Bibliographic record
Abstract
This article will endeavour to accomplish four things: to point out some of the more common challenges in the assessment and management of adult patients with congenital heart defects (CHD); to review in general which adult patients with CHD do not need to be seen in specialised adult CHD centres; to review which patients should be seen in such specialised centres; and to review the resources which should thereby be available to them in the expert centres. ### Atrial septal defects Even the humble atrial septal defect (ASD) has its complexities. First, not all ASDs need to be closed. As a rule, an ASD worth closing should be at least 10 mm in diameter and be associated with clear right ventricular dilation. There is a consensus view that all ASDs meeting these criteria should be closed unless there are reasons not to do so.1 Moreover, the ASD should be closed when diagnosed, and preferably before the age of 25 years if the goal of treatment is to avoid premature mortality and morbidity.2 The dilemma as to whether to recommend ASD closure in the asymptomatic patient has eased greatly now that device closure of ASDs can be done so successfully and easily. That said, one needs to have access to a skilled interventionalist and modern devices to make this promise relevant. Estimation of the size, the number, and type(s) of atrial defects can be difficult at times. While transthoracic echocardiography (TTE) will usually confirm the diagnosis of an ASD, it will seldom identify whether multiple ASDs are present, an issue that must be evaluated by transoesophageal echocardiography (TOE) before considering device closure of the defect. Anomalous pulmonary venous drainage (APVD) must also be excluded before proceeding to device closure. While most isolated ASDs are of the secundum type, it is important to recognise …
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 machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.006 | 0.024 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.003 | 0.003 |
| Scholarly communication | 0.004 | 0.005 |
| Open science | 0.003 | 0.006 |
| Research integrity | 0.006 | 0.011 |
| Insufficient payload (model declined to judge) | 0.006 | 0.003 |
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 itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
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".