Particle detection by means of neural networks and synthetic training data refinement in defocusing particle tracking velocimetry

The presented work addresses the problem of particle detection with neural networks (NNs) in defocusing particle tracking velocimetry. A novel approach based on synthetic training data refinement is introduced, with the scope of revising the well documented performance gap of synthetically trained NNs, applied to experimental recordings. In particular, synthetic particle image (PI) data is enriched with image features from the experimental recordings by means of deep learning through an unsupervised image-to-image translation. It is demonstrated that this refined synthetic training data enables the neural-network-based particle detection for a simultaneous increase in detection rate and reduction in the rate of false positives, beyond the capability of conventional detection algorithms. The potential for an increased accuracy in particle detection is revealed with NNs that utilise small scale image features, which further underlines the importance of representative training data. In addition, it is demonstrated that NNs are able to resolve overlapping PIs with a higher reliability and accuracy in comparison to conventional algorithms, suggesting the possibility of an increased seeding density in real experiments. A further finding is the robustness of NNs to inhomogeneous background illumination and aberration of the images, which opens up defocusing PTV for a wider range of possible applications. The successful application of synthetic training-data refinement advances the neural-network-based particle detection towards real world applicability and suggests the potential of a further performance gain from more suitable training data

TEST-RETEST STUDY OF THE SIX-MINUTE WALK TEST IN PEOPLE WITH BIPOLAR DISORDER

Background: The multidisciplinary care for bipolar disorder is highly fragmented with limited opportunities for prevention and treatment of medical co-morbidities. We examined the reliability of the 6-minute walk test (6MWT). Secondary aims were to assess minimal detectable changes (MDC95), practice effects and the impact of clinical conditions. Subjects and methods: Two 6MWTs were administered within 3 days to 46 (23♂) inpatients with a DSM-V diagnosis of bipolar disorder. Physical complaints before and after the 6MWT were recorded. Patients completed the Quick Inventory of Depressive Symptomatology Self Report (QIDS-SR) and Hypomania Check List-32. Results: Patients walked 594.7±121.3 meters and 600.0±122.9 meters at the first and second test. The intraclass correlation coefficient was 0.98 (95% confidence interval 0.97-0.99). The MDC95 was 37.8 meters for men and 52.9 meters for women. No practice effect was detected. Longer illness duration, higher QIDS-SR scores and the presence of feet or ankle static problems or pain were independently related to shorter 6MWT distance accounting for 59.8% of the variance. Conclusion: The 6MWT is a clinically feasible tool for evaluating the functional exercise capacity in patients with bipolar disorder. Health care professionals should consider depression and physical pain when developing rehabilitation programmes

The implementation of physicians assistant in a surgical ward improves continuity in daily clinical work and increases comprehensibility of nurses and physicians

INTRODUCTION Physician Assistant (PA) have been deployed to increase the capacity of a team, supporting continuity and medical cover. The goal of this study was to assess the implementation of PAs on continuity of surgical rounds, on the collaboration of nurses and physicians and on support of administrative work. METHODS This cross-sectional survey was performed on nurses and physicians who work full-time at a surgical ward in a Swiss reference center. PAs were introduced in our institution in 2019. Participants answered a self-developed questionnaire 6 and 12 months after the implementation of PAs. Administrative work, teamwork, improvement of workflow, and training of physicians has been assessed. Participants answered questions on a 5-point Likert scale and were stratified according to profession (nurse, physician). RESULTS Participants (n = 53) reported a positive effect on the regular conduct of rounds (2.9, SD 1.1 points after 6 weeks and 3.5, SD 1.1 points after 12 weeks, p = 0.05). A significant improvement of nurse-doctor collaboration has been reported (3.6, SD 1.0 and 4.2, SD 0.8, p = 0.05). Nurses (n = 28, 52.8%) reported the that PAs are integrated in the physicians team rather than the nurses team (4.0, SD 0.0 points and 4.4, SD 0.7 points, p = 0.266) and a significant beneficial effect on the surgical clinic (3.7, SD 1.0 points and 4.4, SD 0.8 points, p = 0.043). Improved overall management of surgical cases was reported by the physicians (n = 25, 47.2%) (4.8, SD 0.4 and 4.3, SD 0.6, p = 0.046). CONCLUSION The implementation of PA has improved the collaboration of physicians and nurses substantially. Continuity of rounds has improved and the administrative workload for residents decreased substantially. Overall, the implementation of PA was reported to be beneficial for the surgical clinic

Towards a Time-predictable Dual-Issue Microprocessor: The Patmos Approach

Current processors are optimized for average case performance, often leading to a high worst-case execution time (WCET). Many architectural features that increase the average case performance are hard to be modeled for the WCET analysis. In this paper we present Patmos, a processor optimized for low WCET bounds rather than high average case performance. Patmos is a dual-issue, statically scheduled RISC processor. The instruction cache is organized as a method cache and the data cache is organized as a split cache in order to simplify the cache WCET analysis. To fill the dual-issue pipeline with enough useful instructions, Patmos relies on a customized compiler. The compiler also plays a central role in optimizing the application for the WCET instead of average case performance

Addition of platinum derivatives to neoadjuvant single-agent fluoropyrimidine chemoradiotherapy in patients with stage II/III rectal cancer: protocol for a systematic review and meta-analysis (PROSPERO CRD42017073064)

Background Neoadjuvant (chemo-)radiation has proven to improve local control compared to surgery alone, but this improvement did not translate into better overall or disease-specific survival. The addition of oxaliplatin to fluoropyrimidine-based neoadjuvant chemoradiotherapy holds the potential of positively affecting survival in this context since it has been proven effective in the palliative and adjuvant setting of colorectal cancer. Thus, the objective of this systematic review is to assess the efficacy, safety, and quality of life resulting from adding a platinum derivative to neoadjuvant single-agent fluoropyrimidine-based chemoradiotherapy in patients with Union for International Cancer Control stage II and III rectal cancer. Methods: MEDLINE, Web of Science, and Cochrane Central Register of Controlled Trials will be systematically searched to identify all randomized controlled trials comparing single-agent fluoropyrimidine-based chemoradiotherapy to combined neoadjuvant therapy including a platinum derivative. Predefined data on trial design, quality, patient characteristics, and endpoints will be extracted. Quality of included trials will be assessed according to the Cochrane Risk of Bias Tool, and the GRADE recommendations will be applied to judge the quality of the resulting evidence. The main outcome parameter will be survival, but also treatment toxicity, perioperative morbidity, and quality of life will be assessed. Discussion: The findings of this systematic review and meta-analysis will provide novel insights into the efficacy and safety of combined neoadjuvant chemoradiotherapy including a platinum derivative and may form a basis for future clinical decision-making, guideline evaluation, and research prioritization. Systematic review registration PROSPERO CRD4201707306

Multiple endocrine neoplasia type 4: a new member of the MEN family.

OBJECTIVE Multiple endocrine neoplasia type 4 (MEN4) is caused by a CDKN1B germline mutation first described in 2006. Its estimated prevalence is less than 1/million. The aim of this study was to define the disease characteristics. METHODS Systematic review according to the PRISMA 2020 criteria. MEDLINE® and Web of ScienceTM search from January 2006 to August 2022. RESULTS Forty-eight symptomatic patients fulfilled the pre-defined eligibility criteria. Twenty-eight different CDKN1B variants, mostly missense (21/48, 44%) and frameshift mutations (17/48, 35%), were reported. The majority of patients were women (36/48, 75%). Men became symptomatic at a median age of 32.5 years (range 10-68, mean 33.7 ± 23), whereas the same event was recorded for women at a median age of 49.5 years (range 5-76, mean 44.8 ± 19.9) (p = 0.25). The most frequently affected endocrine organ was the parathyroid gland (36/48, 75%; uniglandular disease 31/36, 86%), followed by the pituitary gland (21/48, 44%; hormone-secreting 16/21, 76%), the endocrine pancreas (7/48, 15%) and the thyroid gland (4/48, 8%). Tumours of the adrenal glands and thymus were found in three and two patients, respectively. The presenting first endocrine pathology concerned the parathyroid (27/48, 56%) and the pituitary gland (11/48, 23%). There were one (27/48, 56%), two (13/48, 27%), three (3/48, 6%), or four (5/48, 10%) syn- or metachronously affected endocrine organs in a single patient, respectively. CONCLUSION MEN4 is an extremely rare disease, which most frequently affects women around 50 years of age. Primary hyperparathyroidism as a uniglandular disease is the leading pathology

An epidemiological and economic simulation model to evaluate strategies for the control of bovine virus diarrhea in Germany

Models can be used to plan, evaluate, and improve programs for animal disease control. In Germany, a nationwide compulsory program to eradicate Bovine viral diarrhea (BVD) is in force since January 2011. As it is associated with substantial expenditures, the program is currently under revision. To provide the basis for a science-based decision on the future course of BVD control in Germany, we evaluated 13 scenarios (sc1-13) with respect to the chance of reaching freedom from disease and their economic implications for a period of 20 years (2011–2030). To simulate the impact of different control strategies on disease dynamics, a disease spread model was developed. To estimate the effects of a transient infection (TI) on animal level, a gross margin analysis was performed. To assess the value of cattle that died prematurely, a valuation model was used. Finally, an economic model was developed to perform a cost-benefit analysis and to compare each control scenario with a baseline setting with no BVD control. Costs comprised the expenditures for diagnostics, vaccination, preventive culling, and trade restrictions. Benefits were animal and production losses avoided by having control measures in place. The results show that reducing the PI prevalence on animal level to 0% is only feasible in scenarios that combine antigen or antibody testing with compulsory vaccination. All other scenarios, i.e., those based exclusively on a “test and cull” approach, including the current control program, will, according to the model, not achieve freedom of BVD by 2030. On the other hand, none of the scenarios that may lead to complete BVD eradication is economically attractive [benefit-cost ratio (BCR) between 0.64 and 0.94]. The average direct costs of BVD in Germany are estimated at 113 million Euros per year (34–402 million Euros), corresponding to 28.3 million Euros per million animals. Only the concepts of the former and the current national BVD control program (“ear tag testing and culling”) may reduce the BVD prevalence to 0.01% with an acceptable BCR (net present value of 222 and 238 million Euros, respectively, with a BCR of 1.22 and 1.24)