Abstracts DGKCH
Bibliographic record
Abstract
Background:Necrotizing enterocolitis (NEC) is a common ailment in premature neonates, marked by intestinal inflammation, hypoxia, and eventual bowel necrosis.Its origins are multifaceted, stemming from intestinal immaturity, abnormal microbial colonization, and inadequate circulatory regulation, culminating in gut hyperinflammation.Despite advancements in preterm infant care, NEC continues to impose a significant burden of morbidity and mortality.Similarly, congenital heart disease (CHD), the most prevalent single-organ congenital anomaly, shares this burden of infant morbidity and mortality.Neonates with CHD face the risk of developing ischemic colitis (IC), with specific CHD phenotypes like ventricular septal defect, atrial septal defect, tetralogy of Fallot, univentricular heart, and coarctation of the aorta being prominent in Germany.Simple CHDs remain stable in incidence since 1996, while complex CHDs have seen a significant rise since 2008.In these CHD patients, compromised cardiac function leads to insufficiently oxygenated blood and reduced bowel wall blood flow, increasing the risk of bowel resection-a primary cause of short bowel syndrome in pediatric cases.Certain types of CHD, such as patent ductus arteriosus, significant left-to-right shunting, and atrioventricular canal defect, have been linked to NEC development, and even after surgery, ischemia and reperfusion injury remain potential threats.Notably, hypoplastic left heart syndrome, truncus arteriosus, and aortopulmonary window carry the highest NEC risk, particularly in premature or very low birth weight infants.Atrioventricular canal defects are a significant risk factor in this population.Our study aims to identify CHD patients who underwent surgery for ischemic colitis and evaluate the associated risk factors, enabling early detection and optimized care. Materials and methods:This retrospective study encompassed all patients with congenital heart defects (CHD) who underwent surgery for ischemic colitis at the Department of Pediatric Surgery, University Medical Center Hamburg-Eppendorf (UKE), from January 2013 to May 2023.The study adhered to the principles outlined in the Helsinki Declaration and received approval from the local institutional review board, the Hamburg Ethics Committee (2023-101012-BO-ff).We collected and analyzed the following demographic and surgical data: age, gender, multiple gestation, birth weight, cardiac diagnosis, extracorporeal membrane oxygenation (ECMO) use, ECMO duration, date of colitis in relation to the cardiac procedure, number of infections prior to ischemic colitis, timing of cardiac surgery, timing of bowel surgery, bowel resection, stoma creation, enteral feeding, timing of patent ductus arteriosus (PDA) closure, and type of PDA closure (medical or surgical), as well as instances of mortality.Statistical analysis was carried out using Prism 9 for macOS (Version 9.5.0) and Microsoft Excel for Mac (Version 16.59). Results:This study included 35 patients, comprising 20 males and 15 females, among whom 20 were born prematurely, 10 had underlying syndromic diseases, and 9 were part of multiple pregnancies.The average birth weight was 2.11 kg, with one missing data point.ECMO treatment was administered to 4 out of the 34 patients, with an average duration of 2.23 days.Cardiac diagnoses were stratified based on congenital heart defect (CHD) complexity, resulting in 11 low-complex, 14 medium-complex, and 10 high-complex cases.Among these CHDs, 13 were cyanotic, and 22 were non-cyanotic.PDA closure was achieved through medical means in 7 patients and surgically in 8 others.After cardiac surgery, 25 patients underwent bowel surgery, 4 had bowel surgery before cardiac surgery, and 5 had bowel surgery s209 DE GRUYTER
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| 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 | 0.003 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
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 teacher head, 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".