A 90 year old man with difficulty swallowing and proximal muscle weakness
Bibliographic record
Abstract
A 90 year old man presented with progressive dysphagia, generalised weakness, and malaise. He had lost 30 lb (13.6 kg) in the past six months, and his mobility had deteriorated because of progressive leg weakness. He had no visual or constitutional symptoms apart from weight loss and denied any bladder or bowel problems. He had a 25 pack year history of smoking and did not drink alcohol. Examination showed signs consistent with bilateral pneumonia. His speech was dysphonic, the gag reflex was absent, but other cranial nerves were intact. He had wasting and weakness of the small muscles of the hands and weakness of the proximal muscles of the lower limbs. Reflexes were absent in the lower limbs. Strength in the remaining muscle groups—including ankle dorsiflexion, planter flexion, knee extension, and flexion—was normal. Proximal muscle groups in the upper extremity were strong, although reflexes were reduced bilaterally. No fasciculations were seen and he had no evidence of fatigable ptosis. Sensory examination was normal. Examination of the cardiovascular and abdominal systems was unremarkable. Investigations showed a white blood cell count of 5.9×109 cells/L (reference range 4.0-10.0), haemoglobin 117 g/L (140-180), platelets 332×109 (320-360), random glucose 10.8 mmol/L (3.6-11), urea 25.3 mmol/L (3.0-7.1), creatinine …
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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 | 0.000 | 0.002 |
| Meta-epidemiology (narrow) | 0.002 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.002 | 0.001 |
| Science and technology studies | 0.002 | 0.001 |
| Scholarly communication | 0.001 | 0.002 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.003 | 0.003 |
| Insufficient payload (model declined to judge) | 0.003 | 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; 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".