Purpose: Early confirmation or ruling out biliary atresia (BA) is essential for infants with delayed onset of jaundice. In the current practice, percutaneous liver biopsy and intraoperative cholangiography (IOC) remain the golden standards for diagnosis. In Taiwan, the diagnostic methods are invasive and can only be performed in selective medical centers. However, referrals from primary physicians and local pediatricians are often delayed because of lacking clinical suspicions. Ultrasounds (US) are common screening tools in local hospitals and clinics, but the pediatric hepatobiliary US particularly requires well-trained imaging personnel. The meaningful comprehension of US is highly dependent on individual experience. For screening BA through human observation on US images, the reported sensitivity and specificity were achieved by pediatric radiologists, pediatric hepatobiliary experts, or pediatric surgeons. Therefore, this research developed a tool based on deep learning models for screening BA to assist pediatric US image reading by general physicians and pediatricians. Methods: De-identified hepatobiliary US images of 180 patients from Taichung Veterans General Hospital were retrospectively collected under the approval of the Institutional Review Board. Herein, the top network models of ImageNet Large Scale Visual Recognition Competition and other network models commonly used for US image recognition were included for further study to classify US images as BA or non-BA. The performance of different network models was expressed by the confusion matrix and receiver operating characteristic curve. There were two methods proposed to solve disagreement by US image classification of a single patient. The first and second methods were the positive-dominance law and threshold law. During the study, the US images of three successive patients suspected to have BA were classified by the trained models. Results: Among all included patients contributing US images, 41 patients were diagnosed with BA by surgical intervention and 139 patients were either healthy controls or had non-BA diagnoses. In this study, a total of 1,976 original US images were enrolled. Among them, 417 and 1,559 raw images were from patients with BA and without BA, respectively. Meanwhile, ShuffleNet achieved the highest accuracy of 90.56% using the same training parameters as compared with other network models. The sensitivity and specificity were 67.83% and 96.76%, respectively. In addition, the undesired false-negative prediction was prevented by applying positive-dominance law to interpret different images of a single patient with an acceptable false-positive rate, which was 13.64%. For the three consecutive patients with delayed obstructive jaundice with IOC confirmed diagnoses, ShuffleNet achieved accurate diagnoses in two patients. Conclusion: The current study provides a screening tool for identifying possible BA by hepatobiliary US images. The method was not designed to replace liver biopsy or IOC, but to decrease human error for interpretations of US. By applying the positive-dominance law to ShuffleNet, the false-negative rate and the specificities were 0 and 86.36%, respectively. The trained deep learning models could aid physicians other than pediatric surgeons, pediatric gastroenterologists, or pediatric radiologists, to prevent misreading pediatric hepatobiliary US images. The current artificial intelligence (AI) tool is helpful for screening BA in the real world.

Metallic film-coated porous silicon (PSi) has been reported as a lucrative surface-enhanced Raman scattering (SERS) substrate. The solution-based fabrication process is facile and easy; however, it requires additional reducing agent and extra chemical treatment, as well as hinders the suitability as a reproducible SERS substrate due to irregular hot spot generation via irregular deposition of metallic nanocrystallites. To address this issue, we report a unique one-step electronic beam (e-beam) physical vapor deposition (PVD) method to fabricate a consistent layer of gold (Au) nanofilm on PSi. Moreover, to achieve the best output as a SERS substrate, PSi prepared by electrochemical etching was used as template to generate an Au layer of irregular surface, offering the surface roughness feature of the PSi–Au thin film. Furthermore, to investigate the etching role and Au film thickness, Au-nanocrystallites of varying thickness (5, 7, and 10 nm) showing discrete surface morphology were characterized and evaluated for SERS effect using Rhodamine 6G (R6G). The SERS signal of R6G adsorbed on PSi–Au thin film showed a marked enhancement, around three-fold enhancement factor (EF), than the Si–Au thin film. The optimal SERS output was obtained for PSi–Au substrate of 7 nm Au film thickness. This study thus indicates that the SERS enhancement relies on the Au film thickness and the roughness feature of the PSi–Au substrate.

In this paper, we report on the enhancement of spectral photoresponsivity of porous silicon metal–semiconductor metal (PS-MSM) photodetector embedded with colloidal quantum dots (QDs) inside the pore layer. The detection efficiency of QDs/PS hybrid-MSM photodetector was enhanced by five times larger than that of the undoped PS-MSM photodetector. The bandgap alignment between PS (approximately 1.77 eV) and QDs (approximately 1.91 eV) facilitates the photoinduced electron transfer from QDs to PS whereby enhancing the photoresponsivity. We also showed that the photoresponsitivity of QD/PS hybrid-MSM photodetector depends on the number of layer coatings of QDs and the pore sizes of PS.

Introduction: Minimal invasive surgery for all kinds of surgical diseases had been practiced for years. The laparoscopic Kasai operation is one of the most challenging procedures and remains controversial for treating biliary atresia (BA). Purpose: This work presented the initial experience of our Institute and compared the outcomes of open and laparoscopic Kasai operations for BA. Materials and Methods: Patients 18 years old and younger, and were operated in our Institute for BA from January 2011 to August 2017, were included in this study. General and operative data and outcomes from open and laparoscopic groups were retrospectively collected and analyzed. Results: A total of 23 patients (13 for conventional open operation and 10 for the laparoscopic procedure) received Kasai portoenterostomy. The mean operative age and body weight in the open versus laparoscopic groups were 57.15 ± 20.14 days old and 4.03 ± 0.69 kg versus 57.70 ± 43.06 days old and 4.49 ± 1.48 kg, respectively, and no statistical difference was observed. The mean operative times were 209.62 ± 60.40 and 293.50 ± 39.09 minutes in the open and laparoscopic groups, respectively. The mean follow-up durations were 54.62 ± 22.00 and 23.30 ± 11.87 months for the open and laparoscopic patients, correspondingly. No statistically significant differences were observed for hospital stay and outcomes (including early jaundice clearance rate, episodes of cholangitis, and 2-year native liver survival rate) between the open and the laparoscopic Kasai operations. Conclusion: Experienced pediatric laparoscopic surgeons may reconsider the laparoscopic Kasai operation for application to BA treatment.

Our report is the first example describing the successful synthesis of magnetic Fe₃O₄ nanoparticles (NPs), for which we used pulsed-laser induced photolysis (PLIP). Compared with the previous method of using pulsed-laser ablation of a target, or strong energy of pulsed-laser light to decompose precursors in generating a solvated-ion reaction, the PLIP method used here is dependent on hydrogen peroxide (H₂O₂) to generate a hydrolysis reaction. Energy-dispersive X-ray spectroscopy (EDS) and X-ray diffraction (XRD) were used to demonstrate the Fe₃O₄ crystalline structure of the synthesized NPs. Scanning electron microscopy (SEM) and transmission electron microscopy (TEM) images revealed that the average size of the NPs was about 20–50 nm. Regarding their magnetic characteristics, the synthesized NPs exhibited a saturation magnetization of 5.62 emu/g, remanence of 3.82 emu/g, and coercive force of 49.8 Oe. The photocatalytic experiments confirmed that the synthesized magnetic Fe₃O₄ NPs have visible light-degradation effects based on their ability to photocatalytically degrade methylene blue (MB). The MB degradation efficiency was 60–80% under white-light exposure for 180 min. This study presents a new route for synthesizing magnetic Fe₃O₄ NPs for their potential use in photocatalysis.

We fabricated surface-enhanced Raman scattering (SERS) substrates using gold nanoparticle (AuNP)-decorated zinc oxide (ZnO) nanorods (NRs). Prior to decoration with AuNPs, ZnO NRs on the glass substrate fabricated using the sol–gel method could enhance the SERS signal for detecting 10⁻⁵ M rhodamine 6G (R6G). Microscopic analysis revealed that the thermal-annealing process for fabricating the seed layers of ZnO facilitated the growth of ZnO NRs with the highly preferred c-axis (002) orientation. A decrease in the diameter of ZnO NRs occurred because of the use of annealed seek layers further increased the surface-to-volume ratio of ZnO NRs, resulting in an increase in the SERS signal for R6G of 10⁻⁵ M. To combine the localized surface plasmon resonance (LSPR) mode with the charge transfer (CT) mode, ZnO NRs were decorated with AuNPs through pulsed-laser-induced photolysis (PLIP). However, the preferred vertical (002) orientation of ZnO NRs was prone to the aggregation of AuNPs, which hindered the SERS signal. The experimental results revealed that ZnO NRs with the crystalline structure of horizontal (100) and (101) orientations facilitated the growth of homogeneous, independent and isolated AuNPs which serves as “hot spots” for SERS signal of detecting R6G at a low concentration of 10⁻⁹ M. Comparing to previous fabrication of SERS substrate, our method has advantage to fabricate AuNP-decorated ZnO NR in a short time. Moreover, the optimization of the SERS behaviors for different fabrication conditions of AuNPs using the PLIP method was investigated in detail.