American Academy of Pediatrics guidelines for detecting neonatal hyperbilirubinaemia and preventing kernicterus
Bibliographic record
Abstract
Are there worldwide implications? Although neonatal jaundice is usually a self limited condition, in exceptional circumstances, extreme hyperbilirubinaemia, with its devastating potential of irreversible brain damage due to bilirubin encephalopathy or kernicterus, may occur. For the most part, kernicterus should nowadays be a preventable condition; however, cases continue to occur. The reasons for the persistence of kernicterus are undoubtedly multifactorial. One factor may have been an opinion which evolved at the beginning of the 1990s that in some cases higher serum total bilirubin (STB) concentrations could be allowed than were previously acceptable. At about the same time a new phenomenon developed: that of earlier and earlier discharge of the mother-infant dyad. The potential consequences of discharge at or even earlier than 24 hours are that in many instances lactation may not yet be established, jaundice may often not have become manifest, to say nothing of reaching its peak, and associated illnesses may not yet have declared themselves. Additional factors included discharge of borderline premature neonates of 35–37 weeks gestation as if they were born at term, and failure of physicians to abide by the guidelines for the detection of hyperbilirubinaemia and prevention of kernicterus published by the American Academy of Pediatrics (AAP) in 1994.1 During the last 15 years, cases of kernicterus were reported not only from the United States,2 but also, although to a lesser extent, from other industrialised countries, including Canada, Denmark, Holland, and New Zealand.3 The myth that haemolysis was a prerequisite for kernicterus was disproved.4 By the year 2001 the number of cases of kernicterus reported was sufficient for the AAP to publish a warning cautioning paediatricians of the potential of kernicterus and the dangers of hyperbilirubinaemia.5 In response to the continuing occurrence of cases of kernicterus, the AAP has recently …
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 | 0.015 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.004 | 0.003 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.002 | 0.001 |
| Open science | 0.003 | 0.001 |
| Research integrity | 0.003 | 0.007 |
| Insufficient payload (model declined to judge) | 0.010 | 0.007 |
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".