Bibliographic record
Abstract
TO THE EDITOR—We read with interest the report by Seña et al [1] on the predictors of serological cure or development of serofast state in human immunodeficiency virus–negative individuals who receive treatment for early syphilis. The study addresses the important issue of predicting which individuals will not achieve an adequate serological response measured by reversion of nontreponemal test to negative or a 4-fold decline in titers. The authors identified age, number of sex partners, baseline rapid plasma reagin (RPR) titer, syphilis disease stage, and development of Jarisch-Herxheimer reaction (JHR) as correlated with the likelihood of cure at 6 months. Two points are worth mentioning: First, <10% of participants screening positive for syphilis were enrolled in the study, introducing concern about the representativeness of the data. Second, the authors conclude that development of a Jarisch-Herxheimer reaction is predictive of cure. This conclusion may not be supported by the data failing to reach significance for this association (P = .08). Moreover, the subsequent multivariate analysis that the authors conducted further weakened the association. This latter observation is not surprising given the postulated mechanism that underlies the appearance of this reaction: Release of endotoxin or treponemal lipopolysaccharide [2, 3] or with release of proinflammatory cytokines upon treatment of syphilis has been demonstrated in 2 studies. Levels of tumor necrosis factor, interleukin 6, and interleukin 8 were shown to correlate with symptoms of JHR [4, 5]. The occurrence of JHR has been recently shown to correlate with pretreatment RPR, the risk for the reaction increasing by 19% for each 2-fold increase of RPR titer, suggesting that the higher baseline load of organisms may drive the observed risk of JHR either directly through intrinsic spirochetal factors or through induction of proinflammatory cytokines [6]. It is therefore premature to conclude, based on a nonsignificant association and in presence of potential confounding factors (ie, age, RPR titer), that the occurrence of JHR is associated with serological response to treatment of early syphilis. Author certifies no potential conflicts of interest. The author has submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest. Conflicts that the editors consider relevant to the content of the manuscript have been disclosed.
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 | 0.001 | 0.012 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.003 | 0.004 |
| Insufficient payload (model declined to judge) | 0.003 | 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 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".