Comparison of anaesthesia strategies on postoperative nausea and vomiting in laparoscopic sleeve gastrectomy: a randomised controlled trial.

BACKGROUND: Intra-operative anaesthesia management should be optimised to reduce the occurrence of postoperative nausea and vomiting in high-risk patients; however, a single intervention may not effectively reduce postoperative nausea and vomiting in such patients. This study assessed the effect of an optimised anaesthetic protocol versus a conventional one on postoperative nausea and vomiting in patients who underwent laparoscopic sleeve gastrectomy. METHODS: A single-centre randomised trial was conducted at Peking University Shenzhen Hospital from June 2021 to December 2022. Among 168 patients who underwent laparoscopic sleeve gastrectomy, 116 qualified, and 103 completed the study with available data. Patients were categorized into the conventional group (received sevoflurane and standard fluids) and the optimised group (underwent propofol-based anaesthesia and was administered goal-directed fluids). The primary endpoints were postoperative nausea and vomiting incidence and severity within 24 h. RESULTS: Postoperative nausea and vomiting assessment at 0-3 h post-surgery revealed no significant differences between groups. However, at 3-24 h, the optimised anaesthetic protocol group showed lower postoperative nausea and vomiting incidence and severity than those of the conventional group (P = 0.005). In the conventional group, 20 (37.04%) patients experienced moderate-to-severe postoperative nausea and vomiting, compared to six (12.25%) patients in the optimised group (odds ratio = 0.237; 95% CI = 0.086, 0.656; P = 0.006). No significant differences were noted in antiemetic treatment, moderate-to-severe pain incidence, anaesthesia recovery, post-anaesthetic care unit stay, or postoperative duration between the groups. While the total intra-operative infusion volumes were comparable, the optimised group had a significantly higher colloidal infusion volume (500 mL vs. 0 mL, P = 0.014) than that of the conventional group. CONCLUSIONS: The incidence and severity of postoperative nausea and vomiting 3-24 h postoperatively in patients who underwent laparoscopic sleeve gastrectomy were significantly lower with propofol-based total intravenous anaesthesia and goal-directed fluid therapy than with sevoflurane anaesthesia and traditional fluid management. Total intravenous anaesthesia is an effective multimodal antiemetic strategy for bariatric surgery. TRIAL REGISTRATION: This trial was registered with the Chinese Clinical Trial Registry (ChiCTR-TRC- 2,100,046,534, registration date: 21 May 2021).

Boosting Whale Optimizer with Quasi-Oppositional Learning and Gaussian Barebone for Feature Selection and COVID-19 Image Segmentation.

Whale optimization algorithm (WOA) tends to fall into the local optimum and fails to converge quickly in solving complex problems. To address the shortcomings, an improved WOA (QGBWOA) is proposed in this work. First, quasi-opposition-based learning is introduced to enhance the ability of WOA to search for optimal solutions. Second, a Gaussian barebone mechanism is embedded to promote diversity and expand the scope of the solution space in WOA. To verify the advantages of QGBWOA, comparison experiments between QGBWOA and its comparison peers were carried out on CEC 2014 with dimensions 10, 30, 50, and 100 and on CEC 2020 test with dimension 30. Furthermore, the performance results were tested using Wilcoxon signed-rank (WS), Friedman test, and post hoc statistical tests for statistical analysis. Convergence accuracy and speed are remarkably improved, as shown by experimental results. Finally, feature selection and multi-threshold image segmentation applications are demonstrated to validate the ability of QGBWOA to solve complex real-world problems. QGBWOA proves its superiority over compared algorithms in feature selection and multi-threshold image segmentation by performing several evaluation metrics. Supplementary Information: The online version contains supplementary material available at 10.1007/s42235-022-00297-8.

Synthesis of Pure Thiophene-Sulfur-Doped Graphene for an Oxygen Reduction Reaction with High Performance.

Various S-bonding configurations existing in sulfur-doped reduced graphene oxide (S-rGO) show different electronic structures and physiochemical properties. Thus, understanding the properties of unique S-bonding configurations requires the construction of S-rGO with only single configuration. Here, we synthesized S-rGO with a pure thiophene-sulfur configuration through a simple and low-cost hydrothermal method by simply controlling the oxidation degree of the graphene oxide (GO) precursor. Through the use of a GO precursor with a high content of C-O groups, pure doping of the thiophene-sulfur configuration in the rGO can be achieved. Further electrochemical characterization reveals an increased electrocatalytic activity of the pure thiophene-sulfur-doped S-rGO in the oxygen reduction reaction, indicating the important role of thiophene-sulfur. The present work deepens the understanding of the functions of doped nonmetal elements in carbon materials in electrocatalysis and helps in the design of high performance electrocatalysts.