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Context: Companies that operate in the software-intensive business are confronted with high market dynamics, rapidly evolving technologies as well as fast-changing customer behavior. Traditional product roadmapping practices, such as fixed-time-based charts including detailed planned features, products, or services typically fail in such environments. Until now, the underlying reasons for the failure of product roadmaps in a dynamic and uncertain market environment are not widely analyzed and understood.
Objective: This paper aims to identify current challenges and pitfalls practitioners face when developing and handling product roadmaps in a dynamic and uncertain market environment.
Method: To reach our objective we conducted a grey literature review (GLR).
Results: Overall, we identified 40 relevant papers, from which we could extract 11 challenges of the application of product roadmapping in a dynamic and uncertain market environment. The analysis of the articles showed that the major challenges for practitioners originate from overcoming a feature-driven mindset, not including a lot of details in the product roadmap, and ensuring that the content of the roadmap is not driven by management or expert opinion.
„Bürgerrechtler klagen gegen Weitergabe von Gesundheitsdaten“ – so titelt (spiegel.de, 2022) am 29.04.2022. Dabei geht es um die Weitergabe pseudonymisierter Daten von 73 Millionen Versicherten durch die gesetzlichen Krankenkassen. Diese Daten sollen der Forschung zur Verfügung gestellt werden. Die Kläger bezweifeln, dass die Daten nicht deanonymisiert werden können. Dieses aktuelle Beispiel zeigt einen konkreten und relevanten Anwendungsfall des Themas Anonymisierung/Pseudonymisierung im aktuariellen Kontext auf. Es ist davon auszugehen, dass die Relevanz in den kommenden Jahren weiter zunehmen wird.
Spätestens seit dem Inkrafttreten der DSGVO ist das Thema Datenschutz allgegenwärtig und stellt uns Aktuare vor große Herausforderungen. Europäische Initiativen zur Schaffung eines Binnenmarktes für Daten sollen zwar die Möglichkeit schaffen, Daten einfacher zu teilen und so beispielsweise Dritten für Forschungszwecke zur Verfügung zu stellen, werfen aber auch viele Fragestellungen auf. Eine naheliegende Lösung ist es, Daten zu anonymisieren oder zu pseudonymisieren. Aber was bedeutet das konkret und welche Konsequenzen ergeben sich daraus? Bis zu welchem Grad müssen Daten anonymisiert werden und welche ReIdentifikationsrisiken bestehen weiterhin?
Ultra wideband real-time locating system for tracking people and devices in the operating room
(2022)
Position tracking within the OR could be one possible input for intraoperative situation recognition. Our approach demonstrates a Real-time Locating System (RTLS) using the Ultra Wideband (UWB) technology to determine the position of people or objects. The UWB RTLS was integrated into the research OR at Reutlingen University and the system’s settings were optimized regarding the four factors accuracy, susceptibility to interference, range, and latency. Therefore, different parameters were adapted and the effects on the factors were compared. Goodtracking quality could be achieved under optimal settings. These results indicate that a UWB RTLS is well suited to determine the position of people and devices in our setting. The feasibility of the system needsto be evaluated under real OR conditions.
Turning students into Industry 4.0 entrepreneurs: design and evaluation of a tailored study program
(2022)
Startups in the field of Industry 4.0 could be a huge driver of innovation for many industry sectors such as manufacturing. However, there is a lack of education programs to ensure a sufficient number of well-trained founders and thus a supply of such startups. Therefore, this study presents the design, implementation, and evaluation of a university course tailored to the characteristics of Industry 4.0 entrepreneurship. Educational design-based research was applied with a focus on content and teaching concept. The study program was first implemented in 2021 at a German university of applied sciences with 25 students, of which 22 participated in the evaluation. The evaluation of the study program was conducted with a pretest–posttest-design targeting three areas: (1) knowledge about the application domain, (2) entrepreneurial intention and (3) psychological characteristics. The entrepreneurial intention was measured based on the theory of planned behavior. For measuring psychological characteristics, personality traits associated with entrepreneurship were used. Considering the study context and the limited external validity of the study, the following can be identified in particular: The results show that a university course can improve participants' knowledge of this particular area. In addition, perceived behavioral control of starting an Industry 4.0 startup was enhanced. However, the results showed no significant effects on psychological characteristics.
Today, companies face increasing market dynamics, rapidly evolving technologies, and rapid changes in customer behavior. Traditional approaches to product development typically fail in such environments and require companies to transform their often feature-driven mindset into a product-led mindset. A promising first step on the way to a product-led company is a better understanding of how product planning can be adapted to the requirements of an increasingly dynamic and uncertain market environment in the sense of product roadmapping. The authors developed the DEEP product roadmap assessment tool to help companies evaluate their current product roadmap practices and identify appropriate actions to transition to a more product-led company. Objective: The goal of this paper is to gain insight into the applicability and usefulness of version 1.1 of the DEEP model. In addition, the benefits, and implications of using the DEEP model in corporate contexts will be explored. Method: We conducted a multiple case study in which participants were observed using the DEEP model. We then interviewed each participant to understand their perceptions of the DEEP model. In addition, we conducted interviews with each company's product management department to learn how the application of the DEEP model influenced their attitudes toward product roadmapping. Results: The study showed that by applying the DEEP model, participants better understood which artifacts and methods were critical to product roadmapping success in a dynamic and uncertain market environment. In addition, the application of the DEEP model helped convince management and other stakeholders of the need to change current product roadmapping practices. The application also proved to be a suitable starting point for the transformation in the participating companies.
With the progress of technology in modern hospitals, an intelligent perioperative situation recognition will gain more relevance due to its potential to substantially improve surgical workflows by providing situation knowledge in real-time. Such knowledge can be extracted from image data by machine learning techniques but poses a privacy threat to the staff’s and patients’ personal data. De-identification is a possible solution for removing visual sensitive information. In this work, we developed a YOLO v3 based prototype to detect sensitive areas in the image in real-time. These are then deidentified using common image obfuscation techniques. Our approach shows that it is principle suitable for de-identifying sensitive data in OR images and contributes to a privacyrespectful way of processing in the context of situation recognition in the OR.
The euphoria around microservices has decreased over the years, but the trend of modernizing legacy systems to this novel architectural style is unbroken to date. A variety of approaches have been proposed in academia and industry, aiming to structure and automate the often long-lasting and cost-intensive migration journey. However, our research shows that there is still a need for more systematic guidance. While grey literature is dominant for knowledge exchange among practitioners, academia has contributed a significant body of knowledge as well, catching up on its initial neglect. A vast number of studies on the topic yielded novel techniques, often backed by industry evaluations. However, practitioners hardly leverage these resources. In this paper, we report on our efforts to design an architecture-centric methodology for migrating to microservices. As its main contribution, a framework provides guidance for architects during the three phases of a migration. We refer to methods, techniques, and approaches based on a variety of scientific studies that have not been made available in a similarly comprehensible manner before. Through an accompanying tool to be developed, architects will be in a position to systematically plan their migration, make better informed decisions, and use the most appropriate techniques and tools to transition their systems to microservices.
Public transport maps are typically designed in a way to support route finding tasks for passengers, while they also provide an overview about stations, metro lines, and city-specific attractions. Most of those maps are designed as a static representation, maybe placed in a metro station or printed in a travel guide. In this paper, we describe a dynamic, interactive public transport map visualization enhanced by additional views for the dynamic passenger data on different levels of temporal granularity. Moreover, we also allow extra statistical information in form of density plots, calendar-based visualizations, and line graphs. All this information is linked to the contextual metro map to give a viewer insights into the relations between time points and typical routes taken by the passengers. We also integrated a graph-based view on user-selected routes, a way to interactively compare those routes, an attribute- and property-driven automatic computation of specific routes for one map as well as for all available maps in our repertoire, and finally, also the most important sights in each city are included as extra information to include in a user-selected route. We illustrate the usefulness of our interactive visualization and map navigation system by applying it to the railway system of Hamburg in Germany while also taking into account the extra passenger data. As another indication for the usefulness of the interactively enhanced metro maps we conducted a controlled user experiment with 20 participants.
In our initial DaMoN paper, we set out the goal to revisit the results of “Starring into the Abyss [...] of Concurrency Control with [1000] Cores” (Yu in Proc. VLDB Endow 8: 209-220, 2014). Against their assumption, today we do not see single-socket CPUs with 1000 cores. Instead, multi-socket hardware is prevalent today and in fact offers over 1000 cores. Hence, we evaluated concurrency control (CC) schemes on a real (Intel-based) multi-socket platform. To our surprise, we made interesting findings opposing results of the original analysis that we discussed in our initial DaMoN paper. In this paper, we further broaden our analysis, detailing the effect of hardware and workload characteristics via additional real hardware platforms (IBM Power8 and 9) and the full TPC-C transaction mix. Among others, we identified clear connections between the performance of the CC schemes and hardware characteristics, especially concerning NUMA and CPU cache. Overall, we conclude that no CC scheme can efficiently make use of large multi-socket hardware in a robust manner and suggest several directions on how CC schemes and overall OLTP DBMS should evolve in future.
Background
Although teledermatology has been proven internationally to be an effective and safe addition to the care of patients in primary care, there are few pilot projects implementing teledermatology in routine outpatient care in Germany. The aim of this cluster randomized controlled trial was to evaluate whether referrals to dermatologists are reduced by implementing a store-and-forward teleconsultation system in general practitioner practices.
Methods
Eight counties were cluster randomized to the intervention and control conditions. During the 1-year intervention period between July 2018 and June 2019, 46 general practitioner practices in the 4 intervention counties implemented a store-and-forward teledermatology system with Patient Data Management System interoperability. It allowed practice teams to initiate teleconsultations for patients with dermatologic complaints. In the four control counties, treatment as usual was performed. As primary outcome, number of referrals was calculated from routine health care data. Poisson regression was used to compare referral rates between the intervention practices and 342 control practices.
Results
The primary analysis revealed no significant difference in referral rates (relative risk = 1.02; 95% confidence interval = 0.911–1.141; p = .74). Secondary analyses accounting for sociodemographic and practice characteristics but omitting county pairing resulted in significant differences of referral rates between intervention practices and control practices. Matched county pair, general practitioner age, patient age, and patient sex distribution in the practices were significantly related to referral rates.
Conclusions
While a store-and-forward teleconsultation system was successfully implemented in the German primary health care setting, the intervention's effect was superimposed by regional factors. Such regional factors should be considered in future teledermatology research.
Background
Personalized medicine requires the integration and analysis of vast amounts of patient data to realize individualized care. With Surgomics, we aim to facilitate personalized therapy recommendations in surgery by integration of intraoperative surgical data and their analysis with machine learning methods to leverage the potential of this data in analogy to Radiomics and Genomics.
Methods
We defined Surgomics as the entirety of surgomic features that are process characteristics of a surgical procedure automatically derived from multimodal intraoperative data to quantify processes in the operating room. In a multidisciplinary team we discussed potential data sources like endoscopic videos, vital sign monitoring, medical devices and instruments and respective surgomic features. Subsequently, an online questionnaire was sent to experts from surgery and (computer) science at multiple centers for rating the features’ clinical relevance and technical feasibility.
Results
In total, 52 surgomic features were identified and assigned to eight feature categories. Based on the expert survey (n = 66 participants) the feature category with the highest clinical relevance as rated by surgeons was “surgical skill and quality of performance” for morbidity and mortality (9.0 ± 1.3 on a numerical rating scale from 1 to 10) as well as for long-term (oncological) outcome (8.2 ± 1.8). The feature category with the highest feasibility to be automatically extracted as rated by (computer) scientists was “Instrument” (8.5 ± 1.7). Among the surgomic features ranked as most relevant in their respective category were “intraoperative adverse events”, “action performed with instruments”, “vital sign monitoring”, and “difficulty of surgery”.
Conclusion
Surgomics is a promising concept for the analysis of intraoperative data. Surgomics may be used together with preoperative features from clinical data and Radiomics to predict postoperative morbidity, mortality and long-term outcome, as well as to provide tailored feedback for surgeons.
Database management systems and K/V-Stores operate on updatable datasets – massively exceeding the size of available main memory. Tree-based K/V storage management structures became particularly popular in storage engines. B+ -Trees [1, 4] allow constant search performance, however write-heavy workloads yield in inefficient write patterns to secondary storage devices and poor performance characteristics. LSM-Trees [16, 23] overcome this issue by horizontal partitioning fractions of data – small enough to fully reside in main memory, but require frequent maintenance to sustain search performance.
Firstly, we propose Multi-Version Partitioned BTrees (MV-PBT) as sole storage and index management structure in key-sorted storage engines like K/V-Stores. Secondly, we compare MV-PBT against LSM-Trees. The logical horizontal partitioning in MV-PBT allows leveraging recent advances in modern B+ -Tree techniques in a small transparent and memory resident portion of the structure. Structural properties sustain steady read performance, yielding efficient write patterns and reducing write amplification.
We integrated MV-PBT in the WiredTiger [15] KV storage engine. MV-PBT offers an up to 2× increased steady throughput in comparison to LSM-Trees and several orders of magnitude in comparison to B+ -Trees in a YCSB [5] workload.
One of the key challenges for automatic assistance is the support of actors in the operating room depending on the status of the procedure. Therefore, context information collected in the operating room is used to gain knowledge about the current situation. In literature, solutions already exist for specific use cases, but it is doubtful to what extent these approaches can be transferred to other conditions. We conducted a comprehensive literature research on existing situation recognition systems for the intraoperative area, covering 274 articles and 95 cross-references published between 2010 and 2019. We contrasted and compared 58 identified approaches based on defined aspects such as used sensor data or application area. In addition, we discussed applicability and transferability. Most of the papers focus on video data for recognizing situations within laparoscopic and cataract surgeries. Not all of the approaches can be used online for real-time recognition. Using different methods, good results with recognition accuracies above 90% could be achieved. Overall, transferability is less addressed. The applicability of approaches to other circumstances seems to be possible to a limited extent. Future research should place a stronger focus on adaptability. The literature review shows differences within existing approaches for situation recognition and outlines research trends. Applicability and transferability to other conditions are less addressed in current work.
The respiratory rate is a vital sign indicating breathing illness. It is necessary to analyze the mechanical oscillations of the patient's body arising from chest movements. An inappropriate holder on which the sensor is mounted, or an inappropriate sensor position is some of the external factors which should be minimized during signal registration. This paper considers using a non-invasive device placed under the bed mattress and evaluates the respiratory rate. The aim of the work is the development of an accelerometer sensor holder for this system. The normal and deep breathing signals were analyzed, corresponding to the relaxed state and when taking deep breaths. The evaluation criterion for the holder's model is its influence on the patient's respiratory signal amplitude for each state. As a result, we offer a non-invasive system of respiratory rate detection, including the mechanical component providing the most accurate values of mentioned respiratory rate.
Purpose
Context awareness in the operating room (OR) is important to realize targeted assistance to support actors during surgery. A situation recognition system (SRS) is used to interpret intraoperative events and derive an intraoperative situation from these. To achieve a modular system architecture, it is desirable to de-couple the SRS from other system components. This leads to the need of an interface between such an SRS and context-aware systems (CAS). This work aims to provide an open standardized interface to enable loose coupling of the SRS with varying CAS to allow vendor-independent device orchestrations.
Methods
A requirements analysis investigated limiting factors that currently prevent the integration of CAS in today's ORs. These elicited requirements enabled the selection of a suitable base architecture. We examined how to specify this architecture with the constraints of an interoperability standard. The resulting middleware was integrated into a prototypic SRS and our system for intraoperative support, the OR-Pad, as exemplary CAS for evaluating whether our solution can enable context-aware assistance during simulated orthopedical interventions.
Results
The emerging Service-oriented Device Connectivity (SDC) standard series was selected to specify and implement a middleware for providing the interpreted contextual information while the SRS and CAS are loosely coupled. The results were verified within a proof of concept study using the OR-Pad demonstration scenario. The fulfillment of the CAS’ requirements to act context-aware, conformity to the SDC standard series, and the effort for integrating the middleware in individual systems were evaluated. The semantically unambiguous encoding of contextual information depends on the further standardization process of the SDC nomenclature. The discussion of the validity of these results proved the applicability and transferability of the middleware.
Conclusion
The specified and implemented SDC-based middleware shows the feasibility of loose coupling an SRS with unknown CAS to realize context-aware assistance in the OR.
Motivation: Aim of this project is the automatic classification of total hip endoprosthesis (THEP) components in 2D Xray images. Revision surgeries of total hip arthroplasty (THA) are common procedures in orthopedics and trauma surgery. Currently, around 400.000 procedures per year are performed in the United States (US) alone. To achieve the best possible result, preoperative planning is crucial. Especially if parts of the current THEP system are to be retained.
Methods: First, a ground truth based on 76 X-ray images was created: We used an image processing pipeline consisting of a segmentation step performed by a convolutional neural network and a classification step performed by a support vector machine (SVM). In total, 11 classes (5 pans and 6 shafts) shall be classified.
Results: The ground truth generated was of good quality even though the initial segmentation was performed by technicians. The best segmentation results were achieved using a U-net architecture. For classification, SVM architectures performed much better than additional neural networks.
Conclusions: The overall image processing pipeline performed well, but the ground truth needs to be extended to include a broader variability of implant types and more examples per training class.
Current data-intensive systems suffer from scalability as they transfer massive amounts of data to the host DBMS to process it there. Novel near-data processing (NDP) DBMS architectures and smart storage can provably reduce the impact of raw data movement. However, transferring the result-set of an NDP operation may increase the data movement, and thus, the performance overhead. In this paper, we introduce a set of in-situ NDP result-set management techniques, such as spilling, materialization, and reuse. Our evaluation indicates a performance improvement of 1.13 × to 400 ×.
Since half a decade, there has been an increasing interest in Robotic Process Automation (RPA) by business firms. However, academic literature has been lacking attention to RPA, before adopting the topic to a larger extent. The aim of this study is to review and structure the latest state of scholarly research on RPA. This chapter is based on a systematic literature review that is used as a basis to develop a conceptual framework to structure the field. Our study shows that some areas of RPA have been extensively examined by many authors, e.g. potential benefits of RPA. Other categories, such as empirical studies on adoption of RPA or organisational readiness models, have remained research gaps.
Uncontrolled movement of instruments in laparoscopic surgery can lead to inadvertent tissue damage, particularly when the dissecting or electrosurgical instrument is located outside the field of view of the laparoscopic camera. The incidence and relevance of such events are currently unknown. The present work aims to identify and quantify potentially dangerous situations using the example of laparoscopic cholecystectomy (LC). Twenty-four final year medical students were prompted to each perform four consecutive LC attempts on a well-established box trainer in a surgical training environment following a standardized protocol in a porcine model. The following situation was defined as a critical event (CE): the dissecting instrument was inadvertently located outside the laparoscopic camera’s field of view. Simultaneous activation of the electrosurgical unit was defined as a highly critical event (hCE). Primary endpoint was the incidence of CEs. While performing 96 LCs, 2895 CEs were observed. Of these, 1059 (36.6%) were hCEs. The median number of CEs per LC was 20.5 (range: 1–125; IQR: 33) and the median number of hCEs per LC was 8.0 (range: 0–54, IQR: 10). Mean total operation time was 34.7 min (range: 15.6–62.5 min, IQR: 14.3 min). Our study demonstrates the significance of CEs as a potential risk factor for collateral damage during LC. Further studies are needed to investigate the occurrence of CE in clinical practice, not just for laparoscopic cholecystectomy but also for other procedures. Systematic training of future surgeons as well as technical solutions address this safety issue.
We present a multitask network that supports various deep neural network based pedestrian detection functions. Besides 2D and 3D human pose, it also supports body and head orientation estimation based on full body bounding box input. This eliminates the need for explicit face recognition. We show that the performance of 3D human pose estimation and orientation estimation is comparable to the state-of-the-art. Since very few data sets exist for 3D human pose and in particular body and head orientation estimation based on full body data, we further show the benefit of particular simulation data to train the network. The network architecture is relatively simple, yet powerful, and easily adaptable for further research and applications.