Cross-Modal Learning with 3D Deformable Attention for Action Recognition

An important challenge in vision-based action recognition is the embedding of spatiotemporal features with two or more heterogeneous modalities into a single feature. In this study, we propose a new 3D deformable transformer for action recognition with adaptive spatiotemporal receptive fields and a cross-modal learning scheme. The 3D deformable transformer consists of three attention modules: 3D deformability, local joint stride, and temporal stride attention. The two cross-modal tokens are input into the 3D deformable attention module to create a cross-attention token with a reflected spatiotemporal correlation. Local joint stride attention is applied to spatially combine attention and pose tokens. Temporal stride attention temporally reduces the number of input tokens in the attention module and supports temporal expression learning without the simultaneous use of all tokens. The deformable transformer iterates L times and combines the last cross-modal token for classification. The proposed 3D deformable transformer was tested on the NTU60, NTU120, FineGYM, and Penn Action datasets, and showed results better than or similar to pre-trained state-of-the-art methods even without a pre-training process. In addition, by visualizing important joints and correlations during action recognition through spatial joint and temporal stride attention, the possibility of achieving an explainable potential for action recognition is presented.Comment: 10 pages, 8 figure

Preparation of Mgo-ceo2 Mixed Oxide with Ionic Liquid as Catalyst for Dimethyl Carbonate Synthesis Via Transesterification

The synthesis and application of dimethyl carbonate (DMC) are achieving increasing importance due to its low toxicity and versatile reactivity. The phosgenation-route has been losing attraction recently due to the use of virulent phosgene. In transesterification process, DMC is co-generated with ethylene glycol (EG). In this study, various ionic liquids were used as template in coprecipitation methods to prepare mesoporous MgO-CeO2 mixed oxides particles. Among the ionic liquids, [Bmim][BF6] displayed the best performance in terms of activity, while [Omim][PF6] obtained the best selectivity for this reaction. The addition of IL's in the coprecipitation method increased the surface areaand pore volume of the catalysts. Meanwhile, the crystallite size of the catalysts was reduced many times. However, there is no effect of the surface areaand particle size as well on the catalytic activity of the catalyst in this reaction. The activity and selectivity of the catalyst depend on the base strength distribution. The moderate basic site is responsible for the catalytic activity, while the selectivity is more dependableon the strong basic site

Top-down and bottom-up neurodynamic evidence in patients with tinnitus

AbstractAlthough a peripheral auditory (bottom-up) deficit is an essential prerequisite for the generation of tinnitus, central cognitive (top-down) impairment has also been shown to be an inherent neuropathological mechanism. Using an auditory oddball paradigm (for top-down analyses) and a passive listening paradigm (for bottom-up analyses) while recording electroencephalograms (EEGs), we investigated whether top-down or bottom-up components were more critical in the neuropathology of tinnitus, independent of peripheral hearing loss. We observed significantly reduced P300 amplitudes (reflecting fundamental cognitive processes such as attention) and evoked theta power (reflecting top-down regulation in memory systems) for target stimuli at the tinnitus frequency of patients with tinnitus but without hearing loss. The contingent negative variation (reflecting top-down expectation of a subsequent event prior to stimulation) and N100 (reflecting auditory bottom-up selective attention) were different between the healthy and patient groups. Interestingly, when tinnitus patients were divided into two subgroups based on their P300 amplitudes, their P170 and N200 components, and annoyance and distress indices to their tinnitus sound were different. EEG theta-band power and its Granger causal neurodynamic results consistently support a double dissociation of these two groups in both top-down and bottom-up tasks. Directed cortical connectivity corroborates that the tinnitus network involves the anterior cingulate and the parahippocampal areas, where higher-order top-down control is generated. Together, our observations provide neurophysiological and neurodynamic evidence revealing a differential engagement of top-down impairment along with deficits in bottom-up processing in patients with tinnitus but without hearing loss

Bintrafusp Alfa Versus Pembrolizumab in Patients With Treatment-Naive, Programmed Death-Ligand 1–High Advanced NSCLC: A Randomized, Open-Label, Phase 3 Trial

Bintrafusp alfa; NSCLC; PD-L1Bintrafusp alfa; NSCLC; PD-L1Bintrafusp alfa; NSCLC; PD-L1Introduction Bintrafusp alfa, a first-in-class bifunctional fusion protein composed of the extracellular domain of TGF-βRII (a TGF-β “trap”) fused to a human immunoglobulin G1 monoclonal antibody blocking programmed death-ligand 1 (PD-L1), has exhibited clinical activity in a phase 1 expansion cohort of patients with PD-L1–high advanced NSCLC. Methods This adaptive phase 3 trial (NCT03631706) compared the efficacy and safety of bintrafusp alfa versus pembrolizumab as first-line treatment in patients with PD-L1–high advanced NSCLC. Primary end points were progression-free survival according to Response Evaluation Criteria in Solid Tumors version 1.1 per independent review committee and overall survival. Results Patients (N = 304) were randomized one-to-one to receive either bintrafusp alfa or pembrolizumab (n = 152 each). The median follow-up was 14.3 months (95% confidence interval [CI]: 13.1–16.0 mo) for bintrafusp alfa and 14.5 months (95% CI: 13.1–15.9 mo) for pembrolizumab. Progression-free survival by independent review committee was not significantly different between bintrafusp alfa and pembrolizumab arms (median = 7.0 mo [95% CI: 4.2 mo–not reached (NR)] versus 11.1 mo [95% CI: 8.1 mo–NR]; hazard ratio = 1.232 [95% CI: 0.885–1.714]). The median overall survival was 21.1 months (95% CI: 21.1 mo–NR) for bintrafusp alfa and 22.1 months (95% CI: 20.4 mo–NR) for pembrolizumab (hazard ratio = 1.201 [95% CI: 0.796–1.811]). Treatment-related adverse events were higher with bintrafusp alfa versus pembrolizumab; grade 3-4 treatment-related adverse events occurred in 42.4% versus 13.2% of patients, respectively. The study was discontinued at an interim analysis as it was unlikely to meet the primary end point. Conclusions First-line treatment with bintrafusp alfa did not exhibit superior efficacy compared with pembrolizumab in patients with PD-L1–high, advanced NSCLC.The trial was sponsored by the healthcare business of Merck KGaA, Darmstadt, Germany (CrossRef Funder identification: 10.13039/100009945) and was previously part of an alliance between the healthcare business of Merck KGaA, Darmstadt, Germany, and GlaxoSmithKline. The healthcare business of Merck KGaA, Darmstadt, Germany provided the trial drugs. The investigators worked with the healthcare business of Merck KGaA, Darmstadt, Germany on the trial design, collection and analysis of data, and interpretation of results. The authors thank the patients and their families, investigators, co-investigators, and the study teams at each of the participating centers and the healthcare business of Merck KGaA, Darmstadt, Germany. The medical writing support was provided by Joyce Lee, PhD, ClinicalThinking, which was funded by the healthcare business of Merck KGaA, Darmstadt, Germany, and was previously part of an alliance between the healthcare business of Merck KGaA, Darmstadt, Germany, and GlaxoSmithKline in accordance with Good Publication Practice (GPP3) guidelines (http://www.ismpp.org/gpp3)

Tension Pneumothorax after Endoscopic Retrograde Pancreatocholangiogram

We report a case of tension pneumothorax after an endoscopic sphincterotomy. A 78-yr-old woman presented with progressing dyspnea. She had undergone an endoscopic retrograde cholangiopancreatogram three days before due to acute cholecystitis. She underwent endoscopic sphincterotomy for stone extraction, but the procedure failed. On arrival to our hospital, she complained about severe dyspnea and she had subcutaneous emphysema. A computed tomogram scan revealed severe subcutaneous emphysema, right-side tension pneumothorax, and pneumoretroperitoneum. Contrast media injected through a transnasal biliary drainage catheter spilled from the second portion of the duodenum. A second abdominal computed tomogram showed multiple air densities in the retroperitoneum and peritoneal cavity, which were consistent with panperitonitis. We recommended an emergent laparotomic exploration, but the patient's guardians refused. She died eventually due to septic shock. Endoscopic retrograde cholangiopancreatogram is a popular procedure for biliary and pancreatic diseases, but it can cause severe complications such as intestinal perforation. Besides perforations, air can spread through the abdominal cavity, retroperitoneum, mediastinum, and the neck soft tissue, eventually causing pneumothorax. Early recognition and appropriate management is crucial to an optimal output of gastrointestinal perforation and pneumothorax