Brain and heart connections: The trigeminocardiac reflex!
Bibliographic record
Abstract
Abstract Trigeminocardiac reflex (TCR) is a well-established neurogenic reflex although its exact mechanism and clinical significance remain unclear. This reflex may be incited by stimulation of the trigeminal nerve anywhere along its course starting from the peripheral distribution to the central nucleus. It usually manifests as bradycardia, asystole, hypotension, apnoea and gastric hypermotility; though other clinical manifestation such as tachycardia and hypertension may also occur. Diving reflex (DR) shares many similarities with TCR in both clinical manifestation and mechanism of action and is often considered as a modified or subtype of TCR. DR is an important physiological adaptation to withstand hypoxia during apnoea in many animal species including humans and thus belongs to a group of oxygen-conserving reflexes. Although TCR is a physiological reflex having protective function, an exaggerated response may have fatal consequences. Surgeries or stimulation involving head, neck and face region (area supplied by trigeminal nerve) are particularly prone to provoke this reflex. Vigilant and continuous monitoring for early identification of warning signs and communication with surgeon to interrupt the stimulus immediately is enough to cease the reflex in most of the cases. However, failure to identify and treat in time may have deleterious consequences and thus TCR has gained much attention and awareness in recent years. Over the last two decades, our knowledge on TCR has expanded but we still remain far from complete elucidation of pathophysiology, mechanism and clinical significance of this unique ‘brain and heart connection’ called TCR.
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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 | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.002 |
| Scholarly communication | 0.001 | 0.002 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.003 | 0.002 |
| Insufficient payload (model declined to judge) | 0.008 | 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".