A278 PLASMA CITRULLINE HAS LIMITED UTILITY TO PREDICT INTESTINAL ADAPTATION IN NEONATAL SHORT BOWEL SYNDROME
Bibliographic record
Abstract
In the absence of intestinal adaptation, neonates with short bowel syndrome (SBS) depend on long-term parenteral nutrition (PN). This can lead to recurrent sepsis, liver disease, loss of vascular access and poor quality of life. Early referral for transplantation or consideration of novel trophic therapies may be advantageous in this setting. However, current methods to assess the progress of adaptation in neonates are limited. Citrulline has been proposed to have utility as a non-invasive biomarker of intestinal adaptation. Our goal was to evaluate plasma citrulline in two experimental models of SBS that vary in potential for adaptation. Neonatal piglets (2 to 4 days old) were randomly allocated to either a 75% distal gut resection (jejunucolic/ JC, n=9), mid- intestinal resection (jejunoileal/JI, n= 5) or sham control (n=8). A jugular catheter was inserted for PN feeds and a gastric tube for trophic enteral nutrition. On day 7 (D7) small intestinal length and weight were measured and jejunum collected for evaluation of villus height and crypt depth. Plasma citrulline levels were measured day 0 (D0) and D7 using DC/LC-MS. Statistical analysis included independent t tests, one-way ANOVA and linear regression. In all cases average citrulline level declined D0 to D7. Including sham with the SBS piglets, citrulline level correlated with final (D7) length (p< 0.01) and with mucosal mass (p< 0.01). However, considering only SBS piglets, citrulline level did not correlate with length (p=0.68), mucosal mass (p=0.8) or jejunal villus height (p= 0.9). JI, compared to JC, demonstrated more adaptation with increased length post-resection (p <0.01) and mucosal mass (p< 0.01). However, D7 citrulline levels did not differ between the two groups (p=0.63). Plasma citrulline levels do not discriminate between anatomical subtypes of short gut that vary in potential for adaptation, nor correlate with their actual adaptive changes. Mean values shown, P value is shown using one-way ANOVA significance was set at p < 0.05. Intestinal length values in cm, Jejunum measurements each unit is 0.1 mm, citrulline levels in Pico-moles. CIHR
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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 | 0.001 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.000 | 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".