{ "model": { "rank": 2875, "code": "thing-q129279", "model_id": "vr.tr.dysentery", "name": "dysentery", "purpose": "Enable an AI agent to recognise a dysentery episode, assess its course and urgency, and support evidence-based clinical and transmission-control decisions.", "family": "Thing Registry", "category": "Information and virtual systems", "status": "research-draft", "kind": "thing", "plane": "INF", "domain": "INF.KNW", "industry": "", "version": "", "url": "/models/thing/q129279/", "tier": 2, "score": 95, "payload": { "layer": "wikidata", "aliases": [ "protozoal dysentery", "dysentercic syndrome", "bacillary dysentery" ], "aliasCount": 3, "merged": 3, "knownIn": 95, "facets": null, "markers": [], "lexicalClass": "", "senseRank": null, "alsoRegisteredAs": "vr.tr.dysentery", "source": { "dataset": "wikidata", "item": "Q129279", "url": "https://www.wikidata.org/wiki/Q129279", "license": "CC0 1.0" } }, "research": { "vercy": "1.0-draft", "publication": { "status": "research-draft", "adjudicationStatus": "unreviewed", "publishableCanonical": false, "generatedAt": "2026-09-07T13:26:07Z", "providers": [ "Codex", "Grok" ], "missingProviders": [], "pass": 2, "cost": { "grok": { "usd": 0.0099144, "turns": 1, "seconds": 156.9, "error": null }, "codex": { "seconds": 95.9, "error": "Reading additional input from stdin...\nOpenAI Codex v0.153.3\n--------\nworkdir: R:\\02_PROJECTS\\02_Meta_Models_Platforms\\Ver.cy\\current\\thing-registry-backlog\nmodel: gpt-6-astra\nprovider: openai\napproval: never\nsandbox: read-only\nreasoning effort: none\nreasoning summaries: none\nsession id: 01a07c07-6aa3-7792-852f-76ceea48a996\n--------\nuser\nYou are drafting a Vercy meta-model for one registered thing. Answer as JSON only, no prose around it.\n\nThing: dysentery\nRegistry id: vr.tr.dysentery\nPlane / domain: XCT / XCT.STA\nRegistry definition: (none recorded)\nNames folded into this entry: (none)\n\nA Ver" } } }, "metaModel": { "id": "THING-Q129279", "registryId": "vr.tr.dysentery", "name": "dysentery", "version": "0.1.0-research.1", "entryKind": "thing", "family": "Thing Registry", "domain": [ "XCT.STA" ], "status": "research-draft" }, "canonicalUrl": "https://ver.cy/models/thing/q129279/", "model": { "registry_id": "vr.tr.dysentery", "name": "dysentery", "purpose": "Enable an AI agent to recognise a dysentery episode, assess its course and urgency, and support evidence-based clinical and transmission-control decisions.", "definition": "Dysentery is invasive inflammatory colitis in which frequent, small-volume stools contain visible blood and mucus, usually with tenesmus, cramping and fever, caused by mucosal invasion of the large bowel - classically by Shigella spp. (bacillary dysentery) or Entamoeba histolytica (amoebic dysentery), and in practice also by Campylobacter, enteroinvasive Escherichia coli and a few other enteropathogens.", "scope_statement": "This model owns the dysentery episode represented by vr.tr.dysentery in XCT / XCT.STA: its defining observations, diagnostic uncertainty, severity, course and constraints on action, with links to the affected person, identified causes and care decisions.", "in_scope": [ "Evidence of diarrhoea with visible blood and the definition used to classify the episode", "Onset, stool pattern, associated symptoms and changes over time", "Hydration, systemic illness and factors affecting clinical urgency", "Evidence supporting infectious causes or alternative explanations", "Episode-specific treatment decisions, response and transmission precautions" ], "out_of_scope": [ "The person's complete longitudinal health record", "Pathogen taxonomy and organism biology independent of this episode", "Full models of shigellosis, amebiasis or other underlying diseases", "Independent models of inflammatory bowel disease and gastrointestinal bleeding", "Drug catalogues, prescribing protocols and antimicrobial surveillance systems", "Outbreak management and water or sanitation infrastructure" ], "distinguishing_features": [ "Establish diarrhoea with visible red blood in loose or watery stool; mucus alone or an occult-blood result does not establish the WHO operational definition. [WHO dysentery definition](https://www.emro.who.int/health-topics/dysentery/)", "Distinguish blood accompanying diarrhoeal stool from isolated rectal bleeding, blood only on wiping or an uncertain report of red stool.", "Keep syndrome recognition separate from identification of Shigella: shigellosis can produce watery, bloody or prolonged diarrhoea. [CDC clinical overview](https://www.cdc.gov/shigella/hcp/clinical-overview/index.html)", "Do not equate dysentery with amebiasis: amebic dysentery is one presentation, and laboratory identification must distinguish E. histolytica from similar organisms. [CDC amebiasis overview](https://www.cdc.gov/amebiasis/about/index.html)", "Record whether a noninfectious explanation remains plausible instead of treating visible blood as proof of an infectious cause." ], "characteristics": [ { "name": "Syndrome classification", "kind": "state", "unit_or_values": "Criteria met | suspected | criteria not met | unresolved; named definition and assessment time", "why_it_matters": "Separates recognition of the syndrome from certainty about its cause." }, { "name": "Visible stool blood", "kind": "category", "unit_or_values": "Present | absent | uncertain | not assessed; mixed in stool | surface only | wiping only | distribution unknown", "why_it_matters": "Preserves the observation central to classification and identifies ambiguous bleeding reports." }, { "name": "Stool frequency", "kind": "measurement", "unit_or_values": "Stools per recorded observation interval, with usual baseline", "why_it_matters": "Supports assessment of diarrhoea and its trajectory without losing the measurement period." }, { "name": "Stool consistency", "kind": "category", "unit_or_values": "Formed | loose | watery | mixed | unknown", "why_it_matters": "Distinguishes bloody diarrhoea from bleeding with otherwise formed stool." }, { "name": "Episode duration", "kind": "measurement", "unit_or_values": "Hours or days from reported onset; onset uncertainty recorded", "why_it_matters": "Supports reassessment of persistent illness and comparison with earlier observations." }, { "name": "Tenesmus and abdominal symptoms", "kind": "category", "unit_or_values": "Tenesmus, cramps, pain and tenderness: present | absent | unknown; severity and location when assessed", "why_it_matters": "Captures the clinical pattern and changes requiring review." }, { "name": "Body temperature", "kind": "measurement", "unit_or_values": "Degrees Celsius, measurement method and time; reported fever recorded separately", "why_it_matters": "Separates measured fever from recollection and supports assessment of systemic illness." }, { "name": "Hydration assessment", "kind": "state", "unit_or_values": "Clinician-assigned category under a named assessment method | not assessed; supporting signs", "why_it_matters": "Connects urgency and fluid-support decisions to documented evidence." }, { "name": "Cause attribution", "kind": "relation", "unit_or_values": "Links to suspected or established causes, with evidence, confidence and assessor", "why_it_matters": "Prevents treatment assumptions based solely on the syndrome name." }, { "name": "Diagnostic evidence", "kind": "relation", "unit_or_values": "Links to specimens, test methods, results, collection times and interpretation", "why_it_matters": "Makes etiological claims and unresolved test limitations inspectable." }, { "name": "Clinical trajectory", "kind": "state", "unit_or_values": "Worsening | unchanged | improving | symptoms resolved | recurrent | unknown", "why_it_matters": "Supports reassessment while keeping symptom resolution separate from transmission clearance." }, { "name": "Transmission-relevant context", "kind": "relation", "unit_or_values": "Links to exposures, symptomatic contacts, shared settings and applicable public-health instructions", "why_it_matters": "Supports proportionate precautions without asserting an unproven source or transmission chain." } ], "affordances": [ "Classify an episode against an explicit dysentery definition while preserving uncertainty.", "Assemble a time-based clinical summary for assessment and escalation.", "Identify missing stool observations, diagnostic evidence or severity assessments.", "Check a documented treatment proposal against cause-specific guidance and patient constraints.", "Track clinical response and trigger reassessment under an applicable care plan.", "Support episode-specific precautions, reporting review and return-to-activity decisions." ] }, "sources": [ { "id": "who-shigellosis-2005", "title": "Guidelines for the control of shigellosis, including epidemics due to Shigella dysenteriae type 1 - World Health Organization (2005)", "url": "", "what_it_supports": "Clinical picture of bacillary dysentery, epidemic S. dysenteriae type 1, control measures, case-fatality in outbreaks, and public-health response." }, { "id": "who-diarrhoea-manual-2005", "title": "The treatment of diarrhoea: a manual for physicians and other senior health workers, 4th revision - World Health Organization (2005)", "url": "", "what_it_supports": "Operational definition of dysentery as diarrhoea with blood in the stool and its place in primary-care treatment algorithms." }, { "id": "kotloff-lancet-2018", "title": "Shigellosis - Kotloff KL, Riddle MS, Platts-Mills JA, Pavlinac P, Zaidi AKM, The Lancet (2018)", "url": "https://doi.org/10.1016/S0140-6736(17)33296-8", "what_it_supports": "Species distribution, infectious dose, incubation, complications including HUS, antimicrobial resistance, and high-income versus endemic epidemiology.", "url_status": "live" }, { "id": "haque-nejm-2003", "title": "Amebiasis - Haque R, Huston CD, Hughes M, Boettner E, Petri WA Jr, New England Journal of Medicine (2003)", "url": "https://doi.org/10.1056/NEJMra022710", "what_it_supports": "Invasive intestinal amoebiasis as amoebic dysentery, extra-intestinal abscess, diagnostic distinction from non-pathogenic Entamoeba, and treatment.", "url_status": "blocked" }, { "id": "icd10-who", "title": "ICD-10, chapter I (A00-A09 intestinal infectious diseases) - World Health Organization", "url": "", "what_it_supports": "Coding split between shigellosis (A03) and acute amoebic dysentery (A06.0) rather than a single residual 'dysentery' code." }, { "id": "cdc-shigella", "title": "Shigella / shigellosis disease pages and National Notifiable Diseases case definition - Centers for Disease Control and Prevention", "url": "https://www.cdc.gov/shigella/", "what_it_supports": "Surveillance practice in the United States, sexual-network outbreaks, and organism-named reporting in place of the older syndromic label.", "url_status": "live" } ], "structure": { "bundles": [ { "id": "bloody-diarrhoea-recognition", "name": "Bloody diarrhoea recognition", "description": "Establish whether the observed episode warrants the dysentery label.", "rationale": "The model must recognise a syndrome without making its cause part of the definition.", "layers": [ { "id": "defining-stool-observations", "name": "Defining stool observations", "description": "Record the diarrhoeal pattern and evidence of visible blood.", "findings": [ { "id": "diarrhoea-with-visible-blood", "name": "Diarrhoea with visible blood", "description": "Retain stool consistency, change from baseline and blood observations as distinct evidence supporting classification.", "questions": [ { "text": "Were loose or watery stools and visible blood observed within the same episode?", "kind": "definition", "id": "diarrhoea-with-visible-blood-q01" }, { "text": "Who observed the stool, when, and was the account direct or reported?", "kind": "provenance", "id": "diarrhoea-with-visible-blood-q02" }, { "text": "How did stool frequency and consistency differ from the person's usual pattern?", "kind": "measurement", "id": "diarrhoea-with-visible-blood-q03" } ] } ] }, { "id": "classification-boundaries", "name": "Classification boundaries", "description": "Resolve ambiguous bleeding descriptions and competing uses of the term dysentery.", "findings": [ { "id": "syndrome-definition-and-mimics", "name": "Syndrome definition and mimics", "description": "Attach the classification to an explicit definition and preserve observations that may instead indicate another bleeding presentation.", "questions": [ { "text": "Which clinical or surveillance definition supports the dysentery label?", "kind": "definition", "id": "syndrome-definition-and-mimics-q01" }, { "text": "Could the report represent isolated rectal bleeding, stool discoloration or occult blood without visible bloody diarrhoea?", "kind": "boundary", "id": "syndrome-definition-and-mimics-q02" } ] } ] } ] }, { "id": "cause-and-diagnostic-evidence", "name": "Cause and diagnostic evidence", "description": "Separate possible causes from supported attribution.", "rationale": "Similar bloody-diarrhoea presentations can require different investigations and management.", "layers": [ { "id": "etiological-assessment", "name": "Etiological assessment", "description": "Capture candidate infectious causes and competing noninfectious explanations.", "findings": [ { "id": "supported-cause-attribution", "name": "Supported cause attribution", "description": "Record each causal hypothesis, its supporting evidence and its unresolved alternatives without requiring a single premature diagnosis.", "questions": [ { "text": "Which findings support Shigella, E. histolytica, another infectious cause or a noninfectious explanation?", "kind": "provenance", "id": "supported-cause-attribution-q01" }, { "text": "What evidence would change or overturn the current attribution?", "kind": "boundary", "id": "supported-cause-attribution-q02" } ] } ] }, { "id": "stool-test-interpretation", "name": "Stool test interpretation", "description": "Relate laboratory evidence to the sampled episode and the limits of the method.", "findings": [ { "id": "specimen-result-and-limitations", "name": "Specimen result and limitations", "description": "Keep collection timing, prior treatment, organism identification and available susceptibility information together.", "questions": [ { "text": "Which specimen and method produced the result, and when was it collected relative to symptoms and treatment?", "kind": "provenance", "id": "specimen-result-and-limitations-q01" }, { "text": "Does the method distinguish the suspected pathogen from similar organisms or leave clinically relevant uncertainty?", "kind": "boundary", "id": "specimen-result-and-limitations-q02" }, { "text": "What additional testing or susceptibility evidence does the responsible clinician need before acting?", "kind": "action", "id": "specimen-result-and-limitations-q03" } ] } ] } ] }, { "id": "severity-and-clinical-course", "name": "Severity and clinical course", "description": "Represent present physiological impact and its evolution.", "rationale": "The bloody-stool label alone does not express urgency, fluid needs or deterioration.", "layers": [ { "id": "hydration-and-systemic-impact", "name": "Hydration and systemic impact", "description": "Assess fluid losses, intake and signs of serious illness in the person's clinical context.", "findings": [ { "id": "current-urgency-evidence", "name": "Current urgency evidence", "description": "Record hydration findings, ability to drink, urine output, vital signs and relevant host vulnerabilities with an explicit clinical assessment.", "questions": [ { "text": "What current observations describe hydration, oral intake, urine output and systemic illness?", "kind": "measurement", "id": "current-urgency-evidence-q01" }, { "text": "Which age, nutritional, immune or other patient factors alter interpretation of these observations?", "kind": "boundary", "id": "current-urgency-evidence-q02" }, { "text": "What escalation is indicated by the applicable clinical guidance and who is responsible for initiating it?", "kind": "action", "id": "current-urgency-evidence-q03" } ] } ] }, { "id": "trajectory-and-complications", "name": "Trajectory and complications", "description": "Track changes in bloody diarrhoea and evidence requiring reassessment.", "findings": [ { "id": "episode-progression", "name": "Episode progression", "description": "Compare successive observations and link suspected complications to their own clinical assessments.", "questions": [ { "text": "How have blood in stool, stool frequency, pain, fever and hydration changed since onset and intervention?", "kind": "measurement", "id": "episode-progression-q01" }, { "text": "Do persistent symptoms, recurrent bleeding or new systemic findings require investigation of a complication or alternative diagnosis?", "kind": "action", "id": "episode-progression-q02" } ] } ] } ] }, { "id": "care-decisions-and-response", "name": "Care decisions and response", "description": "Make episode-specific care decisions and their evidential basis inspectable.", "rationale": "An agent needs to distinguish supportive care, cause-directed treatment and unresolved prescribing decisions.", "layers": [ { "id": "fluid-support-and-care-setting", "name": "Fluid support and care setting", "description": "Connect assessed losses and drinking ability to the responsible clinician's care plan.", "findings": [ { "id": "supportive-care-feasibility", "name": "Supportive care feasibility", "description": "Record planned fluid support, ability to receive it and the basis for the selected care setting.", "questions": [ { "text": "What fluid-support plan is documented, and can the person receive and tolerate it?", "kind": "action", "id": "supportive-care-feasibility-q01" }, { "text": "What findings determine whether the current care setting and reassessment interval remain adequate?", "kind": "boundary", "id": "supportive-care-feasibility-q02" } ] } ] }, { "id": "cause-directed-treatment-review", "name": "Cause-directed treatment review", "description": "Record medication decisions against diagnosis, contraindications and relevant guidance.", "findings": [ { "id": "treatment-rationale-and-safety", "name": "Treatment rationale and safety", "description": "Preserve the reason to start, withhold or change treatment. Include review of antimotility exposure; CDC advises against these medicines in bloody diarrhoea. [CDC treatment guidance](https://www.cdc.gov/shigella/treatment/index.html)", "questions": [ { "text": "What suspected or established cause and current guidance justify starting, withholding or changing an antimicrobial?", "kind": "action", "id": "treatment-rationale-and-safety-q01" }, { "text": "Have susceptibility results, allergies, patient-specific constraints and antimotility medicine use been reviewed?", "kind": "action", "id": "treatment-rationale-and-safety-q02" }, { "text": "What observed response or adverse effect would trigger review of the treatment decision?", "kind": "measurement", "id": "treatment-rationale-and-safety-q03" } ] } ] } ] }, { "id": "exposure-and-transmission-decisions", "name": "Exposure and transmission decisions", "description": "Connect the episode to plausible exposures and applicable precautions.", "rationale": "Managing a suspected infectious episode requires decisions beyond symptom relief without assuming a proven transmission route.", "layers": [ { "id": "exposure-and-cluster-context", "name": "Exposure and cluster context", "description": "Capture relevant food, water, travel, contact and shared-setting histories.", "findings": [ { "id": "plausible-acquisition-links", "name": "Plausible acquisition links", "description": "Represent exposures and linked illnesses as hypotheses with dates and evidence.", "questions": [ { "text": "Which food, water, travel, caregiving or sexual-contact exposures occurred before onset, and when?", "kind": "provenance", "id": "plausible-acquisition-links-q01" }, { "text": "Are there similarly ill contacts or shared exposures that warrant an outbreak-assessment link?", "kind": "boundary", "id": "plausible-acquisition-links-q02" } ] } ] }, { "id": "precautions-and-episode-closure", "name": "Precautions and episode closure", "description": "Separate clinical recovery from public-health restrictions and their release criteria.", "findings": [ { "id": "activity-and-clearance-decisions", "name": "Activity and clearance decisions", "description": "Record applicable precautions, reporting decisions and criteria for resuming relevant activities with their issuing authority.", "questions": [ { "text": "Which precautions or activity restrictions apply to this suspected cause, setting and jurisdiction?", "kind": "action", "id": "activity-and-clearance-decisions-q01" }, { "text": "Which authority and dated guidance support any reporting, exclusion or clearance requirement?", "kind": "provenance", "id": "activity-and-clearance-decisions-q02" }, { "text": "What evidence permits symptom-based episode closure, and what separate evidence is required to release transmission-related restrictions?", "kind": "boundary", "id": "activity-and-clearance-decisions-q03" } ] } ] } ] }, { "id": "evidence-and-external-alignment", "name": "Evidence and external alignment", "description": "What the world already says about this thing, gathered so the model can be checked against it.", "rationale": "A model that cannot be lined up against existing standards, identifiers and practice cannot be adopted by anyone who already uses them.", "layers": [ { "id": "reported-evidence", "name": "Reported evidence", "description": "Findings from the breadth pass, kept separate from the structural claims.", "findings": [ { "id": "evidence-kinds", "name": "Kinds and varieties", "description": "Reported by the breadth pass; each item needs checking against its source before it becomes normative.", "evidence": [ "Bacillary dysentery (shigellosis: Shigella dysenteriae, S. flexneri, S. boydii, S. sonnei)", "Amoebic dysentery (invasive intestinal infection by Entamoeba histolytica)", "Epidemic Shiga dysentery (S. dysenteriae type 1)", "Campylobacter colitis presenting as dysentery", "Enteroinvasive E. coli (EIEC) dysentery", "Balantidial dysentery (Balantidium coli)", "Sexually transmitted shigellosis (notably in men-who-have-sex-with-men networks)", "Syndromic bloody diarrhoea as used in WHO IMCI (visible blood in stool, organism not yet identified)" ], "questions": [ { "id": "evidence-kinds-q01", "text": "Which of these kinds and varieties hold for the sense of dysentery this model covers, and on what evidence?", "kind": "provenance" } ] }, { "id": "evidence-identifiers", "name": "Identifiers and schemes", "description": "Reported by the breadth pass; each item needs checking against its source before it becomes normative.", "evidence": [ { "scheme": "Wikidata", "value_or_pattern": "Q129279", "note": "Item for dysentery as a disease." }, { "scheme": "MeSH", "value_or_pattern": "D004403", "note": "Dysentery; narrower headings D004405 (bacillary) and D004404 (amebic)." }, { "scheme": "ICD-10", "value_or_pattern": "A03", "note": "Shigellosis (bacillary dysentery), with fourth-character species splits." }, { "scheme": "ICD-10", "value_or_pattern": "A06.0", "note": "Acute amoebic dysentery." }, { "scheme": "ICD-11", "value_or_pattern": "1A02", "note": "Shigellosis; amoebic disease is coded under amoebiasis (1A36), not under a single parent 'dysentery'." }, { "scheme": "SNOMED CT", "value_or_pattern": "111566002", "note": "Dysentery (disorder); organism-specific descendants are preferred in current coding." } ], "questions": [ { "id": "evidence-identifiers-q01", "text": "Which of these identifiers and schemes hold for the sense of dysentery this model covers, and on what evidence?", "kind": "provenance" } ] }, { "id": "evidence-standards-and-regulation", "name": "Standards and regulation", "description": "Reported by the breadth pass; each item needs checking against its source before it becomes normative.", "evidence": [ "WHO Guidelines for the control of shigellosis, including epidemics due to Shigella dysenteriae type 1 (World Health Organization, 2005)", "WHO/UNICEF Integrated Management of Childhood Illness: blood in the stool is classified and treated as dysentery (World Health Organization)", "WHO Model List of Essential Medicines: ciprofloxacin, azithromycin and ceftriaxone for shigellosis; metronidazole or tinidazole (then a luminal agent) for invasive amoebiasis (World Health Organization)", "CDC/CSTE national notifiable disease case definition for shigellosis (Centers for Disease Control and Prevention / Council of State and Territorial Epidemiologists)", "EU case definition for shigellosis used in TESSy reporting (European Centre for Disease Prevention and Control)", "International Health Regulations (2005): not a named IHR disease, but clusters may be assessed as events that may constitute a public health emergency of international concern (World Health Organization)" ], "questions": [ { "id": "evidence-standards-and-regulation-q01", "text": "Which of these standards and regulation hold for the sense of dysentery this model covers, and on what evidence?", "kind": "provenance" } ] }, { "id": "evidence-real-world-use", "name": "Real-world use", "description": "Reported by the breadth pass; each item needs checking against its source before it becomes normative.", "evidence": [ "Primary-care and IMCI clinics treat any diarrhoea with visible blood as dysentery before an organism is known.", "Hospitals work up acute bloody diarrhoea with stool culture, multiplex PCR, microscopy or antigen tests, then name the disease by organism (shigellosis, amoebic colitis, Campylobacter colitis).", "Outbreak investigation in refugee camps, after floods, in day-care and institutions, and historically in armies and ships.", "Sexual-health and public-health teams investigate shigella clusters among men who have sex with men in high-income cities.", "National laboratories track extensively drug-resistant Shigella because oral options are running out.", "Travel and tropical-medicine clinics distinguish bacillary from amoebic disease because the drugs differ." ], "questions": [ { "id": "evidence-real-world-use-q01", "text": "Which of these real-world use hold for the sense of dysentery this model covers, and on what evidence?", "kind": "provenance" } ] }, { "id": "evidence-measurements", "name": "Typical measurements", "description": "Reported by the breadth pass; each item needs checking against its source before it becomes normative.", "evidence": [ { "quantity": "Infectious dose (Shigella)", "typical_range": "10-100", "unit": "CFU" }, { "quantity": "Incubation, bacillary (Shigella)", "typical_range": "1-3 (range about 0.5-4)", "unit": "days" }, { "quantity": "Incubation, amoebic dysentery", "typical_range": "7-28 (often 1-4 weeks)", "unit": "days" }, { "quantity": "Stool frequency in frank dysentery", "typical_range": "8-20 small bloody stools", "unit": "stools/day" }, { "quantity": "Duration of untreated bacillary dysentery", "typical_range": "5-7", "unit": "days" }, { "quantity": "Case fatality, untreated S. dysenteriae type 1 epidemics", "typical_range": "5-15", "unit": "%" }, { "quantity": "Fever in bacillary dysentery", "typical_range": "38-40", "unit": "°C" } ], "questions": [ { "id": "evidence-measurements-q01", "text": "Which of these typical measurements hold for the sense of dysentery this model covers, and on what evidence?", "kind": "provenance" } ] }, { "id": "evidence-failure-modes-and-hazards", "name": "Failure modes and hazards", "description": "Reported by the breadth pass; each item needs checking against its source before it becomes normative.", "evidence": [ "Person-to-person and sexual spread at a very low infectious dose, including in households, day-care and MSM networks.", "Dehydration, hypoglycaemia and death in young children, the malnourished and the frail.", "Haemolytic uraemic syndrome from Shiga toxin, especially S. dysenteriae type 1 (and from STEC if the case was mislabelled dysentery and given antibiotics).", "Toxic megacolon and colonic perforation, particularly in untreated severe amoebic colitis.", "Amoebic liver (and rarer brain) abscess after intestinal invasion.", "Seizures and toxic encephalopathy in children with shigellosis.", "Reactive arthritis after Shigella or Campylobacter.", "Extensively drug-resistant Shigella leaving few or no reliable oral drugs.", "Wrong drug class: antibacterial therapy does not treat E. histolytica; metronidazole does not treat shigellosis; empiric antibiotics can worsen STEC." ], "questions": [ { "id": "evidence-failure-modes-and-hazards-q01", "text": "Which of these failure modes and hazards hold for the sense of dysentery this model covers, and on what evidence?", "kind": "provenance" } ] }, { "id": "evidence-regional-variation", "name": "Regional variation", "description": "Reported by the breadth pass; each item needs checking against its source before it becomes normative.", "evidence": [ "In WHO/UNICEF child-health programmes across Africa and South Asia the working name is still the syndrome 'dysentery' (blood in stool); US and much of European hospital practice prefers 'infectious colitis' or the organism name.", "S. sonnei predominates in high-income countries; S. flexneri in endemic low- and middle-income settings; S. dysenteriae type 1 caused large late-20th-century epidemics in Central/East Africa and South Asia and is now uncommon.", "Invasive amoebiasis is concentrated in parts of Mexico, the Indian subcontinent, western and southern Africa, and parts of South America, not in high-income temperate cities except among travellers and migrants.", "Azithromycin- and ciprofloxacin-resistant S. sonnei/flexneri now circulate in Europe, North America and Australia, especially in sexual networks.", "Historical English 'bloody flux' and Japanese notifiable 'sekiri' (赤痢) named the same syndrome; modern Japanese and ICD practice split shigellosis from amoebiasis." ], "questions": [ { "id": "evidence-regional-variation-q01", "text": "Which of these regional variation hold for the sense of dysentery this model covers, and on what evidence?", "kind": "provenance" } ] }, { "id": "evidence-neighbours", "name": "Neighbouring kinds and how to tell them apart", "description": "Reported by the breadth pass; each item needs checking against its source before it becomes normative.", "evidence": [ { "name": "STEC/EHEC haemorrhagic colitis", "difference": "Typically little or no fever and few faecal leukocytes; Shiga-toxin/PCR or culture for non-Shigella E. coli; antibiotics are avoided because of HUS risk." }, { "name": "Ulcerative colitis (first attack)", "difference": "Repeated negative stool tests for pathogens, chronic relapsing course, and endoscopic/histologic chronic colitis rather than an acute self-limited or outbreak-linked illness." }, { "name": "Clostridioides difficile colitis", "difference": "Recent antibiotics or healthcare exposure plus stool toxin/NAAT for C. difficile; not a classical camp or travel dysentery." }, { "name": "Amoebic versus bacillary dysentery (each other)", "difference": "Bacillary disease is explosive over hours to a few days with high fever; amoebic disease is more subacute. Microscopy/antigen/PCR for E. histolytica versus Shigella culture/PCR; liver abscess points to amoeba." }, { "name": "Non-invasive watery diarrhoea (including cholera)", "difference": "Large-volume watery stool without visible blood or tenesmus; vibrio or enterotoxin work-up rather than invasive colitis." }, { "name": "Ischaemic colitis", "difference": "Older patient with vascular risk, sudden left-sided pain, and watershed injury on imaging/endoscopy; stool tests for enteropathogens are negative." }, { "name": "Enteric fever (typhoid)", "difference": "Prolonged fever, relative bradycardia and bacteraemia on blood culture; stool is not typically frequent small bloody motions of colitis." }, { "name": "Childhood intussusception", "difference": "Currant-jelly stool with intermittent pain and a target sign on ultrasound, not an infectious colitis of the whole colon." } ], "questions": [ { "id": "evidence-neighbours-q01", "text": "Which of these neighbouring kinds and how to tell them apart hold for the sense of dysentery this model covers, and on what evidence?", "kind": "provenance" } ] } ] } ] } ] }, "openQuestions": [ "Should the registry adopt the WHO visible-blood syndrome definition exclusively, or accommodate clinical usages that imply an infectious cause?", "Which age-specific and setting-specific severity assessments should govern escalation, particularly when measurements are unavailable?", "What minimum diagnostic evidence should distinguish suspected from established bacterial or amebic attribution across settings with different laboratory capabilities?", "How should current local guidance address empiric treatment when etiology is unresolved, including possible Shiga toxin-producing organisms and antimicrobial resistance?", "Which clinical recovery, recurrence and jurisdiction-specific transmission-clearance criteria should determine episode closure?" ], "statistics": { "bundles": 6, "layers": 11, "findings": 18, "questions": 33 } }, "draft": { "generator": "vr.draft.v3", "status": "draft-generated", "researched": false, "archetype": "discipline or field of knowledge", "method": "Written from the archetype playbook - what this kind of thing needs beyond identity and provenance - and from the structure that recurred across 6,333 models already researched by two engines. Applied to this entry by rule. No source was read for this thing and no claim here is researched. This entry carries no facets of its own, so they were inferred from its domain - a guess about a whole domain applied to one thing.", "facetsInferred": true, "nextPass": "A researcher replaces this draft with a sourced specification. Treat every sentence below as a proposal to argue with.", "purpose": "Give an agent a durable, checkable way to recognise a dysentery, record what state it is in, and decide what may be done with it.", "whatItIs": "Enable an AI agent to recognise a dysentery episode, assess its course and urgency, and support evidence-based clinical and transmission-control decisions.", "characteristics": { "substance": "information", "origin": "conceptual", "agency": "inert" }, "whatYouCanDoWithIt": [ "read and interpreted" ], "distinguishingFeatures": [ "Names folded into this entry, which a task may need to split apart again: protozoal dysentery, dysentercic syndrome, bacillary dysentery.", "3 finer distinctions are held as aliases rather than separate entries, because telling them apart needs a task that asks for it.", "Described in 95 Wikipedia languages, which is a measure of how widely the thing is known, not of how important it is." ], "openQuestionsForResearch": [ "Which of the bundles below does a real task actually need, and which are ceremony?", "What does this thing have that the facets do not capture at all?", "Which neighbouring kind is most often confused with a dysentery, and on what evidence are they told apart?" ], "whatItIsMadeOf": "content that has to be carried by something else", "physicalCharacter": [ "Does nothing on its own; everything it does, something else did to it.", "These come from the domain this entry sits in rather than from the entry itself, so treat them as a first guess about the whole domain applied to one thing." ], "whatCanBeDoneWithIt": [ "read it and act on what it says" ], "howItIsRecognised": [], "relatedModels": [ { "relation": "covers", "note": "Finer kinds folded into this entry because telling them apart needs a task that asks for it. Each is a model waiting to be split out when one does.", "targets": [ "protozoal dysentery", "dysentercic syndrome", "bacillary dysentery" ] } ], "standing": "Described in 95 Wikipedia languages, which measures how widely it is written about rather than how important or how common it is. 3 finer distinctions are held inside this entry as names rather than as separate models.", "structure": { "bundles": [ { "id": "identity-and-classification", "name": "Identity, naming and classification", "description": "How an agent tells one dysentery from another, and a dysentery from things that resemble it.", "rationale": "Recognition comes before every other claim. Without stable identity nothing else in the model can be trusted to be about the same thing twice.", "layers": [ { "id": "naming-and-identifiers", "name": "Names and identifiers", "description": "The names this thing goes by and the identifiers that survive translation and time.", "findings": [ { "id": "preferred-name-and-aliases", "name": "Preferred name, aliases and local names", "description": "Which name to use, which names mean the same thing, and which merely sound similar.", "questions": [ { "id": "preferred-name-and-aliases-q01", "text": "What identifies and describes the name of a dysentery, and in what units or vocabulary?", "kind": "definition", "answer_data": [ "identifiers", "types and classes", "values with units", "explicit unknowns" ] }, { "id": "preferred-name-and-aliases-q02", "text": "Who or what asserted this about the name of a dysentery, by which method, and when was it true?", "kind": "provenance", "answer_data": [ "authority", "method", "evidence", "event time", "knowledge time" ] }, { "id": "preferred-name-and-aliases-q03", "text": "What may an agent decide or do once the name of a dysentery is known, and what must it refuse?", "kind": "action", "answer_data": [ "permitted actions", "preconditions", "refusals", "escalation" ] } ] }, { "id": "stable-identifiers", "name": "Stable identifiers and external keys", "description": "Identifiers that keep pointing at this kind of thing across systems and languages.", "questions": [ { "id": "stable-identifiers-q01", "text": "What identifies and describes an identifier for a dysentery, and in what units or vocabulary?", "kind": "definition", "answer_data": [ "identifiers", "types and classes", "values with units", "explicit unknowns" ] }, { "id": "stable-identifiers-q02", "text": "Who or what asserted this about an identifier for a dysentery, by which method, and when was it true?", "kind": "provenance", "answer_data": [ "authority", "method", "evidence", "event time", "knowledge time" ] }, { "id": "stable-identifiers-q03", "text": "What may an agent decide or do once an identifier for a dysentery is known, and what must it refuse?", "kind": "action", "answer_data": [ "permitted actions", "preconditions", "refusals", "escalation" ] } ] } ] }, { "id": "classification-and-granularity", "name": "Classification and granularity", "description": "Where a dysentery sits among kinds, and how finely a task needs to cut it.", "findings": [ { "id": "kind-and-parents", "name": "Kind, parents and neighbouring kinds", "description": "The classes this thing belongs to and the ones it is next to.", "questions": [ { "id": "kind-and-parents-q01", "text": "What identifies and describes the kind of a dysentery, and in what units or vocabulary?", "kind": "definition", "answer_data": [ "identifiers", "types and classes", "values with units", "explicit unknowns" ] }, { "id": "kind-and-parents-q02", "text": "Who or what asserted this about the kind of a dysentery, by which method, and when was it true?", "kind": "provenance", "answer_data": [ "authority", "method", "evidence", "event time", "knowledge time" ] }, { "id": "kind-and-parents-q03", "text": "What may an agent decide or do once the kind of a dysentery is known, and what must it refuse?", "kind": "action", "answer_data": [ "permitted actions", "preconditions", "refusals", "escalation" ] } ] }, { "id": "distinguishing-features", "name": "Distinguishing features", "description": "What separates a dysentery from the things most often confused with it.", "questions": [ { "id": "distinguishing-features-q01", "text": "What identifies and describes what distinguishes a dysentery, and in what units or vocabulary?", "kind": "definition", "answer_data": [ "identifiers", "types and classes", "values with units", "explicit unknowns" ] }, { "id": "distinguishing-features-q02", "text": "Who or what asserted this about what distinguishes a dysentery, by which method, and when was it true?", "kind": "provenance", "answer_data": [ "authority", "method", "evidence", "event time", "knowledge time" ] }, { "id": "distinguishing-features-q03", "text": "What may an agent decide or do once what distinguishes a dysentery is known, and what must it refuse?", "kind": "action", "answer_data": [ "permitted actions", "preconditions", "refusals", "escalation" ] } ] } ] } ] }, { "id": "state-and-lifecycle", "name": "State and lifecycle", "description": "The states a dysentery passes through and the events that move it between them.", "rationale": "Most decisions about a thing depend on what state it is in now, which is a claim with a time on it, not a property.", "layers": [ { "id": "lifecycle-stages", "name": "Lifecycle stages", "description": "From coming into existence to ceasing to be one of these.", "findings": [ { "id": "stages-and-transitions", "name": "Stages and transitions", "description": "The stages worth naming and what moves a dysentery between them.", "questions": [ { "id": "stages-and-transitions-q01", "text": "What identifies and describes the lifecycle of a dysentery, and in what units or vocabulary?", "kind": "definition", "answer_data": [ "identifiers", "types and classes", "values with units", "explicit unknowns" ] }, { "id": "stages-and-transitions-q02", "text": "Who or what asserted this about the lifecycle of a dysentery, by which method, and when was it true?", "kind": "provenance", "answer_data": [ "authority", "method", "evidence", "event time", "knowledge time" ] }, { "id": "stages-and-transitions-q03", "text": "What may an agent decide or do once the lifecycle of a dysentery is known, and what must it refuse?", "kind": "action", "answer_data": [ "permitted actions", "preconditions", "refusals", "escalation" ] } ] } ] }, { "id": "observations-and-status", "name": "Observations and current status", "description": "What is observed about a dysentery, how often and by whom.", "findings": [ { "id": "observation-record", "name": "Observation record", "description": "How an observation of a dysentery is recorded so that it can be superseded rather than overwritten.", "questions": [ { "id": "observation-record-q01", "text": "What identifies and describes an observation of a dysentery, and in what units or vocabulary?", "kind": "definition", "answer_data": [ "identifiers", "types and classes", "values with units", "explicit unknowns" ] }, { "id": "observation-record-q02", "text": "Who or what asserted this about an observation of a dysentery, by which method, and when was it true?", "kind": "provenance", "answer_data": [ "authority", "method", "evidence", "event time", "knowledge time" ] }, { "id": "observation-record-q03", "text": "What may an agent decide or do once an observation of a dysentery is known, and what must it refuse?", "kind": "action", "answer_data": [ "permitted actions", "preconditions", "refusals", "escalation" ] } ] } ] } ] }, { "id": "content-and-access", "name": "Content, encoding and access", "description": "What a dysentery says, how it is encoded and who may read it.", "rationale": "An informational thing carries content that can be copied, versioned and withheld, none of which its physical carrier explains.", "layers": [ { "id": "content-and-encoding", "name": "Content and encoding", "description": "The content itself, its format and its language.", "findings": [ { "id": "content-and-format", "name": "Content, format and language", "description": "What a dysentery contains and in what form it is held.", "questions": [ { "id": "content-and-format-q01", "text": "What identifies and describes the content of a dysentery, and in what units or vocabulary?", "kind": "definition", "answer_data": [ "identifiers", "types and classes", "values with units", "explicit unknowns" ] }, { "id": "content-and-format-q02", "text": "Who or what asserted this about the content of a dysentery, by which method, and when was it true?", "kind": "provenance", "answer_data": [ "authority", "method", "evidence", "event time", "knowledge time" ] }, { "id": "content-and-format-q03", "text": "What may an agent decide or do once the content of a dysentery is known, and what must it refuse?", "kind": "action", "answer_data": [ "permitted actions", "preconditions", "refusals", "escalation" ] } ] } ] }, { "id": "access-and-rights", "name": "Access, rights and retention", "description": "Who may read, copy or change it, and for how long it is kept.", "findings": [ { "id": "access-rules", "name": "Access rules and retention", "description": "The permissions attached to a dysentery and the period it survives.", "questions": [ { "id": "access-rules-q01", "text": "What identifies and describes access to a dysentery, and in what units or vocabulary?", "kind": "definition", "answer_data": [ "identifiers", "types and classes", "values with units", "explicit unknowns" ] }, { "id": "access-rules-q02", "text": "Who or what asserted this about access to a dysentery, by which method, and when was it true?", "kind": "provenance", "answer_data": [ "authority", "method", "evidence", "event time", "knowledge time" ] }, { "id": "access-rules-q03", "text": "What may an agent decide or do once access to a dysentery is known, and what must it refuse?", "kind": "action", "answer_data": [ "permitted actions", "preconditions", "refusals", "escalation" ] } ] } ] } ] }, { "id": "subject-and-method", "name": "Subject matter and method", "description": "What dysentery studies and how it establishes anything.", "rationale": "A field is identified by its questions and its methods, and those are what distinguish it from the fields next to it.", "layers": [ { "id": "subject", "name": "Subject matter", "description": "The questions it takes as its own.", "findings": [ { "id": "subject-record", "name": "Questions and objects of study", "description": "What it is about, stated so a neighbouring field can be told apart.", "questions": [ { "id": "subject-record-q01", "text": "What questions and objects does dysentery take as its own?", "kind": "definition" }, { "id": "subject-record-q02", "text": "Which questions does it share with a neighbouring field, and who claims them?", "kind": "boundary" } ] } ] }, { "id": "method", "name": "Method and evidence", "description": "How claims are established and what counts as evidence.", "findings": [ { "id": "method-record", "name": "Methods and standards of evidence", "description": "The methods used and what they are taken to establish.", "questions": [ { "id": "method-record-q01", "text": "By what methods does dysentery establish claims, and what counts as sufficient evidence?", "kind": "provenance" }, { "id": "method-record-q02", "text": "What kind of claim can this field not settle, and where should an agent look instead?", "kind": "action" } ] } ] } ] }, { "id": "institutions-and-classification", "name": "Institutions and classification", "description": "Where dysentery is practised and how catalogues place it.", "rationale": "The institutional footprint is the evidence that a field exists as a field rather than as a topic.", "layers": [ { "id": "institutions", "name": "Institutional markers", "description": "Societies, journals, degrees and departments.", "findings": [ { "id": "institution-record", "name": "Bodies and venues", "description": "Where the field organises itself.", "questions": [ { "id": "institution-record-q01", "text": "Which societies, journals or degrees mark dysentery as an established field?", "kind": "provenance" }, { "id": "institution-record-q02", "text": "What would show that it is emerging or dissolving rather than established?", "kind": "boundary" } ] } ] }, { "id": "classification", "name": "Classification schemes", "description": "Where library and research classifications put it.", "findings": [ { "id": "classification-record", "name": "Codes and their disagreements", "description": "The classification codes that place it, and where they differ.", "questions": [ { "id": "classification-record-q01", "text": "Which classification schemes place dysentery, under what codes?", "kind": "definition" }, { "id": "classification-record-q02", "text": "Where do those schemes disagree about its scope?", "kind": "boundary" } ] } ] } ] }, { "id": "provenance-and-evidence", "name": "Provenance, evidence and time", "description": "Where every claim about a dysentery came from and when it held.", "rationale": "A claim without a source and a time cannot be superseded, only overwritten, and an agent that overwrites loses the ability to explain itself.", "layers": [ { "id": "source-and-authority", "name": "Source and authority", "description": "Who said it, on what evidence, and how strongly.", "findings": [ { "id": "claim-provenance", "name": "Claim provenance and confidence", "description": "The authority behind each claim about a dysentery and how confident it is.", "questions": [ { "id": "claim-provenance-q01", "text": "What identifies and describes a claim about a dysentery, and in what units or vocabulary?", "kind": "definition", "answer_data": [ "identifiers", "types and classes", "values with units", "explicit unknowns" ] }, { "id": "claim-provenance-q02", "text": "Who or what asserted this about a claim about a dysentery, by which method, and when was it true?", "kind": "provenance", "answer_data": [ "authority", "method", "evidence", "event time", "knowledge time" ] }, { "id": "claim-provenance-q03", "text": "What may an agent decide or do once a claim about a dysentery is known, and what must it refuse?", "kind": "action", "answer_data": [ "permitted actions", "preconditions", "refusals", "escalation" ] } ] } ] }, { "id": "time-and-versions", "name": "Time, versions and supersession", "description": "When a claim was true, when it was learnt, and what replaced it.", "findings": [ { "id": "validity-and-supersession", "name": "Validity period and supersession", "description": "How an old claim about a dysentery is retired without being erased.", "questions": [ { "id": "validity-and-supersession-q01", "text": "What identifies and describes the validity of a claim about a dysentery, and in what units or vocabulary?", "kind": "definition", "answer_data": [ "identifiers", "types and classes", "values with units", "explicit unknowns" ] }, { "id": "validity-and-supersession-q02", "text": "Who or what asserted this about the validity of a claim about a dysentery, by which method, and when was it true?", "kind": "provenance", "answer_data": [ "authority", "method", "evidence", "event time", "knowledge time" ] }, { "id": "validity-and-supersession-q03", "text": "What may an agent decide or do once the validity of a claim about a dysentery is known, and what must it refuse?", "kind": "action", "answer_data": [ "permitted actions", "preconditions", "refusals", "escalation" ] } ] } ] } ] } ] }, "statistics": { "bundles": 6, "layers": 12, "findings": 14, "questions": 38 } } } }