Bibliographic record
Abstract
The letter by Quintini and colleagues addresses, as did the earlier paper (Rock, 2000), the significant success that has been achieved with various forms of plasma therapy in the treatment of thrombotic thrombocytopenic purpura (TTP). The authors presented the results of Furlan et al (1998) and Tsai & Lian (1998) implicating an altered or absent metalloprotease activity in the various forms of TTP, as was also described in our review (Rock, 2000). However, it may not be appropriate at this time to state, as Quintini et al do, that ‘these observations clearly explain the dramatic improvement of the outcome in TTP’, as the improvement is variable and, as the authors themselves point out, is not universally successful, with some groups of patients (e.g. post bone marrow transplantation) not responding well at all. This has resulted in the application of a variety of alternative treatments, as was referred to (Rock, 2000); that is, while our paper described the suggested and usual approach to management, we also addressed the issue of refractory patients and the use of various therapies including vincristine, cyclophosphamide, splenectomy, i.v. IgG and Staph A columns, and further stated that, ‘concerned physicians will continue to attempt treatment of refractory patients using any or all of a mixture of available therapies in the hope of resolving the disease’. In fact, as indicated, a variety of extensive and heroic therapies have been attempted in these critically ill patients who do not respond to ‘standard’ treatment. The introduction of autologous stem cell transplantation to the scenario is certainly interesting, adding one more consideration to the therapeutic armamentarium. However, we maintain that, as stated (Rock, 2000), until a definite aetiology and diagnostic tests are determined, practitioners will have to contend with the fact that treatment is still empirical and not predictably effective. Hopefully this will soon change.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.002 | 0.001 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.001 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.008 | 0.002 |
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; both teacher heads 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".