Apical ballooning syndrome, emotional stress and women: reply
Bibliographic record
Abstract
In our systematic overview, we found that apical ballooning syndrome is preceded by an emotional stressor in ∼27% of cases and by a physical stressor in 38%.1 Čulič suggests that emotional stress may be a more frequent trigger, especially in women. Indeed, in his meta-analysis of triggers of acute myocardial infarction (MI), Čulič2 observed a greater association between emotional stress and MI in women vs. men. However, this finding relates to MI in general and not to Takotsubo cardiomyopathy in particular. Čulič cites a couple of specific studies, conducted in western populations, which did indeed report a higher prevalence of emotional stressors as triggers for apical ballooning syndrome cases3,4 and a report from Japan linking the stress associated with earthquakes to this syndrome in Japan. We thank Čulič for drawing the readers' attention to the interesting report from Japan, which was not incorporated in our systematic overview, as it was published in brief as a research letter and did not meet the a priori criteria set for the inclusion of studies in our meta-analysis.
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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 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| 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".