Description of a Phenomenon Resembling Spontaneous Echocardiographic Contrast in the Venous System
Bibliographic record
Abstract
Introduction. —According to Beppu et al., spontaneous echocardiographic contrast (SEC or smoke) is a pattern of “spontaneous swirling echoes originally visualized by transthoracic echocardiography in the enlarged left atrium of patients with mitral stenosis” (J Am Cardiol 1985;6:744–749). It has since been primarily associated with atrial fibrillation and flutter. The clinical significance of SEC is its association with left atrial thrombus, increased thromboembolic complications, and death. The pathogenesis of SEC seems to involve Rouleau formation between red cells and fibrinogen at low shear rates, which is an in vitro equivalent of blood stasis. Black noted that “Red cell aggregation, manifested as SEC, appears to be a precursor to thrombosis. Left atrial thrombi are rich in fibrin and red cells, resembling venous more than arterial thrombi” (Echocardiography 2000;17(4):373–382). Methods. —If left atrial thrombi are associated with SEC and resemble venous thrombi, it was hypothesized that actual venous thrombi in previously undescribed locations, most notably deep vein thrombosis, may equally be associated with SEC. We asked our coauthors (H.T. and M-C.Y.) to search for such a phenomenon among patients referred to the vascular laboratory for suspected venous thrombosis. Case Presentation. —In the following case series, we report an original phenomenon of swirling echogenicity in the venous system that we believe is SEC. The phenomenon was fairly rare (maximum 1.5% of referred patients, whereas deep venous thrombosis itself was 15-20%). The clinical significance of this phenomenon is discussed.
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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 | 0.004 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.003 | 0.001 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.002 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.003 | 0.003 |
| 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".