Long-standing Spiny Papules on the Lower Extremities—Quiz Case
Why this work is in the frame
A frame that forgets how it found something cannot be audited. These are the routes that admitted this work.
Bibliographic record
Abstract
A 17-year-old boy with congenital absence of the intrahepatic bile ducts owing to Alagille syndrome presented with a pruritic eruption of 3 months’ duration. He also reported a new problem, seeing “dark spots” at night. His medical therapy included bile acid–binding resins and supplementation of fat-soluble vitamins. His chronic jaundice was unchanged. Physical examination revealed jaundice and numerous 2to 8-mm follicular, keratotic erythematous papules on the distal extensor surfaces of his arms and legs (Figure 1). His vitamin A level was 11 μg/dL (reference level, 26-72 μg/dL), and his carotene level was less than 2 μg/dL (reference level, 9-190 μg/dL). (To convert vitamin A and -carotene to micromoles per liter, multiply by 0.0349 and 0.01863, respectively.) Treatment resolved his lesions and vision changes. A punch biopsy specimen was obtained from the forearm for histopathologic evaluation (Figure 2 and Figure 3). What is your diagnosis?
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
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 | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
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 it