Why this work is in the frame
A frame that forgets how it found something cannot be audited. These are the routes that admitted this work.
Bibliographic record
Abstract
Approximately 5 percent of microvascular free-tissue transfers fail; often this is due to microvascular or peri-anastomotic thrombosis. Various reports have advocated the use of thrombolytics for salvage of these flaps, although clinical evidence supporting this approach is sparse. The authors attempted to review their own and other published results and present an algorithm for the use of thrombolytics in the management of failing free flaps. A retrospective review of 590 free flaps, revealed 71 (12 percent) requiring re-exploration for impending flap failure, determined by standard clinical indicators. Forty-four (62 percent) were found to have pedicle thrombosis and 20 (28 percent) received thrombolysis with streptokinase or urokinase. All 44 flaps were grouped by final outcome and thrombolytic use for comparison. In 24 (55 percent) of the flaps with evidence of thrombosis, the use of thrombolytics was felt to be inappropriate or unnecessary; 13 (54 percent) of these were salvaged. Twenty flaps, however, did receive thrombolysis and 6 (30 percent) of these were salvaged. There was no statistically significant difference among groups with respect to preoperative risk factors, age, gender, flap type, and site of anastomotic thrombosis. There was a twofold higher use of vein grafts in the failed vs. salvaged flaps (36 percent vs. 15.7 percent), and no flaps with vessel grafts were salvaged with thrombolytics. Despite the fact that all flaps were re-explored within 3 hr of a problem being detected, the mean time from the initial operation to re-exploration was significantly higher in flaps that did not respond to thrombolytics (63. 8 vs. 32.8 hr, respectively, p=0.0457). Also, the mean time to re-exploration was significantly higher in the salvaged flaps receiving thrombolysis vs. those that did not (32.8 vs. 22.3 hr, respectively, p=0.0264). While early detection and re-exploration are crucial for salvaging failing free flaps, those flaps unresponsive to other standard interventions may benefit from the selective use of thrombolytics.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it