysfunction or radicular pain persisting for >6 months, a plausible timely association between documented B. burgdorferi infection and onset of symptoms (i.e., persistent or recurrent symptoms that began within 6 months of completion of a recommended antibiotic therapy for early or late Lyme borreliosis), and exclusion of other somatic or psychiatric causes of symptoms. The main therapeutic options remain cognitive behavioural therapy and low-impact aerobic exercise programmes. Growing and unequivocal evidence confirms that prolonged or repeated antibiotic therapy for PTLDS is not beneficial, but potentially harmful and therefore contraindicated. The Guidelines of the Swiss Society of Infectious Diseases offer an evidence based, diagnostic and therapeutic framework for physicians caring for patients suffering from presumptive PTLDS in Switzerland

A severe case of neuro-Sjögren's syndrome induced by pembrolizumab.

The prevalence of connective tissue disease (CTD) induced by immune checkpoint inhibitors (CPIs) in the absence of pre-existing autoimmunity is unknown. We report the case of a melanoma patient treated for 8 months with pembrolizumab who developed a subacute ataxic sensory neuronopathy (SNN), including a right trigeminal neuropathy. Salivary gland biopsy showed inflammatory changes suggestive of Sjögren's syndrome, while brain MRI revealed enhancement of the right trigeminal ganglia. A high level of protein and pleocytosis was found in the cerebrospinal fluid, with negative cultures. Nerve conduction studies revealed the absence of sensory nerve action potentials in the upper and lower limbs and reduced motor responses in the upper limbs, fulfilling criteria for SNN. Blood tests revealed an important inflammatory syndrome, hemolytic anemia, elevation of total IgG levels and the presence of ANA autoantibodies specific to anti-SSA (52 and 60 kd). All these elements were absent before the initiation of the treatment with pembrolizumab. Initially, there was a clinical response following intravenous frontline methylprednisone, but the subacute relapse required the introduction of second-line treatment with intravenous immunoglobulins and then rituximab, which led to a quick clinical improvement. Herein, we describe the first case of a patient who developed a typical SNN as a complication of severe neuro-Sjögren's syndrome induced by pembrolizumab treatment

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