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Kasai portoenterostomy (KPE) is currently the first-line treatment for biliary atresia. Many pediatric surgeons have reported that the dissection of the fibrous remnant at the porta hepatis is one of the most important components of this procedure. Furthermore, laparoscopic portoenterostomy is being increasingly used to treat biliary atresia. An advantage of laparoscopic surgery is that surgeons can more easily identify microbiliary ducts, owing to the magnification. We report the case of a 61-day-old girl on whom we performed an exploratory laparotomy and diagnosed type III biliary atresia using intraoperative cholangiography. For the first time, we performed an open KPE using an 8K ultra-high-definition television system. This allowed us to clearly view the porta hepatis and to successfully perform the portoenterostomy.The most common congenital lung malformations are congenital pulmonary airway malformations and pulmonary sequestrations. Many surgeons advocate resection to prevent complications of infection, malignancy, and pneumothorax. The standard of care is lobectomy, but segmentectomy and embolization alone have been reported. These methods avoid the complications of lobectomy but are not widely practiced due to concerns about incomplete resection or involution of the lesion. learn more We present a novel approach to the treatment of a pulmonary sequestration in a 7-month-old male using preoperative embolization followed by a sublobar pulmonary resection. The embolization clearly demarcated the affected lung intraoperatively, thereby facilitating complete removal of the lesion with a segmental lung resection rather than complete lobectomy.Class imbalance issue that presents in many real-world datasets exhibit favouritism toward the majority class and showcases poor performance for the minority class. Such misclassifications may incur dubious outcome in case of disease diagnosis and other critical applications. Hence, it is a hot topic for the researchers to tackle the class imbalance issue. We present a novel hybrid approach for handling such datasets. learn more We utilize simulated annealing algorithm for undersampling and apply support vector machine, decision tree, k-nearest neighbor and discriminant analysis for the classification task. We validate our technique in 51 real-world datasets and compare it with other recent works. Our technique yields better efficacy than the existing techniques and hence it can be applied in imbalance datasets to mitigate the misclassification.Currently, rapidly developing digital technological innovations affect and change the integrated information management processes of all sectors. The high efficiency of these innovations has inevitably pushed the health sector into a digital transformation process to optimize the technologies and methodologies used to optimize healthcare management systems. In this transformation, the Internet of Things (IoT) technology plays an important role, which enables many devices to connect and work together. IoT allows systems to work together using sensors, connection methods, internet protocols, databases, cloud computing, and analytic as infrastructure. In this respect, it is necessary to establish the necessary technical infrastructure and a suitable environment for the development of smart hospitals. This study points out the optimization factors, challenges, available technologies, and opportunities, as well as the system architecture that come about by employing IoT technology in smart hospital environments. In order to do that, the required technical infrastructure is divided into five layers and the system infrastructure, constraints, and methods needed in each layer are specified, which also includes the smart hospital's dimensions and extent of intelligent computing and real-time big data analytic. As a result of the study, the deficiencies that may arise in each layer for the smart hospital design model and the factors that should be taken into account to eliminate them are explained. It is expected to provide a road map to managers, system developers, and researchers interested in optimization of the design of the smart hospital system.In the Internet of Things (IoT) era, the capacity-limited Internet and uncontrollable service delays for various new applications, such as video streaming analysis and augmented reality, are challenges. Cloud computing systems, also known as a solution that offloads energy-consuming computation of IoT applications to a cloud server, cannot meet the delay-sensitive and context-aware service requirements. To address this issue, an edge computing system provides timely and context-aware services by bringing the computations and storage closer to the user. The dynamic flow of requests that can be efficiently processed is a significant challenge for edge and cloud computing systems. To improve the performance of IoT systems, the mobile edge orchestrator (MEO), which is an application placement controller, was designed by integrating end mobile devices with edge and cloud computing systems. In this paper, we propose a flexible computation offloading method in a fuzzy-based MEO for IoT applications in order to improve the efficiency in computational resource management. Considering the network, computation resources, and task requirements, a fuzzy-based MEO allows edge workload orchestration actions to decide whether to offload a mobile user to local edge, neighboring edge, or cloud servers. Additionally, increasing packet sizes will affect the failed-task ratio when the number of mobile devices increases. To reduce failed tasks because of transmission collisions and to improve service times for time-critical tasks, we define a new input crisp value, and a new output decision for a fuzzy-based MEO. Using the EdgeCloudSim simulator, we evaluate our proposal with four benchmark algorithms in augmented reality, healthcare, compute-intensive, and infotainment applications. Simulation results show that our proposal provides better results in terms of WLAN delay, service times, the number of failed tasks, and VM utilization.The issue of coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), has created enormous threat to global health. link2 In an effort to contain the spread of COVID-19, a huge amount of disinfectants and antibiotics have been utilized on public health. Accordingly, the concentration of disinfectants and antibiotics is increasing rapidly in various environments, including wastewater, surface waters, soils and sediments. The aims of this study were to analyze the potential ecological environment impacts of disinfectants and antibiotics by summarizing their utilization, environmental occurrence, distribution and toxicity. The paper highlights the promoting effects of disinfectants and antibiotics on antibiotic resistance genes (ARGs) and even antibiotic resistant bacteria (ARB). The scientific evidences indicate that the high concentration and high dose of disinfectants and antibiotics promote the evolution toward antimicrobial resistance through horizontal gene transformation and vertical gene transformation, which threaten human health. learn more Further concerns should be focused more on the enrichment, bioaccumulation and biomagnification of disinfectants, antibiotics, antibiotic resistance genes (ARGs) and even antibiotic resistant bacteria (ARB) in human bodies.To present an extraordinary and likely first case of secondary multiple intraabdominal hydatidosis, probably as a sequel to primary renal hydatid cyst surgery. A 34-year-old male who underwent a right nephrectomy four years ago for renal hydatidosis was admitted. His abdominopelvic computed tomography scan revealed the hypodense lesions adjacent to the anterior lobe of the liver, splenic hilus, right common iliac vein, and left paracolic area. He underwent the total surgical resection and the histopathologic evaluation revealed the hydatidosis (echinococcosis) and the medical therapy, Albendazole 15 mg/kg/day, was administrated for three months. No recurrence has occurred after the clinical and radiologic follow-up. To the best of our knowledge, it is an extreme and first case of secondary multiple intraabdominal hydatidosis as a sequel to the primary renal echinococcosis surgery, in the English language literature. link2 Providers should be aware of considering a primary focus as encountering multiple intraabdominal hydatidosis.Idiopathic basal ganglia calcification (IBGC), also known as Fahr's disease or primary familial brain calcification, manifests as bilaterally symmetric calcifications in the brain. Clinical symptoms range from movement disorders to cognitive impairment and psychiatric symptoms. Since 2012, IBGC has been reported as an inherited disorder with several causative genes, including SLC20A2; however, the genotype-phenotype association remains unclear. Furthermore, longitudinal follow-up studies investigating the prognosis of neuropsychiatric symptoms in IBGC are lacking. A 36-year-old woman who experienced recurrent psychosis since the age of 30 years was admitted to our hospital. Her symptoms included delusions, hallucinations, disorganized speech, and grossly disorganized behavior. Cranial CT revealed calcification of the bilateral basal ganglia and dentate nucleus. The possibility of metabolic or endocrinological disorders causing secondary calcification was excluded via laboratory examinations. The genetic analysis revealed SLC20A2 mutation, and therefore, she was diagnosed with definite IBGC. At the age of 37, 42, and 43 years, similar psychosis recurred due to a decrease in medication. Each episode was relieved within one week with a low dose of risperidone (1.5-2 mg/day p.o.). Eventually, remission was maintained with risperidone (1.5 mg/day). To our knowledge, genetically confirmed case of IBGC with psychosis has been rarely reported. link2 Recurrent psychosis can be the sole symptom of SLC20A2-associated IBGC and may be remitted with a low dose of risperidone. Literature review including eight case reports shows no superiority between medications. link3 Although our case indicates that a low dose of antipsychotics can alleviate symptoms without any side effects and should be continued to prevent relapse in some patients with IBGC, there has been still shortage of the clinical evidence. link3 Further longitudinal studies on genotype-phenotype associations may expedite personalized medicine for patients with IBGC.Postoperative scarring is one of the complications after arthroscopic knee surgery, which is usually treated with manual therapy or arthroscopic debridement. The incidence of symptomatic scarring requiring surgery within six months postoperatively has been reported to be approximately 0.06-6.00%. We treated a patient after arthroscopic surgery with a new "ultrasound-guided hydrorelease" procedure and we describe it. A 50-year-old woman with a history of arthroscopic anterior cruciate ligament reconstruction of the right knee presented to our clinic 10 months ago with a complaint of right anterior knee pain. Ultrasound imaging showed an infrapatellar fat pad (IPFP) scarring and sliding defects. The pre-treatment Kujala scale was 62 points and the visual analogue scale was 72. link3 The inferolateral side of the patella was palpated to identify the scarring after arthroscopy at the IPFP area. An ultrasound probe was applied vertically to identify the site of adhesion of interest. Ultrasound-guided hydrorelease was performed using 7.

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