{
    "model": {
        "rank": 3407,
        "code": "thing-q168805",
        "model_id": "vr.tr.gangrene",
        "name": "gangrene",
        "purpose": "Enable an agent to recognise and document suspected or confirmed gangrene, assess threatened tissue and systemic deterioration, and support timely clinician-led decisions.",
        "family": "Thing Registry",
        "category": "Information and virtual systems",
        "status": "research-draft",
        "kind": "thing",
        "plane": "INF",
        "domain": "INF.KNW",
        "industry": "",
        "version": "",
        "url": "/models/thing/q168805/",
        "tier": 2,
        "score": 86,
        "payload": {
            "layer": "wikidata",
            "aliases": [
                "gangrene and necrosis of lung",
                "Chronic undermining burrowing ulcers",
                "Dermatitis gangrenosa"
            ],
            "aliasCount": 3,
            "merged": 3,
            "knownIn": 86,
            "facets": null,
            "markers": [],
            "lexicalClass": "",
            "senseRank": null,
            "alsoRegisteredAs": null,
            "source": {
                "dataset": "wikidata",
                "item": "Q168805",
                "url": "https://www.wikidata.org/wiki/Q168805",
                "license": "CC0 1.0"
            }
        },
        "research": {
            "vercy": "1.0-draft",
            "publication": {
                "status": "research-draft",
                "adjudicationStatus": "unreviewed",
                "publishableCanonical": false,
                "generatedAt": "2026-09-07T14:41:01Z",
                "providers": [
                    "Codex"
                ],
                "breadth": "recalled by Codex without web access - no source was read",
                "missingProviders": [],
                "pass": 2,
                "cost": {
                    "grok": {
                        "seconds": 22.5,
                        "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: 01a07c4f-6d2c-7403-8c33-8d22e880c666\n--------\nuser\nDescribe what is already known about one registered thing. Answer as JSON only, no prose around it.\n\nThing: gangrene\nSense to describe: (none recorded)\nDomain code: XCT.STA\nAlso known as: (none)\n\n\nContext for this batch of 546 things:\n# Batch 003: 1001 registe",
                        "usd": 0,
                        "recall": true
                    },
                    "codex": {
                        "seconds": 86.9,
                        "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: 01a07c4f-6d2b-73f2-b5c3-b4cb950dcea8\n--------\nuser\nYou are drafting a Vercy meta-model for one registered thing. Answer as JSON only, no prose around it.\n\nThing: gangrene\nRegistry id: vr.tr.gangrene\nPlane / domain: XCT / XCT.STA\nRegistry definition: (none recorded)\nNames folded into this entry: (none)\n\n\nContex"
                    }
                }
            },
            "metaModel": {
                "id": "THING-Q168805",
                "registryId": "vr.tr.gangrene",
                "name": "gangrene",
                "version": "0.1.0-research.1",
                "entryKind": "thing",
                "family": "Thing Registry",
                "domain": [
                    "XCT.STA"
                ],
                "status": "research-draft"
            },
            "canonicalUrl": "https://ver.cy/models/thing/q168805/",
            "model": {
                "registry_id": "vr.tr.gangrene",
                "name": "gangrene",
                "purpose": "Enable an agent to recognise and document suspected or confirmed gangrene, assess threatened tissue and systemic deterioration, and support timely clinician-led decisions.",
                "definition": "Gangrene is tissue necrosis caused by critically impaired blood supply, destructive infection, or both, most often affecting the extremities but also occurring in internal organs.",
                "scope_statement": "This model owns gangrene as a pathological tissue state under vr.tr.gangrene, XCT / XCT.STA: tissue death associated with loss of blood supply, infection, or their interaction, including its anatomical extent, diagnostic evidence, progression and management status. [NHS: Gangrene](https://www.nhs.uk/conditions/gangrene/)",
                "in_scope": [
                    "Suspected and confirmed gangrene affecting external tissues or internal organs",
                    "Dry, wet and gas gangrene descriptors, with evidence and uncertainty recorded separately",
                    "Location, depth, extent and viability of affected and adjacent tissue",
                    "Contributions from impaired perfusion, infection and local injury",
                    "Progression, systemic complications and clinician-directed management decisions"
                ],
                "out_of_scope": [
                    "Complete models of diabetes, peripheral arterial disease and other predisposing conditions",
                    "General necrosis, infarction and wounds without a gangrene assessment",
                    "Full organism taxonomy and antimicrobial pharmacology",
                    "Standalone sepsis and shock management protocols",
                    "Detailed surgical techniques, prosthetic design and rehabilitation programmes"
                ],
                "distinguishing_features": [
                    "Require evidence of tissue death or an explicit suspicion of it; reduced blood flow alone establishes ischemia, not confirmed gangrene.",
                    "Treat discoloration, coldness, numbness, swelling and discharge as supporting observations rather than individually decisive tests. [NHS: Gangrene](https://www.nhs.uk/conditions/gangrene/)",
                    "Distinguish gangrene from uncomplicated cellulitis or an ulcer by documenting the evidence for nonviable tissue and its extent.",
                    "Do not infer clostridial gas gangrene from tissue gas alone: other organisms can produce gas, and suspected clostridial myonecrosis requires urgent clinical assessment. [IDSA: Skin and soft tissue infection guideline](https://www.idsociety.org/practice-guideline/skin-and-soft-tissue-infections/)",
                    "Keep anatomical labels separate from mechanism and morphology; a named presentation must not automatically determine the organism, tissue depth or perfusion state."
                ],
                "characteristics": [
                    {
                        "name": "Diagnostic status",
                        "kind": "state",
                        "unit_or_values": "suspected | confirmed | excluded | unresolved; assessor, timestamp and evidence",
                        "why_it_matters": "Prevents an observation or provisional label from becoming an unsupported diagnosis."
                    },
                    {
                        "name": "Anatomical distribution",
                        "kind": "relation",
                        "unit_or_values": "body site, laterality, organ, tissue compartment and multiplicity",
                        "why_it_matters": "Locates the lesion and identifies which clinical service and neighbouring structures are relevant."
                    },
                    {
                        "name": "Gangrene descriptors",
                        "kind": "category",
                        "unit_or_values": "dry | wet | gas gangrene suspected | gas gangrene confirmed | mixed | unclassified; attributed terminology",
                        "why_it_matters": "Preserves clinical distinctions without forcing every presentation into one exclusive subtype."
                    },
                    {
                        "name": "Nonviable tissue extent",
                        "kind": "measurement",
                        "unit_or_values": "length and depth in cm, area in cm² where appropriate, or organ-specific extent; method and timestamp",
                        "why_it_matters": "Supports assessment of spread and planning while acknowledging limits of surface measurement."
                    },
                    {
                        "name": "Adjacent tissue viability",
                        "kind": "state",
                        "unit_or_values": "viable | threatened | nonviable | indeterminate; assessment method",
                        "why_it_matters": "Separates established tissue loss from tissue potentially amenable to preservation."
                    },
                    {
                        "name": "Perfusion evidence",
                        "kind": "measurement",
                        "unit_or_values": "test-specific results, such as pressure in mmHg, pressure ratios or imaging findings; site and interpretation",
                        "why_it_matters": "Records the evidence informing assessment of blood supply and potential restoration."
                    },
                    {
                        "name": "Infection assessment",
                        "kind": "state",
                        "unit_or_values": "suspected | supported | not currently supported | unknown; specimen, organism and sampling context when available",
                        "why_it_matters": "Separates clinical infection assessment from isolated microbiological results."
                    },
                    {
                        "name": "Progression",
                        "kind": "state",
                        "unit_or_values": "new | stable on serial assessment | extending | recurrent | indeterminate; observation interval",
                        "why_it_matters": "Makes change over time explicit rather than inferred from a single examination."
                    },
                    {
                        "name": "Systemic complication status",
                        "kind": "relation",
                        "unit_or_values": "linked assessments of sepsis, shock or organ dysfunction; suspected or confirmed",
                        "why_it_matters": "Connects local tissue injury to whole-person deterioration without duplicating those models."
                    },
                    {
                        "name": "Management status",
                        "kind": "state",
                        "unit_or_values": "awaiting specialist assessment | intervention planned | intervention underway | reassessment | recovery | comfort-focused care",
                        "why_it_matters": "Shows the responsible team, pending decisions and agreed goals."
                    }
                ],
                "affordances": [
                    "Assemble a time-stamped record of tissue findings and their diagnostic provenance.",
                    "Compare serial assessments to flag extension, new infection concerns or systemic deterioration.",
                    "Link gangrenous tissue to documented perfusion deficits, infection evidence and contributing conditions.",
                    "Route suspected gangrene for urgent clinical assessment; the NHS advises immediate emergency assessment when gangrene is suspected. [NHS: Gangrene](https://www.nhs.uk/conditions/gangrene/)",
                    "Track clinician-directed decisions about tissue removal, blood-supply restoration and infection treatment. [NHS: Gangrene](https://www.nhs.uk/conditions/gangrene/)",
                    "Expose missing evidence and unresolved tissue viability before a decision is treated as settled."
                ]
            },
            "sources": [],
            "structure": {
                "bundles": [
                    {
                        "id": "gangrene-identification",
                        "name": "Gangrene identification",
                        "description": "Establish what the gangrene label refers to and how strongly it is supported.",
                        "rationale": "Ischemia, discoloration and necrosis-related labels must not be collapsed into an unqualified gangrene diagnosis.",
                        "layers": [
                            {
                                "id": "tissue-death-evidence",
                                "name": "Tissue death evidence",
                                "description": "Record the basis for suspected or established nonviability.",
                                "findings": [
                                    {
                                        "id": "basis-of-gangrene-assessment",
                                        "name": "Basis of gangrene assessment",
                                        "description": "Keep direct examination, operative observations, imaging and pathology distinguishable, with assessor and date.",
                                        "questions": [
                                            {
                                                "text": "What evidence supports tissue death rather than ischemia or discoloration alone?",
                                                "kind": "boundary",
                                                "id": "basis-of-gangrene-assessment-q01"
                                            },
                                            {
                                                "text": "Who assessed the tissue, when, and using which examination or investigation?",
                                                "kind": "provenance",
                                                "id": "basis-of-gangrene-assessment-q02"
                                            }
                                        ]
                                    }
                                ]
                            },
                            {
                                "id": "presentation-classification",
                                "name": "Presentation classification",
                                "description": "Separate morphology, anatomical naming and suspected infectious mechanism.",
                                "findings": [
                                    {
                                        "id": "qualified-gangrene-descriptors",
                                        "name": "Qualified gangrene descriptors",
                                        "description": "Record the clinician's terminology and its supporting observations without allowing the label to supply missing evidence.",
                                        "questions": [
                                            {
                                                "text": "Which observations support the recorded dry, wet, gas or mixed descriptor?",
                                                "kind": "definition",
                                                "id": "qualified-gangrene-descriptors-q01"
                                            },
                                            {
                                                "text": "If gas gangrene is recorded, what supports clostridial myonecrosis beyond the presence of gas?",
                                                "kind": "boundary",
                                                "id": "qualified-gangrene-descriptors-q02"
                                            }
                                        ]
                                    }
                                ]
                            }
                        ]
                    },
                    {
                        "id": "anatomy-and-viability",
                        "name": "Anatomy and viability",
                        "description": "Represent the location and extent of dead tissue and the surrounding tissue at risk.",
                        "rationale": "A surface lesion and a deep or internal lesion require different evidence to establish their true extent.",
                        "layers": [
                            {
                                "id": "affected-tissue-map",
                                "name": "Affected tissue map",
                                "description": "Describe each affected site and tissue compartment.",
                                "findings": [
                                    {
                                        "id": "distribution-and-depth",
                                        "name": "Distribution and depth",
                                        "description": "Document visible involvement separately from suspected or demonstrated deeper involvement.",
                                        "questions": [
                                            {
                                                "text": "Which sites, sides, organs and tissue compartments are involved?",
                                                "kind": "measurement",
                                                "id": "distribution-and-depth-q01"
                                            },
                                            {
                                                "text": "How was the extent measured, and what involvement remains inaccessible to that method?",
                                                "kind": "measurement",
                                                "id": "distribution-and-depth-q02"
                                            }
                                        ]
                                    }
                                ]
                            },
                            {
                                "id": "viability-at-the-margin",
                                "name": "Viability at the margin",
                                "description": "Capture the assessed transition between nonviable, threatened and viable tissue.",
                                "findings": [
                                    {
                                        "id": "adjacent-tissue-assessment",
                                        "name": "Adjacent tissue assessment",
                                        "description": "Keep uncertainty about surrounding tissue explicit and attributable to a clinical assessment.",
                                        "questions": [
                                            {
                                                "text": "Which adjacent tissues are judged viable, threatened or indeterminate, and on what evidence?",
                                                "kind": "boundary",
                                                "id": "adjacent-tissue-assessment-q01"
                                            },
                                            {
                                                "text": "What reassessment is needed before the proposed tissue-preservation or removal decision?",
                                                "kind": "action",
                                                "id": "adjacent-tissue-assessment-q02"
                                            }
                                        ]
                                    }
                                ]
                            }
                        ]
                    },
                    {
                        "id": "perfusion-and-infection",
                        "name": "Perfusion and infection",
                        "description": "Represent the interacting mechanisms behind this gangrene episode.",
                        "rationale": "Management depends on the actual perfusion and infection findings, not merely on the word gangrene.",
                        "layers": [
                            {
                                "id": "blood-supply-failure",
                                "name": "Blood supply failure",
                                "description": "Connect affected tissue to evidence of impaired perfusion and its attributed cause.",
                                "findings": [
                                    {
                                        "id": "perfusion-deficit-and-cause",
                                        "name": "Perfusion deficit and cause",
                                        "description": "Record site-specific perfusion evidence and distinguish demonstrated causes from background risk factors.",
                                        "questions": [
                                            {
                                                "text": "What examination, pressure measurement or vascular imaging supports inadequate perfusion at this site?",
                                                "kind": "measurement",
                                                "id": "perfusion-deficit-and-cause-q01"
                                            },
                                            {
                                                "text": "Which vascular event, compression, injury or underlying condition is implicated, and how certain is that attribution?",
                                                "kind": "provenance",
                                                "id": "perfusion-deficit-and-cause-q02"
                                            }
                                        ]
                                    }
                                ]
                            },
                            {
                                "id": "infectious-involvement",
                                "name": "Infectious involvement",
                                "description": "Characterise clinical and microbiological evidence of infection in the affected tissue.",
                                "findings": [
                                    {
                                        "id": "infection-evidence-and-organisms",
                                        "name": "Infection evidence and organisms",
                                        "description": "Interpret microbiology with specimen depth, collection timing and prior treatment rather than equating any positive sample with invasive infection.",
                                        "questions": [
                                            {
                                                "text": "What supports invasive infection, and which tissue compartments are thought to be involved?",
                                                "kind": "boundary",
                                                "id": "infection-evidence-and-organisms-q01"
                                            },
                                            {
                                                "text": "Where and when were specimens obtained, what was detected, and had antimicrobial treatment already started?",
                                                "kind": "provenance",
                                                "id": "infection-evidence-and-organisms-q02"
                                            }
                                        ]
                                    }
                                ]
                            }
                        ]
                    },
                    {
                        "id": "progression-and-urgency",
                        "name": "Progression and urgency",
                        "description": "Assess local extension and whole-person deterioration over time.",
                        "rationale": "An apparently limited lesion must be interpreted alongside its trajectory and systemic effects.",
                        "layers": [
                            {
                                "id": "local-trajectory",
                                "name": "Local trajectory",
                                "description": "Compare observations of lesion extent, tissue appearance, sensation and pain.",
                                "findings": [
                                    {
                                        "id": "serial-change",
                                        "name": "Serial change",
                                        "description": "Record changes against dated observations, retaining uncertainty when examinations are not comparable.",
                                        "questions": [
                                            {
                                                "text": "Over what interval have the affected area, swelling, discharge, pain or sensation changed?",
                                                "kind": "measurement",
                                                "id": "serial-change-q01"
                                            },
                                            {
                                                "text": "Do the observations support stability or extension, and were they collected by comparable methods?",
                                                "kind": "boundary",
                                                "id": "serial-change-q02"
                                            }
                                        ]
                                    }
                                ]
                            },
                            {
                                "id": "systemic-deterioration",
                                "name": "Systemic deterioration",
                                "description": "Link local gangrene to current systemic assessment and escalation responsibility.",
                                "findings": [
                                    {
                                        "id": "urgent-assessment-and-escalation",
                                        "name": "Urgent assessment and escalation",
                                        "description": "Track emergency assessment and specialist involvement. Suspected gas gangrene warrants urgent surgical exploration and debridement under IDSA guidance. [IDSA guideline](https://www.idsociety.org/practice-guideline/skin-and-soft-tissue-infections/)",
                                        "questions": [
                                            {
                                                "text": "What current observations support suspected sepsis, shock or organ dysfunction?",
                                                "kind": "measurement",
                                                "id": "urgent-assessment-and-escalation-q01"
                                            },
                                            {
                                                "text": "Which team has accepted urgent assessment, and is any pending investigation delaying required intervention?",
                                                "kind": "action",
                                                "id": "urgent-assessment-and-escalation-q02"
                                            }
                                        ]
                                    }
                                ]
                            }
                        ]
                    },
                    {
                        "id": "intervention-and-residual-state",
                        "name": "Intervention and residual state",
                        "description": "Track clinical decisions and the tissue state remaining after intervention.",
                        "rationale": "Removing dead tissue, addressing its causes and preserving remaining function are distinct objectives.",
                        "layers": [
                            {
                                "id": "tissue-directed-decisions",
                                "name": "Tissue-directed decisions",
                                "description": "Represent proposed and completed interventions with their clinical rationale.",
                                "findings": [
                                    {
                                        "id": "intervention-rationale",
                                        "name": "Intervention rationale",
                                        "description": "Record decisions concerning debridement, amputation, perfusion restoration and infection treatment, including goals and responsible clinicians.",
                                        "questions": [
                                            {
                                                "text": "Which interventions are proposed or completed, and what tissue, perfusion or infection findings justify them?",
                                                "kind": "action",
                                                "id": "intervention-rationale-q01"
                                            },
                                            {
                                                "text": "How do assessed tissue viability, clinical feasibility and the person's goals shape the plan?",
                                                "kind": "action",
                                                "id": "intervention-rationale-q02"
                                            }
                                        ]
                                    }
                                ]
                            },
                            {
                                "id": "post-intervention-tissue-state",
                                "name": "Post-intervention tissue state",
                                "description": "Assess residual nonviability, ongoing causes and resulting tissue loss.",
                                "findings": [
                                    {
                                        "id": "residual-disease-and-function",
                                        "name": "Residual disease and function",
                                        "description": "Distinguish control of the gangrene episode from wound healing and recovery of function.",
                                        "questions": [
                                            {
                                                "text": "What evidence shows residual or recurrent necrosis, persistent infection or inadequate perfusion?",
                                                "kind": "measurement",
                                                "id": "residual-disease-and-function-q01"
                                            },
                                            {
                                                "text": "What tissue loss, healing needs and functional consequences require follow-up or linked rehabilitation records?",
                                                "kind": "action",
                                                "id": "residual-disease-and-function-q02"
                                            }
                                        ]
                                    }
                                ]
                            }
                        ]
                    },
                    {
                        "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-confidence-notes",
                                        "name": "Check these first",
                                        "description": "Recalled without web access and unsourced; every item is a lead to verify.",
                                        "evidence": [
                                            "This describes the medical condition; no alternative sense was supplied.",
                                            "The listed kinds overlap: dry and wet describe clinical appearance, whereas gas and Fournier gangrene identify infectious or anatomical patterns.",
                                            "Recalled information only; verify current coding rules and disease-specific exclusions before using I96."
                                        ],
                                        "questions": [
                                            {
                                                "id": "evidence-confidence-notes-q01",
                                                "text": "Which of these check these first hold for the sense of gangrene this model covers, and on what evidence?",
                                                "kind": "provenance"
                                            }
                                        ]
                                    },
                                    {
                                        "id": "evidence-kinds",
                                        "name": "Kinds and varieties",
                                        "description": "Recalled without web access and unsourced; every item is a lead to verify.",
                                        "evidence": [
                                            "Dry gangrene",
                                            "Wet gangrene",
                                            "Gas gangrene, typically clostridial myonecrosis",
                                            "Fournier gangrene, a necrotizing infection of the perineal, genital or perianal tissues"
                                        ],
                                        "questions": [
                                            {
                                                "id": "evidence-kinds-q01",
                                                "text": "Which of these kinds and varieties hold for the sense of gangrene this model covers, and on what evidence?",
                                                "kind": "provenance"
                                            }
                                        ]
                                    },
                                    {
                                        "id": "evidence-identifiers",
                                        "name": "Identifiers and schemes",
                                        "description": "Recalled without web access and unsourced; every item is a lead to verify.",
                                        "evidence": [
                                            {
                                                "scheme": "ICD-10",
                                                "value_or_pattern": "I96",
                                                "note": "World Health Organization category for gangrene, not elsewhere classified; gangrene associated with particular diseases or infections may require other codes."
                                            }
                                        ],
                                        "questions": [
                                            {
                                                "id": "evidence-identifiers-q01",
                                                "text": "Which of these identifiers and schemes hold for the sense of gangrene this model covers, and on what evidence?",
                                                "kind": "provenance"
                                            }
                                        ]
                                    },
                                    {
                                        "id": "evidence-real-world-use",
                                        "name": "Real-world use",
                                        "description": "Recalled without web access and unsourced; every item is a lead to verify.",
                                        "evidence": [
                                            "Recognition of irreversible tissue injury in vascular surgery, emergency medicine and wound care.",
                                            "Assessment of complications of peripheral arterial disease and diabetes-related foot disease.",
                                            "Distinguishing ischemic tissue loss from rapidly spreading necrotizing infection.",
                                            "Documentation of tissue loss and infection when planning revascularization, debridement or amputation."
                                        ],
                                        "questions": [
                                            {
                                                "id": "evidence-real-world-use-q01",
                                                "text": "Which of these real-world use hold for the sense of gangrene this model covers, and on what evidence?",
                                                "kind": "provenance"
                                            }
                                        ]
                                    },
                                    {
                                        "id": "evidence-measurements",
                                        "name": "Typical measurements",
                                        "description": "Recalled without web access and unsourced; every item is a lead to verify.",
                                        "evidence": [
                                            {
                                                "quantity": "Extent of affected tissue",
                                                "typical_range": "No universal range; documented by anatomical distribution, wound dimensions and depth.",
                                                "unit": "cm or cm² for wound dimensions or area"
                                            }
                                        ],
                                        "questions": [
                                            {
                                                "id": "evidence-measurements-q01",
                                                "text": "Which of these typical measurements hold for the sense of gangrene this model covers, and on what evidence?",
                                                "kind": "provenance"
                                            }
                                        ]
                                    },
                                    {
                                        "id": "evidence-failure-modes-and-hazards",
                                        "name": "Failure modes and hazards",
                                        "description": "Recalled without web access and unsourced; every item is a lead to verify.",
                                        "evidence": [
                                            "Permanent tissue loss, potentially requiring amputation.",
                                            "Secondary infection of initially dry gangrene.",
                                            "Rapid spread of infection and tissue destruction in wet or gas gangrene.",
                                            "Sepsis, shock, multiorgan failure and death.",
                                            "Delayed recognition when neuropathy reduces pain or affected tissue is not readily visible."
                                        ],
                                        "questions": [
                                            {
                                                "id": "evidence-failure-modes-and-hazards-q01",
                                                "text": "Which of these failure modes and hazards hold for the sense of gangrene this model covers, and on what evidence?",
                                                "kind": "provenance"
                                            }
                                        ]
                                    },
                                    {
                                        "id": "evidence-regional-variation",
                                        "name": "Regional variation",
                                        "description": "Recalled without web access and unsourced; every item is a lead to verify.",
                                        "evidence": [
                                            "Underlying causes and outcomes vary with the prevalence of diabetes and peripheral arterial disease and with access to vascular, surgical and infection care.",
                                            "Diagnostic coding varies between the WHO ICD classification and national modifications."
                                        ],
                                        "questions": [
                                            {
                                                "id": "evidence-regional-variation-q01",
                                                "text": "Which of these regional variation hold for the sense of gangrene this model covers, and on what evidence?",
                                                "kind": "provenance"
                                            }
                                        ]
                                    },
                                    {
                                        "id": "evidence-neighbours",
                                        "name": "Neighbouring kinds and how to tell them apart",
                                        "description": "Recalled without web access and unsourced; every item is a lead to verify.",
                                        "evidence": [
                                            {
                                                "name": "Necrosis",
                                                "difference": "Necrosis is the broader category of cell or tissue death; gangrene describes particular clinical patterns of tissue necrosis associated with ischemia or destructive infection."
                                            },
                                            {
                                                "name": "Ischemia",
                                                "difference": "Ischemia is inadequate blood supply and can be reversible; gangrene entails established tissue death."
                                            },
                                            {
                                                "name": "Necrotizing fasciitis",
                                                "difference": "Necrotizing fasciitis is an infection spreading through fascia and adjacent soft tissue; gangrene can arise without infection, although Fournier gangrene is a form of necrotizing fasciitis."
                                            },
                                            {
                                                "name": "Cellulitis",
                                                "difference": "Cellulitis is an infection of the skin and subcutaneous tissue that does not, by definition, entail tissue necrosis."
                                            },
                                            {
                                                "name": "Frostbite",
                                                "difference": "Frostbite is freezing injury that can cause gangrene; gangrene is the resulting tissue-death pattern rather than the cold exposure injury itself."
                                            }
                                        ],
                                        "questions": [
                                            {
                                                "id": "evidence-neighbours-q01",
                                                "text": "Which of these neighbouring kinds and how to tell them apart hold for the sense of gangrene this model covers, and on what evidence?",
                                                "kind": "provenance"
                                            }
                                        ]
                                    }
                                ]
                            }
                        ]
                    }
                ]
            },
            "openQuestions": [
                "Which operational definitions should govern dry, wet and mixed gangrene across vascular surgery, infectious disease and pathology records?",
                "What evidence is sufficient to confirm gangrene at each external or internal site when operative or histological confirmation is unavailable?",
                "Which extent and viability measures are sufficiently comparable for serial assessment, particularly across skin tones and in people with impaired sensation?",
                "How should Fournier gangrene and organ-specific gangrenous conditions link to this entry and neighbouring models without creating duplicate sources of truth?",
                "Which site-specific criteria establish episode resolution when a wound, perfusion deficit or functional impairment persists?"
            ],
            "statistics": {
                "bundles": 6,
                "layers": 11,
                "findings": 18,
                "questions": 28
            }
        },
        "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 gangrene, record what state it is in, and decide what may be done with it.",
            "whatItIs": "Enable an agent to recognise and document suspected or confirmed gangrene, assess threatened tissue and systemic deterioration, and support timely clinician-led 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: gangrene and necrosis of lung, Chronic undermining burrowing ulcers, Dermatitis gangrenosa.",
                "3 finer distinctions are held as aliases rather than separate entries, because telling them apart needs a task that asks for it.",
                "Described in 86 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 gangrene, 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": [
                        "gangrene and necrosis of lung",
                        "Chronic undermining burrowing ulcers",
                        "Dermatitis gangrenosa"
                    ]
                }
            ],
            "standing": "Described in 86 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 gangrene from another, and a gangrene 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 gangrene, 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 gangrene, 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 gangrene 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 gangrene, 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 gangrene, 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 gangrene 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 gangrene 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 gangrene, 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 gangrene, 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 gangrene 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 gangrene from the things most often confused with it.",
                                        "questions": [
                                            {
                                                "id": "distinguishing-features-q01",
                                                "text": "What identifies and describes what distinguishes a gangrene, 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 gangrene, 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 gangrene 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 gangrene 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 gangrene between them.",
                                        "questions": [
                                            {
                                                "id": "stages-and-transitions-q01",
                                                "text": "What identifies and describes the lifecycle of a gangrene, 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 gangrene, 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 gangrene 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 gangrene, how often and by whom.",
                                "findings": [
                                    {
                                        "id": "observation-record",
                                        "name": "Observation record",
                                        "description": "How an observation of a gangrene 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 gangrene, 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 gangrene, 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 gangrene 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 gangrene 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 gangrene contains and in what form it is held.",
                                        "questions": [
                                            {
                                                "id": "content-and-format-q01",
                                                "text": "What identifies and describes the content of a gangrene, 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 gangrene, 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 gangrene 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 gangrene and the period it survives.",
                                        "questions": [
                                            {
                                                "id": "access-rules-q01",
                                                "text": "What identifies and describes access to a gangrene, 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 gangrene, 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 gangrene 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 gangrene 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 gangrene 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 gangrene 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 gangrene 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 gangrene 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 gangrene, 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 gangrene 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 gangrene and how confident it is.",
                                        "questions": [
                                            {
                                                "id": "claim-provenance-q01",
                                                "text": "What identifies and describes a claim about a gangrene, 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 gangrene, 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 gangrene 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 gangrene is retired without being erased.",
                                        "questions": [
                                            {
                                                "id": "validity-and-supersession-q01",
                                                "text": "What identifies and describes the validity of a claim about a gangrene, 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 gangrene, 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 gangrene 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
            }
        }
    }
}