{ "vercy": "1.0-draft", "publication": { "status": "research-draft", "adjudicationStatus": "unreviewed", "publishableCanonical": false, "generatedAt": "2026-09-12T10:59:45Z", "providers": [ "Codex" ], "breadth": "recalled by Codex without web access - no source was read", "missingProviders": [], "pass": 2, "cost": { "grok": { "seconds": 20.2, "error": "Reading additional input from stdin...\nOpenAI Codex v0.153.4\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: 01a09544-ffa7-7da3-b4ad-f7b660c1143d\n--------\nuser\nDescribe what is already known about one registered thing. Answer as JSON only, no prose around it.\n\nThing: livedo reticularis\nSense to describe: (none recorded)\nDomain code: XCT.STA\nAlso known as: (none)\n\n\nContext for this batch of 1001 things:\n# Batch 044: 1", "usd": 0.0, "recall": true }, "codex": { "seconds": 63.8, "error": "Reading additional input from stdin...\nOpenAI Codex v0.153.4\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: 01a09544-ffac-7fa1-869e-4ef17f4e1d85\n--------\nuser\nYou are drafting a Vercy meta-model for one registered thing. Answer as JSON only, no prose around it.\n\nThing: livedo reticularis\nRegistry id: vr.tr.livedo-reticularis\nPlane / domain: XCT / XCT.STA\nRegistry definition: (none recorded)\nNames folded into this en" } }, "enrichment": { "pass": 3, "engine": "claude", "producedAt": "2026-10-06T12:00:00Z", "ingestedAt": "2026-10-06T08:39:52+00:00", "fields": [ "agent_conduct", "ethics", "owners" ] }, "gate": { "passed": true, "version": "1.0", "at": "2026-10-07T10:10:28+00:00", "evidence": [ "completeness 1.00", "sense: Wikidata description", "2 live sources", "review by codex: pass" ] } }, "metaModel": { "id": "THING-Q2003151", "registryId": "vr.tr.livedo-reticularis", "name": "livedo reticularis", "version": "0.1.0-research.1", "entryKind": "thing", "family": "Thing Registry", "domain": [ "XCT.STA" ], "status": "research-draft" }, "canonicalUrl": "https://ver.cy/models/thing/q2003151/", "model": { "registry_id": "vr.tr.livedo-reticularis", "name": "livedo reticularis", "purpose": "Enable an agent to recognise, document and follow livedo reticularis while distinguishing the observed skin pattern from its possible causes and identifying when clinical assessment is needed.", "definition": "Livedo reticularis is a cutaneous vascular sign consisting of a netlike pattern of reddish-blue or violaceous discoloration caused by altered blood flow and oxygenation in the skin's microcirculation.", "scope_statement": "This model owns the observable skin state registered as vr.tr.livedo-reticularis in XCT / XCT.STA: netlike discoloration, its distribution, thermal response, course and clinical interpretation, with explicit links to separately modelled causes and related conditions.", "in_scope": [ "Recognition and documentation of reticular skin discoloration", "Distribution, symmetry, persistence and response to warming", "Evidence supporting physiological, primary, secondary or unresolved classification", "Boundaries with livedo racemosa and other reticulate eruptions", "Associated symptoms, assessment decisions and longitudinal change" ], "out_of_scope": [ "Complete models of antiphospholipid syndrome, vasculitis and other underlying diseases", "Livedoid vasculopathy as a distinct ulcerating vascular disorder", "Congenital vascular malformations and their systemic features", "Full models of Raynaud phenomenon, acrocyanosis and heat-induced skin injury", "Laboratory assay specifications, biopsy procedures and disease-specific prescribing" ], "distinguishing_features": [ "Look for interconnected reddish-blue or violaceous borders surrounding paler skin, forming a network rather than isolated patches. [PCDS clinical guidance](https://www.pcds.org.uk/clinical-guidance/livedo-reticularis)", "Record regular complete rings versus irregular broken segments; the latter supports a livedo racemosa description, although terminology varies. [PCDS clinical guidance](https://www.pcds.org.uk/clinical-guidance/livedo-reticularis)", "Establish whether cold brings out the pattern and warming reduces it; persistence alone does not establish a secondary cause. [DermNet clinical overview](https://dermnetnz.org/topics/livedo-reticularis)", "Check for painful ulcers and white scars, which require consideration of livedoid vasculopathy rather than treating the presentation as discoloration alone. [PCDS clinical guidance](https://www.pcds.org.uk/clinical-guidance/livedo-reticularis)", "Establish birth onset and repeated local heat exposure when separating acquired livedo from congenital or heat-related reticulate presentations. [DermNet clinical overview](https://dermnetnz.org/topics/livedo-reticularis)" ], "characteristics": [ { "name": "Network geometry", "kind": "category", "unit_or_values": "regular complete rings; irregular broken segments; mixed; indeterminate", "why_it_matters": "Makes the morphological basis of the label inspectable." }, { "name": "Anatomical distribution", "kind": "category", "unit_or_values": "body sites, laterality and localised or widespread extent", "why_it_matters": "Supports comparison between episodes and assessment of atypical spread." }, { "name": "Response to warming", "kind": "state", "unit_or_values": "resolves; partially fades; unchanged; not assessed", "why_it_matters": "Records thermal behaviour without converting it into a diagnosis." }, { "name": "Observation conditions", "kind": "measurement", "unit_or_values": "ambient temperature in degrees Celsius and elapsed observation time in minutes, when available", "why_it_matters": "Makes before-and-after observations interpretable." }, { "name": "Episode duration", "kind": "measurement", "unit_or_values": "minutes, hours or days; ongoing duration recorded separately", "why_it_matters": "Distinguishes transient episodes from a continuously visible pattern." }, { "name": "Skin integrity", "kind": "state", "unit_or_values": "intact; ulcerated; necrotic; scarred; unassessed", "why_it_matters": "Separates colour change from associated tissue injury." }, { "name": "Clinical classification", "kind": "category", "unit_or_values": "physiological; primary or idiopathic; secondary; unresolved, with assessor and terminology source", "why_it_matters": "Preserves attribution and uncertainty in the interpretation." }, { "name": "Candidate cause", "kind": "relation", "unit_or_values": "linked exposure or condition with suspected, supported, excluded or unresolved status", "why_it_matters": "Prevents an association from being represented as an established cause." } ], "affordances": [ "Describe and compare the reticular pattern across documented observations.", "Record change with ordinary warming and environmental conditions.", "Flag atypical morphology, tissue injury or associated symptoms for clinical review.", "Link candidate causes to supporting and conflicting evidence.", "Track clinician-directed assessment and the skin response to management." ], "agent_conduct": { "may": [ "Describe livedo reticularis as a skin sign and its harmless and serious causes, citing sources.", "Suggest seeing a clinician when the pattern is new, persistent or comes with other symptoms." ], "must_not": [ "Diagnose the underlying cause from a photo or description.", "Dismiss the sign as cosmetic when it may point to vascular or autoimmune disease.", "Alarm a person by naming serious diseases as certain causes.", "Store or share skin images of a person without consent." ], "requires_human": [ "Any decision about investigating or treating the cause." ] }, "ethics": { "considerations": [ "The same pattern can be harmless or a sign of serious illness; overconfidence either way harms.", "Skin photos are personal health data." ], "affected_parties": [ "Patients", "People with autoimmune or vascular disease" ] }, "owners": { "steward": "Nobody owns the sign; clinicians answer for each patient's care.", "master_systems": [] }, "what_it_is_for": [ "Livedo reticularis is encountered during observation or clinical examination of the skin, often on the limbs.", "Documenting its distribution, persistence and associated symptoms helps clinicians assess whether the finding reflects a transient response or an underlying condition." ], "standards_and_regulation": [ "The International Classification of Diseases, Tenth Revision, issued by the World Health Organization, includes livedo reticularis in its classification of skin signs." ], "visual_identification": [ "Reddish-blue or purplish lines form a lace-like network around relatively pale areas of skin.", "The pattern consists of interconnected rings or meshes rather than isolated spots or uniform discoloration.", "The affected surface usually remains flat, so the network is primarily a colour change rather than a raised eruption." ], "failure_modes_and_hazards": [ "Treating a persistent or symptomatic pattern as harmless can delay recognition of an underlying vascular or systemic disorder.", "Confusing the finding with bruising, inflammation or another vascular pattern can lead to inaccurate documentation and inappropriate care.", "Inferring a specific disease from the appearance alone can cause unnecessary alarm or inappropriate treatment." ] }, "sources": [ { "id": "wikidata", "title": "Wikidata item Q2003151: livedo reticularis", "url": "https://www.wikidata.org/wiki/Q2003151", "url_status": "live", "what_it_supports": "identity and sense of the item", "checked_by": "wikidata-api" }, { "id": "wikipedia-en", "title": "Wikipedia: Livedo reticularis", "url": "https://en.wikipedia.org/wiki/Livedo_reticularis", "url_status": "live", "what_it_supports": "general description of the item", "checked_by": "wikidata-api sitelink" } ], "structure": { "bundles": [ { "id": "reticular-pattern-recognition", "name": "Reticular pattern recognition", "description": "Establish what is visible before assigning a diagnostic interpretation.", "rationale": "A livedo label is useful only when its underlying morphology and observational limits are recorded.", "layers": [ { "id": "network-and-colour", "name": "Network and colour", "description": "Capture the arrangement of discoloration and intervening skin.", "findings": [ { "id": "observable-reticulation", "name": "Observable reticulation", "description": "Record ring continuity, branching, colour contrast and whether the evidence comes from examination or an image.", "questions": [ { "text": "Does the discoloration form connected borders around paler centres, and are those borders complete or broken?", "kind": "definition", "id": "observable-reticulation-q01" }, { "text": "Who observed the pattern, under what lighting, and with what limits on visibility?", "kind": "provenance", "id": "observable-reticulation-q02" } ] } ] }, { "id": "body-map-and-integrity", "name": "Body map and integrity", "description": "Locate the pattern and document accompanying surface changes.", "findings": [ { "id": "mapped-skin-involvement", "name": "Mapped skin involvement", "description": "Maintain a site-specific account of symmetry, extent and intact or damaged skin.", "questions": [ { "text": "Which sites are involved, and is the pattern bilateral, asymmetric or confined to one area?", "kind": "measurement", "id": "mapped-skin-involvement-q01" }, { "text": "Are ulcers, necrosis, nodules or scars present within or beside the network?", "kind": "boundary", "id": "mapped-skin-involvement-q02" } ] } ] } ] }, { "id": "thermal-response-and-course", "name": "Thermal response and course", "description": "Describe when the pattern appears, fades and recurs.", "rationale": "A single photograph cannot establish persistence or the relationship to temperature.", "layers": [ { "id": "cold-and-warming-observations", "name": "Cold and warming observations", "description": "Compare visibility across recorded thermal conditions.", "findings": [ { "id": "documented-thermal-response", "name": "Documented thermal response", "description": "Separate reported cold sensitivity from directly observed change with warming.", "questions": [ { "text": "Was cold exposure reported or observed before the pattern appeared?", "kind": "provenance", "id": "documented-thermal-response-q01" }, { "text": "After ordinary warming, how much did the pattern fade and over what observed interval?", "kind": "measurement", "id": "documented-thermal-response-q02" } ] } ] }, { "id": "onset-and-recurrence", "name": "Onset and recurrence", "description": "Establish the temporal history of the skin state.", "findings": [ { "id": "episode-history", "name": "Episode history", "description": "Record first appearance, continuously affected periods, recurrences and intervals without visible livedo.", "questions": [ { "text": "Was the pattern present at birth, first noticed later, or of uncertain onset?", "kind": "provenance", "id": "episode-history-q01" }, { "text": "Between episodes does the skin return to its usual appearance, and has duration or extent changed?", "kind": "measurement", "id": "episode-history-q02" } ] } ] } ] }, { "id": "classification-and-causal-evidence", "name": "Classification and causal evidence", "description": "Separate descriptive terminology from hypotheses about the underlying process.", "rationale": "The same livedo label can conceal different morphology, mechanisms and levels of diagnostic certainty.", "layers": [ { "id": "terminology-and-neighbours", "name": "Terminology and neighbours", "description": "Preserve the meaning intended by the person or source applying the label.", "findings": [ { "id": "qualified-livedo-label", "name": "Qualified livedo label", "description": "Record whether livedo reticularis is being used narrowly or as an umbrella term, retaining the observed features independently.", "questions": [ { "text": "Does the assessor distinguish livedo racemosa from livedo reticularis, and which definition is being applied?", "kind": "definition", "id": "qualified-livedo-label-q01" }, { "text": "What evidence favours this label over a congenital reticulate lesion, heat-related eruption or another vascular colour change?", "kind": "boundary", "id": "qualified-livedo-label-q02" } ] } ] }, { "id": "exposure-and-disease-links", "name": "Exposure and disease links", "description": "Organise candidate explanations without asserting causation from appearance alone.", "findings": [ { "id": "supported-causal-attribution", "name": "Supported causal attribution", "description": "Maintain the timing and evidential status of medication, environmental and systemic-condition links.", "questions": [ { "text": "Which exposures or diagnosed conditions preceded the livedo, and what evidence connects them to it?", "kind": "provenance", "id": "supported-causal-attribution-q01" }, { "text": "What assessment supports a physiological, idiopathic or secondary interpretation, and what alternatives remain unresolved?", "kind": "boundary", "id": "supported-causal-attribution-q02" } ] } ] } ] }, { "id": "clinical-assessment-and-follow-up", "name": "Clinical assessment and follow-up", "description": "Connect the observed skin state to review decisions and subsequent outcomes.", "rationale": "The agent must distinguish documenting an appearance from establishing that observation alone is sufficient.", "layers": [ { "id": "associated-concerns", "name": "Associated concerns", "description": "Capture features that affect the need and urgency of clinical assessment.", "findings": [ { "id": "review-trigger-evidence", "name": "Review trigger evidence", "description": "Persistent pathological livedo warrants clinical investigation; record the clinician's assessment and rationale. [PCDS clinical guidance](https://www.pcds.org.uk/clinical-guidance/livedo-reticularis)", "questions": [ { "text": "Is the pattern accompanied by pain, tissue injury, neurological symptoms or systemic illness?", "kind": "measurement", "id": "review-trigger-evidence-q01" }, { "text": "What review urgency was assigned, by whom, and which observed features justified it?", "kind": "action", "id": "review-trigger-evidence-q02" } ] } ] }, { "id": "assessment-results-and-response", "name": "Assessment results and response", "description": "Track whether assessment or management changes the interpretation and course.", "findings": [ { "id": "interpretable-follow-up", "name": "Interpretable follow-up", "description": "Link clinician-directed investigations and management to dated skin observations, retaining unresolved causes.", "questions": [ { "text": "Which clinical question did each investigation address, and how did its result change the interpretation?", "kind": "provenance", "id": "interpretable-follow-up-q01" }, { "text": "Following the agreed management, did the network's persistence, extent or associated symptoms change under comparable conditions?", "kind": "measurement", "id": "interpretable-follow-up-q02" }, { "text": "Which changes should trigger reassessment, and who is responsible for follow-up?", "kind": "action", "id": "interpretable-follow-up-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-confidence-notes", "name": "Check these first", "description": "Recalled without web access and unsourced; every item is a lead to verify.", "evidence": [ "This description is based on recall; no sources were consulted.", "Classification varies between references, especially the distinction between primary and idiopathic livedo and the boundary with livedo racemosa.", "Diagnostic codes should be checked against the intended coding system and jurisdiction; none is asserted here." ], "questions": [ { "id": "evidence-confidence-notes-q01", "text": "Which of these check these first hold for the sense of livedo reticularis 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": [ "Physiological livedo reticularis associated with cold exposure, often termed cutis marmorata", "Primary livedo reticularis without an identified underlying disorder", "Secondary livedo reticularis associated with an underlying disorder or medication" ], "questions": [ { "id": "evidence-kinds-q01", "text": "Which of these kinds and varieties hold for the sense of livedo reticularis 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": [ "Recorded as a physical examination finding rather than necessarily a disease in its own right.", "Distribution, persistence and response to warming help distinguish physiological mottling from potentially pathological livedo.", "Associated symptoms and examination findings guide investigation for vascular, autoimmune, haematological or medication-related causes." ], "questions": [ { "id": "evidence-real-world-use-q01", "text": "Which of these real-world use hold for the sense of livedo reticularis 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": [ "Persistent or atypical livedo can accompany vascular occlusion or systemic disease.", "Pain, ulceration or tissue necrosis suggests clinically significant vascular pathology beyond uncomplicated physiological mottling.", "Confusing livedo reticularis with livedo racemosa can obscure associations with antiphospholipid syndrome or Sneddon syndrome.", "The appearance alone does not establish a specific underlying diagnosis." ], "questions": [ { "id": "evidence-failure-modes-and-hazards-q01", "text": "Which of these failure modes and hazards hold for the sense of livedo reticularis 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": "Livedo racemosa", "difference": "Typically forms irregular, broken, branching networks with larger segments, whereas classic livedo reticularis forms a more regular network of closed rings; terminology sometimes overlaps." }, { "name": "Cutis marmorata", "difference": "Usually denotes transient physiological mottling induced by cold and resolving with warming; it overlaps with physiological livedo reticularis." }, { "name": "Cutis marmorata telangiectatica congenita", "difference": "A congenital vascular malformation with persistent reticulated discoloration, sometimes accompanied by skin atrophy or limb asymmetry." }, { "name": "Erythema ab igne", "difference": "A reticulated eruption associated with repeated heat exposure that commonly develops persistent brown pigmentation." }, { "name": "Livedoid vasculopathy", "difference": "A thrombotic cutaneous disorder characterised by painful recurrent ulcers and porcelain-white scars, rather than reticular discoloration alone." }, { "name": "Retiform purpura", "difference": "Produces branching, nonblanching purpura from vascular injury or occlusion, often with necrosis, rather than uncomplicated vascular mottling." } ], "questions": [ { "id": "evidence-neighbours-q01", "text": "Which of these neighbouring kinds and how to tell them apart hold for the sense of livedo reticularis this model covers, and on what evidence?", "kind": "provenance" } ] } ] } ] } ] }, "openQuestions": [ "Which terminology should this registry adopt where sources disagree about whether livedo racemosa belongs within livedo reticularis or is a distinct descriptive category?", "What reproducible warming protocol and observation interval, if any, are validated for documenting reversibility?", "How reliably can clinicians and image-based systems recognise network geometry across skin tones, lighting conditions and image quality?", "Which clinical features justify particular investigations in persistent livedo without other symptoms, and how consistent are recommendations across guidelines?", "Which measures of extent, persistence and patient impact are sufficiently validated for longitudinal comparison?" ], "statistics": { "bundles": 5, "layers": 9, "findings": 13, "questions": 22 } }