Esophagitis dissecans: a rare cause of odynophagia
Why this work is in the frame
A frame that forgets how it found something cannot be audited. These are the routes that admitted this work.
Bibliographic record
Abstract
A 67-year-old woman with Sjögren’s syndrome, IgA paraproteinemia, and bronchiectasis presented with a 3-month history of worsening odynophagia and weight loss. Initial endoscopy revealed erythema in the mid- to distal esophagus and a small mucosal tear. Barium swallow, esophageal manometry, and 24-hour pH studies were all normal. Her symptoms worsened despite proton-pump inhibitor therapy. Repeat endoscopy showed denuded mucosa with overlying slough in the mid-esophagus ([Figure 1]) and a superficial bulla ([Figure 2]). The patient had no mucocutaneous lesions and an empirical trial of oral corticosteroids was ineffective. Esophageal biopsies showed ulcerated and inflamed squamous mucosa ([Figure 3]), but indirect immunofluorescence studies were negative. Fungal hyphae were noted but antifungal therapy was unsuccessful. All routine and autoimmune-screen blood tests were essentially normal. She later developed generalized lymphadenopathy and diffuse large B-cell lymphoma was diagnosed. Treatment with rituximab (anti-CD 20) resulted in a rapid improvement in her dysphagia, and subsequent endoscopy showed normal mucosa with a fibrotic esophageal stricture, which was dilated ([Figure 4]). Biopsies showed only mild, nonspecific inflammation and no malignancy.
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Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.001 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.001 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.003 | 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 it