Create data/train.csv

data/train.csv

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+id,case_id,real_case_summary,counterfactual_action,baseline_state_vector,divergence_trigger,cascade_sequence,cross_system_effects,time_to_divergence,new_basin_entered,cascade_evidence,constraints,gold_checklist
+CFCS-001,"CSEPS-01","Suspected sepsis; antibiotics delayed; lactate 3.9; hypotension; ICU later","Start antibiotics within 1h, then de-escalate after cultures and imaging","MAP 62, lactate 3.9, HR 110, CRP rising, urine low","earlier pathogen control reduces inflammatory drive","t+6h lactate 3.2; t+12h MAP 70 with less pressor; t+24h lactate 2.1; t+48h off pressors; day3 delirium shorter; day5 step-down","immune_inflammatory down, autonomic stabilizes, renal perfusion improves, neuro delirium less","6h","improved_stable_recovery","Earlier antibiotics shifts inflammatory trajectory and reduces need for escalation","Under 220 words.","sequence+effects+time+basis"
+CFCS-002,"CSEPS-01","Same case; fluids 3L caused pulmonary edema","Use 250-500mL boluses with early norepinephrine and bedside echo guidance","HFpEF, MAP 60, HR 112, SpO2 93, crackles mild","avoids fluid overload while maintaining perfusion","t+2h MAP 68 on low-dose pressor; t+6h SpO2 95 stable; t+12h no pulmonary edema; t+24h lactate 2.4; day2 mobilizes earlier","cardiopulmonary avoids overload, renal perfusion preserved, immune trend improves with less hypoxia","2h","improved_stable_recovery","Perfusion maintained without iatrogenic lung worsening, enabling faster recovery","Under 220 words.","sequence+effects+time+basis"
+CFCS-003,"CPE-03","Dyspnea; CT angio negative; discharged; returned worse pneumonia","Observe 24h with repeat vitals and CXR, start empiric antibiotics if infiltrate evolves","RR 24, SpO2 92, temp 37.9, WBC 12","observation detects deterioration early","t+6h repeat CXR shows infiltrate; t+8h antibiotics started; t+24h SpO2 94; day3 no readmission; day5 recovery at home","respiratory stabilizes, inflammation contained, social risk reduced","6h","improved_stable_recovery","Early detection and treatment prevents worsening basin and readmission","Under 220 words.","sequence+effects+time+basis"
+CFCS-004,"CPOSTOP-06","Post-op ileus; opioids high; nausea prolonged","Shift to opioid-sparing regimen early and add bowel regimen with mobilization targets","pain 8, HR 98, no flatus, nausea 7","reduced gut motility suppression","t+12h nausea down; day2 flatus; day3 diet advanced; day4 discharge; less delirium","GI recovery improves, autonomic stabilizes, neuro less delirium from opioids","12h","improved_stable_recovery","Removing opioid burden shifts GI and neuro system into recovery basin","Under 220 words.","sequence+effects+time+basis"
+CFCS-005,"CABX-04","Abscess found; drain delayed; prolonged fever","Urgent IR drainage same day with source control protocol","temp 39.2, WBC 17, pain focal, HR 120","source control collapses infection driver","t+6h fever down; t+24h WBC 13; day2 appetite returns; day3 mobility up; day5 discharge","immune resolves, autonomic improves, metabolic intake recovers","6h","improved_stable_recovery","Source control produces rapid coherence across vitals, labs, and function","Under 220 words.","sequence+effects+time+basis"
+CFCS-006,"CADR-08","Rash+fever; drug continued; later stopped and improved","Stop suspect drug immediately and provide supportive care while excluding infection","temp 38.7, rash diffuse, eos high, cultures pending","dechallenge removes trigger","t+12h fever down; day2 rash fading; day3 eos down; no steroids needed","immune calming, skin improves, avoids steroid harms","12h","improved_stable_recovery","Trigger removal prevents escalation and reduces iatrogenic risk","Under 220 words.","sequence+effects+time+basis"
+CFCS-007,"CCHF-09","Mixed shock; fluids worsened; diuresis helped; antibiotics late","Adopt mixed-shock frame early: cautious fluids, early antibiotics, early diuresis if congestion signs","MAP 60, BNP high, PCT high, SpO2 91, JVP high","avoids congestion and treats infection early","t+2h diuresis improves SpO2; t+6h MAP 68 with pressor; t+24h PCT down; day2 no ICU intubation; day4 step-down","cardiopulmonary stabilizes, immune improves, renal protected by avoiding overload","2h","improved_stable_recovery","Integrative action prevents oscillation between overload and hypoperfusion","Under 220 words.","sequence+effects+time+basis"
+CFCS-008,"CTBI-07","Mild TBI; no sleep protocol; prolonged fog","Implement sleep protocol day1 and graded cognitive rest with rehab start day3","sleep 4h, anxiety high, cognition low","early stabilization reduces oscillation","day1 sleep 7h; day3 rehab starts; week1 fewer symptom spikes; week3 return to work earlier","neuro stabilizes, autonomic sleep improves, subjective anxiety drops","24h","delayed_recovery","Improves coherence but still requires time; basin shifts from oscillation to slower ascent","24h","sequence includes rhythm change","Under 220 words.","sequence+effects+time+basis"
+CFCS-009,"CSEPS-02","Sepsis; delayed antibiotics; AKI worsened","Start antibiotics within 1h with renal dosing and monitoring","MAP 58, lactate 4.1, creatinine rising","earlier control reduces AKI drivers","t+6h lactate 3.4; t+24h creatinine stabilizes; day2 urine output improves; day4 ICU avoided","renal trajectory improves, immune load down, autonomic stable","6h","improved_stable_recovery","Earlier control prevents progression to AKI basin","Under 220 words.","sequence+effects+time+basis"
+CFCS-010,"CENDO-05","Gait issues; B12 low; treated late","Treat B12 immediately while MS workup continues","B12 120, MCV high, gait unstable","nutrient correction improves neuro function","week1 paresthesia less; week3 gait improves; week6 recovery continues","neuro improves, fatigue drops, avoids steroid harms","7 days","improved_stable_recovery","Treating low-risk high-yield cause shifts system toward coherence","Under 220 words.","sequence+effects+time+basis"