Bibliographic record
Abstract
Mr. Irving, an elderly man with a recent diagnosis of metastatic duodenal adenocarcinoma, had a longstanding history of Peutz-Jeghers syndrome that required multiple surgeries to remove intestinal polyps.He presented to the emergency department with 10 days of intermittent, left-sided abdominal pain that radiated to his back.He described the pain as "sharp" and "crampy", and unresponsive to opioids administered both orally and subcutaneously.The subsequent addition of a neuropathic adjuvant drug did not provide relief.This pain resulted in four emergency department visits during a 10-day period.Imaging of the abdomen identified significant retroperitoneal lymphadenopathy, for which he had previously received palliative radiation therapy.The palliative care team had seen the patient several months prior as an out-patient and was reconsulted by the emergency department for suggestions regarding pain management.Due to the refractory nature of the pain, a subcutaneous continuous opioid infusion pump was ordered and homecare services were arranged for the patient.Shortly after the pump was initiated the patient experienced severe pain, which he rated as 8 of 10.As directed, he appropriately self-administered a breakthrough dose; however, before its onset of action he immediately telephoned the on-call service stating he feared the pain would not abate.The physician on-call contacted the patient roughly 20 minutes afterward.The patient's voice was described as tremulous, suggestive of an anxious effect.He informed the physician his pain had come on suddenly and that he was terrified the breakthrough dose would be ineffective.The patient now described the pain as a "comfortable" 3 of 10.Despite this decline in severity, the patient remained fretful.It was only after significant reassurance that he would not be left alone with his pain, and that the physician would be available to him 24 hours a day over the course of the weekend that the patient's anxiety lessened.His voice was described as calm and no longer quivering.No further calls were made by the patient that night or the remainder of the weekend.On reassessment early the following week, the patient indicated his pain was adequately controlled and responsive to self-administered breakthrough doses.
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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 | 0.001 | 0.008 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.009 | 0.002 |
| Scholarly communication | 0.005 | 0.005 |
| Open science | 0.001 | 0.007 |
| Research integrity | 0.006 | 0.010 |
| Insufficient payload (model declined to judge) | 0.197 | 0.066 |
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".