Bibliographic record
Abstract
The authors present the case of a patient with a 46, XX ovotesticular disorder of sex development diagnosed only in adulthood.[ 1 ] Cases like this one always result in a challenge for the treating team, as all treatment needs to be individualized. Since the 2005 Chicago consensus for disorders of sex development (DSD), the importance of a standardized terminology has become of significant relevance.[ 2 ] From an academic point of view, using the same technical terminology reduces confusion and helps the compilation of data for future studies. Authors fail to use standard terminology despite having the consensus as a reference. The frequency of these conditions makes management very challenging, and it is important to have specialized transdisciplinary teams, as this may improve the quality of care for these patients.[ 3 ] [ 4 ] [ 5 ] The authors present the chronological management for this patient, and it would be interesting to know the evolution and support given to the patient, from a psychosocial perspective, after surgery.[ 6 ] It would also be interesting to include in the discussion the rationale for the second laparotomy and how this was discussed with the patient. I found it confusing that the authors support the possibility of 46, XX ovotesticular diagnosis concomitant with 46, XX congenital adrenal hyperplasia. Pathophysiologically, these two conditions cannot be linked together, and it is difficult to believe that they can present simultaneously. It would also be interesting to know the background of the patient with bilateral non-palpable gonads because currently, in Colombia, access to healthcare is a worrisome component for patients and families with complex conditions at birth.[ 7 ] About 50% of the patients with congenital urological anomalies are not being seen by any specialists after birth, and from of the other 50% that have an appointment assigned, 90% are still waiting to be seen for the first time by a specialist by the age of 3 (personal data, not yet published). Our urological community needs to become more active and protect our patients from late diagnosis, which could lead to serious medical and psychological implications, such as in the case presented by the authors. Lastly, I would emphasize the importance of stating on the manuscript that the patient consented with the publication of his case and photographies, and I would also suggest submitting the consent as a supplementary document to be used in future publications.
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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 | 0.002 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.002 | 0.001 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.003 | 0.002 |
| Insufficient payload (model declined to judge) | 0.004 | 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".