Bibliographic record
Abstract
Introduction and Objective: Antenatal hydronephrosis (HN) represents a challenging dilemma in pediatric urology.Difficulties reside in identifying patients who require a pyeloplasty as well as those who do not, but might over time.Aside from differential function and T1/2 measurements, no other renographic criteria have stood the test of time to diagnose obstruction.At our institution, renograms have been performed in an original fashion over the last 10 years using additional criteria including delayed cortical excretion (DCE) and a postfurosemide washout (PFW) at 90 minutes.Materials and Methods: Between 1998 and 2007, 236 of 613 patients with antenatal HN had a renogram done in the first month of life.Ultrasonography and VCUG were also obtained.Renograms were classified as class 1: 20-minute PFW 40% or greater; class 2: 20-minute PFW less than 40% and additional PFW at 90 minutes 50% or greater; class 3: 20-minute PFW less than 40% and additional PFW at 90 minutes less than 50%; class 4: class 3 with DCE; or class 5: class 3 with differential function less than 40%.Decisions to operate were based on the findings of poor drainage (class 3), worsened drainage on repeated studies (classes 1-2 becoming > 3) and/or signs of renal suffering (classes 4-5).Results: Seventy-six percent have been managed conservatively with improved dilatation, hence drainage, on sequential studies (renograms and/or ultrasounds) without loss of function overtime.Three class 1 HN required pyeloplasties because of worsening drainage over time.All renal functions were preserved and drainage improved postoperatively.No class 2 required surgery while 40% of class 3 showed renographic deterioration within months and were operated without losing function.Pyeloplasties were performed for all classes 4 and 5 with most of them losing function after surgery despite improved HN and drainage (Table 1). Conclusion:Renograms can be performed accurately in patients younger than 1 month old who are evaluated for antenatal HN using our renographic classification to decide for whom a pyeloplasty will most likely be needed, regardless of the T1/2.
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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 | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.002 | 0.000 |
| Scholarly communication | 0.002 | 0.002 |
| Open science | 0.001 | 0.003 |
| Research integrity | 0.004 | 0.004 |
| Insufficient payload (model declined to judge) | 0.525 | 0.276 |
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".