Bibliographic record
Abstract
M edical students in the 1940s observed that stroke vic- tims were regarded as in a hopeless situation.Severely disabled patients with stroke and those in coma from intracerebral clots were confined to Observation Units.What was learned in my early days allowed us to replace this Medical Bedlam with Stroke Prevention and Treatment Units.Stroke neurologists, specialized nurses, and imaging technicians became available to give expert care in these new units.The hopeless era of stroke disappeared.With a growing number of colleagues I was privileged to contribute to this change or watch from the sidelines, as others were involved.The biggest differences have resulted from epidemiological observations, dramatic scientific breakthroughs, including microbiology, treating infectious disease, pharmacology, and technology, coupled with the advent of rigid clinical trials.The most important may be listed as follows:• Fleming's discovery of penicillin eliminated brain abscess and much pneumonia and strokes because of pneumococcal and syphilitic meningo-vascular changes.Streptomycin could cure tuberculous meningitis.Endocarditis with embolic brain infarction was becoming uncommon.I can recall in the mid-1940s, discharging home to their young families, 2 well individuals, 1 recovered from coma because of tuberculous meningitis, the other cured of strep viridans endocarditis.These were pioneering events that before those days were fatal but today we take the cure for granted.• Confirmation of the risk factors emerged from a combination of research strategies.One of the keys to affirmation of many was the collecting of life-time records of populations as in the Framingham Study 1 and the Oxfordshire Stroke Project. 2 The Four Horsemen of the Stroke Apocalypse are hypertension, tobacco, diabetes mellitus, and cholesterol excess.Control of all of these has been shown clearly to reduce stroke occurrence.Some important factors cannot be changed (eg, old age, male sex, and heredity) but with these in the patient's background assiduous management of the risk profile is needed.Clinical trials have been of particular consequence in proving the necessity to regulate blood pressure in all age groups and to maintain normal levels of the low-density lipoprotein fraction of cholesterol.
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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 | 0.089 | 0.155 |
| Meta-epidemiology (narrow) | 0.002 | 0.002 |
| Meta-epidemiology (broad) | 0.008 | 0.006 |
| Bibliometrics | 0.004 | 0.005 |
| Science and technology studies | 0.001 | 0.002 |
| Scholarly communication | 0.008 | 0.006 |
| Open science | 0.002 | 0.005 |
| Research integrity | 0.006 | 0.008 |
| Insufficient payload (model declined to judge) | 0.009 | 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".