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Background: Alzheimer's Disease (AD) poses a major challenge as a neurodegenerative disorder, and early detection is critical for effective intervention. Magnetic resonance imaging (MRI) is a critical tool in AD research due to its availability and cost-effectiveness in clinical settings., Objective: This study aims to conduct a comprehensive analysis of machine learning (ML) methods for MRI-based biomarker selection and classification to investigate early cognitive decline in AD. The focus to discriminate between classifying healthy control (HC) participants who remained stable and those who developed mild cognitive impairment (MCI) within five years (unstable HC or uHC)., Methods: 3-Tesla (3T) MRI data from the Alzheimer's Disease Neuroimaging Initiative (ADNI) and Open Access Series of Imaging Studies 3 (OASIS-3) were used, focusing on HC and uHC groups. Freesurfer's recon-all and other tools were used to extract anatomical biomarkers from subcortical and cortical brain regions. ML techniques were applied for feature selection and classification, using the MATLAB Classification Learner (MCL) app for initial analysis, followed by advanced methods such as nested cross-validation and Bayesian optimization, which were evaluated within a Monte Carlo replication analysis as implemented in our customized pipeline. Additionally, polynomial regression-based data harmonization techniques were used to enhance ML and statistical analysis. In our study, ML classifiers were evaluated using performance metrics such as Accuracy (Acc), area under the receiver operating characteristic curve (AROC), F1-score, and a normalized Matthew's correlation coefficient (MCC')., Results: Feature selection consistently identified biomarkers across ADNI and OASIS-3, with the entorhinal, hippocampus, lateral ventricle, and lateral orbitofrontal regions being the most affected. Classification results varied between balanced and imbalanced datasets and between ADNI and OASIS-3. For ADNI balanced datasets, the naíve Bayes model using z -score harmonization and ReliefF feature selection performed best (Acc = 69.17%, AROC = 77.73%, F1 = 69.21%, MCC' = 69.28%). For OASIS-3 balanced datasets, SVM with zscore-corrected data outperformed others (Acc = 66.58%, AROC = 72.01%, MCC' = 66.78%), while logistic regression had the best F1-score (66.68%). In imbalanced data, RUSBoost showed the strongest overall performance on ADNI (F1 = 50.60%, AROC = 81.54%) and OASIS-3 (MCC' = 63.31%). Support vector machine (SVM) excelled on ADNI in terms of Acc (82.93%) and MCC' (70.21%), while naïve Bayes performed best on OASIS-3 by F1 (42.54%) and AROC (70.33%)., Conclusion: Data harmonization significantly improved the consistency and performance of feature selection and ML classification, with z -score harmonization yielding the best results. This study also highlights the importance of nested cross-validation (CV) to control overfitting and the potential of a semi-automatic pipeline for early AD detection using MRI, with future applications integrating other neuroimaging data to enhance prediction., Competing Interests: The authors declare there are no competing interests., (©2024 Ahmad et al.)

We report the case of a 38-year-old patient with an undocumented history of lung disease who presented with Kartagener's syndrome diagnosed on CT scan in the context of lupus erythematosus. Kartagener's syndrome is a distinct entity among primary ciliary dyskinesias, but its association with lupus has not been described in the literature., (© 2024 The Authors. Published by Elsevier Inc. on behalf of University of Washington.)

Anticoagulant-induced spontaneous small bowel hematoma is a rare cause of acute mechanical bowel obstruction. We report the case of a 77-year-old patient with complete arrhythmia due to atrial fibrillation under acenocoumarol 4mg daily who was seen for right iliac fossa pain. The laboratory tests showed a prothrombin rate (PT) of 12%, an International Normalized Ratio (INR) of 6, and an aPTT (activated partial thromboplastin time) of 43 seconds. Abdominopelvic ultrasound showed an echogenic pelvic effusion. The diagnosis of the small hematoma was made by abdominopelvic CT scan, which showed a thickening of the small bowel wall reducing its caliber associated with a parietal hematoma . The evolution was unremarkable under supplementation therapy vitamin K., (© 2024 The Authors. Published by Elsevier Inc. on behalf of University of Washington.)

Objectives: Human T-lymphotropic virus 1 infection is endemic in the French Antilles, French Guiana, and sub-Saharan Africa, the origin of many immigrants currently living in France. There are no national screening recommendations outside of the regulatory obligations concerning donations of blood, tissue, gametes, or milk to a lactarium. This study aimed to investigate the screening and diagnostic practices for this infection in France., Methods: Serological statistics for regulatory, antenatal, sexually transmitted infections (for CeGIDDs (Centre Gratuit d'Information, de Dépistage et de Diagnostic des Infections Sexuellement Transmissibles), which are public sexual health clinics), accidental exposure to blood screenings, and diagnosis since January 1, 2018 were collected from 23 hospital laboratories (two in the French Antilles, 21 in mainland France) associated with 55 hospitals and 22 maternity units., Results: A total absence of antenatal screening was reported by 75% of the laboratories associated with maternity units in mainland France. All the laboratories in mainland France reported an absence of screening in the accidental exposure to blood context, as did all the laboratories in mainland France associated with a CeGIDD in the context of sexually transmitted infection screening. Conversely, screening in accordance with the existing regulations was generally systematically carried out. The most frequently reported diagnostic contexts were hematology and neurology., Conclusions: This study reveals an underscreening of human T-lymphotropic virus 1 in the hospital laboratories of mainland France., Competing Interests: The authors have no competing interests to declare., (© 2024 The Author(s).)

Posterior Reversible Encephalopathy Syndrome (PRES) is a radio-clinical entity associating reversible damage of the central nervous system and typical brain imaging. The clinical context is often suggestive with, in half of cases, the use of vasoactive substances (cannabis, antidepressants, nasal decongestants) and/or postpartum. The etiologies are dominated by hypertensive encephalopathy, preeclampsia, eclampsia, immunosuppressive therapies, and systemic diseases. We report a case of posterior encephalopathy syndrome occurring in a young female without hypertension. It was about a 40-year-old female without hypertension underlying condition, received at the emergency department for headaches and generalized tonic-clonic seizures. The physical examination was unremarkable, and her blood pressure was 130/70 mm Hg. CT scan revealed bilateral white matter hypodensity in the posterior occipital regions and a right frontal subarachnoid hemorrhage. There was no aneurysmal malformation of the polygon of Willis and no cerebral thrombophlebitis. Brain MRI showed T2 and FLAIR hypersignal areas in the occipital and frontal cortico-subcortical regions, with no diffusion signal abnormalities or contrast enhancement, and a right frontal subarachnoid hemorrhagic lesion with no other impairment. The diagnosis of reversible posterior encephalopathy syndrome was made up, and the outcome was favorable under treatment. Posterior reversible encephalopathy syndrome is an uncommon but probably underdiagnosed condition. Hypertensive encephalopathy is the most common etiology. However, there would be cases of PRES without hypertension as shown in this observation., (© 2024 The Authors. Published by Elsevier Inc. on behalf of University of Washington.)

Cystic dysplasia of the testis is characterized by the presence of multiple cysts within the testicular parenchyma. It is a rare benign tumor. It is often accompanied by kidney malformations. There is no consensus on treatment. We report here the case of testicular dysplasia revealed by a torsion of the spermatic cord in an adult. The diagnosis of cystic dysplasia of the testis was made intraoperatively and confirmed by pathology. An orchiectomy was performed. Serum testicular cancer markers were normal postoperatively., (© 2024 Published by Elsevier Inc.)

Automatic identification of visual learning style in real time using raw electroencephalogram (EEG) is challenging. In this work, inspired by the powerful abilities of deep learning techniques, deep learning-based models are proposed to learn high-level feature representation for EEG visual learning identification. Existing computer-aided systems that use electroencephalograms and machine learning can reasonably assess learning styles. Despite their potential, offline processing is often necessary to eliminate artifacts and extract features, making these methods unsuitable for real-time applications. The dataset was chosen with 34 healthy subjects to measure their EEG signals during resting states (eyes open and eyes closed) and while performing learning tasks. The subjects displayed no prior knowledge of the animated educational content presented in video format. The paper presents an analysis of EEG signals measured during a resting state with closed eyes using three deep learning techniques: Long-term, short-term memory (LSTM), Long-term, short-term memory-convolutional neural network (LSTM-CNN), and Long-term, short-term memory-Fully convolutional neural network (LSTM-FCNN). The chosen techniques were based on their suitability for real-time applications with varying data lengths and the need for less computational time. The optimization of hypertuning parameters has enabled the identification of visual learners through the implementation of three techniques. LSTM-CNN technique has the highest average accuracy of 94%, a sensitivity of 80%, a specificity of 92%, and an F1 score of 94% when identifying the visual learning style of the student out of all three techniques. This research has shown that the most effective method is the deep learning-based LSTM-CNN technique, which accurately identifies a student's visual learning style.

Cultivated peanut or groundnut (Arachis hypogaea L.) is a grain legume grown in many developing countries by smallholder farmers for food, feed, and/or income. The speciation of the cultivated species, that involved polyploidization followed by domestication, greatly reduced its variability at the DNA level. Mobilizing peanut diversity is a prerequisite for any breeding program for overcoming the main constraints that plague production and for increasing yield in farmer fields. In this study, the Groundnut Improvement Network for Africa assembled a collection of 1,049 peanut breeding lines, varieties, and landraces from 9 countries in Africa. The collection was genotyped with the Axiom_Arachis2 48K SNP array and 8,229 polymorphic single nucleotide polymorphism (SNP) markers were used to analyze the genetic structure of this collection and quantify the level of genetic diversity in each breeding program. A supervised model was developed using dapc to unambiguously assign 542, 35, and 172 genotypes to the Spanish, Valencia, and Virginia market types, respectively. Distance-based clustering of the collection showed a clear grouping structure according to subspecies and market types, with 73% of the genotypes classified as fastigiata and 27% as hypogaea subspecies. Using STRUCTURE, the global structuration was confirmed and showed that, at a minimum membership of 0.8, 76% of the varieties that were not assigned by dapc were actually admixed. This was particularly the case of most of the genotype of the Valencia subgroup that exhibited admixed genetic heritage. The results also showed that the geographic origin (i.e. East, Southern, and West Africa) did not strongly explain the genetic structure. The gene diversity managed by each breeding program, measured by the expected heterozygosity, ranged from 0.25 to 0.39, with the Niger breeding program having the lowest diversity mainly because only lines that belong to the fastigiata subspecies are used in this program. Finally, we developed a core collection composed of 300 accessions based on breeding traits and genetic diversity. This collection, which is composed of 205 genotypes of fastigiata subspecies (158 Spanish and 47 Valencia) and 95 genotypes of hypogaea subspecies (all Virginia), improves the genetic diversity of each individual breeding program and is, therefore, a unique resource for allele mining and breeding., Competing Interests: Conflicts of interest The author(s) declare no conflicts of interest., (© The Author(s) 2023. Published by Oxford University Press on behalf of The Genetics Society of America.)

Congenital band is a rare cause of bowel obstruction, most commonly occurring in childhood. We report a case of a young adult with no medical and surgical previous history who had symptoms of bowel obstruction evolving for 2 days. Computed tomography (CT) found an adhesive band causing a small bowel obstruction. An open laparotomy was performed, and the intraoperative findings were consistent with a congenital band compressing the ileum. Through this clinical case, we illustrate an uncommon cause of bowel obstruction and the interest of the CT for the management., (© 2023 The Authors. Published by Elsevier Inc. on behalf of University of Washington.)

Acute mesenteric ischemia is a rare life-threatening diagnostic and therapeutic emergency. Lack of clinical and biological specificity makes the diagnosis difficult. Imaging, particularly computed tomography can help confirm the diagnosis. An underlying cause is identified in about 30%-70% of cases and should always be sought. We report a case of a 51-year-old man with chronic alcoholic liver disease admitted to the emergency department for abdominal pain. Computed tomography showed mesenteric venous thrombosis with signs of small bowel ischemia and cirrhosis with portal hypertension. Through this observation, we describe the imaging aspects of mesenteric ischemia and emphasize the necessity of seeking underlying pathological condition., (© 2023 The Authors. Published by Elsevier Inc. on behalf of University of Washington.)

Background: Anterior dislocation of the shoulder associated with a diaphyseal fracture of the ipsilateral humerus is a rare and controversial occurrence, with very few cases reported in the literature., Case Presentation: We present a case of a 39-year-old right-handed driver who presented with an anterior dislocation of the shoulder associated with a diaphyseal fracture of the ipsilateral humerus following a road traffic accident. The lateral approach to the fracture allowed us to use two forceps to gain a good grip on the proximal fragment and perform the maneuver to reduce the dislocation. The fracture was reduced and fixed with a molded Lecestre-type plate., Conclusion: In this case, we employed the approach of initially reducing the shoulder dislocation with forceps, followed by osteosynthesis of the humeral fracture. The functional results were excellent after 6 months., Competing Interests: All authors declared that there are no conflicts of interest.Sponsorships or competing interests that may be relevant to content are disclosed at the end of this article., (Copyright © 2023 The Author(s). Published by Wolters Kluwer Health, Inc.)

Cerebral amyloid angiopathy (CAA) is an age-related cerebral microangiopathy characterized by the accumulation of amyloid-beta peptide in the wall of leptomeningeal arteries and cortical vessels. Diagnosis of sporadic amyloid angiopathy is most often made in elderly patient with lobar hematoma. We report a case of a 68-year-old female who had minimal head injury. Cerebral CT showed a right cerebellar hematoma. Follow-up MRI after 4 months showed signs of cerebral amyloid angiopathy. Through this observation, we describe the MRI semiology that helps make the diagnosis of cerebral amyloid angiopathy., (© 2023 The Authors. Published by Elsevier Inc. on behalf of University of Washington.)

It has been more than three decades since researchers began investigating functional near-infrared spectroscopy (fNIRs) and its applications with near-infrared light for use in both clinical and pre-clinical settings. In order to increase the accuracy of fNIRs of complex tissue structures, it is necessary to create more advanced image reconstruction methods. Real fNIRs data have been used to develop an implementation of the L1-Norm approach for tackling the inverse problem in this work. The Monte Carlo (MC) simulation is used to construct the sensitivity matrix for this research. Finally, a numerical algorithm for the L1-Norm approach of image reconstruction is developed and implemented in MATLAB to aid in the process. The results showed good agreement with the actual fNIRs data.

Atypical fibromuscular dysplasia of the bulb or carotid web is a nonatheromatous pathology more common in African and African-American populations. It is implicated in the occurrence of cerebral infarcts of unknown causes. Its diagnosis is made by angio-CT of the supra-aortic trunks and is characterized by a defect in the posterior wall of the bulb. Treatment with antiplatelet agents prevents the occurrence of stroke, but radical treatment remains surgical and endovascular. We report 2 observations of carotid web diagnosed and medically managed at the regional hospital of Saint Louis., (Published by Elsevier Inc. on behalf of University of Washington.)

Key Clinical Message: Weber's syndrome revealing a Percheron artery infarction is a rare clinical occurrence. Its diagnosis requires careful clinical examination and brain MRI, which is the gold standard for diagnosis. If this is not available, combined cerebral CT scan with a CT angiography of supra-aortic arteries may be useful for the diagnosis., Abstract: Percheron's artery (PA) occlusion is an uncommon type of stroke involving paramedian thalamus and/or midbrain infarction. It accounts for 4%-18% of all thalamic infarcts and 0.1%-2% of all strokes. Its clinical manifestations are variable and its mode of presentation as Weber's syndrome is exceptional due to the unusual clinical presentation., Competing Interests: The authors declared that they have no conflict of interest., (© 2023 The Authors. Clinical Case Reports published by John Wiley & Sons Ltd.)

Pylephlebitis is a complication of intra-abdominal infections. Its occurrence during cholecystitis is a rare situation. We report the case of a 43-year-old female patient who presented with septic thrombosis of the right portal branch following acute calculous cholecystitis diagnosed on abdominal CT. The clinical evolution was favorable under antibiotic therapy and a cholecystectomy was scheduled., (© 2023 The Authors. Published by Elsevier Inc. on behalf of University of Washington.)

A brain tumor is a dynamic system in which cells develop rapidly and abnormally, as is the case with most cancers. Cancer develops in the brain or inside the skull when aberrant and odd cells proliferate in the brain. By depriving the healthy cells of leisure, nutrition, and oxygen, these aberrant cells eventually cause the healthy cells to perish. This article investigated the development of glioma cells in treating brain tumors. Mathematically, reaction-diffusion models have been developed for brain glioma growth to quantify the diffusion and proliferation of the tumor cells within brain tissues. This study presents the formulation the two-stage successive over-relaxation (TSSOR) algorithm based on the finite difference approximation for solving the treated brain glioma model to predict glioma cells in treating the brain tumor. Also, the performance of TSSOR method is compared to the Gauss-Seidel (GS) and two-stage Gauss-Seidel (TSGS) methods in terms of the number of iterations, the amount of time it takes to process the data, and the rate at which glioma cells grow the fastest. The implementation of the TSSOR, TSGS, and GS methods predicts the growth of tumor cells under the treatment protocol. The results show that the number of glioma cells decreased initially and then increased gradually by the next day. The computational complexity analysis is also used and concludes that the TSSOR method is faster compared to the TSGS and GS methods. According to the results of the treated glioma development model, the TSSOR approach reduced the number of iterations by between 8.0 and 71.95%. In terms of computational time, the TSSOR approach is around 1.18-76.34% faster than the TSGS and GS methods., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2022 Elsevier Ltd. All rights reserved.)

Background and Objective: Brain connectivity plays a pivotal role in understanding the brain's information processing functions by providing various details including magnitude, direction, and temporal dynamics of inter-neuron connections. While the connectivity may be classified as structural, functional and causal, a complete in-vivo directional analysis is guaranteed by the latter and is referred to as Effective Connectivity (EC). Two most widely used EC techniques are Directed Transfer Function (DTF) and Partial Directed Coherence (PDC) which are based on multivariate autoregressive models. The drawbacks of these techniques include poor frequency resolution and the requirement for experimental approach to determine signal normalization and thresholding techniques in identifying significant connectivities between multivariate sources., Methods: In this study, the drawbacks of DTF and PDC are addressed by proposing a novel technique, termed as Efficient Effective Connectivity (EEC), for the estimation of EC between multivariate sources using AR spectral estimation and Granger causality principle. In EEC, a linear predictive filter with AR coefficients obtained via multivariate EEG is used for signal prediction. This leads to the estimation of full-length signals which are then transformed into frequency domain by using Burg spectral estimation method. Furthermore, the newly proposed normalization method addressed the effect on each source in EEC using the sum of maximum connectivity values over the entire frequency range. Lastly, the proposed dynamic thresholding works by subtracting the first moment of causal effects of all the sources on one source from individual connections present for that source., Results: The proposed method is evaluated using synthetic and real resting-state EEG of 46 healthy controls. A 3D-Convolutional Neural Network is trained and tested using the PDC and EEC samples. The result indicates that compared to PDC, EEC improves the EEG eye-state classification accuracy, sensitivity and specificity by 5.57%, 3.15% and 8.74%, respectively., Conclusion: Correct identification of all connections in synthetic data and improved resting-state classification performance using EEC proved that EEC gives better estimation of directed causality and indicates that it can be used for reliable understanding of brain mechanisms. Conclusively, the proposed technique may open up new research dimensions for clinical diagnosis of mental disorders., Competing Interests: Declaration of Competing Interest The authors have no conflict of interest to disclose., (Copyright © 2022 Elsevier B.V. All rights reserved.)

Communication, neuro-prosthetics, and environmental control are just a few applications for disabled persons who use robots and manipulators that use brain-computer interface (BCI) systems. The brain's motor imagery (MI) signal is an essential input for a brain-related task in BCI applications. Due to their noninvasive, portability, and cost-effectiveness, electroencephalography (EEG) signals are the most widely used input in BCI systems. The EEG data are often collected from more than 100 different locations in the brain; channel selection techniques are critical for selecting the optimum channels for a given application. However, when analyzing EEG data, the principal purpose of channel selection is to reduce computational complexity, improve classification accuracy by avoiding overfitting, and reduce setup time. Several channel selection assessment algorithms, both with and without classification-based methods, extracted appropriate channel subsets using defined criteria. Therefore, based on the exhaustive analysis of the EEG channel selection, this manuscript analyses several existing studies to reduce the number of noisy channels and improve system performance. We review several existing works to find the most promising MI-based EEG channel selection algorithms and associated classification methodologies on various datasets. Moreover, we focus on channel selection methods that choose fewer channels with great precision. Finally, our main finding is that a smaller channel set, typically 10-30% of total channels, provided excellent performance compared to other existing studies.

Pylephlebitis is a thrombotic occlusion of the portal vein or its branches secondary to infection in regions that drain to the portal venous system. Clinical presentation is often atypical, and patients may initially present with non-specific abdominal symptoms. We report a case of pylephlebitis secondary to inflammatory colitis depicted by CT scan in a 35-year-old female admitted for acute abdominal pain associated with vomiting and fever., (© 2022 The Authors.)

Introduction and Importance: Parry-Romberg syndrome (PRS) is a rare clinical entity characterized by progressive atrophy of the hemifacial region, occasionally associated with systemic manifestations. The presence of facial muscles spasms is exceptional., Case Presentation: We report the case of a young woman who presented with progressive atrophy of the right hemiface associated with vitiligo and facial muscles spasms. The diagnosis of Parry Romberg syndrome was retained. Electromyogram showed an intermittent motor unit potential. Cerebral MRI showed atrophy of the muscle and subcutaneous fat of the right hemiface. She received corticosteroid in combination with botulinum toxin injection, which stopped the spasms., Clinical Discussion: It is a rare condition with a poorly understood etiology, which is responsible for the delay in diagnosis often noted. The association of this syndrome with neurological signs is exceptional and rarely described in the literature. Injection of botulinum toxin associated with corticosteroids can stop the spasms but only surgery can reduce the facial deformities., Conclusion: Parry-Romberg syndrome is a rare disease, more frequent in women. It poses a real diagnostic problem and its treatment is poorly codified., Competing Interests: The authors declare no conflict of interest., (© 2022 The Authors.)

Intracranial aneurysms are focal dilations of an intracranial artery. They can be discovered incidentally, during a hemorrhagic stroke or subarachnoid hemorrhage, but it is rare for it to be detected after an ischemic stroke. The prevalence of the association between symptomatic carotid occlusion or stenosis and intracranial aneurysms is estimated to be 6.3%. We report the case of a patient hospitalized for the management of a stroke in whom investigations had revealed the coexistence of right carotid occlusion and multiple aneurysms in the right middle cerebral artery. The diagnosis was made by CT angiography of supra-aortic trunks., (© 2022 The Authors. Published by Elsevier Inc. on behalf of University of Washington.)

Background and Objective: Medical imaging techniques are widely employed in disease diagnosis and treatment. A readily available medical report can be a useful tool in assisting an expert for investigating the patient's health. A radiologist can benefit from an automatic medical image to radiological report translation system while preparing a final report. Previous attempts on automatic medical report generation task includes image captioning algorithms without taking domain-specific visual and textual contents into account, thus arises the question about credibility of generated report., Methods: In this work, a novel Adaptive Multilevel Multi-Attention (AMLMA) approach is proposed by offering domain-specific visual-textual knowledge to generate a thorough and believable radiological report for any view of a human chest X-ray image. The proposed approach leverages the encoder-decoder framework incorporated with multiple adaptive attention mechanisms. The potential of a convolutional neural network (CNN) with residual attention module (RAM) is demonstrated as a strong visual encoder for multi-label abnormality detection. The multilevel visual features (local and global) are extracted from proposed visual encoder to retrieve regional-level and abstract-level radiology-based semantic information. The Word2Vec and FastText word embeddings are trained on medical reports to acquire radiological knowledge and further used as textual encoders, feeding as input to Bi-directional Long Short Term Memory (Bi-LSTM) network to learn the co-relationship between medical terminologies in radiological reports. The AMLMA employs a weighted multilevel association of adaptive visual-semantic attention and visual-based linguistic attention mechanisms. This association of adaptive attention is exploited as a decoder and produces significant improvements in the report generation task., Results: The proposed approach is evaluated on a publicly available Indiana University chest X-ray (IU-CXR) dataset. The CNN with RAM shows the significant improvement in recall (0.4423), precision (0.1803) and F1-score (0.2551) for prediction of multiple abnormalities in X-ray image. The results of language generation metrics for proposed variants were acquired using the COCO-caption evaluation Application Program Interface (API). The trained embeddings with AMLMA model generates the convincing radiology report and outperform state-of-the-art (SOTA) approaches with high evaluation metrics scores for Bleu-4 (0.172), Meteor (0.247), Rouge_L (0.376) and CIDEr (0.381). In addition, a new "Unique Index" (UI) statistic is introduced to highlight the model's ability for generating unique reports., Conclusion: The overall architecture aids to the understanding of various X-ray image views and generating the relevant normal and abnormal radiography statements. The proposed model is emphasized on multi-level visual-textual knowledge with adaptive attention mechanism to balance visual and linguistic information for the generation of admissible radiology report., Competing Interests: Declaration of Competing Interest None., (Copyright © 2022 Elsevier B.V. All rights reserved.)

Pyonephrosis is a suppurative infection of the kidney caused by ureteral obstruction. It can lead to kidney failure, septic shock, and death. Thus, it requires prompt assessment and appropriate management. We report a case of a 63-year-old male with giant pyonephrosis contained 10 liters of pus and spontaneously ruptured in the adjacent muscles. This clinical case illustrates the value of computed tomography scan in the diagnosis and management of an uncommon upper urinary tract infection and its complications., (© 2022 The Authors. Published by Elsevier Inc. on behalf of University of Washington.)

Objective: The objective of this work was to study the place of ultrasound in the positive diagnosis, etiology and choice of the therapeutic modality of acute intestinal intussusception., Material and Methods: This was a retrospective, descriptive, cross-sectional, multicenterstudy, carried out over a period of 18 months (January 1, 2016 to June 30, 2017) on 45 patient files collected in the radiologydepartments (Aristide Le Dantec and Albert Royer). Were included all patients aged less than 14 years, admitted with acute abdominal pain, whose diagnosis of IIA was retained on ultrasound. Pneumatic disinvagination was performed in patients without signs of severity. We studied the time of management, the ultrasound aspects of the invagination puddles, the therapeutic choice but also the radiosurgical concordance and the factors of failure of the pneumatic enema. Statistical analysis was done by SPSS version 21.0 software., Results: Ultrasound was used to make the diagnosis of IIA in 43 cases (95.5%). The sonographic characteristics were as follows: 27.9% of the IIA were located in the right hypochondrium, 19 cases were ileo-caecal, 10 (22.2%) ileo-caeco-colic, 9 (20%) ileo-colic, 4 (8.9%) colo-colic and one (2.2%) gregelic; 44 cases were idiopathic and one case was a Meckel's diverticulum The management time was less than 48 hours in 34% of cases and 66% more than 48 hours. Pneumatic reduction was performed in 18 cases (40%), with success in 14 cases (77.8%) and one case of pneumoperitoneum complication. Surgery was performed in 31 cases (68.8%). The sensitivity and specificity of ultrasound in the diagnosis of signs of severity were 77.7% and 78.9%. Good agreement was observed between the results of the Doppler ultrasound and the intraoperative findings. Ultrasound parameters associated with failed pneumatic deinvagination were: outer cylinder thickness ≥10 mm, adenopathy at the level of the small-axis bladder ≥10 mm, effusion in the bladder, and hypovascularization of the bladder head. Hypovascularization of the boudin head was the only factor independently associated with failure of pneumatic disinvagination., Conclusion: Ultrasound is a powerful imaging modality in the positive diagnosis, etiology, severity and therapeutic choice of IIA., (Le comité de rédaction se réserve le droit de renvoyer aux auteurs avant toute soumission à l'avis des lecteurs les manuscrits qui ne seraient pas conformes à ces modalités de présentation. En outre il leur conseille de conserver un exemplaire du manuscrit, des figures et des tableaux.)