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Background and Aims: This study aimed to develop an interpretable random forest model for predicting severe acute pancreatitis (SAP). Methods: Clinical and laboratory data of 648 patients with acute pancreatitis were retrospectively reviewed and randomly assigned to the training set and test set in a 3:1 ratio. Univariate analysis was used to select candidate predictors for the SAP. Random forest (RF) and logistic regression (LR) models were developed on the training sample. The prediction models were then applied to the test sample. The performance of the risk models was measured by calculating the area under the receiver operating characteristic (ROC) curves (AUC) and area under precision recall curve. We provide visualized interpretation by using local interpretable model-agnostic explanations (LIME). Results: The LR model was developed to predict SAP as the following function: -1.10-0.13×albumin (g/L) + 0.016 × serum creatinine (μmol/L) + 0.14 × glucose (mmol/L) + 1.63 × pleural effusion (0/1)(No/Yes). The coefficients of this formula were utilized to build a nomogram. The RF model consists of 16 variables identified by univariate analysis. It was developed and validated by a tenfold cross-validation on the training sample. Variables importance analysis suggested that blood urea nitrogen, serum creatinine, albumin, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, calcium, and glucose were the most important seven predictors of SAP. The AUCs of RF model in tenfold cross-validation of the training set and the test set was 0.89 and 0.96, respectively. Both the area under precision recall curve and the diagnostic accuracy of the RF model were higher than that of both the LR model and the BISAP score. LIME plots were used to explain individualized prediction of the RF model. Conclusions: An interpretable RF model exhibited the highest discriminatory performance in predicting SAP. Interpretation with LIME plots could be useful for individualized prediction in a clinical setting. A nomogram consisting of albumin, serum creatinine, glucose, and pleural effusion was useful for prediction of SAP. [ABSTRACT FROM AUTHOR]

The aim of this study was to describe the anatomy of the fetal umbilical-portal venous system, in fetuses with persistent right umbilical vein (PRUV). All patients carrying a fetus diagnosed with PRUV underwent a comprehensive anatomy scan in addition to a detailed umbilical-portal system evaluation. Then the PS/RPV courses to the left, at which point it merges with the main portal vein (MPV) to form the left portal vein (LPV), which give rise to the ductus venosus and then bifurcates to the anterior (LPVa) and posterior (LPVp) left branches, resembling the configuration of the ordinary right portal vein (RPV). [Extracted from the article]

Meticulous sonographic evaluation of the portal system and other vascular anomalies should be considered in the prenatal workup of FGR, as UPSVS may have implications during infancy and childhood, Short term perinatal outcome is comparable between FGR fetuses with and without UPSVS. The aims of this study were: to determine the prevalence of fetal umbilico-porto-systemic venous shunts (UPSVS) in fetal growth restriction (FGR); to compare the perinatal outcome in FGR pregnancies with and without UPSVS; to determine the association between UPSVS and other anomalies in growth restricted fetuses. The median gestational age (GA) of FGR diagnosis and GA at delivery were 32.6 (IQR: 28.9-36.6) vs. 33.6 (30.3-35.5) ( I p i = 0.82) and 35 (31.1-37.4) vs. 37 (35.3-37.3) ( I p=0.40 i ) weeks, in the shunt and non-shunt group, respectively. [Extracted from the article]