Bibliographic record
Abstract
A 64-year-old male was assessed for incidental jejunal thickening noted on computed tomography (CT). The CT was performed for lower back pain resistant to analgesia. Medical history was notable for light chain amyloidosis in the left eye which was biopsied and resected eight years ago. Upon further questioning, he reported a 2-year history of dull abdominal pain. Additionally, he reported a 10 lbs weight loss over 1 year. There were no other gastrointestinal symptoms. Family history was noncontributory. Work up including complete blood count, electrolytes, creatinine and liver enzymes were normal. Double Balloon enteroscopy showed large ulcerated, friable and polypoid submucosal projections in the jejunum (Figures 1–3). Pathological examination of the biopsies demonstrated inflammation, plasma cells and positive congo red staining. Mass spectrometry performed on the biopsies was consistent with Lambda light chain (AL) amyloidosis. Significant deep ulcerated area noted in the jejunal fold. Significant deep ulcerated area noted in the jejunal fold. Multiple polypoid growth projection with normal overlying mucosa. Multiple polypoid growth projection with normal overlying mucosa. Widespread superficial ulcerations at the jejunum. Widespread superficial ulcerations at the jejunum. Subsequently, a bone marrow biopsy was indefinite for plasma cell dyscrasia (<5% plasma cell with kappa predominance). Fluorescence in situ hybridization testing for t(11,14) was negative. Serology and urinary protein electrophoresis and a thorough cardiac and ophthalmologic assessment reveled no evidence of amyloidosis elsewhere. He was commenced on Cyclophosphamide-Bortezomib-Dexamethasone (CYBOR-D). Isolated small bowel amyloidosis is a rare disease entity and has been infrequently reported in the literature. J.G. and M.M. both declare no financial or personal conflict of interest and have no financial disclosures. T.B. has received honoraria from Abbvie, Alimentiv Inc (formerly Robarts Clinical Trials), Bristol Myers Squibb, Ferring, Gilead, Janssen, Merck, Pfizer, Roche, Sandoz, Takeda. He reports no conflict of interest.
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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 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.002 | 0.001 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.003 | 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".