Top 10 highest ranked radiomic features were combined, one at a time, with the clinical features, resulting in a very significant (p<0.001) increase in AUC from the addition of the top 9 radiomic features, and no increase from adding the 10 th best radiomic feature. An optimized combination of radiomic and clinical features resulted in a dramatically higher performance (resampled AUC: meanZ0.792, 95% C.I of meanZ0.790-0.793) compared to clinical features alone (0.676, 0.674-0.678). Conclusion: The increase in performance from incorporating radiomic features suggests that quantitative characterization of tumor structure through the use of radiomics adds complementary information to what is typically available in the clinical workflow.
In the midst of the COVID-19 pandemic, we report two cases of children presenting with typical diagnosis of pediatric inflammatory multisystem syndrome temporally associated with SARS-CoV-2 (PIMS-TS) who suffered from complete heart block requiring pacemaker placement which is an unusual presentation of PIMS-TS. We also compared it with the already existing data with similar manifestations. PIMS-TS is reported to occur in children with predominantly gastrointestinal symptoms, hemodynamic instability, and myocardial dysfunction. The implications of development of atrioventricular block during critical illness in PIMS-TS are yet unknown. Both patients had an otherwise normal cardiac structure and had no gastrointestinal symptoms but suffered complete heart block without any other identifiable etiology, both requiring temporary pacemaker placement. While one child recovered completely with medical management, the other child required permanent pacemaker placement. While we cannot be certain that COVID-19 was the cause, complete heart block appeared to be temporally related to COVID-19 infection in both patients, and hence, it is important for pediatricians to be aware of the potential manifestation of this disease.
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