Bibliographic record
Abstract
Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada. lerman@anaes.sickkids.on.caIn Reply:—I thank Dr. Watson for her comments about parental presence at induction of anesthesia (PPIA). Dr. Watson suggests that “a more positive view of parental presence” should be adopted. I disagree. I believe that all interventions should be evidence-based, and, at the present time, no studies indicate that all children benefit from PPIA. 1In contrast, midazolam is uniformly effective without regard to age, temperament, or the child’s or parent’s anxiety level. 2In a busy anesthetic practice, it is easy to understand why midazolam is preferred to PPIA. Dr. Watson also contends that we ought to determine how parental presence “can be made more effective.” I agree. All parents should be required to attend a seminar on induction of anesthesia by responsible physicians, and their role and the limitations of their participation in the induction should be explained. The parents should then be screened: Those who are likely to be positive influences on their children would be permitted to accompany their child, and those who would be negative influences would not be permitted. This is not the standard in most institutions, most likely because of the enormous expense and time that would be needed. It has been my experience that parents request to accompany their child to induction without any preparation for the events that may ensue. Regarding the issue of cardiac dysrhythmias, Kataria et al. 3reported that arrhythmias occurred in 10% of parents during PPIA, with ventricular tachycardia developing in one parent. Finally, cultural, economic, and infrastructure issues are far more complex than alluded to by Dr. Watson. There are few multilingual nurses, few nurses who can leave a child at induction, few induction rooms, and limited resources to address PPIA programs in many institutions. I believe PPIA should be approached in the same manner as any new drug: Properly conducted studies must demonstrate its effectiveness and safety before it is released for widespread use by the public. Until that time, it should be a limited resource.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
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 | 0.050 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.002 | 0.003 |
| Scholarly communication | 0.003 | 0.002 |
| Open science | 0.001 | 0.002 |
| Research integrity | 0.004 | 0.006 |
| Insufficient payload (model declined to judge) | 0.031 | 0.004 |
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".