Effect of Methylphenidate in Patients with Acute Traumatic Brain Injury; a Randomized Clinical Trial
Bibliographic record
Abstract
ABSTRACT Background : Traumatic brain injury (TBI) is one of the major causes of death and disability among young people. Methylphenidate is a neural stimulant with possible brain protection properties and has been mainly used in clinic for childhood attention deficit/hyperactivity disorder. TBI patients with late psychosocial problems could benefit from methylphenidate because of the effect on arousal and consciousness level in the sub-acute phase. We studied this effect during the acute phase of moderate and severe TBI. Design and Methods : Forty patients with severe TBI (GCS = 5–8) and 40 moderate TBI patients (GCS = 9–12) were randomly divided into treatment and placebo groups on the day of admission. Treatment group received methylphenidate 0.3 mg/kg two times a day orally, beginning on the second day of admission and continuing until being discharged. Admission information and daily Glasgow Coma Scale (GCS) were recorded. Medical, surgical, and discharge plans for patients were decided by attending physicians, who were kept blinded during the course of treatment. Results : In the severe TBI patients, both hospital and ICU length of stay, on average, were shorter in the treatment group compared with the control group. In the moderate TBI patients, ICU stay was shorter in the treatment group, there was no significant reduction of the period of hospitalization. Interpretation : There were no significant differences between the treatment and control groups in terms of age, sex, post-resuscitation GCS, or brain scan findings, in either severely or moderately impaired TBI patients. Methylphenidate was associated with reductions in ICU and hospital length of stay by 23% in severe TBI patients ( p = 0.06 for ICU and p = 0.029 for hospital stay time), in the moderately TBI patients who received methylphenidate, there was 26% fall ( p = 0.05) in ICU length of stay.
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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 | 0.002 | 0.003 |
| Meta-epidemiology (narrow) | 0.002 | 0.001 |
| Meta-epidemiology (broad) | 0.004 | 0.002 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.002 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.003 | 0.003 |
| Insufficient payload (model declined to judge) | 0.009 | 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".