In Reply
Bibliographic record
Abstract
We thank Dr Mavridis for his kind words and thoughtful comments on our recently published guidelines.1 The issue of discrepancy in potential coordinates for placement of electrodes into the nucleus accumbens (NA) during deep brain stimulation (DBS) surgery is indeed important. In our article, however, we did not analyze targeting strategies, because our guidelines were largely performed to appraise the level of evidence for conducting DBS in patients with obsessive-compulsive disorder. We agree with the author that further research is needed. In addition, we note that most surgeons also rely on the direct magnetic resonance imaging visualization of the anterior limb of the internal capsule and the NA for targeting. To date, it remains unclear whether targeting of specific regions of the NA is feasible and may help to improve clinical results. Such conclusions will only be possible with an increase in surgical expertise and the development of studies not only to characterize anatomic and radiological landmarks, but also to assess the placement of electrode contacts yielding optimal surgical results. In the future, better neuroimaging techniques and/or the combined use of neuroimaging and electrophysiology may help us establish the optimal site for DBS surgery in the NA/anterior limb of the internal capsule. Disclosures Dr Hamani is a consultant for St Jude Medical. Dr Pilitsis is a consultant for St. Jude, Boston Scientific, and Medtronic and has grant support from Boston Scientfic, St Jude Medical, Medtronic and NIH. Dr Rosenow is a consultant for Boston Scientific Neuromodulation. Dr Patil is a consultant, advisory board member and/or received research grants from Medtronic, St. Jude Medical, Boston Scientific, and Monteris. Dr Abosch has an ad hoc consulting agreement with Medtronic. Dr Slavin is a consultant, advisory board member and/or received honoraria from Medtronic, St. Jude Medical, Boston Scientific, Bioness, Greatbatch, Stimwave and Nevro. The other authors have no personal, financial, or institutional interest in any of the drugs, materials, or devices described in this article.
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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 | 0.006 | 0.092 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.002 | 0.002 |
| Scholarly communication | 0.005 | 0.006 |
| Open science | 0.003 | 0.003 |
| Research integrity | 0.018 | 0.027 |
| Insufficient payload (model declined to judge) | 0.053 | 0.040 |
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".