Multiple Ablation Research Articles

Adaptive Local Cross-Channel Vector Pooling Attention Module for Semantic Segmentation of Remote Sensing Imagery

Adding an attention module to the deep convolution semantic segmentation network has significantly enhanced the network performance. However, the existing channel attention module focusing on the channel dimension neglects the spatial relationship, causing location noise to transmit to the decoder. In addition, the spatial attention module exemplified by self-attention has a high training cost and challenges in execution efficiency, making it unsuitable to handle large-scale remote sensing data. We propose an efficient vector pooling attention (VPA) module for building the channel and spatial location relationship. The module can locate spatial information better by performing a unique vector average pooling in the vertical and horizontal dimensions of the feature maps. Furthermore, it can also learn the weights directly by using the adaptive local cross-channel interaction. Multiple weight learning ablation studies and comparison experiments with the classical attention modules were conducted by connecting the VPA module to a modified DeepLabV3 network using ResNet50 as the encoder. The results show that the mIoU of our network with the addition of an adaptive local cross-channel interaction VPA module increases by 3% compared to the standard network on the MO-CSSSD. The VPA-based semantic segmentation network can significantly improve precision efficiency compared with other conventional attention networks. Furthermore, the results on the WHU Building dataset present an improvement in IoU and F1-score by 1.69% and 0.97%, respectively. Our network raises the mIoU by 1.24% on the ISPRS Vaihingen dataset. The VPA module can also significantly improve the network’s performance on small target segmentation.

Improving Chinese Named Entity Recognition by Interactive Fusion of Contextual Representation and Glyph Representation

Named entity recognition (NER) is a fundamental task in natural language processing. In Chinese NER, additional resources such as lexicons, syntactic features and knowledge graphs are usually introduced to improve the recognition performance of the model. However, Chinese characters evolved from pictographs, and their glyphs contain rich semantic information, which is often ignored. Therefore, in order to make full use of the semantic information contained in Chinese character glyphs, we propose a Chinese NER model that combines character contextual representation and glyph representation, named CGR-NER (Character–Glyph Representation for NER). First, CGR-NER uses the large-scale pre-trained language model to dynamically generate contextual semantic representations of characters. Secondly, a hybrid neural network combining a three-dimensional convolutional neural network (3DCNN) and bi-directional long short-term memory network (BiLSTM) is designed to extract the semantic information contained in a Chinese character glyph, the potential word formation knowledge between adjacent glyphs and the contextual semantic and global dependency features of the glyph sequence. Thirdly, an interactive fusion method with a crossmodal attention and gate mechanism is proposed to fuse the contextual representation and glyph representation from different models dynamically. The experimental results show that our proposed model achieves 82.97% and 70.70% F1 scores on the OntoNotes 4 and Weibo datasets. Multiple ablation studies also verify the advantages and effectiveness of our proposed model.

In vivo imaging of calcium dynamics in zebrafish hepatocytes.

Hepatocytes were the first cell type for which oscillations of cytoplasmic calcium levels in response to hormones were described. Since then, investigation of calcium dynamics in liver explants and culture has greatly increased our understanding of calcium signaling. A bottleneck, however, exists in observing calcium dynamics in a noninvasive manner because of the optical inaccessibility of the mammalian liver. Here, we aimed to take advantage of the transparency of the zebrafish larvae to image hepatocyte calcium dynamics in vivo at cellular resolution. We developed a transgenic model expressing a calcium sensor, GCaMP6s, specifically in zebrafish hepatocytes. Using this, we provide a quantitative assessment of intracellular calcium dynamics during multiple contexts, including growth, feeding, ethanol-induced stress, and cell ablation. Specifically, we show that synchronized calcium oscillations are present in vivo , which are lost upon starvation. Starvation induces lipid accumulation in the liver. Feeding recommences calcium waves in the liver, but in a spatially restricted manner, as well as resolves starvation-induced hepatic steatosis. By using a genetically encoded scavenger for calcium, we show that dampening of calcium signaling accelerates the accumulation of starvation-related lipid droplets in the liver. Furthermore, ethanol treatment, as well as cell ablation, induces calcium flux, but with different dynamics. The former causes asynchronous calcium oscillations, whereas the latter leads to a single calcium spike. We demonstrate the presence of oscillations, waves, and spikes in vivo . Calcium waves are present in response to nutrition and negatively regulate starvation-induced accumulation of lipid droplets.

Very long term outcomes of atrial fibrillation ablation

Little is known about the very long term durability of atrial fibrillation (AF) ablation. The purpose of this study was to evaluate very long term AF ablation outcomes. We followed 5200 patients undergoing 7145 ablation procedures. We evaluated outcomes after single and multiple ablation procedures for paroxysmal (PAF; 33.6%), persistent (PeAF; 56.4%), and long-standing (LsAF; 9.9%) AF. We compared 3 ablation eras by initial ablation catheter: early (101 patients) using solid big tip (SBT) catheters (October 2003 to December 2005), intermediate (2143 patients) using open irrigated tip (OIT) catheters (December 2005 to August 2016), and contemporary (2956 patients) using contact force (CF) catheters (March 2014 to December 2021). AF freedom at 5, 10, and 15 years was as follows: initial ablation: PAF 67.8%, 56.3%, 47.6%; PeAF 46.6%, 35.6%, 26.5%; and LsAF 30.4%, 18.0%, 3.4%; final ablation: PAF 80.3%, 72.6%, 62.5%; PeAF 60.1%, 50.2%, 42.5%; and LsAF 43.4%, 32.0%, 20.6%. For PAF and PeAF, CF ablation procedures were better than OIT ablation procedures (P < .0001) and both were better than SBT ablation procedures (P < .001). LsAF had no outcome improvement over the eras. The 8-year success rate after final ablation for CF, OIT, and SBT catheter eras was as follows: PAF 79.1%, 71.8%, 60.0%; PeAF 55.9%, 50.7%, 38.0%; and LsAF 42.7%, 36.2%, 31.8%. Highest AF recurrence was in the first 2 years, with a 2- to 15-year recurrence of 2%/yr. Success predictors after initial and final ablation procedures were younger age, smaller left atrium, shorter AF duration, male sex, less persistent AF, lower CHA2DS2-VASc score, fewer drugs failed, and more recent catheter era. After year 2, there is 2%/yr recurrence rate for all AF types. Ablation success is best in the CF catheter era, intermediate in the OIT era, and worst in the SBT era. Over the ablation eras, outcomes improved for PAF and PeAF but not for LsAF. We should follow patients indefinitely after ablation. We need an understanding of how to better ablate more persistent AF.

His-Purkinje conduction system pacing combined with atrioventricular node ablation improves quality of life in older patients with persistent atrial fibrillation refractory to multiple ablation procedures.

Recurrence of atrial fibrillation (AF) is common in patients with persistent AF even after multiple ablation procedures. His-Purkinje conduction system pacing (HPCSP) combined with atrioventricular node ablation (AVNA) is effective in managing patients with AF and heart failure. This study aimed to determine whether HPCSP combined with AVNA can improve quality of life and alleviate symptoms in older patients with symptomatic persistent AF refractory to multiple ablation procedures, as well as evaluate the feasibility and safety of this therapy. Older patients (≥ 65 years) with symptomatic persistent AF refractory to at least two ablation procedures were treated with combined HPCSP and AVNA. The success rates and complications were recorded. Pacing parameters, European Heart Rhythm Association (EHRA) scores, and Atrial Fibrillation Effect on Quality-of-Life (AFEQT) scores obtained perioperatively were compared with those recorded at the 6-month follow-up examination. Thirty-one patients were enrolled; of those, only thirty patients were eventually treated with AVNA because one patient developed a complete atrioventricular block following the withdrawal of the His bundle pacing lead. The success rates were 100% for HPCSP (22 cases with His bundle pacing, and 9 cases with left bundle branch pacing) and 93.3% (28/30) for AVNA, respectively. By the 6-month follow-up examination, EHRA scores improved significantly (3.00 ± 0.73 vs. 2.44 ± 0.63, P = 0.014) and AFEQT scores increased markedly (49.6 ± 20.6 vs. 70.9 ± 14.0, P = 0.001). No severe complications developed. When used in older patients with symptomatic persistent AF refractory to multiple ablation procedures, HPCSP combined with AVNA significantly alleviated symptoms and improved quality of life during short-term follow-up. This therapy was proved to be safe and effective in this patient population.

Prognostic Value of Left Atrial Calcification After Catheter Ablation for Atrial Fibrillation

BackgroundLeft atrial calcification (LAC) has occasionally been observed in patients who underwent catheter ablation for atrial fibrillation (AF) by chest computed tomography (CT). However, the evidence regarding the clinical impact of LAC in patients with AF is lacking. ObjectivesThis study aims to investigate the prevalence of LAC in AF patients and evaluate its clinical significance after AF ablation. MethodsThis observational registry included AF patients who received computed tomography and serial transthoracic echocardiography between January 2010 and November 2017. The primary composite outcome included cardiovascular death, hospitalization for worsening heart failure, and ischemic stroke. ResultsAmong 534 patients (age 72 ± 13 years, 62.5% men) who met the inclusion criteria, 31 (5.8%) had LAC. In multivariable analysis, AF ablation was associated with an 11.8-fold (OR: 11.8; 95% CI: 2.03-227.65) increased risk of the development of LAC in AF patients. Among 218 patients with AF ablation, LAC was detected in 30 (13.8%) patients. Prior stroke (HR: 2.73; 95% CI: 1.08-6.93) and multiple ablation procedures (HR: 4.21; 95% CI: 1.63-10.87) were independently associated with the development of LAC in AF-ablation patients. During a median follow-up of 5.8 years, the primary composite outcome occurred in 11 patients in the LAC group (39.8 per 1,000 person-years) and 10 patients in the non-LAC group (8.9 per 1,000 person-years). The adjusted HR for the primary composite outcome in the LAC group, as compared with the non-LAC group, was 2.81 (95% CI: 1.16-6.84; P = 0.02). ConclusionsThe presence of LAC was a significant and independent prognostic factor for identifying major adverse cardiovascular events after AF ablation.

Minimally Invasive Destructive, Ablative, and Disconnective Epilepsy Surgery

AbstractConventional epilepsy surgery performed by microsurgical dissection typically requires large cranial working windows created with high-speed drills and lengthy incisions. In the past few decades, minimally invasive techniques have been developed with smaller incisions, comparable efficacy, shorter hospitalizations, and better safety profiles. These minimally invasive alternatives utilize stereotactic, ultrasonic, radiotherapeutic, and endoscopic techniques. Although not able to completely replace conventional surgery for all etiologies of epilepsy, these minimally invasive techniques have revolutionized modern epilepsy surgery and have been an invaluable asset to the neurosurgeon's repertoire. The endoscope has allowed for surgeons to have adequate visualization during resective and disconnective epilepsy surgeries using keyhole or miniature craniotomies. Modern stereotactic techniques such as laser interstitial thermal therapy and radiofrequency ablation can be used as viable alternatives for mesial temporal lobe epilepsy and can destroy lesional tissue deep areas without the approach-related morbidity of microsurgery such as with hypothalamic hamartomas. These stereotactic techniques do not preclude future surgery in the settings of treatment failure and have been used successfully after failed conventional surgery. Multiple ablation corridors can be performed in a single procedure that can be used for lesioning of large targets or to simplify treating multifocal epilepsies. These stereotactic techniques have even been used successfully to perform disconnective procedures such as hemispherotomies and corpus callosotomies. In patients unable to tolerate surgery, stereotactic radiosurgery is a minimally invasive option that can result in improved seizure control with minimal procedural risks. Advances in minimally invasive neurosurgery provide viable treatment options for drug-resistant epilepsy with quicker recovery, less injury to functional brain, and for patients that may otherwise not choose conventional surgery.

His-Purkinje conduction system pacing and atrioventricular node ablation in treatment of persistent atrial fibrillation refractory to multiple ablation procedures: A case report

In patients with symptomatic atrial fibrillation refractory to optimal medical therapy, atrioventricular node ablation followed by permanent pacemaker implantation is an effective treatment option. A 66-year-old woman with symptomatic persistent atrial fibrillation refractory to multiple ablation procedures was referred to our institution. After optimal drug therapy, the patient still had obvious symptoms. Sequential His-Purkinje conduction system pacing and atrioventricular node ablation were performed. Left bundle branch pacing was used as a backup pacing method if thresholds of His bundle pacing were too high or loss of His bundle capture occurred in the follow-up. At the 6-month follow-up, the European Heart Rhythm Association classification for AF was improved, the score of the Atrial Fibrillation Effect on Quality of Life was enhanced, and the 6-Minute Walk Test was ameliorated. The present case was subjected to His-Purkinje conduction system pacing in combination with atrioventricular node ablation as treatment for a symptomatic persistent atrial fibrillation refractory to multiple ablation procedures, and this procedure alleviated symptoms and improved the quality of life in a short-term follow-up.

Stereotactic radioablation in clinical practice for the treatment of a patient with ventricular tachycardia: case report

The aim of the study is the demonstration of the 1st clinical experience of stereotactic arrhythmia radioablation (STAR) of the patient with antiarrhythmic drug (AAD) refractory ventricular tachycardia (VT) in Russia. The results of STAR of 57 years old patient with AAD and multiple radiofrequency ablation refractory VT are described. This clinical study demonstrates efficacy and safety of STAR of VT.

Background-lead self-attention for image harmonization

Image composition constructs a new image by cutting out a part of one image and then pasting it on another image. However, the quality of the new image is generally low due to inconsistency between the two parts. To overcome this, image harmonization aims to obtain realistic composite images by adjusting the color, illumination, and visual style of the foreground, to make it compatible with the background. Nevertheless, previous image harmonization techniques mostly concentrate on learning a mapping network from composite image to real image, and they ignore the significant role of background visual styles as a mapping guide. In this task, we consider image harmonization as a style transfer problem. Specifically, we take foreground as the content image and background as the style image, to transform the foreground’s style through background’s style features. To do so, we propose a unique self-attention-based module to learn the mapping between foreground features and background features using a modified self-attention mechanism. The proposed module can calculate the degree of correlation between the foreground and background according to the semantic distribution and also aligns the channel-wise mean and variance of the foreground features with that of the background features in the meantime. To comprehensively investigate the effectiveness of proposed module, we perform multiple experiments and ablation studies on the existing benchmark dataset iHarmony4. The experimental results prove that our module is more effective compared to the baseline in our task, and our harmonized image looks much closer to the real image.

Non-Invasive Heat-Induced Numerous Tissue Ablation Simulation in a Medical Environment Using Different Focal Length High Intensity Focused Ultrasound Apparatus

In the field of biomedical, HIFU is a non-invasive therapeutic method that employs non-ionizing acoustic waves to increase the temperature. According to its high efficiency and cheap cost, it has been the main focus of this research. The key stages of this tumor ablation include mechanical and thermal effects. Simulations on tissue ablation with HIFU were implemented in this research to investigate how multiple tissue ablation works and how to enhance tumor ablation while avoiding injury to surrounding healthy tissue by altering the optimal intensity, power, focal length and lens radius of curvature. In order to find the optimal features of the proposed model, this analysis employs clinical applications. Numerous soft and hard tissues from the human body were chosen for this analysis. At a specified acoustic power and exposure period, each tissues optimal frequency (1.6 MHz to 3.5 MHz) and power (120 W to 140 W) were obtained for effective tissue ablation. This research performed all computations by changing the focal length from 55 mm to 65 mm. The outcomes of this therapy might require several weeks to comfortably remove tumor. This optimum result indicates that HIFU tumor ablation procedure has a high probability of success.

Abstract 11573: Refractory Ventricular Tachyardia Storm: Treatment With Sympathetic Denervation in Patient With Non-Ischemic Cardiomyopathy

Introduction: Ventricular tachycardia (VT) is a potentially life-threatening arrhythmia commonly present in cardiomyopathy. Implantable cardioverter-defibrillator (ICD) placement can decrease mortality in patients with VT. However, when an ICD shocks it can cause direct myocardial injury, contraction band necrosis, fibrosis, and significant morbidity. Antiarrhythmic medications and catheter ablation can decrease arrhythmia burden and ICD shocks. Cardiac sympathetic denervation has been effective in a few refractory cases, but prospective data is scarce, especially in non-ischemic cardiomyopathy. Case description We present the case of a 59-year-old gentleman with a past medical history of hypertension, diabetes, hypothyroidism, atrial fibrillation, and non-ischemic cardiomyopathy, who presented to the hospital with recurrent ICD shocks. The patient had an ICD placed due to an episode of non-sustained VT resulting in presyncope. The patient had an arrhythmia-free period of 10 years followed by frequent VT. He was managed in the outpatient setting with amiodarone, dofetilide, and mexiletine which did not suppress his arrhythmia burden. Cardiac MRI showed multi-segment transmural late gadolinium enhancement consistent with a non-ischemic pattern. He underwent three endocardial and epicardial ablations over eight months before this admission. He was started on amiodarone and lidocaine infusions. With his history of recurrent VT despite multiple ablations, the patient underwent bilateral thoracoscopic sympathetic denervation. He was discharged from the hospital six days post-op without any episodes of VT. His latest ICD check which was ten months post-operatively did not show any VT or VT-induced ICD shock. Conclusion VT storm may be associated with a catecholaminergic surge and be refractory to traditional therapy. Due to this, sympathetic denervation is a viable option to prevent morbidity of frequent defibrillator therapy. This case highlights the utility of sympathetic denervation as a treatment of refractory ventricular arrhythmias in non-ischemic cardiomyopathy.

Abstract 15077: Reconnection of Pulmonary Veins and Left Atrial Posterior Wall Following Catheter Ablation for Atrial Fibrillation in Real-World Patients: Registry Data From a High-Volume Center

Introduction: Durable isolation of the pulmonary veins (PV) and the left atrial posterior wall (LAPW) are considered as key determinants of long-term success after catheter ablation in AF patients. Objective: We aimed to evaluate the PV and LAPW reconnection rate in real-world patients undergoing redo-ablation at our center. Methods: Consecutive AF patients that underwent their first AF ablation at our center from 2015-19 were included in this analysis. At the index procedure, all received electrical isolation of PVs and the LAPW area between the PVs, using radiofrequency (RF) ablation. Procedure was conducted with 3.5-mm irrigated-tip catheter guided by circular mapping catheter, intra-cardiac echocardiography and a 3-D mapping system. RF energy was delivered with a maximum temperature setting of 42 0 C, contact force of 10g and a power of up to 45W. Posterior wall isolation was performed using multiple ablation points covering the whole posterior wall. An esophageal probe was utilized in all patients to monitor esophageal temperature during ablation in the LAPW in close proximity to the esophagus. Complete abolition of all PV potentials rather than decrease in the amplitudes was the end point and confirmed by entrance and/or exit block. All patients were followed up prospectively for 2 years with quarterly evaluation during the first year and bi-annually afterwards and the data was collected in our IRB-approved AF registry. Recovery of conduction in the PVs and LAPW were assessed at the redo procedure using pacing or incremental isoproterenol infusion of 20- 30μg/min for 15-20min. Results: During the study period, 6,817 AF ablation procedures were performed at our institution of which 3,113 AF patients undergoing their first catheter ablation were included in the analysis and prospectively followed up for 2 years. Baseline characteristics of the study population is given in Table 1. At 23.1±12.8 months of follow-up, 614 (19.7%) patients had received redo-ablation, of which 139 (22.6%) had one or more PV or LAPW reconnected. Conclusion: In this series, with experienced operators performing the procedures, the rate of recovery of conduction in the PVs and LAPW was low compared to the reported high incidence rate in the literature.

EP News: Case Reports.

Catheter ablation for atrial fibrillation (AF) is more effective than drug therapy. In patients with persistent and long-standing persistent AF, additional ablation is often required that can compromise mechanical function that can lead to long-term morbidity. Ali et al (https://doi.org/10.1016/j.hrcr.2022.07.015) shared a case of a 72-year-old man with a history of 3 prior ablation procedures for symptomatic AF, including multiple linear ablation procedures in addition to pulmonary vein isolation.

Successful Ablation of Decrementally Conducting Atrioventricular Fiber (Mahaim) at The Distal Ventricular Insertion Site by Using 3D-High Density Mapping after Previous Multiple Failed Conventional Ablation Attemps

Successful Ablation of Decrementally Conducting Atrioventricular Fiber (Mahaim) at The Distal Ventricular Insertion Site by Using 3D-High Density Mapping after Previous Multiple Failed Conventional Ablation Attemps

Deep Learning Model with Sequential Features for Malware Classification

Currently, malware shows an explosive growth trend. Demand for classifying malware is also increasing. The problem is the low accuracy of both malware detection and classification. From the static features of malicious families, a new deep learning method of TCN-BiGRU was proposed in this study, which combined temporal convolutional network (TCN) and bidirectional gated recurrent unit (BiGRU). First, we extracted the features of malware assembly code sequences and byte code sequences. Second, we shortened the opcode sequences by TCN to explore the features in the data and then used the BiGRU network to capture the opcode sequences in both directions to achieve deep extraction of the features of the opcode sequences. Finally, the fully connected and softmax layers were used to output predictions of the deep features. Multiple comparisons and ablation experiments demonstrated that the accuracy of malware detection and classification were effectively improved by our method. Our overall performance was 99.72% for samples comprising nine different classes, and our overall performance was 96.54% for samples comprising two different classes.

Medical decision support system using weakly-labeled lung CT scans.

PurposeDetermination and development of an effective set of models leveraging Artificial Intelligence techniques to generate a system able to support clinical practitioners working with COVID-19 patients. It involves a pipeline including classification, lung and lesion segmentation, as well as lesion quantification of axial lung CT studies.ApproachA deep neural network architecture based on DenseNet is introduced for the classification of weakly-labeled, variable-sized (and possibly sparse) axial lung CT scans. The models are trained and tested on aggregated, publicly available data sets with over 10 categories. To further assess the models, a data set was collected from multiple medical institutions in Colombia, which includes healthy, COVID-19 and patients with other diseases. It is composed of 1,322 CT studies from a diverse set of CT machines and institutions that make over 550,000 slices. Each CT study was labeled based on a clinical test, and no per-slice annotation took place. This enabled a classification into Normal vs. Abnormal patients, and for those that were considered abnormal, an extra classification step into Abnormal (other diseases) vs. COVID-19. Additionally, the pipeline features a methodology to segment and quantify lesions of COVID-19 patients on the complete CT study, enabling easier localization and progress tracking. Moreover, multiple ablation studies were performed to appropriately assess the elements composing the classification pipeline.ResultsThe best performing lung CT study classification models achieved 0.83 accuracy, 0.79 sensitivity, 0.87 specificity, 0.82 F1 score and 0.85 precision for the Normal vs. Abnormal task. For the Abnormal vs COVID-19 task, the model obtained 0.86 accuracy, 0.81 sensitivity, 0.91 specificity, 0.84 F1 score and 0.88 precision. The ablation studies showed that using the complete CT study in the pipeline resulted in greater classification performance, restating that relevant COVID-19 patterns cannot be ignored towards the top and bottom of the lung volume.DiscussionThe lung CT classification architecture introduced has shown that it can handle weakly-labeled, variable-sized and possibly sparse axial lung studies, reducing the need for expert annotations at a per-slice level.ConclusionsThis work presents a working methodology that can guide the development of decision support systems for clinical reasoning in future interventionist or prospective studies.

Synthesised Conductive/Magnetic Composite Particles for Magnetic Ablations of Tumours.

Ablation is a clinical cancer treatment, but some demands are still unsatisfied, such as electromagnetic interferences amongst multiple ablation needles during large tumour treatments. This work proposes a physical synthesis for composite particles of biocompatible iron oxide particles and liquid metal gallium (Ga) with different alternative-current (AC)-magnetic-field-induced heat mechanisms of magnetic particle hyperthermia and superior resistance heat. By some imaging, X-ray diffraction, and vibrating sample magnetometer, utilised composite particles were clearly identified as the cluster of few iron oxides using the small weight ratio of high-viscosity liquid metal Ga as conjugation materials without surfactants for physical targeting of limited fluidity. Hence, well penetration inside the tissue and the promotion rate of heat generation to fit the ablation requirement of at least 60 °C in a few seconds are achieved. For the injection and the post-injection magnetic ablations, the volume variation ratios of mice dorsal tumours on Day 12 were expressed at around one without tumour growth. Its future powerful potentiality is expected through a percutaneous injection.

Endoscopic transection of right L3 and L4 medial branch nerves and L5 dorsal ramus: A 2-dimensional operative video

Zygapophyseal joints in the lumbar spine are innervated by medial branches of the dorsal rami of spinal nerves and have been implicated in the generation of axial low back pain. Percutaneous radiofrequency ablation procedures target bony landmarks under fluoroscopic guidance near the anticipated location of medial branches and dorsal rami. In contrast, endoscopic visualization allows for surgical transection of the targeted nerves through either direct visualization or dissection and ablation of the tissues surrounding the expected trajectory of the nerves. Endoscopic transection of medial branches and dorsal rami has been suggested as a possible alternative to percutaneous radiofrequency lesioning although further research is needed to define indications, explore relative risks and benefits, and evaluate efficacy by directly comparing these two techniques. In this video, we present a case of a female with chronic axial low back pain that was refractory to conservative care including physical therapy, exercise, facet steroid injections, and analgesic medications. After positive response to blocking the L3, L4 medial branch nerves and the L5 dorsal ramus, the patient underwent multiple percutaneous radiofrequency ablations, which provided progressively shorter duration of relief. With her persistent symptoms suggestive of facet-mediated lumbar back pain, endoscopic transection was offered as an alternative approach. We provide an operative video including discussion of imaging, target anatomy and operative steps for endoscopically-visualized transection of the L3 and L4 medial branch nerves and the L5 dorsal ramus on the right side.

A High-Performance Day-Age Classification and Detection Model for Chick Based on Attention Encoder and Convolutional Neural Network.

Simple SummaryMost management methods for poultry farming currently rely on human labor. Such management is labor-intensive and inefficient, especially in identifying poultry growth stages. Given the lack of a high-precision artificial method for chick’s day-age detection, a high-performance day-age classification and detection model for chicks was proposed based on artificial intelligent techniques. This method can detect and classify chicks in six different living stages from 1 to 32 day-ages, and the accuracy is 95.2%, superior to other current ones. In order to apply this method in practical scenarios, it has been deployed into an application based on the IOS system, which can recoganize the day-age of chicks by capturing real-time photos. The system is currently deployed in Rizhao City, Shandong Province, China. It helps chicken farm staff automatically detect the behavior of chickens, whose excellent working effect proves the robust availibility of the proposed method.Thanks to the boom of computer vision techniques and artificial intelligence algorithms, it is more available to achieve artificial rearing for animals in real production scenarios. Improving the accuracy of chicken day-age detection is one of the instances, which is of great importance for chicken rearing. To solve this problem, we proposed an attention encoder structure to extract chicken image features, trying to improve the detection accuracy. To cope with the imbalance of the dataset, various data enhancement schemes such as Cutout, CutMix, and MixUp were proposed to verify the effectiveness of the proposed attention encoder. This paper put the structure into various mainstream CNN networks for comparison and multiple ablation experiments. The final experimental results show that by applying the attention encoder structure, ResNet-50 can improve the accuracy of chicken age detection to 95.2%. Finally, this paper also designed a complete image acquisition system for chicken houses and a detection application configured for mobile devices.