Repeated Cross-Scale Structure-Induced Feature Fusion Network for 2D Hand Pose Estimation

Recently, the use of convolutional neural networks for hand pose estimation from RGB images has dramatically improved. However, self-occluded keypoint inference in hand pose estimation is still a challenging task. We argue that these occluded keypoints cannot be readily recognized directly from traditional appearance features, and sufficient contextual information among the keypoints is especially needed to induce feature learning. Therefore, we propose a new repeated cross-scale structure-induced feature fusion network to learn about the representations of keypoints with rich information, 'informed' by the relationships between different abstraction levels of features. Our network consists of two modules: GlobalNet and RegionalNet. GlobalNet roughly locates hand joints based on a new feature pyramid structure by combining higher semantic information and more global spatial scale information. RegionalNet further refines keypoint representation learning via a four-stage cross-scale feature fusion network, which learns shallow appearance features induced by more implicit hand structure information, so that when identifying occluded keypoints, the network can use augmented features to better locate the positions. The experimental results show that our method outperforms the state-of-the-art methods for 2D hand pose estimation on two public datasets, STB and RHD.

Structure and spectral properties of Dy3+ doped CaYAlO4 single crystal

A 2 at.% Dy³⁺: CaYAlO₄ single crystal was grown successfully. The electronic structures of Ca²⁺/Y³⁺ mixed sites in CaYAlO₄ were investigated using first-principles based on density functional theory. The effects of Dy³⁺ doping on the structural parameters of host crystal were studied using XRD pattern. The optical properties including absorption spectrum, excitation spectrum, emission spectra and fluorescence decay curves were thoroughly investigated. The results show that the Dy³⁺: CaYAlO₄ crystal could be pumped by the blue InGaN and AlGaAs or 1281 nm laser diodes. Furthermore, an intense 578 nm yellow emission was obtained directly under excitation at 453 nm, meanwhile, evident mid-infrared light emitting was observed by 808 or 1281 nm laser excitation. The fitted fluorescence lifetimes of ⁴F_9/2 and ⁶H_13/2 levels were about 0.316 ms and 0.038 ms, respectively. It can be concluded that this Dy³⁺: CaYAlO₄ crystal could simultaneously act as a promising medium for both solid-state yellow and mid-infrared laser outputs.

A107 VISCERAL ADIPOSE TISSUE VOLUME DIFFERENTIATES BETWEEN FIBROSTENOTIC AND INFLAMMATORY CROHN’S DISEASE

Background

Creeping fat, a form of visceral adipose tissue (VAT) that wraps the intestinal wall, influences the formation of Crohn’s disease (CD) strictures. The degree of fat wrapping from intestinal stricture resections is correlated with the extent of chronic inflammation, fibrosis, stricture formation, and response to biologic therapy. VAT and subcutaneous adipose tissue (SAT) ratios from CTE (computed tomography) scans are elevated in CD strictures. However, the definition of strictures in these studies has been poorly defined and not included current well-recognized criteria: 1) bowel wall thickness (BWT), 2) narrowed luminal diameter, and 3) pre-stenotic dilation. (PSD).

Purpose

The objective of this pilot study was to assess the relationship of 2D and 3D VAT:SAT ratios with CT stricture parameters in patients with terminal ileal (TI) CD strictures.

Method

2D VAT:SAT ratios from CT’s of CD patients with TI strictures defined as increased BWT, narrowed luminal diameter (< 50% relative to normal adjacent distended loop), and PSD greater than the stricture diameter were retrospectively obtained from a database and chart review. CT’s from fibrostenotic CD patients were sex and BMI matched to patients with only TI inflammatory behaviour. Patient demographics, medication, smoking, and surgical history were also obtained. Analyses were adjusted for age, sex, and BMI covariates. Unpaired t-tests and multi-variable logistic regression analyses were conducted.

Result(s)

Twenty-eight patients with stricturing CD had a significantly greater mean VAT:SAT volume ratio than 29 non-stricturing CD (41.5 cm³ vs 34.2 cm³, p=0.03). Thirty-six percent (10/28) of CD stricture patients had prior ileocolic resection with a mean disease duration of 13.5 years (range 0-48). The median ileal BWT (7.0 mm, range 4.0-13.0 mm) for the stricturing group was significantly greater than those with inflammatory behaviour (BWT 2.0 mm, p<0.0001). The median luminal diameter and PSD for the stricture group was 2.0 mm (range 0 - 14.0 mm), and 3.0 cm (range 1.0 - 7.3 cm), respectively.

Image

Conclusion(s)

Fibrostenotic TI CD patients have increased VAT:SAT ratios in comparison to those with only inflammatory behaviour. These pilot VAT:SAT results provide an initial foundation for further studies to assess its predictive role in responsiveness of medical or surgical therapies in stricturing CD.

Please acknowledge all funding agencies by checking the applicable boxes below

None

Disclosure of Interest

None Declared

Meta-analysis of InterTan, PFNA and PFNA-II internal fixation for the treatment of unstable intertrochanteric fractures in elderly individuals

Elderly individuals are often affected by osteoporosis and have poor stability after fracture reduction. Moreover, there is still controversy regarding the clinical effects of the treatment for unstable intertrochanteric fractures in the elderly. The Cochrane, Embase, PubMed, and other databases were searched, and a meta-analysis of the literature on the treatment of unstable intertrochanteric fractures of the elderly with InterTan, PFNA, and PFNA-II was conducted. Seven studies were screened, with a total of 1236 patients. Our meta-analysis results show that InterTan is not significantly different from PFNA in terms of operation and fluoroscopy times, but it takes longer than PFNA-II. In terms of postoperative screw cut, pain, femoral shaft fracture, and secondary operations, InterTan is superior to PFNA and PFNA-II. Conversely, in terms of intraoperative blood loss, hospital stay, and postoperative Harris score, there is no significant difference between InterTan and PFNA and PFNA-II. Compared to PFNA and PFNA-II, InterTan internal fixation has advantages in the treatment of unstable intertrochanteric fractures in elderly individuals in terms of screw cutting, femoral shaft fractures, and secondary operations. However, InterTan operation and fluoroscopy times take longer than PFNA and PFNA-II.

Tensile mechanical properties and finite element simulation of the wings of the butterfly Tirumala limniace

This study examined the morphological characteristics and mechanical properties of the wings of Tirumala limniace. The wings of this butterfly, including the forewings and hindwings, are composed mainly of a flexible wing membrane and supporting wing veins. Scanning electron microscopy was employed to observe specific positions of the wing membrane and veins and reveal the morphological characteristics. Tensile experiments were conducted to evaluate the mechanical properties of the wings and proved that the multifiber layer structures have a significantly fixed orientation of fiber alignment. A butterfly wing model reconstructed in reverse based on the finite element method was used to analyze the static characteristics of the wing structure in detail. Evaluation of stress and strain after applying uniform loading, perpendicular loading, and torsion revealed that minor wing deformation occurred and was concentrated near the main wing vein, which verifies the steadiness of the butterfly wing structure. Additionally, the flapping of butterfly wings was simulated using computational fluid dynamics to study the flow field near the butterfly wings and the distribution of pressure gradient on the wings. The results confirmed the effect of wing veins on maintaining the flight performance.

Experimental investigation of light non-aqueous phase liquid mobilization in filled fractured network media

With the increasing requirement of international energy security, oil storage projects have been constructed in large numbers, but leaking petroleum-based contaminants are threatening the soil and groundwater environment. In order to assess the environmental risk of petroleum-based contaminants, an experimental apparatus was designed and developed to monitor the concentration and pressure variations of light non-aqueous phase liquid (LNAPL) in filled fractured network media. The mobilization mechanism of LNAPL was investigated by theoretical analysis and laboratory experiments; the pressure balance relationships at different interfaces were investigated. When the experimental model was unsaturated, the dynamic processes of concentration and pressure at different locations in filled fractures were explored. When the groundwater level was raised to 35 cm, the cumulative height of LNAPL (H_L) was a function of the density of LNAPL, interfacial tension, interfacial contact angle, aperture of fracture, porosity, and particle diameter of filling and H_L21 > H_L22. The final concentrations of H21, H22, H25, H26, and H27 were 0.467, 0.458, 0.026, 0.062, and 0.041 mg/mL, respectively. Subsequently, the effect of the particle diameter of filling sand on LNAPL mobilization was further discussed, the concentration of each point in the fractures increased with the increase of the particle diameter of filling sand, and its peak decreased with the increase of the burial depth. The response time of pressure at each point was advanced and the peak of pressure dynamic curve increased as the particle diameter of filling sand increased. The peak pressure heads of H12 and H13 were 22.360 cm and 25.332 cm respectively when the particle diameter of filling was 0.5-1.0 mm. The Spearman analysis results between LNAPL concentration and time showed a significant correlation (≥ 0.879, [Formula: see text]). Research results characterized the existence and mobilization of LNAPL in filled fractured network media from the perspectives of concentration and pressure, which could provide a reference for the study of the leakage and migration mechanism of LNAPL.

Exploration of 68Ga-labelled prostate-specific membrane antigen-11 PET/CT parameters for identifying PBRM1 status in primary clear cell renal cell carcinoma

AIM

To investigate the predictive value of ⁶⁸Ga-labelled prostate-specific membrane antigen-11 (⁶⁸Ga-PSMA-11) integrated positron-emission tomography (PET)/computed tomography (CT) in PBRM1-deficient clear cell renal cell carcinoma (ccRCC).

MATERIALS AND METHODS

A total of 41 patients with ccRCC, were enrolled retrospectively and underwent ⁶⁸Ga-PSMA-11 PET/CT preoperatively. Radiological parameters, including CT attenuation value and maximum standard uptake value (SUVmax), were derived. Immunohistochemical and multiple immunofluorescences staining were performed to evaluate the PBRM1 status and immune response. The predictive value of imaging factors was analysed using a receiver operator characteristic curve analysis. Univariate and multivariate logistic regression analyses were used to investigate the relationship between clinical and radiological variables and PBRM1 status.

RESULTS

A total of 41 patients were included in this study, with 14 patients having PBRM1-deficient status. The tumour diameter on imaging and SUVmax differed significantly in patients with different PBRM1 expression statuses and no difference in CT attenuation was identified. Univariate and multivariate logistic regression analyses showed SUVmax was an obvious predictor for identification of PBRM1-deficient tumours. In addition, PBRM1-deficient tumours tended to be accompanied by greater cytotoxic T-cell infiltration, although most of them were in an exhausted state.

CONCLUSIONS

⁶⁸Ga-PSMA-11 PET/CT could be used to discriminate invasive PBRM1-deficient ccRCC.

Migration behaviour of LNAPL in fractures filled with porous media: Laboratory experiments and numerical simulations

With the increasing requirement of maintaining world energy security and strategic reserves, oil storage and transportation facilities are being built at a large scale. Taking the safe and efficient operation of petroleum storage projects as the goal, a set of experimental apparatus to investigate the migration of contaminants in fractures filled with media was developed to predict and evaluate the environmental risk of oil contaminants leakage. A multiphase numerical flow model based on COMSOL was built based on the laboratory experimental model. Specifically, the migration behaviour of Light Non-aqueous Phase Liquid (LNAPL) through a sand-filled fractured medium was studied by laboratory experiments and numerical simulations. Image and chemical analyses methods were used to monitor and study LNAPL migration behaviour for varying grain sizes of porous medium filling the fractures and varying groundwater table elevations. Laboratory experimental results showed that the LNAPL migration velocity in filled fracture network was significantly faster than that in adjoining porous media during the initial stage of infiltration. The migration velocity increased with the relative permeability of filled sand, which was closely related to the Van Genuchten (VG) model parameters α and n. LNAPL migrated downward with the falling groundwater table and became entrapped with the rising groundwater table, and the amount of entrapment depended on VG model parameters. Hydrogeological parameters were calibrated and LNAPL migration in filled fractured media was predicted using the calibrated numerical model. Simulation results revealed that fracture inclination had an important influence on LNAPL migration in filled fractured media and its migration velocity decreased with a decrease in fracture inclination. These research results can be applied to the control and remediation of oil-contaminated sites in fractured rock settings, such as at underground oil storage tanks and caverns, as well as at underground oil pipelines.

Effects of letrozole co-treatment on the cumulative live-birth rate among normal responders in gonadotropin-releasing hormone antagonist cycles

Studies have shown that letrozole cotreatment can improve clinical outcomes in high and poor responders in GnRH-antagonist protocol. However, whether letrozole is also beneficial to normal responders is not known. To investigate the clinical value of letrozole cotreatment during ovarian stimulation in vitro fertilization for normal ovarian reserve patients who were treated with the GnRH antagonist protocol, we conducted a retrospective study that based data from 1 January to 31 December 2017 for all IVF-ICSI GnRH-antagonist protocols. A total of 252 women who aged <40 years, FSH <10 IU/L on day 3 and antral follicle counting (AFC) >6 were included in the analysis (96 in the letrozole group and 156 in the no-letrozole group). The cumulative live-birth rate was calculated as the first live birth achieved after all cycles having an embryo transfer (cycles using fresh embryos and frozen-thawed embryos) among both groups. The initial gonadotropin (Gn) dosage and total Gn dosage were significantly lower and the number of days of Gn treatment was significantly fewer in the letrozole group than the non-letrozole group (p < 0.05). There were also significant between-group differences in luteinizing hormone, estradiol, and progesterone concentrations; and the number of metaphase II oocytes on the day of human chorionic gonadotropin treatment (p < 0.05). There was a significant difference in the implantation rate between the two groups that the letrozole group higher than the non-letrozole group (39.79 vs. 27.96%, p = 0.006), but there was no significant difference in the cumulative live-birth rate. The combination of letrozole with a GnRH antagonist may have no effect on the clinical pregnancy rate or cumulative live-birth rate in patients with a normal ovarian reserve. However, letrozole may increase the rate of embryo implantation and may reduce the requirement for exogenous gonadotrophins and, consequently, the cost of an IVF treatment cycle. In addition, the decreased estradiol level in the ovarian simulation by letrozole supports letrozole can be a safe solution for fertility preservation in estrogen-related cancer patients.

[Comparison between transoral radiofrequency coblation surgery and open partial laryngectomy for the treatment of supraglottic laryngeal carcinoma]

Objective: To explore the feasibility and efficacy of radiofrequency coblation assisted transoral surgery for the treatment of supraglottic laryngeal carcinoma by comparing with concurrent patients treated with conventional transcervical approach. To clarify the advantages of different surgical methods and to summarize the experience of supraglottic carcinoma radiofrequency ablation. Methods: Forty-six patients with supraglottic laryngeal carcinoma treated in department of otorhinolaryngology head and neck surgery, Peking University First Hospital from March 2014 to January 2021 were analyzed retrospectively. Among them(43 males, 3 females, aged from 45 to 79 years old), 23 patients were treated with radiofrequency coblation and 23 patients with partial laryngectomy with conventional transcervical approach. The operation time, intra-operative blood loss volume, recovery time, inpatient total medical cost and follow-up information of the two groups were analyzed. SPSS 26.0 software was used for statistical analysis. Results: There were no significant differences in age, gender, TNM staging,tumor staging and postoperative radiotherapy between the two groups (all P>0.05).The operation time, intra-operative blood loss volume, recovery time, inpatient total medical cost of the RFC-TOS group were110.0(60.0,150.0)min,5.0(5.0,30.0)ml,3.0(2.0,5.0)days,6.0(4.0,14.0)days and 26 100.7(16 145.5,47 044.4)yuan. The data of conventional transcervical approach group were 205.0(156.5,272.3)min, 150.0(50,200) ml, 18.0(16.3,22.8)days and 56520.1(440 992.5,67 109.9)yuan, (Z=-4.03, -4.94, -4.97, -4.98 and -4.13;all P<0.001).The 5-year local control rate, disease-specific survival rate and overall survival rate of the two groups were 86.96%,95.65%,91.30% and 86.96%,91.30%,73.90% renspectively, which had no significant difference between the two groups(all P>0.05). Conclusions: Compared with conventional transcervical surgeries, RFC-TOS could be a reliable new surgical option for organ-function preservation strategy in the treatment of supraglottic laryngeal carcinoma.The RFC is a suitable new technique and deserving more multi-center clinical trials for its clinical promotion.

Exposure assessment of aryl-organophosphate esters based on specific urinary biomarkers and their associations with reproductive hormone homeostasis disruption in women of childbearing age

The effects of aryl-organophosphate esters (aryl-OPEs) on female reproduction health are still unclear owing to the lack of specific exposure biomarkers. Here, we analyzed the hydroxylated metabolites of three aryl-OPEs (phenyl diphenyl phosphate [TPhP], 2-ethylhexyl diphenyl phosphate [EHDPP], and tricresyl phosphate [TCrP]) and diphenyl phosphate (DPhP) in urine samples from 913 women of childbearing age, and explored the association between exposure to the aryl-OPEs and reproductive hormone levels. The detection frequencies of 2-ethyl-5-hydroxyhexyl diphenyl phosphate (5-OH-EHDPP), phenyl di-p-tolyl phosphate (4-OH-MDTP), and 4-hydroxyphenyl diphenyl phosphate (4-OH-TPhP) were 94.6 %, 93.3 %, and 84.2 %, respectively. Multivariate linear regression analyses revealed that the quartiles of 4-OH-TPhP were positively associated with the progesterone (P4) level (p-trend = 0.008), and the P level in the highest quartile of 5-OH-EHDPP was 7.2 % (95 % CI, 5.7 % to 8.7 %) higher than that in the lowest quartile. The 17β-estradiol levels in the highest quartiles of 4-OH-TPhP and 5-OH-EHDPP were 15.0 % (95 % CI, 13.7 % to16.1 %) and 5.9 % (95 % CI, 15.7 % to 16.1 %) lower than those in the lowest quartiles, respectively. The anti-Müllerian hormone level linearly increased across the quartiles of 4-OH-MDTP (p-trend = 0.036), and the follicle-stimulating hormone exhibited the opposite trend (p-trend = 0.0047). These results indicate that aryl-OPEs may disrupt hormone homeostasis using their specific biomarkers and may negatively affect female reproduction.

Experimental and numerical simulation of solute transport in non-penetrating fractured clay

A set of one-dimensional experimental device for solute transport in non-penetrating fractured clay are developed, which can study the laws of groundwater flow and solute transport under different hydraulic heads, fractured aperture, and thickness of non-penetrating zones. The experimental results show that the solute will quickly reach the bottom of the clay along the non-penetrating fracture, and there is an obvious dominant flow phenomenon compared with the intact clay. According to the experimental data and numerical calculation results, the model parameters of the fracture and each soil layer were identified, and the verified numerical model was used to simulate the solute transport in the non-penetrating fractured clay. The numerical results show that the increase of the thickness for the non-penetrating zone has a significant improvement on the anti-seepage ability of clay, and the increase of the hydraulic head pressure and fractured aperture leads to a faster growth rate of the solute concentration, which indicates that the solute breaks down the lower impermeable clay layer under high head pressure. The research results are of great significance for the bottom anti-seepage layer similar to landfill projects.

PGT-A: The biology and hidden failures of randomized control trials

OBJECTIVE

PGT-A for embryo selection has undergone significant advancements in the last two decades and yet many studies still fail to demonstrate any clinical benefits over traditional embryo morphology selection. To understand this conundrum, we performed a multi-center clinical study of PGT-A patients, where morphology selection (Mo-S) and euploid selection (Eu-S) outcomes were directly compared.

METHOD

All suitable blastocysts were biopsied and analysed for chromosome copy number. Outcomes (positive beta hCG, implantation, ongoing pregnancy and live birth rates) for euploid selection were compared to morphology selection using single embryo transfers RESULTS: Compared to Eu-S embryos, Mo-S embryos resulted in significant reduction of outcomes for positive beta hCG (P=0.0005), implantation (P=0.0008), ongoing pregnancy (P=0.0046), livebirth (P=0.0112), babies per transfer (P=0.0112) and babies per embryo transferred (P=0.0112). Morphology selection resulted in patients of all age groups having non-euploid embryos chosen for transfer. Post-hoc evaluation of individual clinic performances showed variable transfer outcomes that could potentially confound the true benefits of PGT-A.

CONCLUSION

Embryo chromosome status is central to improved embryo transfer outcomes and sole reliance on current morphology-based selection practices, without euploid selection, will always compromise outcomes. Often overlooked but a major effector of successful PGT-A outcomes are individual clinic performances. This article is protected by copyright. All rights reserved.

The forewing of a black cicada Cryptotympana atrata (Hemiptera, Homoptera: Cicadidae): Microscopic structures and mechanical properties

Insects in nature flap their wings to generate lift force and driving torque to adjust their attitude and control stability. An insect wing is a biomaterial composed of flexible membranes and tough veins. In this paper, we study the microscopic structures and mechanical properties of the forewing of the black cicada, Cryptotympana atrata. The thickness of the wing membranes and the diameter of veins varied from the wing root to the tip. The thickness of the wing membranes ranged from 6.0 to 29.9 μm, and the diameter of the wing veins decreased in a gradient from the wing root to the tip, demonstrating that the forewing of the black cicada is a nonuniform biomaterial. The elastic modulus of the membrane near the wing root ranged from 4.45 to 5.03 GPa, which is comparable to that of some industrial membranes. The microstructure of the wing vein exhibited a hollow tubular structure with flocculent structure inside. The "fresh" sample stored more water than the "dry" sample, resulting in a significant difference in the elastic modulus between the fresh and dried veins. The different membrane thicknesses and elastic moduli of the wing veins near the root and tip resulted in varied degrees of deformation on both sides of the flexion line of the forewing during twisting. The measurements of the forewing of the cicada may serve as a guide for selecting airfoil materials for the bionic flapping-wing aircraft and promote the design and manufacture of more durable bionic wings in the future.