Bibliographic record
Abstract
A 38-year-old male patient was involved in a motor vehicle accident in 1997, resulting in tetraplegia and posttracheostomy tracheal stenosis. The patient is a 30-pack-year active smoker, and smokes around 4-5 cannabis cigarettes daily.Initial management of this tracheal stenosis had relied upon tracheal dilatation and Dumon silicone endoprosthesis (50 mm) insertion, which was replaced annually [1].While travelling abroad in 2006, the patient had an episode of acute respiratory distress of unknown aetiology (endoprosthesis obstruction or migration), which was managed by a large incision tracheostomy. This procedure was technically difficult, since the endoprosthesis was still in place, and resulted in a major loss of tracheal and cutaneous tissue. Upon his return to France, a new, longer tracheal endoprosthesis was inserted (70 mm), in order to cover the tracheal and cutaneous gap as well as the subglottic, suprastomal stenosis.Figure 1 shows a cervical outside view of the endoprosthesis, which was implanted 37 months ago. Figure 2 shows the endoprosthesis once removed. It appears to have a yellow-brown discolouration, with a black zone, corresponding to the area exposed to outside air.Such a discolouration of a bronchial or tracheal endoprosthesis has not been described in the literature [2]. However, cigarette smoke does in fact result in a brownish colour in active smokers with an airway endoprosthesis. In this particular case, direct exposure to air and sunlight might also have caused the black colour, through oxidation due both to oxygen in ambient air and ultraviolet solar rays. So far there has been no report of the effect of sunlight on silicone, in particular on the external branch of the Montgomery T tube which is made of silicone.
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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 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.002 | 0.003 |
| Insufficient payload (model declined to judge) | 0.020 | 0.013 |
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".