Liver Pathology in First Presentation Diabetic Ketoacidosis at Autopsy
Bibliographic record
Abstract
Diabetes mellitus is an enormous health burden on developed and developing nations. Eight percent of people in the United States are stated to have diabetes mellitus and 79 million people have impaired glucose tolerance. Sudden death from diabetic ketoacidosis (DKA) is common and nonalcoholic fatty liver disease (NAFLD) is a frequent finding in patients with diabetes mellitus and impaired glucose tolerance. Diabetic ketoacidosis accounts for around 1% of autopsy cases in our units and 25% of these cases did not have a previous diagnosis of diabetes mellitus. We have analyzed for the presence of NAFLD in 16 patients dying on first presentation of DKA. Some degree of NAFLD was present in all cases, with all but one case having some degree of steatosis and some degree of fibrosis was present in 14 out of 16 cases, though none where cirrhotic. Inflammation was present in nine of 13 cases and glyogenated nuclei in five of 13 cases. NAFLD can be well established in patients dying of DKA who were not known to be diabetic before death. The pathology shares features with alcoholic liver disease. They should not be mistakenly diagnosed as dying of other causes of ketoacidosis based upon the liver pathology present.
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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 | 0.005 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.003 | 0.001 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.004 | 0.001 |
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".