Of parachutes and tricuspid valves
Bibliographic record
Abstract
We would like to congratulate Purvis et al. on their marvellous images of a dysplastic tricuspid valve apparatus 1 and thank them for their interest in our own case report on an unusual anterior papillary muscle of the tricuspid valve. 2 Before discussing their proposed label ‘parachute-like asymmetric tricuspid valve’ for both our cases, it is worth reflecting on the normal anatomy of the tricuspid valve apparatus. As the name implies, the tricuspid valve consists of three leaflets, named according to their location: septal, posterior (often the smallest), and anterior (mostly the largest) leaflet. From an anatomical study published in 1971, we know the anterior leaflet often shows a notch close to the anteroseptal commissure, which in three-dimensional transoesophageal echocardiography (3D TEE) may give the impression of a fourth small leaflet. 3 Of equal interest are the chordae tendinae and the corresponding papillary muscles. Silver et al.3 describe five different types of chordae tendinae (not distinguishable by 3D TEE). They also showed that there is a considerable variation on how these cords are anchored. Most of the septal chords insert directly into tiny papillary muscles arising from the septum. The rather small posterior papillary muscle (sometimes we see two) gets chords from the posterior part of the septal leaflet, the posteroseptal commissure, and the septal part of the posterior leaflet. The anterior papillary muscle, often a prominent trunk arising from the right ventricular free wall or the moderator band, gets chords from the posterior leaflet, the anteroposterior commissure, and the posterior part of the anterior leaflet. Last but not the least, there is the medial papillary complex with its main muscle (Lancisi's muscle) at the bifurcation of the septomarginal trabeculation. 4 The chords inserting here support mainly the anteroseptal commissure and small parts of the adjacent septal and anterior leaflets.
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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 | 0.004 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.003 | 0.001 |
| Science and technology studies | 0.001 | 0.002 |
| Scholarly communication | 0.002 | 0.002 |
| Open science | 0.002 | 0.002 |
| Research integrity | 0.002 | 0.002 |
| Insufficient payload (model declined to judge) | 0.007 | 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".