ABSTRACT
Strasberg's criteria to detect a critical view of safety is a widely known strategy to reduce bile duct injuries during laparoscopic cholecystectomy. In spite of its popularity and efficiency, recent studies have shown that human miss-identification errors have led to important bile duct injuries occurrence rates. Developing tools based on artificial intelligence that facilitate the identification of a critical view of safety in cholecystectomy surgeries can potentially minimize the risk of such injuries. With this goal in mind, we present Cholec80-CVS, the first open dataset with video annotations of Strasberg's Critical View of Safety (CVS) criteria. Our dataset contains CVS criteria annotations provided by skilled surgeons for all videos in the well-known Cholec80 open video dataset. We consider that Cholec80-CVS is the first step towards the creation of intelligent systems that can assist humans during laparoscopic cholecystectomy.
ABSTRACT
BACKGROUND: Machine learning is a useful tool for predicting medical outcomes. This study aimed to develop a machine learning-based preoperative score to predict cardiac surgical operative mortality. METHODS: We developed various models to predict cardiac operative mortality using machine learning techniques and compared each model to European System for Cardiac Operative Risk Evaluation-II (EuroSCORE-II) using the area under the receiver operating characteristic (ROC) and precision-recall (PR) curves (ROC AUC and PR AUC) as performance metrics. The model calibration in our population was also reported with all models and in high-risk groups for gradient boosting and EuroSCORE-II. This study is a retrospective cohort based on a prospectively collected database from July 2008 to April 2018 from a single cardiac surgical center in Bogotá, Colombia. RESULTS: Model comparison consisted of hold-out validation: 80% of the data were used for model training, and the remaining 20% of the data were used to test each model and EuroSCORE-II. Operative mortality was 6.45% in the entire database and 6.59% in the test set. The performance metrics for the best machine learning model, gradient boosting (ROC: 0.755; PR: 0.292), were higher than those of EuroSCORE-II (ROC: 0.716, PR: 0.179), with a P value of .318 for the AUC of the ROC and .137 for the AUC of the PR. CONCLUSIONS: The gradient boosting model was more precise than EuroSCORE-II in predicting mortality in our population based on ROC and PR analyses, although the difference was not statistically significant.
Subject(s)
Cardiac Surgical Procedures/mortality , Machine Learning , Aged , Aged, 80 and over , Female , Humans , Latin America , Male , Middle Aged , Retrospective StudiesABSTRACT
Los ritmos circadianos, períodos fisiológicos de 24 horas aproximadamente, coordinan la actividad temporal de la mayoría, si no, de todos los seres vivos del planeta. Uno de los procesos más importantes del cuerpo, la proliferación celular, también está regulado por el reloj biológico cuya alteración puede tener repercusiones directas en el desarrollo del cáncer. El concepto de cronoterapia ha surgido a partir de la evidencia que tanto la proliferación de las células, como los mecanismos responsables de la farmacocinética y la farmacodinamia de los antineoplásicos ocurren a horas específicas del día. En esta revisión se presentan las generalidades del ciclo circadiano y su relación con el ciclo celular y el cáncer. Además, se expone evidencia del uso de la cronoterapia en pacientes con leucemia linfocítica aguda y en estudios clínicos de cáncer de colon, endometrio y ovario con asignación aleatoria. Se concluye que la hora de administración de la quimioterapia debe tener en cuenta los ritmos circadianos de los pacientes. Se enfatiza en la necesidad de hacer estudios clínicos enfocados en la quimioterapia cronomodulada, con el fin de aumentar la tolerancia y efectividad de los medicamentos con los protocolos existentes.
Circadian rhythms, physiological periods of about 24 hours, coordinate the temporal processes of most, or maybe all, living beings on the planet. Cell proliferation, one of the most important events in the body, is also regulated by the biological clock, whose alteration may have a direct impact on cancer development. The concept of chronotherapy comes from evidence showing that both cell proliferation and the mechanisms responsible for pharmacokinetics and pharmacodynamics of antineoplastic drugs occur at specific times of the day. This review presents an overview of the circadian cycle and its relation to cell cycle and cancer. Also, it presents evidence for the use of chronotherapy in patients with acute lymphocytic leukemia and in randomized clinical trials for colon, endometrial and ovarian cancer. As a conclusion, the time of chemotherapy administration should take into account the circadian rhythms of patients. We emphasize on the need to conduct clinical trials focused on chronomodulated chemotherapy, in order to increase the tolerance and effectiveness of drugs under the existing protocols.
Os ritmos circadianos, períodos fisiológicos de 24 horas aproximadamente, coordenam a atividade temporal da maioria, se não, de todos os seres vivos do planeta. Um dos processos mais importantes do corpo, a proliferação celular, também está regulada pelo relógio biológico cuja alteração pode ter repercussões diretas no desenvolvimento do câncer O conceito de cronoterapia há surgido a partir da evidência que tanto a proliferação das células, como os mecanismos responsáveis da farmacocinética e a farmacodinâmica dos antineoplásicos ocorrem a horas específicas do dia. Nesta revisão se apresentam as generalidades do ciclo circadiano e sua relação com o ciclo celular e o câncer. Ademais, se expõe evidência do uso da cronoterapia em pacientes com leucemia linfocítica aguda e em estudos clínicos de câncer de cólon, endométrio e ovário com designação aleatória. Se conclui que na hora de administração da quimioterapia deve ter em conta os ritmos circadianos dos pacientes. Se enfatiza na necessidade de fazer estudos clínicos enfocados na quimioterapia cronomodulada, com o fim de aumentar a tolerância e efetividade dos medicamentos com os protocolos existentes.
