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Are three patients better than one?

2011· article· en· W1517180566 on OpenAlexaboutno aff
Massimo Boffini, Mauro Rinaldi

Bibliographic record

VenueTransplant International · 2011
Typearticle
Languageen
FieldMedicine
TopicTransplantation: Methods and Outcomes
Canadian institutionsnot available
Fundersnot available
KeywordsMedicineLung transplantationIntensive care medicineLife expectancyLungMortality rateTransplantationSurgeryInternal medicine

Abstract

fetched live from OpenAlex

Lung transplantation represents the only effective strategy for treatment of end stage respiratory failure. Nevertheless its clinical application remains quite limited and a significant discrepancy between the number of LTx performed and its real need still remains evident [1]. Therefore patients wait for LTx for a long period with a high mortality rate while on the waiting list. For this reason we wrote a review with a provocative title in which we wondered if LTx was a clinical reality or should be conversely considered an experimental procedure [2]. In the recent period, we are witnessing epochal changes at different levels in the field of lung transplantation. On the side of donor management, application of particular ventilatory strategies may be effective in increasing the rate of lung suitability [3]. After the initial experience published by Steen [4], very recently an important article from the Toronto Lung Transplant Program showed how initially rejected or sub-optimal grafts can be successfully transplanted after the recovery of a normal pulmonary function, obtained by ex-vivo lung perfusion [5]. ECMO and interventional lung assist devices have been introduced in the clinical armamentarium for the management of lung transplant recipients suffering from severe deterioration of pulmonary function. As it happens for heart and kidney recipients, novel technological advances of the devices nowadays available allow their applications as a bridge to transplant also for LTx. These technologies not only increase the life expectancy of patients in the waiting list but also avoid the necessity of mechanical ventilation and lead these patients to LTx in better conditions even without the need of an intensive care unit stay [6–8]. Waiting time for LTx is highly dependent from somatic characteristics of recipients and very small patients may wait for a suitable graft for a longer period. For these patients, living lobar lung transplant may be one of the possible strategies to overcome this issue. Chen et al. describe excellent results regarding pulmonary function on living lobar lung transplant donors. This is an important message but a word of caution is mandatory. In comparison with other solid transplant performed using living donor graft (e.g. kidney), living lobar lung transplant is a highly demanding procedure performed on ‘healthy’ patients (the donor). In fact, the procedure Correspondence Massimo Boffini, Cardiac Surgery Department, San Giovanni Battista Hospital, University of Turin, Corso Bramante 88, Turin 18100, Italy. Tel.: +39 011 6335511; fax: +39 011 6336130; e-mail: massimo.boffini@unito.it

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.

How this classification was reachedexpand

Full frame distilled prediction

Teacher imitation

Not 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.

metaresearch head score (Codex)0.000
metaresearch head score (Gemma)0.000
Version: codex-gemma-dda1882f352aValidation status: machine_predicted_unvalidated
Candidate categoriesInsufficient payload (model declined to judge)
Consensus categoriesnone
DomainCandidate signal: none · Consensus signal: none
Study designCandidate signal: Observational · Consensus signal: Observational
GenreCandidate signal: Empirical · Consensus signal: Empirical
Teacher disagreement score0.020
Threshold uncertainty score0.999

Codex and Gemma teacher scores by category

CategoryCodexGemma
Metaresearch0.0000.000
Meta-epidemiology (narrow)0.0000.000
Meta-epidemiology (broad)0.0000.000
Bibliometrics0.0000.000
Science and technology studies0.0000.000
Scholarly communication0.0000.000
Open science0.0000.000
Research integrity0.0000.000
Insufficient payload (model declined to judge)0.0020.000

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.

Opus teacher head0.085
GPT teacher head0.298
Teacher spread0.213 · how far apart the two teachers sit on this one work
Validation statusscore_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it

Classification

machine, unvalidated

Machine predicted; a candidate call from one teacher head, not a consensus.

Study designObservational
Domainnot available
GenreEmpirical

How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".

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Citations0
Published2011
Admission routes1
Has abstractyes

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