Bibliographic record
Abstract
A 41-kg 14-year-old girl with chronic renal failure was referred to our unit for renal transplantation. She had recently had a veno-venous haemodialysis catheter inserted at another hospital. Our paediatricians were unable to aspirate blood freely from this catheter, so a chest X-ray was taken. The catheter was seen to pass inferior to the middle third of the left clavicle and to lie with its tip against the left side of the mediastinum. It was thought that this was most unlikely to lie in a central vein other than an anomalous one such as a left superior vena cava. Twenty millilitres of Niopam 300 was injected into the line. The contrast was seen to flow away into a natural space, so an erect PA chest X-ray was taken (Fig. 5). This shows the contrast collected in the subpulmonary part of the left pleural space (arrow). No pneumothorax is seen. The line was not removed pre-operatively because of concern that if intra-operative heparinisation was required (to aid graft patency) bleeding might be a problem. We were also concerned about precipitating a pneumothorax. The line was spigoted off and labelled ‘do not use’. The renal transplant was uneventfully carried out under general anaesthesia according to our hospital protocol. Postoperatively the transplanted kidney functioned well. Several days later the misplaced catheter was removed in the operating theatre under general anaesthesia. A chest X-ray taken 2 h later showed a large left-sided pneumothorax. An intercostal drain was inserted under general anaesthesia. A chest X-ray taken later that evening showed that the lung had partially re-expanded. Full expansion required the application of negative pressure to the drain. The patient was discharged home 26 days after her transplant. Misplaced vascular catheters are newsworthy items at present [1]. They may cause the unfortunate doctor to become involved with the General Medical Council. In view of the current ‘one-strike-and-you-are-out’ phase that regulation of the medical profession is going through, we must take meticulous care both with our own vascular catheters and those inserted by others.
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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 | 0.004 |
| 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 | 0.001 |
| Scholarly communication | 0.001 | 0.002 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.002 | 0.004 |
| Insufficient payload (model declined to judge) | 0.004 | 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".