Automated polyp detection in the colorectum: a prospective study (with videos).

BACKGROUND AND AIMS: Adenoma detection is a highly personalized task that differs markedly among endoscopists. Technical advances are therefore desirable for the improvement of the adenoma detection rate (ADR). An automated computer-driven technology would offer the chance to objectively assess the presence of colorectal polyps during colonoscopy. We present here the application of a real-time automated polyp detection software (APDS) under routine colonoscopy conditions. METHODS: This was a prospective study at a university hospital in Germany. A prototype of a novel APDS ("KoloPol," Fraunhofer IIS, Erlangen, Germany) was used for automated image-based polyp detection. The software functions by highlighting structures of possible polyp lesions in a color-coded manner during real-time colonoscopy procedures. Testing the feasibility of APDS deployment under real-time conditions was the primary goal of the study. APDS polyp detection rates (PDRs) were defined as secondary endpoints provided that endoscopists' detection served as criterion standard. RESULTS: The APDS was applied in 55 routine colonoscopies without the occurrence of any clinically relevant adverse events. Endoscopists' PDRs and ADRs were 56.4% and 30.9%, respectively. The PDRs and ADRs of the APDS were 50.9% and 29.1%, respectively. The APDS detected 55 of 73 polyps (75.3%). Smaller polyp size and flat polyp morphology were correlated with insufficient polyp detection by the APDS. CONCLUSION: Computer-assisted automated low-delay polyp detection is feasible during real-time colonoscopy. Efforts should be undertaken to improve the APDS with respect to smaller and flat shaped polyps. (Clinical trial registration number: NCT02838888.).

[Johannes des Sacrobosco and the Sphere Tradition in Early Modern Catholic Censorship]. / Johannes de Sacrobosco und die Sphaera-Tradition in der katholischen Zensur der Frühen Neuzeit.

Johannes de Sacrobosco's (c. 1195-c. 1256) On the Sphere, a short introduction into qualitative cosmology written in the thirteenth century, was the most widely used textbook on cosmology in the early-modern period, being reprinted, re-edited or commented over 320 times. While the reception and circulation of this work in the sixteenth and seventeenth century is well known, one fact has so far escaped the notice of scholars: Sphaera textbooks were subject to several acts of ecclesiastical censorship in the early modern period, even though the content of this work promoted a cosmology that opposed the allegedly heretical implications of Copernicanism. This paper investigates for the very first time the dynamics and motives behind Roman and Iberian censorship in relation to this cosmology treatise. Editions and commentaries published by Protestants were generally regarded as suspect, but rarely prohibited across-the-board. Instead, they were usually approved for scientific use after expurgations had removed problematic theological passages. However, the commentary (1550) authored by the Catholic Mauro da Firenze (1493-1556) was prohibited repeatedly and completely because it contained theologically dangerous ideas. The case studies presented in this paper shall shed light on the dynamics of knowledge within the Sphere tradition from a new perspective, that of the Catholic censorship of books. Moreover, a longitudinal study based on a specific genre of books provides insight into the ideology and practices of early modern catholic book censorship, whereby the well-known problematic relationship between science and religion in the pre-modern period is seen in the context of a confessionalisation of science.

In Situ Time-dependent Dielectric Breakdown in the Transmission Electron Microscope: A Possibility to Understand the Failure Mechanism in Microelectronic Devices.

The time-dependent dielectric breakdown (TDDB) in on-chip interconnect stacks is one of the most critical failure mechanisms for microelectronic devices. The aggressive scaling of feature sizes, both on devices and interconnects, leads to serious challenges to ensure the required product reliability. Standard reliability tests and post-mortem failure analysis provide only limited information about the physics of failure mechanisms and degradation kinetics. Therefore it is necessary to develop new experimental approaches and procedures to study the TDDB failure mechanisms and degradation kinetics in particular. In this paper, an in situ experimental methodology in the transmission electron microscope (TEM) is demonstrated to investigate the TDDB degradation and failure mechanisms in Cu/ULK interconnect stacks. High quality imaging and chemical analysis are used to study the kinetic process. The in situ electrical test is integrated into the TEM to provide an elevated electrical field to the dielectrics. Electron tomography is utilized to characterize the directed Cu diffusion in the insulating dielectrics. This experimental procedure opens a possibility to study the failure mechanism in interconnect stacks of microelectronic products, and it could also be extended to other structures in active devices.

Medical topics in the De anima commentary of Coimbra (1598) and the Jesuits' attitude towards medicine in education and natural philosophy.

Early-modern Jesuit universities did not offer studies in medicine, and from 1586 onwards, the Jesuit Ratio studiorum prohibited digressions on medical topics in the Aristotelian curriculum. However, some sixteenth-century Jesuit text books used in philosophy classes provided detailed accounts on physiological issues such as sense perception and its organic location as discussed in Aristotle's De anima II, 7-11. This seeming contradiction needs to be explained. In this paper, I focus on the interst in medical topics manifested in a commentary by the Jesuits of Coimbra. Admittedly, the Coimbra commentary constituted an exception, as the Jesuit college that produced it was integrated in a royal university which had a strong interest in educating physicians. It will be claimed that the exclusion of medicine at Jesuit universities and colleges had its origin in rather incidental events in the course of the foundation of the first Jesuit university in Sicily. There, the lay professors of law and medicine intended to avoid subordination to the Jesuits and thereby provoked a conflict which finally led the Jesuit administration to refrain from including faculties of medicine and law in Jesuit universities. Towards the end of the sixteenth century, a veritable Jesuit animosity towards medicine emerged for philosophical and pedagogical reasons. This development reflects educational concerns within the Society as well as the role of commentaries on Aristotle for early-modern learning.

A possible influence of gingival dimensions on attachment loss and gingival recession following placement of artificial crowns.

The aim of the present study was to determine the influence of gingival dimensions on the development of gingival recession following placement of artificial crowns. The study population consisted of 11 periodontally healthy patients in whom 44 maxillary anterior teeth and/or premolars had to be crowned. A total of 36 teeth (82%) had, after crown placement, a mean intracrevicular crown margin of 0.57 +/- 0.47 mm. Thirty-nine teeth without restorations served as controls. Immediately after incorporation, as well as after 3, 6, 9, and 12 months, periodontal examinations were carried out. Gingival thickness was determined sonometrically and averaged 1.25 +/- 0.40 mm. Mean periodontal probing depth was 1.80 +/- 0.54 mm. Twelve months later, crowned teeth had experienced a mean attachment loss of 0.17 +/- 0.99 mm as compared to an attachment gain of 0.18 +/- 0.46 mm at control teeth. At test teeth, the gingival margin had receded a mean of 0.43 +/- 0.74 mm. In multivariate analyses considering the correlated structure of the data employing generalized estimating equation methods, crown placement was identified as a major factor for attachment loss and development of gingival recession. In addition, a shallow probing depth and narrow band of gingiva negatively influenced the level of periodontal attachment. The present results point to the importance of a more detailed periodontal diagnosis of the dentogingival region before placement of artificial crowns.