New Advances in the Knowledge of Elemental Enthesis Lesions: Doppler, Erosion, and Thickness
Bibliographic record
Abstract
The entheses are more than a point of anatomical attachment for tendons, ligaments, joint capsules and fascia to bones; its involvement in the pathophysiology of spondyloarthritis (SpA) and psoriatic arthritis (PsA) is the cornerstone of these diseases. In 1971, the relevance of the enthesis as the primary pathological site of seronegative SpA was clearly defined.1 In 1999, McGonagle et al highlighted this central role with the concepts of the “enthesis organ”2 and the “synovio-entheseal complex,”3 in which the multiple enthesis components (eg, tendon fibers, paratenon, bursae, sinovium, fibrocartilage, specific cells, and cytokines) shape the physiopathological basis and the primary inflammatory location both in SpA and PsA, even leaving synovial involvement a secondary role.4 The term enthesis organ should be taken into special consideration, as it is very significant and was surely chosen to translate not only its complexity but also the systemic character of this affectation (leaving again the local boundary) and its capacity for remote connection with other distant disease domains. The Assessment of SpondyloArthritis international Society (ASAS), Group for Research and Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA), and European Alliance of Associations for Rheumatology (EULAR) recommend evaluating the enthesis as one of the outcome domains for assessing disease activity and response in SpA and PsA.5 Globally, enthesis is the epicenter of these diseases, and experts suggest its evaluation as a main outcome. However, in clinical practice, only indirect data of enthesis status in the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) and the Ankylosing Spondylitis Disease Activity Score (ASDAS) are used, as physical entheses examination is associated with a lack of sensitivity, specificity, and reliability that limit its use.6 For this reason, ultrasound (US) indices have emerged in recent years as an attempt to improve the evaluation of the enthesis, with … Address correspondence to Dr. C. Macía-Villa, Rheumatology Department, Hospital Universitario Ramón y Cajal, Carretera M-607, km 9.100, 28034, Madrid, Spain. Email: ccmacia{at}gmail.com.
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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 | 0.007 | 0.011 |
| Meta-epidemiology (narrow) | 0.002 | 0.001 |
| Meta-epidemiology (broad) | 0.003 | 0.001 |
| Bibliometrics | 0.010 | 0.006 |
| Science and technology studies | 0.001 | 0.004 |
| Scholarly communication | 0.004 | 0.012 |
| Open science | 0.003 | 0.002 |
| Research integrity | 0.003 | 0.006 |
| 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".