Bibliographic record
Abstract
A 31 year old man was brought by ambulance to the emergency department of his local hospital having vomited several basins full of bright red blood. He had no medical history but admitted to a decade long history of excess alcohol intake, consuming 60-70 units a week. On examination he was pale, sweaty, and restless with a marked tremor. His pulse was 110 beats per minute and blood pressure was 90/50 mm Hg. He was not jaundiced, but his abdomen was distended with shifting dullness in the flanks. The liver could not be palpated, but the spleen was palpable 5 cm below the costal margin. Blood results showed haemoglobin 80 g/l, international normalised ratio 1.8, platelets 45×109/l, bilirubin 14 μmol/l, creatinine 77 μmol/l. While being assessed he had a further large haematemesis, vomiting more than a litre of fresh blood, and he became drowsy and uncooperative. ### 1 What is the most likely diagnosis? #### Short answer Decompensated alcoholic liver disease with portal hypertension leading to haemorrhage from gastro-oesophageal varices. #### Long answer The most likely diagnosis is that he has developed cirrhosis as a consequence of long standing alcohol use. In the United Kingdom, alcohol is the main cause of liver disease, and it accounts for more than half of liver related admissions to hospital. The problem is increasing, with hospital admissions for alcohol related liver disease having doubled in the past 10 years.1 The spectrum of alcohol associated liver disease spans steatosis, steatohepatitis, and cirrhosis.2 Sinusoidal hypertension results from compression of the portal venous channels in the fibrotic liver and leads to the development of portosystemic anastomoses. The anastomosis at …
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.
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 | 0.001 |
| 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 | 0.006 |
| Insufficient payload (model declined to judge) | 0.005 | 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".