Comparative analysis of machine learning algorithms for computer-assisted reporting based on fully automated cross-lingual RadLex mappings.

Computer-assisted reporting (CAR) tools were suggested to improve radiology report quality by context-sensitively recommending key imaging biomarkers. However, studies evaluating machine learning (ML) algorithms on cross-lingual ontological (RadLex) mappings for developing embedded CAR algorithms are lacking. Therefore, we compared ML algorithms developed on human expert-annotated features against those developed on fully automated cross-lingual (German to English) RadLex mappings using 206 CT reports of suspected stroke. Target label was whether the Alberta Stroke Programme Early CT Score (ASPECTS) should have been provided (yes/no:154/52). We focused on probabilistic outputs of ML-algorithms including tree-based methods, elastic net, support vector machines (SVMs) and fastText (linear classifier), which were evaluated in the same 5 × fivefold nested cross-validation framework. This allowed for model stacking and classifier rankings. Performance was evaluated using calibration metrics (AUC, brier score, log loss) and -plots. Contextual ML-based assistance recommending ASPECTS was feasible. SVMs showed the highest accuracies both on human-extracted- (87%) and RadLex features (findings:82.5%; impressions:85.4%). FastText achieved the highest accuracy (89.3%) and AUC (92%) on impressions. Boosted trees fitted on findings had the best calibration profile. Our approach provides guidance for choosing ML classifiers for CAR tools in fully automated and language-agnostic fashion using bag-of-RadLex terms on limited expert-labelled training data.

Mantle flow and deep electrical anisotropy in a main gateway: MT study in Tierra del Fuego.

Asthenospheric mantle flow drives lithospheric plate motion and constitutes a relevant feature of Earth gateways. It most likely influences the spatial pattern of seismic velocity and deep electrical anisotropies. The Drake Passage is a main gateway in the global pattern of mantle flow. The separation of the South American and Antarctic plates since the Oligocene produced this oceanic and mantle gateway connecting the Pacific and Atlantic oceans. Here we analyze the deep crustal and upper mantle electrical anisotropy of its northern margin using long period magnetotelluric data from Tierra del Fuego (Argentina). The influence of the surrounding oceans was taken into account to constrain the mantle electrical conductivity features. 3D electrical models were calculated to fit 18 sites responses in this area. The phase tensor pattern for the longest periods reveals the existence of a well-defined NW-SE electrical conductivity anisotropy in the upper mantle. This anisotropy would result from the mantle flow related to the 30 to 6 Ma West Scotia spreading, constricted by the subducted slab orientation of the Pacific plate, rather than the later eastward mantle flow across the Drake Passage. Deep electrical anisotropy proves to be a key tool for a better understanding of mantle flow.

Fractures of the occipital condyle clinical spectrum and course in eight patients.

INTRODUCTION: Occipital condyle fractures (OCFs) are considered to be rare injuries. OCFs are now diagnosed more often because of the widespread use of computed tomography. Our aim is to report the incidence, treatment and long term outcome of 8 patients with OCFs. MATERIALS AND METHODS: All patients presenting with multiple trauma from 1993 to 2006 were analyzed retrospectively. Characteristics and course of the treatment were evaluated. Follow-up was performed after 11,7 years (range 5,9 to 19,3 years). RESULTS: Nine cases of OCF in 8 patients were identified. All injuries resulted from high velocity trauma. The average scores on the ISS Scale were 39,6 (24-75) and 7,3 (3-15) on the GCS. According to Anderson's classification, 5 cases of Type III and 4 cases of Type I fractures were identified. According to Tuli's classification, 5 cases of Type IIA and 4 cases of Type I were found. Indications for immobilization with the halo-vest were type III injuries according to Anderson's classification or Tuli's type IIA injuries, respectively. Patients with Tuli's type I injuries were treated with a Philadelphia collar for 6 weeks. In one patient with initial complete tetraplegia and one with incomplete neurological deficits the final follow-up neurologic examination showed no neurological impairment at all (Frankel-grade A to E, respectively B to E). At follow-up, 3 patients were asymptomatic. Four patients suffered from mild pain when turning their head, pain medication was necessary in one case only. DISCUSSION: OCF's are virtually undetectable using conventional radiography. In cases of high velocity, cranio-cervical trauma or impaired consciousness, high resolution CT-scans of the craniocervical junction must be performed. We suggest immobilization using a halo device for type III injuries according to Anderson's classification or Tuli's type IIa injuries, respectively. Patients with Tuli's type I injuries should be treated with a Philadelphia collar.

The sternal fracture: radiographic analysis of 200 fractures with special reference to concomitant injuries.

BACKGROUND: The assessment of the sternal fracture and concomitant injuries is discussed. METHODS: Two hundred sternal fractures were analyzed with respect to accident circumstances, fracture morphology and topography, and associated injuries. RESULTS: Traffic accidents were frequent; 89.2% of them were motor vehicle crashes of restrained passengers, 76.5% of fractures were localized in the corpus sterni, and 8.5% of the injuries resulted in fractures or complete disruptions of the synchondrosis manubriosternalis. Nondisplaced or slightly displaced fractures (75.5%) occurred more frequently compared with moderately and severely displaced fractures (24.5%). In 29.5% of the patients, concomitant thoracic injuries were diagnosed. Spinal fractures were evaluated in 13%. In displaced fractures of the corpus, thoracic and cardiac injuries were observed frequently. In fractures or disruptions of the synchondrosis manubriosternalis, concurrence of spinal fractures clearly increased. CONCLUSION: The observation of fracture morphology and topography, with reference to displacement, gives important information about the existence of serious concomitant injuries and can determine further diagnostic and therapeutic options in sternal fractures.

Dislocation of the pisiform bone after severe crush injury to the hand.

The pisiform bone dislocated in a 56-year-old worker who had a crush injury of his wrist. Open reduction and reconstruction of the ligaments resulted in proximal subluxation of the pisiform bone and post-traumatic arthritic changes. Other authors recommend that excision of the pisiform is considered to be a more appropriate method of treatment.