Reply to Wennen <i>et al.</i> : Interpretation of Diaphragmatic Force Measurements in Reverse Triggering in a Porcine Model
Bibliographic record
Abstract
single twitch is not reported as part of the F/F relationship analysis, which makes the interpretation of Figure 5 challenging in the context of increasing or decreasing diaphragm function.The response of a muscle to a summation of twitches can be influenced by many factors, including twitch duration (pulse width), amplitude, and time between stimuli.With similar pulse intensity (charge = amplitude 3 pulse width), a generated force after a twitch stimulation is always lower than the force generated with a pulse train.This was also demonstrated for the diaphragm muscle, for example, in rabbits (2) and in vivo using magnetic stimulation (3).We noticed differences in pulse width between the single twitch and stimulations for the F/F response curve (0.015 vs. 0.0015 s, respectively).Therefore, single twitches may have resulted in higher force output.What was the reason for this difference, and why were twitch measurements not presented within the F/F response analysis?It would ease the interpretation of the measured diaphragm force if the authors could comment on this, potentially by presenting Pdi waveforms of a representative case per group.Last, animals were divided into groups based on the tertiles of measured levels of breathing effort and not by defining limits for effort a priori.It is suggested that a certain level of breathing effort can be protective for the diaphragm; however, it appears that some subjects in the RT middle-effort and RT low-effort groups have very similar levels of breathing effort (Figure 3 of the original work [1]).We therefore suggest that the emphasis on group-related outcomes should be attenuated.A sensitivity analysis on the impact of grouping animals on the basis of different breathing effort limits could be considered.Undoubtedly, unraveling the effects of RT on diaphragm function is crucial to understanding the impact of RT on clinical outcomes.Developing animal models may be of great help to study the impact of patient-ventilator interaction, especially RT, on the diaphragm.However, results should be interpreted with care in light of the physiology of diaphragm function and breathing effort.
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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 | 0.008 | 0.039 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.002 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.002 | 0.003 |
| Scholarly communication | 0.003 | 0.004 |
| Open science | 0.004 | 0.002 |
| Research integrity | 0.032 | 0.034 |
| Insufficient payload (model declined to judge) | 0.003 | 0.006 |
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".