Bibliographic record
Abstract
Comment on: Underwater compression hemostasis method for active bleeding in underwater endoscopic submucosal dissection Endoscopy 2025; 57(S 01): E257-E258 DOI: 10.1055/a-2556-5656 10.1055/a-2556-5656 Bleeding control is a key step during endoscopic submucosal dissection (ESD). Identification and precoagulation of vessels is ideal, but when bleeding occurs, a rapid and structured response is critical. Accumulated blood can quickly obscure the dissection field – especially in underwater conditions or gravity-dependent locations. This video emphasizes the fundamental first step in managing active bleeding: precise compression using the distal cap (as bidigital compression is the first step for epistaxis control), combined with generous irrigation, to restore visibility and buy time for hemostatic intervention. The second step involves progressively releasing pressure while carefully maneuvering the endoscope to localize the bleeding vessel. This everyday technique should be mastered and taught to avoid blind coagulation. However, pressure intensity must be controlled, as excessive force may risk mechanical perforation, particularly in fragile areas such as the sigmoid or duodenum. Publication History Article published online: 29 July 2025 © 2025. Thieme. All rights reserved. Georg Thieme Verlag KG Oswald-Hesse-Straße 50, 70469 Stuttgart, Germany
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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 | 0.005 | 0.047 |
| Meta-epidemiology (narrow) | 0.002 | 0.001 |
| Meta-epidemiology (broad) | 0.002 | 0.003 |
| Bibliometrics | 0.002 | 0.001 |
| Science and technology studies | 0.006 | 0.003 |
| Scholarly communication | 0.007 | 0.004 |
| Open science | 0.003 | 0.005 |
| Research integrity | 0.066 | 0.042 |
| Insufficient payload (model declined to judge) | 0.071 | 0.031 |
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".