Bibliographic record
Abstract
Purpose: Case Presentation: A 29 year old female immigrant from India presented with a 5 month history of recurrent abdominal pain. Past medical history was significant for vitamin B12 deficiency, iron deficiency anemia and acute pancreatitis. History was negative for smoking, alcohol, drug use, gallstone disease, constitutional symptoms and medication use. Lab work was unremarkable. Abdominal CT showed extensive calcification within the head, body and tail of the pancreas and dilated pancreatic ducts. Endoscopic retrograde cholangiopancreatography (ERCP) showed a pancreatic duct stricture in the neck of the pancreas. Stent placement did not relieve pain. Repeat ERCP showed multiple calcified stones with a large stone in the head of the pancreas causing obstruction. Endoscopic shock wave lithotripsy (ESWL) and ERCP were attempted for stone removal but were unsuccessful. Surgical decompression (lateral pancreaticojejunostomy) was effective in achieving pain relief. The patient was diagnosed with Tropical Pancreatitis (TP). Discussion: TP is a form of chronic pancreatitis (CP) found in people residing within 30 degrees of the equator (Asia, Africa, South America). It is the most common type of CP in India, accounting for approximately 70% of patients with CP. The etiology of TP is unknown. Environmental factors and decreased inhibitory capacity within the pancreas (SPINK1 mutation) have been implicated. Characteristic features of TP include young age at onset, residence in the tropics, absence of alcohol use, no other cause of CP, large duct disease with ductal dilatation, large pancreatic calculi (predominantly in the head) and chronic abdominal pain. Patients can develop nutritional deficiencies and insulin-requiring diabetes. They are at high risk of pancreatic cancer. Management is directed towards pain relief, and control of diabetes and steatorrhea. ERCP coupled with ESWL has been used for stone fragmentation and removal in patients unresponsive to medical therapy. Recently, surgical decompression and drainage have been shown to be more effective than endoscopic treatment in patients with obstruction of the pancreatic duct. TP is an important diagnosis to consider in an immigrant patient from the tropics with chronic abdominal pain and pancreatic calcification.
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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) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.002 | 0.001 |
| Open science | 0.001 | 0.002 |
| Research integrity | 0.001 | 0.002 |
| Insufficient payload (model declined to judge) | 0.033 | 0.011 |
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".