Self-Induced Vomiting as a Probable Mechanism of an Isolated Hyoid Bone Fracture
Bibliographic record
Abstract
Fractures of the laryngeal skeleton (hyoid bone and thyroid horns) are an important finding in a forensic autopsy because they are almost always caused by significant trauma and often are relevant in determining the cause and manner of death. In the forensic setting, these injuries are seen in some hangings and more frequently in manual strangulation. Less common mechanisms include direct blows, "choke holds," and hyperextension of the neck. We present a case of a 37-year-old woman who died of complications of acute ethanol intoxication. The case involves an incidental hyoid bone fracture unrelated to the cause of death as well as facial petechiae. After review of all of the medical records, autopsy findings and scene/police investigations-the key findings of facial petechial hemorrhages and hyoid bone fracture are best attributed to the mechanism of self-induced vomiting. This case emphasizes the importance of synthesizing autopsy findings with the patient's medical and social history to avoid unnecessary investigation or prosecution. This is the second known case of this novel mechanism of hyoid bone fracture in the medical literature and the first in the forensic literature.
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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 | 0.002 |
| 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 | 0.002 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.003 | 0.002 |
| Insufficient payload (model declined to judge) | 0.004 | 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".