Forensic Pathology and Newborn Screening for Inborn Errors of Metabolism: Implications for the Middle East
Bibliographic record
Abstract
We report the postmortem findings of two infants and one child who died in Iraq. In each case, a specific clinical diagnosis was never established and all died at home. None of the cases had undergone newborn screening tests for inherited diseases. In case 1, a 3-day old neonate died without ever passing meconium. Autopsy revealed complete small intestinal obstruction due to meconium ileus. This was most likely due to cystic fibrosis. In case 2, a 6 month old boy died suddenly and unexpectedly after developing dehydration from vomiting. Autopsy revealed marked hepatomegaly with fatty infiltration that also involved the myocardium and kidney. This was most likely due to Medium Chain Aacyl Co-A dehydrogenase (MCAD) deficiency. In case 3, a 12-year-old boy died after a progressive neurological disorder of childhood. At autopsy, the body showed cachexia and flexion contractions. The brain showed loss of white matter bulk and thinning of the corpus callosum. The major organs showed no abnormalities. Histologic examination revealed only mild spongy change of the white matter. These findings indicate that the child likely had an organic acidemia, most probably phenylketonuria (PKU). These cases highlight the critical importance of newborn screening for inborn errors of metabolism in Iraq, including laboratory testing for PKU, MCAD deficiency and cystic fibrosis. Such screening can prevent unnecessary morbidity and mortality in infants and children. On this basis, forensic pathologists should advocate for widespread newborn screening in the Middle East.
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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 | 0.004 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.002 | 0.002 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.002 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 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".