© 2000 Canadian Medical Association or its licensors Research
Bibliographic record
Abstract
A31-year-old woman had sudden onset of globalheadache at 1 pm when she was resting that shecharacterized as the “worst of her life, ” rating the pain as 10/10. Associated symptoms included nausea, vom-iting, sonophobia and photophobia. The headache waxed and waned over the next 4 days, and on day 4 the patient presented to the emergency department in a community hospital. Her blood pressure, findings on neurological ex-amination and initial CT scan were normal. Her past med-ical history included hiatal hernia, cigarette smoking and remote use of marijuana (she denied any other illicit drugs), and she was taking sertraline, peptobismol, lanso-prazole and domperidone. A lumbar puncture revealed normal cerebrospinal fluid with no xanthochromia. The opening pressure in the seated position was 37 cm H2O. She was transferred to our hospital, and CT venography was performed. It revealed no venous sinus thrombosis, but multifocal vessel irregularities in both the anterior and posterior arterial circulations were observed. Cerebral an-giography confirmed focal areas of vasospasm in the inter-nal carotid circulations bilaterally as well as in the verte-brobasilar system (Fig. 1A, B, C). Results of hematologic and serologic investigations were negative for signs of sys-temic infection, inflammation or vasculitis. The patient had been using Afrin, a nasal spray that con-tains oxymetazoline, regularly for the previous 6 months. Al-though she was using the medication at recommended daily dosages (2–3 sprays twice daily), she was using it consistently. Two weeks before presentation she had noticed a pattern of headache starting 20 minutes after use of the nasal spray. The index event had occurred immediately after its use. Use of the nasal spray was discontinued. Narcotic anal-gesics reduced the pain, but the nausea and vomiting re-sponded to ondansetron only. The patient had no improve-ment in her headache with nimodipine, a calcium-channel antagonist that causes dilatation of arterial smooth muscle. Repeat lumbar puncture was done in the supine position at discharge and demonstrated an opening pressure of 19 cm H2O. Two weeks after discharge the headache had nearly resolved. A repeat angiogram at 6 weeks showed complete resolution of most areas of arterial narrowing (Fig. 1D).
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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 | 0.003 | 0.007 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.002 | 0.003 |
| Science and technology studies | 0.004 | 0.002 |
| Scholarly communication | 0.005 | 0.002 |
| Open science | 0.002 | 0.002 |
| Research integrity | 0.006 | 0.003 |
| Insufficient payload (model declined to judge) | 0.880 | 0.805 |
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; the direct Gemma label and the distilled Codex classifier agree on what is shown here.
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".