News & Blog

Great news! Our “ML in appe” proposal got approved, first shot! Initially conceived as a way for our lab to gain expertise in AI, this is now a grown-up, 5-year, $400k funded grant proposal aiming to move the diagnosis of perforated appendicitis from the operating room to the ED.

Appendicitis is like that – an odd, common, condition where a one-day delay can make the difference between a simple operative procedure with same-day discharge and quick recovery to a challenging intervention followed by a week-long hospitalization often complicated by septic complications and further interventions… If only we could now which case it is (simple or perforated) right from the ED, so we can council the family and prepare for the resources likely needed…

… which is exactly what our grant project will hopefully achieve, filling a significant gap in the literature by using machine learning to develop an AI model including all patient data available in the ED to predict perforation, and even grade (severity) of perforation. And, unlike most of the ML models available out there in health care, we plan to validate the winning algorithm in an external, prospectively-collected data set. The ultimate goal would be to embed the algorithm in the standard ED workflow, hence generating the prediction live for each patient.

Now the real work starts!

Yes we do! Thanks to an incredibly resourced crowd-sourced effort, we’re proud of our new logo. It highlights the key connection between people, teams, and domains – while keeping the human person at the center – with just a dash of neural networks mixed in!

Deep in an interesting book called “Culture Care: Reconnecting with Beauty for Our Common Life” Makoto Fujimura alludes to an odd concept with an even odder name: the mearcstapas

In Fujimura’s own words, it’s 

“an Old English word used in Beowulf: mearcstapas, translated “border-walkers” or “border-stalkers.” In the tribal realities of earlier times, these were individuals who lived on the edges of their groups, going in and out of them, sometimes bringing back news to the tribe.”(Fujimura 2017) 

But Beowulf’s mearcstapas are flesh-eating monsters, and thankfully Fujimura provides us with a more palatable image: Strider in “The Lord of the Rings”: 

“It is in large part his ability to move in and out of tribes and boundaries that makes him an indispensable guide and protector and that helps him become an effective leader, fulfilling his destiny as Aragorn, high king of Gondor and Arnor, uniting two kingdoms.” 

But why mearcstapa, and why in a research lab? Fujimura beautifully identifies their roles: 

“in ‘border-stalking’ we have a role that both addresses the reality of fragmentation and offers a fitting means to help people from all our many and divided cultural tribes learn to appreciate the margins, lower barriers to understanding and communication, and start to defuse the culture wars.”

Fragmentation. Division. Barriers to communication. If such terms even remotely remind you of our research silos, specialty turf wars, departmental or professional subcultures, then you might see how useful some border-walkers or even border-stalkers might be in our labs and conferences! They might make us talk to one another from across our silos or lab doors, exchange information and make us desire to learn more about what our neighbours are doing, translate our subculture “tribal” lingo so we can actually understand each other… 

And there’s something else that Fujimura brilliantly points out. He notices that one such interface (or border to be crossed) is modelled by estuaries – those unique connected habitats forming the transition between river and maritime habitats. Estuaries are rich with life, with exchange of nutrients, with preparation for growth and advance out into the neighbouring habitats. Fujimura coins “cultural estuaries” as key places of safe preparation and growth for culture. And why should our labs not be likewise – bringing visionaries and researchers together from various habitats, allowing them to “nourish” each other with diverse skills and expertise?

Just one more metaphor: the Old Testament (Torah) concept of gleaning:

“When you reap the harvest of your land, do not reap to the very edges of your field or gather the gleanings of your harvest. Leave them for the poor and for the foreigner residing among you.”
Leviticus 23:22

In other words, the edges of our fields might hold life-sustaining riches! Unlike the “over-farmed” (read: “over-published”) centers of our research fields, it is at the edges of our fields, close to the boundaries with other fields, that new ideas, findings, and opportunities abound. These gleaned edges border rich research estuaries – and all they need are some brave mearcstapas to cross them and start gleaning!

This is what CommiSur Lab aims to be, and to do. To be a rich research estuary full of novel ideas and ripe with research opportunities, ready to be gleaned by interdisciplinary research teams crossing administrative and scientific boundaries. For CommiSur is not just Communication in Surgery – it is the commissure that links disparate parts, connects across tracts, and joins that which is separate. 

Mearcstapa anyone?