{
  "vercy": "1.0-draft",
  "publication": {
    "status": "research-draft",
    "adjudicationStatus": "unreviewed",
    "publishableCanonical": false,
    "generatedAt": "2026-09-14T00:01:21Z",
    "providers": [
      "Claude"
    ],
    "breadth": "written by Claude from model knowledge without web access - no source was read, every claim is a lead to verify",
    "pass": 2,
    "wave": 4,
    "engine": "claude",
    "enrichment": {
      "pass": 3,
      "engine": "claude",
      "producedAt": "2026-10-06T11:00:00Z",
      "ingestedAt": "2026-10-06T07:45:15+00:00",
      "fields": [
        "agent_conduct",
        "ethics",
        "owners"
      ]
    }
  },
  "metaModel": {
    "id": "THING-Q1360044",
    "registryId": "vr.tr.syndactyly",
    "name": "syndactyly",
    "version": "0.2.0-wave.4",
    "entryKind": "thing",
    "family": "Thing Registry",
    "domain": [
      "XCT.STA"
    ],
    "status": "research-draft"
  },
  "canonicalUrl": "https://ver.cy/models/thing/q1360044/",
  "model": {
    "registry_id": "vr.tr.syndactyly",
    "name": "syndactyly",
    "purpose": "Let an agent explain syndactyly in general terms, relay types, genetics, associated syndromes and treatment approaches from paediatric hand surgery and genetics sources, point families to specialists and support, describe the named syndromes, and distinguish syndactyly from polydactyly, webbed toes as a mild variant, amniotic band syndrome and brachydactyly, without diagnosing individuals.",
    "definition": "A congenital condition in which two or more fingers or toes are fused, by skin only in simple syndactyly or also by bone in complex syndactyly, among the most common congenital hand differences, occurring alone, inherited in types such as syndactyly type 4, or as part of syndromes the registry aliases name, including acrocephalosyndactyly syndromes such as Apert syndrome, Filippi syndrome, Sakati-Nyhan syndrome, Robinow-Sorauf syndrome and Goodman syndrome; the registry parents synostosis and chromosomal duplication syndrome apply only to some forms. Surgical separation is often performed in early childhood by hand surgeons, and genetic counselling may be offered.",
    "what_it_is_for": "Not applicable; a congenital limb difference.",
    "affordances": [
      "explain types and genetics",
      "relay treatment approaches in general terms",
      "describe named syndromes",
      "point to specialists"
    ],
    "distinguishing_features": [
      "Digit fusion",
      "Simple or complex",
      "Isolated or syndromic",
      "Surgically treatable"
    ],
    "appearance": "Fingers or toes joined partly or fully by skin or bone.",
    "visual_identification": [
      "Congenital fusion of digits",
      "Filippi syndrome, acrocephalosyndactylia, Sakati-Nyhan syndrome, Robinow-Sorauf syndrome, Goodman syndrome, syndactyly type 4",
      "Polydactyly means extra digits; mild webbed toes may need no treatment; amniotic bands constrict digits; brachydactyly means short digits"
    ],
    "physical_properties": [
      {
        "quantity": "incidence",
        "typical_range": "about 1 in 2,000-3,000 births",
        "unit": "note",
        "note": "estimates vary"
      },
      {
        "quantity": "most common site",
        "typical_range": "between middle and ring fingers",
        "unit": "note",
        "note": ""
      },
      {
        "quantity": "typical surgery age",
        "typical_range": "often 1-2 years",
        "unit": "note",
        "note": "varies"
      }
    ],
    "families_and_kinds": [
      "simple syndactyly",
      "complex syndactyly",
      "non-syndromic types",
      "acrocephalosyndactyly syndromes",
      "other syndromic syndactyly"
    ],
    "related_models": [
      {
        "relation": "is a kind of",
        "target": "congenital limb deformity",
        "why": "in registry terms"
      },
      {
        "relation": "includes",
        "target": "Apert syndrome",
        "why": "syndromic"
      },
      {
        "relation": "is contrasted with",
        "target": "polydactyly",
        "why": ""
      },
      {
        "relation": "is related to",
        "target": "synostosis",
        "why": "complex forms"
      }
    ],
    "identifiers": [],
    "standards_and_regulation": [
      "Paediatric hand surgery guidelines",
      "Genetic counselling standards"
    ],
    "failure_modes_and_hazards": [
      "Diagnosing individuals",
      "Stigmatising language",
      "Overgeneralising registry parents"
    ],
    "in_scope": [],
    "out_of_scope": [],
    "characteristics": [],
    "agent_conduct": {
      "may": [
        "Explain syndactyly and its types in general terms with sources.",
        "Help families find specialist hand surgery services and prepare questions."
      ],
      "must_not": [
        "Advise for or against surgery or its timing for a specific child.",
        "Share images of a child's hands or feet without parental consent.",
        "Describe the condition in stigmatising language."
      ],
      "requires_human": [
        "Any decision about surgery or genetic testing."
      ]
    },
    "ethics": {
      "considerations": [
        "Visible differences can bring stigma, and parents face hard decisions about surgery for infants."
      ],
      "affected_parties": [
        "Children with the condition",
        "Parents and families"
      ]
    },
    "owners": {
      "steward": "The patient's treating clinicians and, for a child, the parents or guardians.",
      "master_systems": []
    }
  },
  "sources": [],
  "structure": {
    "bundles": [
      {
        "id": "understand",
        "name": "Understand",
        "description": "What syndactyly is.",
        "rationale": "Science.",
        "layers": [
          {
            "id": "definition",
            "name": "Definition",
            "description": "Definition.",
            "findings": [
              {
                "id": "definition-finding",
                "name": "Definition",
                "description": "Definition.",
                "questions": [
                  {
                    "text": "What is syndactyly, and how does it differ from polydactyly, mild webbed toes, amniotic band syndrome and brachydactyly?",
                    "kind": "definition"
                  },
                  {
                    "text": "Is the question about a child s care, which specialists should assess, or about genetics and history?",
                    "kind": "boundary"
                  }
                ]
              }
            ]
          },
          {
            "id": "syndromes",
            "name": "Syndromes",
            "description": "Named syndromes.",
            "findings": [
              {
                "id": "syndromes-finding",
                "name": "Syndromes",
                "description": "Syndromes.",
                "questions": [
                  {
                    "text": "What are Filippi, Sakati-Nyhan, Robinow-Sorauf and Goodman syndromes, acrocephalosyndactyly and syndactyly type 4?",
                    "kind": "definition"
                  },
                  {
                    "text": "Which entry fits the specific syndrome?",
                    "kind": "action"
                  }
                ]
              }
            ]
          }
        ]
      },
      {
        "id": "biology",
        "name": "Biology",
        "description": "Development and genetics.",
        "rationale": "Science.",
        "layers": [
          {
            "id": "development",
            "name": "Development",
            "description": "Digit separation.",
            "findings": [
              {
                "id": "development-finding",
                "name": "Development",
                "description": "Development.",
                "questions": [
                  {
                    "text": "How does programmed cell death normally separate digits in the embryo?",
                    "kind": "provenance"
                  },
                  {
                    "text": "Which references are standard?",
                    "kind": "provenance"
                  }
                ]
              }
            ]
          },
          {
            "id": "genetics",
            "name": "Genetics",
            "description": "Genetic types.",
            "findings": [
              {
                "id": "genetics-finding",
                "name": "Genetics",
                "description": "Genetics.",
                "questions": [
                  {
                    "text": "Which genes and inheritance patterns are associated with syndactyly types?",
                    "kind": "provenance"
                  },
                  {
                    "text": "Which sources are cited?",
                    "kind": "provenance"
                  }
                ]
              }
            ]
          }
        ]
      },
      {
        "id": "care",
        "name": "Care",
        "description": "Treatment.",
        "rationale": "Regulation.",
        "layers": [
          {
            "id": "surgery",
            "name": "Surgery",
            "description": "Surgical release.",
            "findings": [
              {
                "id": "surgery-finding",
                "name": "Surgery",
                "description": "Surgery.",
                "questions": [
                  {
                    "text": "How is syndactyly release surgery done, in general terms, and why is timing chosen carefully?",
                    "kind": "provenance"
                  },
                  {
                    "text": "Which entry fits hand surgery?",
                    "kind": "action"
                  }
                ]
              }
            ]
          },
          {
            "id": "counselling",
            "name": "Counselling",
            "description": "Genetic counselling.",
            "findings": [
              {
                "id": "counselling-finding",
                "name": "Counselling",
                "description": "Counselling.",
                "questions": [
                  {
                    "text": "When is genetic counselling offered to families?",
                    "kind": "provenance"
                  },
                  {
                    "text": "Which entry fits genetic counseling?",
                    "kind": "action"
                  }
                ]
              }
            ]
          }
        ]
      },
      {
        "id": "context",
        "name": "Context",
        "description": "Society.",
        "rationale": "Context.",
        "layers": [
          {
            "id": "language",
            "name": "Language",
            "description": "Respectful language.",
            "findings": [
              {
                "id": "language-finding",
                "name": "Language",
                "description": "Language.",
                "questions": [
                  {
                    "text": "What language do support organisations prefer for limb differences?",
                    "kind": "provenance"
                  },
                  {
                    "text": "Is the presentation respectful?",
                    "kind": "boundary"
                  }
                ]
              }
            ]
          },
          {
            "id": "support",
            "name": "Support",
            "description": "Support organisations.",
            "findings": [
              {
                "id": "support-finding",
                "name": "Support",
                "description": "Support.",
                "questions": [
                  {
                    "text": "Which organisations support families with congenital hand differences?",
                    "kind": "provenance"
                  },
                  {
                    "text": "Which entry fits Reach charity?",
                    "kind": "action"
                  }
                ]
              }
            ]
          }
        ]
      }
    ]
  },
  "openQuestions": [
    "The registry parents synostosis and chromosomal duplication syndrome should be reviewed as applying only to some forms",
    "Should syndromes be separate entries?",
    "How should hand surgery guidance be linked?"
  ],
  "statistics": {
    "bundles": 4,
    "layers": 8,
    "findings": 8,
    "questions": 16
  }
}