Human islet transplantation - state of the art
Bibliographic record
Abstract
Currently, only vascularized pancreas transplantation can reestablishlong-term normoglycemia but the scenario has beenassociated with significant morbidity and mortality. An attractivealternative that was clinically proposed approximately 25 yearsago is islet transplantation, because it avoids both major surgeryand complications related to exocrine enzymes. The aim of thisreview is to discuss why insulin-independence after isletallotransplantation has been so difficult to achieve. A literaturereview was undertaken using Medline from 1975 to October 2004.Results reported to the International Islet Transplant Registry upto December 2000 were also analyzed. Up to December 2000, 355islet allotransplants were reported to the Islet Transplant Registry.Of those accurately documented between 1990 and 2000 (n =355) only 19% (52/281) achieved insulin-independence (greaterthan 7 days). However with refined peritransplant protocols, insulinindependence can reach 11% (27/237) within one year. Howevermost of the studies describe single-donor transplants. Islettransplantation is a safe and effective strategy for betacellreplacement but many technical and scientific obstaclesremain. The first challenge is to obtain similar clinical successwith single-donor grafts; afterwards, to analyze which is the criticalislet mass to achieve insulin-independence and finally what arethe detrimental effects of transplanting islets in an ectopic site.Recent evidence from the Edmonton group demonstrated that isletallotransplatation still has the potential to become an establishedtreatment option for diabetic patients.
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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 | 0.004 | 0.003 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.002 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.004 | 0.003 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.002 | 0.002 |
| Insufficient payload (model declined to judge) | 0.025 | 0.013 |
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".