374 NUTRITIONAL FAILURE AND CACHEXIA IN A PEDIATRIC PALLIATIVE CARE POPULATION.
Bibliographic record
Abstract
Children with neurologic and metabolic conditions face significant challenges with nutrition. Often, they require assistance with feeding, whether surgical or medical, to prevent weight loss and malnutrition. Among pediatric palliative caregivers, the phenomenon of nutritional failure is known to occur in these children at the end of life; however, it has never been documented in the literature. The goal of this research study was to retrospectively illustrate and document the time course of nutritional failure in children with metabolic and/or neurologic conditions by reviewing a select series of cases. Our hypothesis was that unexplained nutritional failure is a marker for the end of life trajectory in children with these underlying diseases. An extensive review of literature regarding the above phenomenon was performed. In addition, a series of representative cases from children who died while at Canuck Place—a pediatric palliative hospice—was studied. Charts were reviewed for information regarding the nutrition route and composition, the results of relevant laboratory and imaging studies, and the symptoms of feeding intolerance that led to nutritional failure prior to death. Nutritional failure, which manifested as progressive intolerance of enteral feeding despite modifications in the artificial route used, the formula composition, and the use of a variety of medications, was observed in the representative cases of children. Symptoms of worsening gastroesophageal reflux, vomiting, abdominal bloating, ileus, seizures, and pain preceded the end of life in each of the case studies. The clinical phenomenon of nutritional failure at end of life is an important guide to the management of these children as well as a prognostic indicator for both clinicians and families.
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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 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
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".