Clinical and radiologic features of pediatric opioid use‐associated neurotoxicity with cerebellar edema (POUNCE) syndrome
Bibliographic record
Abstract
A 20-month-old boy weighing 15 kg underwent a successful surgery for hypospadias under general anesthesia. Before discharge, he was given a 2 mg dose of oral morphine. His parents reportedly administered a 3 mg dose of oral morphine at home 2 hours later. Three hours later, he appeared drowsy and was put to bed. The next morning, approximately 14 hours later, he was not arousable and the ambulance was called. His oxygen saturation was at 94%, blood pressure at 90/60, and had decreased level of consciousness with poor respiratory effort. His blood venous gas showed pH = 6.91, PCO2 = 115 mm Hg, PO2 = 21 mm Hg, and bicarbonate of 22 mmol/L. He had pinpoint pupils and abnormal dystonic posturing. He was given naloxone 0.15 mg twice, 1 hour apart, with no effect, and he was then intubated.
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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 | 0.002 |
| Meta-epidemiology (narrow) | 0.002 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.002 | 0.001 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.002 | 0.001 |
| 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".