Changes in the neuro-glial-vascular interface in metabolic intoxications in children (based on acetonemic syndrome and hyperammonemia)
Bibliographic record
Abstract
Objective: To investigate morphofunctional changes of the neuro-glial-vascular interface in children with metabolic intoxications, particularly in acetonemic syndrome and hyperammonemia. Materials and methods: A systematic literature review with elements of narrative analysis was conducted following PRISMA guidelines. Literature search was performed in PubMed/MEDLINE, Web of Science Core Collection, Scopus, and Cochrane Library for the period 1990-2024. Included studies involved children from birth to 18 years and investigated neurotoxic effects of acetonemic syndrome and hyperammonemia. Study quality was assessed using Newcastle-Ottawa Scale, AMSTAR-2, and SYRCLE tools. Results: Key morphofunctional disorders of the neuro-glial-vascular interface were identified: cytotoxic astrocytic swelling due to glutamine accumulation during ammonia detoxification; blood-brain barrier disruption with decreased expression of tight junction proteins (claudin-5, occludin, ZO-1); impaired energy metabolism due to glycolysis inhibition and mitochondrial dysfunction; excitotoxicity resulting from glutamate-glutamine cycle disruption; microglial activation with increased expression of CD68, Iba1, MHC II, and pro-inflammatory cytokine secretion. Conclusions: Morphofunctional changes of the neuro-glial-vascular interface with acetonemic syndrome and hyperammonemia are characterized by complex disruptions of blood-brain barrier (BBB) structure and function, energy metabolism, neurotransmitter balance, and neuroinflammatory processes. A personalized approach to diagnosis and treatment using biomarkers of BBB damage and neuroinflammation is necessary.
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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 | 0.007 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.003 | 0.002 |
| Bibliometrics | 0.008 | 0.007 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.000 |
| 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".