Research and surgical residency: moving beyond one-and-done projects and motivating for scholarly excellence
Bibliographic record
Abstract
The aims of this study were to evaluate the effectiveness of a standardized insulin protocol in reducing glycemia, review 18F-FDG biodistribution with such a protocol, and assess its clinical impact. Methods: Sixty-three patients with glycemia greater than 10 mmol/L received insulin doses intravenously according to a standardized protocol. One hundred six consecutive euglycemic patients (<6.2 mmol/L) served as controls. 18F-FDG biodistribution was evaluated by 2 experienced PET readers on a 5-point visual scale based on muscular uptake. The 63 patients who received insulin were divided into insulin subgroup A, with adequate biodistribution (score 0, 1, or 2) and insulin subgroup B, with altered biodistribution (score 3 or 4). 18F-FDG biodistribution was also evaluated semiquantitatively by standardized uptake value (SUV) measurements over the liver, gluteal muscles, and myocardium. Clinical impact (complications and diagnostic accuracy) was assessed by follow-up. Results: Glycemia decreased from 13 ± 2 to 7 ± 2 mmol/L after insulin injection. Images showed significantly more muscular uptake in patients who received insulin than in the control group (scores 1.6 ± 1.5 vs. 0.4 ± 0.6, P < 0.05). Twenty-five percent of insulin patients studied had altered biodistribution (insulin subgroup B). The two most important factors increasing muscular uptake were the time interval between insulin and 18F-FDG injection (mean in insulin subgroup A, 80.2 ± 17 min; mean in insulin subgroup B, 65.7 ± 10 min; P < 0.01) and the glycemia interval decrease after insulin injection (mean in insulin subgroup A, 5.3 ± 2.6 mmol/L; mean in insulin subgroup B, 7.6 ± 1.8 mmol/L; P < 0.01). In insulin subgroup B, mean hepatic SUV was lower (1.3 ± 0.4 vs. 2.1 ± 0.4, P < 0.01) and mean muscular SUV was higher (1.8 ± 0.1 vs. 0.9 ± 0.01, P < 0.01). Of the 63 patients who received insulin, 6 had hypoglycemia, but only 2 were symptomatic. No patient had severe complications causing permanent disability. Conclusion: A standardized protocol of intravenous insulin before 18F-FDG injection in diabetic cancer patients was safe and effective in reducing glycemia. Acceptable 18F-FDG biodistribution was obtained in 75% of patients receiving insulin. In addition to visually increased muscular uptake, low hepatic 18F-FDG uptake was a good indicator of altered biodistribution.
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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 | 0.019 | 0.028 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.004 | 0.004 |
| Scholarly communication | 0.005 | 0.003 |
| Open science | 0.001 | 0.009 |
| Research integrity | 0.002 | 0.003 |
| Insufficient payload (model declined to judge) | 0.010 | 0.004 |
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".