Local Block Research Articles

Global–Local Deep Fusion: Semantic Integration with Enhanced Transformer in Dual-Branch Networks for Ultra-High Resolution Image Segmentation

The fusion of global contextual information with local cropped block details is crucial for segmenting ultra-high resolution images. In this study, A novel fusion mechanism termed global–local deep fusion (GL-Deep Fusion) is introduced, based on an enhanced transformer architecture that efficiently integrates global contextual information and local details. Specifically, we propose the global–local synthesis networks (GLSNet), a dual-branch network where one branch processes the entire original image, while the other branch handles cropped local patches as input. The feature fusion of different branches in GLSNet is achieved through GL-Deep Fusion, significantly enhancing the accuracy of ultra-high resolution image segmentation. Identifying tiny overlapping items is a task where the model excels, demonstrating its particular effectiveness. To optimize GPU memory utilization, a dual-branch architecture was meticulously designed. This architecture proficiently leverages the features it extracts and seamlessly integrates them into the enhanced transformer framework of GL-Deep Fusion. Benchmarks on the DeepGlobe and Vaihingen datasets demonstrate the efficiency and accuracy of the proposed model. It significantly reduces GPU memory usage by 24.1% on the DeepGlobe dataset, enhancing segmentation accuracy by 0.8% over the baseline model. On the Vaihingen dataset, our model delivers a Mean F1 score of 90.2% and achieves a mIoU of 90.9%, highlighting its exceptional memory efficiency and segmentation precision.

Anterior cervical surgery for the treatment of cervigonenic headache caused by cervical spondylosis

Cervicogenic headache (CEH) is a common disorder with cervical spine-specific nociceptive headache symptoms. Cervicogenic headaches have been studied for years, but diagnosis and treatment are continually evolving. Due to non-specific criteria and its relationship with cervical degenerative illness, diagnosis may be underestimated. In many situations, it contributes to myelopathy or radiculopathy. Local anaesthetic blocks are used to confirm the diagnosis, however, non-invasive methods are being explored. Identifying the nociceptive origin improves pain management. Physical therapy and percutaneous interventional procedures are used to treat isolated CEH. However, cervical decompression and/or fusion are often performed in situations of cervical myelopathy and/or radiculopathy. Here we report a 57-year-old female with cervicogenic headache treated with anterior lower cervical discectomy to relieve cervical myelopathy and/or radiculopathy headaches.

Measures and results of prevention and control on casing deformation and frac-hit in deep shale gas wells in southern Sichuan Basin

Casing deformation and frac-hit pose significant challenges to the development of deep shale gas in southern Sichuan Basin. By analyzing the mechanism and main control factors of casing deformation and frac-hit, two kinds of risk assessment methods were defined, and the overall prevention and control concept and practice were formulated. The results show that initial stress, pore pressure, fault development and large scale fracturing in local block are the main factors leading to the deformation. The development of fracture through well group and uncontrolled fracturing fluid volume are the main factors leading to pressure channeling. Based on this, the risk classification technology of casing deformation and frac-hit is established, and the dual-optimal, dual-control concept and technology are formed. In terms of the prevention and control of casing deformation, the formation of small-diameter bridge plug fracturing, large section combined fracturing, glass beads cementing, single-well staggered and platform straddle fracturing mode, dual-dimension controlled and lift fracturing, hyperbolic diagnosis, etc. Frac-hit prevention and control formed pump sequence optimization mode, physical and chemical temporary plugging and other methods. The above technology achieved casing deformation rate decreased from 50.4% to 25.4%, frac-hit rate decreased from 58.6% to 33.9%, and the average well kilometer EUR reached 0.52–0.7 million square meters, an increase of 7.7% compared with the previous research, with remarkable results.

ON BLOCKWISE AND REFERENCE PANEL-BASED ESTIMATORS FOR GENETIC DATA PREDICTION IN HIGH DIMENSIONS.

Genetic prediction holds immense promise for translating genetic discoveries into medical advances. As the high-dimensional covariance matrix (or the linkage disequilibrium (LD) pattern) of genetic variants often presents a block-diagonal structure, numerous methods account for the dependence among variants in predetermined local LD blocks. Moreover, due to privacy considerations and data protection concerns, genetic variant dependence in each LD block is typically estimated from external reference panels rather than the original training data set. This paper presents a unified analysis of blockwise and reference panel-based estimators in a high-dimensional prediction framework without sparsity restrictions. We find that, surprisingly, even when the covariance matrix has a block-diagonal structure with well-defined boundaries, blockwise estimation methods adjusting for local dependence can be substantially less accurate than methods controlling for the whole covariance matrix. Further, estimation methods built on the original training data set and external reference panels are likely to have varying performance in high dimensions, which may reflect the cost of having only access to summary level data from the training data set. This analysis is based on novel results in random matrix theory for block-diagonal covariance matrix. We numerically evaluate our results using extensive simulations and real data analysis in the UK Biobank.

A Robust Mismatch Removal Method for Image Matching Based on the Fusion of the Local Features and the Depth

Feature point matching is a fundamental task in computer vision such as vision simultaneous localization and mapping (VSLAM) and structure from motion (SFM). Due to the similarity or interference of features, mismatches are often unavoidable. Therefore, how to eliminate mismatches is important for robust matching. Smoothness constraint is widely used to remove mismatch, but it cannot effectively deal with the issue in the rapidly changing scene. In this paper, a novel LCS-SSM (Local Cell Statistics and Structural Similarity Measurement) mismatch removal method is proposed. LCS-SSM integrates the motion consistency and structural similarity of a local image block as the statistical likelihood of matched key points. Then, the Random Sampling Consensus (RANSAC) algorithm is employed to preserve the isolated matches that do not satisfy the statistical likelihood. Experimental and comparative results on the public dataset show that the proposed LCS-SSM can effectively and reliably differentiate true and false matches compared with state-of-the-art methods, and can be used for robust matching in scenes with fast motion, blurs, and clustered noise.

Evaluation of Local Anesthetic Blockade in Cats Undergoing Castration in a High-Quality, High-Volume Spay/Neuter Setting: A Randomized, Blinded, Placebo-Controlled Trial

Sustainable high-quality, high-volume spay/neuter (HQHVSN) clinic operations require optimal efficiency and resource-management, and humane patient care. Locoregional anesthesia is not standard across HQHVSN protocols because evidence that these techniques are safe, efficient, and cost-effective in the HQHVSN environment is lacking. The objective of this study was to compare the analgesic efficacy of local anesthesia to placebo in cats castrated in a HQHVSN setting. Eighty-eight shelter-owned male cats presenting to a HQHVSN clinic in the northeastern US between August 2019 and October 2020 were enrolled in this blinded, randomized, placebo-controlled trial. Inclusion criteria included estimated age ≥6 weeks and ≤8 years, body weight ≥3 pounds, and ASA 1 status. Cats were assigned via simple randomization to receive an intratesticular injection of saline placebo (Group SP; n=32), lidocaine 1mg/kg (Group L; n=34), or a mixture of lidocaine 1mg/kg and bupivacaine 1mg/kg (Group LB; n=22) prior to routine castration. Standard HQHVSN protocols for anesthesia and surgery were followed. Indicators of analgesic efficacy included perioperative heart rates, requirements for additional anesthesia, surgeon satisfaction with anesthetic depth and tissue quality, and postoperative pain scores and incisional complications. Treatment groups did not differ in demographic characteristics or baseline heart rate. Group SP showed a significant elevation in heart rate in response to surgical stimulus compared to Groups L (p=0.006) and LB (p=0.002) and to their baseline heart rate (p<0.001). Perioperative heart rates measured in Groups L and LB did not differ. Surgeon-reported unsatisfactory anesthetic depth during castration occurred more frequently in Group SP (z=2.68; p=0.044). Additional anesthetic requirements, surgeon satisfaction with tissue quality, and postoperative pain and incision scores were statistically similar between groups. Despite the short duration between intratesticular injection to near completion of castration (median [IQR]=5.0 [3.0-7.0] minutes), local anesthesia was effective at decreasing nociception compared to placebo without increasing the frequency of incisional complications. These perioperative benefits support the inclusion of local blocks in multimodal anesthesia/analgesia protocols for HQHVSN clinics. Additional materials and labor costs for administering intratesticular blocks were estimated at $1.07-$1.19 per 4kg cat at the study location.

Practical pain mitigation for castration – effective and efficient relief

Pain management for cattle during veterinary procedures is be­coming a strong topic within our industry. In this presentation we will be discussing pain relief pre- and post-castration. Some of the highlights include local nerve blocks, non-steroidal anti-inflammatory, and how to communicate with producers about implementing it within a production system.

Core Optimization for Extending the Graphite Irradiation Lifespan in a Small Modular Thorium-Based Molten Salt Reactor

The lifespan of core graphite under neutron irradiation in a commercial molten salt reactor (MSR) has an important influence on its economy. Flattening the fast neutron flux (≥0.05 MeV) distribution in the core is the main method to extend the graphite irradiation lifespan. In this paper, the effects of the key parameters of MSRs on fast neutron flux distribution, including volume fraction (VF) of fuel salt, pitch of hexagonal fuel assembly, core zoning, and layout of control rod assemblies, were studied. The fast neutron flux distribution in a regular hexagon fuel assembly was first analyzed by varying VF and pitch. It was demonstrated that changing VF is more effective in reducing the fast neutron flux in both global and local graphite blocks. Flattening the fast neutron flux distribution of a commercial MSR core was then carried out by zoning the core into two regions under different VFs. Considering both the fast neutron flux distribution and burnup depth, an optimized core was obtained. The fast neutron flux distribution of the optimized core was further flattened by the rational arrangement of control rod channels. The calculation results show that the final optimized core could reduce the maximum fast neutron flux of the graphite blocks by about 30% and result in a more negative temperature reactivity coefficient, while slightly decreasing the burnup and maintaining a fully acceptable core temperature distribution.

Outpatient mastectomy is a safe surgical option for patients treated in a rural Appalachian tertiary facility

IntroductionThe feasibility of the outpatient mastectomy in a rural setting is poorly characterized. The aim of this study is to analyze the efficacy and safety of an outpatient mastectomy program in our tertiary care facility treating rural Appalachian patients. MethodsWe performed a single-institution, retrospective review of all women with breast cancer older than 18 years of age treated with mastectomy with or without immediate alloplastic breast reconstruction at JW Ruby Memorial Hospital from 2019 to 2022. Our primary objective was to determine the 30, 60, and 90-day readmission rates and complications. Our secondary objective analyzed perioperative pain control variables that contribute to appropriate discharge. ResultsWe identified thirty-two women between 2019–2022 who underwent same-day mastectomy at JW Ruby Memorial Hospital in Morgantown, West Virginia. Overall readmission rates at 30- 60- and 90-days were 3.1% (n = 1), 9.4% (n = 3) and 9.4% (n = 3), respectively. Two patients were admitted for reasons unrelated to surgery. The patient in the 30-day readmission group required washout for hematoma due to perioperative apixaban making the overall surgical readmission rate 3.1% (n = 1). Preoperatively, 90.6% (n = 29) of women received a local anesthetic block by the anesthesia provider. The mean milligram morphine equivalents received for the duration of the hospital encounter was 15.9 (STD = 10.1). ConclusionOutpatient mastectomy is a safe and effective option for eligible patients in rural settings. Careful patient selection and a multidisciplinary team should assess the individual circumstances to determine if outpatient mastectomy is appropriate.

Abstract PO1-09-07: Outpatient mastectomy is a safe surgical option for patients treated in a rural Appalachian tertiary facility

Abstract Background The feasibility of the outpatient mastectomy in a rural setting is poorly characterized. Centers treating rural patient populations have unique challenges. Limited access to resources and distance to facilities that can care for post-surgical patients are two such challenges. The aim of this study is to analyze the efficacy and safety of an outpatient mastectomy program in our tertiary care facility treating rural Appalachian patients. Methods We performed a single-institution retrospective review of all patients with breast cancer over 18 years of age who underwent a mastectomy with or without immediate alloplastic breast reconstruction at JW Ruby Memorial Hospital from 2019-2022. Our primary objective was to determine the 30, 60, and 90-day readmission rates. Our secondary objective included an analysis of perioperative pain control variables to develop an enhanced recovery protocol. Data collected included age, ethnicity, prognostic factors, stage at diagnosis, surgical treatment, opioid and non-opioid based treatments pre- and postoperatively by milligram morphine equivalents (MMEs), comorbidities as analyzed by the Charlson comorbidity index (CCI) variables, and distance from the tertiary hospital. Results We identified thirty-two women between 2019-2022 who underwent same-day mastectomy at JW Ruby Memorial Hospital in Morgantown, West Virginia. The mean age was 55.4 years. The mean distance to the hospital was 22.1 miles with a maximum distance of 111 miles (SEM = 3.90). The mean CCI score was 2.9 (SEM = 0.51). Overall readmission rates at 30- 60- and 90-days were 6.3% (n = 2), 3.1% (n = 1) and 0%, respectively. One woman was readmitted eight days postoperatively from a unilateral mastectomy and sentinel lymph node biopsy without reconstruction for an expanding hematoma of the chest after resuming anticoagulation on postoperative day three. The other two patients were admitted for unrelated surgical reasons. Thus, readmission related to surgical complications alone was 3.1% (n = 1). Preoperatively, 90.6% (n = 29) of women received a local anesthetic block by the anesthesia provider. Neither a preoperative nor intraoperative block was given to the remaining three. Bilateral mastectomies occurred in 21.9% (n = 7) of women and 78.1% (n = 25) underwent unilateral mastectomy. Of these 32 women, 25.0% (n = 8) underwent immediate staged reconstruction with tissue expanders. There were no direct-to-implant reconstructions in this population. There were twenty-six sentinel lymph node biopsies and four axillary dissections performed. The mean MMEs received for the duration of the hospital encounter was 132 (SEM = 23.4). An enhanced recovery after surgery protocol was not used. Discussion Outpatient mastectomy is a safe and effective option for eligible patients living in rural settings. Factors such as the type of mastectomy, reconstruction, the patient's overall health status, and the availability of support at home can impact the feasibility of this approach. Careful patient selection and a multidisciplinary team including the patient, surgeon, and anesthesiologist should carefully assess the individual’s circumstances to determine if outpatient mastectomy is appropriate. Implementation of enhanced recovery after surgery protocols will be further investigated and guided by this study. Citation Format: Gregory Stimac, Kristin Lupinacci, Michael Cowher, Hannah Hazard-Jenkins. Outpatient mastectomy is a safe surgical option for patients treated in a rural Appalachian tertiary facility [abstract]. In: Proceedings of the 2023 San Antonio Breast Cancer Symposium; 2023 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2024;84(9 Suppl):Abstract nr PO1-09-07.

Global pixel-value-ordering framework with dynamic sequence partition for reversible data hiding

Recently, pixel-value-ordering (PVO) based reversible data hiding (RDH) methods have become hotspots in spatial domain RDH research. In PVO-based methods, the pixel value correlation within a local region is exploited for data embedding. To embed secret data, the cover images are partitioned into non-overlapped rectangle blocks to be sorted locally, and a lower embedding distortion is thus obtained. However, their embedding capacities are often limited by the fixed local blocks from which pixels are sorted. To maintain the advantages and overcome disadvantages of the PVO-based methods, a new global pixel-value-ordering (GPVO) framework is proposed in this paper. By applying our GPVO framework, a PVO-based method can utilize pixels from any position in the cover image rather than from local pixel blocks. Then, through the dynamic sequence partition realized by the GPVO framework for the first time, the embedding capacity of PVO-based methods can be greatly improved while reducing embedding distortion further reduced. Finally, we propose a two-stage pairwise embedding scheme to be applied to the sequences, aiming to achieve an advanced embedding performance. Experimental results illustrate that the proposed GPVO works better than other related state-of-the-art RDH methods.

Permanent Peripheral Nerve Stimulator for Complex Regional Pain Syndrome of the Forearm and Hand

Summary: A 51-year-old woman with diabetes and depression was referred to the anesthesia pain clinic with a 15-year history of complex regional pain syndrome type I of the right forearm and hand in the radial sensory nerve distribution. There was no recognized antecedent trauma and she had failed both medical treatment and radial sensory nerve decompression surgery. An ultrasound-guided local anesthetic block of the radial nerve in the upper arm resulted in partial and temporary improvement in pain. She subsequently underwent trial of a peripheral nerve stimulator (PNS) followed by permanent PNS implant placement over the radial nerve proper proximal to the elbow. Within the first month of use, she endorsed substantially improved pain and strength in her right hand. These improvements were sustained for more than 1 year. Applications of PNS technology for treatment of extremity complex regional pain syndrome and neuropathic extremity pain in general are reviewed.

Heterogeneity constrained color ellipsoid prior image dehazing algorithm

To address the issue of inaccurate transmission estimation in areas with sudden depth changes in hazy images, the image dehazing algorithm with Heterogeneity Constrained Color Ellipsoid Prior (HC-CEP) is proposed. Firstly, a local threshold optimization quadtree search method is designed, in order to solve the problem of inaccurate global atmospheric light estimation and avoid the overall darkening of the image caused by white objects.Then, different regions are selected by a local block heterogeneity window to construct diversity prior vectors to estimate the initial transmission. Finally, by constructing neighborhood heterogeneity weighted constraints on each pixel of the initial transmission and improving the high-order differential filtering of the Scharr operator, the optimization of the transmission is achieved, eliminating halo artifacts in the depth mutation area of the image. Both qualitative and quantitative experimental results show that the proposed algorithm comprehensively considers the heterogeneity of local pixel characteristics, and the dehazing image obtained has better color fidelity and edge detail preservation ability, which can effectively eliminate halo artifacts on the edges of hazy images.The proposed method has better dehazing performance and has a 8% improvement in terms of the FADE metric compared to state-of-the-art dehazing methods.

Model test study on the dynamic response of surrounding rock in deep buried tunnel under explosive plane wave

In order to clarify the dynamic failure mechanism in deep buried tunnels, a modeling test of the dynamic response of the surrounding rock in deep buried tunnels under the action of explosion plane wave was carried out by using the geotechnical multi-functional test device. Based on Froude’s similarity theory, a model with dimensions of 1600 × 1300 × 400 mm was constructed using low-strength cement mortar. Using the detonating fuse as the explosive source, the explosion tests were conducted with an equivalent TNT amount of 52.8 g and 105.6 g, respectively. According to the measured data, the stress and deformation characteristics of the surrounding rock, the motion and deformation characteristics of the tunnel and the dynamic instability process of the tunnel were analyzed. The results show that explosive stress waves exhibit exponential attenuation above the arch crown of the tunnel, with the rate of attenuation depending on the amount of explosive used. The deformation process of the surrounding rock of the crown in the tunnel arch under the action of the explosion stress wave was compression followed by tension, which fully proves the existence of the reflected tensile wave. Movement and deformation parameters within the tunnel escalate as the explosive charge increases, especially at the crown of the arch. According to the monitoring results of the motion camera, the dynamic instability process of the tunnel was divided into several stages, such as initial calm, tunnel vibration, particle ejection, atomization, local block ejection, and return to calm. The results of the study have important reference value for the safe excavation and effective support of deep underground engineering.

Effective Management of Recurrent Trauma-Induced Neck Pain With Radiofrequency Neurotomy Using the Nimbus Electrosurgical Radiofrequency Multitined Expandable Electrode: A Case Report

BACKGROUND: Radiofrequency neurotomy (RFN) can be an effective treatment for patients with chronic neck pain and cervicogenic headaches resistant to conservative care. However, the degree and duration of pain relief after RFN is dependent upon the thoroughness of target nerve coagulation. CASE REPORT: This is a case of a 37-year-old patient with debilitating neck pain and headaches following a motor vehicle accident. Successful local anesthetic block of the third occipital nerve (TON) confirmed pain of C2-C3 facet joint origin. An initial RFN treatment of the TON, using standard 18G electrodes in bipolar mode, resulted in complete symptom amelioration for 8 months. Repeat RFN, using the same electrode configuration, was unsuccessful in alleviating the severe neck pain and headaches, and produced no demonstrable sensory loss in the distribution of the TON. RFN was then performed using the Nimbus® electrosurgical RF multitined expandable electrode, which provides a larger zone of coagulation in volume than standard RFN electrodes even when used in bipolar configuration. CONCLUSIONS: The Nimbus procedure resulted in successful coagulation of the TON with sensory loss in the TON distribution and reinstatement of palliative relief. KEY WORDS: Cervical pain, radiofrequency neurotomy, third occipital nerve, Nimbus, case report

Study on vibration signals identification method for pipeline leakage detection based on deep learning technology

For natural gas pipeline leakage systems based on distributed feedback fiber laser vibration sensors (DFB-FL), a novel neural network model (mCNN-LFLBs) integrating multi-scale convolutional neural networks (mCNN) with local feature extraction blocks (LFLBs) is proposed in this study. To address the problem of feature loss in the traditional signal image transfer process, the one-dimensional original signal is directly used as the input of the model, effectively maintaining the time-domain correlation of the leaked signal. The time-domain correlation of the leakage signal is preserved. To address the problem that traditional pattern recognition algorithms have a weak ability to extract deep features and local features, mCNN is established by this model, which realizes the use of convolution kernels of different scales to extract features of different frequency bands in one-dimensional signals. Additionally, LFLBs are introduced, which enhances the local expression ability of the model, further improves the feature mining quality of the model, and better presents the deep features of leaked signals. Experimental results demonstrate that the mCNN-LFLBs model has a classification accuracy of up to 98.6%, with a testing response time of approximately 10 ms, and outstanding performance in terms of convergence speed. These results highlight the potential practical application of the mCNN-LFLBs model in natural gas leak detection.

Perioperative Cannabinoids Significantly Reduce Postoperative Opioid Requirements in Patients Undergoing Coronary Artery Bypass Graft Surgery.

Background Opioids, commonly used to control pain associated with surgery, are known to prolong the duration of mechanical ventilation and length of hospital stay. A wide range of adjunctive strategies are currently utilized to reduce postoperative pain, such as local and regional nerve blocks, nerve cryoablation, and adjunctive medications. We hypothesized that dronabinol (a synthetic cannabinoid) in conjunction with standard opioid pain management will reduce opioid requirements to manage postoperative pain. Methods Sixty-eight patients who underwent isolated first-time coronary artery bypass graft surgery were randomized to either the control group, who received only standard opioid-based analgesia, or the dronabinol group, who received dronabinol (a synthetic cannabinoid) in addition to standard opioid-based analgesia. Dronabinol was given in the preoperative unit, before extubation in the ICU, and after extubation on the first postoperative day. Preoperative, intraoperative, and postoperative parameters were compared under an IRB-approved protocol. The primary endpoints were the postoperative opioid requirement, duration of mechanical ventilation, and ICU length of stay, and the secondary endpoints were the duration of inotropic support needed, left ventricular ejection fraction (LVEF), and the change in LVEF. This study was undertaken at Northwest Medical Center, Tucson, AZ, USA. Results Sixty-eight patients were randomized to either the control group (n = 37) or the dronabinol group (n = 31). Groups were similar in terms of demographic features and comorbidities. The total postoperative opioid requirement was significantly lower in the dronabinol group [39.62 vs 23.68 morphine milligram equivalents (MMEs), p = 0.0037], representing a 40% reduction. Duration of mechanical ventilation (7.03 vs 6.03h, p = 0.5004), ICU length of stay (71.43 vs 63.77h, p = 0.4227), and inotropic support requirement (0.6757 vs 0.6129 days, p = 0.7333) were similar in the control and the dronabinol groups. However, there was a trend towards lower durations in each endpoint in the dronabinol group. Interestingly, a significantly better preoperative to postoperative LVEF change was observed in the dronabinol group (3.51% vs 6.45%, p = 0.0451). Conclusions Our study found a 40% reduction in opioid use and a significantly greater improvement in LVEF in patients treated with adjunctive dronabinol. Mechanical ventilation duration, ICU length of stay, and inotropic support requirement tended to be lower in the dronabinol group, though did not reach statistical significance. The results of this study, although limited by sample size, are very encouraging and validate our ongoing investigation.

Application of propofol-remifentanil intravenous general anesthesia combined with regional block in pediatric ophthalmic surgery

ObjectiveThe aim of this study is to observe the anesthetic effect and safety of intravenous anesthesia without muscle relaxant with propofol-remifentanil combined with regional block under laryngeal mask airway in pediatric ophthalmologic surgery.MethodsA total of 90 undergoing ophthalmic surgery were anesthetized with general anesthesia using the laryngeal mask airway without muscle relaxant. They were randomly divided into two groups: 45 children who received propofol-remifentanil intravenous anesthesia combined with regional block (LG group), and 45 children who received total intravenous anesthesia (G group). The peri-operative circulatory indicators, awakening time after general anesthesia, postoperative analgesic effect and the incidence of anesthesia-related adverse events were respectively compared between the two groups.ResultsAll the children successfully underwent the surgical procedure. The awakening time after general anesthesia and removal time of laryngeal mask were significantly shorter in the LG group than in the G group (P < 0.05). There was no statistically significant difference in the heart rates in the perioperative period between the two groups (P > 0.05). There was no statistically significant difference in the incidence of intraoperative physical response, respiratory depression, postoperative nausea and vomiting (PONV) and emergence agitation (EA) between the two groups (P > 0.05). The pain score at the postoperative hour 2 was lower in the LG group than in the G group (P < 0.05).ConclusionPropofol-remifentanil intravenous anesthesia combined with long-acting local anesthetic regional block anesthesia, combined with laryngeal mask ventilation technology without muscle relaxants, can be safely used in pediatric eye surgery to achieve rapid and smooth recovery from general anesthesia and better postoperative analgesia. This anesthesia scheme can improve the comfort and safety of children in perioperative period, and has a certain clinical popularization value.

An Automated Multi-scale Feature Fusion Network for Spine Fracture Segmentation Using Computed Tomography Images.

Spine fractures represent a critical health concern with far-reaching implications for patient care and clinical decision-making. Accurate segmentation of spine fractures from medical images is a crucial task due to its location, shape, type, and severity. Addressing these challenges often requires the use of advanced machine learning and deep learning techniques. In this research, a novel multi-scale feature fusion deep learning model is proposed for the automated spine fracture segmentation using Computed Tomography (CT) to these challenges. The proposed model consists of six modules; Feature Fusion Module (FFM), Squeeze and Excitation (SEM), Atrous Spatial Pyramid Pooling (ASPP), Residual Convolution Block Attention Module (RCBAM), Residual Border Refinement Attention Block (RBRAB), and Local Position Residual Attention Block (LPRAB). These modules are used to apply multi-scale feature fusion, spatial feature extraction, channel-wise feature improvement, segmentation border results border refinement, and positional focus on the region of interest. After that, a decoder network is used to predict the fractured spine. The experimental results show that the proposed approach achieves better accuracy results in solving the above challenges and also performs well compared to the existing segmentation methods.

Exploring the Protective Effects of Bellucia dichotoma Cong. Aqueous Extract on Spleens Following Bothrops atrox Envenomation in Mice: A Stereological Investigation

The aqueous extract of Bellucia dichotoma (AeBd) has traditionally been used in cases of snakebites and has been shown to be promising against the effects of Bothrops atrox venom (BaV). There is evidence of local venom blocking action by AeBd in envenomed mice; however, studies of the systemic action of this plant against BaV are lacking. Antibothropic serum (ABS) is the conventional therapy after envenomation by B. atrox. The association of AeBd and ABS can also be an alternative for the patient. As an organ capable of initiating the innate and adaptive defense, the spleen is a sensor of the body’s immune status. Via stereology, this study evaluated the mouse spleen when challenged with the venom of B. atrox, as well as the role of AeBd (alone or in association with ABS) as an alternative treatment for Bothrops envenomations. In this study, male Swiss mice were divided into five groups: control, BaV, AeBd, AeBd/ABS, and ABS. After 24 h, the spleens were removed and set in plastic resin according to the norms of stereology to produce 9-13 sections/organ. Red (RP) and white pulp (WP) represented 67-75 % and 22-29 %, respectively, in all groups. Spleen volume was reduced in BaV due to decreased RP and WP (PALS). The number of macrophages was increased in BaV in relation to the other groups (from 2.289 ± 301 in the control to 3.807 ± 494 cells.mm-2). No changes were detected in the numbers of lymphocytes and megakaryocytes. In conclusion, the aqueous extract of B. dichotoma administered orally shortly after a B. atrox envenomation was effective in inhibiting morphological alterations in the spleen of the mice. The association AeBd/ABS maintains the same venom blocking effectiveness, thus showing that the use of this traditional therapy (AeBd) by local populations can be effective in inhibiting the systemic effects caused by B. atrox envenomations.