Detecting neonatal acute bilirubin encephalopathy based on T1-weighted MRI images and learning-based approaches.

BACKGROUND: Neonatal hyperbilirubinemia is a common clinical condition that requires medical attention in newborns, which may develop into acute bilirubin encephalopathy with a significant risk of long-term neurological deficits. The current clinical challenge lies in the separation of acute bilirubin encephalopathy and non-acute bilirubin encephalopathy neonates both with hyperbilirubinemia condition since both of them demonstrated similar T1 hyperintensity and lead to difficulties in clinical diagnosis based on the conventional radiological reading. This study aims to investigate the utility of T1-weighted MRI images for differentiating acute bilirubin encephalopathy and non-acute bilirubin encephalopathy neonates with hyperbilirubinemia. METHODS: 3 diagnostic approaches, including a visual inspection, a semi-quantitative method based on normalized the T1-weighted intensities of the globus pallidus and subthalamic nuclei, and a deep learning method with ResNet18 framework were applied to classify 47 acute bilirubin encephalopathy neonates and 32 non-acute bilirubin encephalopathy neonates with hyperbilirubinemia based on T1-weighted images. Chi-squared test and t-test were used to test the significant difference of clinical features between the 2 groups. RESULTS: The visual inspection got a poor diagnostic accuracy of 53.58 ± 5.71% indicating the difficulty of the challenge in real clinical practice. However, the semi-quantitative approach and ResNet18 achieved a classification accuracy of 62.11 ± 8.03% and 72.15%, respectively, which outperformed visual inspection significantly. CONCLUSION: Our study indicates that it is not sufficient to only use T1-weighted MRI images to detect neonates with acute bilirubin encephalopathy. Other more MRI multimodal images combined with T1-weighted MRI images are expected to use to improve the accuracy in future work. However, this study demonstrates that the semi-quantitative measurement based on T1-weighted MRI images is a simple and compromised way to discriminate acute bilirubin encephalopathy and non-acute bilirubin encephalopathy neonates with hyperbilirubinemia, which may be helpful in improving the current manual diagnosis.

Experiences of the parents caring for their children during a tuberculosis outbreak in high school: a qualitative study.

BACKGROUND: Tuberculosis (TB) remains a serious epidemic in China. In the past five years, the number of TB infections in high school students is rising and thus high school students are becoming a high risk group of TB. Parents of children with TB have to endure high psychological pressures from the disease itself, children's education, employment and life. The purpose of this study was to investigate the psychological pressure of parents with high school students suffering from TB. METHODS: A total of 22 parents who have been taking care of their children suffering from TB were interviewed and a framework approach was used to analyze the interviews. RESULTS: In our study, 21/22 parents had low levels of understanding about TB; 22/22 were under psychological stress; and 20/22 stated that their daily life was impacted on TB. CONCLUSIONS: Parents need to be given appropriate knowledge on TB and psychological counseling. Authorities should not only implement the therapeutic measures, but also focus on solving the psychological problems of patients and their families when a similar outbreak occurs.

The sense of familial responsibility of PLHIVs in the rural areas of western China.

In this paper, we explore the strong familial responsibility sense of people living with HIV (PLHIV) in rural western China, based on the data obtained from in-depth interviews. The data show that PLHIV were coping positively with a poor family economic status, caring for their family more than themselves, and taking concrete steps to fulfill their familial obligations. However, unique economic, cultural, and social factors exert negative impact on their ability to achieve their aims. The findings from our study illustrate that proper governmental and social interventions should be launched based on the actual situation and needs of local PLHIV and their families.