Bibliographic record
Abstract
Introduction and Objectives: Kidney and pancreas transplant recipients undergo significant fluid shifts in the postoperative period, leading to significant lower limb edema.Intermittent compression (IPC) devices are used to reverse the edema, however, many factors may limit the use of IPC units.The Geko Plus device is an internally powered calf neuromuscular stimulator, which has previously been shown to have beneficial effects in improving blood flow.Its role in transplantation has not previously been assessed.Our objective was to prospectively evaluate the effects of IPC and Geko Plus devices on lower limb edema in renal and pancreatic transplant patients.Methods: We performed a prospective, randomized, controlled, single-centre, study where 30 patients were randomly assigned to wear IPC (Group1, n= 16) or the Geko Plus device (Group 2, n=14) postoperatively until Day 6 after surgery.We measured patient weight and lower leg and thigh circumferences daily.Ultrasound Doppler of the allograft and of the lower limbs was carried out on postoperative Days 1 and 5 to assess venous flow and velocity in the femoral vein.Also, we monitored total urine output, serum creatinine levels.Results: Median age of the recipients was 50 (24-72) years and 66% were male.27 patients underwent kidney transplantation and three underwent kidney and pancreas transplantation.There were no differences in the body mass index (BMI) of the recipients in either group.Donor types were as follows: Group 1: 4 DCD, 7 NDD, 5 LD; and Group 2: 4 DCD, 7 NDD, 3 LD.We observed a significant increase in calf circumference following transplantation in Group 1 by 7.2% (2.3 +/-2 cm) compared to Group 2, which showed no change from baseline (0.13%, 0.05 +/-0.95cm; p<0.0001).Thigh circumference also followed a similar trend, with only Group 1 showing a significant increase (5.5%, 2.4 +/-2 cm) from baseline compared to Group 2 (p<0.001).Doppler ultrasound showed a remarkable increase in mean flow velocity in the Geko Plus patients of 19 cm/s, whereas the IPC patients showed lower velocities 11cm/s (p<0.0005).There was no significant difference between groups in serum creatinine, weight change, urine output, and resistive index of the allograft.There were no complications in either group.Conclusions: We report, for the first time, that the use of the Geko Plus device in the immediate postoperative period leads to an improvement in lower limb edema and in venous flow in kidney and pancreas transplant recipients compared to standard IPC.
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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 | 0.002 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.003 | 0.001 |
| Open science | 0.001 | 0.002 |
| Research integrity | 0.003 | 0.003 |
| Insufficient payload (model declined to judge) | 0.586 | 0.311 |
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".