Machine Learning Approach for Prediction of the Test Results of Gonadotropin-Releasing Hormone Stimulation: Model Building and Implementation.

Precocious puberty in girls is defined as the onset of pubertal changes before 8 years of age, and gonadotropin-releasing hormone (GnRH) agonist treatment is available for central precocious puberty (CPP). The gold standard for diagnosing CPP is the GnRH stimulation test. However, the GnRH stimulation test is time-consuming, costly, and requires repeated blood sampling. We aimed to develop an artificial intelligence (AI) prediction model to assist pediatric endocrinologists in decision making regarding the optimal timing to perform the GnRH stimulation test. We reviewed the medical charts of 161 girls who received the GnRH stimulation test from 1 August 2010 to 31 August 2021, and we selected 15 clinically relevant features for machine learning modeling. We chose the models with the highest area under the receiver operating characteristic curve (AUC) to integrate into our computerized physician order entry (CPOE) system. The AUC values for the CPP diagnosis prediction model (LH ≥ 5 IU/L) were 0.884 with logistic regression, 0.912 with random forest, 0.942 with LightGBM, and 0.942 with XGBoost. For the Taiwan National Health Insurance treatment coverage prediction model (LH ≥ 10 IU/L), the AUC values were 0.909, 0.941, 0.934, and 0.881, respectively. In conclusion, our AI predictive system can assist pediatric endocrinologists when they are deciding whether a girl with suspected CPP should receive a GnRH stimulation test. With proper use, this prediction model may possibly avoid unnecessary invasive blood sampling for GnRH stimulation tests.

Conformal CVD-Grown MoS2 on Three-Dimensional Woodpile Photonic Crystals for Photonic Bandgap Engineering.

To achieve the modification of photonic band structures and realize the dispersion control toward functional photonic devices, composites of photonic crystal templates with high-refractive-index material are fabricated. A two-step process is used: 3D polymeric woodpile templates are fabricated by a direct laser writing method followed by chemical vapor deposition of MoS2. We observed red-shifts of partial bandgaps at the near-infrared region when the thickness of deposited MoS2 films increases. A ∼10 nm red-shift of fundamental and high-order bandgap is measured after each 1 nm MoS2 thin film deposition and confirmed by simulations and optical measurements using an angle-resolved Fourier imaging spectroscopy system.

Identifying additional risk factors for early asymptomatic neonatal hypoglycemia in term and late preterm babies.

BACKGROUND: Neonatal hypoglycemia is a common metabolic disorder in newborns, which may present with non-specific symptoms or even be asymptomatic. Current guidelines recommend screening for hypoglycemia in at-risk babies (late preterm, small for gestational age, large for gestational age, and infants of diabetic mothers). Past studies have suggested other potential risk factors, such as maternal obesity, gestational hypertension, cesarean section, etc. In this study, we aim to identify additional prenatal and perinatal maternal/fetal characteristics associated with early asymptomatic hypoglycemia in term and late preterm babies. METHODS: We performed a retrospective review on medical charts of all newborns, born between January, 2017 and December, 2020, in the well-baby newborn nursery of a tertiary medical center. We identified newborns who had received blood glucose concentration monitor after birth. Detailed prenatal and perinatal maternal/newborn information were collected for analysis. RESULTS: In the study period, 841 newborns had received blood glucose screening after birth. After matching by sex and indication for postnatal blood glucose screen (SGA, LGA, and GDM), 148 newborns were included in the "hypoglycemia group" and 296 newborns were included in the "euglycemia group". In the univariate analysis, parity, insulin treatment for gestational diabetes mellitus (GDM), and cesarean section were associated with an increased risk for neonatal hypoglycemia. Factors associated with decreased risk included higher gestational age, longer duration of skin-to-skin contact, neonatal hyperthermia, higher maternal labor pain score, and epidural anesthesia administration. By multivariable analysis, insulin treatment for GDM was identified as an independent factor associated with increased risk for neonatal hypoglycemia. CONCLUSION: Our study showed insulin treatment for GDM to be independently associated with neonatal hypoglycemia. Other risk factors noted in the univariate analysis, such as decreased skin-to-skin contact duration, hypothermia, Cesarean section, and preterm delivery, would require further investigation to confirm the findings.

Prolonged touch screen device usage is associated with emotional and behavioral problems, but not language delay, in toddlers.

BACKGROUND: Touch screen devices are now ubiquitous, and their usage by young children is increasing. However, the effects of these devices on young children are still unknown. Therefore, this study aimed to address the associations of touch screen device exposure with symptomatic emotional and behavioral problems and language development in children between the ages of 18 and 36 months. METHOD: A total of 161 primary caregivers of children between the ages of 18 and 36 months were recruited from the pediatric ward and outpatient clinic at a medical center in southern Taiwan. All caregivers were asked to fill out the Child Behavior Checklist for Ages 1½-5 (CBCL 1½-5) and a questionnaire on basic personal information and touch screen device usage, and they were also interviewed with the Communication and Language Screening Test for Birth to Three Chinese-Speaking Infant-Toddlers (CLST). Independent t-test and one-way ANOVA were used to examine the differences among the categories in the demographic variables and to characterize the touch screen device usage behaviors. Pearson's correlation was used to analyze the relationship between language delay and the extent of touch screen device exposure. After primary univariate analysis, we used multiple regression models to examine the relationships among the effects of touch screen device usage behaviors on children's emotional and behavioral problems and language development. RESULT: The children's mean age was 25.63 months (SD = 5.35). Children who spent more time on touch screen devices were more likely to have emotional problems (ß = .219, p < .010, 95 % CI: .279-1.518), anxious/depressive symptoms (ß = .206, p < .050, 95 % CI: .170-1.244), somatic complaints (ß = .291, p < .001, 95% CI: .455-1.462), social withdrawal symptoms (ß = .194, p < .050, 95 % CI: 0.133-1.150), attention problems (ß = .300, p < .001, 95 % CI: .432-1.267), and aggressive behaviors (ß = .247, p < .010, 95 % CI: .967-3.983). The effects were not noted on language development (ß = -.136, p < .100, 95 % CI: -2.595-.147). CONCLUSION: Young children who spent more time on touch screen devices were more likely to have emotional problems, anxious/depressive symptoms, somatic complaints, social withdrawal symptoms, attention problems, and aggressive behaviors, but not language delay.

Enhancement of dissolution rate of mitotane and warfarin prepared by using microemulsion systems.

Micronization is the most effective way to enhance the dissolution rate of poorly water-soluble drugs and bioavailability in human body. Microemulsion systems were applied to micronize mitotane and warfarin by cooling method and solvent diffusion process. The triangle phase diagram of the ternary benzyl alcohol+sodium dodecyl sulfate (SDS)+water system was investigated at six different temperatures to determine an appropriate operational microemulsion regime for crystallization. The particle sizes of mitotane and warfarin re-crystallized from microemulsion systems were greatly reduced (to ∼1 µm) compared with that of the commercial ones. Consequently, the dissolution rate coefficients of re-crystallized mitotane and warfarin were significantly improved by, respectively, 7.5 and 13.3 times larger than that of the commercial ones. The crystal structures of re-crystallized mitotane and warfarin were the same as the commercial ones based on the XRD and DSC measurements. In addition, it is interesting to observe the variation of morphology of re-crystallized mitotane as a function of the composition of the SDS and the drug concentrations.

Volatile organic compounds absorption in a cross-flow rotating packed bed.

A cross-flow rotating packed bed (RPB) process was evaluated for its absorption of some volatile organic compounds (VOCs) into water, including isopropyl alcohol, acetone, and ethyl acetate. The experimental results showed that the mass transfer coefficient (KGa) increased with increasing rotational speed, liquid rate, and gas rate, and thus an empirical correlation of KGa was proposed for the cross-flow RPB for the first time. It was found thatthis correlation could reasonably estimate our experimental KGa data as well as those reported in literatures. Although the mass transfer coefficient was lower than that in a countercurrent-flow RPB, a cross-flow RPB is believed to be capable of handling a higher gas rate because of its flow pattern.