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Over the past decade, artificial intelligence (AI) methods in pathology have advanced substantially. However, integration into routine clinical practice has been slow due to numerous challenges, including technical and regulatory hurdles in translating research results into clinical diagnostic products and the lack of standardized interfaces.The open and vendor-neutral EMPAIA initiative addresses these challenges. Here, we provide an overview of EMPAIA's achievements and lessons learned. EMPAIA integrates various stakeholders of the pathology AI ecosystem, i.e., pathologists, computer scientists, and industry. In close collaboration, we developed technical interoperability standards, recommendations for AI testing and product development, and explainability methods. We implemented the modular and open-source EMPAIA Platform and successfully integrated 14 AI-based image analysis apps from eight different vendors, demonstrating how different apps can use a single standardized interface. We prioritized requirements and evaluated the use of AI in real clinical settings with 14 different pathology laboratories in Europe and Asia. In addition to technical developments, we created a forum for all stakeholders to share information and experiences on digital pathology and AI. Commercial, clinical, and academic stakeholders can now adopt EMPAIA's common open-source interfaces, providing a unique opportunity for large-scale standardization and streamlining of processes.Further efforts are needed to effectively and broadly establish AI assistance in routine laboratory use. To this end, a sustainable infrastructure, the non-profit association EMPAIA International, has been established to continue standardization and support broad implementation and advocacy for an AI-assisted digital pathology future.

Objective The exchange of health-related data is subject to regional laws and regulations, such as the General Data Protection Regulation (GDPR) in the EU or the Health Insurance Portability and Accountability Act (HIPAA) in the United States, resulting in non-trivial challenges for researchers and educators when working with these data. In pathology, the digitization of diagnostic tissue samples inevitably generates identifying data that can consist of sensitive but also acquisition-related information stored in vendor-specific file formats. Distribution and off-clinical use of these Whole Slide Images (WSIs) are usually done in these formats, as an industry-wide standardization such as DICOM is yet only tentatively adopted and slide scanner vendors currently do not provide anonymization functionality. Methods We developed a guideline for the proper handling of histopathological image data particularly for research and education with regard to the GDPR. In this context, we evaluated existing anonymization methods and examined proprietary format specifications to identify all sensitive information for the most common WSI formats. This work results in a software library that enables GDPR-compliant anonymization of WSIs while preserving the native formats. Results Based on the analysis of proprietary formats, all occurrences of sensitive information were identified for file formats frequently used in clinical routine, and finally, an open-source programming library with an executable CLI tool and wrappers for different programming languages was developed. Conclusions Our analysis showed that there is no straightforward software solution to anonymize WSIs in a GDPR-compliant way while maintaining the data format. We closed this gap with our extensible open-source library that works instantaneously and offline.

Background: Previous studies suggest that brain atrophy can not only be defined by its morphological extent, but also by the cerebral blood flow (CBF) within a certain area of the brain, including white and gray matter. The aim of this study is to investigate known atrophy patterns in different forms of dementia and to compare segmented brain volumetrics and pulsed arterial spin labeling (pASL) data to explore the correlation between brain maps with atrophy and this non-contrast-enhanced brain-perfusion method. Methods: Our study comprised 17 patients with diagnosed cognitive impairment (five Alzheimer’s disease = AD, five frontotemporal dementia = FTD, seven mild cognitive impairment = MCI) and 19 healthy control subjects (CO). All patients and controls underwent 4D-pASL brain-perfusion MR imaging and T1w MPRAGE. The data were assessed regarding relative brain volume on the basis of 286 brain regions, and absolute and relative cerebral blood flow (CBF/rCBF) were derived from pASL data in the corresponding brain regions. Mini-Mental State Examination (MMSE) was performed to assess cognitive functions. Results: FTD patients demonstrated significant brain atrophy in 43 brain regions compared to CO. Patients with MCI showed significant brain atrophy in 18 brain regions compared to CO, whereas AD patients only showed six brain regions with significant brain atrophy compared to CO. There was good correlation of brain atrophy and pASL perfusion data in five brain regions of patients with diagnosed FTD, especially in the superior temporal gyrus (r = 0.900, p = 0.037), the inferior frontal white matter (pars orbitalis; r = 0.968, p = 0.007) and the thalami (r = 0.810, p = 0.015). Patients with MCI demonstrated a correlation in one brain region (left inferior fronto-occipital fasciculus; r = 0.786, p = 0.036), whereas patients with diagnosed AD revealed no correlation. Conclusions: pASL can detect affected brain regions in cognitive impairment and corresponds with brain atrophy, especially for patients suffering from FTD and MCI. However, there was no correlation of perfusion alterations and brain atrophy in AD. pASL perfusion might thus represent a promising tool for noninvasive brain-perfusion evaluation in specific dementia subtypes as a complimentary imaging-based bio marker in addition to brain volumetry.

Abstract The high‐frequency and low‐voltage operation of organic thin‐film transistors (OTFTs) is a key requirement for the commercial success of flexible electronics. Significant progress has been achieved in this regard by several research groups highlighting the potential of OTFTs to operate at several tens or even above 100 MHz. However, technology maturity, including scalability, integrability, and device reliability, is another crucial point for the semiconductor industry to bring OTFT‐based flexible electronics into mass production. These requirements are often not met by high‐frequency OTFTs reported in the literature as unconventional processes, such as shadow‐mask patterning or alignment with unrealistic tolerances for production, are used. Here, ultra‐short channel vertical organic field‐effect transistors (VOFETs) with a unity current gain cut‐off frequency (fT) up to 43.2 MHz (or 4.4 MHz V−1) operating below 10 V are shown. Using state‐of‐the‐art manufacturing techniques such as photolithography with reliable fabrication procedures, the integration of such devices down to the size of only 12 × 6 µm2 is shown, which is important for the adaption of this technology in high‐density circuits (e.g., display driving). The intrinsic channel transconductance is analyzed and demonstrates that the frequencies up to 430 MHz can be reached if the parasitic electrode overlap is minimized.

Biomechanical simulation allows for in silico estimations of biomechanical parameters such as muscle, joint and ligament forces. Experimental kinematic measurements are a prerequisite for musculoskeletal simulations using the inverse kinematics approach. Marker-based optical motion capture systems are frequently used to collect this motion data. As an alternative, IMU-based motion capture systems can be used. These systems allow flexible motion collection without nearly any restriction regarding the environment. However, one limitation with these systems is that there is no universal way to transfer IMU data from arbitrary full-body IMU measurement systems into musculoskeletal simulation software such as OpenSim. Thus, the objective of this study was to enable the transfer of collected motion data, stored as a BVH file, to OpenSim 4.4 to visualize and analyse the motion using musculoskeletal models. By using the concept of virtual markers, the motion saved in the BVH file is transferred to a musculoskeletal model. An experimental study with three participants was conducted to verify our method’s performance. Results show that the present method is capable of (1) transferring body dimensions saved in the BVH file to a generic musculoskeletal model and (2) correctly transferring the motion data saved in the BVH file to a musculoskeletal model in OpenSim 4.4.

The computer aided internal optimisation (CAIO) method produces an optimised fibre layout for parts made from fibre-reinforced plastics (FRP), starting from an initial shell geometry and a given load case. Its main principle is iterative reduction of shear stresses by aligning fibre main axes with principal normal stress trajectories. Previous contributions, ranging from CAIO’s introduction over testing to extensions towards multi-layer FRP laminates, highlighted its lightweight design potential. For its application to laminate design approaches, alterations have been proposed; however, questions remain open. These questions include which convergence criteria to use, how to handle ambiguous principle normal stress trajectories, influence of using multi-layer CAIO optimisation instead of the initial single-layer CAIO and how dire consequences of slightly deviating fibre orientations from the optimised trajectories are. These challenges are discussed in depth and guidelines are given. This paper is an enhanced version of a distinguished contribution at the first symposium ‘Lightweight Design in Product Development’, Zurich (June 14–15, 2018).

On board of communication satellites, there are numerous RF filters in the payload used for guiding wanted signals as desired and for rejecting unwanted signals such as not to interfere with wanted signals. At present, satellites have a long lifetime (15 years at least for a typical geostationary communication satellite) and there is also time elapsing between its design and the start of in-orbit service (2 years at least). On the other hand, conventional RF filters for satellite applications are fixed frequency. Therefore, there is a growing demand for in-orbit tunable filters to be able to cope with changes in the market situation during that long time. Also, there are communication systems evolving that rely on tunable devices used for adaptive filtering or steering. This article reports on in-orbit tunable bandpass filters employing liquid crystal material and operating at 20 GHz, and especially on design aspects dealing with the harsh space environment, on the operating principles for commanding the filters on board the satellite, and on a qualification campaign passed successfully. A demonstrator unit is in manufacturing for in-orbit verification.

Revising Heidegger’s dictum about Hölderlin being «the poet’s poet» and the philosopher’s remarks on the «essence» of poetry, the emphasis is shifted on the “method” of poetry, a crucial question for Hölderlin, which is here analyzed on the basis of his “Homburg poetology” (cfr. the table in the appendix) as well as of his poetry and prose.

Structured interviews or questionnaires often comprise open-ended questions, especially to obtain additional information from the interviewee not covered by standardised questions. Ordinarily, the analysis of these open-ended questions cannot be undertaken by the same computer program, in which quantitative data is entered and managed, which impedes the combination of open-ended and closed answer formats. The usage of the database management program Microsoft Access is widespread. It allows for various ways of entering quantitative data, of data management and data export. The entry of text material is convenient and almost unrestricted due to memo-format variables. Given the possibility to manage quantitative and qualitative data with the same computer software, we tried to use the programming properties of MS Access (Visual Basic with MS-Access-supplements) for the purpose of content analysis. The present paper comprises a description of the construction of data tables, queries, code lists and data entry forms. In addition, the construction of coding units (paraphrasing of text data), the coding process and the restructuring for subsequent statistical analysis is illustrated. In addition, the export of data into the statistical software package SPSS and the analysis of inter-coder reliability are discussed. This is based on the data collected from open-ended quality of life interviews with chronic schizophrenic persons and a paper-pencil assessment of patient satisfaction during a psychiatric hospital stay. URN: urn:nbn:de:0114-fqs0202206

Abstract Infectious diseases are influenced by interactions between host and pathogen, and the number of infected hosts is rarely homogenous across the landscape. Areas with elevated pathogen prevalence can maintain a high force of infection and may indicate areas with disease impacts on host populations. However, isolating the ecological processes that result in increases in infection prevalence and intensity remains a challenge. Here we elucidate the contribution of pathogen clade and host species in disease hotspots caused by Ophidiomyces ophidiicola, the pathogen responsible for snake fungal disease, in 21 species of snakes infected with multiple pathogen strains across 10 countries in Europe. We found isolated areas of disease hotspots in a landscape where infections were otherwise low. O. ophidiicola clade had important effects on transmission, and areas with multiple pathogen clades had higher host infection prevalence. Snake species further influenced infection, with most positive detections coming from species within the Natrix genus. Our results suggest that both host and pathogen identity are essential components contributing to increased pathogen prevalence.

Introduction: This study was designed to determine the mineral composition of calculi in nephrocalcinosis with nephrolithiasis, diagnose the underlying disease, and monitor the course of renal function in patients with nephrocalcinosis-nephrolithiasis. Methods: Renal calculi extruded in a series of 8 patients with nephrocalcinosis were analysed using Fourier transmission infrared spectrometry. In 4 patients, next-generation sequencing using a nephrocalcinosis-nephrolithiasis panel was performed to determine the nature of the underlying disease. In addition, longitudinal analysis of renal function was performed in all patients. Results: Seven patients revealed carbonate apatite as the sole constituent of renal calculi. One patient showed a mixed composition of dicalcium phosphate dihydrate/carbonate apatite at first analysis yet in subsequent episodes also had calculi composed of pure carbonate apatite. Further molecular analysis displayed distal renal tubular acidosis in 2 of 4 patients who consented to sequencing. No known genetic defect could be found in the other two cases. In line with prior reports, decline of renal function was dependent on underlying disease. Distal renal tubular acidosis revealed a progressive course of renal failure, whereas other causes showed stable renal function in long term analysis. Conclusion: Nephrocalcinosis with nephrolithiasis is a rare condition with heterogeneous aetiology. Yet mineral composition of renal calculi predominantly consisted of pure carbonate apatite. This uniform finding is similar to subcutaneous calcifications of various origins and might propose a general principle of tissue calcification. Progressive decline of renal function was found in distal renal tubular acidosis, whereas other conditions remained stable over time.

The high‐frequency and low‐voltage operation of organic thin‐film transistors (OTFTs) is a key requirement for the commercial success of flexible electronics. Significant progress has been achieved in this regard by several research groups highlighting the potential of OTFTs to operate at several tens or even above 100 MHz. However, technology maturity, including scalability, integrability, and device reliability, is another crucial point for the semiconductor industry to bring OTFT‐based flexible electronics into mass production. These requirements are often not met by high‐frequency OTFTs reported in the literature as unconventional processes, such as shadow‐mask patterning or alignment with unrealistic tolerances for production, are used. Here, ultra‐short channel vertical organic field‐effect transistors (VOFETs) with a unity current gain cut‐off frequency (fT) up to 43.2 MHz (or 4.4 MHz V−1) operating below 10 V are shown. Using state‐of‐the‐art manufacturing techniques such as photolithography with reliable fabrication procedures, the integration of such devices down to the size of only 12 × 6 µm2 is shown, which is important for the adaption of this technology in high‐density circuits (e.g., display driving). The intrinsic channel transconductance is analyzed and demonstrates that the frequencies up to 430 MHz can be reached if the parasitic electrode overlap is minimized. [ABSTRACT FROM AUTHOR]

Background: Previous studies suggest that brain atrophy can not only be defined by its morphological extent, but also by the cerebral blood flow (CBF) within a certain area of the brain, including white and gray matter. The aim of this study is to investigate known atrophy patterns in different forms of dementia and to compare segmented brain volumetrics and pulsed arterial spin labeling (pASL) data to explore the correlation between brain maps with atrophy and this non-contrast-enhanced brain-perfusion method. Methods: Our study comprised 17 patients with diagnosed cognitive impairment (five Alzheimer's disease = AD, five frontotemporal dementia = FTD, seven mild cognitive impairment = MCI) and 19 healthy control subjects (CO). All patients and controls underwent 4D-pASL brain-perfusion MR imaging and T1w MPRAGE. The data were assessed regarding relative brain volume on the basis of 286 brain regions, and absolute and relative cerebral blood flow (CBF/rCBF) were derived from pASL data in the corresponding brain regions. Mini-Mental State Examination (MMSE) was performed to assess cognitive functions. Results: FTD patients demonstrated significant brain atrophy in 43 brain regions compared to CO. Patients with MCI showed significant brain atrophy in 18 brain regions compared to CO, whereas AD patients only showed six brain regions with significant brain atrophy compared to CO. There was good correlation of brain atrophy and pASL perfusion data in five brain regions of patients with diagnosed FTD, especially in the superior temporal gyrus (r = 0.900, p = 0.037), the inferior frontal white matter (pars orbitalis; r = 0.968, p = 0.007) and the thalami (r = 0.810, p = 0.015). Patients with MCI demonstrated a correlation in one brain region (left inferior fronto-occipital fasciculus; r = 0.786, p = 0.036), whereas patients with diagnosed AD revealed no correlation. Conclusions: pASL can detect affected brain regions in cognitive impairment and corresponds with brain atrophy, especially for patients suffering from FTD and MCI. However, there was no correlation of perfusion alterations and brain atrophy in AD. pASL perfusion might thus represent a promising tool for noninvasive brain-perfusion evaluation in specific dementia subtypes as a complimentary imaging-based bio marker in addition to brain volumetry. [ABSTRACT FROM AUTHOR]

Calciphylaxis is a rare, yet underdiagnosed condition causing high mortality in patients with severe renal and cardiovascular disease. Since knowledge of the pathophysiology of calciphylaxis is limited, a differential analysis of histological alterations in patient subgroups with various comorbidities might expose different disease phenotypes and allow deeper insights into the pathophysiology of the condition. Histological markers of osteogenesis and calcification were investigated in a group of 18 patients with clinically and histologically verified calciphylaxis, using immunohistochemical staining. Analysis of staining intensity and distribution of marker proteins in histological structures was performed to evaluate distinct patterns between subgroups with different clinical comorbidities in comparison with a control group. In all cases, immunohistochemical staining for bone matrix proteins, bone-morphogenic proteins and matrix-Gla proteins co-localized with subcutaneous vascular and interstitial calcifications. Significant expression of bone-morphogenic protein-7 and active matrix-Gla protein was observed. Mortality was associated with renal comorbidities and increased expression of bone-morphogenic protein-7. However, no distinct histological patterns were found between subgroups with renal disease, warfarin intake or coexisting micro- and macro-angiopathies. The upregulation of osteogenic markers (including bone-morphogenic protein-7) plays a major role in the development of calciphylaxis. Clinical outcome correlates with kidney function and phosphate handling, suggesting different pathophysiological mechanisms. However, biopsy at late-stage disease shows a common histological phenotype, involving enchondral ossification.