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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 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.
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.
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.
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.
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.
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.