Behaviour Concerns in Preschool Cardiac Surgery Survivors
Bibliographic record
Abstract
Background Behavior concerns (BC) are reported in survivors of complex cardiac surgery (CCSx) with inconsistent evidence about health and demographic variables that impact outcomes. Methods Prospective inception-cohort study of infants (without known chromosomal abnormalities) after CCSx from 2001-2017 determined Behavior Assessment System for Children (BASC-II/III) Parent Rating Scales at 4.5 years. T-scores ≥60 for externalizing, internalizing, and behavioral symptom index (BSI), and ≤40 for adaptive behavior defined BC. Potential predictive variables included demographic, acute care, and health factors after initial CCSx. Multiple logistic regression using purposeful selection method gave Odds Ratios (OR) with 95% confidence Intervals (CI). Results Survivors (n=585; 61% boys, 40% single ventricle) were assessed at median age 55 months [interquartile range 53, 57]. Independent predictors were non-cardiac hospitalizations (OR 1.10, 95% CI 1.02, 1.19, p=0.015) for externalizing; non-cardiac hospitalizations (OR 1.14, 95% CI 1.05, 1.24, p=0.003), female sex (OR 1.62, 95% CI 1.04, 2.52, p=0.031), single ventricle (OR 1.82, 95% CI, 1.04, 3.17, p=0.035) for internalizing; non-cardiac hospitalizations (OR 1.10, 95% CI 1.02, 1.19, p=0.017), SES (OR 0.98, 95% CI 0.96, 0.10, p=0.031), years of maternal schooling (OR 0.91, 95% CI 0.84, 0.10, p=0.04) for adaptive; and extracorporeal life-saving support (OR 2.03, 95% CI 1.01, 3.96, p=0.041) for BSI, indicating more pervasive behaviors. Conclusions Number of non-cardiac hospitalizations predicted increased odds of BC and requires further attention. Improving inpatient trauma-informed care experiences and optimizing access to primary care to prevent non-cardiac hospitalization may be modifiable.
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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 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 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 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".