An unappetizing dog bone: cardiac sarcoidosis presenting with heart block and unusual left ventricular bulging
Bibliographic record
Abstract
A 39-year-old woman presented with syncope to a peripheral hospital where she was found to be bradycardic and hypotensive. A temporary transvenous pacemaker was inserted and the patient was transferred to our hospital. The patient was in complete heart block (Panel A). Cardiac catheterization revealed unusual bulging of the anterior left ventricular wall into the shape of a dog bone during left ventricular systole (Panel B). A cardiac CT showed an eccentric aneurysm of the anteroapical segment and the presence of a zonal gradient density of the myocardium at the apex with a relative hypodense subendocardial and mid-layer zones (Panel C). These findings were consistent with an infiltrative process. Left ventricle biopsy showed a focal mild endocarditis overlying a non-caseating granulomatous lesion, morphological features most consistent with sarcoidosis (Panel D). Gallium scanning showed increased uptake in the left ventricular apex (Panel E). Treatment with corticosteroids and methotrexate was initiated. A repeat gallium scan after 3 months of treatment showed no evidence of active disease (Panel F).
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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 | 0.000 | 0.003 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.002 | 0.001 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.004 | 0.002 |
| Insufficient payload (model declined to judge) | 0.003 | 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".