Bibliographic record
Abstract
ABSTRACT Congestive heart failure (CHF) is an important public health problem in Canada. While angiotensin converting enzyme (ACE) inhibitors have decreased morbidity and mortality in patients suffering from this syndrome, one- and five-year mortality rates remain grim. Although traditionally β-adrenergic blocking agents have been contraindicated in CHF, more recent data indicate these agents may be beneficial in a subset of patients. β-blockers may produce beneficial effects in CHF by inhibiting stimulation of sympathetic nervous system and renin-angiotensin-aldosterone systems, protecting against norepinephrine 's cardiotoxic effects and restoring myocardial response to β-agonists via upregulation of β-receptors. To date, small, well-controlled studies have demonstrated improvements in systolic function. Common to these trials was the addition of the β-blocker to traditional therapy, gradual incremental dosage increases, and extended durations of therapy. Success was seen predominately in patients suffering from idiopathic dilated cardiomyopathy. Many questions remain regarding the use of β-blockers in CHF including optimal time of therapy initiation, effect on mortality, and prediction of which patients will benefit most. Although evidence appears promising, further work is needed. RESUME L'insuffisance cardiaque congestive (ICC) pose un probleme de sante publique de taille pour le Canada. Bien que l'utilisation des inhibiteurs de l'enzyme de conversion de l'angiotensine (IECA) ait freine la morbidite et la mortalite chez les patients atteints de cette affection, les taux de mortalite a un an et a cinq ans associes a l'ICC demeurent inquietants. Cependant, de nouvelles donnees indiquent que les beta-bloquants, traditionnellement contre-indiques dans l'ICC, pourraient etre benefiques pour un sous-groupe de patients. En effet, les beta-bloquants pourraient exercer un effet benefique dans le traitement de l'ICC en inhibant la stimulation du systeme nerveux sympathique et du systeme renine-angiotensine-aldosterone, en conferant une protection contre les effets cardiotoxiques de la norepinephrine et en retablissant la reponse du myocarde aux β-agonistes par l'elevation du seuil de regulation des β-recepteurs. A ce jour, de petites etudes bien controlees ont demontre des ameliorations de la fonction systolique. Ces etudes avaient en commun l'ajout d'un β-bloquant au traitement classique, l'accroissement par palier graduel de la dose et l'administration du traitement pendant des periodes prolongees. La reussite therapeutique a ete observee principalement chez les patients souffrant de myocardiopathie congestive dilatee. De nombreuses questions devront trouver reponses quant a l'utilisation des β-bloquants dans le traitement de l'ICC, notamment en ce qui concerne le moment ideal pour amorcer le traitement, l'effet sur la mortalite et quels sont les patients les plus susceptibles de tirer le maximum d'avantages d'un tel traitement. Malgre que les donnees actuelles semblent etre prometteuses, des recherches plus poussees sont necessaires.
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 | 0.002 | 0.004 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.001 | 0.002 |
| Insufficient payload (model declined to judge) | 0.005 | 0.001 |
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".