'Wondering and waiting’ after obstetrical brachial plexus injury: Are we underestimating the effects of the traumatic experience on the families?
Bibliographic record
Abstract
O bstetrical brachial plexus injury (OBPI) results from lateral torsion to the neck or direct traction to the upper extremity during birth.Approximately 1.6 to 2.9 per 1000 infants sustain an OBPI (1), with risk factors including birth weight >4000 g, shoulder dystocia, multiparity, prolonged labour, assisted delivery, maternal diabetes and breech presentation (2,3).The Narakas system classifies OBPI according to nerve injury severity, from least severe Narakas level I (C5-C6 lesion) to most severe Narakas level IV (C5-T1 lesion with Horner's sign) (4).Spontaneous recovery for infants with OPBI is variable (30% to 80%) (5) and infants who do not recover spontaneously may undergo microsurgery to repair the damaged plexus.Children fall into a 'gray zone' when the decision regarding the benefits and risk of surgery versus no surgery is unclear (6).Reports vary with regard to outcomes with and without surgery (1,6,7).Although most of the literature has focused on the biological aspects of OBPI, a growing body of knowledge addresses the effects of this injury on the family.Kerr and McIntosh (8) reported that parental response to OBPI (shock, panic, denial, grief and anger) mimics the bereavement response.Bellew et al (9) questioned the parents of 44 children with OBPI (mean age 27 months; range 12 to 51 months) about early experiences with their child.Parents reported that these times were stressful as they attempted to cope with the functional, emotional and social difficulties related to OBPI.McLean et al (10) administered
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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 | 0.005 | 0.056 |
| Meta-epidemiology (narrow) | 0.000 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.003 | 0.005 |
| Scholarly communication | 0.004 | 0.009 |
| Open science | 0.001 | 0.002 |
| Research integrity | 0.004 | 0.007 |
| Insufficient payload (model declined to judge) | 0.006 | 0.001 |
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".