Bibliographic record
Abstract
400 A32 year-old male smoker presented to the emergency room with increasing breathlessness over two weeks. Past history was unremarkable, including no history of rheumatic fever, heart murmurs, intravenous drug use or recent invasive procedures. Oral hygiene was poor, and an aortic insufficiency murmur was heard on physical examination. Blood work revealed leukocytosis (white blood cells=18.3×109/L), hyperglycemia (serum blood glucose=17.8 mmol/L) and ketoacidosis. A chest radiograph displayed cardiomegaly, pulmonary edema and bilateral pneumonia. Serial electrocardiograms showed ST elevation in the precordial leads and troponin I was 4 μg/L. Two initial blood cultures grew coagulase-negative staphylococci (CNS). The patient was treated with levofloxacin and vancomycin, along with usual therapy for hyperglycemia, congestive heart failure and acute coronary syndrome. A transesophageal echocardiogram (TEE) revealed severe aortic insufficiency, an aortic root abscess and a large cauliflower-shaped vegetation extending into the aortic valve. The patient underwent urgent aortic valve replacement and pericardial closure of the abscess. Two preoperative blood cultures each grew Staphylococcus warneri and Staphylococcus haemolyticus, as speciated by VITEK (bioMerieux, USA). Intraoperative aortic valve and pericardial fluid cultures, as well as two postoperative blood cultures, grew Staphylococcus epidermidis and S warneri, which were also speciated by VITEK. The automated antibiograms produced by VITEK for the various isolates differed, which is consistent with a polymicrobial endocarditis. The patient was treated with vancomycin, rifampin and gentamicin (to which all isolates were sensitive), but worsened clinically and demonstrated persistent fever. What is your diagnosis? What would you recommend?
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
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 | 0.004 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.003 | 0.001 |
| Scholarly communication | 0.002 | 0.002 |
| Open science | 0.001 | 0.002 |
| Research integrity | 0.003 | 0.003 |
| Insufficient payload (model declined to judge) | 0.008 | 0.003 |
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".