Bibliographic record
Abstract
The author reported no conflicts of interest.The Journal policy requires editors and reviewers to disclose conflicts of interest and to decline handling or reviewing manuscripts for which they may have a conflict of interest. The editors and reviewers of this article have no conflicts of interest. The author reported no conflicts of interest. The Journal policy requires editors and reviewers to disclose conflicts of interest and to decline handling or reviewing manuscripts for which they may have a conflict of interest. The editors and reviewers of this article have no conflicts of interest. This letter's authors,1Lobo Filho H.G. Lobo Filho J.G. Pimentel M.D. Left internal thoracic artery and saphenous vein composite grafts: the value of valveless veins.J Thorac Cardiovasc Surg Open. 2021; 8: 379Google Scholar and the original source article's authors, reflect opinions in their practice that emphasize that much of what we do is based on personal opinion. We have taken our best shots at trying to parse out physiology to do what surgeons do best—innovate. This process is a practical implementation of ideas that results in the introduction of new goods or services. When one considers the question presented in this strategy of coronary revascularization, we can demonstrate multiple steps at which our true quality as innovators shines through. The first is the question of the application of the valvulotome, a tool introduced in another surgical specialty for peripheral vascular intervention.2Connolly J.E. The history of the in situ saphenous vein bypass.J Vasc Surg. 2011; 53: 241-244Abstract Full Text Full Text PDF PubMed Scopus (11) Google Scholar The benefit of this approach is the ability to use the vein in an orientation that preserves its normal tapering course in terms of diameter of inflow and outflow. In contrast, this may result in trauma that could jeopardize long-term outcomes, and are the acceptable outcomes of in situ bypass in the leg due to preserved adventitial blood supply by not removing the vein?3Dreifaldt M. Souza D.S. Loesch A. Muddle J.R. Karlsson M.G. Filbey D. et al.The “no-touch” harvesting technique for vein grafts in coronary artery bypass surgery preserves an intact vasa vasorum.J Thorac Cardiovasc Surg. 2011; 141: 145-150Abstract Full Text Full Text PDF PubMed Scopus (53) Google Scholar Having done a lot of basic research looking at endothelial injury, would I feel comfortable doing this? Likely not. The next is the question of anastomosing the vein, prone to atherosclerosis, to the smaller internal thoracic artery. Is this folly? The theoretical benefit of local antiatherogenic materials is appealing, but is there proof? Do we need more information to properly avoid the potential complication of jeopardizing the superb results of an isolated left internal thoracic artery–left anterior descending coronary artery anastomosis? To this reviewer, these papers have supported that this strategy is feasible and in “a pinch” I feel ever so slightly better to apply them if my standard tried-and-true strategy is not available. But, to move forward, we need to encourage surgeons to break down innovations step by step and test each stride along the innovation pathway before encouraging universal acceptance. These communications are what they are—you can do it. Should you do it routinely? That is for another day. Left internal thoracic artery and saphenous vein composite grafts: The value of valveless veinsJTCVS OpenVol. 8PreviewWe read with great interest the study published by Hwang and colleagues,1 which demonstrated equivalence between the clinical results obtained in coronary artery bypass graft (CABG) surgery with composite arteriovenous grafts when compared with using exclusively arterial composite grafts. Our team has considerable interest in this topic, as we are part of a pioneering and enthusiastic group that regularly performs CABG without cardiopulmonary bypass and avoiding manipulation of the ascending aorta, with studies since the 1990s indicating good results with this technique. Full-Text PDF Open Access
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 | 0.010 | 0.122 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.002 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.002 | 0.004 |
| Scholarly communication | 0.004 | 0.006 |
| Open science | 0.003 | 0.003 |
| Research integrity | 0.031 | 0.037 |
| Insufficient payload (model declined to judge) | 0.016 | 0.008 |
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".