Bibliographic record
Abstract
Introduction: the traditional prone position (pp) for percutaneous nephrolithotomy (pcnl) has undergone modifications since it was first described in 1976.the prone-flexed position (pFp) (Figure 1) is one such modification that improves the safety and ergonomics of pcnl; however, the effect of airway pressures and ventilation has been questioned for the pFp.In this study, we sought to quantify the changes in peak airway pressure (pap) in the supine position (sp), pp and pFp, and to shed light on the relationship between abdominal girth, body mass index (BmI), and pap.Methods: this was a prospective study of patients undergoing pcnl.their pap and positive end-expiratory pressure (peep) were recorded in the sp, pp, and pFp. the paps were compared with a repeated measures anoVa.the paired t-test was used to compare sp and pFp groups across obese and non-obese patients.linear regression was used to assess if abdominal girth was a predictor of change in pap from sp to pFp.Results: of the 63 patients included in the study, the mean pap was <35 cm H 2 o for all groups.the mean pap was higher with pFp (20.3±5.6 cm H 2 o) than pp (17.2±5.0 cm H 2 o, p<0.001), which was higher than sp (15.4±4.1 cm H2o, p<0.001).the mean change in pap when moving from the sp to pFp did not differ significantly in the obese vs. non-obese population (p=0.13).abdominal girth was not a significant predictor of the change in pap from sp to pFp (linear regression, p=0.23); however, girth was a significant predictor of elevated pap in the pFp (p=0.024).none of the patients required conversion out of the pFp for anesthetic or other reasons.Conclusions: the prone-flexed position is a safe and simple modification to the traditional prone pcnl.changes in airway pressures are not clinically significant in pFp compared to pp or sp.given the anatomical and surgical advantages, pFp is a safe and optimal position for prone pcnl, even in the obese population group.
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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 | 0.001 |
| Meta-epidemiology (narrow) | 0.002 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.002 | 0.001 |
| Open science | 0.001 | 0.002 |
| Research integrity | 0.003 | 0.002 |
| Insufficient payload (model declined to judge) | 0.262 | 0.104 |
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".