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Uncontrolled movements of laparoscopic instruments can lead to inadvertent injury of adjacent structures. The risk becomes evident when the dissecting instrument is located outside the field of view of the laparoscopic camera. Technical solutions to ensure patient safety are appreciated. The present work evaluated the feasibility of an automated binary classification of laparoscopic image data using Convolutional Neural Networks (CNN) to determine whether the dissecting instrument is located within the laparoscopic image section. A unique record of images was generated from six laparoscopic cholecystectomies in a surgical training environment to configure and train The CNN. By using a temporary version of the neural network, the annotation of the training image files could be automated and accelerated. A combination of oversampling and selective data augmentation was used to enlarge the fully labelled image data set and prevent loss of accuracy due to imbalanced class volumes. Subsequently the same approach was applied to the comprehensive, fully annotated Cholec80 database. The described process led to the generation of extensive and balanced training image data sets. The performance of the CNN-based binary classifiers was evaluated on separate test records from both databases. On our recorded data, an accuracy of 0.88 with regard to the safety-relevant classification was achieved. The subsequent evaluation on the Cholec80 data set yielded an accuracy of 0.84. The presented results demonstrate the feasibility of a binary classification of laparoscopic image data for the detection of adverse events in a surgical training environment using a specifically configured CNN architecture.
Unternehmen wenden insbesondere bei IT-nahen Projekten seit einigen Jahren auch im Controlling verstärkt ein agiles Vorgehen an. Erfahrungen zeigen jedoch, dass dies nicht bei allen Projekten in jedem Unternehmen funktioniert. Hybride Ansätze, die agile mit klassischen Projekt-Management-Methoden verbinden, bieten eine Lösung.
The situation in the markets is changing rapidly and competition in the business sector is increasing rapidly. As a result, corporate marketing decisions are based on creating greater value for the consumer, which creates competitiveness and provides an advantage in competing for future customer loyalty. The purpose of this study is to determine whether there is a link between marketing communication tools and consumer perceived value in pursuit of consumer loyalty. Qualitative (observational research) and quantitative (a questionnaire survey) research methods were used to investigate the problem empirically. The observational research elucidated the value provided to the consumer by the research objects through marketing communication tools, supplementing the key questions for the quantitative study. Correlation and regression analysis were used in the study, with the results showing a statistically significant relationship between marketing communication tools and consumer perceived value in terms of user loyalty. It has also been determined that the greatest and strongest relationship in consumer value creation through marketing communication tools is the appropriate, mutually coordinated and complementary use of a package of marketing communication tools to achieve synergies that create the preconditions for increasing consumer loyalty in a competitive market.
Access to clinical information during interventions is an important aspect to support the surgeon and his team in the OR. The OR-Pad research project aims at displaying clinically relevant information close to the patient during surgery. With the OR-Pad system, the surgeon shall be able to access case-specific information, displayed on a sterile-packaged, portable display device. Therefore, information shall be prepared before surgery and also be available afterwards. The project follows an user-centered design process. Within the third iteration, the interaction concept was finalized, resulting in an application that can be used in two modes, mobile and intraoperative, to support the surgeon before/after and during surgery, respectively. By supporting the surgeon perioperatively, it is expected to improve the information situation in the OR and thereby the quality of surgical results. Based on this concept, the system architecture was designed in detail, using a client-server architecture. Components, communication interfaces, exchanged data, and intended standards for data exchange of the OR-Pad system including connecting systems were conceived. Expert interviews by using a clickable prototype were conducted to evaluate the concepts.
The paper explains a workflow to simulate the food energy water (FEW) nexus for an urban district combining various data sources like 3D city models, particularly the City Geography Markup Language (CityGML) data model from the Open Geospatial Consortium, Open StreetMap and Census data. A long term vision is to extend the CityGML data model by developing a FEW Application Domain Extension (FEW ADE) to support future FEW simulation workflows such as the one explained in this paper. Together with the mentioned simulation workflow, this paper also identifies some necessary FEW related parameters for the future development of a FEW ADE. Furthermore, relevant key performance indicators are investigated, and the relevant datasets necessary to calculate these indicators are studied. Finally, different calculations are performed for the downtown borough Ville-Marie in the city of Montréal (Canada) for the domains of food waste (FW) and wastewater (WW) generation. For this study, a workflow is developed to calculate the energy generation from anaerobic digestion of FW and WW. In the first step, the data collection and preparation was done. Here relevant data for georeferencing, data for model set-up, and data for creating the required usage libraries, like food waste and wastewater generation per person, were collected. The next step was the data integration and calculation of the relevant parameters, and lastly, the results were visualized for analysis purposes. As a use case to support such calculations, the CityGML level of detail two model of Montréal is enriched with information such as building functions and building usages from OpenStreetMap. The calculation of the total residents based on the CityGML model as the main input for Ville-Marie results in a population of 72,606. The statistical value for 2016 was 89,170, which corresponds to a deviation of 15.3%. The energy recovery potential of FW is about 24,024 GJ/year, and that of wastewater is about 1,629 GJ/year, adding up to 25,653 GJ/year. Relating values to the calculated number of inhabitants in Ville-Marie results in 330.9 kWh/year for FW and 22.4 kWh/year for wastewater, respectively.
Towards Automated Surgical Documentation using automatically generated checklists from BPMN models
(2021)
The documentation of surgeries is usually created from memory only after the operation, which is an additional effort for the surgeon and afflicted with the possibility of imprecisely, shortend reports. The display of process steps in the form of checklists and the automatic creation of surgical documentation from the completed process steps could serve as a reminder, standardize the surgical procedure and save time for the surgeon. Based on two works from Reutlingen University, which implemented the creation of dynamic checklists from Business Process Modelling Notation (BPMN) models and the storage of times at which a process step was completed, a prototype was developed for an android tablet, to expand the dynamic checklists by functions such as uploading photos and files, manual user entries, the interception of foreseeable deviations from the normal course of operations and the automatic creation of OR documentation.
Purpose
Computerized medical imaging processing assists neurosurgeons to localize tumours precisely. It plays a key role in recent image-guided neurosurgery. Hence, we developed a new open-source toolkit, namely Slicer-DeepSeg, for efficient and automatic brain tumour segmentation based on deep learning methodologies for aiding clinical brain research.
Methods
Our developed toolkit consists of three main components. First, Slicer-DeepSeg extends the 3D Slicer application and thus provides support for multiple data input/ output data formats and 3D visualization libraries. Second, Slicer core modules offer powerful image processing and analysis utilities. Third, the Slicer-DeepSeg extension provides a customized GUI for brain tumour segmentation using deep learning-based methods.
Results
The developed Slicer-DeepSeg was validated using a public dataset of high-grade glioma patients. The results showed that our proposed platform’s performance considerably outperforms other 3D Slicer cloud-based approaches.
Conclusions
Developed Slicer-DeepSeg allows the development of novel AI-assisted medical applications in neurosurgery. Moreover, it can enhance the outcomes of computer-aided diagnosis of brain tumours. Open-source Slicer-DeepSeg is available at github.com/razeineldin/Slicer-DeepSeg.
The present work proposes the use of modern ICT technologies such as smartphones, NFCs, internet, and web technologies, to help patients in carrying out their therapies. The implemented system provides a calendar with a reminder of the assumptions, ensures the drug identification through NFC, allows remote assistance from healthcare staff and family members to check and manage the therapy in real-time. The system also provides centralized information on the patient's therapeutic situation, helpful in choosing new compatible therapies.
Preliminary results of homomorphic deconvolution application to surface EMG signals during walking
(2021)
Homomorphic deconvolution is applied to sEMG signals recorded during walking. Gastrocnemius lateralis and tibialis anterior signals were acquired according to SENIAM recommendation. MUAP parameters like amplitude and scale were estimated, whilst the MUAP shape parameter was fixed. This features a useful time-frequency representation of sEMG signal. Estimation of scale MUAP parameter was verified extracting the mean frequency of filtered EMG signal, extracted from the scale parameter estimated with two different MUAP shape values.
Normal breathing during sleep is essential for people’s health and well-being. Therefore, it is crucial to diagnose apnoea events at an early stage and apply appropriate therapy. Detection of sleep apnoea is a central goal of the system design described in this article. To develop a correctly functioning system, it is first necessary to define the requirements outlined in this manuscript clearly. Furthermore, the selection of appropriate technology for the measurement of respiration is of great importance. Therefore, after performing initial literature research, we have analysed in detail three different methods and made a selection of a proper one according to determined requirements. After considering all the advantages and disadvantages of the three approaches, we decided to use the impedance measurement-based one. As a next step, an initial conceptual design of the algorithm for detecting apnoea events was created. As a result, we developed an activity diagram on which the main system components and data flows are visually represented.
Respiratory diseases are leading causes of death and disability in the world. The recent COVID-19 pandemic is also affecting the respiratory system. Detecting and diagnosing respiratory diseases requires both medical professionals and the clinical environment. Most of the techniques used up to date were also invasive or expensive.
Some research groups are developing hardware devices and techniques to make possible a non-invasive or even remote respiratory sound acquisition. These sounds are then processed and analysed for clinical, scientific, or educational purposes.
We present the literature review of non-invasive sound acquisition devices and techniques.
The results are about a huge number of digital tools, like microphones, wearables, or Internet of Thing devices, that can be used in this scope.
Some interesting applications have been found. Some devices make easier the sound acquisition in a clinic environment, but others make possible daily monitoring outside that ambient. We aim to use some of these devices and include the non-invasive recorded respiratory sounds in a Digital Twin system for personalized health.
Bausparverträge sind kombinierte Spar- und Finanzierungsinstrumente, die für die breite Bevölkerung ausgelegt sind. Im Jahr 2020 umfasste der Bestand an Bausparverträgen in Deutschland ca. 25 Mio. Verträge. Ein wesentlicher Teil der Attraktivität des Bausparvertrags für Kunden liegt in der hohen Flexibilität dieser Finanzprodukte, die im Vertragsablauf eine flexible Anpassung an individuelle Finanzierungsbedingungen ermöglicht. In der Sparphase sind das insbesondere Möglichkeiten zur Erhöhung, Ermäßigung und Teilung der Verträge sowie zur relativ flexiblen Anpassung der Sparrate. Bei einem zuteilungsreifen Vertrag kann die Sparphase innerhalb bestimmter zeitlicher Grenzen fortgesetzt werden. In der Darlehensphase sind flexible Sondertilgungen jederzeit und ohne Vorfälligkeitsentschädigung möglich.
Die Vielzahl eingebetteter Optionen beeinflussen sich wechselseitig und müssen in ihrer Wirkungsweise immer gesamthaft betrachtet und gesteuert werden. Die empirische Erfahrung der letzten Jahrzehnte zeigt bezüglich der Optionsausübung ein Kundenverhalten, das sich zwar an finanzmathematischen Überlegungen orientiert, aber nicht vollständig finanzrational abläuft.
Sustainable technologies are being increasingly used in various areas of human life. While they have a multitude of benefits, they are especially useful in health monitoring, especially for certain groups of people, such as the elderly. However, there are still several issues that need to be addressed before its use becomes widespread. This work aims to clarify the aspects that are of great importance for increasing the acceptance of the use of this type of technology in the elderly. In addition, we aim to clarify whether the technologies that are already available are able to ensure acceptable accuracy and whether they could replace some of the manual approaches that are currently being used. A two-week study with people 65 years of age and over was conducted to address the questions posed here, and the results were evaluated. It was demonstrated that simplicity of use and automatic functioning play a crucial role. It was also concluded that technology cannot yet completely replace traditional methods such as questionnaires in some areas. Although the technologies that were tested were classified as being “easy to use”, the elderly population in the current study indicated that they were not sure that they would use these technologies regularly in the long term because the added value is not always clear, among other issues. Therefore, awareness-raising must take place in parallel with the development of technologies and services.
Context
Microservices as a lightweight and decentralized architectural style with fine-grained services promise several beneficial characteristics for sustainable long-term software evolution. Success stories from early adopters like Netflix, Amazon, or Spotify have demonstrated that it is possible to achieve a high degree of flexibility and evolvability with these systems. However, the described advantageous characteristics offer no concrete guidance and little is known about evolvability assurance processes for microservices in industry as well as challenges in this area. Insights into the current state of practice are a very important prerequisite for relevant research in this field.
Objective
We therefore wanted to explore how practitioners structure the evolvability assurance processes for microservices, what tools, metrics, and patterns they use, and what challenges they perceive for the evolvability of their systems.
Method
We first conducted 17 semi-structured interviews and discussed 14 different microservice-based systems and their assurance processes with software professionals from 10 companies. Afterwards, we performed a systematic grey literature review (GLR) and used the created interview coding system to analyze 295 practitioner online resources.
Results
The combined analysis revealed the importance of finding a sensible balance between decentralization and standardization. Guidelines like architectural principles were seen as valuable to ensure a base consistency for evolvability and specialized test automation was a prevalent theme. Source code quality was the primary target for the usage of tools and metrics for our interview participants, while testing tools and productivity metrics were the focus of our GLR resources. In both studies, practitioners did not mention architectural or service-oriented tools and metrics, even though the most crucial challenges like Service Cutting or Microservices Integration were of an architectural nature.
Conclusions
Practitioners relied on guidelines, standardization, or patterns like Event-Driven Messaging to partially address some reported evolvability challenges. However, specialized techniques, tools, and metrics are needed to support industry with the continuous evaluation of service granularity and dependencies. Future microservices research in the areas of maintenance, evolution, and technical debt should take our findings and the reported industry sentiments into account.
Enterprise architecture (EA) is useful for promoting digital transformation in global companies and information societies. In this paper, the authors investigated and analyzed the process for digital transformation in global companies, together with related work in using and applying an enterprise architecture framework for the digital era named the adaptive integrated digital architecture framework (AIDAF). Moreover, they position the AIDAF framework for processing digital transformation in global companies. Based on this analysis, the authors propose and describe a new enterprise architecture process for promoting digital transformation in global companies. Furthermore, the authors propose an adaptive EA cycle-based architecture board framework on digital platforms, while verifying them with case studies in global companies. Finally, the authors clarify the challenges and critical success factors of the process and framework for digital transformation with architecture board reviews in the adaptive EA cycle to assist EA practitioners with its implementation.
Enterprise architecture (EA) is useful for effectively structuring digital platforms with digital transformation in information societies. Moreover, digital platforms in the healthcare industry accelerate and increase the efficiency of drug discovery and development processes. However, there is the lack of knowledge concerning relationships between EA and digital platforms, in spite of the needs of it. In this paper, we investigated and analyzed the process of drug design and development within the healthcare industry, together with related work in using an enterprise architecture framework for the digital era named the Adaptive Integrated Digital Architecture Framework (AIDAF), specifically supporting the design of digital platforms there. Based on this analysis, we evaluate a method and propose a new reference architecture for promoting digital platforms in the healthcare industry, with future specific aspects of them making effective use of Artificial Intelligence (AI). The practical and theoretical contributions include: (1) Streamlined processes through digital platforms in organizations. (2) Informal knowledge supply and sharing among organizational members through digital platforms. (3) Efficiency and effectiveness in planning production and business for drug development. The findings indicate that EA with digital platforms using the AIDAF contribute to digital transformation with effectiveness for new drugs in the healthcare industry.
Theory and practice of implementing a successful enterprise IoT strategy in the industry 4.0 era
(2021)
Since the arrival of the internet and affordable access to technologies, digital technologies have occupied a growing place in industries, propelling us towards a 4th industrial revolution: Industry 4.0. In today’s era of digital upheaval, enterprises are increasingly undergoing transformations that are leading to their digitalization. The traditional manufacturing industry is in the throes of a digital transformation that is accelerated by exponentially growing technologies (e.g., intelligent robots, Internet of Things, sensors, 3D printing). Around the world, enterprises are in a frantic race to implement solutions based on IoT to improve their productivity, innovation, and reduce costs and improve their markets on the international scene. Considering the immense transformative potential that IoTs and big data have to bring to the industrial sector, the adoption of IoT in all industrial systems is a challenge to remain competitive and thus transform the industry into a smart factory. This paper presents the description of the innovation and digitalization process, following the Industry 4.0 paradigm to implement a successful enterprise IoT strategy.
Context:
Test-driven development (TDD) is an agile software development approach that has been widely claimed to improve software quality. However, the extent to which TDD improves quality appears to be largely dependent upon the characteristics of the study in which it is evaluated (e.g., the research method, participant type, programming environment, etc.). The particularities of each study make the aggregation of results untenable.
Objectives:
The goal of this paper is to: increase the accuracy and generalizability of the results achieved in isolated experiments on TDD, provide joint conclusions on the performance of TDD across different industrial and academic settings, and assess the extent to which the characteristics of the experiments affect the quality-related performance of TDD.
Method:
We conduct a family of 12 experiments on TDD in academia and industry. We aggregate their results by means of meta-analysis. We perform exploratory analyses to identify variables impacting the quality-related performance of TDD.
Results:
TDD novices achieve a slightly higher code quality with iterative test-last development (i.e., ITL, the reverse approach of TDD) than with TDD. The task being developed largely determines quality. The programming environment, the order in which TDD and ITL are applied, or the learning effects from one development approach to another do not appear to affect quality. The quality-related performance of professionals using TDD drops more than for students. We hypothesize that this may be due to their being more resistant to change and potentially less motivated than students.
Conclusion:
Previous studies seem to provide conflicting results on TDD performance (i.e., positive vs. negative, respectively). We hypothesize that these conflicting results may be due to different study durations, experiment participants being unfamiliar with the TDD process, or case studies comparing the performance achieved by TDD vs. the control approach (e.g., the waterfall model), each applied to develop a different system. Further experiments with TDD experts are needed to validate these hypotheses.
Software is an integrated part of new features within the automotive sector, car manufacturers, the Hersteller Initiative Software (HIS) consortium defined metrics to determine software quality. Yet, problems with assigning metrics to quality attributes often occur in practice. The specified boundary values lead to discussions between contractors and clients as different standards and metric sets are used. This paper studies metrics used in the automotive sector and the quality attributes they address. The HIS, ISO/IEC 25010:2011, and ISO/IEC 26262:2018 are utilized to draw a big picture illustrating (i) which metrics and boundary values are reported in literature, (ii) how the metrics match the standards, (iii) which quality attributes are addressed, and (iv) how the metrics are supported by tools. Our findings from analyzing 38 papers include a catalog of 112 metrics of which 17 define boundary values and 48 are supported by tools. Most of the metrics are concerned with source code, are generic, and not specifically designed for automotive software development. We conclude that many metrics exist, but a clear definition of the metrics' context, notably regarding the construction of flexible and efficient measurement suites, is missing.
We examine the role of communication from users on dropout from digital learning systems to answer the following questions: (1) how does the sentiment within qualitative signals (user comments) affect dropout rates? (2) does the variance in the proportion of positive and negative sentiments affect dropout rates? (3) how do quantitative signals (e.g. likes) moderate the effect of the qualitative signals? and (4) how does the effect of qualitative signals on dropout rates change across early and late stages of learning? Our hypotheses draws from learning theory and self-regulation theory, and were tested using data of 447 learning videos across 32 series of online tutorials, spanning 12 different fields of learning. The findings indicate a main effect of negative sentiment on dropout rates but no effect of positive sentiment on preventing dropout behaviour. This main effect is stronger in the early stages of learning and weakens at later stages. We also observe an effect of the extent of variance of positive and negative sentiments on dropout behaviour. The effects are negatively moderated by quantitative signals. Overall, making commenting more broad-based rather than polarised can be a useful strategy in managing learning, transferring knowledge, and building consensus.
Context-aware systems to support actors in the operating room depending on the status of the intervention require knowledge about the current situation in the intra-operative area. In literature, solutions to achieve situation awareness already exist for specific use cases, but applicability and transferability to other conditions are less addressed. It is assumed that a unified solution that can be adapted to different processes and sensors would allow for greater flexibility, applicability, and thus transferability to different applications. To enable a flexible and intervention-independent system, this work proposes a concept for an adaptable situation recognition system. The system consists of four layers with several modular components for different functionalities. The feasibility is demonstrated via prototypical implementation and functional evaluation of a first basic framework prototype. Further development goal is the stepwise extension of the prototype.
Massive data transfers in modern data-intensive systems resulting from low data-locality and data-to-code system design hurt their performance and scalability. Near-Data processing (NDP) and a shift to code-to-data designs may represent a viable solution as packaging combinations of storage and compute elements on the same device has become feasible. The shift towards NDP system architectures calls for revision of established principles. Abstractions such as data formats and layouts typically spread multiple layers in traditional DBMS, the way they are processed is encapsulated within these layers of abstraction. The NDP-style processing requires an explicit definition of cross-layer data formats and accessors to ensure in-situ executions optimally utilizing the properties of the underlying NDP storage and compute elements. In this paper, we make the case for such data format definitions and investigate the performance benefits under RocksDB and the COSMOS hardware platform.
Together with many success stories, promises such as the increase in production speed and the improvement in stakeholders' collaboration have contributed to making agile a transformation in the software industry in which many companies want to take part. However, driven either by a natural and expected evolution or by contextual factors that challenge the adoption of agile methods as prescribed by their creator(s), software processes in practice mutate into hybrids over time. Are these still agile In this article, we investigate the question: what makes a software development method agile We present an empirical study grounded in a large-scale international survey that aims to identify software development methods and practices that improve or tame agility. Based on 556 data points, we analyze the perceived degree of agility in the implementation of standard project disciplines and its relation to used development methods and practices. Our findings suggest that only a small number of participants operate their projects in a purely traditional or agile manner (under 15%). That said, most project disciplines and most practices show a clear trend towards increasing degrees of agility. Compared to the methods used to develop software, the selection of practices has a stronger effect on the degree of agility of a given discipline. Finally, there are no methods or practices that explicitly guarantee or prevent agility. We conclude that agility cannot be defined solely at the process level. Additional factors need to be taken into account when trying to implement or improve agility in a software company. Finally, we discuss the field of software process-related research in the light of our findings and present a roadmap for future research.
The cloud evolved into an attractive execution environment for parallel applications, which make use of compute resources to speed up the computation of large problems in science and industry. Whereas Infrastructure as a Service (IaaS) offerings have been commonly employed, more recently, serverless computing emerged as a novel cloud computing paradigm with the goal of freeing developers from resource management issues. However, as of today, serverless computing platforms are mainly used to process computations triggered by events or user requests that can be executed independently of each other and benefit from on-demand and elastic compute resources as well as per-function billing. In this work, we discuss how to employ serverless computing platforms to operate parallel applications. We specifically focus on the class of parallel task farming applications and introduce a novel approach to free developers from both parallelism and resource management issues. Our approach includes a proactive elasticity controller that adapts the physical parallelism per application run according to user-defined goals. Specifically, we show how to consider a user-defined execution time limit after which the result of the computation needs to be present while minimizing the associated monetary costs. To evaluate our concepts, we present a prototypical elastic parallel system architecture for self-tuning serverless task farming and implement two applications based on our framework. Moreover, we report on performance measurements for both applications as well as the prediction accuracy of the proposed proactive elasticity control mechanism and discuss our key findings.
Entrepreneurial software engineering: towards a hybrid development method for early-stage startups
(2021)
A considerable share of innovative software-intensive products is developed by startups. However, product development in an early-stage startup is not a sequential process. A business idea is usually based on a number of assumptions. The riskiest assumptions need to be tested. Depending on the test results, a product strategy may change several times. This raises the question of how to create sufficiently stable software using engineering principles despite a dynamic product strategy that is subject to many uncertainties. Hybrid development methods that combine agile aspects with classical engineering methods seem to be a good choice in such a start-up context. This paper proposes a lightweight hybrid development method that provides early-stage startups with a framework to support the development of single-feature minimum viable products. The method was derived from a start-up company's founding case and evaluated in expert interviews. The proposed method is intended to provide a basis for discussion between practitioners and scientists with the aim of better understanding the application of software engineering principles in software start-ups.
Science-based analysis for climate action: how HSBC Bank uses the En-ROADS climate policy simulation
(2021)
In 2018, the Intergovernmental Panel on Climate Change (IPCC, 2018) found that rapid decarbonization and net negative greenhouse gas (GHG) emissions by mid-century are required to "hold the increase in global average temperature to well below 2°C above pre-industrial levels and pursue efforts to limit the temperature increase to 1.5°C," as stipulated by the Paris Agreement (UNFCCC, 2015, p. 2). Meeting these goals reduces physical climate-related risks from, for example, sea-level rise, ocean acidification, extreme weather, water shortages, declining crop yields, and other impacts. These impacts threaten our economy, security, health, and lives.
At the same time, policies to mitigate these harms by rapidly reducing GHG emissions can create transition risks for businesses - for example, stranded assets and loss of market value for fossil fuel producers and firms dependent on fossil energy (Carney, 2019). Rapid decarbonization requires an unprecedented energy transition (IEA, 2021a) driven by and affecting economic players including businesses, asset managers, and investors in all sectors and all countries (Kriegler et al., 2014).
However, GHG emissions are not falling rapidly enough to meet the goals of the Paris Agreement (Holz et al., 2018). The UNFCCC, 2021 found that the emissions reductions pledged by all nations as of early 2021 "fall far short of what is required, demonstrating the need for Parties to further strengthen their mitigation commitments under the Paris Agreement" (2021, p. 5). Businesses are faring no better. Despite high-profile calls to action from influential firms such as BlackRock (Fink, 2018, 2021), corporate action to meet climate goals has thus far fallen short (e.g. the Right, 2019 analysis of the German DAX 30 companies' emissions targets by NGO "right."). Instead of implementing climate strategies that might mitigate the risks, managers are often caught up in "firefighting" and capability traps that erode the resources needed for ambitious climate action (Sterman, 2015). Firms may also exaggerate environmental accomplishments, leading to greenwashing (Lyon and Maxwell, 2011); implement policies that are vague, rely on unproven offsets, or are not climate neutral (e.g. Sterman et al., 2018); or simply take no action at all (Delmas and Burbano, 2011; Sterman, 2015).
Adding to the confusion are difficulties evaluating the effectiveness of different climate policies. Misperceptions include wait-and-see approaches (Dutt and Gonzalez, 2012; Sterman, 2008), underestimating time delays and ignoring the unintended consequences of policies (Sterman, 2008), and beliefs in "silver bullet" solutions (Gilbert, 2009; Kriegler et al., 2013; Shackley and Dütschke, 2012). These beliefs arise in part because the climate–energy system is a high-dimensional dynamic system characterized by long time delays, multiple feedback loops, and nonlinearities (Sterman, 2011), while even simple systems are difficult for people to understand (Booth Sweeney and Sterman, 2000; Cronin et al., 2009; Kapmeier et al., 2017). Although senior executives might receive briefings on climate change, simply providing more information does not necessarily lead to more effective action (Pearce et al., 2015; Sterman, 2011).
Alternatively, interactive approaches to learning about climate change and policies to mitigate it can trigger climate action (Creutzig and Kapmeier, 2020). Decision-makers require tools and methods grounded in science that enable them to learn for themselves how a low-carbon economy can be achieved and how climate policies condition physical and transition risks. The system dynamics climate–energy simulation En-ROADS (Energy-Rapid Overview and Decision Support; Jones et al., 2019b), codeveloped by the climate think-tank Climate Interactive and the MIT Sloan Sustainability Initiative, provides such a tool.
Here we show how En-ROADS helps HSBC Bank U.S.A., the American subsidiary of U.K.-based multinational financial services company HSBC Holdings plc, focus its global sustainability strategy on activities with higher impact and relevance, communicate and implement the strategy, understand transition risks, and better align the strategy with global climate goals. We show how the versatility and interactivity of En-ROADS increases its reach throughout the organization. Finally, we discuss challenges and lessons learned that may be helpful to other organizations.
Introduction
Despite its high accuracy, polysomnography (PSG) has several drawbacks for diagnosing obstructive sleep apnea (OSA). Consequently, multiple portable monitors (PMs) have been proposed.
Objective
This systematic review aims to investigate the current literature to analyze the sets of physiological parameters captured by a PM to select the minimum number of such physiological signals while maintaining accurate results in OSA detection.
Methods
Inclusion and exclusion criteria for the selection of publications were established prior to the search. The evaluation of the publications was made based on one central question and several specific questions.
Results
The abilities to detect hypopneas, sleep time, or awakenings were some of the features studied to investigate the full functionality of the PMs to select the most relevant set of physiological signals. Based on the physiological parameters collected (one to six), the PMs were classified into sets according to the level of evidence. The advantages and the disadvantages of each possible set of signals were explained by answering the research questions proposed in the methods.
Conclusions
The minimum number of physiological signals detected by PMs for the detection of OSA depends mainly on the purpose and context of the sleep study. The set of three physiological signals showed the best results in the detection of OSA.
Accurate and safe neurosurgical intervention can be affected by intra-operative tissue deformation, known as brain-shift. In this study, we propose an automatic, fast, and accurate deformable method, called iRegNet, for registering pre-operative magnetic resonance images to intra-operative ultrasound volumes to compensate for brain-shift. iRegNet is a robust end-to-end deep learning approach for the non-linear registration of MRI-iUS images in the context of image-guided neurosurgery. Pre-operative MRI (as moving image) and iUS (as fixed image) are first appended to our convolutional neural network, after which a non-rigid transformation field is estimated. The MRI image is then transformed using the output displacement field to the iUS coordinate system. Extensive experiments have been conducted on two multi-location databases, which are the BITE and the RESECT. Quantitatively, iRegNet reduced the mean landmark errors from pre-registration value of (4.18 ± 1.84 and 5.35 ± 4.19 mm) to the lowest value of (1.47 ± 0.61 and 0.84 ± 0.16 mm) for the BITE and RESECT datasets, respectively. Additional qualitative validation of this study was conducted by two expert neurosurgeons through overlaying MRI-iUS pairs before and after the deformable registration. Experimental findings show that our proposed iRegNet is fast and achieves state-of-the-art accuracies outperforming state-of-the-art approaches. Furthermore, the proposed iRegNet can deliver competitive results, even in the case of non-trained images as proof of its generality and can therefore be valuable in intra-operative neurosurgical guidance.
In recent years, the Graph Model has become increasingly popular, especially in the application domain of social networks. The model has been semantically augmented with properties and labels attached to the graph elements. It is difficult to ensure data quality for the properties and the data structure because the model does not need a schema. In this paper, we propose a schema bound Typed Graph Model with properties and labels. These enhancements improve not only data quality but also the quality of graph analysis. The power of this model is provided by using hyper-nodes and hyper-edges, which allows to present data structures on different abstraction levels. We prove that the model is at least equivalent in expressive power to most popular data models. Therefore, it can be used as a supermodel for model management and data integration. We illustrate by example the superiority of this model over the property graph data model of Hidders and other prevalent data models, namely the relational, object-oriented, XML model, and RDF Schema.
Background: One of the most promising health care development areas is introducing telemedicine services and creating solutions based on blockchain technology. The study of systems combining both these domains indicates the ongoing expansion of digital technologies in this market segment.
Objective: This paper aims to review the feasibility of blockchain technology for telemedicine.
Methods: The authors identified relevant studies via systematic searches of databases including PubMed, Scopus, Web of Science, IEEE Xplore, and Google Scholar. The suitability of each for inclusion in this review was assessed independently. Owing to the lack of publications, available blockchain-based tokens were discovered via conventional web search engines (Google, Yahoo, and Yandex).
Results: Of the 40 discovered projects, only 18 met the selection criteria. The 5 most prevalent features of the available solutions (N=18) were medical data access (14/18, 78%), medical service processing (14/18, 78%), diagnostic support (10/18, 56%), payment transactions (10/18, 56%), and fundraising for telemedical instrument development (5/18, 28%).
Conclusions: These different features (eg, medical data access, medical service processing, epidemiology reporting, diagnostic support, and treatment support) allow us to discuss the possibilities for integration of blockchain technology into telemedicine and health care on different levels. In this area, a wide range of tasks can be identified that could be accomplished based on digital technologies using blockchains.