Bellybutton: accessible and customizable deep-learning image segmentation.

The conversion of raw images into quantifiable data can be a major hurdle and time-sink in experimental research, and typically involves identifying region(s) of interest, a process known as segmentation. Machine learning tools for image segmentation are often specific to a set of tasks, such as tracking cells, or require substantial compute or coding knowledge to train and use. Here we introduce an easy-to-use (no coding required), image segmentation method, using a 15-layer convolutional neural network that can be trained on a laptop: Bellybutton. The algorithm trains on user-provided segmentation of example images, but, as we show, just one or even a sub-selection of one training image can be sufficient in some cases. We detail the machine learning method and give three use cases where Bellybutton correctly segments images despite substantial lighting, shape, size, focus, and/or structure variation across the regions(s) of interest. Instructions for easy download and use, with further details and the datasets used in this paper are available at pypi.org/project/Bellybuttonseg .

Effect of lung isolation with different airway devices on postoperative pneumonia in patients undergoing video-assisted thoracoscopic surgery: a propensity score-matched study.

BACKGROUND: Postoperative pneumonia is one of the common complications after video-assisted thoracoscopic surgery. There is no related study on the effect of lung isolation with different airway devices on postoperative pneumonia. Therefore, in this study, the propensity score matching method was used to retrospectively explore the effects of different lung isolation methods on postoperative pneumonia in patients undergoing video-assisted thoracoscopic surgery. METHODS: This is A single-center, retrospective, propensity score-matched study. The information of patients who underwent VATS in Weifang People 's Hospital from January 2020 to January 2021 was retrospectively included. The patients were divided into three groups according to the airway device used in thoracoscopic surgery: laryngeal mask combined with bronchial blocker group (LM + BB group), tracheal tube combined with bronchial blocker group (TT + BB group) and double-lumen endobronchial tube group (DLT group). The main outcome was the incidence of pneumonia within 7 days after surgery; the secondary outcome were hospitalization time and hospitalization expenses. Patients in the three groups were matched using propensity score matching (PSM) analysis. RESULTS: After propensity score matching analysis, there was no significant difference in the incidence of postoperative pneumonia and hospitalization time among the three groups (P > 0.05), but there was significant difference in hospitalization expenses among the three groups (P < 0.05). CONCLUSIONS: There was no significant difference in the effect of different intubation lung isolation methods on postoperative pneumonia in patients undergoing thoracoscopic surgery.

Clinical Study of Flumazenil Antagonizing Remimazolam on Nausea and Vomiting After Gynecologic Day Surgery.

Purpose: To evaluate the effect of flumazenil antagonizing remimazolam on postoperative nausea and vomiting (PONV) after gynecologic day surgery. Patients and Methods: 141 cases of gynaecological daycase surgery patients in Weifang People's Hospital were selected, randomized into group F (flumazenil group, 71 cases) and group C (control group, 70 cases). Dexamethasone 5 mg, flurbiprofen axetil 50 mg, and droperidol 1 mg were given intravenously before induction of anesthesia in both groups. Anesthesia induction: Remimazolam 0.25mg / kg was injected within 1 minute. After the patient fell asleep, mivacurium chloride 0.2mg / kg was injected for 30 seconds and alfentanil 20ug / kg was injected for 30 seconds. Anesthesia maintenance: Remimazolam 1mg/kg/h and alfentanil 40ug/kg/h were continuously pumped by micro pump. Stopping the injection of remimazolam and alfentanil at the end of the operation. Flumazenil 0.2 mg was given to antagonize remimazolam in group F after 1 minute. Group C was given an equal volume of saline. The incidence of PONV in the postoperative PACU and over a 24-hour period, patient awakening time, and general patient information were recorded. Results: The incidence of PONV in both groups within 24 hours was 50.70% in group F was significantly higher than 32.86% in group C. The difference was statistically significant (P < 0.05). The incidence of PONV in the PACU was 5.6% in group F and 8.6% in group C. The difference was not statistically significant (p > 0.05). Conclusion: Flumazenil antagonism of remimazolam increases the incidence of PONV within 24 hours in gynecologic day surgery patients and has no significant effect on the incidence of PONV in the PACU.

Identification of aneuploidy-related gene signature to predict survival in head and neck squamous cell carcinomas.

BACKGROUND: To parse the characteristics of aneuploidy related riskscore (ARS) model in head and neck squamous cell carcinomas (HNSC) and their predictive ability on patient prognosis. METHODS: Molecular subtyping of HNSC specimens was clustered by Copy Number Variation (CNV) data from The Cancer Genome Atlas (TCGA) dataset applying consistent clustering, followed by immune condition evaluation, differentially expressed genes (DEGs) analysis and DEGs function annotation. Weighted gene co-expression network analysis (WGCNA), protein-protein interaction, Univariate Cox regression analysis, least absolute shrinkage and selection operator (LASSO) and stepwise multivariate Cox regression analysis were implemented to construct an ARS model. A nomogram for clinic practice was designed by rms package. Immunotherapy evaluation and drug sensitivity prediction were also carried out. RESULTS: We stratified HNSC patients into three different molecular subgroups, with the best prognosis in C1 cluster among 3 clusters. C1 cluster displayed greatest immune infiltration status. The most DEGs between C1 and C2 groups, mainly enriched in cell cycle and immune function. We constructed a nine-gene ARS model (ICOS, IL21R, CCR7, SELL, CYTIP, ZAP70, CCR4, S1PR4 and CD79A) that effectively differentiates between high- and low-risk patients. Patients in low ARS group showed a higher sensitivity to immunotherapy. A nomogram built by integrating ARS and clinic-pathological characteristics helped predict clinic survival benefit. Drug sensitivity evaluation found that 4/9 inhibitor drugs (MK-8776, AZD5438, PD-0332991, PHA-665752) acted on the cell cycle. CONCLUSIONS: We classified 3 molecular subtypes for HNSC patients and established an ARS prognostic model, which offered a prospective direction for prognosis in HNSC.

Identifying microscopic factors that influence ductility in disordered solids.

There are empirical strategies for tuning the degree of strain localization in disordered solids, but they are system-specific and no theoretical framework explains their effectiveness or limitations. Here, we study three model disordered solids: a simulated atomic glass, an experimental granular packing, and a simulated polymer glass. We tune each system using a different strategy to exhibit two different degrees of strain localization. In tandem, we construct structuro-elastoplastic (StEP) models, which reduce descriptions of the systems to a few microscopic features that control strain localization, using a machine learning-based descriptor, softness, to represent the stability of the disordered local structure. The models are based on calculated correlations of softness and rearrangements. Without additional parameters, the models exhibit semiquantitative agreement with observed stress-strain curves and softness statistics for all systems studied. Moreover, the StEP models reveal that initial structure, the near-field effect of rearrangements on local structure, and rearrangement size, respectively, are responsible for the changes in ductility observed in the three systems. Thus, StEP models provide microscopic understanding of how strain localization depends on the interplay of structure, plasticity, and elasticity.

Effect of low-dose propofol combined with dexamethasone on the prevention of postoperative nausea and vomiting in gynaecological day surgery under remimazolam-based general anesthesia.

BACKGROUND: To observe the effect of low-dose propofol combined with dexamethasone on the prevention of postoperative nausea and vomiting (PONV) in gynaecological day surgery under remimazolam-based general anesthesia. METHODS: A total of 120 patients, aged from 18 to 65 years old, American Society of Anesthesiologists grade I or II, were scheduled to undergo hysteroscopy under total intravenous anesthesia. The patients were divided into 3 groups (n = 40 each): dexamethasone plus saline group (DC group), dexamethasone plus droperidol group (DD group) and dexamethasone plus propofol group (DP group). Dexamethasone 5 mg and flurbiprofen axetil 50 mg were given intravenously before induction of general anesthesia. Anesthesia induction: remimazolam 6 mg/kg/hours was continuously pumped until sleep and slow intravenous injection of alfentanil 20 ug/kg and mivacurium chloride 0.2 mg/kg was given. Anesthesia maintenance: remimazolam 1 mg/kg/hour and alfentanil 40 ug/kg/hours were continuously pumped. After the start of surgery, DC group was given 2 mL saline, DD group was given droperidol 1 mg, and DP group was given propofol 20 mg. Primary outcome: incidence of PONV in the postanesthesia care unit (PACU). Secondary outcome: incidence of PONV in patients within 24 hours after surgery, as well as general patient data, duration of anesthesia, the recovery time of patients, dose of remimazolam and alfentanil, etc. RESULTS: In PACU, patients of group DD and DP showed less PONV than those in group DC (P < .05). Within 24 hours after operation, there was no significant difference in the incidence of PONV among the 3 groups (P > .05), but the incidence of vomiting in DD group and DP group was significantly lower than that in DC group (P < .05). There was no significant difference in general data, anesthesia time, the recovery time of patients and dosage of remimazolam and alfentanil among the 3 groups (P > .05). CONCLUSION: The effect of low-dose propofol combined with dexamethasone to prevent PONV under remimazolam-based general anesthesia was similar to that of droperidol combined with dexamethasone, both of which significantly reduced the incidence of PONV in the PACU compared to dexamethasone alone. However, low-dose propofol combined with dexamethasone had little effect on the incidence of PONV within 24 hours compared to dexamethasone alone and only reduced the incidence of postoperative vomiting in patients.

Study on the effectiveness and safety of ciprofol in anesthesia in gynecological day surgery: a randomized double-blind controlled study.

BACKGROUD: ciprofol is a new type of intravenous anesthetic, which is a tautomer of propofol, with the characteristics of less injection pain, less respiratory depression and higher potency, but little clinical experience. The aim of this study was to observe the efficacy and safety of the application of ciprofol in ambulatory surgery anesthesia in gynecology. METHODS: 128 patients were selected to undergo gynecological day surgery under general anesthesia, and the patients were randomly divided into the ciprofol group and the propofol group, with 64 cases in each group. During anesthesia induction, the ciprofol group was infused at a time limit of 0.5 mg/kg for one minute, and the propofol group was infused at a time limit of 2 mg/kg for 1 min. The overall incidence of adverse events was the primary outcome for this study, while secondary outcomes included the success rate of anesthesia induction, the time of loss of consciousness, the time of awakening,top-up dose and frequency of use of rescue drugs. RESULTS: The overall incidence of adverse events was significantly lower in the ciprofol group compared with the propofol group (56.2% vs. 92.2%,P < 0.05). The success rate of anesthesia induction of ciprofol and propofol group was 100.0%. The time of loss of consciousness of the ciprofol group was longer than that of the propofol group (1.6 ± 0.4 min vs. 1.4 ± 0.2 min, P < 0.05). The time of awakening was not statistically significant (5.4 ± 2.8 min vs. 4.6 ± 1.6 min, P > 0.05). The number of drug additions and resuscitation drugs used were not statistically significant. CONCLUSIONS: Compared with propofol, ciprofol had a similar anesthetic effect in gynecological ambulatory surgery, and the incidence of adverse events in the ciprofol group was lower.

Analysis of the Combination of the Regional Natural Environment and Local Characteristics of the Tourism Industry under the Perspective of Synergistic Development.

Ecological environmental protection and tourism development are complex systems that are inextricably linked, mutually influencing, and interdependent, forming an organic whole. The natural environment and its various natural factors constitute an ecosystem, which both is a prerequisite for regional tourism development and has a certain impact on the regional ecosystem. The development of tourism must take the protection of the natural environment as the premise, the protection of ecological environment must be throughout the whole process of tourism development, and the principles and methods of system science must be used to solve this problem. Tourism is an important strategic support for the development of China's national economy. However, with the rapid increase in the number of tourists, tourist attractions are also facing unprecedented pressure. Tourism and its related industries are a complex and open system that consists of economic, social, and ecological environment; policy; technology; and other factors. By analyzing the interrelationship of each element in the tourism sustainable development system, we can provide a scientific basis for sustainable tourism development.

Prevention of postoperative nausea and vomiting after gynaecological day surgery under remimazolam general anesthesia: a randomized double-blind controlled study.

PURPOSE: To observe the effect of different antiemetic drugs for the prevention of postoperative nausea and vomiting (PONV) after gynaecological day surgery under remimazolam general anesthesia. METHODS: One hundred ninety-two patients were selected for gynaecological day surgery and randomly divided into three groups: droperidol group (DD group), tropisetron group (DT group) and control group (DC group). Flurbiprofen axetil 50 mg and dexamethasone 5 mg were given intravenously before induction of anesthesia, and 2 min later droperidol 1 mg was given intravenously to the DD group, tropisetron 5 mg to the DT group and saline (5 ml) to the DC group. Induction of anesthesia: remimazolam 6 mg/kg/h was continuously infused until sleep, mivacurium 0.2 mg/kg and alfentanil 20ug/kg were slowly pushed, 3 min later intubation was performed to control breathing. Maintenance of anesthesia: 40ug/kg/h of alfentanil, 1 mg/kg/h of remimazolam continuous infusion. After awakening and extubation, the patient was transferred to the PACU. PONV were recorded in the PACU and an electronic questionnaire was pushed 24 h after surgery. RESULTS: The incidence of PONV within the PACU was significantly lower in the DD (14.5%)and DT(26.7%) groups than in the DC(50%) group (p < 0.01), there was no significantly difference between the DT and DD groups. There were no significant difference in the incidence of PONV in 24 h after surgery between the three groups(DD:DT:DC = 44.5%:45.1%:63.8%,p > 0.05). CONCLUSIONS: Droperidol or tropisetron combined with dexamethasone is superior to dexamethasone alone for the prevention of PONV in the PACU after remimazolam combined with alfentanil anesthesia, with no significant difference in the incidence of PONV in 24 h after surgery.

Probing Gardner Physics in an Active Quasithermal Pressure-Controlled Granular System of Noncircular Particles.

To search for experimental signals of the Gardner crossover, an active quasithermal granular glass is constructed using a monolayer of air-fluidized star-shaped particles. The pressure of the system is controlled by adjusting the tension exerted on an enclosing boundary. Velocity distributions of the internal particles and the scaling of the pressure, density, effective temperature, and relaxation time are examined, demonstrating that the system has key features of a thermal system. Using a pressure-based quenching protocol that brings the system into deeper glassy states, signals of the Gardner crossover are detected via cage size and separation order parameters for both particle positions and orientations, offering experimental evidence of Gardner physics for a system of anisotropic quasithermal particles in a low spatial dimension.

Bacillus coagulans 13002 and fructo-oligosaccharides improve the immunity of mice with immunosuppression induced by cyclophosphamide through modulating intestinal-derived and fecal microbiota.

This study aims to evaluate the effects of probiotic Bacillus coagulans 13,002 (BCS) and prebiotic fructo-oligosaccharides (FOS) on mice treated with the alkylating agent cyclophosphamide (CTX). We found that both BCS and FOS, especially BCS, significantly alleviated CTX-induced injury by modulating intestinal-derived and fecal microbiota. BCS and BCS + FOS increased serum immunoglobulin levels, which were reduced by CTX. In addition, BCS and BCS + FOS upregulated IFN-γ and IL-4, which protect mucosal barriers and the balance of Th1/Th2. BCS promoted the growth of some beneficial bacteria, such as Bacteroides, Coprococcus, Enterococcus, Oscillospira, and Ruminococcus in mouse gut. In addition, BCS + FOS inhibited the growth of several harmful bacteria, including Acinetobacter, Arthrobacter, Brachybacterium, Corynebacterium, Jeotgalicoccus, Sporosarcina, and Staphylococcus. Furthermore, BCS potentially improved the growth of Anaerotruncus bacteria, which can promote the production of butyrate acids. In summary, according our results suggest that BCS and FOS improved the immunity of mice with immunosuppression induced by CTX through modulating intestinal-derived and fecal microbiota.

A Local-Exchange Model of Folding Chain Surface of Polymer Crystal Based on Worm-Like Chain Model within Single-Chain in Mean-Field Theory.

The structure of amorphous layer of folding surface controls the properties of the polymer lamellar crystal, which consists of chains with a loop conformation. The surface tension depends on the length and the distance between two injection points of the loop which involving the reptation motion and lateral exchange motion of the stems. In the present work, a local-exchange motion model based on the worm-like chain model is developed to investigate the effects of lateral motion of stems on the release the surface tension. The optimal distance between two injection points is determined by the balance of chain bending energy and conformational entropy. The numerical results provide evidences to the adjacent re-entry model for various loop lengths. A possible explanation involving density of injection points is proposed to interpret the mechanism.

Strain localization and failure of disordered particle rafts with tunable ductility during tensile deformation.

Quasi-static tensile experiments were performed for a model disordered solid consisting of a two-dimensional raft of polydisperse floating granular particles with capillary attractions. The ductility is tuned by controlling the capillary interaction range, which varies with the particle size. During the tensile tests, after an initial period of elastic deformation, strain localization occurs and leads to the formation of a shear band at which the pillar later fails. In this process, small particles with long-ranged interactions can endure large plastic deformation without forming significant voids, while large particles with short-range interactions fail dramatically by fracturing at small deformation. Particle-level structure was measured, and the strain-localized region was found to have higher structural anisotropy than the bulk. Local interactions between anisotropic sites and particle rearrangements were the main mechanisms driving strain localization and the subsequent failure, and significant differences of such interactions exist between ductile and brittle behaviors.

Diffusion of size bidisperse spheres in dense granular shear flow.

Diffusion is an important particle behavior in granular flow. Although granular diffusion has been studied for decades, the diffusion of size bidisperse particles has not been well understood. In this paper, discrete element method simulations with the Lees-Edwards boundary condition are performed to quantify the relation between the diffusion coefficient (D) and flow parameters for size bidisperse spheres in dense granular flow. The influences of the shear rate (γ[over ̇]), the solids fraction (f), and the diameter ratio (D_{LS}) of particles on diffusion are studied. The effects of the friction coefficient (µ) and the restitution coefficient (e) are also investigated. The results indicate that while small particles diffuse faster than large particles in a binary system the volume weighted average diffusion coefficient is proportional to the shear rate and the square of the volume weighted average particle diameter, d^{2}, and it is inversely proportional to the solids fraction. The quantified relation is given as D=k_{d}γ[over ̇]d^{2}, where k_{d}=0.0186/f, and this relation is not sensitive to the diameter ratio for D_{LS}≤3. The diffusion coefficient is not sensitive to the friction coefficient except for the extreme condition where µ<0.1, and it is also not sensitive to the restitution coefficient between 0.3 and 0.9.

Transient response in granular quasi-two-dimensional bounded heap flow.

We study the transition between steady flows of noncohesive granular materials in quasi-two-dimensional bounded heaps by suddenly changing the feed rate. In both experiments and simulations, the primary feature of the transition is a wedge of flowing particles that propagates downstream over the rising free surface with a wedge front velocity inversely proportional to the square root of time. An additional longer duration transient process continues after the wedge front reaches the downstream wall. The entire transition is well modeled as a moving boundary problem with a diffusionlike equation derived from local mass balance and a local relation between the flux and the surface slope.