Esophageal button battery impactions in children: an analysis of 89 cases.

OBJECTIVE: To analyze the clinical characteristics of esophageal button battery impactions in children and explore safe and effective treatment methods. METHODS: This retrospective cohort study was conducted at a single tertiary care center, Shenzhen Children's Hospital, encompassing 89 children diagnosed with esophageal button battery impactions between January 2013 and January 2023. To minimize esophageal mucosal corrosion, prompt removal of the button battery with a first-aid fast track rigid esophagoscopy under general anesthesia was performed within thirty minutes of diagnosis. The clinical features and complications were recorded and analyzed. RESULTS: Button battery as esophageal foreign body was prevalent among children under 3 years old (79.8%), with boys exhibiting a higher incidence rate (56.2%) compared to girls (43.8%), and an average age of 25.8 months. The median duration from ingestion to hospital admission was 3 h (range: 0.5 h to 3 months). Common symptoms included vomiting and dysphagia, with early stage vomiting of brown foamy secretions being a characteristic presentation of esophageal button battery impactions. The majority (77.5%) of batteries were lodged in the upper esophagus. The larger batteries were verified to be more prone to complications. All 89 cases exhibited varying degrees of esophageal mucosal erosion, with 31 cases (34.8%) experiencing severe complications, including esophageal stenosis in 11 cases (35.5%), esophageal perforation in 9 cases (29%) with 4 cases of tracheoesophageal fistula, vocal cord paralysis in 6 cases (19.4%), hemorrhage in 2 cases (6.5%), mediastinitis in 2 cases (6.5%), and periesophageal abscess in 1 case (3.2%). Despite the severity of these complications, none of the patients died after emergency surgery. CONCLUSION: Esophageal button battery impactions can lead to significant damage to the esophageal mucosa due to its strong corrosiveness. Prompt action is crucial to mitigate the risk of complications. For the first time, we implement a first-aid fast track surgical intervention following diagnosis is imperative to minimize the incidence of adverse outcomes.

Bilateral matching decision-making for rural homesteads withdrawal patterns and types of peasant households' welfare needs: Evidence from China in the context of land spatial planning regulation.

In order to solve the issue of idle rural homesteads and enhance the welfare of peasant households, the Chinese government has implemented various rural homestead withdrawal patterns. In the context of land spatial planning regulation, based on the field survey data from 210 peasant households in Xuzhou City and Ganzhou City, this study constructs a bilateral matching model between rural homestead withdrawal patterns and types of welfare needs of peasant households. This study uses a Discrete Particle Swarm Optimization algorithm improved on the 0-1 knapsack strategy to solve the matching model, aiming to find the optimal homestead withdrawal patterns that match the types of peasant households. The results show that: (1) The matching of rural homestead withdrawal patterns and types of peasant households conforms to the principle of comparative advantage. (2) In the case of "one-to-one matching" between peasant households and homestead withdrawal patterns, matching the "economic-material-oriented" peasant households with the withdrawal pattern of "monetary compensation", matching the "social-service-oriented" peasant households with withdrawal pattern of "indicator replacement", and matching the "welfare-assistance-oriented" peasant households with the withdrawal pattern of "asset replacement". (3) The bilateral overall preference of the combined rural homestead withdrawal patterns is higher than that of the single rural homestead withdrawal pattern, and satisfaction has increased by at least 8 %. The authors argue that the government should design and implement diversified withdrawal patterns based on a full understanding of the welfare needs of peasant households.

Ultrasonography in Children With Congenital Pyriform Sinus Fistula: Analysis of 31 Cases.

OBJECTIVES: Congenital pyriform sinus fistula (CPSF) is a rare disease that can be easily misdiagnosed. This study investigates the value of ultrasonography in the early diagnosis and treatment of CPSF in children. METHODS: Clinical features and ultrasonography images of 31 CPSF pediatric patients confirmed by operation were retrospectively analyzed, different sonographic features during the infection period and the quiescence period were summarized and the consistency test of ultrasonic recognition and diagnosis between observers was conducted. RESULTS: In this study, 25 CPSF children had thick-walled cystic masses during the infection period, and cystic masses of 8 cases showed gas echo inside; after the modified valsalva maneuver, gas echo was found in another 5 cases. The detection rate of gas can be enhanced through the modified valsalva maneuver and infants' cry so as to provide an important basis for the diagnosis of pyriform sinus fistula. During the quiescent period of inflammation of 6 cases, fistula can be completely shown, and the wall structure has not been completely destroyed, so that the running position of fistula can be clearly seen. Ultrasonography boasted a good inter-observer consistency in identification and determination (Kappa:0.799-0.857; P<0.001). CONCLUSION: Ultrasonography could clearly reveal the position and direction of CPSF fistula. Different ultrasonic characteristics in different periods could provide relevant information for the selection of clinical operation timing and evaluate the post-operative effects.

Bayesian Nonlocal Patch Tensor Factorization for Hyperspectral Image Super-Resolution.

The synthesis of high-resolution (HR) hyperspectral image (HSI) by fusing a low-resolution HSI with a corresponding HR multispectral image has emerged as a prevalent HSI super-resolution (HSR) scheme. Recent researches have revealed that tensor analysis is an emerging tool for HSR. However, most off-the-shelf tensor-based HSR algorithms tend to encounter challenges in rank determination and modeling capacity. To address these issues, we construct nonlocal patch tensors (NPTs) and characterize low-rank structures with coupled Bayesian tensor factorization. It is worth emphasizing that the intrinsic global spectral correlation and nonlocal spatial similarity can be simultaneously explored under the proposed model. Moreover, benefiting from the technique of automatic relevance determination, we propose a hierarchical probabilistic framework based on Canonical Polyadic (CP) factorization, which incorporates a sparsity-inducing prior over the underlying factor matrices. We further develop an effective expectation-maximization-type optimization scheme for framework estimation. In contrast to existing works, the proposed model can infer the latent CP rank of NPT adaptively without tuning parameters. Extensive experiments on synthesized and real datasets illustrate the intrinsic capability of our model in rank determination as well as its superiority in fusion performance.

A novel biomimetic nanofibrous cardiac tissue engineering scaffold with adjustable mechanical and electrical properties based on poly(glycerol sebacate) and polyaniline.

Biomaterial tissue engineering scaffolds play a critical role in providing mechanical support, promoting cells growth and proliferation. However, due to the insulation and inappropriate stiffness of most biomaterials, there is an unmet need to engineer a biomimetic nanofibrous cardiac tissue engineering scaffold with tailorable mechanical and electrical properties. Here, we demonstrate for the first time the feasibility to generate a novel type of biocompatible fibrous scaffolds by blending elastic poly(glycerol sebacate) (PGS) and conductive polyaniline (PANI) with the help of a nontoxic carrier polymer, poly (vinyl alcohol) (PVA). Aligned and random PGS/PANI scaffolds are successfully obtained after electrospinning, cross-linking, water and ethanol wash. Incorporating of different concentrations of PANI into PGS fibers, the fibrous sheets show enhanced conductivity and slower degradation rates while maintaining the favorable hemocompatibility. The elastic modulus of the PGS/PANI scaffolds is in the range of 0.65-2.18 MPa under wet conditions, which is similar to that of natural myocardium. All of these fibrous mats show good cell viability and were able to promote adhesion and proliferation of H9c2 cells. Furthermore, the in vivo host responses of both random and aligned scaffolds confirm their good biocompatibility. Therefore, these PGS/PANI scaffolds have great potential for cardiac tissue engineering.

Outcomes and Prognostic Factors of Balloon Eustachian Tuboplasty Combined With Ventilation Tubes Insertion in Children: A Retrospective Study.

Objective: To evaluate the efficacy and safety of balloon eustachian tuboplasty (BET) combined with ventilation tube (VT) insertion in pediatric population and to identify the predictive factors for symptom recurrence. Methods: We conducted a retrospective study between August 2018 and February 2022 at Shenzhen Children's Hospital. The study analyzed the data of pediatric patients who underwent BET + VT insertion, as well as the data of pediatric patients who underwent VT insertion alone. The outcomes were efficacy, safety, and predictive factors of BET combined with VT. Kaplan‒Meier curves were used to examine the failure-free survival rate. A multivariate Cox regression model was used to identify the independent predictors of BET failure. Results: We evaluated the data of 29 pediatric patients (48 ears) who underwent BET with VT insertion (BET + VT group) and the data of 29 pediatric patients (46 ears) who underwent VT insertion alone (VT group). The total effectiveness rates at the first follow-up after VT removal and at 12 months in the BET + VT group were 90.9% and 84.6%, respectively. The decrease in the air-bone gap (ABG) was more significant in the BET + VT group at 12 months (13.7 ± 10.8 vs 6.4 ± 15.3, P < .05). The subgroup analyses did not show any significant difference between the groups in high-risk. For non-high-risk patients, the decrease in the ABG was more significant in the BET + VT group (14.2 ± 10.6 vs 4.3 ± 13.1, P < .05) at 12 months. The multivariate analysis showed that a history of VT insertion was independently associated with a higher rate of recurrence in the BET + VT group (hazard ratio 3.177; 95% CI, 1.027-9.826; P < .05). Conclusions: BET + VT insertion is an effective procedure to decrease the ABG in pediatric patients with eustachian tube dysfunction (ETD) who have no risk factors for conventional therapy failure. Treatment of patients with ETDs who have coexisting risk factors remains a challenge that warrants further high-quality prospective research.

Degradable Antimicrobial Ureteral Stent Construction with Silver@graphdiyne Nanocomposite.

In the surgical treatment of urinary diseases, ureteral stents are commonly used interventional medical devices. Although polymer ureteral stents with polyurethane as the main constituent are widely used in the clinic, the need for secondary surgery to remove them and their propensity to cause bacterial infections greatly limit their effectiveness. To satisfy clinical requirements, an electrospinning-based strategy to fabricate PLGA ureteral stents with silver@graphdiyne is innovated. Silver (Ag) nanoparticles are uniformly loaded on the surface of graphdiyne (GDY) flakes. It is found that the incorporation of Ag nanoparticles into GDY markedly increases their antibacterial properties. Subsequently, the synthesized and purified Ag@GDY is homogeneously blended with poly(lactic-co-glycolic acid) (PLGA) as an antimicrobial agent, and electrospinning along with high-speed collectors is used to make tubular stents. The antibacterial effect of Ag@GDY and the porous microstructure of the stents can effectively prevent bacterial biofilm formation. Furthermore, the stents gradually decrease in toughness but increase in strength during the degradation process. The cellular and subcutaneous implantation experiments demonstrate the moderate biocompatibility of the stents. In summary, considering these performance characteristics and the technical feasibility of the approach taken, this study opens new possibilities for the design and application of biodegradable ureteral stents.

Effect of static tensile stress on enzymatic degradation of poly(glycerol sebacate).

Poly(glycerol sebacate) (PGS) is an excellent scaffold material in tissue engineering due to good biocompatibility and tunable mechanical properties. The degradation properties of PGS have been primarily explored in static phosphate buffer solution or enzyme solution. It is vital to understand how the tensile stress affect the degradation rate. In this study, PGS was synthetized by melt polycondensation and its properties were characterized. Then an in vitro degradation device which could provide different constant tensile stresses was carefully designed and established, and the enzymatic degradation of PGS was tested under 0-150 kPa at 37°C. It was found that holes of PGS surface arranged almost parallel to each other and perpendicular to the direction of tensile stresses at 100 kPa and 150 kPa after 2-4 days degradation. After 8 days degradation, the ultimate tensile strength (UTS) of PGS at 150 kPa was 0.28 MPa and the elastic modulus was 1.11 MPa, while the UTS of PGS was 0.44 MPa and the elastic modulus was 1.63 MPa before degradation, both of them have significant differences. Hence, the tensile stress and degradation time were proportional to the appear time and size of holes, leading to the decrease of mass loss, UTS and elastic modulus. The relationship between stress and PGS degradation rates was quantitatively described through our degradation experiments, providing guidance for suitable PGS applications in the future.

Topological phase transition and skyrmions in a Janus MnSbBiSe2Te2 monolayer.

Using first-principles calculations and micro-magnetic simulations, we propose a Janus MnSbBiSe2Te2 (MSBST) monolayer derived from the MnBi2Te4 (MBT) ferromagnet and investigate the influence of biaxial strain on the electronic structures, topological characteristics and spin textures. Different from pristine MBT with an out-of-plane easy axis, the anisotropy of MSBST prefers an in-plane direction. Intriguingly, switching the easy axis direction of MSBST will significantly modify the band structure. Topological phase transition can be achieved by applying a compressive strain, making MSBST become a topological insulator with . Moreover, due to the inherent inversion asymmetry of Janus MSBST, a large Dzyaloshinskii-Moriya interaction (DMI) is induced for generating and stabilizing skyrmions. By micro-magnetic simulations, the results of spin textures show that the skyrmions phase can be achieved in MSBST with an external magnetic field of 0.8 T. Our findings provide guidelines for the development and application of spintronic devices with nontrivial topological properties and a large DMI.

Spontaneous magnetic merons in a half-metallic Mn2I3Br3 monolayer with easy-plane anisotropy.

In recent years, great effort has been made in the study of two-dimensional (2D) van der Waals ferromagnets that can stabilize peculiar chiral spin textures, such as magnetic skyrmions and merons. Here, by first-principles calculations and micromagnetic simulations, we systematically investigate the in-plane magnetic anisotropy, Dzyaloshinskii-Moriya interaction (DMI) and magnetic merons in a Mn2I3Br3 monolayer. Mn2I3Br3 exhibits half-metallic behavior with a large band gap (∼2.7 eV) for spin-down electrons, but is gapless for spin-up ones. In addition, unlike most 2D ferromagnets with an off-plane magnetic easy axis and negligible DMI, the magnetic easy axis of Mn2I3Br3 is in-plane, with a large magnetic anisotropy energy of -13.2 meV and a strong DMI of 4.6 meV, which are mainly induced by the strong spin-orbital coupling of I atoms, microscopically. In particular, spontaneous magnetic merons, stabilized by the DMI, can exist in a wide magnetic field range (0-6 T). Our work not only provides important guidelines for the investigation of the DMI and merons in half-metallic materials, but also demonstrates the Mn2I3Br3 monolayer as an ideal platform to explore the deep physics of magnetic merons and as a promising candidate for magnetic storage devices, as well as spin filters.

Management of oesophageal foreign bodies in children: a 10-year retrospective analysis from a tertiary care center.

OBJECTIVE: Oesophageal foreign bodies (EFBs) are a common emergency issue in paediatrics, and few studies have revealed its clinical features and treatment methods. We conducted this retrospective study to provide our 10-year clinical evidence for the diagnosis and treatment of EFB and reduce the incidence of complications. METHODS: We retrospectively reviewed all paediatric cases diagnosed with EFB from January 2012 to December 2021 at Shenzhen Children's Hospital. The age and sex of the patients, types of foreign bodies (FBs), preoperative examination, location and duration of FB impaction, clinical symptoms, surgical methods, therapeutic effects and complications were analysed. RESULTS: Among the 1355 cases, 759 were boys and 596 were girls, with a median age of 2.9 years (4 months to 16 years). The shortest FB lodged time was 1 hour, while the longest time was 3 months. The types of foreign bodies included coins and blunt objects (812,59.9%), bones and sharp objects (278,20.5%), button batteries (86,6.3%), food impactions (84,6.2%), toys (51,3.8%) and plastic objects (44,3.2%). A total of 720 of 812 cases impacted by coins and blunt subjects were successfully treated with a Foley catheter without any complications. A total of 558 patients underwent rigid oesophageal endoscopy under general anaesthesia, and foreign bodies were successfully removed in 525 cases. No FB was found in 33 cases, and FBs pushed into the lower digestive tract during operation in 5 cases. Oesophageal injury was found in 130 cases (23.3%). Our study showed that the age of the patient, time of foreign body incarceration, type of foreign body, location of the lodged foreign body, and fever or cough were risk factors leading to oesophageal foreign body complications, and the differences were statistically significant (P < 0.05). CONCLUSION: Children with EFB have a risk of complications, especially if the FB is a button battery. The appropriate surgical method should be selected through the analysis of the clinical characteristics of the foreign body in the oesophagus and the risk factors for complications to reduce the incidence of complications. Health education and effective care are the keys to the prevention of EFB.

Visualizing the unusual spectral weight transfer in DyBa2Cu3O7-δ thin film.

We report a Spectroscopic Imaging Scanning Tunneling Microscopy (SI-STM) study of a DyBa2Cu3O7-δ (DBCO) thin film (Tc ~ 79 K) synthesized by the molecular beam epitaxy (MBE). We observed an unusual transfer of spectral weight in the local density of states (LDOS) spectra occurring only within the superconducting gap. By a systematic control of the tip-sample distance and the junction resistance, we demonstrate that the spectral weight transfer can be switched at a nano-meter length scale. These results suggest that an interaction between the STM tip and the sample alters the electronic configurations in the film. This probably originates from a combination of an intrinsic band bending at the interface between the surface and the bulk, and a tip-induced band bending. These results may open a new avenue for band engineering and applications of thin films of high-Tc cuprates.

Tensor Cascaded-Rank Minimization in Subspace: A Unified Regime for Hyperspectral Image Low-Level Vision.

Low-rank tensor representation philosophy has enjoyed a reputation in many hyperspectral image (HSI) low-level vision applications, but previous studies often failed to comprehensively exploit the low-rank nature of HSI along different modes in low-dimensional subspace, and unsurprisingly handled only one specific task. To address these challenges, in this paper, we figured out that in addition to the spatial correlation, the spectral dependency of HSI also implicitly exists in the coefficient tensor of its subspace, this crucial dependency that was not fully utilized by previous studies yet can be effectively exploited in a cascaded manner. This led us to propose a unified subspace low-rank learning regime with a new tensor cascaded rank minimization, named STCR, to fully couple the low-rankness of HSI in different domains for various low-level vision tasks. Technically, the high-dimensional HSI was first projected into a low-dimensional tensor subspace, then a novel tensor low-cascaded-rank decomposition was designed to collapse the constructed tensor into three core tensors in succession to more thoroughly exploit the correlations in spatial, nonlocal, and spectral modes of the coefficient tensor. Next, difference continuity-regularization was introduced to learn a basis that more closely approximates the HSI's endmembers. The proposed regime realizes a comprehensive delineation of the self-portrait of HSI tensor. Extensive evaluations conducted with dozens of state-of-the-art (SOTA) baselines on eight datasets verified that the proposed regime is highly effective and robust to typical HSI low-level vision tasks, including denoising, compressive sensing reconstruction, inpainting, and destriping. The source code of our method is released at https://github.com/CX-He/STCR.git.

Comparison on the properties of bovine pericardium and porcine pericardium used as leaflet materials of transcatheter heart valve.

BACKGROUND: In order to obtain the smaller delivery diameter, porcine pericardium had been used as a substitute material of bovine pericardium for the leaflet materials of transcatheter heart valve (THV). However, the differences between them had not been fully studied. Therefore, this study compared the microstructure, biochemical and mechanical properties of two materials and hydrodynamics of THV made by the two materials in detail. METHODS: In this study, firstly, the microstructure of pericardium was analyzed by staining and scanning electron microscope; secondly, the biochemical properties of pericardium after different processes were compared by heat shrinkage temperature test, free amino and carboxyl concentration test, enzyme degradation test, subcutaneous implantation calcification analysis in rats; finally, the mechanical properties were evaluated by uniaxial tensile test before and after the pericardium being crimped, and then, the hydrodynamics of THV was studied according to the ISO5840 standard. RESULTS: Compared with bovine pericardium, after the same process, porcine pericardium showed a looser and tinier fiber bundle, a similar free carboxyl concentration, a lower resistance to enzyme degradation, a significantly lower calcification, bearing capacity and damage after being crimped, a better hydrodynamic and adaption with lower cardiac output and deformation of implantation position. Meanwhile the dehydration process of pericardium almost had preserved all the biochemical advantages of two materials. CONCLUSION: In this study, porcine and bovine pericardium showed some significant differences in biochemical, mechanical properties and hydrodynamics. According to the results, it was presumed that the thinner porcine pericardium might be more suitable for THV of right heart system. Meanwhile, more attention should be taken for the calcification of THV made by the bovine pericardium.

A time-shared switching scheme designed for multi-probe scanning tunneling microscope.

We report the design of a time-shared switching scheme, aiming to realize the manipulation and working modes (imaging mode and transport measurement mode) switching between multiple scanning tunneling microscope (STM) probes one by one with a shared STM control system (STM CS) and an electrical transport characterization system. This scheme comprises three types of switch units, switchable preamplifiers (SWPAs), high voltage amplifiers, and a main control unit. Together with the home-made software kit providing the graphical user interface, this scheme achieves a seamless switching process between different STM probes. Compared with the conventional scheme using multiple independent STM CSs, this scheme possesses more compatibility, flexibility, and expansibility for lower cost. The overall architecture and technique issues are discussed in detail. The performances of the system are demonstrated, including the millimeter scale moving range and atomic scale resolution of a single STM probe, safely approached multiple STM probes beyond the resolution of the optical microscope (1.1 µm), qualified STM imaging, and accurate electrical transport characterization. The combinational technique of imaging and transport characterization is also shown, which is supported by SWPA switches with ultra-high open circuit resistance (909 TΩ). These successful experiments prove the effectiveness and the usefulness of the scheme. In addition, the scheme can be easily upgraded with more different functions and numbers of probe arrays, thus opening a new way to build an extremely integrated and high throughput characterization platform.

A Review: Optimization for Poly(glycerol sebacate) and Fabrication Techniques for Its Centered Scaffolds.

Poly(glycerol sebacate) (PGS), an emerging promising thermosetting polymer synthesized from sebacic acid and glycerol, has attracted considerable attention due to its elasticity, biocompatibility, and tunable biodegradation properties. But it also has some drawbacks such as harsh synthesis conditions, rapid degradation rates, and low stiffness. To overcome these challenges and optimize PGS performance, various modification methods and fabrication techniques for PGS-based scaffolds have been developed in recent years. Outlining the current modification approaches of PGS and summarizing the fabrication techniques for PGS-based scaffolds are of great importance to accelerate the development of new materials and enable them to be appropriately used in potential applications. Thus, this review comprehensively overviews PGS derivatives, PGS composites, PGS blends, processing for PGS-based scaffolds, and their related applications. It is envisioned that this review could instruct and inspire the design of the PGS-based materials and facilitate tissue engineering advances into clinical practice.

Presentation and management of nasal foreign bodies in a Chinese metro area.

ABSTRACT: Nasal foreign bodies in children are common complaints encountered by pediatric otolaryngologists. We investigated clinical features, diagnosis, and treatment of nasal foreign bodies in children in a Chinese metro area.Six hundred sixty eight children with nasal foreign bodies presented to Shenzhen Children's Hospital, diagnosed and treated by the authors were enrolled from January 2016 to October 2019, causes for medical consultation, age, sex, duration, types, locations, removal, and complications were recorded and analyzed.Nasal foreign bodies were common in children between 1 and 5 years of ages (96.8%). The right nasal cavity (61.4%) was the most common site for foreign body insertion (61.4%). Most of the children (89.4%) presented for a complaint of nasal discomfort or foreign body insertion themselves, or for foreign body impaction discovered by the caregivers. Most of the foreign bodies (85.0%) were discovered within 1 day. The most nasal foreign bodies were the whole toys and toy parts (34.1%). The majority of nasal foreign bodies (99.1%) located in the antero-inferior portion of the nasal cavities and could be removed with simple instruments. The occurrence of complications in nasal foreign bodies (10.2%) was not common.The present study objectively exhibited clinical features, diagnosis, and treatment of nasal foreign bodies in a Chinese metro area.

Deep Learning for Classification of Pediatric Otitis Media.

OBJECTIVES/HYPOTHESIS: To create a new strategy for monitoring pediatric otitis media (OM), we developed a brief, reliable, and objective method for automated classification using convolutional neural networks (CNNs) with images from otoscope. STUDY DESIGN: Prospective study. METHODS: An otoscopic image classifier for pediatric OM was built upon the idea of deep learning and transfer learning using the two most widely used CNN architectures named Xception and MobileNet-V2. Otoscopic images, including acute otitis media (AOM), otitis media with effusion (OME), and normal ears were obtained from our institution. Among qualified otoendoscopic images, 10,703 images were used for training, and 1,500 images were used for testing. In addition, 102 images captured by smartphone with WI-FI connected otoscope were used as a prospective test set to evaluate the model for home screening and monitoring. RESULTS: For all diagnoses combined in the test set, the Xception model and the MobileNet-V2 model had similar overall accuracies of 97.45% (95% CI 96.81%-97.94%) and 95.72% (95% CI 95.12%-96.16%). The overall accuracies of two models with smartphone images were 90.66% (95% CI 90.21%-90.98%) and 88.56% (95% CI 87.86%-90.05%). The class activation map results showed that the extracted features of smartphone images were the same as those of otoendoscopic images. CONCLUSIONS: We have developed deep learning algorithms for the successfully automated classification of pediatric AOM and OME with otoscopic images. With a smartphone-enabled wireless otoscope, artificial intelligence may assist parents in early detection and continuous monitoring at home to decrease the visit frequencies. LEVEL OF EVIDENCE: NA Laryngoscope, 131:E2344-E2351, 2021.

Association between effective hepatic blood flow and the severity and prognosis of hepatitis B virus-related acute on chronic liver failure.

BACKGROUND: Hepatic inflammation resulted in hepatocyte necrosis and microcirculatory dysfunction in acute on chronic liver failure (ACLF) with cirrhosis or not. The influence of effective hepatic blood flow (EHBF) on the severity of liver failure has not been fully elucidated. AIM: The aim of this study was to assess the correlation between the EHBF and the severity and the prediction of 90-day mortality rate of hepatitis B virus-related ACLF (HBV-ACLF). METHODS: In this retrospective study, patients hospitalized for HBV-ACLF or decompensated cirrhosis and who underwent an indocyanine green (ICG) clearance test between June 2016 and July 2018 were enrolled. EHBF was measured by the ICG clearance test and patients were categorized into the ACLF without cirrhosis (HBV-ACLF-no-Cir), ACLF with cirrhosis (HBV-ACLF-Cir) and decompensated cirrhosis (HBV-De-Cir). RESULTS: A total of 522 patients (HBV-ACLF-no-Cir: 84, HBV-ACLF-Cir: 111 and HBV-De-Cir: 327) were enrolled. The mean EHBF in the HBV-De-Cir was significantly higher than that in the HBV-ACLF-no-Cir and HBV-ACLF-Cir (0.36 vs. 0.21 vs. 0.20 L/min, P < 0.001). EHBF was significantly correlated with the total bilirubin, prothrombin activity and model for end-stage liver disease (MELD) in the HBV-ACLF-no-Cir. The predicted 90-day mortality rate using the MELD, EHBF, ICG-retention rate at 15 min (R15%) and EHBF-R15% scores were similar. The sensitivity and specificity of the EHBF varied between 68.5-80.2% and 45.8-73.7%, respectively. The EHBF-MELD score had the highest specificity. CONCLUSION: EHBF was significantly lower in the patients with ACLF compared to decompensated cirrhosis. The EHBF were closely related to the severity of HBV-ACLF and can be used for predicting the 90-day mortality rate of HBV-ACLF.

Scheduling-Guided Automatic Processing of Massive Hyperspectral Image Classification on Cloud Computing Architectures.

The large data volume and high algorithm complexity of hyperspectral image (HSI) problems have posed big challenges for efficient classification of massive HSI data repositories. Recently, cloud computing architectures have become more relevant to address the big computational challenges introduced in the HSI field. This article proposes an acceleration method for HSI classification that relies on scheduling metaheuristics to automatically and optimally distribute the workload of HSI applications across multiple computing resources on a cloud platform. By analyzing the procedure of a representative classification method, we first develop its distributed and parallel implementation based on the MapReduce mechanism on Apache Spark. The subtasks of the processing flow that can be processed in a distributed way are identified as divisible tasks. The optimal execution of this application on Spark is further formulated as a divisible scheduling framework that takes into account both task execution precedences and task divisibility when allocating the divisible and indivisible subtasks onto computing nodes. The formulated scheduling framework is an optimization procedure that searches for optimized task assignments and partition counts for divisible tasks. Two metaheuristic algorithms are developed to solve this divisible scheduling problem. The scheduling results provide an optimized solution to the automatic processing of HSI big data on clouds, improving the computational efficiency of HSI classification by exploring the parallelism during the parallel processing flow. Experimental results demonstrate that our scheduling-guided approach achieves remarkable speedups by facilitating the automatic processing of HSI classification on Spark, and is scalable to the increasing HSI data volume.