Bibliographic record
Abstract
To the Editor: The article by Holmes et al. (1) on hyperventilation (HV) and seizures concludes that their findings “provide compelling evidence that both localization-related and generalized epilepsies are relatively resistant to routine HV activation in adults and adolescents.” I disagree with their interpretation. Absence of a witnessed clinical or electrographic seizure, especially with a retrospective study, does not imply that epilepsies are resistant to HV. We often use HV when attempting ictal single-photon emission computed tomography (SPECT) scan in our hospitalized telemetry patients and have been doing so for the last several years. Of the last 40 to 50 patients who underwent HV, seizures were personally witnessed in three to four patients (unpublished data). These were all adult patients with localization-related epilepsies. Seizures can occur during HV or a few minutes after the procedure. This is significantly contradictory to the numbers provided by the author. While conducting routine EEGs, the technologists encourage a good effort with HV but may not consistently get ideal results. Second, HV by technologists is not aimed at provoking a seizure but rather at unmasking epileptiform activity. Therefore a trained technologist will often stop HV if a suspicion exists that the patient is about to seize. Based on the observation of Holmes et al., it would be more appropriate to conclude that seizures are very infrequently witnessed during routine HV. However, this does not provide “compelling evidence” that epilepsies are relatively resistant to this procedure.
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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 | 0.020 |
| Meta-epidemiology (narrow) | 0.002 | 0.001 |
| Meta-epidemiology (broad) | 0.003 | 0.001 |
| Bibliometrics | 0.002 | 0.001 |
| Science and technology studies | 0.001 | 0.002 |
| Scholarly communication | 0.003 | 0.004 |
| Open science | 0.004 | 0.001 |
| Research integrity | 0.014 | 0.017 |
| Insufficient payload (model declined to judge) | 0.004 | 0.003 |
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".