Deep learning for the rapid automatic quantification and characterization of rotator cuff muscle degeneration from shoulder CT datasets.

This study aimed at developing a convolutional neural network (CNN) able to automatically quantify and characterize the level of degeneration of rotator cuff (RC) muscles from shoulder CT images including muscle atrophy and fatty infiltration. One hundred three shoulder CT scans from 95 patients with primary glenohumeral osteoarthritis undergoing anatomical total shoulder arthroplasty were retrospectively retrieved. Three independent radiologists manually segmented the premorbid boundaries of all four RC muscles on standardized sagittal-oblique CT sections. This premorbid muscle segmentation was further automatically predicted using a CNN. Automatically predicted premorbid segmentations were then used to quantify the ratio of muscle atrophy, fatty infiltration, secondary bone formation, and overall muscle degeneration. These muscle parameters were compared with measures obtained manually by human raters. Average Dice similarity coefficients for muscle segmentations obtained automatically with the CNN (88% ± 9%) and manually by human raters (89% ± 6%) were comparable. No significant differences were observed for the subscapularis, supraspinatus, and teres minor muscles (p > 0.120), whereas Dice coefficients of the automatic segmentation were significantly higher for the infraspinatus (p < 0.012). The automatic approach was able to provide good-very good estimates of muscle atrophy (R <sup>2</sup> = 0.87), fatty infiltration (R <sup>2</sup> = 0.91), and overall muscle degeneration (R <sup>2</sup> = 0.91). However, CNN-derived segmentations showed a higher variability in quantifying secondary bone formation (R <sup>2</sup> = 0.61) than human raters (R <sup>2</sup> = 0.87). Deep learning provides a rapid and reliable automatic quantification of RC muscle atrophy, fatty infiltration, and overall muscle degeneration directly from preoperative shoulder CT scans of osteoarthritic patients, with an accuracy comparable with that of human raters. • Deep learning can not only segment RC muscles currently available in CT images but also learn their pre-existing locations and shapes from invariant anatomical structures visible on CT sections. • Our automatic method is able to provide a rapid and reliable quantification of RC muscle atrophy and fatty infiltration from conventional shoulder CT scans. • The accuracy of our automatic quantitative technique is comparable with that of human raters

One transition, many transitions? A corpus-based study of societal sustainability transition discourses in four civil society’s proposals

When the civil society makes ‘transition’ its label, it cannot be assumed that different civil society actors share compatible varieties of localist or radical transformationists discourses. This study has comparatively analyzed the discourses in four civil society sustainability transition proposals using a corpus-based methodology. We found that the proposals are similar as they identify the economy as an object and an entry point for transition, frame the economy as embedded in the socio–ecological system, ascribe agency to grassroots movements for transitions from the bottom–up. We also found crucial differences among the discourses regarding the role of the State, the degree of reform or radical innovation, the degree of imaginative character of the sustainability vision, the degree of opposition to capitalism. We suggest that insights on how the civil society employs notions of transition with respect to the themes of politics, emotions and place can help advance theorizations and practices of societal sustainability transitions led by the civil society

Progressive ductile shearing during till accretion within the deforming bed of a palaeo-ice stream

This paper presents the results of a detailed microstructural study of a thick till formed beneath the Weichselian (Devensian) Odra palaeo-ice stream, west of Środa Wielkopolska, Poland. This SE-flowing ice stream was one of a number of corridors of faster flowing ice which drained the Scandinavian Ice Sheet in the Baltic region. Macroscopically, the massive, laterally extensive till which formed the bed of this ice stream lacks any obvious evidence of glaciotectonism (thrusting, folding). However, microscale analysis reveals that bed deformation was dominated by foliation development, recording progressive ductile shearing within a subhorizontal subglacial shear zone. Five successive generations of clast microfabric (S1 to S5) have been identified defining a set of up-ice and down-ice dipping Riedel shears, as well as a subhorizontal shear foliation coplanar to the ice-bed interface. Cross-cutting relationships between the shear fabrics record temporal changes in the style of deformation during this progressive shear event. Kinematic indicators (S-C and ECC-type fabrics) within the till indicate a consistent SE-directed shear sense, in agreement with the regional ice flow pattern. A model of bed deformation involving incremental progressive simple shear during till accretion is proposed. The relative age of this deformation was diachronous becoming progressively younger upwards, compatible with subglacial shearing having accompanied till accretion at the top of the deforming bed. Variation in the relative intensity of the microfabrics records changes in the magnitude of the cumulative strain imposed on the till and the degree of coupling between the ice and underlying bed during fast ice flow

Using surface velocities to calculate ice thickness and bed topography: A case study at Columbia Glacier, Alaska, USA

Information about glacier volume and ice thickness distribution is essential for many glaciological applications, but direct measurements of ice thickness can be difficult and costly. We present a new method that calculates ice thickness via an estimate of ice flux. We solve the familiar continuity equation between adjacent flowlines, which decreases the computational time required compared to a solution on the whole grid. We test the method on Columbia Glacier, a large tidewater glacier in Alaska, USA, and compare calculated and measured ice thicknesses, with favorable results. This shows the potential of this method for estimating ice thickness distribution of glaciers for which only surface data are available. We find that both the mean thickness and volume of Columbia Glacier were approximately halved over the period 1957-2007, from 281m to 143 m, and from 294 km3 to 134 km 3, respectively. Using bedrock slope and considering how waves of thickness change propagate through the glacier, we conduct a brief analysis of the instability of Columbia Glacier, which leads us to conclude that the rapid portion of the retreat may be nearing an end

New insights into changes in corneal thickness in healthy mountaineers during a very-high-altitude climb to Mount Muztagh Ata

OBJECTIVE: To investigate the effect of very high altitude and different ascent profiles on central corneal thickness (CCT). METHODS: Twenty-eight healthy mountaineers were randomly assigned to 2 different ascent profiles during a medical research expedition to Mount Muztagh Ata (7546 m) in western China. Group 1 was allotted a shorter acclimatization time prior to ascent to 6265 m. The main outcome measure was CCT. Secondary outcome measures were oxygen saturation (SpO(2)) and symptom assessments of acute mountain sickness (cerebral acute mountain sickness score). Examinations were performed at 490, 4497, 5533, and 6265 m. RESULTS: Central corneal thickness increased in both groups with increasing altitude and decreased after descent. In group 1 (with the shorter acclimatization), mean CCT increased from 537 to 572 microm. Mean CCT in group 2 increased from 534 to 563 microm (P = .048). The amount of decrease in SpO(2) paralleled the increase in CCT. There was no significant decrease in visual acuity. There was a significant correlation between CCT and cerebral acute mountain sickness score when controlled for SpO(2) and age. CONCLUSIONS: Corneal swelling during high-altitude climbs is promoted by low SpO(2). Systemic delivery of oxygen to the anterior chamber seems to play a greater role in corneal oxygenation than previously thought. Adhering to a slower ascent profile results in less corneal edema. Visual acuity in healthy corneas is not adversely affected by edema at altitudes of up to 6300 m. Individuals with more acute mountain sickness-related symptoms had thicker corneas, possibly due to their higher overall susceptibility to hypoxia

New insights into ocular blood flow at very high altitudes

Little is known about the ocular and cerebral blood flow during exposure to increasingly hypoxic conditions at high altitudes. There is evidence that an increase in cerebral blood flow resulting from altered autoregulation constitutes a risk factor for acute mountain sickness (AMS) and high-altitude cerebral edema (HACE) by leading to capillary overperfusion and vasogenic cerebral edema. The retina represents the only part of the central nervous system where capillary blood flow is visible and can be measured by noninvasive means. In this study we aimed to gain insights into retinal and choroidal autoregulatory properties during hypoxia and to correlate circulatory changes to symptoms of AMS and clinical signs of HACE. This observational study was performed within the scope of a high-altitude medical research expedition to Mount Muztagh Ata (7,546 m). Twenty seven participants underwent general and ophthalmic examinations up to a maximal height of 6,800 m. Examinations included fundus photography and measurements of retinal and choroidal blood flow, as well as measurement of arterial oxygen saturation and hematocrit. The initial increase in retinal blood velocity was followed by a decrease despite further ascent, whereas choroidal flow increase occurred later, at even higher altitudes. The sum of all adaptational mechanisms resulted in a stable oxygen delivery to the retina and the choroid. Parameters reflecting the retinal circulation and optic disc swelling correlated well with the occurrence of AMS-related symptoms. We demonstrate that sojourns at high altitudes trigger distinct behavior of retinal and choroidal blood flow. Increase in retinal but not in choroidal blood flow correlated with the occurrence of AMS-related symptoms