Complement activation by the artificial surface of cardiopulmonary bypass is a persistent clinical problem
Bibliographic record
Abstract
Activation of the alternative complement pathway by artificial extracorporeal surfaces is relevant to several clinical applications such as cardiac surgery with cardiopulmonary bypass (CPB), thoracic organ transplantation and hemodialysis. In the pediatric cardiac surgery population, complement mediators have been associated with systemic inflammation, post-operative morbidity and delayed recovery. Small children require CPB circuit prepared with allogeneic blood products and these sanguineous primes have substantially higher concentrations of biologically active anaphylatoxins C3a and C5a relative to the patient's baseline circulation. Sequential samples were collected during forty-five ex-vivo sanguineous prime preparations of CPB circuits coated with phosphorylcholine, as a biocompatibility technology, to characterize complement activation in this context. We observed and quantified evidence of alternative and terminal complement pathway activation indicated by dynamic concentration increases of C3a, C3b, C5a and terminal complement complex. Circuit exposure time was a predictor of only C3a concentration in multivariable generalized linear mixed-effects models. Despite modern biocompatibility technology, there is significant alternative complement activation during ex-vivo sanguineous CPB prime preparation. Patient exposure to this activated mediator burden during CPB could promote systemic endothelial inflammation with negative end-organ and post-operative clinical impacts. Further research is required to evaluate and inhibit complement responses to artificial surfaces broadly used for clinical care.
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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 | 0.002 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.001 | 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".