Bibliographic record
Abstract
Introduction: Sepsis is a Systemic Inflammation Response to Infection.SIRS increases the production of cytokines,leading to a procoagulant state.This coagulopathy combines 3 mechanisms:Activation of the coagulation system;Decrease of physiologic anticoagulants;Inhibition of fibrinolysis.Severe Sepsis(SS)is associated with acute organ dysfunction. Hypothesis: Hemodynamic instability is the main cause of organ failure during an episode of SS;but fibrin deposition and formation of thrombi in the microvasculature may disrupt blood flow to vital organs,and cause Multiple Organ Failure(MOF). Methods: 68 patients admitted to the ICU with a diagnosis of Sepsis were screened for these variables:1)All-cause mortality during hospital stay;2)Number of Organs showing an acute Dysfunction(NOD);3)Serial values of platelets,PT,D-Dimers,fibrinogen,Protein-C(PC),Antithrombin-III(AT);4)Calculation of our novel Hemostatic Score(HS):Platelets >100(0 point),50-100(1),< 50(2);Increase of PT(in seconds):< 3(0),3-6(1),>6(2);D-Dimers=N(0),>N(2),>5 times the upper limit of N(3);PC=N(0), 0.50 Un/l(1),< 0.50(2);AT=N(0),< N but >0.50 Un/l(1),< 0.50(2). Results: All-cause mortality during hospital stay was 53%(36/68).Most patients(97%)developed SS(66/68).Among the 36 patients who died, there was an average of 5.6NOD,with a mean calculated HS of 8.7 points.Among the 47% of survivors(32/68),there was an average of 3.3NOD,with a mean HS of 7.0 points.Patients with a NOD< or =2 showed a mortality of 0%(0/11),with a mean HS of 5.8 points.Patients with SS and a NOD> or =3 showed a mortality of 63%(36/57),with a mean HS of 8.3 points. Conclusions: The International Society on Thrombosis and Hemostasis developed a scoring system to identify DIC.This algorithm considers the activation of hemostasis and coagulation(platelets, PT,fibrinogen),the anomalies of fibrinolysis(D-Dimers),but not the decrease of natural anticoagulants.By adding both PC and AT to our novel HS,the latter pathophysiologic mechanism is taken into account.An Acute Hematologic Dysfunction,as seen in SS,with the formation of microthrombi,leads to a significant perfusion deficit to vital organs.The data show a link between our novel HS,the NOD,the risk of developing MOF,and rate of death.
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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 | 0.003 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.003 | 0.002 |
| Open science | 0.001 | 0.003 |
| Research integrity | 0.002 | 0.001 |
| Insufficient payload (model declined to judge) | 0.614 | 0.537 |
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".