Doing the right thing at the right time: is there more to pulmonary valve replacement than meets the eye?
Bibliographic record
Abstract
Prior to Lillehei's first intracardiac repair, a child born with tetralogy of Fallot had a 50% chance of being alive at the age of 2 years.1 In the modern era, >90% of patients reach the age of 40.2 This dramatic increase in survival is primarily a reflection of the improvements in surgical technique and peri-operative care at the time of primary repair. Indeed, the overall late mortality and morbidity have not changed substantially during the last decades.2 Consequently there are a growing number of teenage and adult survivors after right ventricular outflow tract (RVOT) surgery, many of whom are destined to become symptomatic as a result of decades of free pulmonary incompetence. Previously thought to be the innocent bystander of successful relief of RVOT obstruction at the time of repair, pulmonary incompetence is now known to be the primary determinant of exercise intolerance, right ventricular dilation and failure, and ventricular arrhythmia and sudden death in these patients3. As a result, surgical pulmonary valve replacement late after repair of tetralogy of Fallot has gone from being relatively unusual to one of the most common operations performed in teenagers and adults with congenital heart disease.
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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 | 0.002 | 0.013 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.003 | 0.005 |
| Scholarly communication | 0.005 | 0.007 |
| Open science | 0.001 | 0.002 |
| Research integrity | 0.006 | 0.009 |
| Insufficient payload (model declined to judge) | 0.012 | 0.003 |
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".