Bibliographic record
Abstract
Background and Goals: Intraoperative MRI (IMRI) provides substantial benefits for the treatment of intracranial disease.1 Magnet safety underlies all aspects of patient care, but the unique workflow, limited access, and difficult communication make patient care extremely challenging. The MR OR is dark and noisy with multiple distractions, unfamiliar equipment, and limited access to the patient. This abstract outlines the unique hazards and our initial experience in developing an IMRI program. Methods: The Yale-New Haven Hospital MR OR opened in June 2010. The room was designed and built by IMRIS (Winnipeg, Manitoba, Canada). A Siemens 3 Tesla MRI is moved into the OR during surgery. Anesthesiologists use Invivo MRI physiologic monitors, GE Aestiva MRI anesthesia gas machines, and iRadimed infusion pumps. The neuroanesthesia group developed its own safety and training program. Checklists are used for all safety procedures. The MRI's built-in patient call system is used to call for help in an emergency. Training includes use of monitors and infusion pumps, workflow, and demonstrations of the magnet's strength. Neuroanesthesiologists and residents receive this training and undergo a short mentoring period. Results: 176 scans have been done since June 2010. IMRI is used to guide surgery and assess tumor resection. Active research protocols with the intraoperative MRI are underway. Conclusions and Discussion: All supplies and equipment are MR safe. MRI monitors and pumps were originally developed for patients receiving sedation for a diagnostic scan, and have a limited set of features. Room entry is through multiple locked doors, delaying help in an emergency. Team training improves communication and crisis management.2 Extensive cooperation between surgeons, nurses, anesthesiologists, and MRI personnel is required. Any team member can stop the scan if a problem occurs. We have developed a program to provide safe care for patients undergoing IMRI. References: Schulder M, Spiro D. Intraoperative MRI for stereotactic biopsy. Acta Neurochir Suppl. 2011;109:81–7. Leonard M, Graham S, Bonacum D. The human factor: the critical importance of effective teamwork and communication in providing safe care. Qual Saf Health Care. 2004 Oct;13 Suppl 1:i85–90.
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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 | 0.001 | 0.003 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.002 | 0.001 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.002 | 0.002 |
| Open science | 0.001 | 0.002 |
| Research integrity | 0.002 | 0.003 |
| Insufficient payload (model declined to judge) | 0.147 | 0.076 |
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".