Search

Since diagnostic primary depositional sedimentary structures and depth‐dependent grain‐size trends are rarely preserved, building a comprehensive sequence stratigraphic framework for the vast majority of the Phanerozoic carbonate platform sequences is pending. Among the two most important sequence stratigraphic surfaces, while the subaerial unconformity can be reliably identified by either karst development or the appearance of siliciclastic materials, the demarcation of the maximum flooding surface remains difficult in lithologically uniform shallow marine carbonate sequences. The present study attempts to identify the globally documented maximum flooding surface within the body of the negative carbon isotope excursion of the Palaeocene–Eocene Thermal Maximum recorded in the shallow marine carbonate platform sequences. The results show that, along with the carbonate microfacies, the yttrium to holmium ratio (Y/Ho ratio) of the carbonate fraction reliably records the sea‐level changes. A Y/Ho ratio between 70 and 80 demarcates the stratigraphic position of the maximum sea‐level state (the most open marine condition in the studied interval) and maximum flooding surface in the studied sections. Since the Y/Ho ratios remain relatively stable throughout diagenesis, they can be used for maximum flooding surface identification in shallow marine carbonate platform sequences. The possibility exists that the same method can also be applied to the mixed siliciclastic–carbonate systems. [ABSTRACT FROM AUTHOR]

Background: Managing lower pole renal stones presents clinical challenges influenced by various factors such as stone size, location, and density. This study aims to assess the efficacy, safety, and stone-free rates of Flexible Ureteroscopy (FURS), Extracorporeal Shock Wave Lithotripsy (ESWL), and Mini Percutaneous Nephrolithotomy (Mini PCNL) for treating lower pole renal hard stones (< 2 cm). Methods: A prospective single-centre comparative study was conducted on 414 adult patients with primary lower pole renal hard stones. Patients were evenly distributed into three groups: Flexible Ureteroscopy (FURS) utilizing holmium laser lithotripsy, Extracorporeal Shock Wave Lithotripsy (ESWL), and Mini PCNL employing holmium laser lithotripsy. Results: Statistically significant differences with P value < 0.001 were observed among groups in stone-free rates, hospital stay, radiation exposure, operative duration, auxiliary treatments, and overall cost. No statistically significant differences were found in demographic data with P value = 0.245 or complication rates with P value = 0.611 among the groups. At the 2-week follow-up, stone-free rates were 90.2% for Flexible Ureteroscopy which was comparable with mini PCNL and both were significantly higher than ESWL 61.5%. Conclusions: Mini PCNL and Flexible URS demonstrated comparable stone-free rates for moderate-sized, hard lower pole renal stones, surpassing ESWL. However, Mini PCNL showed longer operative times, increased radiation exposure, and elevated risks of complications and morbidity compared to Flexible URS. Considering these factors, Flexible URS might be recommended in those types of stones. Trial Registration: Our study has been approved by local ethical committee Kafrelsheikh university (KFSIRB20069) on 30/10/2023 and by clinical trials (NCT06120257) on 15/12/2023. [ABSTRACT FROM AUTHOR]

This study aims to evaluate the feasibility, safety, and effectiveness of an optimized treatment approach for complex renal calculi, utilizing visual needle nephroscopy in conjunction with standard PCNL and holmium YAG laser. We collected data from 62 patients diagnosed with complex kidney stones who underwent this combined procedure using the visual needle nephroscope (Needle-perc®, Youcare Tech, Wuhan, China). The percutaneous nephroscopic working channel was established by visual needle nephroscope, and the primary channel was expanded to 20 F to treat most of the main body of the calculi with a 550 μm holmium laser fiber. Visual needle nephroscope was used to locate the renal calyx where the residual calculi were located for precise puncture as a secondary channel, and the residual stones were treated by a 200 μm holmium laser fiber. Clinical data were collected, and intraoperative variables, postoperative complications and outcomes were assessed. All 62 patients successfully completed the operation without severe complications. The S.T.O.N.E. score of 62 patients before operation was 10.5 ± 0.9 points and above, of which the N score was more than 2 points. The average operation time was (65.5 ± 12.7) minutes, and the average hospital stay was (7.3 ± 2.1) days. After operation, 2 patients developed a fever, which improved after symptomatic treatment by intravenous antibiotics. 4 patients had clinically significant residual fragments, and the stone-free rate of primary operation was 93.5% (58/62). The optimized operation for the treatment of complex renal calculi based on standard PCNL combined with visual needle nephroscope by holmium YAG laser has good feasibility, safety and effectiveness. [ABSTRACT FROM AUTHOR]

Introduction: Holmium laser enucleation of the prostate (HoLEP) is known to have a steep learning curve. The top-down technique was introduced to lessen the number of procedures required to master HoLEP. We aimed to present the experiences of two successive clinical fellows with the top-down HoLEP learning curve and compare their performance with the supervisor. Methods: We conducted a prospective study of 40 patients who underwent top-down HoLEP performed by two successive fellows at our institution from September 2020 to November 2022. Before data collection, each learner observed three top-down HoLEP procedures and assisted with seven additional cases before independently performing top-down HoLEP under supervision. We collected data from each fellow's first 20 consecutive top-down HoLEP procedures. The learners' cases were grouped according to chronological order (Cases 1-10 and 11-20). The primary outcome was defined as the number of cases before the fellow could independently complete all steps of top-down HoLEP without any major intraoperative complications. The secondary outcomes included the intraoperative and postoperative outcomes of both groups. The fellows' 40 cumulative cases were then compared against retrospective data from 148 procedures conducted by their supervisor. Results: There were no significant differences in patient demographics for both clinical fellows. Each learner performed the first 20 cases independently without needing the supervisor to intervene. No major intraoperative complications were recorded, and there were no statistically significant differences in intraoperative and postoperative outcomes between fellows' cases. There was a statistically significant difference between the fellows and their supervisor in terms of operative efficiency and enucleation efficiency (p < 0.001). We did not find a significant difference between the fellows and the supervisor regarding intraoperative complications, major postoperative complications, or postoperative subjective and objective parameters. Conclusions: Top-down HoLEP shows promising and reproducible results in shortening HoLEP's learning curve. Larger comparative and multi-institutional studies are warranted. [ABSTRACT FROM AUTHOR]

Introduction: Holmium laser enucleation of the prostate (HoLEP) is an increasingly utilized surgical intervention for benign prostatic hyperplasia (BPH) with lower urinary tract symptoms (LUTS). It is unclear how pre-HoLEP voiding performance (including pre-HoLEP incontinence) affects post-HoLEP urinary symptom performance and recovery which challenges effective patient counseling. Methods: This is a single-institution retrospective analysis of 266 patients who underwent HoLEP. Pre-HoLEP continence status was determined by patient report. Continence (severity and bother, severity broken into urge and stress) and LUTS (total IPSS score and QoL) were assessed preoperatively and 1 week (1wk), 1 month (1m), 3 months (3m), and 1-year (1y) post-HoLEP using the Michigan Incontinence Symptom Index (MISI) and International Prostate Symptom Score (IPSS), respectively. Primary outcome measures were MISI differences between groups at each time point. Results: Of the 376 patients who underwent HoLEP from two surgeons from 11/6/2020 to 12/18/2023, 266 were included in the study. Inclusion criteria were patients undergoing HoLEP during this period. There were no exclusion criteria. A total of 178 participants were continent and 88 were incontinent pre-HoLEP. Average age at time of HoLEP was 70.3 and 70.8 respectively, average preoperative prostate size measured by ultrasound or axial imaging was 109.0 g and 113.7 g, respectively. Based on MISI stress (#1–3) and urge (#4–6) items, pre-HoLEP Stress:Urge ratio in continent pre-HoLEP patients was 1.29:3.02. In the incontinent pre-HoLEP group, Stress:Urge was 2.45:6.18. MISI scores were statistically similar between cohorts at 1wk. Preop incontinent patients had a statistical and clinically significant improvement in MISI severity score at 1y post-HoLEP (5.62 n = 11 vs 10.170 n = 50, p = 0.013). IPSS total scores were statistically similar between cohorts at 1m and IPSS QoL scores were statistically similar at preop. At preop evaluation, urge symptoms were worse than stress symptoms in all cohorts. Conclusions: Preoperative incontinence should not be considered a predictor of poor intermediate or long-term post-HoLEP outcomes. Pre-HoLEP incontinence is likely largely urge-related. [ABSTRACT FROM AUTHOR]

To compare post-operative outcomes in patients who underwent holmium laser enucleation of the prostate (HoLEP) for benign prostatic hyperplasia (BPH) and had urodynamic evidence of bladder hypocontractility versus those with normocontractile bladders. We retrospectively reviewed HoLEP patients with pre-operative urodynamic studies at a single institution, categorizing them into normocontractile and hypocontractile groups based on the bladder contractility index (BCI) (hypocontractile defined as BCI < 100). Post-void residual (PVR) volume was measured at 6 weeks and 6 months. Secondary outcomes included maximum flow rate (Qmax) and catheterization status. Among 114 HoLEP patients with pre-operative urodynamic data, 49 had hypocontractile bladders. The median pre-operative PVR was 305 (202-446) mL in the hypocontractile group, higher than the median PVR of 190 (60-361) mL in the normocontractile group (P =.013). At 6 weeks post-op, the median PVR was higher in the hypocontractile compared to normocontractile group (38 [3-61] vs 5 [0-44] mL, P =.016), but at 6 months post-op there was no significant difference (18 [0-39] vs 12 (0-70) mL, P =.97). Among men who were catheter-dependent pre-operatively, 98% of hypocontractile and 100% of normocontractile patients were catheter-free post-operatively. Qmax and symptom scores were similar at both follow-up time points. HoLEP can be an effective surgical option for BPH patients with hypocontractile bladders, including those who are catheter-dependent, with minimal differences in post-operative voiding parameters compared to those with normal bladder function. [ABSTRACT FROM AUTHOR]

Two series of NaY 0.85 Tm 0.15-x Ho x GeO 4 (x = 0.005–0.03) and NaY 0.85-x Tm 0.15 Ho x GeO 4 (x = 0.0–0.055) phosphors have been prepared by the citrate technique. According to XRPD study, all the germanates crystallize in olivine structure and have an orthorhombic lattice, space group Pnma , Z = 4. The diffuse reflectance spectra have been measured and the optical band gap has been estimated. Under 808 nm laser diode excitation, the NaYGeO 4 :Tm3+, Ho3+ samples exhibit luminescence in the range of 1640–2240 nm, which is caused by 3F 4 → 3H 6 transition in Tm3+ and 5I 7 → 5I 8 transition in Ho3+ ions. The highest intensity of holmium lines, while maintaining relatively high intensity of thulium lines, was observed for NaY 0.82 Tm 0.15 Ho 0.03 GeO 4 , NaY 0.815 Tm 0.15 Ho 0.035 GeO 4 samples with the Tm3+/Ho3+ ratio close to 5/1. The luminescence decay kinetics has been studied and the rate of energy transfer from Tm3+ to Ho3+ ions has been calculated. The obtained results indicate an effective energy transfer accelerated by migration due to dipole-dipole interaction. The mechanism of excitation and infrared luminescence in NaYGeO 4 :Tm3+, Ho3+ phosphors has been proposed. [ABSTRACT FROM AUTHOR]

The core-level spectra for the lanthanide metal, holmium, are presented, including the typically unreported Ho 3d peaks. The spectra exhibit multiplet splitting that must be included for accurate quantification of the metallic state. Given the complexity of the spectra due to overlapping Auger structure and background determination, modified sensitivity factors are suggested for some regions, together with recommended background integration limits and shape. [ABSTRACT FROM AUTHOR]

Background and Objectives: This study aimed to evaluate the recurrence rates at three years for upper tract urothelial carcinoma (UTUC) cases managed conservatively, using Narrow Band Imaging (NBI)-assisted flexible ureteroscopy and Holmium laser vaporization. Materials and Methods: The study group included 61 patients who were diagnosed with NBI-assisted visualization with superficial pyelo-calyceal urothelial tumor lesions, treated conservatively by the flexible ureteroscopic approach and Holmium laser vaporization, also assisted by NBI. This was compared with a control group with the same number of cases, which underwent the same procedure, but without NBI technology. Recurrence rates, the rate of patients who underwent nephroureterectomy, and cancer-specific survival were compared. Results: The relapse rate at 1 year was 3.3% in the study group, and respectively 8.2% in the control group (p < 0.05). Depending on the histological characteristics, at 1 year the relapse rates in the study group were 1.8% in patients with low-grade tumors and 20% in those with high-grade tumors. At 3 years, the relapse rate was 11.5% in the study group versus 18% in the control group, (p < 0.05): 7.1% in patients with low-grade lesions and 40% in patients with high-grade lesions versus 21.4% in patients with low-grade lesions and 100% in patients with high-grade lesions (both arms with statistically significant differences, p < 0.05). Cancer-specific survival was 93.4% in the study group versus 86.9% in the control group (p < 0.05). Conclusions: The recurrence rates at three years for the UTUC cases managed conservatively, using NBI-assisted flexible ureteroscopy and Holmium laser vaporization, were lower than in patients treated by the same technique without NBI assistance, both in low- and high-grade tumors. Cancer-specific survival was also significantly improved by the association of NBI visualization during diagnosis and laser vaporization. [ABSTRACT FROM AUTHOR]

Purpose: Urethral stricture disease (USD) incidence is estimated to be as high as 0.6–1.2%. In 2022, it was published that the bladder mucosal graft to be used in urethroplasty can be obtained endoscopically with a holmium laser. We aimed to present our single center graft urethroplasty results obtained with the endoscopic holmium laser harvesting of bladder mucosal graft technique. Methods: We retrospectively reviewed the results of patients who underwent bladder mucosal graft (BlMG) urethroplasty by single surgeon at our center hospital between December 2022 and May 2023. Results: A total of 14 patients underwent BlMG urethroplasty surgery. Of them 8 were male and 6 were female patients. The mean patient age was 53 (range 26–76) years. The mean length of stricture was 4,35 (range 1–11) cm. The maximum postoperative flow rate was < 10 ml/sec in three of the 14 patients. Conclusion: To our knowledge this is the first study investigating the preliminary results of substitution urethroplasties that is performed with bladder mucosal grafts harvested with laser energy via transurethral (endoscopic) route. Though more work is needed to better understand its current role in complex urethral reconstruction, our patient cohort will be a niche for further studies. [ABSTRACT FROM AUTHOR]

Recently, a minimally invasive procedure based on a laser technique (SiLaT) has been developed for the treatment of pilonidal cysts. Although less invasive and less painful than surgery, this solution is nevertheless limited by its high cost. Other more affordable laser devices, such as the holmium laser, are also used in minimally invasive surgery. The objective of this study was to evaluate the possibility of using the holmium laser instead of the SiLaT laser in the treatment of pilonidal cysts. Retrospective cohort study with the primary endpoint being the cure rate one month after treatment. Median duration of local care was 21 days (mean = 22 ± 7.5) and healing rate at 1 month was 90.7%. During follow-up, 102 patients (44.9%) experienced pain in the coccygeal region often exacerbated by sitting and significantly more common in people with a small frame, overwhelmingly female. A surgical site infection was reported in 36 patients (15.9%). Recurrence, occurred in 39 patients (17.2%), was related to cyst type (type 1 do not recur, type 3 recur twice three time than type 2). Holmium laser does not differ from SiLaT laser in the healing rate of pilonidal cysts after treatment. However, it is characterised by a moderately higher incidence of complications, foremost of which is the occurrence of pain that can persist for up to a year after the procedure and which could be related to an increase in heat inherent to the use of holmium. As a result, this procedure does not seem to represent an alternative to SiLaT. [ABSTRACT FROM AUTHOR]

BACKGROUND: Soft ureteroscopic holmium laser lithotripsy is becoming increasingly popular as the preferred method for treating mid-to-lower ureteral stones. Studies have indicated that the size, composition, hardness, and fragility of the stones can impact the treatment's effectiveness. OBJECTIVE: To explore the relationship between stone volume, average CT value and operation time and efficiency before ureteral soft lens laser lithotripsy. METHODS: Our study on 126 patients undergoing ureteroscopic holmium laser lithotripsy for ureteral calculi from May 2020 to January 2022 categorized them into groups based on stone volume and CT value. We compared surgical outcomes and analyzed correlations between stone characteristics, operation parameters, and stone clearance rate to identify independent risk factors influencing treatment efficacy. RESULTS: Group A demonstrated significantly shorter operation durations and lower blood loss compared to Group B, along with higher single stone clearance rates and fewer postoperative complications. Similarly, Group C exhibited shorter operation times, reduced blood loss, higher stone clearance rates, and lower complication rates than Group D. Preoperative stone volume and CT value correlated positively with operation time and stone clearance rate, with both factors identified as independent risk factors affecting ureteral stone clearance following holmium laser lithotripsy. CONCLUSION: The stone volume and average CT value before ureteral soft lens laser lithotripsy show a positive correlation with operation time and efficiency, indicating that larger stone volumes and higher CT values lead to slower lithotripsy speeds and reduced operation efficiency. Furthermore, preoperative stone volume and average CT value are identified as independent risk factors for residual stones. [ABSTRACT FROM AUTHOR]

Background and objective: Our objective was to evaluate whether a very large prostate volume significantly affects the incidence of perioperative complications and compromises outcomes among patients undergoing holmium laser enucleation of the prostate (HoLEP). Methods: We retrospectively analyzed data for 1815 adult patients who underwent HoLEP at Evangelisches Krankenhaus Königin Elisabeth Herzberge, Berlin, between January 2019 and May 2024. Patients were divided into two groups according to their prostate volume: ≤149 ml (group A) and ≥150 ml (group B). Propensity score matching on age, body mass index, American Society of Anesthesiologists physical status, and the presence of an indwelling catheter was used to balance baseline differences. A Mann-Whitney U test was used for comparison of continuous variables between the groups, and a χ2 test for comparison of categorical variables, with p

Abstract Background To develop and validate a novel administration device for holmium-166 transarterial radioembolisation (TARE) with the purpose of facilitating controlled fractional microsphere administration for a more flexible and image-guided TARE procedure. Methods A Controlled Administration Device (CAD) was developed using MR-conditional materials. The CAD contains a rotating syringe to keep the microspheres in suspension during administration. Different rotational speeds were tested ex vivo to optimise the homogeneity of microsphere fractions administered from the device. The technical performance, accuracy, and safety was validated in three patients in a clinical TARE setting by administering a standard clinical dose in 5 fractions (identifier: NCT05183776). MRI-based dosimetry was used to validate the homogeneity of the given fractions in vivo, and serious adverse device event ((S)A(D)E) reporting was performed to assess safety of the CAD. Results A rotational speed of 30 rpm resulted in the most homogeneous microsphere fractions with a relative mean deviation of 1.1% (range: -9.1-8.0%). The first and last fraction showed the largest deviation with a mean of -26% (std. 16%) and 7% (std. 13%). respectively. In the three patient cases the homogeneity of the microsphere fractions was confirmed given that MRI-based dosimetry showed near linear increase of mean absorbed target liver dose over the given fractions with R2 values of 0.98, 0.97 and 0.99. No (S)A(D)E’s could be contributed to the use of the CAD. Conclusions The newly developed CAD facilitates safe and accurate fractional microsphere administration during TARE, and can be used for multiple applications in the current and future workflows of TARE.

Purpose Little is known about the soft tissue destruction by holmium laser clinically used for holmium laser enucleation of the prostate (HoLEP), subject to the distance between the laser fiber tip and the tissue surface. We aimed to investigate the impact of the distance between the laser fiber tip and the phantom surface (DLP) on a soft tissue phantom (STP) in relation to the surgical modes of HoLEP. Methods STP responses to the laser pulses produced by a commercial holmium:yttrium aluminum garnet (Holmium:YAG) laser at an output setting 2 J were observed at different values of the DLP (0, 1, 2, 3, and 4 mm) to look at (1) the single laser pulse-induced cavitation bubble and its penetration into the STP, (2) the STP destruction by a single pulse, (3) the STP destruction by 60 pulses repeated at 12 Hz, and (4) the thermal effect by the multiple pulses visualized on a thermosensitive bovine serum albumin (BSA) STP. Results We observed that the laser pulse produced a heated gas bubble in water centered at the laser fiber tip. The bubble shape depended on the DLP. The bubble completely penetrated into the STP at the DLP of 0 mm and the penetration decreased with the DLP. The size of the destruction of the STP by the laser pulses was shown to decrease as the DLP increased. Test with the BSA STP showed that, at the DLP of 3 mm, the destruction became insignificant while the thermal effects were still effective. Conclusions We illustrated that soft tissue destruction by the Holmium:YAG laser is associated with cavitation effects. We provide for the first time experimental evidence for various surgical modes in HoLEP such as incision and hemostasis in relation to the DLP.

Holmium based metal–organic frameworks (MOFs) are attractive due to their potential biomedical and radiotherapeutic applications. Two new three-dimensional MOFs consisting of holmium(III) and 3,3′,5,5′-azobenzenetetracarboxylate (H4abtc) were prepared. The microporous Ho(III) binuclear MOF (Ho2-abtc) with the chemical formula of [Ho2(abtc)1.5(DMF)4]·DMF exhibited a three-dimensional framework. A hexacluster (RE6X8) based three-dimensional MOF with the chemical formula ([Ho6(abtc)3(μ3-X)8]·DMA; X = OH−/F−, DMA = dimethyl ammonium) exhibited Ho6 clusters bridged by OH−/F− ions. The presence of hexaclusters in the holmium MOFs opens up the design of new MOFs for the holmium delivery with high holmium content. The crystal structures of the MOFs were solved. These MOFs are characterized by single-crystal X-ray diffraction (SC-XRD), powder XRD, scanning electron microscopy (SEM), energy dispersive spectroscopy (EDS), 19F nuclear magnetic resonance (NMR), thermogravimetric analysis (TGA), gas adsorption analysis, and X-ray photoelectron spectroscopy (XPS). [ABSTRACT FROM AUTHOR]

Background: To develop and validate a novel administration device for holmium-166 transarterial radioembolisation (TARE) with the purpose of facilitating controlled fractional microsphere administration for a more flexible and image-guided TARE procedure. Methods: A Controlled Administration Device (CAD) was developed using MR-conditional materials. The CAD contains a rotating syringe to keep the microspheres in suspension during administration. Different rotational speeds were tested ex vivo to optimise the homogeneity of microsphere fractions administered from the device. The technical performance, accuracy, and safety was validated in three patients in a clinical TARE setting by administering a standard clinical dose in 5 fractions (identifier: NCT05183776). MRI-based dosimetry was used to validate the homogeneity of the given fractions in vivo, and serious adverse device event ((S)A(D)E) reporting was performed to assess safety of the CAD. Results: A rotational speed of 30 rpm resulted in the most homogeneous microsphere fractions with a relative mean deviation of 1.1% (range: -9.1-8.0%). The first and last fraction showed the largest deviation with a mean of -26% (std. 16%) and 7% (std. 13%). respectively. In the three patient cases the homogeneity of the microsphere fractions was confirmed given that MRI-based dosimetry showed near linear increase of mean absorbed target liver dose over the given fractions with R2 values of 0.98, 0.97 and 0.99. No (S)A(D)E's could be contributed to the use of the CAD. Conclusions: The newly developed CAD facilitates safe and accurate fractional microsphere administration during TARE, and can be used for multiple applications in the current and future workflows of TARE. [ABSTRACT FROM AUTHOR]

Fungal bezoars are extremely rare in the urinary bladder, and there is limited literature regarding the modality of management. We report a case, where the piecemeal removal of a vesical fungal bezoar was performed using Ho:YAG LASER. A 60-year-old man presented with lower urinary tract symptoms and on evaluation was diagnosed with vesical calculus. On cystoscopy, a white-colored, smooth contoured ball was identified in the bladder. The effective endourological modalities for the removal of fungal bezoar require mention in the literature. This case report demonstrates the possibility and efficiency of Ho:YAG LASER in the endourological retrieval of fungal bezoar in the bladder. The rarity of the diagnosis results in difficulty in prompt management. [ABSTRACT FROM AUTHOR]

Symptom improvement following therapies for lower urinary tract symptoms suggestive of benign prostatic hyperplasia (LUTS/BPH) is associated with a decrease in Bladder Outlet Obstruction Index (BOOI). Surgical therapies for LUTS/BPH provide greater BOOI and symptom improvement than medical therapies. Symptomatic benefit and urodynamic obstruction relief represent relevant outcomes of therapies for lower urinary tract symptoms suggestive of benign prostatic hyperplasia (LUTS/BPH). We summarized evidence from studies concurrently assessing variations in terms of symptoms severity and invasive urodynamic measures of obstruction following medical and surgical therapies for LUTS/BPH. We performed a systematic review of PubMed, Scopus, and Web of Science in June 2023. We identified 29 publications: 14 (872 patients) and 15 (851 patients) studies addressing medical and surgical therapies, respectively. The mean percentage total International Prostate Symptom Score (IPSS) improvements ranged from −2.5% to 56.3% and from 35.1% to 82.1% following medical and surgical therapies, respectively. The corresponding mean percentage Bladder Outlet Obstruction Index (BOOI) improvements ranged from 7.8% to 53.5% and from 22.4% to 138.6%, respectively. Holmium laser enucleation of the prostate (HoLEP) provided IPSS improvements in the higher range and the greatest BOOI reduction. Globally, based on available evidence, more pronounced symptomatic benefits are observed following treatments providing greater deobstructive effect. In detail, patients undergoing surgery exhibit greater IPSS and BOOI improvements than those receiving medical therapy. [ABSTRACT FROM AUTHOR]

To compare the outcomes of using Ultrathin semirigid retrograde ureteroscopy and antegrade flexible ureteroscopy to treat proximal ureteric stones of sizes 1–2 cm. A prospective randomized multicenter study included patients who had proximal ureteric stones 1–2 cm, amenable for ureteroscopy and laser lithotripsy between August 2023 and February 2024. Two hundred thirty patients were divided evenly into two treatment groups. Group I included patients treated with antegrade flexible ureteroscopy and holmium laser stone fragmentation, and Group II included patients treated with retrograde ultrathin semirigid ureteroscopy. The study groups were compared in terms of patient demographics, stone access success, operation time, reoperation rates, peri-operative complications, and stone-free status. Group I included 114 patients, while Group II included 111. The mean age of the patients was 33.92 ± 10.37 years, and the size of the stones was 15.88 ± 3 mm. The study groups had comparable demographics and stone characteristics. The mean operative time was significantly longer in group I than in group II (102.55 ± 72.46 min vs. 60.98 ± 14.84 min, respectively, P < 0.001). Most reported complications were MCCS grades I and II, with no significant difference between the study groups. The stone-free rate after four weeks was 92.1% and 81.1% for groups I and II, respectively, which increased to 94.7% and 85.6% after eight weeks (P > 0.05). Antegrade flexible ureteroscopy is equivalent to retrograde ultrathin semirigid ureteroscopy in treating proximal ureteric stones regarding stone-free status and procedure-related morbidity. However, the antegrade approach has a longer operative time, greater fluoroscopy exposure, and longer hospital stays. [ABSTRACT FROM AUTHOR]

Synthesis of unique morphologies in photocatalytic materials, coupled with utilization of wide-spectrum solar energy through rare earth doping, holds significant promise to maximize the potential of photocatalysts. Herein in, cube-like Holmium (Ho) doped Bi 5 Nb 3 O 15 was synthesized by the hydrothermal method and integrated with reduced graphene oxide (rGO) sheets. As synthesized Ho–Bi 5 Nb 3 O 15 @rGO composite along its analogs i.e., Bi 5 Nb 3 O 15 and Ho–Bi 5 Nb 3 O 15 was characterized by XRD, SEM, FT-IR, TGA, I–V, EIS, Mott-Schottky and photo-current measurements. Phase studies showed that crystallite size for Bi 5 Nb 3 O 15 , Ho–Bi 5 Nb 3 O 15 , and Ho–Bi 5 Nb 3 O 15 @rGO was 27.4, 25.5, and 13.5 nm, respectively. Optical analysis exhibited a reduction in the band gap in consequent to Ho doping from 2.54 to 2.19 eV for Ho–Bi 5 Nb 3 O 15. Conductivity and photo-current measurements showed a remarkable increase in both electrical conductivity and photo-response of Ho–Bi 5 Nb 3 O 15 upon its incorporation into rGO matrix, reaching maximum values of 1.72 × 10−2 S/m and 0.66 μA, respectively. The enhanced photocatalytic activity of Ho–Bi 5 Nb 3 O 15 @rGO was ensured through the outstanding photo-degradation efficiency (96.5 %) against crystal violet (CV), greater than Bi 5 Nb 3 O 15 (49 %) and Ho–Bi 5 Nb 3 O 15 (63.4 %). Additionally, Ho–Bi 5 Nb 3 O 15 @rGO showed sufficient potential towards the degradation of acetylsalicylic acid (ASA) with 79.1 % photo-degradation. This elevated photocatalytic activity of Ho–Bi 5 Nb 3 O 15 @rGO is believed to be contributed by the collaborative outcomes aroused from the Ho-doping and heterojunction fabrication among cubical Ho–Bi 5 Nb 3 O 15 and rGO sheets. Hence, our work proposes an efficient strategy for the development of innovative photolytic materials for sustainable wastewater remediation. [ABSTRACT FROM AUTHOR]

Nanocrystalline cobalt ferrites co-substituted with rare earth Ho and Er (CoFe 2-2 x Ho x Er x O 4 , 0 ≤ x ≤ 0.10) have been synthesized via the sol-gel method. X-ray Diffraction (XRD) confirmed the single-phase spinel structure with reduced crystallite sizes (65 nm–12 nm), micro-strain (ε) and increased lattice constant (a) with Ho–Er co-substitution. Rietveld refinement and theoretical computation revealed Ho and Er occupancy at octahedral sites and Fe and Co ions redistribution between the tetrahedral and octahedral sites. Infrared spectroscopy, Field Emission Scanning Electron Microscopy (FESEM), Energy Dispersive X-ray spectroscopy (EDX) and X-ray Photoelectron Spectroscopy (XPS) supported the formation of the desired spinel structure, aggregated spherical morphology, chemical stoichiometry and elemental states. Magnetic measurements showed a systematic decrease in saturation magnetization (M s), magnetocrystalline anisotropy (K 1), coercivity (H c) and Curie temperature (T c) with Ho–Er co-substitution. Electron Spin Resonance (ESR) exhibited asymmetric resonance peaks, reduced resonance field (H r), linewidth (ΔH pp) and deviation in Lande g values. Impedance spectroscopy revealed two conduction mechanisms (holes and electrons) with distinct activation energies (E aI and E aII). Modulus spectrum analysis confirmed the thermally activated sample-electrode effects and the Nyquist plots indicated the dominant contribution of the grain boundary resistance to the conduction process. A notable enhancement in the dielectric constant (ε′) was observed with Ho–Er co-substitution. The ac conductivity (σ ac) followed the Jonscher Power Law (JPL). The temperature-dependent frequency exponent s(T) , suggests the existence of two conduction mechanisms: non-overlapping small polaron tunneling (NSPT) and correlated barrier hopping (CBH). [ABSTRACT FROM AUTHOR]

OBJECTIVE: To compare 3 perioperative feeding regimens and their effect on anesthetic complications, manure output, and colic proportion in healthy horses. METHODS: 45 horses presenting for elective orthopedic procedures were randomly assigned to 1 of 3 groups: not fasted (NF; continuous access to hay perioperatively), fasted muzzled (FM; 10-hour preoperative fast with slow refeeding postoperatively and muzzle placement), or fasted not muzzled (FNM; same as FM without muzzle placement). Anesthetic protocol was standardized. Outcomes compared between groups included anesthesia time, arterial oxygenation, duration of hypotension, perioperative manure output, time to first passage of manure postoperatively, pain scores, and colic proportion. Comparisons were made with a mixed model and Fisher exact test with statistical significance considered at P s .05. RESULTS: No differences were seen in pain scores, oxygenation, hypotension, or colic between groups. Groups FM and FNM had a significantly greater mean reduction in postoperative manure weight (-81% and -70%; P = .003) and number of manure piles (-63% and -55%; P = .005) compared to group NF (-39% and -22%; P < .001; weight and piles, respectively). Mean + SD minutes to passage of manure postoperatively was significantly shorter in group NF (238 + 13 minutes) than groups FM (502 + 174 minutes; P <.001) and FNM (444 + 171 minutes; P = .003). CLINICAL RELEVANCE: Horses with continuous access to hay prior to and following recovery from anesthesia passed more manure and passed manure sooner after surgery than their fasted counterparts without detrimental effect on anesthetic parameters and postoperative complications. Continuous access to hay perioperatively supports manure production in healthy horses without increase in anesthetic complications. [ABSTRACT FROM AUTHOR]

Purpose: Little is known about the soft tissue destruction by holmium laser clinically used for holmium laser enucleation of the prostate (HoLEP), subject to the distance between the laser fiber tip and the tissue surface. We aimed to investigate the impact of the distance between the laser fiber tip and the phantom surface (DLP) on a soft tissue phantom (STP) in relation to the surgical modes of HoLEP. Methods: STP responses to the laser pulses produced by a commercial holmium:yttrium aluminum garnet (Holmium:YAG) laser at an output setting 2 J were observed at different values of the DLP (0, 1, 2, 3, and 4 mm) to look at (1) the single laser pulse-induced cavitation bubble and its penetration into the STP, (2) the STP destruction by a single pulse, (3) the STP destruction by 60 pulses repeated at 12 Hz, and (4) the thermal effect by the multiple pulses visualized on a thermosensitive bovine serum albumin (BSA) STP. Results: We observed that the laser pulse produced a heated gas bubble in water centered at the laser fiber tip. The bubble shape depended on the DLP. The bubble completely penetrated into the STP at the DLP of 0 mm and the penetration decreased with the DLP. The size of the destruction of the STP by the laser pulses was shown to decrease as the DLP increased. Test with the BSA STP showed that, at the DLP of 3 mm, the destruction became insignificant while the thermal effects were still effective. Conclusions: We illustrated that soft tissue destruction by the Holmium:YAG laser is associated with cavitation effects. We provide for the first time experimental evidence for various surgical modes in HoLEP such as incision and hemostasis in relation to the DLP. [ABSTRACT FROM AUTHOR]

Background: To compare the operative effect and clinical efficacy of the Moses laser mode and the Raykeen holmium laser energy platform powder mode under flexible ureteroscopic lithotripsy in patients with impacted upper ureteral stones. Methods: From March 2022 to September 2022, 72 patients were divided into a Moses laser group and a Raykeen laser group according to surgical method, with 36 patients in each group. CT and ureteroscopy confirmed that all patients had isolated impacted upper ureteral stones. The stone volume (mm3), stone density (Hu) and severity of hydronephrosis were measured by CT. Postoperative complications were evaluated using the Clavien–Dindo score. Results: There were no complications of ureteral stenosis related to the laser treatment. The operative time and lithotripsy time were lower in the Moses laser group than in the Raykeen laser group (P < 0.05). The stone-free survival rate did not differ significantly between the two groups (P = 0.722). Stone volume was found to be positively correlated with laser energy and lithotripsy time in both groups (P < 0.01). There was no significant correlation between laser energy and lithotripsy time or ureteral stone density (Hu) in the Moses laser group (P > 0.05) or the Raykeen laser group (P > 0.05). Conclusions: The contact mode of Moses technology and the powder mode of Raykeen laser lithotripsy can be used for the ablation of a single impacted upper ureteral stone. The ablation speed was related to the stone volume and the severity of polyp hyperplasia, not the stone density. We recommend the use of the powdered mode as a therapeutic measure for the treatment of impacted upper ureteral stones in flexible ureteroscopic lithotripsy. [ABSTRACT FROM AUTHOR]

To assess the feasibility, safety, and predictive factors for the success of holmium laser enucleation of the prostate (HoLEP) with catheter removal and hospital discharge on the same day of the procedure. This prospective study included 34 patients who underwent HoLEP using a 60-W holmium laser device and the Wolf Piranha morcellation system. Surgeries began at 10:30 am and the patients were expected to be discharged by 5 pm on the same day. The patients underwent a voiding trial to remove the urinary catheter before hospital discharge. Functional outcomes were assessed 90 days after the procedure. Mean (range) age, prostate-specific antigen value, and prostate weight were as follows: 63.4 (50-80) years, 4.81 (0.19-14) ng/mL, and 89.3 (33-258) g, respectively. The mean (range) enucleation and morcellation times were 56.2 (29-91) minutes and 14.67 (3-45) minutes, respectively. Thirty-one patients (91.1%) were discharged on the same day of the procedure after urinary catheter removal. The performance of HoLEP is safe on an outpatient basis. Same-day catheter removal is feasible and does not affect hospital discharge. [ABSTRACT FROM AUTHOR]

Copyright of Anatolian Journal of General Medical Research is the property of Galenos Yayinevi Tic. LTD. STI and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Inorganic Chemicals Industry is the property of Editorial Office of Inorganic Chemicals Industry and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

ObjectivesDuring holmium:yttrium-aluminum-garnet (holmium:YAG) laser lithotripsy to break urinary stones, urologists frequently see flashes of light. As infrared laser pulses are invisible, what is the source of light? Here we studied the origin, characteristics, and some effects of flashes of light in laser lithotripsy.MethodsUltrahigh-speed video-microscopy was used to record single laser pulses at 0.2-1.0 J energy lasered with 242 µm glass-core-diameter fibers in contact with whole surgically retrieved urinary stones and hydroxyapatite (HA)-coated glass slides in air and water. Acoustic transients were measured with a hydrophone. Visible-light and infrared photodetectors resolved temporal profiles of visible-light emission and infrared-laser pulses.ResultsTemporal profiles of laser pulses showed intensity spikes of various duration and amplitude. The pulses were seen to produce dim light and bright sparks with submicrosecond risetime. The spark produced by the intensity spike at the beginning of laser pulse generated a shock wave in the surrounding liquid. The subsequent sparks were in a vapor bubble and generated no shock waves. Sparks enhanced absorption of laser radiation, indicative of plasma formation and optical breakdown. The occurrence and number of sparks varied even with the same urinary stone. Sparks were consistently observed at laser energy >0.5 J with HA-coated glass slides. The slides broke or cracked by cavitation with sparks in 63 ± 15% of pulses (1.0 J, N = 60). No glass-slide breakage occurred without sparks (1.0 J, N = 500).ConclusionUnappreciated in previous studies, plasma formation with free-running long-pulse holmium:YAG lasers can be an additional physical mechanism of action in laser procedures.

Purpose: This study investigated the factors associated with transient urinary incontinence (TUI) after holmium laser enucleation of the prostate (HoLEP) as a palliative treatment in patients with severe bladder outlet obstruction (BOO) and advanced prostate cancer (PCA). Materials and Methods: Data of 28 patients with advanced PCA (≥cT3) who underwent palliative HoLEP between October 2018 and March 2021 were included in this retrospective study. After collection of the pre-, intra-, and postoperative (1, 3, and 12 months) data of patients from their medical records, variables of patients with and without TUI at 1 and 3–12 months postoperatively were statistically compared. Multivariate analysis was performed to investigate the factors associated with postoperative TUI. Results: Compared to baseline, the mean total international prostate symptom score, quality of life score, maximum flow rate (Qmax), and postvoid residual (PVR) were significantly improved 1 month postoperatively, and this was maintained until 12 months postoperatively (p

Purpose: To evaluate the efficacy and safety of holmium laser enucleation of the prostate (HoLEP) in a large prospective cohort of patients with benign prostatic hyperplasia (BPH) through systematic follow-up at a single institution. Materials and Methods: Clinical outcomes were analyzed between August 2008 and June 2022. Patients were followed-up at 2 weeks, 3 months and 6 months postoperatively. Results: A total of 3,000 patients (mean age, 69.6±7.7 years) underwent HoLEP. Baseline total International Prostate Symptom Score (IPSS) was 19.3±7.7 and maximum flow rate (Qmax) was 9.4±4.8 mL/s. Mean total prostate volume was 67.7±3.4 mL. Total operation time was 60.7±31.5 minutes, and catheterization time was 1.0 days (range, 1.0–1.0 days). At 6 months postoperatively, the total IPSS decreased to 6.6±5.8 and Qmax increased to 22.2±11.3 mL/s. Complications at 6 months postoperatively included stress urinary incontinence (SUI) in 36 patients (1.9%), urgency urinary incontinence (UUI) in 25 (1.3%), bladder neck contracture (BNC) requiring transurethral incision (TUI) in 16 (0.5%), and urethral stricture in 29 (1.0%). Eleven patients (0.4%) with prostatic fossa stones required stone removal. Sixty-one patients (2.0%) required secondary surgery (transurethral coagulation, 16 [0.5%]; TUI for BNC, 16 [0.5%]; stone removal for prostatic fossa stones, 11 [0.4%]; and endoscopic internal urethrotomy for urethral stricture, 18 [0.6%]). Conclusions: Mid-term follow-up results after HoLEP in BPH patients showed excellent efficacy and low complication rates. Unlike previous reports, the incidence of SUI and UUI after HoLEP was low, but the occurrence of de novo stone formation in prostatic fossa was notable.

Each crystal structure has its own phonon modes, which appear in the Raman spectrum of Raman scattering. In the case of silicon, phonon modes associated with the diamond structure of silicon can be detected. In a Raman spectrum, the position of the lines, their intensity, and the width of the lines are usually measured. Raman spectroscopy is a powerful tool for studying crystalline materials at the molecular level, and its application in the study of semiconductors and nanomaterials provides important information about their structure and properties. In this study, the spectra of two types of silicon were analyzed: n-Si and p-Si, as well as their doped analogues n-Si and p-Si. The obtained Raman imaging results demonstrated spatially varying nanocrystallinity and microcrystallinity of the samples. The n-Si and p-Si spectra indicate the appearance of a Raman band at 525 cm-1 with a shift of -5 cm-1 and +5 cm-1, respectively, relative to the position of the silicon substrate peak, indicating the presence of tensile strain in the materials. The absence of other impurity peaks indicates the high purity of the n-Si and p-Si samples. The holmium doped Si material exhibits additional peaks in the Raman spectra, which is attributed to the presence of vacancies and defects in the newly formed Si-Ho compositions. The results of the analysis of the spectra indicate the influence of doping silicon with holmium on its structure and properties, forming new bonds and defects.

The neutral holmium(III) oxalate octadecahydrate {[Ho2(ox)3(H2O)6]·12H2O}n of mixed hexagonal/decagonal (63·103) 3D net topology shows important changes in the magnetocaloric efficiency upon dehydration/rehydration by heating and water vapor exposition to give the holmium(III) oxalate decahydrate {[Ho2(ox)3(H2O)6]·4H2O}n of hexagonal (63) 2D net topology through the intermediacy of the elusive amorphous anhydrous compound {Ho2(ox)3}n. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate perioperative parameters, clinical outcomes, and the learning curve of holmium laser enucleation of the prostate (HoLEP) of a single surgeon in 500 consecutive cases. Methods: Demographic parameters, outcomes, and adverse events were evaluated. The learning curve for HoLEP in en-bloc technique of the first 500 consecutive patients was analyzed in clusters of 100 (clusters 1–5) using the Wilcoxen rank test, Chi² test and Kruskal Wallis test. Results: Enucleation weight was similar in the clusters 1,2,3, and 5 (62 g, 63 g, 61 g, 61 g), in cluster 4 it was slightly higher at 73 g. There was a significant reduction in operating time from 67 min (cluster 1) to 57 min (cluster 2), 46 min (cluster 3), 53 min (cluster 4), and 43 min (cluster 5), p < 0.001. Enucleation efficiency (g/min) showed a steady increase (1.72, 2.24, 2.79, 2.92 vs. 2.99, p < 0.001). Laser energy efficiency also improved (2.17 vs. 2.12 vs. 1.71 vs. 1.65 vs. 1.55; p < 0.001). There was no measurable learning curve regarding the length of hospital stay (mean 2.5 days), catheterization time (1.9 days), hemoglobin drop (approx. 1 g/dl) or complications (p > 0.1). Conclusions: HoLEP using the en-bloc technique is a safe and highly effective method. Over time, a slight but steady learning curve and improvement in operation time, enucleation efficiency and laser energy efficiency were shown even for an experienced surgeon - after 500 cases, still no plateau was reached. There was no measurable learning curve regarding blood loss, complications, length of hospital stay, and catheterization time. [ABSTRACT FROM AUTHOR]

Purpose: Accurate identification of lymph node (LN) metastases is pivotal for surgical planning of pancreatic neuroendocrine tumours (PanNETs); however, current imaging techniques have sub-optimal diagnostic sensitivity. Aim of this study is to investigate whether [68Ga]Ga-DOTATOC PET radiomics might improve the identification of LN metastases in patients with non-functioning PanNET (NF-PanNET) referred to surgical intervention. Methods: Seventy-two patients who performed preoperative [68Ga]Ga-DOTATOC PET between December 2017 and March 2022 for NF-PanNET. [68Ga]Ga-DOTATOC PET qualitative assessment of LN metastases was measured using diagnostic balanced accuracy (bACC), sensitivity (SN), specificity (SP), positive and negative predictive values (PPV, NPV). SUVmax, SUVmean, Somatostatin receptor density (SRD), total lesion SRD (TLSRD) and IBSI-compliant radiomic features (RFs) were obtained from the primary tumours. To predict LN involvement, these parameters were engineered, selected and used to train different machine learning models. Models were validated using tenfold repeated cross-validation and control models were developed. Models' bACC, SN, SP, PPV and NPV were collected and compared (Kruskal–Wallis, Mann–Whitney). Results: LN metastases were detected in 29/72 patients at histology. [68Ga]Ga-DOTATOC PET qualitative examination of LN involvement provided bACC = 60%, SN = 24%, SP = 95%, PPV = 78% and NPV = 65%. The best-performing radiomic model provided a bACC = 70%, SN = 77%, SP = 61%, PPV = 60% and NPV = 83% (outperforming the control model, p < 0.05*). Conclusion: In this study, [68Ga]Ga-DOTATOC PET radiomics allowed to increase diagnostic sensitivity in detecting LN metastases from 24 to 77% in NF-PanNET patients candidate to surgery. Especially in case of micrometastatic involvement, this approach might assist clinicians in a better patients' stratification. [ABSTRACT FROM AUTHOR]

A series of ZnCr2−xHoxSe4 microcrystalline spinels (where x = 0.05, 0.075, and 0.10) containing holmium ions in octahedral coordination were obtained by sintering of adequate reactants at high temperatures. The obtained doped materials were characterized by X-ray diffraction, Scanning Electron Microscopy, UV–Vis–NIR, molecular field approximation, and XPS spectroscopies. Their thermal properties were also investigated. The doping of the ZnCr2S4 matrix with paramagnetic Ho3+ ions with a content of not more than 0.1 and a screened 4f shell revealed a significant effect of orbital and Landau diamagnetism, a strong reduction in short-range ferromagnetic interactions, and a broadening and shift of the peak of the first critical field by simultaneous stabilization of the sharp peak in the second critical field. These results correlate well with FPLO calculations, which show that Cr sites have magnetic moments of 3.19 µB and Ho sites have significantly larger ones with a value of 3.95 µB. Zn has a negligible magnetic polarization of 0.02 µB, and Se induces a polarization of approximately −0.12 µB. [ABSTRACT FROM AUTHOR]

The results of studying the effect of the central metal ion on the stability of gadolinium and holmium complexes with 1,10'-phenanthroline-2,9-dicarboxylic acid diamide are presented. The obtained values of the stability constants of the complexes turned out to be an order of magnitude lower than the previously known values for the complexes of these elements with 4,7-dichloro-1,10'-phenanthroline-2,9-dicarboxylic acid diamide. [ABSTRACT FROM AUTHOR]

To investigate the difference in postoperative incontinence and quality of life comparing standard vs early apical release (EAR) Holmium Laser Enucleation of the Prostate (HoLEP). A retrospective review was performed to identify patients who underwent HoLEP from December 2021 to December 2022 at a single tertiary referral center with two participating consultant urologists. Patients were assessed with questionnaires and evaluated clinically. We performed propensity score matching with a logistic regression and a 1:1 matching method. A propensity score-adjusted logistic regression (PSRM) was performed to compare the pads per day between surgical techniques controlling for age, prostate size, preoperative survey data, uroflow, and postvoid residual. One hundred fourteen patients underwent HoLEP, of which 60 patients were treated with EAR and 54 patients with standard technique. EAR technique demonstrated shorter operative times (P =.046). The EAR cohort demonstrated improved AUASS (P =.034, P =.001), QOL (P =.001, P <.001), and continence rates (P <.001, P <.001) at 6 and 12 weeks postoperatively. PSRM showed that the standard HoLEP increased the risk of requiring ≥2 pads per day 4.2x (P =.031, HR 95%, CI = 1.16, 15.35) and 8.3x (P <.001, HR 95% CI 3.17, 21.6) at 6 and 12 weeks postoperatively. EAR technique promoted earlier return of continence and improved quality of life within 6 weeks of surgery. [ABSTRACT FROM AUTHOR]

Benign prostatic hyperplasia (BPH) management has evolved from transurethral resection of the prostate (TURP) to holmium laser enucleation of the prostate (HoLEP). Recent innovation introduces Moses™ technology in holmium lasers, with the Lumenis Pulse™ system. To compare Moses-augmented HoLEP (MoLEP) to non-Moses HoLEP in terms of enucleation efficiency, hemostasis, and applicability in day surgery settings. A single-blind, prospective, parallel randomized controlled trial was conducted in Shanghai, China, from March to December 2022. Ethical approval (SK2020-038) was obtained, and 100 consenting men over 50 with BPH indications were randomized (1:1) into MoLEP and HoLEP groups. Surgical procedures were standardized, and outcomes were assessed by blinded analysts. Data from 80 participants (38 MoLEP, 42 HoLEP) were analyzed. Baseline characteristics were comparable. MoLEP demonstrated superior enucleation efficiency (3.5±0.8 g/min) and shorter enucleation time (22.5±7.6 minutes) compared to HoLEP, although not statistically significant. MoLEP achieved hemostasis in less time (6.6±4.2 minutes) than HoLEP (11.2±5.1 minutes). Postoperative care demands varied, with MoLEP requiring less bladder irrigation. MoLEP exhibited a shorter average catheterization time (1.3±0.1 days) and reduced hospitalization compared to HoLEP. Both groups showed significant postoperative improvements in functional outcomes. While statistical significance was not achieved in certain outcome measures, MoLEP exhibited potential advantages in postoperative care demands, shorter catheterization time, and reduced hospitalization, suggesting its feasibility and safety in day surgery settings. Postoperative functional outcomes improved significantly in both groups. [ABSTRACT FROM AUTHOR]

Introduction: Before holmium laser enucleation of the prostate (HoLEP), many patients have undergone short-term prostate biopsy (PB) to rule out the presence of prostate cancer. The aim of this study is to determine whether a short-term PB before HoLEP has an impact on the perioperative outcomes or complications of HoLEP. Methods: In total, 734 consecutive patients treated with HoLEP at a tertiary care university hospital between January 2021 and July 2023 were retrospectively enrolled. Patients who had PB within 6 months before HoLEP were matched to patients who underwent PB more than 6 months or had no PB before HoLEP using propensity score matching (PSM) based on age, prostate volume (PV), prostate-specific antigen (PSA), preoperative urinary tract infection (UTI), and surgeon. Perioperative parameters, such as operation time (OT), enucleation efficiency (EF), as well as complications according to the Satava classification, the Clavien–Dindo classification (CDC), and the Comprehensive Complication Index (CCI) were evaluated. Results: In total, 206 patients were matched. Age, PV, PSA, as well as the presence of a preoperative UTI and surgeons did not differ significantly between both groups after PSM. There were no significant differences in mean OT (75 vs. 81 minutes, p = 0.28) and EF (2.13 vs. 2.13 g/min, p = 0.99). No differences were noted regarding intraoperative (16 vs. 25, p = 0.16) or postoperative complications graded by CDC (p = 0.53) and CCI (p = 0.92). Conclusion: PB within 6 months preoperatively before HoLEP showed no effect on perioperative outcomes or intra- and postoperative complications. [ABSTRACT FROM AUTHOR]

Holmium laser enucleation of the prostate has been shown to offer a number of advantages over transurethral resection of the prostate and yet uptake of the technique to treat benign prostatic hyperplasia is slow. The authors examine the technique and look at some of the reasons it has not become the treatment of choice for a condition that affects more and more men as they age. [ABSTRACT FROM AUTHOR]

Using sol–gel technique, we synthesized a novel series of titania-silicate glasses doped with Ho3+ ions, featuring a chemical composition (80-x) SiO2 + 20TiO2 + xHoCl3 (where x varied from 0.5 to 3.5 mol%, and was referred to as Ho3+ ions concentrations). Subsequently, we conducted comprehensive characterization to investigate both the physical parameters and spectroscopic properties of these glasses. Structural analysis involved techniques such as X-ray diffraction (XRD), Fourier transform infrared spectroscopy (FTIR), and transmission electron microscopy (TEM) to elucidate their structural properties. Using the Debye–Scherrer equation, the average grain size of polymorphic anatase phase TiO2 NPs was determined to be 14 nm. To comprehend the visible photoluminescence and lasing potentialities of titania-silicate glasses, spectroscopic studies including optical absorption and emission measurements were carried out. The bonding behavior of the Ho3+ ions and its surrounding ligand was studied using Judd–Ofelt (JO) intensity parameters (Ωλ, λ = 2, 4, 6); Ω2 > Ω4 > Ω6; regardless of Ω2 or Ω4 or Ω6, they all initially rise and then decrease with Ho3+ ion concentration, reaching their maximum value at 1.5 mol%. There are five visible emissions in the glass photoluminescence spectrum: two red, one green, and one blue. The green emission has the maximum intensity, occurring at 549 nm from the 5S2 → 5I8 transition. Analysis involved employing calculations to ascertain various parameters including the spectroscopic quality factor (χ = Ω4/Ω6), color chromaticity coordinates (x, y), correlated color temperature (CCT), and color purity (CP). Its appropriateness for designing and developing visible green lasers is demonstrated by the strong visible emission, large stimulated emission cross-section (σse), and high branching ratio (β) achieved during the 5S2 → 5I8 (green) transition of titania-silicate glass doped with 1.5 mol% of Ho3+ ions. [ABSTRACT FROM AUTHOR]

Objectives: We assessed preoperative factors predicting the poor therapeutic efficacy of holmium laser enucleation of the prostate (HoLEP) in benign prostatic hyperplasia (BPH) patients. Methods: The present study included 159 patients who underwent HoLEP between August 2015 and June 2021 at our institution. Overall therapeutic efficacy was divided into good and poor therapeutic efficacies according to changes in the international prostate symptom score (IPSS), IPSS quality of life (IPSS‐QOL), and the maximum urinary flow rate. Patients were divided into good and poor therapeutic efficacy groups based on findings obtained 3 months after HoLEP, and comparative assessments were performed between the two groups. Results: The therapeutic efficacy of HoLEP was poor in 53 (33.3%) out of 159 patients. Intravesical prostatic protrusion (IPP), IPSS, IPSS‐QOL, post‐void residual volume (PVR), and the presence of overactive bladder (OAB) were significantly higher in the poor therapeutic efficacy group than in the good therapeutic efficacy group. A multivariable analysis of several factors identified the preoperative presence of OAB and short IPP as independent risk factors for the poor therapeutic efficacy of HoLEP. When treatment efficacy was divided according to risk factors, poor therapeutic efficacy was observed in only 14% of patients with prolonged IPP and the absence of OAB. Conclusions: The therapeutic efficacy of HoLEP may be poor in patients with OAB and short IPP, resulting in the significant deterioration of lower urinary tract symptoms. Accordingly, it is important to consider the presence or absence of OAB and IPP measurements when selecting indications for HoLEP. [ABSTRACT FROM AUTHOR]

Introduction and Objectives: Our goals were to study prostatic volume as a limiting factor after HoLEP surgery with short‐circuit outpatient care (4 h) and to define other factors that affect the success of the proposed circuit. Materials and Methods: An observational analysis and review was performed using a prospective database. Preoperative, intraoperative, and postoperative variables were included for patients who were scheduled for short‐circuit outpatient care (SCOC) and who underwent HoLEP between 2020 and 2023. We defined SCOC as a postoperative hospital stay of 4 h. Subjects who required more than 4 h in hospital were categorized as conventional hospital admission (CHA). A descriptive populational study was conducted, expressing the mean using a 95% confidence interval and percentages for the continuous variables. In order to analyze them, we used the Student's t‐test for the continuous variables and the chi‐squared test for the categorical variables. Results: Sixty‐eight patients were included, 54 of which completed SCOC, which represented a success ratio of 79.5%. The mean age and prostatic volume of the whole cohort were 68.9 (±6.8) years and 79.5 (±29.1) mL, respectively. We found no significant differences in age, prostatic volume, antiplatelet drug use, indwelling bladder catheter, or applied energy among the subjects who completed SCOC and those who required CHA. No patient was presented with a complication of Grade 3 (or higher) in the modified Clavien–Dindo classification. At the six‐month follow‐up, no differences were observed in the uroflowmetry or International Prostate Symptoms Score variables. Conclusions: Prostatic volume does not seem to be a limiting factor after undergoing HoLEP with short‐circuit outpatient care. [ABSTRACT FROM AUTHOR]

In the search of novel photocatalysts to increase the effect of visible light in photocatalysis, g-C3N4 (CN) has become a shining star. Rare earth metals have been used as dopant material to reinforce the photocatalytic activity of CN due to their unique electron configuration recently. In this present study, the pure and different amounts of Ho-doped g-C3N4 (HoCN) photocatalysts were successfully synthesized using urea as a precursor by the one-pot method. Morphological, structural, optical, and vibrational properties of the synthesized photocatalysts were characterized by SEM, EDX, XRD, TGA, XPS, FTIR, PL, TRPL, Raman, DRS, and BET analyses. In addition, theoretical calculations using density functional theory (DFT) were meticulously carried out to delve the changes in the structural and electronic structure of CN with holmium doping. According to calculations, the chemical potential, electrophilicity, and chemical softness are higher for HoCN, while HOMO–LUMO gap, dipole moment, and the chemical hardness are lower for the pure one. Thus, holmium doping becomes desirable with low chemical hardness which indicates more effectivity and smaller HOMO–LUMO gap designate high chemical reactivity. To determine the photocatalytic efficiency of the pure and doped CN photocatalysts, the degradation of methylene blue (MB) was monitored under visible light. The results indicate that holmium doping has improved the photocatalytic activities of CN samples. Most strikingly, this improvement is noticeable for the 0.2 mmol doped CN sample that showed two times better photocatalytic activity than the pure one. [ABSTRACT FROM AUTHOR]

Introduction Thermal injury to kidney tissue during holmium laser lithotripsy represents a significant complication. This issue is often unavoidable due to the variability of renal conditions and the absence of techniques for real-time intrarenal temperature monitoring. The objective of this research was to evaluate influence of manual hand pump irrigation on temperature of the fluid within a pelvicalyceal model during holmium laser lithotripsy. Material and methods Laser lithotripsy of artificial stones was carried out in a 3D-printed model of the renal pelvicalyceal system. The irrigation system employed a continuous gravity approach (P = 60 cmH2O), augmented by manual pumping as required. A 9.2 Fr ureteroscope was inserted into the model via a ureteral access sheath (UAS), with sizes of either 10/12 Fr or 12/14 Fr. The power settings for the lithotripsy varied between 12 and 25 W. Temperature monitoring during the procedure was conducted using thermographic methods. Results For all laser power settings, the temperatures recorded under gravity irrigation alone were significantly higher compared to those achieved when gravity was combined with a manual hand pump, regardless of the ureteral access sheath size. When using the hand pump system and a 12/14Fr UAS, the median temperatures in none of the laser settings exceeded 30°C. However, using a 10/12Fr UAS, the median temperatures did not exceed 35°C in any of the settings and were significantly lower compared to the use of the gravity flow system alone. Conclusions The employment of gravity irrigation supplemented by a manually on-demand pump in retrograde intrarenal surgery is a critical component in mitigating the risk of significant temperature elevations, leading to thermal injury to the adjacent kidney tissues. Moreover, the interquartile ranges of temperatures indicating that gravity system enhanced by an on-demand pump irrigation not only reduce the median temperature but also promote a more consistent thermal environment. [ABSTRACT FROM AUTHOR]