Non-uniform aortic medial degenerative changes associated with aortic valve disease
Bibliographic record
Abstract
We read with interest the excellent article by Agozzino et al. [1], regarding the variable degree of aortic medial degenerative changes observed at the different aortic sinuses. They report more severe aortic medial degenerative changes above the non-coronary aortic sinus, as compared to the changes observed above the aortic sinus associated with the right coronary artery. Ten of their 22 cases are categorized as ‘dystrophic calcific valve disease’. It would be of interest to know the breakdown of this group to determine the number of cases that were actually tricuspid degenerative valves and more importantly, how many were congenitally bicuspid aortic valves with degeneration. This division of the data is of interest since congenitally bicuspid aortic valves are known to be associated with aortic medial disease (cystic medial necrosis), coarctation and congenital aortic arch abnormalities [2]. Investigators have postulated a common pathogenesis of aortic valve and aorta diseases, with evidence that the aortic valve and portions of the aorta may share a common embryonic origin [3]. In addition, echocardiographic observations by Pachulski and colleagues [4], demonstrated an association of aortic dilatation with congenitally bicuspid aortic valve in the absence of hemodynamic valvular abnormalities. We previously studied the severity of aortic medial degenerative changes associated with stenotic congenitally bicuspid and tricuspid aortic valves in patients who died shortly after aortic valve replacement [5]. Interestingly, the aortic sections in our study were taken from the aorta above the right coronary cusp (right anterior, 2 cm from the sinotubular junction). Computer aided morphometry demonstrated that the aortas of congenitally bicuspid aortic valve patients had less elastic tissue than those of patients with tricuspid aortic valves. In the study of Agozzino et al. [1], the aortic medial degeneration scores of aortic segments above the right aortic sinus, in Table 1, show variable scores, ranging from mild to severe. One wonders if the aortic medial degeneration score differs between tricuspid and bicuspid valves in the study group? The findings of this valuable study [1] add to our increasing knowledge concerning the aortic root, which is now recognized to be a complicated asymmetrical structure. The preliminary protein data are important and future studies will be important.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.009 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.002 | 0.002 |
| Scholarly communication | 0.001 | 0.002 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.012 | 0.006 |
| Insufficient payload (model declined to judge) | 0.005 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".