The Use of Fecal Calprotectin and Intestinal Ultrasound in the Evaluation and Management of Stricturing Crohn’s Disease in Pregnancy
Bibliographic record
Abstract
To the Editors, Intestinal strictures affect over 30% of individuals with Crohn’s disease (CD),1 with the peak age of onset of CD overlapping with childbearing years. Distinguishing CD strictures that will respond to medical therapy and those that will not is challenging. In pregnancy, instituting medical therapy is further complicated by high levels of patient anxiety regarding medications, and surgery for symptomatic strictures is a confronting and high-risk prospect.2 Herein, we discuss our diagnostic approach to and management of stricturing CD in pregnancy with reference to clinical case examples. A 33-year-old gestation 4, para 2 with Montreal classification A1L1B2 Crohn’s Disease (CD) on oral 5-aminosalicylic acid (5-ASA) presented at 11 weeks’ gestational age with abdominal pain and vomiting. Her previous pregnancies were complicated by hyperemesis gravidarum (HG), to which her recent symptoms were attributed. Her fecal calprotectin (FC) was 24 ug/g. A magnetic resonance elastography (MRE) performed...
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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) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.002 | 0.000 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.000 |
| Research integrity | 0.002 | 0.002 |
| Insufficient payload (model declined to judge) | 0.001 | 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".