Bibliographic record
Abstract
Thank you. We do appreciate these insightful comments. They are correct in observing that our recommendations show a preference for deferring cord clamping in babies who do not require resuscitation and that the decision-making process for clamping and associated resuscitation steps are not indicated on the algorithm. The decision not to place new steps or branches in the algorithm in 2020 was deliberate: the algorithm views neonatal resuscitation from a high level and remains a condensed version of practice that is detailed in the text.In addition, the science of each resuscitation step and, in this case, cord management overlaps with practical and educational principles. The “Utstein Formula for Survival” clearly delineates how science, education, and practice are inextricably intertwined and need to be addressed both in sequence and independently.1 We believe that clinicians and educators who develop educational programs for neonatal resuscitation should contribute to the translation of evidence into practice. We have therefore resisted the temptation to pre-empt their recommendations. The American Heart Association and American Academy of Pediatrics recognized these steps of translating science into education and then into practice in the formation and membership of the Neonatal Life Support Writing Group as a bridge between the International Liaison Committee on Resuscitation (ILCOR) guidelines and the Neonatal Resuscitation Program (NRP).2,3We agree with Drs. Ghirardello and Katheria that cord management should be integrated into educational programs but have been cautious about prejudging how clinicians and educators will address the challenges that the science presents to them. We agree that the evidence provides us with a range of timing and approaches to cord management in low- and high-risk populations and eagerly anticipate new educational materials that promote effective training, assessments, and interventions. In regard to the question on “term gestation,” it is intended primarily to prepare the team for the next steps for care, not to guide cord management decisions. The recommendations, including those on cord management, will be incorporated into the Neonatal Resuscitation Program (NRP), 8th edition, which will be available in June 2021.
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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 | 0.010 | 0.113 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.002 | 0.002 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.004 | 0.004 |
| Scholarly communication | 0.004 | 0.005 |
| Open science | 0.004 | 0.004 |
| Research integrity | 0.032 | 0.043 |
| Insufficient payload (model declined to judge) | 0.026 | 0.022 |
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".