Editorial: Oesophageal Atresia-Tracheoesophageal Fistula
Bibliographic record
Abstract
Esophageal atresia is among the most common congenital digestive malformations, affecting 1 in 3,000 newborn babies at birth.Since the first successful primary repair of esophageal atresia (EA) in 1941, improvements in operative and perioperative care have led to better outcomes, and thus we have seen an evolvement from mortality to morbidity and quality-of-life issues.In fact, EA is no longer a mere neonatal surgical problem but rather a lifelong problem for the patient.It appears that respiratory, nutritional, and gastroenterological issues are the most prevalent sequelae-not only in the first years of life but also in adolescence and adulthood.Hence a multidisciplinary approach has been advocated by many centers in order to coordinate and optimize the management of these patients at all stages of life.In 2010, the First International Workshop on Esophageal Atresia was held in Lille, France.The success of that event established a new model of conference based not on medical subspecialty but specifically on disease, bringing together diverse disciplines all linked together by their common interest and expertise in treating EA.The International Network of Esophageal Atresia (INoEA) was founded in 2013.On September 15-16, 2016, the fourth International Conference on Esophageal Atresia "Coming Together" took place in Sydney, NSW, Australia.More than 200 participants from all over the world attended the conference.There were over 80 scientific abstracts submitted.All the categories of people involved in the care of EA patients were represented; not only neonatologists, pediatricians, surgeons, gastroenterologists, otolaryngologists, pulmonologists, radiologists, anesthesiologists, intensivists, but also, nurses, dieticians, speech pathologists, psychologists, occupational therapists, social workers, parents of patients, and children and adults with EA.The scientific program was both comprehensive and innovative, covering the entire spectrum of disease from genetic predisposition and pathophysiology, aspiration risk and chronic respiratory morbidity (CRM), investigation and management of gastroesophageal reflux disease including risk of Barrett's and esophageal cancer, tracheomalacia, and its management including novel techniques like posterior aortopexy, newer techniques of reflux and motility testing, techniques of surgical repair and role of fundoplication, stricture management, feeding difficulties and their practical management, quality of life of these patients, the need for ongoing care with transition to adulthood, and the need for an international registry.For the first time, the ESPGHAN-NASPGHAN consensus guidelines on the management of gastrointestinal complication in children with EA were presented and very well received not only by the clinicians involved in the care of these patients but also the parent support groups.Innovative topics, which were presented for the first time and which stimulated interesting discussions included: deliberations from the InoEA working group on Long Gap Esophageal Atresia, Preliminary deliberations from the respiratory working group, Prevalence of abnormal Gastric Function and Dumping syndrome in this cohort, the role of pH-impedance
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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 | 0.003 | 0.012 |
| Meta-epidemiology (narrow) | 0.005 | 0.001 |
| Meta-epidemiology (broad) | 0.004 | 0.002 |
| Bibliometrics | 0.003 | 0.001 |
| Science and technology studies | 0.002 | 0.002 |
| Scholarly communication | 0.004 | 0.004 |
| Open science | 0.003 | 0.001 |
| Research integrity | 0.010 | 0.012 |
| Insufficient payload (model declined to judge) | 0.019 | 0.013 |
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".