Adverse HBOC-Endothelial Dysfunction Synergism: A Possible Contributor to Adverse Clinical Outcomes?
Bibliographic record
Abstract
Adverse outcomes in clinical trials on Hemoglobin Based Oxygen Carriers (HBOCs) appear to have occurred more frequently in HBOC treated than in control treated subjects. The differential may be related to many factors, including study complexity and compliance issues. Adverse outcomes also appear to be related to chronic comorbidities in subjects undergoing elective surgery. Frequently occurring comorbidities in these populations are those related to aging, cardiovascular and metabolic disease (hypertension, atherosclerosis, diabetes, etc.). These are highly prevalent among many population subsets. These conditions have been extensively studied and are characterized by dysfunction of important endothelial vasoregulatory mechanisms, including impaired nitric oxide bioavailability, excessive generation of reactive oxygen species (ROS) and possibly enhanced vasoconstrictor mechanisms. Although less extensively studied, HBOCs have properties that may have an important amplifying effect upon mechanisms operating in endothelial dysfunction, by scavenging nitric oxide, generating further excess of ROS which in turn react with nitric oxide, inhibit nitric oxide synthase and possibly stimulate the release of vasoconstrictors such as endothelin. It is likely that amplification of vasoconstrictor effects is not uniformly operative in all vascular beds, and that some protective autoregulatory mechanisms maintain sufficient blood flow in vital organs as long as sufficient vasodilator reserve is available. When the latter is exhausted in the presence of arterial disease with physical obstructions, blood flow to vital organs may become compromised. This paper suggests avenues of further exploration to elucidate whether the combination of HBOC and endothelial dysfunction is a contributing factor in HBOC related adverse outcomes. Keywords: Angiotensin, atherosclerosis, coronary vascular disease, diabetes, endothelial dysfunction, endothelial function, endothelium, endothelin, guanylyl cyclase, hemoglobin-based oxygen carrier, hemoglobin, hypertension, nitric oxide, nitric oxide synthase, peroxynitrite, prostaglandins, reactive oxygen species, vascular smooth muscle, vasoconstriction, vasodilation.
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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 | 0.021 | 0.025 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.003 | 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 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".