Bibliographic record
Abstract
INTRODUCTION Background The treatment of Langerhans cell histiocytosis (LCH) has varied greatly over the past century, and is still controversial. Early treatment approaches reflected contemporary views on disease pathogenesis, which included granulomatous, inflammatory or infectious origins for LCH. Consequently, children with LCH were treated with antibiotics, anti-inflammatory agents including steroids, and with radiation therapy and over the last 30–40 years with cytotoxic chemotherapy. While varying degrees of success have been reported, it remains true that only once the issues of aetiology and pathogenesis have been resolved can a definitive therapy be envisioned. Nevertheless, systematic approaches to diagnosis and treatment, which were major advances of the 1980s, have improved the outlook for children with LCH and are the main focus of this chapter. Historical perspective The first systematic treatment trial of children with LCH was that of Lahey (1962). In that study, children were matched for age and extent of disease, and outcome was analysed according to whether or not ‘specific’ treatment for LCH was given. Treatment was not controlled however, and a variety of agents, including antibiotics, steroids and cytotoxic drugs were given, making direct comparisons problematic. Nevertheless, the principal, and important, finding of this study was a significant increase in survival in the group of children receiving therapy compared to those who were untreated. These findings led to a number of studies in which, unfortunately, the patient populations varied greatly with respect to extent of disease. This variability made interpretation of results difficult, and conclusions regarding superior treatment approaches were at best tenuous.
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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 | 0.000 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.001 | 0.002 |
| Insufficient payload (model declined to judge) | 0.007 | 0.004 |
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".