Reply: Hydrodissection for conduit harvesting: Catch the wave!
Bibliographic record
Abstract
We thank Drs Dashwood and Iino for their interest and comments regarding our recent findings 1 and recognize their significant contributions to the field of vascular biology of venous grafts used in coronary artery bypass grafting, in particular those concerning the open no-touch (ONT) technique as developed by Dashwood and colleagues. 2 We take this opportunity to provide clarifications to some of the issues they raise in their letter.We appreciate the comment regarding our comparisons between the no-touch and minimally invasive no-touch (MINT) techniques and acknowledge this point directly.It is accurate that our team is not among the mostpracticed groups in the ONT technique.This method, although valuable, has seen limited adoption in North America because of its historically high rates of legwound morbidity, which many institutions consider prohibitive.With that said, the intergroup differences in nitric oxide (NO) remain biologically consistent with the corresponding structural observations showcased via scanning electron microscopy.The more pristine endothelial architecture observed in MINT specimens aligns with preserved endothelial NO synthase function, which is the dominant NO synthase isoform in venous endothelium under physiological conditions. 2 The assay used during this study is incapable of distinguishing each individual isoform's contribution to the generation of NO.Although we strive to incorporate the principles of atraumatic handling espoused by the ONT technique, our approach may indeed align more closely with the conventional open-harvesting methods still commonly used across numerous surgical centers.Our findings should not be interpreted as contradicting the established ONT literature; rather, they highlight that no-touch is highly operatorand context-dependent and that ONT outcomes cannot be assumed to be uniform across centers, where experience varies markedly.We believe this reflects practical clinical realities rather than a lack of appreciation for the ONT method's strengths.We thank Drs Dashwood and Iino for highlighting the MINT technique, and we welcome the opportunity to clarify its mechanistic advantages in greater detail.The MINT approach is fundamentally designed to be atraumatic.It uses controlled hydrodissection with a physiologic pH 7.4 solution, which naturally tracks along the anatomical plane of least resistance surrounding the great
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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 | 0.005 | 0.027 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.002 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.003 | 0.004 |
| Scholarly communication | 0.003 | 0.006 |
| Open science | 0.002 | 0.003 |
| Research integrity | 0.045 | 0.047 |
| Insufficient payload (model declined to judge) | 0.010 | 0.010 |
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".