The Contribution of Explainable Machine Learning Algorithms Using ROI-based Brain Surface Morphology Parameters in Distinguishing Early-onset Schizophrenia From Bipolar Disorder.

RATIONALE AND OBJECTIVES: To differentiate early-onset schizophrenia (EOS) from early-onset bipolar disorder (EBD) using surface-based morphometry measurements and brain volumes using machine learning (ML) algorithms. METHOD: High-resolution T1-weighted images were obtained to measure cortical thickness (CT), gyrification, gyrification index (GI), sulcal depth (SD), fractal dimension (FD), and brain volumes. After the feature selection step, ML classifiers were applied for each feature set and the combination of them. The SHapley Additive exPlanations (SHAP) technique was implemented to interpret the contribution of each feature. FINDINGS: 144 adolescents (16.2 ± 1.4 years, female=39%) with EOS (n = 81) and EBD (n = 63) were included. The Adaptive Boosting (AdaBoost) algorithm had the highest accuracy (82.75%) in the whole dataset that includes all variables from Destrieux atlas. The best-performing algorithms were K-nearest neighbors (KNN) for FD subset, support vector machine (SVM) for SD subset, and AdaBoost for GI subset. The KNN algorithm had the highest accuracy (accuracy=79.31%) in the whole dataset from the Desikan-Killiany-Tourville atlas. CONCLUSION: This study demonstrates the use of ML in the differential diagnosis of EOS and EBD using surface-based morphometry measurements. Future studies could focus on multicenter data for the validation of these results.

Comparison of MRI findings of hypothalamic-optic chiasmatic gliomas and craniopharyngiomas.

BACKGROUND: Differential diagnosis of hypothalamic-optic chiasmatic gliomas (HOCGs) and craniopharyngiomas on magnetic resonance imaging (MRI) can be quite challenging. PURPOSE: To compare the MRI features of HOCGs and cranipharyngiomas. MATERIAL AND METHODS: Patients diagnosed with HOCG or craniopharyngioma in histopathological evaluation between 2012 and 2022 and who underwent preoperative contrast-enhanced brain MRI were included. Various MRI features were retrospectively evaluated for each lesion: T2-weighted imaging and fluid attenuation inversion recovery hyperintensity, calcification, cystic change, T1-weighted (T1W) imaging hyperintensity of the cystic component, hemorrhage, involvement of sellar, suprasellar or other adjacent structures, lobulated appearance, presence of hydrocephalus, and contrast enhancement pattern. Apparent diffusion coefficient (ADC) values were also evaluated and compared. RESULTS: Among 38 patients included, 13 (34%) had HOCG and 25 (66%) had craniopharyngioma. Craniopharyngiomas had a significantly higher rate of cystic changes, calcification, and T1W imaging hyperintensity of the cystic component than HOCGs (P <0.05). Of HOCGs, 92% had chiasm involvement, 23% had optic nerve involvement, and 31% had brain stem involvement. On the other hand, chiasm involvement was observed in 8% of craniopharyngiomas, but none had optic nerve and/or brain stem involvement (P <0.05). While 62% (8/13) of HOCGs had diffuse homogeneous enhancement, 80% (20/25) of craniopharyngiomas had a diffuse heterogeneous enhancement pattern. Mean ADC values were significantly higher in craniopharyngiomas compared to HOCGs (2.1 vs. 1.6 ×10-3mm2/s, P <0.05). CONCLUSION: Although some neuroimaging findings may overlap, features such as presence of cyst and calcification, brain stem and optic pathway involvement, different enhancement patterns, and ADC values may be helpful in the differential diagnosis of HOCGs and craniopharyngiomas.

Surgical intervention of Takayasu's arteritis with supraaortic arterial occlusive disease and critical ischemia of upper extremity: A case report.

Type I Takayasu's arteritis is a rare form of large vessel vasculitis with an unknown etiopathogenesis. It is characterized by progressive chronic inflammation and occlusive thromboaortopathy affecting the aorta and its main branches. Type I Takayasu's arteritis predominantly affects women and is most commonly observed in their third decade of life. In this report, we present the case of a 32-year-old female patient who exhibited severe long-segment stenosis in the left common carotid artery and total occlusion of the left subclavian artery. The patient experienced significant ischemic symptoms of the left upper extremity and had previously been diagnosed with Takayasu's arteritis, being followed up under maintenance corticosteroid therapy. To address these complications, we conducted a surgical bypass using a prosthetic graft. The graft was inserted intrathoracically, extending from the patient's ascending aorta to both the left common carotid artery and the left distal subclavian artery. This approach was designed to closely mimic anatomical routes, promoting optimal graft patency. In the context of this case, we highlight the importance of surgical intervention in alleviating ischemia and explore potential surgical alternatives for treating patients with Takayasu's arteritis involving the supraaortic region.

Potential Association Between COVID-19 Vaccination and Facial Palsy: Three Cases With Neuroimaging Findings.

Acute onset Facial palsy was reported in four vaccinated participants in the BNT162b2 (Pfizer-BioNTech) vaccine clinical trials published on December 10, 2020. So far, few cases of Facial palsy among the mRNA vaccine groups have been previously documented in the literature. Facial palsy is cited as medically attended adverse event following immunization on April 12, 2021, after the first dose of the approved Pfizer-BioNTech COVID-19 vaccines for preventive immunization for SARS-CoV-2 is administrated to the population in Turkey. This study is aimed to describe clinical and magnetic resonance imaging features of three patients, who developed acute onset peripheral facial paralysis after administration of the BNT162b2 vaccine, without any previous medical condition. The first patient presented with right sided facial palsy within the same day following the vaccine was administrated, while the second patient presented with left sided facial palsy 2 months after vaccination. The third patient, on the other hand, presented with right sided facial palsy and abducens nerve (CN VI) paralysis two days after vaccine was administrated.

Inactivation of viruses on surfaces by infrared techniques.

Several studies on vaccines and medicines against virus-based illnesses (COVID-19, SARS, MERS) are being conducted worldwide. However, virus mutation is an issue. Therefore, inactivation and disinfection of viruses are crucial. This paper presents a method for virus inactivation by physical techniques. The infrared (IR) technique is preferred over other disinfection techniques such as ultraviolet (UV) and chemical disinfectants (alcohol) due to the associated health and environmental benefits. In this study, IR sources with various wavelengths were characterized and a far infrared (FIR) source was used to inactivate viruses. FIR sources have a therapeutic effect on the human body and have been used in medical centers. Virus spread is highly affected by environmental conditions such as temperature, humidity, and airflow. A setup with IR sources, an IR camera, an automatically controlled humidity chamber, and an airflow unit was constructed to study the viability of viruses in stationary droplets as a function of relative humidity and temperature. Bacteriophage Phi6 was used as a model organism for studying enveloped viruses such as influenza and coronavirus. IR techniques were used for studying virus inactivation. The effect of various physical conditions such as temperature, humidity, and airflows was considered to study the effect of radiation on the stationary droplets of Phi6. All measurements were performed under laboratory conditions with controlled temperature and humidity. The IR camera system was used to measure the surface temperature of Phi6 suspension droplets. The samples subjected to IR radiation were processed for plaque assay preparation and counting. Measurements were carried out to reduce and eliminate droplets, which are one of the transmission pathways of viruses. IR was radiated in closed and open-air conditions with appropriate humidity and temperature. This study reports the effective inactivation of viruses by FIR. The inactivation rate under 50 %rh for IR radiated at 1.4 m height for 3 h in closed environmental chamber was 90%, and that under an airflow rate of 0.20 m/s for 10 min in open-air conditions at a height of 1.0 m was 45.7%.

Comparison and ensemble of 2D and 3D approaches for COVID-19 detection in CT images.

Detecting COVID-19 in computed tomography (CT) or radiography images has been proposed as a supplement to the RT-PCR test. We compare slice-based (2D) and volume-based (3D) approaches to this problem and propose a deep learning ensemble, called IST-CovNet, combining the best 2D and 3D systems with novel preprocessing and attention modules and the use of a bidirectional Long Short-Term Memory model for combining slice-level decisions. The proposed ensemble obtains 90.80% accuracy and 0.95 AUC score overall on the newly collected IST-C dataset in detecting COVID-19 among normal controls and other types of lung pathologies; and 93.69% accuracy and 0.99 AUC score on the publicly available MosMedData dataset that consists of COVID-19 scans and normal controls only. The system also obtains state-of-art results (90.16% accuracy and 0.94 AUC) on the COVID-CT-MD dataset which is only used for testing. The system is deployed at Istanbul University Cerrahpasa School of Medicine where it is used to automatically screen CT scans of patients, while waiting for RT-PCR tests or radiologist evaluation.