Bibliographic record
Abstract
Introduction: Ambulatory percutaneous nephrolithotomy (pCnl) has been proposed as a means to speed patient recovery, decrease hospital stay time, and decrease cost compared to inpatient pCnl.studies evaluating ambulatory pCnl have used highly selective selection criteria that preclude the vast majority of pCnl candidates.the goal of our study was to perform a high-quality, randomized, controlled trial of ambulatory vs. inpatient pCnl in a representative patient population, including those with large stones (>4 cm), BmI >30, and AsA >2.Methods: this was a multicentre, non-inferiority, randomized, controlled trial of ambulatory vs. inpatient pCnl at University of manitoba and University of California, san Francisco.patients were randomized prior to surgery stratified for AsA, BmI, stone size, and study site.primary outcomes were complication and readmission rates within four weeks of surgery.secondary outcomes were stone-free rate (Ct scan four weeks after surgery), quality of life (using WisQol), and return to work time.Results: of 70 patients (35 ambulatory and 35 inpatient), mean age was 71, 48% were BmI >30, 41% were AsA 3/4, and 31% had stone size >4 cm.tract size was similar between ambulatory group (16 French 60%, 30 French 40%) and inpatient group (16 French 57%, 30 French 43%; p=1).there was no difference in our primary outcome of complication rate between those who underwent ambulatory (3%) and inpatient pCnl (9%, p=0.61).readmission rate within four weeks was not different between the ambulatory (3%) and inpatient group (3%, p=1).stone-free rate was not different between the ambulatory (71%) and inpatient group (74%, p=1).the mean recovery time in hospital after surgery was 2-3 hours in the ambulatory group vs. one day in the inpatient group.the rate of patients who were able to return to work within one week was not different between the ambulatory group (89%) vs. the inpatient group (80%, p=0.5).In those randomized to the ambulatory group, three (9%) required crossover to the inpatient group.reasons for this were surgical for one patient (small infundibular tear that the surgeon wanted to monitor overnight), and anesthesia-related for the remaining two patients (obstructive sleep apnea monitoring, elevated potassium monitoring).Conclusions: Ambulatory pCnl has similar complication rates, stone-free rates, and readmission rates compared to those who undergo inpatient pCnl.our results support the use of ambulatory pCnl in patients with BmI >30, AsA >2, and stone size >4 cm who have typically been excluded from consideration for ambulatory pCnl in the past.
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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) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.002 |
| Insufficient payload (model declined to judge) | 0.217 | 0.040 |
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".