A 74-year-old woman with progressive right-hand tremor and inability to use her right side
Bibliographic record
Abstract
A patient was well until 3 years prior to review when she developed a right upper extremity resting tremor. The tremor became progressively more severe over the next year and she had difficulty with writing, knitting, and gardening. A year and a half later, she experienced difficulty using her right leg, and she developed an asymmetric impaired gait. She described a feeling of “restlessness” throughout the right side of her body that was not present on the left. One year prior to review, she began using a cane for ambulation and then 8 months later transitioned to a walker. She would drag her leg and seemed unable to bear weight on it. She had some falls a year prior, but no recent falls, as her mobility was very limited. She denied symptoms of REM sleep behavior disorder or constipation. She had occasional bladder urgency without incontinence but no orthostatic hypotension. She denied involuntary movements, alien limb phenomena, or sensory changes involving the right side. She did not feel truly weak; rather, the right side of her body “doesn’t do what she wants it to do.” When initially evaluated, the patient was diagnosed with Parkinson disease (PD). Initially no treatment was implemented, but subsequently, pramipexole was initiated. She discontinued this following a brief trial when she read about possible side effects. One year later, she received a second neurologic evaluation and was again diagnosed with PD and therapy with levodopa/carbidopa was initiated. Again, she discontinued this medication because of concerns regarding possible side effects. The trial was brief, and of uncertain benefit. Following a third neurologic evaluation, she was started on amantadine, which was discontinued because of drowsiness. She had no cognitive impairment but had become depressed and was crying frequently. Her past medical history was significant for hypertension, fibromyalgia, hypothyroidism, …
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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) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.000 | 0.001 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.003 | 0.001 |
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".