An unusual case of native mitral valve thrombosis and obstruction
Bibliographic record
Abstract
The patient is a 42-year old female known to have mitral stenosis. She had a history of systemic lupus erythematosus and antiphospholipid syndrome. Echocardiogram showed a mean mitral gradient of 27 mmHg (Fig. 1 A and B). She became haemodynamically unstable. At surgery, the mitral valve was found to be covered by a fresh thrombus obstructing almost the entire orifice (Fig. 2 A– C). Echocardiography of a patient in extremis with acute native mitral valve thrombosis. ( A ) A four-chamber transoesophageal image, which shows mitral leaflet thickening and significant tricuspid valve regurgitation. ( B ) An elevated transmitral gradient. Pathologic mitral valve specimen. ( A ) The atrial surface of the resected mitral valve with a thrombus (open arrow) obstructing almost the entire mitral orifice. A 2-mm orifice was observed (dark arrow). ( B ) The ventricular surface of the resected mitral valve showing thrombus formation (open arrow) and a thickened subvalvular apparatus (dark arrow). ( C ) The atrial surface of the freshly resected mitral valve with the thrombus (open arrow) obstructing almost the entire mitral orifice. The authors thank Eric Belanger and Mark Hynes, from the University of Ottawa heart Institute, Canada, for their assistance with this case.
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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 | 0.010 |
| Meta-epidemiology (narrow) | 0.003 | 0.002 |
| Meta-epidemiology (broad) | 0.002 | 0.002 |
| Bibliometrics | 0.005 | 0.003 |
| Science and technology studies | 0.003 | 0.002 |
| Scholarly communication | 0.004 | 0.004 |
| Open science | 0.002 | 0.003 |
| Research integrity | 0.014 | 0.005 |
| Insufficient payload (model declined to judge) | 0.005 | 0.002 |
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".