Abridged version: CUA guideline on the care of the normal foreskin and neonatal circumcision in Canadian infants
Bibliographic record
Abstract
Methods Systematic literature searches were conducted in MEDLINE including Pre-MEDLINE EMBASE, BIOSIS Previews ® , Web of Science ® -with Conference Proceedings, and the Cochrane Central Register of Controlled Trials electronic bibliographic databases and were restricted to either adult or pediatric studies (</> 18 years) (January 2000 to March 2013).An additional limited review was conducted till June 2016 to include any subsequent significant studies.All searches were restricted to studies published in the English language.The search strategy is described in the web version of the guideline.After excluding duplicate records and non-relevant studies, a total of 233 studies out of CUAJ -Guideline Dave et al Guideline: Foreskin care and neonatal circumcision 2674 were included in this analysis, though some studies are only discussed in the detailed version of this guideline. Care of the normal foreskin in childhood and management of physiological phimosisThe prepuce arises from the coronal margin by a combination of folding and epithelial outgrowth and has an outer and inner layer separated by Dartos fascia.At birth, the inner foreskin is fused to the glans penis and should not be retracted until spontaneous retraction occurs over the first few years of life.In the absence of clinical scarring suggesting pathological phimosis (Fig. 1), history of recurrent urinary tract infections (UTI's) or balano-posthitis (Fig. 2), no intervention is required for physiological phimosis.Ballooning of the foreskin during voiding is not associated with obstructed voiding and is not an indication for circumcision 3 .Vigorous retraction has the potential to cause micro-tears leading to scarring and an iatrogenic true phimosis.Therefore, normal foreskin care in early childhood starts once the foreskin is retractable and this occurs at varying ages.Indications for urological consultation include suspicion of true phimosis with evident scarring, Lichen sclerosis of the foreskin (Fig. 3), recurrent episodes of balano-posthitis or recurrent UTI's, and delayed retraction of the foreskin past 8-10 years of age 4 .
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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 | 0.003 | 0.030 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.002 | 0.002 |
| Bibliometrics | 0.002 | 0.002 |
| Science and technology studies | 0.005 | 0.002 |
| Scholarly communication | 0.004 | 0.002 |
| Open science | 0.003 | 0.002 |
| Research integrity | 0.042 | 0.019 |
| Insufficient payload (model declined to judge) | 0.018 | 0.010 |
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".