From overlooked metric to clinical action: ascending aortic length as a translational breakthrough in elective thoracic aneurysm surgery
Bibliographic record
Abstract
BACKGROUND: Ascending aortic length (AAL) has long been overlooked in assessing the risk of adverse aortic events in patients with ascending thoracic aortic aneurysm (ATAA). Our team was among the first globally to investigate AAL's role, and this work contributed to the update of international guidelines. Furthermore, this study aimed to provide mechanistic evidence for AAL as a surgical indicator. METHODS: AAL was measured from the aortic annulus to the origin of the innominate artery along the centerline. Patient-specific fluid-structure interaction (FSI) models were constructed, and hemodynamic parameters, including time-averaged wall shear stress (TAWSS), maximum wall shear stress, average wall stress (WS), maximum WS, oscillatory shear index (OSI), and particle residence time (PRT), were analyzed. RESULTS: Compared with the control group (AAL <11 cm), patients with elongated AAL (≥11 cm) showed significantly disturbed hemodynamics: decreased TAWSS (0.8 vs. 1.1 Pa, P = 0.002), increased average WS (177 644.5 vs. 158 342.8 Pa, P < 0.001), increased maximum WS (876 760.0 vs. 770 420.0 Pa, P = 0.013), increased average OSI (0.2 ± 0.0 vs. 0.1 ± 0.0, P = 0.002), and increased average PRT (2.7 vs. 1.9, P < 0.001). A strong dose-response relationship was observed when AAL was divided into quartiles (Q1-Q4), with TAWSS decreasing and WS, OSI, and PRT increasing progressively with longer AAL (all P < 0.001). CONCLUSION: Elongated AAL is associated with worsening hemodynamics in a proportional manner, confirming its validity as a surgical indicator for ATAA.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
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 | 0.001 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 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".