Powder milk as a user-friendly tool for baked milk challenge
Bibliographic record
Abstract
Cow’s milk allergy is the most common food allergy among children. Previous studies have reported that up to 75% of children may tolerate baked milk goods. Various forms of baked milk challenges have been used in the literature such as muffins, pizza, and waffles. However, the food used for baked milk challenge is often prepared in a non-standardized manner by the parents at home, raising concerns with regards to validity, reproducibility and convenience. Instant skim milk powder is made by a food process that involves heating skim milk to up to 200°C for up to 30 minutes which should be sufficient to denature thermo-labile proteins. To evaluate the usefulness of skim milk powder as a convenient standardized form of baked milk challenge. All challenges to instant skim milk powder (cumulative dose of 4g proteins) performed at Sainte-Justine Hospital in Montreal, Canada between November 2008 and January 2013 were retrospectively reviewed. Observed reaction rates to challenge and to subsequent home introduction were compared to previous literature using different forms of baked milk. Demographic data, clinical characteristics, skin prick tests (SPT) and specific IgE levels were compared between those that passed and those that failed the challenge. Thirty-nine children underwent an open food challenge to instant skim milk powder and thirty patients (76,9%) passed the challenge. All of those who passed the challenge successfully introduced baked milk products at home. Compared to those who were baked milk tolerant, baked milk reactive children had higher median specific IgE levels to cow’s milk (P < .0005), casein (P < .001), α-lactalbumin (P < .001) and β-lactoglobulin (P < .04). Both cohort reaction rates and characteristics were comparable to previous literature using other forms of baked milk product for challenge. Challenge with instant skim milk powder is a safe, convenient and easily standardized alternative to home baked food for baked milk challenge.
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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 | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.002 | 0.001 |
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".