Bibliographic record
Abstract
Worldwide, a significant number of patients have coronary artery disease (CAD). Many such patients end up with heart failure or impaired myocardial function from ischemia or obstruction resulting from multivessel atherosclerosis. There have been many advances in both pharmacological and myocardial revascularization techniques. As a result, the survival of patients has increased after myocardial infarction, which has led to an increased number of patients with debilitating symptoms of chronic refractory angina and ischemic heart disease. Refractory angina pectoris is chronic angina that is not responsive to maximum medical therapies and standard revascularization via coronary artery bypass (CABG) surgery or percutaneous coronary angioplasty (PCA).A subgroup of ischemic heart disease and angina patients can not be treated successfully despite optimal medical management and standard revascularization. For these patients, some advanced therapeutic options have been clinically tested, including transmyocardial laser revascularization, transcutaneous electrical nerve stimulation, or angiogenesis by gene or cell therapy.Transmyocardial laser extravascular angiogenesis (TMLR) has emerged as an option in patients suffering from chronic refractory angina that can improve both patients’ symptoms, exercise capacity, quality of life, and decrease their cardiac rehospitalization. TMLR was approved by the US Food and Drug Administration (FDA) in 1998 to treat moderate to severe angina that occurred due to CAD, and that is nonresponsive to standard revascularization and maximal medical therapy. However, this technique was already in clinical use starting in 1983 in association with CABG as a hybrid technique. In this procedure, the laser is used directly on the surface of the heart to revascularize it.It is important to note that recently all the trials pertaining to TMLR have been closely examined. It was also found that many studies that assessed subjective improvement fromTMLR lacked blinding. Many randomized clinical trials that examined TMLR also did not use important pre-defined outcomes such as myocardial infarction, arrhythmia, or congestive heart failure, which are examined in most practice-changing RCTs in cardiology. Based on current guidelines, for the management of refractory angina, the ACC/AHA guidelines do not recommend TMLR with or without CABG.
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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 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.003 | 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".