Saarland University

Detecting vehicles in satellite images is crucial for traffic management, urban planning, and disaster response. However, current models struggle with real-world diversity, particularly across different regions. This challenge is amplified by geographic bias in existing datasets, which often focus on specific areas and overlook regions like the Middle East. To address this gap, we present the Vehicles in the Middle East (VME) dataset, designed explicitly for vehicle detection in high-resolution satellite images from Middle Eastern countries. Sourced from Maxar, the VME dataset spans 54 cities across 12 countries, comprising over 4,000 image tiles and more than 100,000 vehicles, annotated using both manual and semi-automated methods. Additionally, we introduce the largest benchmark dataset for Car Detection in Satellite Imagery (CDSI), combining images from multiple sources to enhance global car detection. Our experiments demonstrate that models trained on existing datasets perform poorly on Middle Eastern images, while the VME dataset significantly improves detection accuracy in this region. Moreover, state-of-the-art models trained on CDSI achieve substantial improvements in global car detection.

This investigation assesses the functionality, diagnostic efficacy, and limitations of a portable phased-array ultrasound apparatus in pediatric neurosurgical applications within a resource-constrained environment in Mombasa, Kenya. The ultrasound device was integrated into four neurosurgical missions conducted under the auspices of the SAWUBONA Foundation between 2021–2023. A retrospective analysis was performed on the diagnosed cases. Systematic training was provided to local neurosurgeons to enable autonomous operation of the device. Three representative cases were selected to elucidate the device's utility and constraints. The device was incorporated into the diagnostic and therapeutic regimens for 29 pediatric patients, culminating in 30 surgical interventions. Its diagnostic applicability was primarily confined to pediatric patients below one year of age, with a focus on hydrocephalus management. The apparatus consistently yielded sufficient data for discriminating between shunt placement and endoscopic third ventriculostomy. Its portability rendered it highly valuable across multiple healthcare settings, including outpatient clinics, surgical theaters, and inpatient wards. The educational initiative demonstrated a rapid learning curve among local healthcare professionals, enabling them to independently conduct examinations. The portable phased-array ultrasound device exhibited considerable diagnostic precision, particularly in the assessment and management of hydrocephalic conditions among pediatric patients within their first year of life. Its compact design and user-friendliness position it as a viable instrument for resource-limited environments and for educational enhancement in developing countries.

Purpose To analyse the quantitative morphology of the menisci, their roots and relations with a focus on the medial meniscus anterior root (MAR) as a basis for a preclinical model. Methods Data was obtained from 24 tibial plateaus of skeletally mature, female Merino ewes. The MAR attachment (MARA) was scanned with micro‐computed tomography and stained with hematoxylin and eosin. Data of relevant anatomical structures was subjected to principal component analysis (PCA) and Spearman correlations. Results The osteo‐ligamentous junction of the MARA represents a classical enthesis with a type‐I insertion into the cortical bone. The medial tibial plateau was of a significantly smaller area than lateral. Its sagittal length was significantly longer than lateral. The widths of the MAR and lateral meniscus anterior root (LAR) were approximately half of both anterior horn widths. The MAR was significantly wider than the LAR. The medial meniscus body, posterior horn and medial posterior root were significantly thinner than lateral. PCA and cluster analysis revealed a striking, significant distinction between the structures of the medial and lateral tibial plateau. The sagittal length of the articular cartilage of both tibial plateaus correlated with the primary axis length of both menisci. The maximum width of the articular cartilage of both plateaus correlated with the area of both menisci. Significant correlations also existed between the length of the MAR and the total width of the tibia plateau and between the size of the MARA and the coronal distance to the medial tibial eminence (MTE), to the tibial tuberosity and the sagittal distance to the MTE. Conclusion The ovine MAR may be appropriate for repair approaches because of its morphological similarities to the human situation. The substantial differences between the medial and lateral tibial plateau have to be respected. Level of Evidence Not applicable.

Purpose To address a gap in translational research by developing a preclinical sheep model of medial meniscus anterior root (MAR) repair in vivo and to compare probabilities of potential pitfalls and difficulties with humans. Methods Preoperative planning and surgical procedures applied to patients were adapted to adult sheep. Eight healthy, skeletally mature, female Merino ewes between 2 and 4 years of age underwent a mini‐open medial parapatellar approach to both stifle joints without luxating the patella. Next, the MAR was transected in 16 knees (8 sheep) resulting in a subtype 2A tear according to the LaPrade classification, followed by a transtibial pull‐out repair through a 3.2 mm diameter bone tunnel with a reinforced Mason–Allen suture and non‐absorbable suture material. Animals were followed until 21 days after surgery. Results The surgery time per knee ranged between 30 and 50 min (mean, 40.0 ± 7.8 min). The surgical technique was safe without intra‐ or post‐operative complications. Solid repair is most likely if the following surgical principles are respected: (1) Selection of the MAR and the open technique allow for elegant tunnel positioning and less post‐operative loading stress due to the normal extension deficit of sheep; (2) careful preparation of the MAR is mandatory; (3) considering the oval shape of the MAR attachment (MARA) results in anatomic tunnel placement; (4) robust suture placement and configuration avoids suture cut out. The probabilities of potential pitfalls and difficulties differ from the human situation. Conclusion A clinically adapted MAR repair model in adult sheep was developed following its complete transection close to the MARA, followed by an open transtibial pull‐out repair. The surgical technique was safe without intra‐ or short‐term post‐operative complications. This model may be suitable to study the biomechanics and pathophysiology of meniscal root injuries and their repair. Level of Evidence Level IV.

Chemo-mechanical waves play a key role in force generation and long-range signal transmission in cells that dynamically change shape, for example, during cell division or morphogenesis. Reconstituting and controlling such chemically controlled cell deformations is a crucial but unsolved challenge for the development of synthetic cells. Here we present an optogenetic method to investigate the mechanism responsible for coordinating surface contraction waves that occur in oocytes of the starfish Patiria miniata during meiotic cell division. Using optogenetic stimuli, we create chemo-mechanical cortical excitations that are decoupled from meiotic cues and drive various shape deformations, ranging from local pinching to surface contraction waves and breakdown of the cell. A quantitative model entailing both chemical and geometry dynamics allows us to predict and explain the variety of mechanical responses to optogenetic stimuli. Finally, we qualitatively map the observed shape dynamics to understand how the versatility of intracellular protein dynamics can give rise to a broad range of mechanical phenotypes. More broadly, our results suggest a route towards real-time control over dynamical deformations in living organisms and can advance the design of synthetic cells and life-like cellular functions.

Options to prevent oropharyngeal dysphagia are elucidated, addressing dysphagia in primary radio(chemo)therapy-treated patients with a head and neck malignancy, dysphagia prevention in surgical procedures in the head and neck area, prevention in the elderly and during the administration of drugs.

An overview is given on the range of direct and indirect treatment interventions for swallowing problems. The therapist’s role in planning dysphagia interventions, screening, assessment, behavioural treatment and evaluation is elucidated. With emphasis on the multidisciplinary team, tasks and responsibilities of the phoniatrician are described. Basic principles of drug treatment in dysphagia are introduced, addressing pharmacological intervention for swallowing problems in degenerative neurological diseases and medications that potentially affect swallowing function. Botulinum toxin is presented as a treatment option of isolated cricopharyngeal dysfunction or upper oesophageal sphincter spasm. Oral, enteral and parenteral nutrition management in dysphagic patients is introduced in two parts. After a short overview on oral, enteral and parenteral nutrition management in dysphagic patients, the refeeding syndrome is described. Challenges in the production of texture-modified food in oropharyngeal dysphagia are presented in detail. Indications for surgical procedures in dysphagia are introduced, addressing specific organ structures, severe aspiration, swallowing disorders after radio-chemotherapy and percutaneous endoscopic gastrostomy (PEG). Indications and contra-indications of PEG and ethical issues are discussed. Tracheal tube management is described with a stepwise approach to rehabilitation of voice and swallowing. Complications of tracheal cannula usage are described. Causes and predictors of dysphagia in non-surgically treated patients with head and neck cancer are introduced, addressing inter alia the toxicity of radiotherapy. The incidence of aspiration and aspiration pneumonia, dysphagia stages according to swallowing phases and the multidisciplinary management of swallowing in this patient group are given. Prognostic aspects are discussed, considering oropharyngeal dysphagia in neurological disorders, after radio-chemotherapy for, or primarily surgically treated, ENT malignancies and other disorders.

This study aimed to quantitatively analyze subchondral vascularization during the progression of osteoarthritis (OA) in the elderly, particularly regarding the timing of initial blood vessel emergence and when their density peaks. A total of 129 independent areas from 43 human femoral heads, obtained through arthroplasty for OA or hemiarthroplasty for fractures, were analyzed. The femoral heads were grouped by Kellgren-Lawrence (KL) grades: KL 1 (6 heads), KL 2 (14 heads), KL 3 (10 heads), and KL 4 (13 heads), and the Mankin score was assessed. Quantitative measurements of blood vessel length 1 mm below the tidemark, cartilage volume and thickness, chondrocyte volume, ECM volume, subchondral bone volume, and bone marrow volume were performed using stereology and immunohistochemistry. The most substantial increase in the characteristics of blood vessels within the subchondral region began at KL 3 and peaked at KL 4. Blood vessel volume increased from 6.71 ± 5.84 mm³ in group KL 1 to 156.21 ± 138.67 mm³ in group KL 4 (p < 0.001). Blood vessel surface area showed an increase from 14.78 ± 9.89 cm² (group KL 1) to 125.20 ± 93.18 cm² (group KL 4) (p < 0.001). Likewise, blood vessel length grew from 27.53 m (IQR 13.70–65.41 m) in group KL 1 to 112.03 ± 76.07 m in group KL 4 (p = 0.001). This study offers deeper insights into the role of vascularization in OA pathophysiology, quantifying subchondral blood vessel characteristics in the femoral head across different OA stages.

Aspects of paediatric dysphagia are introduced covering definition, differentiation, child’s development, aetiology, diagnostics, therapy and management. Feeding disorders are also presented in detail, covering terminology, aetiology, epidemiology, clinical symptoms, diagnostic procedures and therapy. To explain neurogenic dysphagia, an overview is given of functional neuroanatomy related to swallowing. Neurogenic dysphagia characteristics are listed, as seen in diseases affecting various levels of the nervous system, and associated symptoms (comorbidities) are presented. Neurological and psychiatric disorders are discussed in context with psychogenic swallowing disorders, including globus hystericus and considering dysphagia as a possible side effect of antipsychotic drugs. Dysphagia after head and neck tumour treatment (surgery, radiotherapy, chemotherapy, combined interventions) is addressed, also highlighting special aspects in diagnostics and monitoring of head and neck cancer patients with swallowing disorders. Prevalence, risk factors, symptoms, sequelae, diagnostics and rehabilitative options of dysphagia in the elderly are described. The definition, characteristics and distinctive features of supragastric belching are discussed, as are its diagnosis and therapy. The incidence, mechanisms of development of post-intubation dysphagia, evaluation of swallowing in patients after orotracheal intubation tube removal and management of post-intubation dysphagia are presented in detail.

For smooth surfaces, chemical composition can be readily analyzed using various spectroscopic techniques, a prominent example is X‐ray photoelectron spectroscopy (XPS), where the relative proportions of the elements are mainly determined by the intensity ratio of the element‐specific photoelectrons. However, this analysis becomes more complex for nanorough surfaces like black silicon (b‐Si) due to the geometry's steep slopes, which mimic local variations in emission angles. In this study, this effect is explicitly quantified through an integral geometric analysis using Minkowski tensors, correlating XPS chemical data with topographical information from Atomic Force Microscopy (AFM). This approach yields reliable estimates of layer thicknesses for nanorough surfaces. For b‐Si, it is found that the oxide layer is ≈50%–80% thicker than the native oxide layer on a standard Si wafer. This study underscores the significant impact of nanoscale geometries on chemical property analysis.

Predictive process monitoring (PPM) aims to forecast how a running process instance will unfold in the future, e.g., which activity will be executed next. For this purpose, PPM techniques rely on machine learning models trained on historical event log data. Such models are assumed to learn an implicit representation of the process that accurately reflects the behavior contained in the data, so that they can be used to make correct predictions for new traces with unseen behavior. This capability, called generalization, is fundamental to any machine learning application. However, researchers currently have a limited understanding of what generalization means in a PPM context and how it relates to the characteristics of event logs. In the paper, the authors discuss the generalization capabilities of PPM approaches, focusing on next activity prediction. They develop a framework for generalization in PPM, derived from the understanding of the term in general machine learning. The framework is applied to next activity prediction by developing concrete prediction scenarios, creating corresponding event logs, and using these logs to empirically evaluate the generalization capabilities of state-of-theart models. The evaluation shows that next activity prediction models generalize well in almost all scenarios.

Friction between fingertip and surface is a key contribution to tactile perception during active exploration of materials. We explore the role of skin factors such as stratum corneum thickness and hydration, deformability, elasticity, or density of sweat glands and of Meissner corpuscles in friction and tactile perception. The skin parameters were determined non-invasively for the glabrous skin at the index finger pad of 60 participants. Sets of randomly rough plastic surfaces and of micro-structured fibrillar rubber surfaces were explored as model materials with well-defined parameterized textures. Friction varies greatly between participants, and this variation can be explained to 70% by skin factors for the randomly rough plastic surfaces. The predictability of friction by skin factors is much lower for micro-structured rubber surfaces with bendable fibrils, where 50% of variance is explained for the stiffest fibrils but only 20% for the most bendable fibrils. The participants’ age is the key predictor for their tactile sensitivity to perceive the fibrils, where age is negatively correlated to the density of Meissner corpuscles. The results suggest that stratum corneum hydration, skin deformability, and age are important factors for friction and perception in active tactile exploration of materials.

Background Adjuvant treatment with anti‐PD1 antibodies has been shown to effectively reduce the risk of recurrence in patients with resected metastatic melanoma. Whether a full 12‐month duration of treatment is needed to achieve full clinical benefit is not known. This study investigated the survival outcome depending on the duration of adjuvant anti‐PD1 therapy. Methods From the prospective multicentre real‐world skin cancer registry ADOREG data of 620 patients who finished adjuvant treatment with nivolumab or pembrolizumab for AJCCv8 stage III/IV resected melanoma was analyzed. Recurrence‐free survival (RFS) and overall survival (OS) were compared between patients with regular treatment duration (52 ± 4 weeks; n = 229) and no disease recurrence during therapy (A 1 ) and patients with a premature end of treatment (<48 weeks; n = 214, B). Patients with disease recurrence during adjuvant treatment were included in cohort A 2 . Results The median duration of follow‐up was 26.0 months [interquartile range (IQR) 18.0–34.0] in group A 1 [median treatment duration 51.3 weeks (IQR 50.0–52.1) and 19.0 months (IQR 13.0–29.0)] in group B [median treatment duration 22.2 weeks (IQR 10.0–34.8)]. Reasons for early discontinuation were treatment‐related side effects in 45.3% ( n = 97) and other reasons than toxicity in 54.7% ( n = 117). The 2‐year rate of RFS was 72.4% (95% CI, 68.5–76.3) for patients in group B and 51.5% (95% CI, 48.8–54.2) in patients with regular and intended regular treatment duration (A 1 plus A 2 ). When analysing the patients who did not relapse during adjuvant treatment (A 1 ), there was a significantly higher RFS rate of 84.1% (95% CI, 81.5–86.7). When only assessing patients with a recurrence after more than 12 months after initiation of therapy, there was a trend towards better RFS in patients with regular treatment duration. Conclusion In patients with resected metastatic melanoma, shorter treatment duration with anti‐PD1 antibodies is not associated with a worse outcome.