Learning to school in dense configurations with multi-agent deep reinforcement learning.

Fish are observed to school in different configurations. However, how and why fish maintain a stable schooling formation still remains unclear. This work presents a numerical study of the dense schooling of two free swimmers by a hybrid method of the multi-agent deep reinforcement learning and the immersed boundary-lattice Boltzmann method. Active control policies are developed by synchronously training the leader to swim at a given speed and orientation and the follower to hold close proximity to the leader. After training, the swimmers could resist the strong hydrodynamic force to remain in stable formations and meantime swim in desired path, only by their tail-beat flapping. The tail movement of the swimmers in the stable formations are irregular and asymmetrical, indicating the swimmers are carefully adjusting their body-kinematics to balance the hydrodynamic force. In addition, a significant decrease in the mean amplitude and the cost of transport is found for the followers, indicating these swimmers could maintain the swimming speed with less efforts. The results also show that the side-by-side formation is hydrodynamically more stable but energetically less efficient than other configurations, while the full-body staggered formation is energetically more efficient as a whole.

Surgical treatment of gynecomastia: mastectomy compared to liposuction technique.

BACKGROUND: Gynecomastia is a benign enlargement of the male breast. Yet enlarged breasts cause anxiety, embarrassment, psychosocial discomfort, and fear of breast cancer. The aim of this study was to assess the experience of gynecomastia patients undergoing mastectomy and liposuction surgery. METHODS: Seven hundred thirty-three patients were analyzed for age, chief complaint, position, grade, operation approach, biopsy, and complication between mastectomy group and liposuction group, from 1990 to 2010. RESULTS: Four hundred two patients (436 breasts) were treated with mastectomy and 331 patients (386 breasts) were treated with liposuction techniques. Three hundred thirty (82%) patients complained of breast lump and lump with pain in mastectomy group, and 204 (61%) patients complained of enlargement breast and enlargement with pain in liposuction group (P < 0.05). All excision specimens were performed for routine histological analysis which showed pathologic diagnosis in patients with mastectomy (100%). One hundred fifty-nine (41%) patients with liposuction acquired pathologic diagnosis through fine needle aspiration and/or core biopsy (P < 0.05). The reoperation rates in mastectomy group and liposuction group were 1.4% and 0.5%, respectively. There were no nipple/areola necrosis and scars in liposuction group. CONCLUSIONS: The surgical treatment of gynecomastia required an individual approach, depending on symptoms (lump or enlargement) and requirements of patients. Patients who chose mastectomy were looking for reassurance that their pathologic diagnosis was benign. The increase in the number of liposuction patients was reflected in our study because it was associated with superior esthetic results and few complications.