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Obstructive sleep apnea (OSA) has been a common sleep disorder for years, and polysomnography (PSG) remains the gold standard for diagnosing OSA. Nevertheless, PSG is a time and money consuming test, and patients have to wait long for arranging a PSG test in a hospital. In light of this, portable and wearable tools for OSA classification have been developed recently as a low‐cost and easy‐to‐use screening method before undergoing PSG. Using unsegmented electrocardiogram (ECG) signals, a deep neural network (DNN)‐based model is developed here to categorize OSA severity with the following features. First, the model takes unsegmented ECG signals recorded overnight as input, and then generates a four‐level scale as output. Since all the input ECG signals are unsegmented, the tremendous amount of effort spent on signal annotation can be fully saved. Second, the largest amount of data is used to test the model and consequently provide a high generalization ability, as compared with others in the literature. The overall outperformance of this work is highlighted at the end of this article, and this work is validated as an easy‐to‐use and effective screening tool for OSA accordingly.

We introduce a 39-year-old man with an exceedingly large adrenal schwannoma who visited our outpatient department with epigastric pain and a palpable mass in the left upper abdomen. Abdominal computed tomography revealed a giant cystic lesion measuring >25 cm. Laparotomy was performed for tumor excision and partial nephrectomy. Pathological examination confirmed adrenal schwannoma. The patient has been free of tumor recurrence for 10 months. The tumor size in this case is unprecedented in the English literature indexed in PubMed. Precise preoperative evaluation, delicate radical excision, and postoperative monitoring are essential for successful management of such tumors.

This paper presents a teaching tool for schoolchildren to learn artificial intelligence (AI) technology through which a variety of banknotes can be recognized. This was done by first using a pretrained YOLOv3 object detection model. Secondly, transfer learning was conducted on the pretrained model using 11 collected banknotes, including US$, Euro, Japanese Yen, and NT$. The banknote detection model was experimentally validated to give an average precision (AP) of up to 99.09% if the threshold Intersection over Union (IoU) is not less than 0.8. Once a banknote was successfully recognized, the face value and the country name thereon were displayed, and schoolchildren can access suggested websites, i.e., Wikipedia, Google Maps, and the Bank of Taiwan, to learn more about the exchange rate between currencies and the history and location of the country that issued the banknote. Consequently, schoolchildren can have fun using this tool and acquire a more a global outlook. Moreover, they may be motivated to become AI professionals in the future. [ABSTRACT FROM AUTHOR]

Several studies have shown that liver resection (LR) confers better survival outcomes in intermediate- and advanced-stage hepatocellular carcinoma (HCC) patients. However, the postoperative recurrence rate is high, and little is known about the survival benefits of LR for recurrent HCC patients who have already received systemic treatment. This study aimed to evaluate the impact of LR on recurrent advanced-stage HCC patients who received sorafenib as a systemic treatment. In this study, 147 advanced HCC patients were enrolled between 1 January 2012 and 31 December 2019. Two study groups were classified, based on whether they underwent LR or not. To reduce the possible selection bias, a propensity score matching (PSM) analysis was performed. The primary study endpoint was set as overall survival (OS), and the secondary endpoint was set as progression-free survival (PFS). Our study results revealed that advanced HCC patients who received sorafenib with LR had a longer OS than did those without LR, whether before or after PSM (15.0 months vs. 6.0 months, HR 0.45, 95% CI 0.31–0.67, p < 0.001; 15.0 months vs. 5.0 months, HR 0.46, 95% CI 0.28–0.76, p = 0.001). Similar results were obtained in PFS, before or after PSM (4.14 months vs. 2.60 months, HR 0.60, 95% CI 0.40–0.89, p = 0.01; 4.57 months vs. 2.63 months, HR 0.58, 95% CI 0.34–0.97, p = 0.037). Multivariate analysis showed that the experience of LR was independent of other factors associated with better OS and PFS, whether before or after PSM (p < 0.05). Therefore, advanced HCC patients who have undergone liver resection should be encouraged to continue sorafenib treatment to improve prognosis.

Liver abscesses due to foreign body penetration from the gastrointestinal tract are relatively rare events. The inability to recognize this condition may lead to poor response to standard treatment of liver abscesses. This group of liver abscesses has a distinct location and growth of microorganisms from liver abscesses of other etiologies. Laboratory studies often present nonspecific findings. Computed tomography exam is the best tool to recognize and diagnose this condition. Treatment often would require foreign object removal to prevent the recurrence of abscess formation.

Type 2 diabetes (T2D) and liver cirrhosis remain significant public health threats in Taiwan. These conditions are reported to be associated with the rs738409 polymorphism of the patatin-like phospholipase domain-containing protein three gene (PNPLA3) in European populations. We assessed the effect of T2D and PNPLA3 rs738409 polymorphism on liver cirrhosis among Taiwan Biobank (TWB) participants. In total, 17,985 participants in TWB had their health records linked to the National Health Insurance Research Database (NHIRD). Participants included those who visited the assessment centers between 2008 and 2015, with an age range between 30 and 70 years of age. We performed logistic regression analysis to investigate the odds ratios (OR) for liver cirrhosis among participants based on the T2D status and rs738409 genotypes. Genotyping was performed using the Axiom Genome-Wide TWB Array Plate. In our analysis, 150 of the 17,619 eligible participants were identified as cirrhosis cases. Based on the univariate analysis, liver cirrhosis was positively associated with T2D (OR, 1.83; 95% CI 1.23–2.70) whereas, the variant rs738409 was not (regardless of the genetic model). The variant and T2D, however, showed significant interactions in the additive, genotype, and dominant models (p values of 0.0302, 0.0395, and 0.0455, respectively). We observed a statistically significant association between T2D and liver cirrhosis and variant rs738409 with an OR of 1.71 (95% CI, 1.03–2.84) for individuals carrying a G allele compared to those with a C allele and 2.92 (95% CI 1.07–7.99) for GG compared to CC individuals. According to our study, Taiwanese adults with T2D and the rs738409 GG genotype are more likely to develop liver cirrhosis.

The p16/Ki67 dual immunostaining was performed on anal cytology specimens; this is an anal cancer screening method. A literature search was performed in the BioMed Central, Cochrane Library, Embase, Google Scholar, and PubMed electronic databases for relevant articles. We included studies that discussed the efficacy of p16/Ki67 dual immunostaining for detecting anal intraepithelial neoplasia (AIN). Studies that calculated the diagnostic efficacy on a per-patient basis were included. We excluded review articles, case series, and studies that did not provide sufficient information. We extracted data on true positive, true negative, false positive, and false negative from the included studies to generate pooled sensitivity, specificity, and diagnostic odds ratio (DOR). All analyses were performed with a random-effects model using MetaDiSc 1.4 and MetaDTA. The meta-analysis produced a pooled sensitivity of 0.63 (95% CI: 0.34, 0.86) and specificity of 0.65 (95% CI: 0.46, 0.81) for p16/Ki67 dual immunostaining in detecting AIN. The pooled DOR was 3.26 (95% CI: −0.29, 6.82). A subgroup analysis of HIV-infected men who have sex with men (MSM) demonstrated a pooled sensitivity of 0.75 (95% CI: 0.28, 0.96). p16/Ki67 dual immunostaining might have a higher sensitivity for detecting AIN in HIV-infected MSM. p16/Ki67 dual immunostaining might be more sensitive in HIV-infected MSM and has higher specificity compared to human papillomavirus testing among this high-risk group. p16/Ki67 dual immunostaining might be an adjuvant and potential triage test for anal cytology in anal cancer screening.

The intravoxel incoherent motion (IVIM) model may enhance the clinical value of multiparametric magnetic resonance imaging (mpMRI) in the detection of prostate cancer (PCa). However, while past IVIM modeling studies have shown promise, they have also reported inconsistent results and limitations, underscoring the need to further enhance the accuracy of IVIM modeling for PCa detection. Therefore, this study utilized the control point registration toolbox function in MATLAB to fuse T2-weighted imaging (T2WI) and diffusion-weighted imaging (DWI) MRI images with whole-mount pathology specimen images in order to eliminate potential bias in IVIM calculations. Sixteen PCa patients underwent prostate MRI scans before undergoing radical prostatectomies. The image fusion method was then applied in calculating the patients’ IVIM parameters. Furthermore, MRI scans were also performed on 22 healthy young volunteers in order to evaluate the changes in IVIM parameters with aging. Among the full study cohort, the f parameter was significantly increased with age, while the D* parameter was significantly decreased. Among the PCa patients, the D and ADC parameters could differentiate PCa tissue from contralateral normal tissue, while the f and D* parameters could not. The presented image fusion method also provided improved precision when comparing regions of interest side by side. However, further studies with more standardized methods are needed to further clarify the benefits of the presented approach and the different IVIM parameters in PCa characterization.