OC09.03: Metabolomic changes in amniotic fluid from Twin–twin transfusion syndrome recipient twins in relation to treatment and fetal cardiovascular risk
Bibliographic record
Abstract
To investigate the amniotic fluid metabolomic profile of Twin–twin transfusion syndrome (TTTS) recipient twins. Firstly to explore any relationship between the metabolic changes in metabolism and fetal cardiac function, and secondly assess the metabolomic changes induced by fetoscopic laser coagulation (FLC). Prospective single centre cohort study. Amniotic fluid samples were taken from the sacs of TTTS recipient twins (n = 19) immediately pre- and post-FLC and their metabolomic profile was assessed using ultra high performance liquid chromatography-mass spectrometry. Profiles were compared pre- and post-FLC, and related to fetal recipient twin cardiac function, as assessed by Doppler ultrasound. This study had ethical approval from Birmingham Black Country Local Research Ethics Committee (No: 06/Q2702/71 accepted in 2006) with written consent obtained from all subjects. Recipient right ventricular (RV) myocardial performance index (MPI) was elevated (>95%CI) in 89% (17/19 recipient twins) and LV MPI in 79% (15/19). 37% (7/19) had reversed A-wave in the Ductus Venosus. 11 metabolites had a significant association with recipient fetal RV & LV MPI prior to treatment. 200 metabolites in recipient amniotic fluid demonstrated a statistically significant (p < 0.005) change in their relative concentrations when compared pre- and post-FLC treatment. The most prominent change is in the balance of carbohydrate and fatty acid metabolic profiles contributing to fetal energy metabolism. These changes were also associated with the echocardiographic measures of recipient cardiac function. Changes in fetal carbohydrate and fatty acid metabolic profiles are noted in recipients in TTTS with cardiac dysfunction, and further changes are noted after treatment. Validation and investigation may identify targets for potential prognostic biomarkers, and pharmacological treatment to improve outcome in TTTS.
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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 | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 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".