Bibliographic record
Abstract
(See page 914 for the Photo Quiz.) Diagnosis: Invasive Entamoeba Histolytica Enteritis. Her attending doctors were most surprised when the pathologists phoned to let them know that her bowel showed no evidence of vascular insufficiency but extensive invasion by amebic trophozoites and associated extensive mucosal and submucosal necrosis in a patchy distribution throughout the resected bowel. Numerous ulcers, extending into the underlying submucosa, were noted to contain numerous hemophagocytic trophozoites that morphologically resembled Entamoeba histolytica (Figure). She was discharged following a 14-day course of metronidazole and is currently asymptomatic following a reversion of her jejunostomy. This case of acute, severe amebic enteritis is unusual in a number of respects. First, the duration of preceding symptoms is very brief. In 1 series, patients with amebic colitis had an average duration of prehospital illness of 21 days [1]. Second, it is unusual for patients not to have any history of diarrhea at presentation. Typically, 94%–100% of patients with amebic enteritis have a history of diarrhea [2]. The absence of fever is not atypical—fever is present in only the minority (8%–38%) of patients with amebic colitis at presentation [2]. Third, amebiasis is not commonly thought to affect the small bowel. An autopsy study of 140 patients who died of a diarrheal illness in Bangladesh, however, challenges this perception: 22 patients were found to have evidence of invasive amebiasis, and of these, 23% had evidence of small-bowel disease [3]. Likewise, an autopsy study from Canada showed trophozoites invading the small-bowel wall in 2 of 5 patients who died of invasive amebiasis [4]. There have been 3 cases of ileal amebiasis reported in the literature from South Africa [5, 6]. All 3 of these cases were from Kwazulu, where seropositivity for Entamoebahistolytica antibodies is up to 16% in certain communities. Our patient presented 1 day after flying back from Durban (in Kwazulu) to Cape Town. She had, however, only stayed in Kwazulu for 4 days, making her visit less likely to be the source of her amebiasis.
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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 | 0.001 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.002 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.002 | 0.002 |
| Insufficient payload (model declined to judge) | 0.005 | 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".