Third Place: Stones Lodge at Three Sites of Anatomic Narrowing in the Ureter: Clinical Fact or Fiction?
Bibliographic record
Abstract
UNLABELLED: Abstract Background and Purpose: Throughout the literature, the ureter is described as having three anatomic sites of narrowing at which kidney stones typically become lodged: The ureteropelvic junction (UPJ), the ureteral crossing of the iliac vessels, and the ureterovesical junction (UVJ). There is little evidence to support this notion, however. The purpose of our study is to evaluate whether three peaks in stone distribution corresponding to these anatomic landmarks exist. METHODS: We retrospectively reviewed the kidneys-ureters-bladder (KUB) films of 622 patients with solitary ureteral calculi referred for shockwave lithotripsy (SWL). Pretreatment KUB films were used to categorize the location of their ureteral stone relative to 1 of 19 levels referenced to the axial skeleton. CT scans of 74 patients were used to determine the location of the UPJ, ureteral crossing of the iliac vessels, and UVJ relative to the 19 levels on KUB radiography. Histograms were then constructed to plot the distribution of stones within the ureter relative to these 19 levels. The effect of sex, stone size and side, and presence of a stent on stone distribution were analyzed. RESULTS: There are two peaks in the distribution of stones within the ureter in patients referred for SWL that correspond to the UPJ/proximal ureter and intramural ureter/UVJ. In patients with larger stones (≥100 mm(2)) or a ureteral stent in place, stones were distributed more proximally (P<0.0001). When comparing sexes, there was a difference in stone distribution that approached significance (P=0.0523), with a greater peak more distally in males compared with females. CONCLUSIONS: Our review demonstrates a peak in the distribution of stones corresponding to the UPJ/proximal ureter and the intramural ureter/UVJ. We failed to demonstrate a peak in stone distribution corresponding with the ureteral crossing of the iliac vessels.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
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 teacher head, 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".