Notice bibliographique
Résumé
Mr. Irving, an elderly man with a recent diagnosis of metastatic duodenal adenocarcinoma, had a longstanding history of Peutz-Jeghers syndrome that required multiple surgeries to remove intestinal polyps.He presented to the emergency department with 10 days of intermittent, left-sided abdominal pain that radiated to his back.He described the pain as "sharp" and "crampy", and unresponsive to opioids administered both orally and subcutaneously.The subsequent addition of a neuropathic adjuvant drug did not provide relief.This pain resulted in four emergency department visits during a 10-day period.Imaging of the abdomen identified significant retroperitoneal lymphadenopathy, for which he had previously received palliative radiation therapy.The palliative care team had seen the patient several months prior as an out-patient and was reconsulted by the emergency department for suggestions regarding pain management.Due to the refractory nature of the pain, a subcutaneous continuous opioid infusion pump was ordered and homecare services were arranged for the patient.Shortly after the pump was initiated the patient experienced severe pain, which he rated as 8 of 10.As directed, he appropriately self-administered a breakthrough dose; however, before its onset of action he immediately telephoned the on-call service stating he feared the pain would not abate.The physician on-call contacted the patient roughly 20 minutes afterward.The patient's voice was described as tremulous, suggestive of an anxious effect.He informed the physician his pain had come on suddenly and that he was terrified the breakthrough dose would be ineffective.The patient now described the pain as a "comfortable" 3 of 10.Despite this decline in severity, the patient remained fretful.It was only after significant reassurance that he would not be left alone with his pain, and that the physician would be available to him 24 hours a day over the course of the weekend that the patient's anxiety lessened.His voice was described as calm and no longer quivering.No further calls were made by the patient that night or the remainder of the weekend.On reassessment early the following week, the patient indicated his pain was adequately controlled and responsive to self-administered breakthrough doses.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,001 | 0,008 |
| Méta-épidémiologie (sens strict) | 0,001 | 0,001 |
| Méta-épidémiologie (sens large) | 0,001 | 0,000 |
| Bibliométrie | 0,001 | 0,001 |
| Études des sciences et des technologies | 0,009 | 0,002 |
| Communication savante | 0,005 | 0,005 |
| Science ouverte | 0,001 | 0,007 |
| Intégrité de la recherche | 0,006 | 0,010 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,197 | 0,066 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».