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  3. data/annotators_validate_data_(20_80)/Shama/annotation_results.json +1255 -0
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1312
+ "doc_id":73,
1313
+ "ai_label":"low_health_literacy",
1314
+ "rating_plaban":3,
1315
+ "category_plaban":"intermediate_health_literacy",
1316
+ "rating_mahi":2,
1317
+ "category_mahi":"low_health_literacy",
1318
+ "rating_shama":2,
1319
+ "category_shama":"low_health_literacy",
1320
+ "agreement_count":2
1321
+ },
1322
+ {
1323
+ "doc_id":73,
1324
+ "ai_label":"intermediate_health_literacy",
1325
+ "rating_plaban":4,
1326
+ "category_plaban":"proficient_health_literacy",
1327
+ "rating_mahi":3,
1328
+ "category_mahi":"intermediate_health_literacy",
1329
+ "rating_shama":3,
1330
+ "category_shama":"intermediate_health_literacy",
1331
+ "agreement_count":2
1332
+ },
1333
+ {
1334
+ "doc_id":73,
1335
+ "ai_label":"proficient_health_literacy",
1336
+ "rating_plaban":5,
1337
+ "category_plaban":"proficient_health_literacy",
1338
+ "rating_mahi":4,
1339
+ "category_mahi":"proficient_health_literacy",
1340
+ "rating_shama":4,
1341
+ "category_shama":"proficient_health_literacy",
1342
+ "agreement_count":3
1343
+ },
1344
+ {
1345
+ "doc_id":74,
1346
+ "ai_label":"low_health_literacy",
1347
+ "rating_plaban":3,
1348
+ "category_plaban":"intermediate_health_literacy",
1349
+ "rating_mahi":2,
1350
+ "category_mahi":"low_health_literacy",
1351
+ "rating_shama":1,
1352
+ "category_shama":"low_health_literacy",
1353
+ "agreement_count":2
1354
+ },
1355
+ {
1356
+ "doc_id":74,
1357
+ "ai_label":"proficient_health_literacy",
1358
+ "rating_plaban":5,
1359
+ "category_plaban":"proficient_health_literacy",
1360
+ "rating_mahi":5,
1361
+ "category_mahi":"proficient_health_literacy",
1362
+ "rating_shama":5,
1363
+ "category_shama":"proficient_health_literacy",
1364
+ "agreement_count":3
1365
+ },
1366
+ {
1367
+ "doc_id":75,
1368
+ "ai_label":"low_health_literacy",
1369
+ "rating_plaban":2,
1370
+ "category_plaban":"low_health_literacy",
1371
+ "rating_mahi":1,
1372
+ "category_mahi":"low_health_literacy",
1373
+ "rating_shama":1,
1374
+ "category_shama":"low_health_literacy",
1375
+ "agreement_count":3
1376
+ },
1377
+ {
1378
+ "doc_id":75,
1379
+ "ai_label":"proficient_health_literacy",
1380
+ "rating_plaban":5,
1381
+ "category_plaban":"proficient_health_literacy",
1382
+ "rating_mahi":5,
1383
+ "category_mahi":"proficient_health_literacy",
1384
+ "rating_shama":4,
1385
+ "category_shama":"proficient_health_literacy",
1386
+ "agreement_count":3
1387
+ },
1388
+ {
1389
+ "doc_id":76,
1390
+ "ai_label":"low_health_literacy",
1391
+ "rating_plaban":2,
1392
+ "category_plaban":"low_health_literacy",
1393
+ "rating_mahi":1,
1394
+ "category_mahi":"low_health_literacy",
1395
+ "rating_shama":1,
1396
+ "category_shama":"low_health_literacy",
1397
+ "agreement_count":3
1398
+ },
1399
+ {
1400
+ "doc_id":76,
1401
+ "ai_label":"proficient_health_literacy",
1402
+ "rating_plaban":5,
1403
+ "category_plaban":"proficient_health_literacy",
1404
+ "rating_mahi":4,
1405
+ "category_mahi":"proficient_health_literacy",
1406
+ "rating_shama":4,
1407
+ "category_shama":"proficient_health_literacy",
1408
+ "agreement_count":3
1409
+ },
1410
+ {
1411
+ "doc_id":77,
1412
+ "ai_label":"low_health_literacy",
1413
+ "rating_plaban":2,
1414
+ "category_plaban":"low_health_literacy",
1415
+ "rating_mahi":2,
1416
+ "category_mahi":"low_health_literacy",
1417
+ "rating_shama":1,
1418
+ "category_shama":"low_health_literacy",
1419
+ "agreement_count":3
1420
+ },
1421
+ {
1422
+ "doc_id":77,
1423
+ "ai_label":"intermediate_health_literacy",
1424
+ "rating_plaban":4,
1425
+ "category_plaban":"proficient_health_literacy",
1426
+ "rating_mahi":3,
1427
+ "category_mahi":"intermediate_health_literacy",
1428
+ "rating_shama":3,
1429
+ "category_shama":"intermediate_health_literacy",
1430
+ "agreement_count":2
1431
+ },
1432
+ {
1433
+ "doc_id":77,
1434
+ "ai_label":"proficient_health_literacy",
1435
+ "rating_plaban":5,
1436
+ "category_plaban":"proficient_health_literacy",
1437
+ "rating_mahi":5,
1438
+ "category_mahi":"proficient_health_literacy",
1439
+ "rating_shama":4,
1440
+ "category_shama":"proficient_health_literacy",
1441
+ "agreement_count":3
1442
+ },
1443
+ {
1444
+ "doc_id":78,
1445
+ "ai_label":"proficient_health_literacy",
1446
+ "rating_plaban":5,
1447
+ "category_plaban":"proficient_health_literacy",
1448
+ "rating_mahi":5,
1449
+ "category_mahi":"proficient_health_literacy",
1450
+ "rating_shama":5,
1451
+ "category_shama":"proficient_health_literacy",
1452
+ "agreement_count":3
1453
+ },
1454
+ {
1455
+ "doc_id":79,
1456
+ "ai_label":"low_health_literacy",
1457
+ "rating_plaban":3,
1458
+ "category_plaban":"intermediate_health_literacy",
1459
+ "rating_mahi":2,
1460
+ "category_mahi":"low_health_literacy",
1461
+ "rating_shama":2,
1462
+ "category_shama":"low_health_literacy",
1463
+ "agreement_count":2
1464
+ },
1465
+ {
1466
+ "doc_id":79,
1467
+ "ai_label":"intermediate_health_literacy",
1468
+ "rating_plaban":4,
1469
+ "category_plaban":"proficient_health_literacy",
1470
+ "rating_mahi":3,
1471
+ "category_mahi":"intermediate_health_literacy",
1472
+ "rating_shama":3,
1473
+ "category_shama":"intermediate_health_literacy",
1474
+ "agreement_count":2
1475
+ }
1476
+ ]
data/annotators_validate_data_(20_80)/code/correction_evaluation_full_text.json ADDED
The diff for this file is too large to render. See raw diff
 
data/annotators_validate_data_(20_80)/code/correction_evaluation_full_text_with_gs.json ADDED
The diff for this file is too large to render. See raw diff
 
data/annotators_validate_data_(20_80)/code/data_process.ipynb ADDED
@@ -0,0 +1,206 @@
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
1
+ {
2
+ "cells": [
3
+ {
4
+ "cell_type": "code",
5
+ "execution_count": null,
6
+ "id": "e78262c8",
7
+ "metadata": {},
8
+ "outputs": [],
9
+ "source": [
10
+ "import json\n",
11
+ "import pandas as pd\n",
12
+ "\n",
13
+ "def process_and_save_json(file_paths, annotator_names):\n",
14
+ " all_data = []\n",
15
+ " \n",
16
+ " # Load and categorize data\n",
17
+ " for path, name in zip(file_paths, annotator_names):\n",
18
+ " with open(path, 'r') as f:\n",
19
+ " df = pd.DataFrame(json.load(f))\n",
20
+ " \n",
21
+ " # Map ratings to health literacy categories\n",
22
+ " def map_rating(r):\n",
23
+ " if r in [1, 2]: return \"low_health_literacy\"\n",
24
+ " if r == 3: return \"intermediate_health_literacy\"\n",
25
+ " if r in [4, 5]: return \"proficient_health_literacy\"\n",
26
+ " return None\n",
27
+ "\n",
28
+ " df['human_category'] = df['rating'].apply(map_rating)\n",
29
+ " df = df[['doc_id', 'label', 'rating', 'human_category']]\n",
30
+ " \n",
31
+ " # Rename columns to distinguish between annotators\n",
32
+ " df = df.rename(columns={\n",
33
+ " 'rating': f'rating_{name}',\n",
34
+ " 'human_category': f'category_{name}',\n",
35
+ " 'label': 'ai_label'\n",
36
+ " })\n",
37
+ " all_data.append(df)\n",
38
+ "\n",
39
+ " # Merge all three dataframes\n",
40
+ " merged = all_data[0]\n",
41
+ " for next_df in all_data[1:]:\n",
42
+ " merged = pd.merge(merged, next_df, on=['doc_id', 'ai_label'])\n",
43
+ "\n",
44
+ " # Determine agreement count\n",
45
+ " cat_cols = [f'category_{name}' for name in annotator_names]\n",
46
+ " merged['agreement_count'] = merged.apply(\n",
47
+ " lambda row: sum(1 for col in cat_cols if row[col] == row['ai_label']), axis=1\n",
48
+ " )\n",
49
+ "\n",
50
+ " # Filter into two groups\n",
51
+ " agreement_data = merged[merged['agreement_count'] >= 2]\n",
52
+ " correction_needed = merged[merged['agreement_count'] < 2]\n",
53
+ "\n",
54
+ " # Export to JSON\n",
55
+ " agreement_data.to_json(\"/home/mshahidul/readctrl/data/annotators_validate_data_(20_80)/code/annotator_agreement.json\", orient=\"records\", indent=4)\n",
56
+ " correction_needed.to_json(\"/home/mshahidul/readctrl/data/annotators_validate_data_(20_80)/code/needs_correction.json\", orient=\"records\", indent=4)\n",
57
+ " \n",
58
+ " print(f\"Success! {len(agreement_data)} items agreed, {len(correction_needed)} need correction.\")\n",
59
+ "\n",
60
+ "# Usage\n",
61
+ "paths = [\n",
62
+ " \"/home/mshahidul/readctrl/data/annotators_validate_data_(20_80)/Plaban Das/annotation_results.json\",\n",
63
+ " \"/home/mshahidul/readctrl/data/annotators_validate_data_(20_80)/mahi/annotation_results.json\",\n",
64
+ " \"/home/mshahidul/readctrl/data/annotators_validate_data_(20_80)/Shama/annotation_results.json\"\n",
65
+ "]\n",
66
+ "names = [\"plaban\", \"mahi\", \"shama\"]\n",
67
+ "\n",
68
+ "process_and_save_json(paths, names)"
69
+ ]
70
+ },
71
+ {
72
+ "cell_type": "code",
73
+ "execution_count": null,
74
+ "id": "ab336faf",
75
+ "metadata": {},
76
+ "outputs": [],
77
+ "source": [
78
+ "import json\n",
79
+ "import pandas as pd\n",
80
+ "\n",
81
+ "def create_correction_evaluation_file(source_path, agreement_results_path, output_path):\n",
82
+ " # 1. Load the source full data\n",
83
+ " with open(source_path, 'r') as f:\n",
84
+ " source_data = json.load(f)\n",
85
+ " source_df = pd.DataFrame(source_data)\n",
86
+ " \n",
87
+ " # 2. Load the \"needs correction\" data generated from previous step\n",
88
+ " with open(agreement_results_path, 'r') as f:\n",
89
+ " correction_df = pd.DataFrame(json.load(f))\n",
90
+ " \n",
91
+ " # 3. Merge based on doc_id (annotation) == index (source)\n",
92
+ " # We only keep the rows that exist in the correction list\n",
93
+ " enriched_correction = pd.merge(\n",
94
+ " correction_df, \n",
95
+ " source_df[['index', 'fulltext', 'diff_label_texts']], \n",
96
+ " left_on='doc_id', \n",
97
+ " right_on='index', \n",
98
+ " how='left'\n",
99
+ " )\n",
100
+ " \n",
101
+ " # Optional: Clean up by dropping the redundant 'index' column\n",
102
+ " if 'index' in enriched_correction.columns:\n",
103
+ " enriched_correction = enriched_correction.drop(columns=['index'])\n",
104
+ " \n",
105
+ " # 4. Save to a new JSON file\n",
106
+ " enriched_correction.to_json(output_path, orient=\"records\", indent=4)\n",
107
+ " \n",
108
+ " print(f\"Evaluation file created: {output_path}\")\n",
109
+ " print(f\"Total entries for re-evaluation: {len(enriched_correction)}\")\n",
110
+ "\n",
111
+ "# Paths\n",
112
+ "source_file = '/home/mshahidul/readctrl/data/synthetic_dataset_diff_labels/syn_data_diff_labels_en_0_80_full.json'\n",
113
+ "correction_list = '/home/mshahidul/readctrl/data/annotators_validate_data_(20_80)/code/needs_correction.json' # The file created from the previous script\n",
114
+ "final_output = '/home/mshahidul/readctrl/data/annotators_validate_data_(20_80)/code/correction_evaluation_full_text.json'\n",
115
+ "\n",
116
+ "create_correction_evaluation_file(source_file, correction_list, final_output)"
117
+ ]
118
+ },
119
+ {
120
+ "cell_type": "code",
121
+ "execution_count": 27,
122
+ "id": "93f3ae03",
123
+ "metadata": {},
124
+ "outputs": [],
125
+ "source": [
126
+ "# /home/mshahidul/readctrl/data/synthetic_dataset_diff_labels/syn_data_diff_labels_en_0_80_full_updated.json\n",
127
+ "import json\n",
128
+ "with open(\"/home/mshahidul/readctrl/data/synthetic_dataset_diff_labels/syn_data_diff_labels_en_0_80_full_updated.json\", 'r') as f:\n",
129
+ " data = json.load(f)\n",
130
+ "text_map={}\n",
131
+ "for item in data:\n",
132
+ " for label in list(item['diff_label_texts'].keys()):\n",
133
+ " key=f\"{item['index']}_{label}\"\n",
134
+ " text_map[key] = {\n",
135
+ " 'fulltext': item['fulltext'],\n",
136
+ " \"diff_label_texts\": item['diff_label_texts'][label],\n",
137
+ " 'summary': item.get('summary')\n",
138
+ " }"
139
+ ]
140
+ },
141
+ {
142
+ "cell_type": "code",
143
+ "execution_count": 31,
144
+ "id": "c8d64fdf",
145
+ "metadata": {},
146
+ "outputs": [],
147
+ "source": [
148
+ "# /home/mshahidul/readctrl/data/annotators_validate_data_(20_80)/correction_data/final_corrected_anu.json\n",
149
+ "with open(\"/home/mshahidul/readctrl/data/annotators_validate_data_(20_80)/correction_data/final_corrected_anu.json\", 'r') as f:\n",
150
+ " annotator_corrections = json.load(f)\n",
151
+ "new_data = []\n",
152
+ "for item in annotator_corrections:\n",
153
+ " key = f\"{item['doc_id']}_{item['ai_label']}\"\n",
154
+ " final_text=item['final_text']\n",
155
+ " new_data.append({\n",
156
+ " 'doc_id': item['doc_id'],\n",
157
+ " 'label': item['ai_label'],\n",
158
+ " 'fulltext': text_map[key]['fulltext'],\n",
159
+ " 'diff_label_texts': final_text,\n",
160
+ " 'summary': text_map[key]['summary']\n",
161
+ " })"
162
+ ]
163
+ },
164
+ {
165
+ "cell_type": "code",
166
+ "execution_count": null,
167
+ "id": "9521411f",
168
+ "metadata": {},
169
+ "outputs": [],
170
+ "source": [
171
+ "# /home/mshahidul/readctrl/data/factual_testing/full_details_evaluation_0_80_qwen3-30B_v2.json\n",
172
+ "with open(\"/home/mshahidul/readctrl/data/factual_testing/full_details_evaluation_0_80_qwen3-30B_v2.json\", 'r') as f:\n",
173
+ " factual_data = json.load(f)"
174
+ ]
175
+ },
176
+ {
177
+ "cell_type": "code",
178
+ "execution_count": null,
179
+ "id": "b7628ac8",
180
+ "metadata": {},
181
+ "outputs": [],
182
+ "source": []
183
+ }
184
+ ],
185
+ "metadata": {
186
+ "kernelspec": {
187
+ "display_name": "un",
188
+ "language": "python",
189
+ "name": "python3"
190
+ },
191
+ "language_info": {
192
+ "codemirror_mode": {
193
+ "name": "ipython",
194
+ "version": 3
195
+ },
196
+ "file_extension": ".py",
197
+ "mimetype": "text/x-python",
198
+ "name": "python",
199
+ "nbconvert_exporter": "python",
200
+ "pygments_lexer": "ipython3",
201
+ "version": "3.11.14"
202
+ }
203
+ },
204
+ "nbformat": 4,
205
+ "nbformat_minor": 5
206
+ }
data/annotators_validate_data_(20_80)/code/interface_correction_data.py ADDED
@@ -0,0 +1,210 @@
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
1
+ import gradio as gr
2
+ import json
3
+ import os
4
+ from openai import OpenAI
5
+
6
+ # --- CONFIGURATION ---
7
+ DATA_PATH = '/home/mshahidul/readctrl/data/annotators_validate_data_(20_80)/code/correction_evaluation_full_text_with_gs.json'
8
+ SAVE_DIR = '/home/mshahidul/readctrl/data/annotators_validate_data_(20_80)/correction_data/'
9
+ PROMPT_TEMPLATE_PATH = "/home/mshahidul/readctrl/prompts/syn_data_gen_diff_label_mod.txt"
10
+ API_FILE_PATH = "/home/mshahidul/api_new.json"
11
+
12
+ # --- INITIALIZATION ---
13
+ # Load API Key
14
+ with open(API_FILE_PATH, "r") as f:
15
+ api_keys = json.load(f)
16
+ client = OpenAI(api_key=api_keys["openai"])
17
+
18
+ # Load Prompt Template
19
+ with open(PROMPT_TEMPLATE_PATH, "r") as f:
20
+ PROMPT_TEMPLATE = f.read()
21
+
22
+ def load_data():
23
+ if os.path.exists(DATA_PATH):
24
+ with open(DATA_PATH, 'r') as f:
25
+ return json.load(f)
26
+ return []
27
+
28
+ DATA = load_data()
29
+
30
+ # --- AI LOGIC ---
31
+ def call_ai_processor(index, full_text, gold_summary):
32
+ """Calls GPT-5 (OpenAI API) and extracts the text for the current label."""
33
+ try:
34
+ item = DATA[index]
35
+ target_label = item.get('ai_label') # e.g., "low_health_literacy"
36
+
37
+ # Note: 'source_language' should ideally be in your JSON.
38
+ # Defaulting to English if not found.
39
+ source_lang = item.get('language', 'English')
40
+
41
+ # Format the prompt
42
+ prompt = (PROMPT_TEMPLATE
43
+ .replace("<<<FULL_TEXT>>>", full_text)
44
+ .replace("<<<SOURCE_LANGUAGE>>>", source_lang)
45
+ .replace("<<<GOLD_SUMMARY>>>", gold_summary)
46
+ .replace("<<<TARGET_LABEL>>>", target_label))
47
+ # import ipdb; ipdb.set_trace()
48
+
49
+ response = client.chat.completions.create(
50
+ model="gpt-5-mini", # Change to "gpt-5" or specific model name when available
51
+ messages=[{"role": "user", "content": prompt}],
52
+ response_format={ "type": "json_object" }
53
+ )
54
+
55
+ content = json.loads(response.choices[0].message.content)
56
+
57
+ # Extract only the text for the specific label we are currently editing
58
+ # target_label usually matches the keys: low_health_literacy, etc.
59
+ refined_text = content.get(target_label, "Error: Label not found in AI response.")
60
+ return refined_text
61
+
62
+ except Exception as e:
63
+ return f"AI Error: {str(e)}"
64
+
65
+ # --- DATA HELPERS ---
66
+ def get_user_save_path(username):
67
+ clean_name = "".join([c for c in username if c.isalpha() or c.isdigit()]).rstrip()
68
+ return os.path.join(SAVE_DIR, f"final_corrected_{clean_name}.json")
69
+
70
+ def load_user_results(username):
71
+ path = get_user_save_path(username)
72
+ if os.path.exists(path):
73
+ with open(path, 'r') as f:
74
+ return json.load(f)
75
+ return []
76
+
77
+ def get_record(index):
78
+ if 0 <= index < len(DATA):
79
+ item = DATA[index]
80
+ ai_label = item.get('ai_label', '')
81
+ ai_text = item.get('diff_label_texts', {}).get(ai_label, "Text not found")
82
+ gold_summary = item.get('summary', '') # Added this for the AI prompt
83
+
84
+ anno_info = (
85
+ f"Plaban: {item.get('category_plaban')} (Rating: {item.get('rating_plaban')})\n"
86
+ f"Mahi: {item.get('category_mahi')} (Rating: {item.get('rating_mahi')})\n"
87
+ f"Shama: {item.get('category_shama')} (Rating: {item.get('rating_shama')})"
88
+ )
89
+
90
+ return (
91
+ item.get('doc_id'),
92
+ anno_info,
93
+ ai_label.replace("_", " ").title(),
94
+ item.get('fulltext'),
95
+ ai_text,
96
+ index,
97
+ gold_summary
98
+ )
99
+ return None
100
+
101
+ def login_user(username):
102
+ if not username or len(username.strip()) == 0:
103
+ return gr.update(visible=True), gr.update(visible=False), 0, None, "", "", "", "", ""
104
+
105
+ existing_data = load_user_results(username)
106
+ start_index = len(existing_data)
107
+
108
+ if start_index >= len(DATA):
109
+ return gr.update(visible=False), gr.update(visible=True), start_index, "Finished!", "All caught up!", "No more data.", "No more data.", "", ""
110
+
111
+ record = get_record(start_index)
112
+ return (
113
+ gr.update(visible=False),
114
+ gr.update(visible=True),
115
+ start_index,
116
+ record[0], record[1], record[2], record[3], record[4], record[6]
117
+ )
118
+
119
+ def save_and_next(username, index, corrected_text, is_ok):
120
+ user_results = load_user_results(username)
121
+ current_item = DATA[index]
122
+
123
+ # If the user didn't type anything in manual_correction and hit "AI Text is OK", use original
124
+ final_text = current_item.get('diff_label_texts', {}).get(current_item['ai_label']) if is_ok else corrected_text
125
+
126
+ result_entry = {
127
+ "doc_id": current_item['doc_id'],
128
+ "ai_label": current_item['ai_label'],
129
+ "status": "Approved" if is_ok else "Manually Corrected/AI Refined",
130
+ "final_text": final_text,
131
+ "original_ai_text": current_item.get('diff_label_texts', {}).get(current_item['ai_label'])
132
+ }
133
+
134
+ user_results.append(result_entry)
135
+
136
+ with open(get_user_save_path(username), 'w') as f:
137
+ json.dump(user_results, f, indent=4)
138
+
139
+ next_index = index + 1
140
+ if next_index < len(DATA):
141
+ res = get_record(next_index)
142
+ return list(res) + [""]
143
+ else:
144
+ return [None, "Finished!", "Finished!", "No more data.", "No more data.", next_index, "No more data.", ""]
145
+
146
+ # --- GRADIO UI ---
147
+ with gr.Blocks(theme=gr.themes.Soft()) as demo:
148
+ gr.Markdown("# 📝 AI Label Correction Interface (v2 with GPT-Refinement)")
149
+
150
+ current_idx = gr.State(0)
151
+ user_session = gr.State("")
152
+ gold_summary_hidden = gr.State("") # To hold the summary for the AI prompt
153
+
154
+ with gr.Row() as login_row:
155
+ with gr.Column(scale=1):
156
+ user_input = gr.Textbox(label="Enter Username to Resume", placeholder="e.g., Shahidul")
157
+ btn_login = gr.Button("Start Annotation", variant="primary")
158
+
159
+ with gr.Column(visible=False) as main_container:
160
+ with gr.Row():
161
+ with gr.Column(scale=1):
162
+ doc_id_display = gr.Textbox(label="Document ID", interactive=False)
163
+ ai_label_display = gr.Label(label="Target AI Label")
164
+ annotator_stats = gr.Textbox(label="Human Annotator Ratings", lines=4, interactive=False)
165
+
166
+ with gr.Column(scale=2):
167
+ full_text_display = gr.Textbox(label="Source Full Text", lines=10, interactive=False)
168
+
169
+ with gr.Row():
170
+ with gr.Column():
171
+ ai_generated_text = gr.Textbox(label="Original AI Text", lines=6, interactive=False)
172
+ with gr.Column():
173
+ manual_correction = gr.Textbox(label="AI Refinement / Manual Correction", placeholder="AI generated text will appear here...", lines=6)
174
+ btn_ai_check = gr.Button("✨ Check & Refine through AI", variant="secondary")
175
+
176
+ with gr.Row():
177
+ btn_ok = gr.Button("✅ Original Text is OK", variant="primary")
178
+ btn_fix = gr.Button("💾 Save Current Correction/AI Text", variant="stop")
179
+
180
+ # --- LOGIC ---
181
+ btn_login.click(
182
+ fn=login_user,
183
+ inputs=[user_input],
184
+ outputs=[login_row, main_container, current_idx, doc_id_display, annotator_stats, ai_label_display, full_text_display, ai_generated_text, gold_summary_hidden]
185
+ ).then(fn=lambda username: username, inputs=[user_input], outputs=[user_session])
186
+
187
+ # AI Regeneration Logic
188
+ btn_ai_check.click(
189
+ fn=call_ai_processor,
190
+ inputs=[current_idx, full_text_display, gold_summary_hidden],
191
+ outputs=[manual_correction]
192
+ )
193
+
194
+ action_inputs = [user_session, current_idx, manual_correction]
195
+ action_outputs = [doc_id_display, annotator_stats, ai_label_display, full_text_display, ai_generated_text, current_idx, gold_summary_hidden, manual_correction]
196
+
197
+ btn_ok.click(
198
+ fn=lambda user, idx, txt: save_and_next(user, idx, txt, True),
199
+ inputs=action_inputs,
200
+ outputs=action_outputs
201
+ )
202
+
203
+ btn_fix.click(
204
+ fn=lambda user, idx, txt: save_and_next(user, idx, txt, False),
205
+ inputs=action_inputs,
206
+ outputs=action_outputs
207
+ )
208
+
209
+ if __name__ == "__main__":
210
+ demo.launch(share=True)
data/annotators_validate_data_(20_80)/code/needs_correction.json ADDED
@@ -0,0 +1,497 @@
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
1
+ [
2
+ {
3
+ "doc_id":20,
4
+ "ai_label":"intermediate_health_literacy",
5
+ "rating_plaban":4,
6
+ "category_plaban":"proficient_health_literacy",
7
+ "rating_mahi":2,
8
+ "category_mahi":"low_health_literacy",
9
+ "rating_shama":3,
10
+ "category_shama":"intermediate_health_literacy",
11
+ "agreement_count":1
12
+ },
13
+ {
14
+ "doc_id":23,
15
+ "ai_label":"intermediate_health_literacy",
16
+ "rating_plaban":4,
17
+ "category_plaban":"proficient_health_literacy",
18
+ "rating_mahi":4,
19
+ "category_mahi":"proficient_health_literacy",
20
+ "rating_shama":4,
21
+ "category_shama":"proficient_health_literacy",
22
+ "agreement_count":0
23
+ },
24
+ {
25
+ "doc_id":24,
26
+ "ai_label":"intermediate_health_literacy",
27
+ "rating_plaban":3,
28
+ "category_plaban":"intermediate_health_literacy",
29
+ "rating_mahi":2,
30
+ "category_mahi":"low_health_literacy",
31
+ "rating_shama":2,
32
+ "category_shama":"low_health_literacy",
33
+ "agreement_count":1
34
+ },
35
+ {
36
+ "doc_id":25,
37
+ "ai_label":"intermediate_health_literacy",
38
+ "rating_plaban":4,
39
+ "category_plaban":"proficient_health_literacy",
40
+ "rating_mahi":2,
41
+ "category_mahi":"low_health_literacy",
42
+ "rating_shama":3,
43
+ "category_shama":"intermediate_health_literacy",
44
+ "agreement_count":1
45
+ },
46
+ {
47
+ "doc_id":27,
48
+ "ai_label":"intermediate_health_literacy",
49
+ "rating_plaban":3,
50
+ "category_plaban":"intermediate_health_literacy",
51
+ "rating_mahi":2,
52
+ "category_mahi":"low_health_literacy",
53
+ "rating_shama":2,
54
+ "category_shama":"low_health_literacy",
55
+ "agreement_count":1
56
+ },
57
+ {
58
+ "doc_id":29,
59
+ "ai_label":"low_health_literacy",
60
+ "rating_plaban":4,
61
+ "category_plaban":"proficient_health_literacy",
62
+ "rating_mahi":2,
63
+ "category_mahi":"low_health_literacy",
64
+ "rating_shama":5,
65
+ "category_shama":"proficient_health_literacy",
66
+ "agreement_count":1
67
+ },
68
+ {
69
+ "doc_id":29,
70
+ "ai_label":"intermediate_health_literacy",
71
+ "rating_plaban":4,
72
+ "category_plaban":"proficient_health_literacy",
73
+ "rating_mahi":3,
74
+ "category_mahi":"intermediate_health_literacy",
75
+ "rating_shama":4,
76
+ "category_shama":"proficient_health_literacy",
77
+ "agreement_count":1
78
+ },
79
+ {
80
+ "doc_id":31,
81
+ "ai_label":"intermediate_health_literacy",
82
+ "rating_plaban":4,
83
+ "category_plaban":"proficient_health_literacy",
84
+ "rating_mahi":3,
85
+ "category_mahi":"intermediate_health_literacy",
86
+ "rating_shama":4,
87
+ "category_shama":"proficient_health_literacy",
88
+ "agreement_count":1
89
+ },
90
+ {
91
+ "doc_id":34,
92
+ "ai_label":"intermediate_health_literacy",
93
+ "rating_plaban":4,
94
+ "category_plaban":"proficient_health_literacy",
95
+ "rating_mahi":2,
96
+ "category_mahi":"low_health_literacy",
97
+ "rating_shama":2,
98
+ "category_shama":"low_health_literacy",
99
+ "agreement_count":0
100
+ },
101
+ {
102
+ "doc_id":35,
103
+ "ai_label":"low_health_literacy",
104
+ "rating_plaban":3,
105
+ "category_plaban":"intermediate_health_literacy",
106
+ "rating_mahi":3,
107
+ "category_mahi":"intermediate_health_literacy",
108
+ "rating_shama":3,
109
+ "category_shama":"intermediate_health_literacy",
110
+ "agreement_count":0
111
+ },
112
+ {
113
+ "doc_id":35,
114
+ "ai_label":"intermediate_health_literacy",
115
+ "rating_plaban":4,
116
+ "category_plaban":"proficient_health_literacy",
117
+ "rating_mahi":4,
118
+ "category_mahi":"proficient_health_literacy",
119
+ "rating_shama":4,
120
+ "category_shama":"proficient_health_literacy",
121
+ "agreement_count":0
122
+ },
123
+ {
124
+ "doc_id":36,
125
+ "ai_label":"low_health_literacy",
126
+ "rating_plaban":3,
127
+ "category_plaban":"intermediate_health_literacy",
128
+ "rating_mahi":2,
129
+ "category_mahi":"low_health_literacy",
130
+ "rating_shama":3,
131
+ "category_shama":"intermediate_health_literacy",
132
+ "agreement_count":1
133
+ },
134
+ {
135
+ "doc_id":36,
136
+ "ai_label":"intermediate_health_literacy",
137
+ "rating_plaban":4,
138
+ "category_plaban":"proficient_health_literacy",
139
+ "rating_mahi":3,
140
+ "category_mahi":"intermediate_health_literacy",
141
+ "rating_shama":5,
142
+ "category_shama":"proficient_health_literacy",
143
+ "agreement_count":1
144
+ },
145
+ {
146
+ "doc_id":37,
147
+ "ai_label":"low_health_literacy",
148
+ "rating_plaban":3,
149
+ "category_plaban":"intermediate_health_literacy",
150
+ "rating_mahi":3,
151
+ "category_mahi":"intermediate_health_literacy",
152
+ "rating_shama":4,
153
+ "category_shama":"proficient_health_literacy",
154
+ "agreement_count":0
155
+ },
156
+ {
157
+ "doc_id":37,
158
+ "ai_label":"intermediate_health_literacy",
159
+ "rating_plaban":4,
160
+ "category_plaban":"proficient_health_literacy",
161
+ "rating_mahi":4,
162
+ "category_mahi":"proficient_health_literacy",
163
+ "rating_shama":5,
164
+ "category_shama":"proficient_health_literacy",
165
+ "agreement_count":0
166
+ },
167
+ {
168
+ "doc_id":38,
169
+ "ai_label":"low_health_literacy",
170
+ "rating_plaban":3,
171
+ "category_plaban":"intermediate_health_literacy",
172
+ "rating_mahi":3,
173
+ "category_mahi":"intermediate_health_literacy",
174
+ "rating_shama":3,
175
+ "category_shama":"intermediate_health_literacy",
176
+ "agreement_count":0
177
+ },
178
+ {
179
+ "doc_id":38,
180
+ "ai_label":"intermediate_health_literacy",
181
+ "rating_plaban":4,
182
+ "category_plaban":"proficient_health_literacy",
183
+ "rating_mahi":4,
184
+ "category_mahi":"proficient_health_literacy",
185
+ "rating_shama":4,
186
+ "category_shama":"proficient_health_literacy",
187
+ "agreement_count":0
188
+ },
189
+ {
190
+ "doc_id":41,
191
+ "ai_label":"intermediate_health_literacy",
192
+ "rating_plaban":4,
193
+ "category_plaban":"proficient_health_literacy",
194
+ "rating_mahi":2,
195
+ "category_mahi":"low_health_literacy",
196
+ "rating_shama":3,
197
+ "category_shama":"intermediate_health_literacy",
198
+ "agreement_count":1
199
+ },
200
+ {
201
+ "doc_id":44,
202
+ "ai_label":"intermediate_health_literacy",
203
+ "rating_plaban":4,
204
+ "category_plaban":"proficient_health_literacy",
205
+ "rating_mahi":2,
206
+ "category_mahi":"low_health_literacy",
207
+ "rating_shama":3,
208
+ "category_shama":"intermediate_health_literacy",
209
+ "agreement_count":1
210
+ },
211
+ {
212
+ "doc_id":45,
213
+ "ai_label":"low_health_literacy",
214
+ "rating_plaban":4,
215
+ "category_plaban":"proficient_health_literacy",
216
+ "rating_mahi":3,
217
+ "category_mahi":"intermediate_health_literacy",
218
+ "rating_shama":2,
219
+ "category_shama":"low_health_literacy",
220
+ "agreement_count":1
221
+ },
222
+ {
223
+ "doc_id":45,
224
+ "ai_label":"intermediate_health_literacy",
225
+ "rating_plaban":5,
226
+ "category_plaban":"proficient_health_literacy",
227
+ "rating_mahi":3,
228
+ "category_mahi":"intermediate_health_literacy",
229
+ "rating_shama":4,
230
+ "category_shama":"proficient_health_literacy",
231
+ "agreement_count":1
232
+ },
233
+ {
234
+ "doc_id":49,
235
+ "ai_label":"intermediate_health_literacy",
236
+ "rating_plaban":5,
237
+ "category_plaban":"proficient_health_literacy",
238
+ "rating_mahi":2,
239
+ "category_mahi":"low_health_literacy",
240
+ "rating_shama":3,
241
+ "category_shama":"intermediate_health_literacy",
242
+ "agreement_count":1
243
+ },
244
+ {
245
+ "doc_id":50,
246
+ "ai_label":"low_health_literacy",
247
+ "rating_plaban":3,
248
+ "category_plaban":"intermediate_health_literacy",
249
+ "rating_mahi":3,
250
+ "category_mahi":"intermediate_health_literacy",
251
+ "rating_shama":2,
252
+ "category_shama":"low_health_literacy",
253
+ "agreement_count":1
254
+ },
255
+ {
256
+ "doc_id":52,
257
+ "ai_label":"intermediate_health_literacy",
258
+ "rating_plaban":5,
259
+ "category_plaban":"proficient_health_literacy",
260
+ "rating_mahi":4,
261
+ "category_mahi":"proficient_health_literacy",
262
+ "rating_shama":3,
263
+ "category_shama":"intermediate_health_literacy",
264
+ "agreement_count":1
265
+ },
266
+ {
267
+ "doc_id":53,
268
+ "ai_label":"low_health_literacy",
269
+ "rating_plaban":4,
270
+ "category_plaban":"proficient_health_literacy",
271
+ "rating_mahi":3,
272
+ "category_mahi":"intermediate_health_literacy",
273
+ "rating_shama":2,
274
+ "category_shama":"low_health_literacy",
275
+ "agreement_count":1
276
+ },
277
+ {
278
+ "doc_id":53,
279
+ "ai_label":"intermediate_health_literacy",
280
+ "rating_plaban":5,
281
+ "category_plaban":"proficient_health_literacy",
282
+ "rating_mahi":4,
283
+ "category_mahi":"proficient_health_literacy",
284
+ "rating_shama":3,
285
+ "category_shama":"intermediate_health_literacy",
286
+ "agreement_count":1
287
+ },
288
+ {
289
+ "doc_id":54,
290
+ "ai_label":"low_health_literacy",
291
+ "rating_plaban":4,
292
+ "category_plaban":"proficient_health_literacy",
293
+ "rating_mahi":3,
294
+ "category_mahi":"intermediate_health_literacy",
295
+ "rating_shama":2,
296
+ "category_shama":"low_health_literacy",
297
+ "agreement_count":1
298
+ },
299
+ {
300
+ "doc_id":54,
301
+ "ai_label":"intermediate_health_literacy",
302
+ "rating_plaban":5,
303
+ "category_plaban":"proficient_health_literacy",
304
+ "rating_mahi":4,
305
+ "category_mahi":"proficient_health_literacy",
306
+ "rating_shama":3,
307
+ "category_shama":"intermediate_health_literacy",
308
+ "agreement_count":1
309
+ },
310
+ {
311
+ "doc_id":55,
312
+ "ai_label":"intermediate_health_literacy",
313
+ "rating_plaban":5,
314
+ "category_plaban":"proficient_health_literacy",
315
+ "rating_mahi":4,
316
+ "category_mahi":"proficient_health_literacy",
317
+ "rating_shama":3,
318
+ "category_shama":"intermediate_health_literacy",
319
+ "agreement_count":1
320
+ },
321
+ {
322
+ "doc_id":57,
323
+ "ai_label":"intermediate_health_literacy",
324
+ "rating_plaban":4,
325
+ "category_plaban":"proficient_health_literacy",
326
+ "rating_mahi":2,
327
+ "category_mahi":"low_health_literacy",
328
+ "rating_shama":3,
329
+ "category_shama":"intermediate_health_literacy",
330
+ "agreement_count":1
331
+ },
332
+ {
333
+ "doc_id":59,
334
+ "ai_label":"intermediate_health_literacy",
335
+ "rating_plaban":4,
336
+ "category_plaban":"proficient_health_literacy",
337
+ "rating_mahi":4,
338
+ "category_mahi":"proficient_health_literacy",
339
+ "rating_shama":3,
340
+ "category_shama":"intermediate_health_literacy",
341
+ "agreement_count":1
342
+ },
343
+ {
344
+ "doc_id":60,
345
+ "ai_label":"low_health_literacy",
346
+ "rating_plaban":4,
347
+ "category_plaban":"proficient_health_literacy",
348
+ "rating_mahi":4,
349
+ "category_mahi":"proficient_health_literacy",
350
+ "rating_shama":3,
351
+ "category_shama":"intermediate_health_literacy",
352
+ "agreement_count":0
353
+ },
354
+ {
355
+ "doc_id":60,
356
+ "ai_label":"intermediate_health_literacy",
357
+ "rating_plaban":5,
358
+ "category_plaban":"proficient_health_literacy",
359
+ "rating_mahi":4,
360
+ "category_mahi":"proficient_health_literacy",
361
+ "rating_shama":4,
362
+ "category_shama":"proficient_health_literacy",
363
+ "agreement_count":0
364
+ },
365
+ {
366
+ "doc_id":62,
367
+ "ai_label":"intermediate_health_literacy",
368
+ "rating_plaban":5,
369
+ "category_plaban":"proficient_health_literacy",
370
+ "rating_mahi":4,
371
+ "category_mahi":"proficient_health_literacy",
372
+ "rating_shama":3,
373
+ "category_shama":"intermediate_health_literacy",
374
+ "agreement_count":1
375
+ },
376
+ {
377
+ "doc_id":66,
378
+ "ai_label":"intermediate_health_literacy",
379
+ "rating_plaban":2,
380
+ "category_plaban":"low_health_literacy",
381
+ "rating_mahi":2,
382
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data/annotators_validate_data_(20_80)/combine/verified_20-80.json ADDED
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data/annotators_validate_data_(20_80)/correction_data/final_corrected_anu.json ADDED
@@ -0,0 +1,317 @@
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
1
+ [
2
+ {
3
+ "doc_id": 20,
4
+ "ai_label": "intermediate_health_literacy",
5
+ "status": "Approved",
6
+ "final_text": "A.P. is a 38\u2011year\u2011old woman who developed dilated cardiomyopathy at age 17, likely on the background of infectious myocarditis after a throat infection. She was hospitalized for 10 months and 10 days with severe heart failure and a very low ejection fraction while being evaluated for heart transplantation. There was no clearly dangerous arrhythmia. Treatment focused on heart failure care and on preventing arrhythmias and blood clots.\nHer heart function recovered\u2014a remission seen in about 16% of patients\u2014and that improvement lasted 4 years. She then had a two\u2011year worsening, followed by several stable years and a normal first pregnancy. During her second pregnancy, she experienced a flare in the second trimester with postpartum dilated cardiomyopathy that lasted a couple of months, then improved.\nAs of May 2017, she was stable on guideline\u2011based therapy (an ACE inhibitor, a beta\u2011blocker, diuretics, and an If\u2011channel blocker), reported no limitation in physical activity, and was a mother of two and unemployed.",
7
+ "original_ai_text": "A.P. is a 38\u2011year\u2011old woman who developed dilated cardiomyopathy at age 17, likely on the background of infectious myocarditis after a throat infection. She was hospitalized for 10 months and 10 days with severe heart failure and a very low ejection fraction while being evaluated for heart transplantation. There was no clearly dangerous arrhythmia. Treatment focused on heart failure care and on preventing arrhythmias and blood clots.\nHer heart function recovered\u2014a remission seen in about 16% of patients\u2014and that improvement lasted 4 years. She then had a two\u2011year worsening, followed by several stable years and a normal first pregnancy. During her second pregnancy, she experienced a flare in the second trimester with postpartum dilated cardiomyopathy that lasted a couple of months, then improved.\nAs of May 2017, she was stable on guideline\u2011based therapy (an ACE inhibitor, a beta\u2011blocker, diuretics, and an If\u2011channel blocker), reported no limitation in physical activity, and was a mother of two and unemployed."
8
+ },
9
+ {
10
+ "doc_id": 23,
11
+ "ai_label": "intermediate_health_literacy",
12
+ "status": "Approved",
13
+ "final_text": "A 65-year-old man presented with cough, shortness of breath, and weight loss. Chest CT showed a poorly defined nodule in the right lung. A trans-thoracic biopsy confirmed a pulmonary lymphoepithelioma-like carcinoma: large polygonal tumor cells arranged in sheets with abundant lymphocytes and plasma cells. Immunohistochemistry supported this diagnosis (cytokeratin 5/6 and p63 positive; Napsin A and TTF-1 negative). PD-L1 expression was very high (about 100%), and the tumor cells were positive for Epstein\u2013Barr virus by EBER in situ hybridization. To confirm the lung as the primary site, a nasopharyngeal exam was negative. Additional testing from the case showed no EGFR, KRAS, ALK, or ROS1 alterations. Imaging later showed a right perihilar lesion with nodal disease. He received platinum-based chemotherapy (gemcitabine/cisplatin) with durvalumab; cisplatin was later changed to carboplatin because of side effects. Despite treatment, the disease progressed, and he died 9 months after diagnosis.",
14
+ "original_ai_text": "A 65-year-old man presented with cough, shortness of breath, and weight loss. Chest CT showed a poorly defined nodule in the right lung. A trans-thoracic biopsy confirmed a pulmonary lymphoepithelioma-like carcinoma: large polygonal tumor cells arranged in sheets with abundant lymphocytes and plasma cells. Immunohistochemistry supported this diagnosis (cytokeratin 5/6 and p63 positive; Napsin A and TTF-1 negative). PD-L1 expression was very high (about 100%), and the tumor cells were positive for Epstein\u2013Barr virus by EBER in situ hybridization. To confirm the lung as the primary site, a nasopharyngeal exam was negative. Additional testing from the case showed no EGFR, KRAS, ALK, or ROS1 alterations. Imaging later showed a right perihilar lesion with nodal disease. He received platinum-based chemotherapy (gemcitabine/cisplatin) with durvalumab; cisplatin was later changed to carboplatin because of side effects. Despite treatment, the disease progressed, and he died 9 months after diagnosis."
15
+ },
16
+ {
17
+ "doc_id": 24,
18
+ "ai_label": "intermediate_health_literacy",
19
+ "status": "Manually Corrected/AI Refined",
20
+ "final_text": "We report a unique case of a 13-year-old boy who presented with a palpable, painless mass in the left inguinal (groin) area and no other constitutional symptoms. His medical history included prior spinal surgery with resulting immobility and a pressure sore on the left foot, but otherwise he was well. Routine blood tests were normal except for a very high erythrocyte sedimentation rate (ESR 119 mm/h), and CT scans of the chest, abdomen and pelvis showed enlarged lymph nodes below the inguinal ligament, the largest about 3.5 \u00d7 2.4 cm. Because imaging and blood tests could not rule out malignancy (for example lymphoma or leukemia), the enlarged nodes were surgically removed for definitive diagnosis. Pathology showed features consistent with unicentric Castleman disease, plasma-cell type \u2014 one of the rarest forms in children and, to our knowledge, the first reported unicentric Castleman case in the inguinal area. The patient was discharged after 14 days with a course of oral prednisolone and was followed with clinical exams, laboratory tests and whole-body CT scans every three months. After 12 months of follow-up there were no new symptoms, no new enlarged lymph nodes on exam or imaging, and no abnormal laboratory findings.",
21
+ "original_ai_text": "A 13-year-old boy presented with a painless, movable mass in his left groin and no constitutional symptoms. To rule out serious causes such as lymphoma and to get a definite diagnosis, surgeons removed the mass. Pathology confirmed unicentric Castleman disease, plasma cell type\u2014a rare form in children\u2014and, to the authors\u2019 knowledge, this is the first reported case of UCD in the inguinal region. Over 12 months of follow-up, he had no new lymph node enlargement and no new symptoms."
22
+ },
23
+ {
24
+ "doc_id": 25,
25
+ "ai_label": "intermediate_health_literacy",
26
+ "status": "Approved",
27
+ "final_text": "Researchers reviewed pediatric neurology records from a tertiary hospital (2015\u20132020) to study congenital myotonia. Patients were included based on clinical features (myotonia, a warm\u2011up phenomenon, a characteristic EMG pattern, and/or family history) and/or a molecular finding in the CLCN1 gene. They collected demographics (age, sex), details on disease onset and symptoms, time to diagnosis and clinical course, family history, and response to treatment. Five cases were identified: three with the Becker type and two with the Thomsen type. Using local birth numbers, they estimated an incidence of about 1 in 15,000 births for Becker and 1 in 21,000 for Thomsen. They also identified a previously unreported CLCN1 gene variant (c.824T>C) that is likely disease\u2011causing.",
28
+ "original_ai_text": "Researchers reviewed pediatric neurology records from a tertiary hospital (2015\u20132020) to study congenital myotonia. Patients were included based on clinical features (myotonia, a warm\u2011up phenomenon, a characteristic EMG pattern, and/or family history) and/or a molecular finding in the CLCN1 gene. They collected demographics (age, sex), details on disease onset and symptoms, time to diagnosis and clinical course, family history, and response to treatment. Five cases were identified: three with the Becker type and two with the Thomsen type. Using local birth numbers, they estimated an incidence of about 1 in 15,000 births for Becker and 1 in 21,000 for Thomsen. They also identified a previously unreported CLCN1 gene variant (c.824T>C) that is likely disease\u2011causing."
29
+ },
30
+ {
31
+ "doc_id": 27,
32
+ "ai_label": "intermediate_health_literacy",
33
+ "status": "Manually Corrected/AI Refined",
34
+ "final_text": "A 28-year-old man presented to dermatology with a 48-hour history of two red patches with central blisters and shallow ulcers on the inner (flexor) side of his right arm and forearm. He described burning and itching at the sites, had no other systemic symptoms, and had not self\u2011medicated. He reported being on vacation in the coastal region of Ecuador when the lesions appeared. A skin biopsy showed changes consistent with an acute inflammatory reaction, and, together with the clinical picture and recent travel, the diagnosis of Paederus dermatitis (skin injury caused by contact with certain rove beetles) was made. He was treated with oral antihistamines, topical corticosteroids and cold compresses. After 8 days the lesions resolved, leaving post\u2011inflammatory hyperpigmentation.",
35
+ "original_ai_text": "A 28-year-old man developed, over 48 hours, two red plaques with small central blisters and shallow ulcers on the inner right arm and forearm. The areas burned and itched. He had no other symptoms and had recently been vacationing on the coast of Ecuador. Doctors performed an incisional skin biopsy. Based on how the rash looked, his recent travel to a tropical area, and the biopsy results, they diagnosed Paederus dermatitis. He was treated with antihistamines, topical steroids, and cold compresses. After 8 days, the lesions resolved, leaving post-inflammatory hyperpigmentation."
36
+ },
37
+ {
38
+ "doc_id": 29,
39
+ "ai_label": "low_health_literacy",
40
+ "status": "Approved",
41
+ "final_text": "A 77-year-old woman came to the hospital because she threw up blood. A belly scan (CT) was done. It showed the first part of her small intestine bent sharply on the right side of the body\u2019s main artery and went downward. It did not cross in front of that artery. The meeting point between the first and middle parts of the small intestine was on her right side. The middle part of the small intestine was also on her right side. A camera test of her stomach showed a tear at the top of the stomach where it meets the food pipe. This is called a Mallory\u2013Weiss tear. A week later, another CT showed the intestines moved back to a normal spot by themselves. Two months later, she threw up blood again. The CT again showed that the meeting point and the middle small intestine had slid to the right. The camera test again showed a tear in the same spot. At first, doctors thought she might have been born with her intestines in the wrong place. But because the intestines kept sliding to the right and then moving back on their own, the problem was a weak support band called the ligament of Treitz. Surgery showed the band was there but not firmly attached to the upper small intestine. The scan also showed a nearby tissue space was loose and could move. These issues likely let the small intestine slide to the right.",
42
+ "original_ai_text": "A 77-year-old woman came to the hospital because she threw up blood. A belly scan (CT) was done. It showed the first part of her small intestine bent sharply on the right side of the body\u2019s main artery and went downward. It did not cross in front of that artery. The meeting point between the first and middle parts of the small intestine was on her right side. The middle part of the small intestine was also on her right side. A camera test of her stomach showed a tear at the top of the stomach where it meets the food pipe. This is called a Mallory\u2013Weiss tear. A week later, another CT showed the intestines moved back to a normal spot by themselves. Two months later, she threw up blood again. The CT again showed that the meeting point and the middle small intestine had slid to the right. The camera test again showed a tear in the same spot. At first, doctors thought she might have been born with her intestines in the wrong place. But because the intestines kept sliding to the right and then moving back on their own, the problem was a weak support band called the ligament of Treitz. Surgery showed the band was there but not firmly attached to the upper small intestine. The scan also showed a nearby tissue space was loose and could move. These issues likely let the small intestine slide to the right."
43
+ },
44
+ {
45
+ "doc_id": 29,
46
+ "ai_label": "intermediate_health_literacy",
47
+ "status": "Manually Corrected/AI Refined",
48
+ "final_text": "A 77-year-old woman was admitted with haematemesis. CT scans showed that the third part of her duodenum bent sharply on the right side of the aorta and ran downward without crossing in front of it; the duodenojejunal junction and much of the jejunum were located on the right side of the abdomen. Upper GI endoscopy found a mucosal tear at the gastric cardia consistent with Mallory\u2013Weiss syndrome. Seven days after the first scan the abnormal right-sided position resolved on CT, but two months later the patient had another episode of haematemesis and the duodenojejunal junction and jejunum had again shifted to the right. Because the small bowel moved back and forth rather than staying in the wrong position, true intestinal malrotation was considered unlikely. The working diagnosis was dysplasia (abnormal development) of the ligament of Treitz, meaning the ligament that normally helps fix the upper small intestine was not holding the jejunum securely. At laparotomy the ligament of Treitz was present but did not fully fix the upper jejunum to the back wall of the abdomen (retroperitoneum); the pararenal area also appeared loosely fixed and mobile on CT. These factors probably allowed the jejunum to fold and deviate to the right. Surgically the upper jejunum was tacked to the left retroperitoneum with sutures, the postoperative course was good, and the patient has remained symptom-free.",
49
+ "original_ai_text": "A 77-year-old woman presented with haematemesis. CT showed the third part of the duodenum bending steeply on the right side of the aorta and running downward without crossing in front of it. The duodenojejunal junction and the jejunum were located on the patient\u2019s right side. Upper endoscopy found a laceration at the gastric cardia, consistent with a Mallory\u2013Weiss tear. A repeat CT 7 days later showed that the abnormal bowel position had returned to normal on its own. Two months later she had another episode of haematemesis; CT again showed rightward deviation of the duodenojejunal junction and jejunum, and endoscopy again revealed a cardia laceration. The initial CT pattern raised concern for intestinal malrotation, but the intermittent and self-resolving nature of the right-sided deviation argued against a fixed malrotation. Instead, the findings supported dysplasia (incomplete fixation) of the ligament of Treitz. Laparotomy confirmed that the ligament of Treitz was present but incompletely fixed in the upper jejunum. CT also suggested a mobile anterior pararenal space. Together, these factors likely allowed the small intestine to shift to the right."
50
+ },
51
+ {
52
+ "doc_id": 31,
53
+ "ai_label": "intermediate_health_literacy",
54
+ "status": "Manually Corrected/AI Refined",
55
+ "final_text": "A 12-year-old boy with Down syndrome and motor disorders was referred to the Oral Medicine clinic. On exam he had a dysmorphic face and dry, cracked lips; a cervical collar prevented assessment of his neck lymph nodes. Inside the mouth there was an irregular ulcer on the right lateral border of the tongue measuring about 1 \u00d7 0.7 cm, with a firm (indurated) edge and a white-yellow base. A sharp remnant of tooth 55 was causing repeated trauma to that part of the tongue. Based on the history and exam, the team diagnosed a chronic traumatic ulcer that clinically looked like oral squamous cell carcinoma (OSCC). Other dental problems included caries and several tooth remnants (63, 55, 62, 74, 85) that were recommended for extraction and later space maintenance. Blood tests showed low sodium and a mildly raised lymphocyte percentage, and MRI revealed a cervical spine dislocation; the patient later had neurosurgery. Treatment in hospital included paracetamol and amoxicillin, and local oral care from the Oral Medicine team: saline rinses (0.9% sodium chloride), 1% povidone-iodine mouthwash as an antiseptic, and petroleum jelly for the lips. The mother was instructed to clean the mouth with gauze soaked in saline, apply the povidone-iodine compress to the ulcer three times daily, and use petroleum jelly to moisturize the lips. The oral lesions improved over follow-up visits at 3 days, 1 week, and 10 days. After neurosurgery the patient was observed in the pediatric intensive care unit but developed respiratory failure and died.",
56
+ "original_ai_text": "A 12-year-old boy with Down Syndrome and motor problems was seen in Oral Medicine. On exam, he had a dysmorphic facial appearance and very dry, cracked lips. Lymph nodes could not be checked because he wore a cervical collar. Inside the mouth, there was an irregular ulcer on the right side of the tongue measuring about 1\u00d70.7 cm, with a firm (indurated) edge and a white\u2011yellow base. A sharp baby tooth (tooth 55) was causing repeated biting trauma to that area. Based on the clinical exam, the team diagnosed a chronic traumatic ulcer that can resemble oral squamous cell carcinoma. Treatment included 0.9% saline, a 1% povidone\u2011iodine mouthwash, and petroleum jelly to moisturize the lips."
57
+ },
58
+ {
59
+ "doc_id": 34,
60
+ "ai_label": "intermediate_health_literacy",
61
+ "status": "Manually Corrected/AI Refined",
62
+ "final_text": "A 19-month-old boy came to the emergency department after falling from a highchair and hitting his head. On exam he had severe, unexplained breathing trouble that required tracheal intubation (a tube placed into the windpipe to help him breathe). The team suspected that the breathing problem had caused an altered state of consciousness and led to the fall and head injury. Imaging of the chest showed complete collapse (atelectasis) of the entire left lung and an abrupt cutoff of the left main bronchus about 12 mm from the lung hilum (the area where the bronchus enters the lung). Rigid bronchoscopy found and removed a 2 cm almond that was stuck in the left main bronchus. Earlier signs included very fast breathing and heart rate, low oxygen levels despite bag-mask ventilation, visible chest retractions, and decreased breath sounds on the left. The mother reported the child had an intense coughing episode a few days earlier that resolved without treatment; the child had never eaten almonds before and likely swallowed this one by accident. After the almond was removed the child improved steadily, was extubated 24 hours later, moved from intensive care to the pediatric ward, and made a full recovery of respiratory function.",
63
+ "original_ai_text": "A 19\u2011month\u2011old boy presented to the ER after a fall with head trauma. During evaluation, clinicians discovered severe respiratory distress, so he required tracheal intubation. The team later suspected the breathing crisis likely began first and caused altered consciousness, which led to the fall. Imaging showed complete collapse (atelectasis) of the entire left lung, raising concern for foreign body aspiration. CT demonstrated an abrupt cutoff of the left main bronchus. Bronchoscopy then confirmed and removed a 2\u2011cm almond. A recent history of a brief coughing spell supported the diagnosis. The child improved after removal."
64
+ },
65
+ {
66
+ "doc_id": 35,
67
+ "ai_label": "low_health_literacy",
68
+ "status": "Approved",
69
+ "final_text": "A baby boy was 4 months old. He lived with his mother in a prison cell. A painful lump grew in his left armpit. A chest X-ray looked like some ribs were broken. Doctors worried he might have been hurt. The pictures also showed a pocket of pus in his armpit, damage to his ribs, a lung infection, and small spots in his lungs. He got strong antibiotics. He went home. When he was 8 months old, he got a fever. The pus spread toward his left shoulder. New chest pictures looked worse. Tests found a mold called Aspergillus fumigatus in the pus. The doctors said he had a serious mold infection. He took a strong antifungal medicine called voriconazole for 28 days. A special blood test showed his germ-fighting cells did not work well. He had a rare immune problem called chronic granulomatous disease. It was caused by a change in a gene called CYBB. His mother carried this gene change. When he was 12 months old, the mold infection came back. The treatments did not work. He died.",
70
+ "original_ai_text": "A baby boy was 4 months old. He lived with his mother in a prison cell. A painful lump grew in his left armpit. A chest X-ray looked like some ribs were broken. Doctors worried he might have been hurt. The pictures also showed a pocket of pus in his armpit, damage to his ribs, a lung infection, and small spots in his lungs. He got strong antibiotics. He went home. When he was 8 months old, he got a fever. The pus spread toward his left shoulder. New chest pictures looked worse. Tests found a mold called Aspergillus fumigatus in the pus. The doctors said he had a serious mold infection. He took a strong antifungal medicine called voriconazole for 28 days. A special blood test showed his germ-fighting cells did not work well. He had a rare immune problem called chronic granulomatous disease. It was caused by a change in a gene called CYBB. His mother carried this gene change. When he was 12 months old, the mold infection came back. The treatments did not work. He died."
71
+ },
72
+ {
73
+ "doc_id": 35,
74
+ "ai_label": "intermediate_health_literacy",
75
+ "status": "Approved",
76
+ "final_text": "This case describes a 4\u2011month\u2011old boy who lived with his mother in a crowded prison cell and developed a painful mass in his left armpit. Initial imaging raised concern for rib fractures, so he was hospitalized for possible child abuse. Imaging also showed an axillary abscess, rib damage, pneumonia, and small nodules in both lungs. He received broad\u2011spectrum antibiotics and was discharged. At 8 months, he returned with fever and an enlarging, pus\u2011draining abscess extending toward the left shoulder. Imaging showed progression. Culture of the abscess grew Aspergillus fumigatus, confirming invasive aspergillosis, and he was treated with 28 days of voriconazole. Because the infection was severe and recurrent, doctors tested his innate immune function. A dihydrorhodamine assay showed a defect consistent with chronic granulomatous disease (CGD). Genetic testing identified an X\u2011linked CYBB pathogenic variant (c.80_83del/Y); his mother was a carrier (c.80_83del/WT). At 12 months, he was readmitted with recurrent invasive aspergillosis that did not respond to treatment and he died.",
77
+ "original_ai_text": "This case describes a 4\u2011month\u2011old boy who lived with his mother in a crowded prison cell and developed a painful mass in his left armpit. Initial imaging raised concern for rib fractures, so he was hospitalized for possible child abuse. Imaging also showed an axillary abscess, rib damage, pneumonia, and small nodules in both lungs. He received broad\u2011spectrum antibiotics and was discharged. At 8 months, he returned with fever and an enlarging, pus\u2011draining abscess extending toward the left shoulder. Imaging showed progression. Culture of the abscess grew Aspergillus fumigatus, confirming invasive aspergillosis, and he was treated with 28 days of voriconazole. Because the infection was severe and recurrent, doctors tested his innate immune function. A dihydrorhodamine assay showed a defect consistent with chronic granulomatous disease (CGD). Genetic testing identified an X\u2011linked CYBB pathogenic variant (c.80_83del/Y); his mother was a carrier (c.80_83del/WT). At 12 months, he was readmitted with recurrent invasive aspergillosis that did not respond to treatment and he died."
78
+ },
79
+ {
80
+ "doc_id": 36,
81
+ "ai_label": "low_health_literacy",
82
+ "status": "Approved",
83
+ "final_text": "A 25-year-old man went to the mouth clinic because he had painful canker sores on his lips. The outside of his lips had crusty scabs that hurt and bled easily. Inside his mouth, the inner parts of his upper and lower lips had red, sore, uneven patches. A blood test for the cold sore virus (HSV-1) was positive. The doctor said he had a condition called HAEM. His treatment included a steroid mouth paste (triamcinolone acetonide 0.1% in orabase), acyclovir pills, multivitamins, and salt-water (0.9% NaCl). He was also told to keep his mouth clean, avoid spicy and sour foods, and stop licking his lips.",
84
+ "original_ai_text": "A 25-year-old man went to the mouth clinic because he had painful canker sores on his lips. The outside of his lips had crusty scabs that hurt and bled easily. Inside his mouth, the inner parts of his upper and lower lips had red, sore, uneven patches. A blood test for the cold sore virus (HSV-1) was positive. The doctor said he had a condition called HAEM. His treatment included a steroid mouth paste (triamcinolone acetonide 0.1% in orabase), acyclovir pills, multivitamins, and salt-water (0.9% NaCl). He was also told to keep his mouth clean, avoid spicy and sour foods, and stop licking his lips."
85
+ },
86
+ {
87
+ "doc_id": 36,
88
+ "ai_label": "intermediate_health_literacy",
89
+ "status": "Manually Corrected/AI Refined",
90
+ "final_text": "A 25-year-old man came to the oral medicine clinic with painful canker sores on his lips that started in the mouth four days earlier and involved the lips two days later. On exam there were blood-tinged crusts on the lips that bled easily, and diffuse, painful red lesions on the inside of the upper and lower lips. He had reported a fever about a week before the sores appeared, a period of heavy workload and poor diet, and a habit of frequently licking his lips. Initial tests showed a positive anti-HSV-1 IgG (ratio 6.32), supporting herpes virus involvement, and the working diagnosis was HAEM. Exfoliative cheilitis was considered but less likely because it does not involve the herpes virus. Other findings included poor oral hygiene and several unrelated dental problems. Treatment combined topical and systemic care: topical steroid ointment (triamcinolone acetonide 0.1% in orabase), warm compresses with 0.9% saline, oral acyclovir tablets (200 mg, five times daily for one week), and a daily multivitamin. Patients were also advised on non-drug measures: brush teeth and tongue twice daily with a soft brush and non\u2011detergent toothpaste, drink more water, eat a balanced diet, avoid acidic, spicy or hard foods (and foods with MSG), and stop licking or peeling the lips. Two days after the first visit pain was reduced but lesions remained; after starting acyclovir there was marked healing by the next follow-up and complete clinical recovery after 7 days. Oral-health\u2013related quality of life improved (OHIP-14 score from 35 to 4). The patient was referred for further dental care (periodontics, restorative, oral surgery, and prosthodontics) and gave consent for publication.",
91
+ "original_ai_text": "A 25-year-old man presented with painful canker sores on the upper and lower lips, worse with eating and talking. On exam, his lips had painful serosanguineous crusts that bled easily, and the inner surfaces of the upper and lower lips showed diffuse, irregular erythematous lesions. Serology for anti-HSV-1 IgG was positive, supporting a diagnosis of HAEM. Management included triamcinolone acetonide 0.1% in orabase applied to the lips, saline (0.9% NaCl) compresses, and a daily multivitamin; acyclovir tablets were also prescribed. He was advised to maintain good oral hygiene, avoid spicy and sour foods, and stop lip-licking. The lesions and pain improved with this approach over the following days."
92
+ },
93
+ {
94
+ "doc_id": 37,
95
+ "ai_label": "low_health_literacy",
96
+ "status": "Approved",
97
+ "final_text": "She was 29 years old and had one child. She had HIV and a very weak immune system (CD4 count of 26). She had abnormal vaginal bleeding for one month. A tissue test from her cervix showed a blood cancer called Burkitt lymphoma in the cervix, outside the lymph nodes. Doctors also said the cervical cancer was stage 3B because it reached the pelvic wall and caused the kidneys to swell from blocked urine. A team of cancer doctors said she needed chemotherapy and radiation together. There was a long waiting list for this treatment. The start of care was delayed. She died 43 days after the diagnosis. She did not get the planned treatment.",
98
+ "original_ai_text": "She was 29 years old and had one child. She had HIV and a very weak immune system (CD4 count of 26). She had abnormal vaginal bleeding for one month. A tissue test from her cervix showed a blood cancer called Burkitt lymphoma in the cervix, outside the lymph nodes. Doctors also said the cervical cancer was stage 3B because it reached the pelvic wall and caused the kidneys to swell from blocked urine. A team of cancer doctors said she needed chemotherapy and radiation together. There was a long waiting list for this treatment. The start of care was delayed. She died 43 days after the diagnosis. She did not get the planned treatment."
99
+ },
100
+ {
101
+ "doc_id": 37,
102
+ "ai_label": "intermediate_health_literacy",
103
+ "status": "Manually Corrected/AI Refined",
104
+ "final_text": "A 29-year-old woman (Para 1) with HIV presented with one month of abnormal vaginal bleeding. She had defaulted antiretroviral therapy before this illness and on presentation had a very low CD4 count (26 cells/\u00b5L) and a high viral load. Examination and ultrasound found an 8 \u00d7 8 cm cervical mass with pelvic side wall involvement and bilateral hydronephrosis, and she was clinically staged as FIGO 3B. A cervical punch biopsy confirmed an extranodal Burkitt lymphoma (BL); immunohistochemistry showed B\u2011cell markers and a very high tumor proliferation rate, with focal Epstein\u2013Barr virus (EBV) positivity. Blood tests showed severe anemia (hemoglobin 5.7 g/dL), low platelets (71 \u00d710^9/L), low white cell count (2.67 \u00d710^9/L), and impaired kidney function. The oncology multidisciplinary team recommended chemoradiation, and she was restarted on antiretroviral therapy with a renal\u2011friendly regimen and given supportive care (blood transfusion, pain relief). There was a long delay to start oncologic treatment because of a waiting list and limited imaging availability; she died in the ward 43 days after diagnosis without receiving the planned chemoradiation. The treating physician attributed the most likely primary cause of death to rapidly progressive BL, with multiple organ failure (including kidney and blood\u2011related failure) as contributing causes.",
105
+ "original_ai_text": "A 29-year-old woman (Para 1) presented with a month of abnormal vaginal bleeding. She was living with HIV and had severe immunosuppression (CD4 26 cells/\u03bcL). Examination and ultrasound showed a large cervical mass with pelvic wall involvement and bilateral hydronephrosis, meeting FIGO stage 3B criteria for cervical cancer. Cervical biopsy confirmed extra-nodal Burkitt lymphoma involving the cervix. Her case was reviewed at a multidisciplinary oncology meeting, and chemoradiation was recommended. Because of a long waiting list at the referral oncology unit, treatment did not begin. She died 43 days after diagnosis, before receiving chemoradiation."
106
+ },
107
+ {
108
+ "doc_id": 38,
109
+ "ai_label": "low_health_literacy",
110
+ "status": "Approved",
111
+ "final_text": "This report is about a 56-year-old woman with Sjogren\u2019s syndrome. It caused lung scarring and high blood pressure in the lungs. Doctors found this in 2013. She took medicines for lung pressure and for her immune disease: sildenafil, bosentan, macitentan, iloprost, and steroids. Even with treatment, she got worse. In 2020, she had very hard breathing and went into heart-related shock. In May 2023, her care team added daily hydrogen capsules to help. After starting the hydrogen capsules, tests showed more immune cells that calm the body (CD127+ Tregs). A Sjogren\u2019s antibody called anti-Ro went down. Some B cells, another kind of immune cell, also went down. Her symptoms became stable. She had no side effects.",
112
+ "original_ai_text": "This report is about a 56-year-old woman with Sjogren\u2019s syndrome. It caused lung scarring and high blood pressure in the lungs. Doctors found this in 2013. She took medicines for lung pressure and for her immune disease: sildenafil, bosentan, macitentan, iloprost, and steroids. Even with treatment, she got worse. In 2020, she had very hard breathing and went into heart-related shock. In May 2023, her care team added daily hydrogen capsules to help. After starting the hydrogen capsules, tests showed more immune cells that calm the body (CD127+ Tregs). A Sjogren\u2019s antibody called anti-Ro went down. Some B cells, another kind of immune cell, also went down. Her symptoms became stable. She had no side effects."
113
+ },
114
+ {
115
+ "doc_id": 38,
116
+ "ai_label": "intermediate_health_literacy",
117
+ "status": "Manually Corrected/AI Refined",
118
+ "final_text": "A 56-year-old woman was diagnosed in 2013 with Sjogren\u2019s syndrome, an autoimmune disease that also caused scarring in her lungs (interstitial lung disease). She developed pulmonary arterial hypertension, which means high blood pressure in the blood vessels of her lungs. Over the years she took many medicines for her lung pressure and autoimmune disease, including sildenafil, bosentan, macitentan, iloprost, and steroid drugs, but her condition got worse. In 2020 she had very bad shortness of breath and her heart began to fail, a life-threatening problem called cardiogenic shock. In May 2023 she started taking one hydrogen capsule each day as an extra treatment. After she began the hydrogen capsules, tests showed she had more of a calming immune cell called CD127+ regulatory T cells. The tests also showed lower levels of anti-Ro antibodies, which are harmful antibodies linked to Sjogren\u2019s syndrome. The tests showed fewer B cells, which are the immune system\u2019s antibody-making cells. Her symptoms became stable and she did not have any side effects from the hydrogen capsules.",
119
+ "original_ai_text": "A 56-year-old woman with connective tissue disease\u2013associated pulmonary arterial hypertension (CTD-PAH) from Sjogren\u2019s syndrome, diagnosed in 2013 with interstitial lung disease, was treated over the years with sildenafil, bosentan (later switched to macitentan), iloprost, and corticosteroids. Despite these therapies, her condition worsened and she developed severe dyspnea and cardiogenic shock in 2020. In May 2023, molecular hydrogen was added as an adjuvant therapy in the form of daily hydrogen capsules. After starting hydrogen, immune testing showed an increase in regulatory T cells (CD127+ Tregs), a reduction in anti-Ro antibodies, and a decrease in B cell subsets. Clinically, her symptoms stabilized, and no adverse effects were reported."
120
+ },
121
+ {
122
+ "doc_id": 41,
123
+ "ai_label": "intermediate_health_literacy",
124
+ "status": "Manually Corrected/AI Refined",
125
+ "final_text": "A 16-month-old boy with restrictive cardiomyopathy (and a history of hypoxic\u2011ischaemic encephalopathy at birth but normal psychomotor development) was listed for heart transplant. At 20 months he required implantation of an external biventricular assist device (Berlin Heart) and was started on antiplatelet drugs plus full\u2011dose heparin to prevent clots. At 23 months he presented with reduced consciousness and right\u2011sided weakness; CT scan showed an occlusion of the left middle cerebral artery. Because he was on combined antiplatelet and anticoagulant therapy, intravenous thrombolysis was contraindicated, so an urgent intra\u2011arterial mechanical thrombectomy with a stent\u2011retriever was performed and the artery was reopened in a single pass with good clinical result. Angiography detected a small procedure\u2011related dissection of the left internal carotid artery that had no clinical impact because the left hemisphere was perfused through the anterior communicating artery. One month later he underwent a successful heart transplant; the only lasting neurological deficit was spasticity of the right upper limb.",
126
+ "original_ai_text": "A boy with restrictive cardiomyopathy was listed for a heart transplant at 16 months. At 20 months, he needed an external biventricular assist device (Berlin Heart) to support his heart while he waited. At 23 months, he had a left-hemisphere stroke. Because he was on blood thinners, doctors used an intra-arterial, catheter-based procedure to remove the clot rather than IV clot-busting medicine. He recovered well from the stroke. One month later, he underwent a successful heart transplant."
127
+ },
128
+ {
129
+ "doc_id": 44,
130
+ "ai_label": "intermediate_health_literacy",
131
+ "status": "Manually Corrected/AI Refined",
132
+ "final_text": "A 12-year-old boy was admitted with sudden headaches and a week-long history of excessive urination and thirst. Tests showed central diabetes insipidus (low urine concentration with normal blood sodium and plasma osmolality), and MRI identified apoplexy (bleeding or sudden change) in a Rathke cleft cyst measuring about 15 \u00d7 6 \u00d7 11 mm; the normal bright signal of the posterior pituitary was lost but the anterior pituitary enhanced normally. He had no visual problems and routine pituitary hormone tests were otherwise normal. Because he was early in puberty, had no compressive symptoms, and basic endocrine tests were normal, a multidisciplinary team chose conservative management: clinical, hormonal and MRI follow-up, and treatment of the diabetes insipidus with vasopressin. Over three years the cyst remained stable then decreased in size (about 12 \u00d7 11 \u00d7 10 mm at nine months, 11 \u00d7 12 \u00d7 11 mm at two years, and 7 \u00d7 10 \u00d7 6 mm at three years), puberty progressed normally, and vision stayed normal. During follow-up his growth slowed, and stimulation tests at age 14 years 9 months showed a partial growth hormone deficiency; after starting growth hormone therapy his growth rate improved markedly. Overall, conservative follow-up was effective: the Rathke cleft cyst apoplexy stabilized and shrank, diabetes insipidus was controlled, and the only long-term endocrine issue was a treatable partial GH deficiency.",
133
+ "original_ai_text": "A 12-year-old boy developed new headaches and diabetes insipidus (very high urination and thirst). An MRI showed a Rathke cleft cyst apoplexy. Because there were no signs of pressure on nearby structures, he was at the start of puberty, and his initial hormone tests were normal, the team chose conservative management with regular clinical, laboratory, and MRI follow-up. Over time, he progressed through normal puberty without other pituitary hormone deficits, except for a partial growth hormone deficiency detected later. He was treated for the growth hormone deficit and his growth improved, while serial MRIs showed a stable, then slightly smaller, cyst."
134
+ },
135
+ {
136
+ "doc_id": 45,
137
+ "ai_label": "low_health_literacy",
138
+ "status": "Approved",
139
+ "final_text": "This report is about a 67-year-old person with no major past illnesses. Their overall health got worse over time. They developed a hoarse voice and trouble swallowing. A large lump showed up in the neck/throat area. A small tissue test (biopsy) showed a slow-growing type of lymphoma (non-Hodgkin), grade 1\u20132. A special X\u2011ray scan found a lump behind the nose about 7 cm by 4 cm, reaching about 6 cm in length. Tests on the soft center of the bones (bone marrow) were normal. The checkup before treatment was also normal. The person had four rounds of a chemo mix called rituximab plus CHOP, but it did not work. Then they had three rounds of rituximab plus DHAOX, and the lump stayed. A new biopsy showed the B\u2011cells were gone, and there was a build\u2011up of an abnormal protein called AL amyloid. A blood test found a protein called immunoglobulin M (IgM). A PET scan showed an active spot in the area behind the nose. The person is now on treatment with bortezomib, prednisone, and bendamustine.",
140
+ "original_ai_text": "This report is about a 67-year-old person with no major past illnesses. Their overall health got worse over time. They developed a hoarse voice and trouble swallowing. A large lump showed up in the neck/throat area. A small tissue test (biopsy) showed a slow-growing type of lymphoma (non-Hodgkin), grade 1\u20132. A special X\u2011ray scan found a lump behind the nose about 7 cm by 4 cm, reaching about 6 cm in length. Tests on the soft center of the bones (bone marrow) were normal. The checkup before treatment was also normal. The person had four rounds of a chemo mix called rituximab plus CHOP, but it did not work. Then they had three rounds of rituximab plus DHAOX, and the lump stayed. A new biopsy showed the B\u2011cells were gone, and there was a build\u2011up of an abnormal protein called AL amyloid. A blood test found a protein called immunoglobulin M (IgM). A PET scan showed an active spot in the area behind the nose. The person is now on treatment with bortezomib, prednisone, and bendamustine."
141
+ },
142
+ {
143
+ "doc_id": 45,
144
+ "ai_label": "intermediate_health_literacy",
145
+ "status": "Approved",
146
+ "final_text": "A 67-year-old patient with no significant past medical history presented with declining overall health marked by progressive hoarseness (dysphonia) and difficulty swallowing (dysphagia). Imaging showed a large nasopharyngeal/neck mass. Biopsy confirmed grade 1\u20132 follicular non-Hodgkin lymphoma. CT of the neck, chest, abdomen, and pelvis found a nasopharyngeal mass measuring about 70 \u00d7 40 mm with extension to 60 mm. Bone marrow biopsy and the pre-treatment evaluation were normal. The patient received four cycles of rituximab plus CHOP without response, followed by three cycles of rituximab plus DHAOX, with persistence of the mass. Repeat biopsy then showed loss of B\u2011cell infiltration and the presence of AL amyloid deposits. Serum protein immunoelectrophoresis detected immunoglobulin M. PET imaging demonstrated a hypermetabolic nasopharyngeal process. The patient is currently being treated with bortezomib, prednisone, and bendamustine.",
147
+ "original_ai_text": "A 67-year-old patient with no significant past medical history presented with declining overall health marked by progressive hoarseness (dysphonia) and difficulty swallowing (dysphagia). Imaging showed a large nasopharyngeal/neck mass. Biopsy confirmed grade 1\u20132 follicular non-Hodgkin lymphoma. CT of the neck, chest, abdomen, and pelvis found a nasopharyngeal mass measuring about 70 \u00d7 40 mm with extension to 60 mm. Bone marrow biopsy and the pre-treatment evaluation were normal. The patient received four cycles of rituximab plus CHOP without response, followed by three cycles of rituximab plus DHAOX, with persistence of the mass. Repeat biopsy then showed loss of B\u2011cell infiltration and the presence of AL amyloid deposits. Serum protein immunoelectrophoresis detected immunoglobulin M. PET imaging demonstrated a hypermetabolic nasopharyngeal process. The patient is currently being treated with bortezomib, prednisone, and bendamustine."
148
+ },
149
+ {
150
+ "doc_id": 49,
151
+ "ai_label": "intermediate_health_literacy",
152
+ "status": "Manually Corrected/AI Refined",
153
+ "final_text": "A 16-year-old girl has a depressed gray plaque on the lower outer (lateral) part of her left thigh, about 10.5 \u00d7 8.0 cm. The area includes lighter patches and small dilated surface blood vessels (telangiectasias) around the edges, and some nearby veins are visible. The lesion has been present since birth\u2014it was initially purplish (violaceous) and over the years became lighter and sunken. There is no difference in leg length. Vascular imaging (angioresonance) shows a vascular malformation involving the skin and the fat under the skin in that area, supplied by branches of the popliteal artery. The scan showed early filling of veins, which suggests early venous shunting; no markedly dilated draining veins were found except for a superficial draining vein along the front of the thigh. The subcutaneous tissue beneath the plaque is thinner, and there is no extension into muscle or bone.",
154
+ "original_ai_text": "A 16-year-old girl has a depressed gray plaque on the lower outer part of her left thigh, measuring about 10.5 by 8 cm. It has been present since birth, was initially purple, and gradually became lighter and sunken. Small surface blood vessels can be seen around it, with some nearby veins. An angioresonance (vascular MRI) shows a vascular malformation limited to the skin and subcutaneous tissue, supplied by branches from the popliteal artery, with early venous filling that suggests some artery-to-vein shunting. The subcutaneous tissue in that spot is thinned, with no spread into muscle or bone, and there is no difference in leg length. No large draining veins were seen, aside from one superficial vein in the front of the thigh."
155
+ },
156
+ {
157
+ "doc_id": 50,
158
+ "ai_label": "low_health_literacy",
159
+ "status": "Approved",
160
+ "final_text": "A 57-year-old patient had asthma and nose allergies. She kept having stomach pain. Her blood showed very high levels of allergy-fighting white cells. A certain immune protein (IgG4) was also high. The doctors checked for blood cancers and other causes and did not find them. They gently took tiny samples from the lining of her large intestine. The samples showed too many of those allergy cells sitting in the tissue. This meant she had eosinophilic colitis, which is swelling of the colon from a build-up of allergy cells. She took a steroid medicine to calm the swelling. Then she stayed on montelukast to keep the problem quiet. Her pain went away and did not come back for three months.",
161
+ "original_ai_text": "A 57-year-old patient had asthma and nose allergies. She kept having stomach pain. Her blood showed very high levels of allergy-fighting white cells. A certain immune protein (IgG4) was also high. The doctors checked for blood cancers and other causes and did not find them. They gently took tiny samples from the lining of her large intestine. The samples showed too many of those allergy cells sitting in the tissue. This meant she had eosinophilic colitis, which is swelling of the colon from a build-up of allergy cells. She took a steroid medicine to calm the swelling. Then she stayed on montelukast to keep the problem quiet. Her pain went away and did not come back for three months."
162
+ },
163
+ {
164
+ "doc_id": 52,
165
+ "ai_label": "intermediate_health_literacy",
166
+ "status": "Manually Corrected/AI Refined",
167
+ "final_text": "A 2.5-year-old girl with a known diagnosis of neurofibromatosis type 1 (NF1) developed four weeks of watery diarrhea that became bloody. She was initially treated for dehydration after a rotavirus infection but continued to have bloody stools and weight loss. Colonoscopy showed red, inflamed mucosa from the anal margin through the colon up to the cecum, with loss of the normal visible blood vessels. Biopsies of the colon showed chronic inflammation with cryptitis and microabscesses, findings consistent with ulcerative colitis (UC). A PCR test on the colon tissue was positive for cytomegalovirus (CMV); blood testing showed past CMV exposure (IgG positive), no IgM, and a low CMV viral load. Blood tests showed mild anemia, a raised white count, and slightly increased CRP; faecal calprotectin was >600 \u00b5g/g, supporting active intestinal inflammation. Immunology testing and a broad genetic panel for monogenic immune causes were essentially normal. She was treated with mesalazine and received 15 days of intravenous ganciclovir for CMV, with clinical improvement and undetectable CMV on repeat testing at discharge. Two months later she had a flare with bloody diarrhea; stool testing showed Clostridioides difficile and CMV was undetectable. She was treated with antibiotics and prednisone, improved, and is maintained on mesalazine with only mild ongoing symptoms.",
168
+ "original_ai_text": "A 2.5-year-old preschooler with known neurofibromatosis type 1 (NF1) presented with several weeks of bloody diarrhea. Colonoscopy showed diffuse inflammation from the anal margin to the cecum with loss of the normal vascular pattern. Colon biopsies demonstrated chronic inflammatory changes consistent with ulcerative colitis. Cytomegalovirus (CMV) infection was confirmed by PCR performed on the colon tissue. Together, these findings support a diagnosis of ulcerative colitis with concurrent CMV infection as the likely cause of the bloody diarrhea."
169
+ },
170
+ {
171
+ "doc_id": 53,
172
+ "ai_label": "low_health_literacy",
173
+ "status": "Approved",
174
+ "final_text": "A 40-year-old man has HIV and takes his medicines regularly. For two years, he had fevers that came and went. In the last two months, he also had spreading belly pain and many swollen glands. Blood tests showed very low blood cells, blood that did not clot well, low blood protein, and strong signs of inflammation. A body scan showed a big liver and spleen and many swollen glands. Many germ tests were done and were negative, except one that found the HHV-8 virus. A gland sample showed a rare illness called Castleman\u2019s disease. Even after restarting his HIV drugs, he got worse. Doctors tried steroids and an antiviral called ganciclovir. A week later, many organs started to fail and he swelled all over, so those drugs had to be stopped. A new chest scan showed small branch-like spots in the right lung and fluid around both lungs. The belly scan showed the liver and spleen got bigger and there was fluid in the belly. He went to intensive care because his liver suddenly failed. He died soon after. After his death, a lung sample grew tuberculosis. A liver sample showed tiny immune lumps called granulomas.",
175
+ "original_ai_text": "A 40-year-old man has HIV and takes his medicines regularly. For two years, he had fevers that came and went. In the last two months, he also had spreading belly pain and many swollen glands. Blood tests showed very low blood cells, blood that did not clot well, low blood protein, and strong signs of inflammation. A body scan showed a big liver and spleen and many swollen glands. Many germ tests were done and were negative, except one that found the HHV-8 virus. A gland sample showed a rare illness called Castleman\u2019s disease. Even after restarting his HIV drugs, he got worse. Doctors tried steroids and an antiviral called ganciclovir. A week later, many organs started to fail and he swelled all over, so those drugs had to be stopped. A new chest scan showed small branch-like spots in the right lung and fluid around both lungs. The belly scan showed the liver and spleen got bigger and there was fluid in the belly. He went to intensive care because his liver suddenly failed. He died soon after. After his death, a lung sample grew tuberculosis. A liver sample showed tiny immune lumps called granulomas."
176
+ },
177
+ {
178
+ "doc_id": 53,
179
+ "ai_label": "intermediate_health_literacy",
180
+ "status": "Approved",
181
+ "final_text": "A 40-year-old man with HIV on treatment presented with intermittent fevers for two years. Over the prior two months, he developed progressive, diffuse abdominal pain and generalized lymphadenopathy. Laboratory tests showed pancytopenia, coagulopathy, hypoalbuminemia, and elevated inflammatory markers. CT of the chest, abdomen, and pelvis revealed only hepatosplenomegaly and widespread adenopathy. Broad infectious workup, including mycobacterial cultures from multiple specimens, was negative except for a positive HHV-8 RT-PCR. A left iliac lymph node biopsy was consistent with Castleman\u2019s disease. Despite restarting antiretroviral therapy, his condition worsened, so clinicians initiated corticosteroids and ganciclovir. After one week he developed multiorgan failure with anasarca, making those medications unsafe. Repeat chest CT showed right upper lobe tree-in-bud infiltrates with bilateral pleural effusions; abdominal imaging showed worsening hepatosplenomegaly and new ascites. He was transferred to the ICU 48 hours later for fulminant hepatic failure and died shortly afterward. Postmortem testing grew Mycobacterium tuberculosis from a tracheal aspirate, and liver biopsy showed non-necrotizing granulomas.",
182
+ "original_ai_text": "A 40-year-old man with HIV on treatment presented with intermittent fevers for two years. Over the prior two months, he developed progressive, diffuse abdominal pain and generalized lymphadenopathy. Laboratory tests showed pancytopenia, coagulopathy, hypoalbuminemia, and elevated inflammatory markers. CT of the chest, abdomen, and pelvis revealed only hepatosplenomegaly and widespread adenopathy. Broad infectious workup, including mycobacterial cultures from multiple specimens, was negative except for a positive HHV-8 RT-PCR. A left iliac lymph node biopsy was consistent with Castleman\u2019s disease. Despite restarting antiretroviral therapy, his condition worsened, so clinicians initiated corticosteroids and ganciclovir. After one week he developed multiorgan failure with anasarca, making those medications unsafe. Repeat chest CT showed right upper lobe tree-in-bud infiltrates with bilateral pleural effusions; abdominal imaging showed worsening hepatosplenomegaly and new ascites. He was transferred to the ICU 48 hours later for fulminant hepatic failure and died shortly afterward. Postmortem testing grew Mycobacterium tuberculosis from a tracheal aspirate, and liver biopsy showed non-necrotizing granulomas."
183
+ },
184
+ {
185
+ "doc_id": 54,
186
+ "ai_label": "low_health_literacy",
187
+ "status": "Approved",
188
+ "final_text": "This story is about a 4\u2011month\u2011old baby girl from an Indigenous community in rural Panama. The nearest clinic was three hours away by canoe. She was not getting enough protein and calories. She suddenly had bad diarrhea. She got very dehydrated, like a plant without water. A probiotic medicine called Enterogermina was given at the start. She was moved to a large hospital. She arrived breathing hard. She was in shock, which means her blood was not carrying enough to her organs. A blood test found a hard\u2011to\u2011treat germ called MRSA. A stool test found a germ called C. difficile that can cause diarrhea. Later blood tests from her arm and from a central line found Bacillus clausii. Doctors tried many antibiotics, but the germs did not respond. Her organs began to fail. She died 12 days after she got to the hospital.",
189
+ "original_ai_text": "This story is about a 4\u2011month\u2011old baby girl from an Indigenous community in rural Panama. The nearest clinic was three hours away by canoe. She was not getting enough protein and calories. She suddenly had bad diarrhea. She got very dehydrated, like a plant without water. A probiotic medicine called Enterogermina was given at the start. She was moved to a large hospital. She arrived breathing hard. She was in shock, which means her blood was not carrying enough to her organs. A blood test found a hard\u2011to\u2011treat germ called MRSA. A stool test found a germ called C. difficile that can cause diarrhea. Later blood tests from her arm and from a central line found Bacillus clausii. Doctors tried many antibiotics, but the germs did not respond. Her organs began to fail. She died 12 days after she got to the hospital."
190
+ },
191
+ {
192
+ "doc_id": 54,
193
+ "ai_label": "intermediate_health_literacy",
194
+ "status": "Manually Corrected/AI Refined",
195
+ "final_text": "A 4\u2011month\u2011old indigenous infant from a remote rural area of Panama (about three hours by canoe from the nearest health subcenter) with protein\u2011calorie malnutrition presented with acute diarrhea and moderate\u2011to\u2011severe dehydration. She had limited prior health care, had not received routine vaccinations, and was initially given Enterogermina (Bacillus clausii spores) and oral rehydration before being transferred to higher\u2011level hospitals because local facilities lacked supplies. On arrival at a third\u2011level hospital she had respiratory distress and signs of shock and was admitted to the pediatric intensive care unit, intubated, and treated with fluids, blood products, and multiple antibiotics. Initial blood culture grew methicillin\u2011resistant Staphylococcus aureus (MRSA); a gastrointestinal panel later detected Clostridioides difficile. Subsequent serial blood cultures from both peripheral blood and the central venous catheter repeatedly grew Bacillus clausii. Despite changes to antibiotic therapy to cover MRSA, C. difficile, and B. clausii, she developed worsening multisystem organ failure, including cardiac and kidney dysfunction, and died twelve days after admission.",
196
+ "original_ai_text": "A 4\u2011month\u2011old Indigenous infant from rural Panama, living three hours by canoe from the nearest health center, had severe protein\u2011calorie malnutrition and presented with acute diarrhea and dehydration. At the first clinic, she received oral therapy that included Enterogermina (a probiotic containing Bacillus clausii) and was transferred to a tertiary hospital. She arrived with respiratory distress and clinical shock. The initial blood culture grew methicillin\u2011resistant Staphylococcus aureus (MRSA). A gastrointestinal panel was positive for Clostridioides difficile toxin. Subsequent serial blood cultures from both peripheral draws and a central venous catheter repeatedly isolated Bacillus clausii. Despite multiple antibiotic regimens aimed at MRSA, C. difficile, and B. clausii, her condition worsened. She developed multisystem organ failure and died on hospital day 12."
197
+ },
198
+ {
199
+ "doc_id": 55,
200
+ "ai_label": "intermediate_health_literacy",
201
+ "status": "Manually Corrected/AI Refined",
202
+ "final_text": "A 2-year-old girl had a 1-year history of painless, progressive protrusion of the left eye with the eye displaced inward and upward; vision in that eye was only light perception. MRI showed a well-defined mass in the orbit that was dark on T1-weighted images and bright on T2-weighted images, with no clear contrast enhancement. The mass was removed through the lower eyelid conjunctiva using a transconjunctival approach with canthotomy and cantholysis to widen the surgical field; the tumor was cystic, gray\u2011white, and tightly adherent to the optic nerve, so about 12.5 mL of fluid was aspirated to reduce its size before complete excision. Histology and immunohistochemistry confirmed an orbital teratoma, showing squamous and glandular epithelium, brain tissue, and cartilage\u2011like material. One month after the first surgery the child developed enophthalmos (a sunken eye), conjunctival redness, and keratitis because removal of the large mass left reduced orbital volume and the cornea could not fully close. A second operation implanted donor (allogeneic) scleral tissue into the orbit to increase volume, correct the posterior fossa indentation, and allow the cornea to recover. At 1-year follow-up there was no tumor recurrence; vision remained at the preoperative level and the child had only minor residual enophthalmos and an outer canthus abnormality.",
203
+ "original_ai_text": "A 2-year-old girl presented with left eye proptosis, with the globe displaced inward and upward. MRI showed a well-circumscribed orbital mass that was hypointense on T1-weighted images and hyperintense on T2-weighted images. Pathology, including histology and immunohistochemistry, confirmed teratoma. The mass was removed through a transconjunctival approach via the inferior fornix with canthotomy and cantholysis. One month after surgery, she developed enophthalmos, conjunctival hyperemia, and keratitis. A second procedure placed an allogeneic scleral implant to increase orbital volume, correct the socket hollowing, and resolve the corneal inflammation. At 1-year follow-up, there was no tumor recurrence and no other complications."
204
+ },
205
+ {
206
+ "doc_id": 57,
207
+ "ai_label": "intermediate_health_literacy",
208
+ "status": "Manually Corrected/AI Refined",
209
+ "final_text": "This case report describes a 9-year-old girl who was diagnosed with developmental dyslexia alongside high abilities (giftedness). The team compared her phonological processing, reading and writing before and after a program of 20 weekly phonological remediation sessions. Before intervention (age 8y2m) she showed weak phonological processing, reading at an alphabetic level, and writing in transition between syllabic-alphabetic and alphabetic stages. The remediation targeted phonological awareness, working memory, rapid naming and reading practice. After treatment (age 9y6m) phonological skills improved (notably phonemic awareness), phonological working memory reached age-appropriate levels, and rapid naming times improved for letters, objects and colors (digits stayed below expectation). Her reading advanced from an alphabetic to an orthographic level: oral reading rate rose from about 20 words per minute to about 94 words per minute, with better prosody and comprehension. Writing also showed gains and was classified at the alphabetic phase, but remained imprecise with letter reversals, omissions and segmentation errors that reflect persistent dyslexic features. In summary, phonological remediation produced clear gains in phonology and reading fluency, and helped consolidate alphabetic writing, but some difficulties in lexical access and accurate spelling persisted.",
210
+ "original_ai_text": "This case report describes a 9-year-old child with the unusual combination of high abilities and dyslexia. The goal was to compare her phonological processing, reading, and writing before and after a structured program focused on phonological skills. At the first assessment, she read at the alphabetic level, her writing was in the transition between syllabic\u2013alphabetic and alphabetic stages, and her phonological processing was below expectations. After phonological remediation, her phonological processing improved, her writing consolidated at the alphabetic stage, and her reading advanced to the orthographic level, indicating more efficient recognition of whole-word patterns and spelling regularities."
211
+ },
212
+ {
213
+ "doc_id": 59,
214
+ "ai_label": "intermediate_health_literacy",
215
+ "status": "Manually Corrected/AI Refined",
216
+ "final_text": "This report describes the first known case of heatstroke occurring together with SARS\u2011CoV\u20112 infection in a 52\u2011year\u2011old man. He had a recent cold and a positive self-test for COVID\u201119, then returned to work and lost consciousness after five hours outdoors in 35\u00b0C heat. On arrival at the hospital his core temperature was 40\u00b0C and he was comatose with breathing problems and gastrointestinal bleeding; clinicians diagnosed heatstroke. He was admitted to the ICU, placed on a ventilator, given IV fluids, antibiotics, blood\u2011pressure support, and continuous renal replacement therapy when his kidneys failed. Laboratory tests showed severe infection, low platelets and a severe clotting disorder (disseminated intravascular coagulation), plus liver, kidney and heart injury. Sputum and airway cultures later grew several pathogens (including Stenotrophomonas, Candida, MRSA, Acinetobacter and Aspergillus), and he was treated with broad antibiotics, antifungals, plasma and blood products, and anticoagulation as needed. After these treatments his fever subsided and he regained consciousness by about day 13 and was briefly taken off the ventilator. Several days later he suddenly worsened with respiratory failure, high fever and a return to coma; brain imaging showed an ischemic stroke and a hemorrhagic infarct. Despite further intensive care, he developed a large cerebral hemorrhage with brain herniation; surgery was not performed and his condition progressed to multiple organ dysfunction syndrome (MODS). The combination of multi\u2011pathogen pulmonary infection and an intractable coagulopathy ultimately led to MODS and death on day 29.",
217
+ "original_ai_text": "This is the first reported case of a 52-year-old man with heatstroke occurring alongside infection with SARS-CoV-2 (the virus that causes COVID-19). He was treated with intravenous antibiotics, organ-supportive care, and therapy for a blood-clotting disorder. His fever subsided and his coma resolved. Several days later, he developed severe shortness of breath and a brain hemorrhage. Testing showed a lung infection caused by multiple pathogens, and his coagulopathy was difficult to control. He progressed to multiple organ dysfunction syndrome (MODS) and died despite intensive care."
218
+ },
219
+ {
220
+ "doc_id": 60,
221
+ "ai_label": "low_health_literacy",
222
+ "status": "Approved",
223
+ "final_text": "A 19-year-old woman had a tumor on the gland that sits on top of the kidney that makes stress hormones. She did not have a dangerous attack, even though the tumor was large and she was given high-dose steroid medicine. A DNA test found a change in a gene called RET (c.1900T > C: p.Cys634Arg). This change is linked to a condition called MEN2A. Her thyroid had a small lump. A thyroid hormone called calcitonin was a little high. Her blood salts and the hormone that controls calcium (parathyroid hormone) were normal at first. For 15 months after surgery, calcitonin stayed a little high and the thyroid lump did not grow. Her parathyroid hormone and blood calcium slowly went up. A special scan of the parathyroid glands (99mTc-MIBI) did not show a tumor.",
224
+ "original_ai_text": "A 19-year-old woman had a tumor on the gland that sits on top of the kidney that makes stress hormones. She did not have a dangerous attack, even though the tumor was large and she was given high-dose steroid medicine. A DNA test found a change in a gene called RET (c.1900T > C: p.Cys634Arg). This change is linked to a condition called MEN2A. Her thyroid had a small lump. A thyroid hormone called calcitonin was a little high. Her blood salts and the hormone that controls calcium (parathyroid hormone) were normal at first. For 15 months after surgery, calcitonin stayed a little high and the thyroid lump did not grow. Her parathyroid hormone and blood calcium slowly went up. A special scan of the parathyroid glands (99mTc-MIBI) did not show a tumor."
225
+ },
226
+ {
227
+ "doc_id": 60,
228
+ "ai_label": "intermediate_health_literacy",
229
+ "status": "Manually Corrected/AI Refined",
230
+ "final_text": "A 19-year-old woman came to the emergency room with headache, nausea, vomiting and fever and was found to have very high blood pressure and a fast heart rate. Imaging incidentally showed a large mass on her left adrenal gland, and blood and 24-hour urine tests showed markedly raised catecholamines and their metabolites, confirming a diagnosis of pheochromocytoma. Despite the size of the tumor and receiving high\u2011dose glucocorticoid treatment early in her stay, she did not develop a hypertensive crisis. She had a past episode a year earlier diagnosed as myocarditis and a family history of sudden unexplained death. Genetic testing identified a pathogenic RET gene mutation (c.1900T>C, p.Cys634Arg) consistent with multiple endocrine neoplasia type 2A (MEN2A), so the thyroid and parathyroid glands were evaluated. Thyroid ultrasound found a small nodule and blood tests showed mildly raised calcitonin, while initial electrolytes and parathyroid hormone (PTH) were within the normal range. Three months later she underwent removal of the left adrenal tumor; pathology confirmed pheochromocytoma, and she recovered without recurrence of symptoms. Over 15 months of follow-up she continued to have mildly elevated calcitonin with a stable thyroid nodule, but PTH and serum calcium levels rose progressively. A 99mTc\u2011MIBI parathyroid scan did not show a parathyroid adenoma.",
231
+ "original_ai_text": "A 19-year-old woman was found to have a hormone-secreting adrenal tumor but never developed a pheochromocytoma crisis, even though the adrenal mass was large and she received high-dose glucocorticoids for suspected myocarditis. Biochemical testing confirmed catecholamine excess, and imaging supported a left adrenal pheochromocytoma. She later underwent adrenal tumor removal; pathology confirmed pheochromocytoma with a low Ki-67 index. Germline testing identified a RET mutation (c.1900T > C; p.Cys634Arg), consistent with MEN2A. Thyroid evaluation showed a small nodule with mildly elevated calcitonin; electrolytes and parathyroid hormone were initially normal. Over 15 months after surgery, calcitonin remained mildly elevated and the thyroid nodule size was stable, but parathyroid hormone and serum calcium rose progressively. A 99mTc-MIBI parathyroid scan was negative for an adenoma."
232
+ },
233
+ {
234
+ "doc_id": 62,
235
+ "ai_label": "intermediate_health_literacy",
236
+ "status": "Approved",
237
+ "final_text": "A 13-year-old boy presented with acute pleuritic chest pain but no other systemic symptoms. On exam, he had diminished breath sounds over the lower two thirds of the chest, and his oxygen saturation was normal (98% on room air). Chest X-ray showed a marked interstitial infiltrate similar to an image taken 4 years earlier during an illness treated presumptively with azithromycin. Chest CT demonstrated multiple bilateral ground-glass opacities with areas of \u201ccrazy paving,\u201d involving more than 65% of the lung, which raised concern for pulmonary alveolar proteinosis (PAP). Respiratory viral testing, including SARS-CoV-2, was negative. Bronchoalveolar lavage yielded milky fluid with positive periodic acid\u2013Schiff staining. Pulmonary function testing showed a mild restrictive pattern (FVC 77%) and a moderately reduced diffusing capacity (DLCO 48.6%). A genetic panel found no mutations linked to surfactant dysfunction. Anti\u2013GM-CSF antibodies were strongly positive, supporting autoimmune PAP. At 20 months, he remains asymptomatic, and spirometry has normalized.",
238
+ "original_ai_text": "A 13-year-old boy presented with acute pleuritic chest pain but no other systemic symptoms. On exam, he had diminished breath sounds over the lower two thirds of the chest, and his oxygen saturation was normal (98% on room air). Chest X-ray showed a marked interstitial infiltrate similar to an image taken 4 years earlier during an illness treated presumptively with azithromycin. Chest CT demonstrated multiple bilateral ground-glass opacities with areas of \u201ccrazy paving,\u201d involving more than 65% of the lung, which raised concern for pulmonary alveolar proteinosis (PAP). Respiratory viral testing, including SARS-CoV-2, was negative. Bronchoalveolar lavage yielded milky fluid with positive periodic acid\u2013Schiff staining. Pulmonary function testing showed a mild restrictive pattern (FVC 77%) and a moderately reduced diffusing capacity (DLCO 48.6%). A genetic panel found no mutations linked to surfactant dysfunction. Anti\u2013GM-CSF antibodies were strongly positive, supporting autoimmune PAP. At 20 months, he remains asymptomatic, and spirometry has normalized."
239
+ },
240
+ {
241
+ "doc_id": 66,
242
+ "ai_label": "intermediate_health_literacy",
243
+ "status": "Manually Corrected/AI Refined",
244
+ "final_text": "A 17-year-old male had an asymptomatic nasal foreign body (NFB) found incidentally on routine dental x-rays and cone beam CT during orthodontic planning. He denied any nasal blockage, nosebleeds, or discomfort. His parents recalled that at age seven he had put something in his nose; the family had been advised at the time to remove it under sedation but did not follow up, assuming it had fallen out. Endoscopic exam showed a deviated septum and enlargement of the lower nasal turbinate, with mild redness and swelling of the nasal lining. A shiny object was seen stuck to the floor of the right nasal cavity beneath the inferior turbinate and was partly covered with mucus and crust. X-rays and CBCT confirmed a circular radiopaque object consistent with a metallic snap button about 1 cm across, with mild surrounding inflammation but no damage to the nearby bone or sinuses. With parental consent, the button was removed in the clinic under local anesthesia and nasal decongestion while the patient was semi\u2011upright to reduce the risk of it moving toward the airway; removal with a hook and forceps was uncomplicated, with only minimal bleeding. The retrieved snap button showed corrosion and biological deposits, consistent with being present for many years. The patient was discharged in stable condition, advised to use saline nasal rinses, and was doing well with a normal exam at two-week follow-up.",
245
+ "original_ai_text": "A 17-year-old male had a nasal foreign body found by chance during routine dental imaging for orthodontic planning. He had no symptoms\u2014no nasal blockage, nosebleeds, or discomfort. The imaging showed a round object that stood out on x-ray along the floor of the right nasal cavity. It was later identified as a metallic snap button embedded low in the right nasal passage. His family history suggested he likely put it there as a child, so it had probably been present for over a decade. There was no damage to nearby bone or the sinuses on imaging. The object was removed under local anesthesia without complications, and follow-up was unremarkable."
246
+ },
247
+ {
248
+ "doc_id": 66,
249
+ "ai_label": "proficient_health_literacy",
250
+ "status": "Approved",
251
+ "final_text": "A 17-year-old male with no significant past medical or family history was referred from Dentistry after an incidental nasal foreign body (NFB) was detected during preoperative orthodontic planning with dental radiographs and cone beam computed tomography (CBCT) without contrast. He was entirely asymptomatic, denying nasal obstruction, rhinorrhea, epistaxis, foul odor, hyposmia, halitosis, facial pain, discomfort, or sleep disturbances. The parents recalled a prior event at age seven when he inserted an object into his nose; an anterior rhinoscopy was attempted at that time, and removal under sedation was recommended, but the family did not follow up and assumed spontaneous expulsion given the absence of symptoms. Nasal endoscopy of the right cavity showed a deviated nasal septum with inferior turbinate hypertrophy; the mucosa was erythematous and mildly edematous. A foreign body was visualized, lodged and adherent to the floor of the nasal cavity beneath the inferior turbinate, partially covered with mucus/crust, with a shiny surface suggesting a metallic nature. Lateral and frontal radiographs demonstrated a circular radiopaque object along the nasal floor consistent with a metallic snap button; adjacent bony structures were normal. CBCT confirmed the foreign body and mild surrounding inflammation, without significant bony erosion or sinus involvement. With informed consent, removal was performed under local anesthesia in a semi-sitting position to mitigate the risk of airway dislodgment. After decongestion with xylometazoline 0.1% and topical anesthesia with lidocaine spray (10 mg/spray) in the right nostril, a hook was used to disengage the foreign body, which was then extracted with bayonet forceps. The procedure was uncomplicated with minimal bleeding controlled by saline irrigation, and post-removal inspection showed no significant tissue injury. The retrieved object was a metallic snap button (1 cm diameter) with substantial corrosion and biological deposits, consistent with long-term retention\u2014likely over a decade. The patient was discharged in stable condition with 0.9% sodium chloride nasal irrigations and had an unremarkable two-week follow-up.",
252
+ "original_ai_text": "A 17-year-old male with no significant past medical or family history was referred from Dentistry after an incidental nasal foreign body (NFB) was detected during preoperative orthodontic planning with dental radiographs and cone beam computed tomography (CBCT) without contrast. He was entirely asymptomatic, denying nasal obstruction, rhinorrhea, epistaxis, foul odor, hyposmia, halitosis, facial pain, discomfort, or sleep disturbances. The parents recalled a prior event at age seven when he inserted an object into his nose; an anterior rhinoscopy was attempted at that time, and removal under sedation was recommended, but the family did not follow up and assumed spontaneous expulsion given the absence of symptoms. Nasal endoscopy of the right cavity showed a deviated nasal septum with inferior turbinate hypertrophy; the mucosa was erythematous and mildly edematous. A foreign body was visualized, lodged and adherent to the floor of the nasal cavity beneath the inferior turbinate, partially covered with mucus/crust, with a shiny surface suggesting a metallic nature. Lateral and frontal radiographs demonstrated a circular radiopaque object along the nasal floor consistent with a metallic snap button; adjacent bony structures were normal. CBCT confirmed the foreign body and mild surrounding inflammation, without significant bony erosion or sinus involvement. With informed consent, removal was performed under local anesthesia in a semi-sitting position to mitigate the risk of airway dislodgment. After decongestion with xylometazoline 0.1% and topical anesthesia with lidocaine spray (10 mg/spray) in the right nostril, a hook was used to disengage the foreign body, which was then extracted with bayonet forceps. The procedure was uncomplicated with minimal bleeding controlled by saline irrigation, and post-removal inspection showed no significant tissue injury. The retrieved object was a metallic snap button (1 cm diameter) with substantial corrosion and biological deposits, consistent with long-term retention\u2014likely over a decade. The patient was discharged in stable condition with 0.9% sodium chloride nasal irrigations and had an unremarkable two-week follow-up."
253
+ },
254
+ {
255
+ "doc_id": 67,
256
+ "ai_label": "low_health_literacy",
257
+ "status": "Approved",
258
+ "final_text": "An 18-year-old man came to the emergency room with new chest pain, fever, and trouble breathing when he lay down. A blood test showed strain on his heart. His heart tracing had changes that can happen when the heart is irritated. His chest X-ray made the heart look bigger than normal. An ultrasound showed the heart muscle was very thick on both sides. It also showed fluid around the heart. Blood tests pointed to a common virus called Coxsackie, which can inflame the sac around the heart. Doctors treated him, but he got worse with shortness of breath and very low blood pressure. A new heart ultrasound showed the fluid was starting to squeeze his heart, like a tight jacket. Doctors drained the fluid, but his heart stopped, and he needed a heart-lung machine to stay alive. A small piece of heart tissue did not show infection. A small skin lump on his right arm was tested. It showed a rare blood cancer linked to the Epstein\u2013Barr virus. He started cancer medicines. His heart pumping got better. The fluid around his heart went away. The thick heart muscle slowly went back toward normal.",
259
+ "original_ai_text": "An 18-year-old man came to the emergency room with new chest pain, fever, and trouble breathing when he lay down. A blood test showed strain on his heart. His heart tracing had changes that can happen when the heart is irritated. His chest X-ray made the heart look bigger than normal. An ultrasound showed the heart muscle was very thick on both sides. It also showed fluid around the heart. Blood tests pointed to a common virus called Coxsackie, which can inflame the sac around the heart. Doctors treated him, but he got worse with shortness of breath and very low blood pressure. A new heart ultrasound showed the fluid was starting to squeeze his heart, like a tight jacket. Doctors drained the fluid, but his heart stopped, and he needed a heart-lung machine to stay alive. A small piece of heart tissue did not show infection. A small skin lump on his right arm was tested. It showed a rare blood cancer linked to the Epstein\u2013Barr virus. He started cancer medicines. His heart pumping got better. The fluid around his heart went away. The thick heart muscle slowly went back toward normal."
260
+ },
261
+ {
262
+ "doc_id": 67,
263
+ "ai_label": "intermediate_health_literacy",
264
+ "status": "Manually Corrected/AI Refined",
265
+ "final_text": "An 18-year-old man came to the emergency department with new chest pain, fever, shortness of breath when lying flat (orthopnoea) and a dry cough for several days. Initial tests showed an elevated troponin, diffuse ST-segment elevations on ECG, and an enlarged heart on chest X-ray. Transthoracic echocardiogram (TTE) showed severe concentric thickening of both ventricles and a pericardial effusion; Coxsackie A and B antibody titres were also positive, so clinicians initially treated him for viral myopericarditis with anti-inflammatory medications. Despite treatment he acutely worsened on day four, becoming hypotensive and short of breath; repeat TTE showed impending cardiac tamponade and he underwent pericardiocentesis. The procedure was complicated by a pulseless electrical activity cardiac arrest, and he required intubation and venoarterial extracorporeal membrane oxygenation (VA-ECMO) for circulatory support. An endomyocardial biopsy did not show inflammation, and blood testing found a very high Epstein\u2013Barr virus (EBV) PCR. A separate biopsy of a small painless mass on his right arm unexpectedly showed EBV-positive natural killer/T\u2011cell lymphoma. With a working diagnosis of lymphoma involving the heart and pericardium, he was started on systemic chemotherapy (initially an emergency regimen followed by modified lymphoma protocols). After treatment his heart function steadily improved: ejection fraction recovered to normal range, the pericardial effusion resolved, and the abnormal myocardial thickening decreased. He completed most planned chemotherapy cycles and continues follow-up with cardiology and oncology.",
266
+ "original_ai_text": "An 18-year-old man presented with new chest pain, fever, and shortness of breath when lying flat. Testing showed elevated troponin, diffuse ST-segment elevation on ECG, and an enlarged heart silhouette on chest X-ray. Transthoracic echocardiography revealed markedly thickened heart muscle in both ventricles and a pericardial effusion. Blood tests were positive for Coxsackie A and B, so he was treated for presumed viral pericarditis. Despite this, he became short of breath and hypotensive. Repeat echocardiography showed impending cardiac tamponade. Pericardiocentesis was performed but was complicated by a pulseless electrical activity arrest, and he required venoarterial ECMO. An urgent endomyocardial biopsy did not show inflammation. A biopsy of a small right arm skin lesion unexpectedly diagnosed Epstein\u2013Barr virus\u2013positive NK/T-cell lymphoma. After starting chemotherapy, he improved: his ejection fraction rose, the pericardial effusion resolved, and the previously thickened myocardium gradually regressed."
267
+ },
268
+ {
269
+ "doc_id": 72,
270
+ "ai_label": "low_health_literacy",
271
+ "status": "Approved",
272
+ "final_text": "She had a heart transplant because her heart got very weak after pregnancy. Later, her kidneys\u2014the body\u2019s filters\u2014were hurt by a germ called BK virus. A small kidney sample showed long\u2011lasting irritation and damage from this virus. A blood test also showed a high amount of BK virus (log 4.5). Her doctors turned down her anti\u2011rejection medicines to help. After about two years, her kidney numbers stayed steady. Her creatinine was 2.5 mg/dL and her GFR was 23.4 mL/min/1.73m2.",
273
+ "original_ai_text": "She had a heart transplant because her heart got very weak after pregnancy. Later, her kidneys\u2014the body\u2019s filters\u2014were hurt by a germ called BK virus. A small kidney sample showed long\u2011lasting irritation and damage from this virus. A blood test also showed a high amount of BK virus (log 4.5). Her doctors turned down her anti\u2011rejection medicines to help. After about two years, her kidney numbers stayed steady. Her creatinine was 2.5 mg/dL and her GFR was 23.4 mL/min/1.73m2."
274
+ },
275
+ {
276
+ "doc_id": 72,
277
+ "ai_label": "intermediate_health_literacy",
278
+ "status": "Manually Corrected/AI Refined",
279
+ "final_text": "A 39-year-old woman had a heart transplant in 2014 for peripartum cardiomyopathy and was treated with standard immunosuppression (basiliximab induction, then tacrolimus, everolimus and low\u2011dose prednisone). She had two treated episodes of rejection in the first year and initially normal kidney function. Routine BK virus monitoring was not done. Over the next two to three years her serum creatinine rose: first to 1.9 mg/dL in 2016 (which improved after lowering tacrolimus), then to 2.69 mg/dL in March 2017, when she was hospitalized. Workup including ultrasound and urine tests was unrevealing, so a kidney biopsy was performed. The biopsy showed chronic tubulointerstitial nephritis with late-stage BK virus nephropathy, and blood BK viral load was positive at about 33,800 copies/mL (log 4.5). Tacrolimus was stopped and her creatinine stabilized between 2.2 and 2.5 mg/dL while the BK viral load fell to undetectable levels. After two years of follow-up she had stable renal function with a creatinine of 2.5 mg/dL (estimated GFR about 23.4 mL/min/1.73 m2) and no further cardiac rejection.",
280
+ "original_ai_text": "A woman with peripartum cardiomyopathy underwent a heart transplant and later developed kidney problems due to BK virus. A kidney biopsy showed active, chronic tubulointerstitial nephritis consistent with late-stage BK virus nephropathy. Blood testing confirmed BK viremia with a viral load of log 4.5. Her immunosuppressive therapy was reduced. Over the next two years, her kidney function stabilized, with a serum creatinine of 2.5 mg/dL and an estimated GFR of 23.4 mL/min/1.73m2."
281
+ },
282
+ {
283
+ "doc_id": 74,
284
+ "ai_label": "intermediate_health_literacy",
285
+ "status": "Approved",
286
+ "final_text": "A 56-year-old Italian woman with transfusion-dependent beta-thalassemia major (with prior splenectomy and cholecystectomy) underwent MRI to measure iron in the heart, liver, and pancreas. At the time of imaging, she had no significant endocrine, cardiac, or hepatic complications and was taking deferasirox, vitamin D, and luspatercept. The MRI incidentally revealed a lobulated mass in the prevascular mediastinum. PET showed only mild FDG uptake, and chest CT identified multiple thin-walled cysts throughout both lungs, a pattern consistent with lymphangioleiomyomatosis (LAM). After multidisciplinary review, she had thoracoscopic thymectomy and a lung wedge resection. Pathology confirmed type B2 thymoma and pulmonary LAM. Based on these findings, adjuvant radiation therapy was recommended for the thymoma, and sirolimus was advised for LAM.",
287
+ "original_ai_text": "A 56-year-old Italian woman with transfusion-dependent beta-thalassemia major (with prior splenectomy and cholecystectomy) underwent MRI to measure iron in the heart, liver, and pancreas. At the time of imaging, she had no significant endocrine, cardiac, or hepatic complications and was taking deferasirox, vitamin D, and luspatercept. The MRI incidentally revealed a lobulated mass in the prevascular mediastinum. PET showed only mild FDG uptake, and chest CT identified multiple thin-walled cysts throughout both lungs, a pattern consistent with lymphangioleiomyomatosis (LAM). After multidisciplinary review, she had thoracoscopic thymectomy and a lung wedge resection. Pathology confirmed type B2 thymoma and pulmonary LAM. Based on these findings, adjuvant radiation therapy was recommended for the thymoma, and sirolimus was advised for LAM."
288
+ },
289
+ {
290
+ "doc_id": 75,
291
+ "ai_label": "intermediate_health_literacy",
292
+ "status": "Manually Corrected/AI Refined",
293
+ "final_text": "This report describes a 49-year-old woman with long\u2011standing systemic lupus erythematosus (SLE) who developed progressive kidney and heart failure and was listed for kidney transplantation after four years on dialysis. Her SLE began in childhood with lupus nephritis and she had prior immunosuppressive treatments; she was also hepatitis B and C positive. She had early heart disease, including a heart attack at age 20, later developed ischemic and dilated cardiomyopathy, received an ICD, and underwent mitral and tricuspid valve repair with left\u2011ventricle surgery; after that operation her kidney function worsened and dialysis was started. Before transplant she had severe heart dysfunction (LVEF about 26%, high BNP) and signs suggesting possible pulmonary hypertension, so the team added perioperative cardioprotective therapy with levosimendan. Levosimendan infusion (0.1 \u00b5g/kg/min) began after a dialysis session when the donor match was confirmed and continued through the first 24 hours after surgery. Anesthesia and postoperative care focused on protecting the new kidney and careful fluid and hemodynamic management; invasive pulmonary artery catheterization was avoided because of her ICD and unstable rhythm history. The postoperative course was complicated: she experienced delayed graft function requiring hemodialysis for roughly six weeks, had a biopsy\u2011proven acute rejection episode with acute tubular necrosis, and developed leukopenia and cytomegalovirus infection that led to changes in immunosuppression. BNP rose after surgery but then gradually fell; she was discharged on day 67 with serum creatinine 1.4 mg/dL. By one month after transplant there was measurable improvement in heart size and function (EF up to ~30%, better strain measurements), lower pressures suggesting less pulmonary hypertension, and better exercise tolerance (NYHA III/IV to II). At five months she had continued improvement in heart function, BNP down to about 1066 pg/mL, and normal kidney function.",
294
+ "original_ai_text": "A 49-year-old woman had long-standing lupus that gradually led to kidney failure and heart failure. She was on dialysis for four years while waiting for a kidney transplant. Because her heart\u2019s pumping ability was extremely weak before surgery, the team used levosimendan to support her heart around the time of the transplant.\n\nRecovery was difficult but ultimately successful. Early on, she needed extra support, yet by about one month after transplant her heart function had begun to improve, and her kidney function was normal. At five months, her heart function continued to improve, and her kidney function remained normal."
295
+ },
296
+ {
297
+ "doc_id": 76,
298
+ "ai_label": "intermediate_health_literacy",
299
+ "status": "Manually Corrected/AI Refined",
300
+ "final_text": "A 42-year-old woman with primary cough headache (PCH) could not tolerate oral preventive medicines because of side effects. She developed more than ten short, severe headache attacks a day after a bout of bronchitis; each attack lasted about 30 minutes, was triggered by coughing, straining or lifting, and reached 9/10 on a pain scale. Neurological exam and brain and neck imaging were normal, and she declined a lumbar puncture. Because she could not keep taking indomethacin and could not use other oral options, we offered an ultrasound-guided proximal greater occipital nerve block (PGONB) using bupivacaine. After a single, unilateral block the pain fell from 9/10 to 2/10 within 20 minutes. The block was repeated once weekly for a month; at two months both the number of attacks and their intensity had declined (about two attacks per month at 4/10), and by six months she reported no attacks. No adverse effects from the nerve blocks were observed, suggesting ultrasound-guided GON blockade can be an effective option when oral drugs are not tolerated.",
301
+ "original_ai_text": "A 42-year-old woman with primary cough headache could not tolerate oral medications because of side effects. She presented in an acute attack with pain rated 9/10 and was taken to a local operating room. An ultrasound-guided proximal greater occipital nerve block was performed using a local anesthetic. Her pain fell to 2/10 shortly after the injection. The block was repeated once weekly for one month. At two months, both the frequency and intensity of her headaches had decreased, and no adverse effects were observed."
302
+ },
303
+ {
304
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+ "ai_label": "intermediate_health_literacy",
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+ "status": "Approved",
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+ "final_text": "A term newborn boy had neonatal Marfan syndrome with severe heart involvement. He showed typical features: very long fingers and toes (arachnodactyly), bent fingers and toes (camptodactyly), elbow and knee contractures, an aged facial appearance, deep-set downward-slanting eyes, underdeveloped ear cartilage with a sagging mouth, a short-wide head shape (brachycephaly), and ectopia lentis (displaced eye lenses). Genetic testing identified a new FBN1 mutation affecting a splice site (c.3964+1G>T in intron 32) within the known neonatal region (exons 24\u201332). He developed low cardiac output due to severe mitral and aortic regurgitation and also had pulmonary hypertension. Medical management focused on afterload reduction, deep sedation to lessen cardiac work, and diuretics to treat fluid overload and low urine output. Despite treatment, the valve regurgitation, pulmonary hypertension, and poor heart pumping worsened. Surgery would likely have been required to extend survival, but given the rapid and grave progression, the family chose palliative care. Within a few months after birth, he experienced rapidly progressive heart failure and died.",
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+ "original_ai_text": "A term newborn boy had neonatal Marfan syndrome with severe heart involvement. He showed typical features: very long fingers and toes (arachnodactyly), bent fingers and toes (camptodactyly), elbow and knee contractures, an aged facial appearance, deep-set downward-slanting eyes, underdeveloped ear cartilage with a sagging mouth, a short-wide head shape (brachycephaly), and ectopia lentis (displaced eye lenses). Genetic testing identified a new FBN1 mutation affecting a splice site (c.3964+1G>T in intron 32) within the known neonatal region (exons 24\u201332). He developed low cardiac output due to severe mitral and aortic regurgitation and also had pulmonary hypertension. Medical management focused on afterload reduction, deep sedation to lessen cardiac work, and diuretics to treat fluid overload and low urine output. Despite treatment, the valve regurgitation, pulmonary hypertension, and poor heart pumping worsened. Surgery would likely have been required to extend survival, but given the rapid and grave progression, the family chose palliative care. Within a few months after birth, he experienced rapidly progressive heart failure and died."
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