Deep Learning With Chest Radiographs for Making Prognoses in Patients With COVID-19: Retrospective Cohort Study.

BACKGROUND: An artificial intelligence (AI) model using chest radiography (CXR) may provide good performance in making prognoses for COVID-19. OBJECTIVE: We aimed to develop and validate a prediction model using CXR based on an AI model and clinical variables to predict clinical outcomes in patients with COVID-19. METHODS: This retrospective longitudinal study included patients hospitalized for COVID-19 at multiple COVID-19 medical centers between February 2020 and October 2020. Patients at Boramae Medical Center were randomly classified into training, validation, and internal testing sets (at a ratio of 8:1:1, respectively). An AI model using initial CXR images as input, a logistic regression model using clinical information, and a combined model using the output of the AI model (as CXR score) and clinical information were developed and trained to predict hospital length of stay (LOS) ≤2 weeks, need for oxygen supplementation, and acute respiratory distress syndrome (ARDS). The models were externally validated in the Korean Imaging Cohort of COVID-19 data set for discrimination and calibration. RESULTS: The AI model using CXR and the logistic regression model using clinical variables were suboptimal to predict hospital LOS ≤2 weeks or the need for oxygen supplementation but performed acceptably in the prediction of ARDS (AI model area under the curve [AUC] 0.782, 95% CI 0.720-0.845; logistic regression model AUC 0.878, 95% CI 0.838-0.919). The combined model performed better in predicting the need for oxygen supplementation (AUC 0.704, 95% CI 0.646-0.762) and ARDS (AUC 0.890, 95% CI 0.853-0.928) compared to the CXR score alone. Both the AI and combined models showed good calibration for predicting ARDS (P=.079 and P=.859). CONCLUSIONS: The combined prediction model, comprising the CXR score and clinical information, was externally validated as having acceptable performance in predicting severe illness and excellent performance in predicting ARDS in patients with COVID-19.

Correction: Deep Learning With Chest Radiographs for Making Prognoses in Patients With COVID-19: Retrospective Cohort Study.

[This corrects the article DOI: 10.2196/42717.].

Respiratory Protection Effect of Ear-loop-type KF94 Masks according to the Wearing Method in COVID-19 Pandemic: a Randomized, Open-label Study.

BACKGROUND: Ear-loop-type Korean Filter 94 masks (KF94 masks, equivalent to the N95 and FFP2) are broadly used in health care settings in Korea for the coronavirus disease 2019 pandemic. METHODS: A prospective randomized open-label study was designed to identify differences in the fitting performance between mask wearing methods in three different types of KF94 mask with ear loops between January to March 2021. General-fitting involved wearing an ear-loop-type KF94 mask, and tight-fitting involved wearing a mask aided by a clip connecting the ear loops. Each of the 30 participants wore three types of masks according to a randomly assigned order in both methods and performed a total of six quantitative fit tests (QNFTs) according to the occupational safety and health administration protocol. RESULTS: All fit factors (FFs) measured by the QNFT were significantly higher for tight-fitting method with the clip in all KF94 masks (P < 0.001). However, the total FFs were very low, with a median (interquartile range) of 6 (3-23) and 29 (9-116) for general-fitting and tight-fitting, respectively. When wearing tightly, the horizontal 3-fold type mask with adjustable ear-loop length had the highest FF, with a median of 125, and the QNFT pass rate (FF ≥ 100) increased significantly from 4 (13%) to 18 (60%). CONCLUSION: Even with sufficient filter efficiency, ear-loop-type-KF94 masks do not provide adequate protection. However, in relatively low-risk environments, wearing a face-seal adjustable KF94 mask and tight wearing with a clip can improve respiratory protection for healthcare workers. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT04794556.

Spring protistan communities in response to warming in the northeastern East China Sea.

The northeastern East China Sea is a highly dynamic marine ecosystem influenced by seasonally varying water mass properties. However, despite being among the world's fastest-warming ocean, there has been limited investigation into the impacts of warming on protistan communities. We collected seawater from two stations (E42 and E46) with different natural protist communities and environmental attributes to investigate the acclimation of the two communities to artificially elevated temperatures (ambient T, +2, and +4 °C). Nutrient and Chl-a conditions reflected oceanographic differences, providing insights into protistan community dynamics. Notably, small-sized autotrophic protists prevailed in the phosphate-deficient E42 community, with mid-incubation heterotrophic conversions. Higher temperatures exacerbated the effects of the P deficiency on the E42 community. While the proportions of Bacillariophyta increased only in the nutrient-balanced E46 communities, those of mixotrophic dinoflagellates increased with elevated temperature, regardless of P deficiency, suggesting that mixotrophy likely aids adaptation in changing marine environments. In summary, the findings of this microcosm study illuminate the potential modulation of spring protistan communities in the northeastern East China Sea under anticipated future warming.

Effects of harmful microalgae on the behavior and morphology of ephyrae of the moon jellyfish Aurelia aurita.

Although microalgae typically serve as prey for jellyfish ephyrae in marine food webs, this study investigated the potential of harmful microalgae to produce detrimental effects on the moon jellyfish Aurelia aurita. Understanding the biological interactions between Aurelia and microalgal species is crucial, particularly considering their common co-occurrence in coastal waters worldwide. We examined the effects of 11 protist strains, comprising seven species of harmful microalgae and two non-toxic microalgae, on A. aurita ephyrae. The rhythmic pulsation behavior of A. aurita was significantly suppressed when exposed to the raphidophytes Heterosigma akashiwo and Chattonella marina var. ovata and the dinoflagellates Amphidinium carterae, Coolia canariensis, and Pfiesteria piscicida. Notably, the media filtrates of all H. akashiwo strains and C. marina var. ovata killed ephyrae, implying a possible extracellular release of chemicals. This study discovered novel interactions between microalgae and jellyfish ephyrae, implying that harmful algal blooms may suppress mass occurrences of Aurelia medusae.

CT Findings of Supraglottitis in Adults

PURPOSE: To determine the CT findings and to evaluate the role of CT scanning in adult supraglottitis. MATERIALS AND METHODS: The CT findings of five male patients aged between 29 and 69 (mean, 53) years with adult supraglottitis were reviewed and evaluated. Particular attention was focussed on swelling of epiglottis and laryngeal structures, abscess formation and extension of the inflammatory process to adjacent neck spaces. In addition, the findings of CT were compared with those of plain radiography. RESULTS: In all patients, CT revealed swelling of the epiglottis and aryepiglottic folds, while in four, swelling of the paralaryngeal space was noted. Abscesses in the epiglottis were seen in four patients, and in three of these, small abscesses in the preepiglottic, parapharyngeal, or peritonsillar space or palatine tonsil, were also noted. One patient had an emphysematous epiglottitis, and in three, inflammation extended to adjacent regions of the neck, namely the parapharyngeal, retropharyngeal, submandibular, or peritonsillar space. Plain radiographs gave only restricted information regarding abscess formation and the extension of inflammation to adjacent neck space. CONCLUSION: CT is useful for assessing the extent of adult supraglottitis and for evaluating ensuing complications. It may also be useful for differentiating this condition from other supraglottic diseases, for the planning of treatment, and for evaluating the results of therapy.

Pulmonary Fat Embolism Induced Intravenous Injection of Autologous Bone Marrow in Rabbit: CT and Pathologic Correlation

PURPOSE: To evaluate the correlation between CT and pathologic findings of pulmonary fat embolism in rabbits. MATERIALS AND METHODS: In 16 rabbits, pulmonary fat embolism was induced by intravenous injection of autologous bone marrow(mean 3.3 mL). Chest CT scans were obtained immediately(within 1 hour), and 1, 3, and 7 days after embolization. The rabbits were divided into four groups. Group 1 underwent CT scanning immediately after embolization, group 2 immediately and 1 day after embolization, group 3 immediately, 1 day and 3 days after embolization, group 4 immediately, 1 day, 3 days and 7 days after embolization. Pathologic specimens were obtained immediately after the last CT scan. RESULTS: The earliest CT findings of pulmonary fat embolism in rabbits were peripheral lung lucency(16/16, 1 00 %), perivascular ground-glass (12/16, 75.0 %) and enlargement of the central pulmonary artery(11/16, 6 8 .8 %). Pathologically, perivascular ground-glass opacity correlated with extensive perivascular alveolar congestion and enlargement of the central pulmonary artery correlated with perivascular connective tissue edema and reactive pulmonary arterial engorgement. Peripheral lung lucency was probably caused by embolic occlusion of the pulmonary artery and decreased perfusion and air trapping induced by arterial and bronchial s-pasm associated with hypoxia. CT scans obtained 1 and 3 days after embolization showed nodules and patchy ground-glass opacity and consolidation. Aggregation of nodules resulted in patch opacities. Pathologically, pulmonary nodules correlated with focal inflammation surrounding an artery and parenchymal opacity correlated with parenchymal consolidation and hemorrhagic edema. CT scans and pathologic specimens obtained 7 days after embolization showed improvement of parenchymal lung abnormalities. CONCLUSION: Pulmonary fat embolism in rabbits show CT and pathologic findings which vary with dynamic change. Typical earliest findings of pulmonary fat embolism were peripheral lung lucency, perivascular ground-glass opacity and enlargement of the central pulmonary artery.