Bibliographic record
Abstract
We would like to thank Drs Takeuchi, Otani, and Nawashiro for their interest in our article.1 However, we find that the 2 studies they are referring to do not really lend support to their hypothesis that the divergence between our results and those of Waziri et al2 lies in the difference in patient characteristics, specifically the extent of infarction. In the article of Bogousslavsky and Regli,3 the authors analyzed the development of unilateral ipsilateral ventricular dilation and cortical atrophy in patients with large strokes secondary to internal carotid artery occlusion or stenosis. There was no mention of hydrocephalus in their report. It is important to distinguish between true hydrocephalus, that is, mismatch between CSF production and resorption, and ventricular dilation or hydrocephalus ex vacuo, which is merely a radiological finding caused by large areas of neuronal loss and encephalomalacia after a massive infarction. In their publication, Barber et al4 sought to determine early CT signs predictive of death after large middle cerebral artery (MCA) infarction in a large cohort of conservatively managed patients, none of which had undergone decompressive craniectomy. The authors found that moderate or severe hydrocephalus was predictive of death on univariate, but not multivariate analysis. It must be noted, however, that these authors were referring to acute obstructive hydrocephalus, a complication of cerebral edema-related mass effect in large ischemic strokes. Conversely, in our study1 and that of Waziri et al,2 patients were typically protected against obstructive hydrocephalus by the wide surgical decompression. Rather, the incidence of chronic communicating hydrocephalus in survivors of malignant MCA territory infarction and other types of stroke was assessed. To the best of our knowledge, there is no direct relationship between communicating hydrocephalus and ischemic stroke. Additionally, in our experience, hydrocephalus is not a frequent complication of decompressive craniectomy.1 Therefore, unless new scientific evidence comes to disprove these findings, we have no reason to believe that hydrocephalus should be a major concern in the management of patients with large MCA or internal carotid artery infarctions. Ralph Rahme Alexander G. Weil Michel W. Bojanowski Montreal, Quebec, Canada
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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 | 0.004 | 0.040 |
| 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 | 0.003 |
| Scholarly communication | 0.004 | 0.006 |
| Open science | 0.003 | 0.003 |
| Research integrity | 0.024 | 0.036 |
| Insufficient payload (model declined to judge) | 0.026 | 0.021 |
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".