88: Effectiveness of Therapeutic Hypothermia on Transport within a Large Geographical Area
Bibliographic record
Abstract
The Canadian Paediatric Society (CPS) recommends Therapeutic Hypothermia (TH) be provided at level 3 NICUs. Initiation of TH within 6 h of life has been associated with benefit and is the current CPS standard of care. Given our large catchment area, the initiation of TH by conventional passive means often has to be considered at the referral hospital prior to or immediately upon arrival of the neonatal transport team (NNTT). To determine the effectiveness of our approach to initiating TH within our region. Retrospective cohort study of all cases accepted for TH, between October 2009 and December 2013 at CHEO, a university-affiliated level 3 NICU and transported by our NNTT. All infants had moderate to severe encephalopathy and met NICHD criteria for TH. Sixty infants (mean gestational age 39.1 weeks, birth weight 3.3 kg, arterial cord pH 6.9, Apgar scores 3 and 4 at 5 and 10 min) were included. The median time to initiation of TH was 123.5 mins and to target temperature 328 mins. No infant had temperatures <30°C when cooled, 3 (5.4%) were /= 1 h). Comparing In town v Out of town; the median age of referral was 101 v. 53.5 mins, median time to initiation of TH 98 v. 238 mins, median age at NNTT arrival 169 v. 218.5 mins and the median birth to target temperature 321 v. 367 mins. Meeting current CPS target for TH using passive cooling in a large catchment area is challenging. Preliminary studies using a servo-controlled device on transport indicate significant reductions in TH times in urban settings. The efficacy of novel technology in remote geographical areas remains to be determined.
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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 | 0.007 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
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".