Leading Article Current views on aetiology and management of haemolytic uraemic syndrome
Why this work is in the frame
A frame that forgets how it found something cannot be audited. These are the routes that admitted this work.
Bibliographic record
Abstract
The haemolytic uraemic syndromes (HUS) are a heterogeneous group of disorders characterized by haemolytic anaemia, thrombocytopaenia and renal failure occurring predominantly in infants and young children. The disorder, which is acknow-ledged as the commonest cause of acute renal failure in children in Britain, is increasingly recog-nized in adults.23 Two broad subtypes are now recognized: the first is common in children and is associated with a diarrhoeal prodrome (D +), whereas the second is rare in childhood and not associated with antecedent diarrhoea (D-).4 D + HUS is synonymous with typical, prototypic, epidemic or enteropathic HUS and D- with atypical or sporadic disease. Many causes of D + HUS, mainly infectious agents,5`8 have been proposed but a strong associa-tion has now been found between D + HUS and enteric infection with verocytotoxin-producing Escherichia coli (VTEC).9'0 These organisms are associated with clinical conditions ranging from mild diarrhoea to haemorrhagic colitis and HUS.8"l ' VTEC strains of several serotypes have been isolated from patients with HUS, but the majority of such isolates belong to the serotype 01 57: H7. 2 VTEC produce 2 types ofverocytotoxin (VT1 and VT2),'3 which resemble Shiga toxin in structure and mode of action; linking D + cases to the HUS which may complicate Shigella dysen-teriae infections.'4 The toxins consist of a biologically active subunit A, linked to B subunits,'5"16 which bind to a specific cell surface glycoprotein GB3.'7 Once attached to the cell surface subunit A enters the cell and inhibits protein synthesis by inactivating 60s ribosomal subunits, which leads to cell death.'8 Karmali et al. found evidence ofVTEC infection in an estimated 75 % of Canadian children with D + HUS using a combination of laboratory methods, involving recovery of VTEC or neut-ralizable free verocytotoxin in faeces, and a rise in antibody titre to verocytotoxin.'0 A collaborative study by the British Association for Paediatric Nephrology, the Communicable Disease Surveil-lance Centre, and the Division of Enteric
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Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| 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 it