Bibliographic record
Abstract
Sir, Heart failure has a fair share in disease burden worldwide. A very large portion with advanced heart failure has a very poor prognosis despite being on optimized medical therapy. Unfortunately, there is a huge mismatch in demand and supply for heart donors and recipients. For the patients awaiting cardiac transplantation, mechanical circulatory support has been widely utilized in the form of left ventricular assist device (LVAD) or total artificial heart (TAH). Both TAH and LVAD have been approved for the use as a bridge to transplantation; however, only LVAD has been approved for use as the destination therapy.[1] Currently, a trial is underway to support the use of TAH as the destination therapy. Most of the patients benefit from LVADs; however, the use of TAH is more appropriate in the patients who have concurrent right heart failure or other structural abnormalities. Until now, almost 1600 TAHs have been transplanted. SynCardia temporary TAH is currently the only Food and Drug Administration (FDA), and Health Canada approved artificial heart commercially available in the market that is being used in over 50 centers in the world. A trial for Cardio West TAH (now being marketed as SynCardia TAH) was conducted between 1993 and 2002. Eighty-one patients were implanted with the device. At the end of the study, the rate of survival to transplantation was 79%, and 1- and 5-year survival rates after transplantation were 86% and 64%.[2] SynCardia TAH consists of two artificial ventricles, each made of semirigid polyurethane. Each ventricle consists of two single leaflet mechanical valves, which regulate the blood flow. This pulsatile device is capable of generating up to 9.5 L/min of blood flow. Both the ventricles are attached to pneumatic drivelines, which are connected to the back of the external console. The console includes a monitoring computer that provides noninvasive diagnostic information. The device is surgically implanted after the removal of both the ventricles and four valves. It can only be placed in the patients with large enough body habitus that can accommodate its positioning. A study of 47 patients evaluating the safety of device showed that patients who were supported on SynCardia TAH for more than 1 year had the following complications: systemic infections in 25 patients (53%), driveline infections in 13 patients (27%), thromboembolic events in 9 patients (19%), and hemorrhagic events in 7 patients (14%).[3] FDA has already approved a clinical study for 19 patients to evaluate the effectiveness of SynCardia as the destination therapy.[4] Smaller SynCardia has also been designed for the use in patients with smaller body habitus and pediatric population. Moreover, the use of portable freedom driver allows the mobility of the patients and safe discharge from the hospital.[5] More clinical trials are needed to evaluate the efficacy of artificial hearts for their utilization in destination therapy. Awareness is needed about these devices in the medical community that would eventually prompt the government agencies to promote research in this area. Financial support and sponsorship Nil. Conflicts of interest There are no conflicts of interest.
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 | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.002 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.002 |
| Insufficient payload (model declined to judge) | 0.031 | 0.016 |
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".