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Background: Computerized tomography (CT) is considered indispensable in percutaneous nephrolithotomy (PCNL) planning. We aimed to define the reliability of pre-PCNL CT for planning renal access by assessing renal positional changes between supine and prone CTs. Subjects and methods: CT urographies (CTU) of 30 consecutive patients were reviewed for distances upper pole (UP)–diaphragm, UP–diaphragm attachment, renal pelvis (RP)–lateral body wall, RP- posterior body wall, and lower pole (LP)- anterior–superior iliac spine (ASIS). The posterior and lateral renal axes angles were also calculated. Results: The most consistent overall movement in transition from prone to supine was backward rotation, as demonstrated by a decrease in distance UP–posterior body wall (p = 0.010) and increase in the posterior renal angle (p < 0.0001). This finding correlated with the patient's body mass index (BMI) (p = 0.029). The left kidney was more mobile than the right one, moving significantly for five of the measured parameters compared to the right kidney which moved significantly for only two parameters. The UP-diaphragm distance of the left kidney correlated with age (p = 0.014), the RP-lateral wall distance correlated with previous abdominal surgery (p = 0.006), and the RP-posterior wall distance with BMI (p = 0.017). On the right, the UP-diaphragm distance correlated with gender (p = 0.002) and the lateral renal rotation was smaller (p = 0.046). Conclusions: Kidneys present significant mobility between supine and prone positions. CT assessment should be performed in the position expected during surgery and should be interpreted with caution, while a real-time imaging modality should be used in the operating room. [ABSTRACT FROM AUTHOR]

Introduction: Thulium fiber laser (TFL) is a novel laser in the field of urology. There is no consensus for optimal parameters. As most urologists use social media, being Twitter the platform with the most dissemination in healthcare, we aim to review the preferred TFL settings chosen by the experts and, to evaluate their pros and cons. Materials and methods: A Twitter review was performed from November 2019 (firsts TFL experiences in urology) until October 2021 using the hashtags: "thuliumfiber", "ThuliumFiberLaser", "TFL" "soltive", "fiberdust", "OlympusUrology", "quanta_system", "IPG_Photonics", "rocamed". Only board-certified urologists were considered. The "tweets" selected include information about TFL preferred settings for stone lithotripsy and tissue ablation. Additionally, we also seek information regarding laser technique, fiber size, laser time, stone type and equipment. Results: A total of 42 opinions were identified. The 23 endourologists have a median of 2.298 followers (range 202–10.000). Most comments were about TFL settings for kidney stone dusting (61%). There was a significant difference (p < 0.05) for kidney stone dusting settings (dusting, frequency, and power) between endourologists. Only 24% reported their fiber size, 4 reported the stone composition and 2 endourologists mentioned their type of ureteroscope. There was no discussion about technique used (burst or continuous) nor equipment. Surgery time was reported 3 times. Conclusion: There is no consensus in TFL pre-settings. When a pre-setting is proposed, it should also recommend technique to be used. Settings are personal and related to multiple factors, such as training, technique, equipment and fiber size. [ABSTRACT FROM AUTHOR]

To assess the effectiveness of incorporating hygienic-dietary recommendations in laboratory reports in reducing the incidence of renal colic (RC). A study was performed to compare the incidence of RC in two groups of patients who had suffered at least a crystalluria event associated with the risk of urolithiasis. Recommendations were only incorporated in the laboratory reports of one group.

This research is focussed on Anne Brontë's collection of stones, which are housed at the Brontë Parsonage Museum, and how they connect to her time in Scarborough. Obtained during the 'golden age' of geology, the collection was recently recharacterized using Raman spectroscopy. In this interdisciplinary study, we explore possible sources of the stones and the different factors that may have influenced Anne to obtain and maintain her collection of stones. The significance of Anne Brontë's stones and her connections to mineralogy and geology reveal Anne's interest, knowledge and abilities within these fields. [ABSTRACT FROM AUTHOR]

To evaluate the role of stone size on the efficacy and safety of extracorporeal shockwave lithotripsy (ESWL) monotherapy vs ureteroscopy (URS) for managing upper ureteric stones. The study design was a randomised prospective study of a total cohort of 180 patients with upper ureteric single stones of 0.5–1.5 cm. Half of the patients were managed by ESWL monotherapy, while the other half underwent URS with stone fragmentation using an ultrasound lithotripter (URSL). The success rate, re-treatment rate, auxiliary procedure (AP) rate, efficacy quotient, and complications were compared between the two groups. After single URSL and ESWL procedures 70/90 (77.8%) and 35/90 (38.9%) of the stones were successfully cleared, respectively (P < 0.001). The re-treatment rate after ESWL was significantly higher than in the URSL group (38.9% vs 11.1%, P < 0.001). Requiring an AP was not significantly different following ESWL (22.2%) and URSL (24.4%) treatment. The overall stone-free rate (SFR) at 3 months was significantly superior in the URSL group (88.9% vs 77.8%); however, both procedures had excellent results with no significant difference for stones of <1 cm (95.5% vs 92.9%, P > 0.05), compared to better results following URSL for stones of >1 cm (82.6% vs 64.6%, P < 0.05). Our present study supports that ESWL is recommended as a first-line non-invasive monotherapy for upper ureteric opaque stones of <1 cm, while URSL is recommended as a first-line treatment for stones of >1 cm. The results for URSL were superior with lower a re-treatment rate, rapid stone clearance in a very short time, and less radiation exposure. Therefore, stone size is an important factor for the final decision of the initial management of upper ureteric stones because it has a direct relation to the efficacy of ESWL, but it has no effect on the results of URSL. [ABSTRACT FROM AUTHOR]

Inorganic compounds have been known and used since antiquity. Dynameron is the largest Byzantine medical manuscript divided into 24 sections, in accordance with the letters of the Hellenic alphabet, which contains 2667 recipes. The majority of them contain ingredients of plant origin, followed by animal origin, while fewer inorganic substances are quoted. In the present study, the latter ones are listed. Moreover, the information on the uses of inorganic ingredients in the treatment of many diseases in the late Byzantine era is presented and their evaluation in light of the modern Pharmacology and Toxicology.

Ants prefer to nest under stones. This is due to temperature regimes favorable to the development of ant broods. In this paper, we investigated the influence of stone and ambient parameters on ant nests and created a model of thermal processes in ant nests under stones. The simulation results were compared with temperature measurements. Temperature was measured under 20 stones under different illumination conditions (sun, penumbra and shade) for 3 ant species (Myrmica rubra, Formica cinerea, Lasius niger) in Ukraine from April to August 2021. Stones were categorized as hot, warm and cold. Each stone was checked once a week for the number of workers and brood. Under two stones, temperature was measured using loggers. The number of workers under hot stones in spring increased three weeks earlier than under cold and warm ones. In May-June, the maximum number of workers was recorded under hot stones. In July, the number of ants was minimal under all categories of stones. Larvae appeared under hot stones two weeks earlier than under other categories of stones. In August, the number of pupae under cold and warm stones was greater than under hot ones. Number of larvae and pupae was positively influenced by the diameter of the stone, whereas stone height did not exert an important role. Ants preferred to inhabit nests under large flat stones, which are easily heated in spring and warm the soil under them. Another important characteristic was the location of the stones. The highest brood development was noted in nests under stones in open areas well lit by the sun in the daytime. In summer ants migrated from under hot stones, because soil under it dry and warmed. Stones and their position may be important factors in accelerating the development of brood in colonies of ant species that do not have active thermoregulation. [ABSTRACT FROM AUTHOR]

In Ex 1,15-22, the confrontation between the pharaoh and the midwives Siphrah and Puah is narrated for the gift of the offspring. The monarch orders the murder of the newborn Hebrew males and the brave midwives disobey. In this pericope, the terms of אבְָניָםִ (Ex 1,16) and חָיותֺ (Ex 1,19) appear, both fundamental in the construction of the dialogues between the king and the midwives. The pharaoh rules to kill the boys and leave the Hebrew girls alive in childbirth, ordering to look at האָבְָניָםִ to determine the sex of the newborn. The term used does not have a clear meaning in that context; therefore, it has received different attempts at explanation throughout history. When the monarch claims to the midwives that his order has not been observed, they respond: "Hebrew women are not like Egyptians; they are more חָיותֺ " (Ex 1,19). The adjective that describes the Hebrews has different meanings referring to strength, vitality and animality; which have influenced the different translations and interpretations. The following study carries out a linguistic approach to both terms, analyzing the options made by translators, both ancient and modern, with particular attention to those made in the Spanish language. Then, it presents the reception of the same in various works, and their role in the construction of the narrative plot. [ABSTRACT FROM AUTHOR]

Context: Extracorporeal shock wave lithotripsy (ESWL) has inferior results in the lower calyceal stones, especially in obese patients. Aims: This study aimed at evaluating of the efficacy of extracorporeal shockwave lithotripsy, with modified position of the machine head in the treatment of single lower calyceal stones in obese patients. Settings and Design: This was a prospective study (phase IV trial). Subjects and Methods: We studied the anterior rotation of the shock wave machine head in obese patients for the treatment of lower calyx stones. From February 2015 to June 2019, 105 obese patients (body mass index [BMI] ≥35) having lower calyx stones (≤20 mm) underwent ESWL at our institute. The procedure was done in a supine position, and the head of the shock-wave machine was tilted anteriorly. ESWL was considered successful if the kidney was completely cleared of stones. Statistical Analysis Used: The statistical methods used were descriptive statistics, mean, standard deviation frequency analysis, Chi-square test, unpaired t-test test, and Pearson correlations (r). Results: The mean BMI of these patients was 39.71 ± 2.8 kg/m2, the mean stone size was 17.4 ± 2.1 mm, the mean stone density was 767.1 ± 193.4 Hounsfield unit, and the mean of skin to stone distance (SSD) was 145.4 ± 4.5 mm. ESWL was successful in 86 (81.9%) patients; 13 patients (12.4%) showed complete success after the first session, while 37 (35.2%), 25 (23.8%), and 11 (10.5%) patients showed success after the second, third, and fourth sessions, respectively. ESWL failed in 19 (19.1%) cases. The success rate decreased significantly with higher stone density and SSD (P < 0.001), with negative correlations (r values) of −0.871 and −0.811, respectively. Conclusions: Anterior rotation of the head of the shock wave machine is a suitable option for the treatment of lower calyceal stones in obese patients. [ABSTRACT FROM AUTHOR]

Background: Deep learning Computed Tomography (CT) reconstruction (DLR) algorithms promise to improve image quality but the impact on clinical diagnostic performance remains to be demonstrated. We aimed to compare DLR to standard iterative reconstruction for detection of urolithiasis by unenhanced CT in children and young adults. Methods: This was an IRB approved retrospective study involving post-hoc reconstruction of clinically acquired unenhanced abdomen/pelvis CT scans. Images were reconstructed with six different manufacturer-standard DLR algorithms and reformatted in 3 planes (axial, sagittal, and coronal) at 3 mm intervals. De-identified reconstructions were loaded as independent examinations for review by 3 blinded radiologists (R1, R2, R3) tasked with identifying and measuring all stones. Results were compared to the clinical iterative reconstruction images as a reference standard. IntraClass correlation coefficients and kappa (k) statistics were used to quantify agreement. Results: CT data for 14 patients (mean age: 17.3 ± 3.4 years, 5 males and 9 females, weight class: 31-70 kg (n = 6), 71-100 kg (n = 7), > 100 kg (n = 1)) were reconstructed into 84 total exams. 7 patients had urinary tract calculi. Interobserver agreement on the presence of any urinary tract calculus was substantial to almost perfect (k = 0.71–1) for all DLR algorithms. Agreement with the reference standard on number of calculi was excellent (ICC = 0.78–0.96) and agreement on the size of the largest calculus was fair to excellent (ICC = 0.51–0.97) depending on reviewer and DLR algorithm. Conclusion: Deep learning reconstruction of unenhanced CT images allows similar renal stone detectability compared to iterative reconstruction. [ABSTRACT FROM AUTHOR]

This study aimed to report a multi-institutional experience with robot-assisted laparoscopic surgery (RALS) for treatment of urinary tract stones in children. The medical records of 15 patients (12 boys), who underwent RALS for urolithiasis in 4 international centers of pediatric urology over a 5-year period, were retrospectively collected. The median patient age was 8.5 years (range 4–15). Eleven/fifteen patients (73.3%) had concurrent uretero–pelvic junction obstruction (UPJO) and 2/15 patients (13.3%) had neurogenic bladder. Stones were in the renal pelvis in 8/15 (53.3%), in the lower pole in 3/15 (20%), in the bladder in 2/15 (13.3%), and in multiple locations in 2/15 (13.3%). One patient (6.6%) had bilateral multiple kidney stones. The median stone size was 10.8 mm (range 2–30) in upper tract location and 27 mm (range 21–33) into the bladder. Eleven patients with concomitant UPJO underwent simultaneous robot-assisted pyelolithotomy and pyeloplasty in 12 kidney units. Two patients with isolated staghorn stones received robot-assisted pyelolithotomy. Robot-assisted cystolithotomy was performed in two patients with bladder stones. The median operative time was 131.8 min (range 60–240). The stone-free rate was 80% following initial surgery and 100% after secondary treatment. Clavien 2 complications (hematuria, infections) were recorded in 5/15 patients (33.3%). Three/fifteen patients (20%) with residual renal stones were successfully treated using ureterorenoscopy (Clavien 3b). RALS was a feasible, safe and effective treatment option for pediatric urolithiasis in selected cases such as large bladder stones, bilateral kidney stones, staghorn stones or concomitant anomalies such as UPJO requiring simultaneous pyeloplasty. [ABSTRACT FROM AUTHOR]

Objective: Due to advances in surgical techniques and anaesthesia, day surgery is now becoming the standard care pathway for many complex procedures traditionally treated through inpatient pathways. Our aim was to study outcomes for patients undergoing rigid and flexible ureteroscopy before and after moving this service from a district general hospital to a day surgery unit. Methods: This was a retrospective observational study of 136 consecutive patients undergoing elective ureteroscopy for stone treatment. Half of the patients (n =68, inpatient group) underwent treatment according to the standard inpatient pathway, while the other half underwent treatment following relocation of this service to a day case unit (n =68, day case group). Outcomes were length of stay, readmission rate and complications. Results: In the inpatient group, 12 patients (17.6%) were discharged home the day of surgery (day 0), 42 patients (61.8%) stayed in hospital for one night. In the day case group, 58 patients (85.3%) were discharged on day 0, nine patients (13.2%) stayed for one night. Length of stay in the day case group was significantly shorter (P <0.001). Rates of postoperative complications and readmissions were not significantly different. Conclusion: Day case ureteroscopy for stone treatment is feasible and safe. It is associated with a significantly reduced length of stay without an increase in postoperative complications or readmission. [ABSTRACT FROM AUTHOR]

The aim of this study was to determine the suitable conservation treatments to control water erosion from skid trails in ShastKalate forests. Two longitudinal slopes of 20-40% and > 40% were considered as critical slopes for skid trails. Treatments of water diversion ruts, water diversion ruts filled with slash and stones were implemented on each slope. A rubber bar was installed at the end of the slope to convert runoff into collectors. Sampling was done during rainfall events in autumn and winter seasons. Findings indicated that the treatment of water diversion ruts filled with slash was better than the other treatments in the control of sediment and soil loss, especially in the slope class of 20-40%. In the slope class of > 40%, there was not any significant difference between treatments in sediment and soil loss control, but generally water diversion ruts filled with slash and stones were better in soil erosion control than water diversion ruts. In both slope classes, the rainfall intensity of 0.11 mm.h-1 (2.64 mm in 24 h) was the threshold of soil erosion on skid trails. The control of water erosion of soil on skid trails by the operation of water diversions is a suitable treatment for conserving skid trails.

Background and objective: This study aimed to evaluate the effect of adding postoperative antibiotics in reducing the incidence of symptomatic urinary tract infections following ureteroscopic stone treatment beyond the recommended preoperative dose. Methods: This prospective comparative study was conducted between March and November 2017. A total of 80 patients with preoperative negative urine cultures who underwent ureteroscopy were randomly allocated. All the patients received a single dose antibiotic before the induction of anesthesia, and a group of them also received postoperative antibiotics. The rate of symptomatic urinary tract infection was compared between the patients who received only preoperative antibiotics (group 1) and those who received pre- and postoperative antibiotics (group 2). Results: Eighty patients underwent ureteroscopy for stone treatment. The time to follow up was 4±2 weeks from ureteroscopy. Eleven (13.8%) patients in total developed urinary tract infections postoperatively, including five (12.5%) from group 1 and six (15%) from group 2, P = 0.74. In group 1, four patients presented with cystitis and one with sepsis; those patients with infections in group 2 presented with pyelonephritis (n=2) and cystitis (n=4). Risk factors such as preoperative stenting, nephrostomy tubes, and Foleys catheters did not differ between groups. Conclusion: The postoperative symptomatic urinary tract infection rate in this study (13.8%) is in agreement with previous reports. This study suggests that a single preoperative dose of antibiotics is sufficient, and additional postoperative antibiotics do not decrease infection rates after ureteroscopic stone treatment.

Objectives: The objective is to evaluate the relative risks of ureteric stents application while managing uric acid stones with potassium citrate in terms of stone encrustations and urinary tract infection (UTI). Patients and Methods: We prospectively enrolled patients with renal uric acid stones who received K citrate from 2013 to 2018. Patient's demographics were collected. All patients were evaluated using noncontrast computed tomography (CT) scan to measure the stone size and density. JJ ureteric stent was inserted prior to the initiation of treatment. At follow-up, all patients underwent urine analysis for pH and to detect UTI. CT was repeated at 1 month and those patients who showed incomplete stone resolution underwent another course of treatment for another month. CT was repeated prior to stent removal. The presence of encrustations was inspected and collected. Results: We collected 59 patients with a median age of 36 years (18–73) and median stone burden of 26 mm3 (15–50). The median stone density was 310 HU (175–498). Twenty-one patients (35.6%) received K citrate treatment for 1-month, while the remaining patients had 2 months treatment. Sixteen patients (27.1%) had a complete stone dissolution, 41 patients (69.5%) had more than 50% decrease of stone burden while only 2 patients (3.4%) had stones with poor dissolution. Four patients (6.8%) experienced UTI while 2 patients (3.4%) had visible JJ encrustations. Most of these complications occurred when the treatment was offered for the 2nd month. Conclusion: Short-term use of ureteral stents is safe during the management of uric acid stones with K citrate.

In some Greek and Latin testimonies of Late Antiquity, several stones are used as core material in the making of different objects; these objects are described as jewels (body ornament) and as amulets (powerful objects). The texts in which the making of these garments is told include a divine empowerment of the objects. Three examples show how the divine adornment for mortal use is conceived. These cases are: 1. the pantarbe in a ring which, in Heliodorus’ Aethiopica, repels fire itself, 2. the isiac emerald in fibula that, in the Damigeron-Evax lapidary, gives charm to the wearer, and 3. the remaking of the kestos of the goddess Aphrodite by the Cyranides, around an obsidian stone and from the pattern of a divine diadem capable of emasculating men or even of changing gender assignment.

Abstract Background To report current worldwide variation in techniques and clinical practice of flexible ureteroscopy (FURS) among endourologists of different case volumes per year. Methods Two invitations to complete an internet survey were emailed to Endourological Society members. Some of survey questions asked about indications of using FURS for renal and upper ureteral stones. Others were concerned with clinical practice of FURS (such as preoperative stenting, use of ureteral access sheath (UAS) and safety guidewire, technique of Laser lithotripsy and fragment retrieval, and post-FURS stenting. Responders were distributed into two groups; high-volume (> 100 cases/year) and low-volume surgeons ( 20 mm was used by 61% of high-volume surgeons compared with 28.6% for low-volume (P 20 mm. Low-volume surgeons prefer to use semi-rigid URS for treatment of upper ureteral stones, to apply Laser stone dusting and maintain ureteral stents for longer periods.

Shelby N Harper,1,2 Patrick D Leidig,2 Francis M Hughes Jr,2 Huixia Jin,2 J Todd Purves2,3 1Duke University School of Medicine, Durham, NC, USA; 2Department of Surgery, Division of Urology, Duke University Medical Center, Durham, NC, USA; 3Department of Pediatrics, Duke University Medical Center, Durham, NC, USACorrespondence: Francis M Hughes JrDepartment of Surgery, Division of Urology, Duke University Medical Center, P.O. Box 3831, Durham, NC 27710, USATel +1 843 709 2128Email monty.hughes@duke.eduObjective: To investigate the in vitro activation of the NLRP3 inflammasome within bladder urothelium by stone-forming components. Further, to describe the contributions of reactive oxygen species (ROS) and thioredoxin-interacting protein (TXNIP), an important structural component of the inflammasome, to this activation.Methods: Urothelial cells were harvested and incubated overnight. For agonist studies, cells were treated with varying concentrations of calcium pyrophosphate (CPPD) and monosodium urate (MSU). For inhibitor studies, cells were treated with either N-acetylcysteine (NAC) (1 hr) or Verapamil (4 hrs) prior to incubation with either CPPD (62.5 ug/mL) or MSU (1.25 ug/mL) for 24 hrs. Untreated controls were incubated with ATP (1.25 mM) for 1 hr to maximally stimulate NLRP3 inflammasome activity (measured as caspase-1 cleavage of the fluorogenic substrate Ac-YVAD-AFC). Results are reported as a percentage of maximum ATP response.Results: CPPD and MSU activate caspase-1 in urothelial cells in a dose-dependent manner, reaching ∼50% and ∼25% of the ATP response, respectively. Pre-treatment with the general ROS scavenger NAC reduces this activation in a dose-dependent manner. Additionally, activation was suppressed through treatment with Verapamil, a known downregulator of TXNIP expression.Conclusion: The stone components CPPD and MSU activate NLRP3 in an ROS and TXNIP-dependent manner in bladder urothelium. These findings demonstrate the importance of ROS and TXNIP, and suggest that targeting either may be a way to decrease stone-dependent NLRP3 inflammation within the bladder.Keywords: stones, urothelium, inflammation, NLRP3 inflammasome, TXNIP, ROS

Although rare, sulfamethoxazole-induced urolithiasis has been reported in patients taking trimethoprim-sulfamethoxazole (TMP/SMX). We present the case of a 79-year-old female who formed sulfamethoxazole stones in the setting of chronic indwelling catheterization with recurrent urinary tract infections (UTIs). The patient was a recurrent stone former with five prior stone composition analyses over a 10-year period varying from calcium phosphate to calcium oxalate, to struvite. We highlight the need for further investigation of this phenomenon given the frequent use of TMP/SMX in stone formers with recurrent infections.

Background and study aims Biliary sphincterotomy is a crucial step in endoscopic retrograde cholangiopancreatography (ERCP), a procedure known to carry a 5% to 10% risk of complications. The relationship between Pure cut, Endocut, post-ERCP pancreatitis (PEP) and bleeding is unclear. This systematic review and meta-analysis compared these two current types and their relationships with adverse events. Patients and methods This systematic review involved searching articles in multiple databases until August 2023 comparing pure cut versus Endocut in biliary sphincterotomy. The meta-analysis followed the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA). Results A total of 987 patients from four randomized controlled trials were included. Overall pancreatitis: A higher risk of pancreatitis was found in the Endocut group than in the Pure cut group ( P =0.001, RD=0.04 [range, 0.01 to 0.06]; I 2 =29%). Overall immediate bleeding: Statistical significance was found to favor Endocut, ( P =0.05; RD=-0.15 [range, -0.29 to -0.00]; I 2 =93%). No statistical significance between current modes was found in immediate bleeding without endoscopic intervention ( P =0.10; RD=-0.13 [range, -0.29 to 0.02]; I 2 =88%), immediate bleeding with endoscopic intervention ( P =0.06; RD=-0.07 [range, -0.14 to 0.00]; I 2 =76%), delayed bleeding (P=0.40; RD=0.01 [range, -0.02 to 0.05]; I 2 =72%), zipper cut ( P =0.58; RD=-0.03 [range, -0.16 to 0.09]; I 2 =97%), perforation ( P =1.00; RD=0.00 [range, -0.01 to 0.01]; I 2 =0%) and cholangitis ( P =0.77; RD=0.00 [range, -0.01 to 0.02]; I 2 =29%). Conclusions The available data in the literature show that Endocut carries an increased risk for PEP and does not prevent delayed or clinically significant bleeding, although it prevents intraprocedural bleeding. Based on such findings, Pure cut should be the preferred electric current mode for biliary sphincterotomy., Competing Interests: Conflict of Interest Vitor Ottoboni Brunaldi: payment for lectures by Erbe Elektromedizin GmbH; Tomazo Antonio Prince Franzini: consultant to Boston Scientific; Eduardo Guimarães Hourneaux de Moura: consultant to Boston Scientific and Olympus; The remaining authors have no conflicts of interest to declare., (The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).)

Objectives: To evaluate the safety and efficacy of ultrasound (US) and primary ureteroscopy (URS) in the management of symptomatic obstructive ureteric stones during pregnancy. Patients and Methods: A prospective multicenter study was performed between June 2013 and December 2019, including all consecutive pregnant patients admitted to three urology centers with intractable renal colic with obstructed ureter secondary to obstructive ureteral calculi. Color Doppler ultrasound was used to evaluate renal Resistive Index (RI) and ureter jet. Primary URS was performed to remove the blocking stones. The safety and effectiveness of the procedures were assessed, as well as the stone-free rate (SFR) and the condition of the upper tract after delivery. Results: A total of 111 pregnant patients were included with a mean age of 27.4 ± 4.4 years and a mean renal RI of 0.78 ± 0.02. US diagnosed stones in 46.8% of patients, while 100 (90%) patients had altered lower ureter urinary jet, including 86.5% who had URS-confirmed ureteric stones; SFR was 95.8% with no serious urologic, fetal, or obstetric complications. Nine percent of patients had premature delivery, which was significantly correlated with postoperative urinary tract infection and premature uterine contraction (p ˂ 0.0001). In the third-month follow-up of US, all patients showed no residual hydronephrosis. Postoperative follow-up procedures were required in 15.3% of patients. Conclusion: Obstructive ureteral stones during pregnancy can be detected safely and appropriately with a combined elevated renal RI and absent ureteral jet detected by Doppler US. Definitive URS is an efficient and safe alternative option for those who fail in conservative management. [ABSTRACT FROM AUTHOR]

Background: Medical dissolution of struvite uroliths in dogs is commonly recommended, but data on success rates and complications are limited. Objectives: To evaluate the efficacy of medical dissolution for suspected struvite cystoliths in dogs. Animals: Fifty client‐owned dogs fed a therapeutic dissolution diet, with or without administration of antimicrobials, for treatment of suspected struvite cystoliths. Methods: Single institution, retrospective case series. Medical records were reviewed for dogs with at least 1 follow‐up visit. Dissolution success, complications, and possible predictors of success were evaluated. Results: Full dissolution of cystoliths was achieved in 58% (29/50) of dogs within a median of 35 days (range, 13‐167). Of 21 dogs without success, 7 each had partial dissolution, no dissolution, or undetermined outcome. Uroliths containing >10% nonstruvite mineral were common in the nonsuccess group (11/16 analyzed). Maximum urolith diameter, number of uroliths, and baseline urine pH did not differ significantly between dogs with and without success. Dissolution was more likely in dogs receiving antimicrobial therapy (OR = 16.3, 95% confidence interval 1.9‐787.4, P =.002). Adverse events occurred in 9 dogs (18%); urethral obstructions were the most common, but 3 of 4 dogs with this complication were obstructed on presentation, before trial initiation. Conclusions and Clinical Importance: Results support a medical dissolution trial for dogs with suspected struvite cystoliths. If no reduction in urolith size or number occurs by 1 month, a nonstruvite composition is likely, and alternative interventions should be considered. Dogs presenting with urethral obstructions should not be considered candidates for medical dissolution. [ABSTRACT FROM AUTHOR]

Objectives: In performing mini-percutaneous nephrolithotomy (PCNL), we aimed at achieving the trifecta of stone-free status and no complications in a single treatment session. We analyzed our experience to determine negative predictors for achieving these three-fold goals. Patients and Methods: The data of all consecutive patients who underwent tubeless mini-PCNL between July 2015 and March 2020 in two hospitals were retrospectively reviewed. Stone-free was defined as no residual stones. Complications were recorded and graded according to modified Clavien classification. Patients were divided into two groups according to the outcome (trifecta and non-trifecta). Factors affecting the outcome were compared between both groups by using univariate and multivariate analyses to detect independent unfavorable risk factors. Results: The study included 944 patients with mean age 40.2 years (standard deviation: 13.6). The stone-free rate after one session of mini-PCNL was 90.7%. Auxiliary procedures were needed in 14 patients (1.5%). Complications were observed in 76 patients (8.1%). Trifecta was achieved in 792 patients (84%). Independent unfavorable risk factors in multivariate analysis were number of caliceal groups affected by the stones (relative risks were 1.95 to 2.27 and 5.7 for one, two, and three caliceal groups respectively) and number of percutaneous tracts (relative risk was 2.2). Stone size and complexity were not significant predictors of missing trifecta in multivariate analysis. Conclusions: Mini-PCNL can achieve a high rate of trifecta (84%) for different stone sizes and complexities. Stones distribution in multiple caliceal groups and multiple tracts are the independent unfavorable risk factor. [ABSTRACT FROM AUTHOR]

In colonial seabirds, differences in the nesting or fledging success have been associated with differences in nest position within the breeding aggregation (subcolony): less successful nests are located on the periphery, with more successful nests closer to the center. For Pygoscelid penguins, central nests tend to be larger, with nest size being an indicator of individual quality because stones must be gathered singly, so more stones reflect more individual effort. Competition for nest materials, including the collection of materials from another's nest, has also frequently been described in penguins and other colonial seabirds. We used the data collected during the incubation stage from a total of 20 subcolonies at two separate breeding colonies of Adélie penguins (Pygoscelis adeliae) on Ross Island (Antarctica) to test the influence of nest position on breeding success. We also investigated how competition for nest stones could occur at different intensities depending on size of the subcolony, nest position, and quality within a subcolony. We found that peripheral nests experienced lower breeding success and higher number of individuals attempting to remove stones with higher removal success rates than from nests toward the center. The higher costs associated with maintaining and defending nests that incur higher removal pressure could be an additional factor involved in the lower breeding success of peripheral nests. [ABSTRACT FROM AUTHOR]

Objective: The aim of this study is to evaluate the efficacy of a food supplement containing Phyllanthus niruri and Chrysanthellum americanum in association with potassium and magnesium citrates in the treatment and prophylaxis of urinary stones. Materials and methods: Eighty-two patients (mean age 49.7 ± 11.2) with history of urinary stones received this food supplement, one capsule a day for 6 months. Each administration contained a combination of the following ingredients: 244 mg Potassium citrate, 735 mg Magnesium citrate, Phyllanthus (Phyllantus niruri) herb d.e. 15% mg Tannins 220 mg, Chrysanthellum (Chrysanthellum americanum Vatke) plant d.e. ¼ 55 mg. After 6 months, all patients underwent urologic visit, urinalysis, imaging and quality of life (QoL) questionnaires evaluation. Each patient was also evaluated by computed tomography (CT) scan at baseline and at 6 months. Result: From January 2018 to March 2019, 82 patients (mean age 49.7 ± 11.2) completed the follow-up period and were analyzed. Fifty patients showed lower stone dimensions (60.9%). The average stone size was 0.9 mm, with a significant reduction in comparison with the baseline (-6.7 mm ± 3 mm) (p < 0.001). Forty-nine patients (59.7%) did not show any symptomatic episode with an improving in QoL (+0.4 ± 0.1) (p < 0.001) in comparison with the baseline. At the end of the follow-up period, 27 patients out of 82 were stone-free (32.9%). Moreover, we report a significant reduction of patients with asymptomatic bacteriuria (ABU) between the baseline and the end of the follow-up evaluation (p < 0.001). Conclusions: In conclusion, this food supplement is able to improve quality of life in patients with urinary stones, reducing symptomatic episodes and the prevalence of ABU.

The crash of a coach with 58 occupants at 100 kmph revealed the danger of covering ditch areas with sharp stones 5–20 cm in size. Stones and dirt were sprayed into the coach compartment resulting in serious injuries and death. Road safety works need to address this factor in the future.

Background: Concomitant common bile duct (CBD) stone in the setting of acute calculous cholecystitis (ACC) should be suspected once abnormal liver indices are noticed. Aim: We aimed to identify predictors of CBD stone in patients hospitalized with ACC. Methods: We performed a retrospective multi-center, case-controlled, study from 1st of January 2016 until the 31th of December 2018. Inclusion criteria included patients with an established diagnosis of ACC based on clinical, laboratory and radiological criteria and who had an endoscopic ultrasound (EUS) for suspected CBD stone. One-hundred and twelve patients were included, of these fifty-three patients (47.3%) were diagnosed with CBD stone by EUS. Results: In univariate analysis, Age (OR 1.038, P = 0.001), total bilirubin (mg/dl) (OR 1.429, P = 0.02) and CBD width (mm) by US (OR 1.314, P = 0.01) were statistically significant in predicting CBD stone and remained significant in multivariate regression analysis. We developed a diagnostic score that included these three parameters, with assignment of weights for each variable according to the coefficient estimate. A low cut-off score of 0 was associated with sensitivity of 100% for CBD stone, whereas a high cut-off score of 3 was associated with sensitivity of 10% and specificity of 96.6% with a positive predictive value of 67% (ROC of 0.7558). We validated this score with an independent cohort (ROC of 0.7416) with a sensitivity of 46.6%, a specificity of 91.5% and a PPV of 87.1%. Conclusion: We recommend incorporating this score as an aid for stratifying patients with ACC into low or high probability for concomitant CBD stone. [ABSTRACT FROM AUTHOR]

Objective: The objective of this study was to predict computed tomography (CT)-controlled treatment success after minimally invasive percutaneous nephrolithotomy (Mini-PCNL). Patients and Methods: We relied on retrospective single institutional data from 92 kidney stone patients treated with Mini-PCNL. Residual stones after treatment were evaluated by post-Mini-PCNL CT scans. Stone-free status was defined as clinically insignificant residual stones ≤3 mm after surgery. Multivariable logistic regression analyses predicted stone-free status after Mini-PCNL. Results: Overall, 53 (57.6%) patients achieved stone-free status after Mini-PCNL treatment. In multivariable logistic regression analyses, stone localization was the strongest predictor for stone-free status after Mini-PCNL. Specifically, patients with exclusively pelvic stones were 7.1-fold more likely to achieve stone-free status than those patients with stones at multiple localizations (OR: 7.1; p = 0.005). Additionally, stone size represented a barrier for stone-free status (OR: 0.9; p = 0.03). Conclusions: Stone localization revealed the highest impact on treatment success after Mini-PCNL. Especially, those patients with exclusively pelvic stones were most likely to achieve stone-free status. Conversely, patients with multiple stone localizations were less likely to achieve stone-free status and need to be informed about higher risk of additional interventions after initial Mini-PCNL. [ABSTRACT FROM AUTHOR]

Objectives: To study a modification to the conventional retrograde ureteroscopic approach for treating proximal ureteric stones of 1–2 cm; we intentionally push the stone from the proximal ureter into a favourable calyx then the flexible ureteroscope is used to fragment the trapped stone using laser lithotripsy ('boxing in the corner'). Patients and methods: The study was conducted in a randomised prospective manner and included 100 patients who presented with a single proximal ureteric stone of 1–2 cm. We randomised the patients into two equal groups: Group A (50 patients) underwent the conventional retrograde technique (CRT) and Group B (50 patients) underwent the modified retrograde technique (MRT) with the primary intention of relocating the stone into a favourable calyx. Intended relocation of the proximal ureteric stone in the MRT group was achieved in a stepwise manner. All intraoperative parameters and postoperative outcomes were recorded and compared between the two groups. Results: There was no statistical significant difference in terms of the patients' demographics and stone criteria between the two groups. The stone-free rate (SFR) was significantly higher in Group B (92%) compared to Group A (78%) (P = 0.049). Fluoroscopy time was significantly longer in Group B (P < 0.001), while operative time, lithotripsy time and hospital stay were comparable. There was no difference between the groups regarding complications. Conclusion: The MRT was found to be safe and more effective than the CRT for treating proximal ureteric stones of 1–2 cm, with a significantly higher SFR. Abbreviations CONSORT: Consolidated Standards of Reporting Trials; ESWL: extracorporeal shockwave lithotripsy; fURS: flexible ureteroscope; NCCT: non-contrast CT; SFR: stone-free rate; YAG: yttrium-aluminium-garnet [ABSTRACT FROM AUTHOR]

Ureteroscopy (URS) can be proposed as first-line therapy for the management of pelvic stones from 10 to 20 mm and for lower ureteric stones in children. However, little is known about the success and the morbidity of URS in young children. Ureteroscopic treatment may present matters in young children because of the small size of the pediatric kidney and the small size of the collecting system. To assess safety and efficacy of URS for the treatment of urinary stones in children aged of 5 years or less. After the institutional ethical board approval was obtained, we conducted a retrospective, analytic, multicentric study that included all URS performed between January 2016 and April 2022 in children aged of 5 years or less. In this non-comparative case series, anonymized pooled data were collected from 7 tertiary care centers of pediatric patients. Endpoints were the one-session SFR at 3 months and per and postoperatives complications. Descriptive statistics were applied to describe the cohort. Eighty-three patients were included. For them, 96 procedures were performed at the median age of 3.5 years (IQR: 0.8–5) and median weight of 14 Kg (6.3–23). Median stone size was 13 mm (4–45). There were 65 (67 %) renal stones treated with flexible URS, most of which were in the renal pelvis (30 %) and in the lower calix (33 %). A ureteral access sheath was used in 91 % procedures. Preoperative ureteral stent was placed in 52 (54 %) of patients. None of patients had ureteral dilatation. The single-session SFR was 67.4 % (56.3 and 89.2 % for flexible URS and semi-rigid URS respectively) and children require 1.4 procedures to achieve complete stone clearance. The overall complication rate was 18.7 %, most of them were minor (Clavien I-II). Intraoperative perirenal extravasation (Clavien IIIb) due to forniceal rupture was documented in 6.2 % of cases, related to an increased intrapelvic pressure (IPP) performed in a closed pelvicalyceal system. Pediatric urologists should be aware of forniceal rupture based on the presence of extravasation of contrast during endourological procedures especially when they have difficulties to reach lower caliceal stone in small patient. URS in patients aged of 5 years or less, is a complex minimally invasive procedure with reasonable efficacy and low morbidity. Intrarenal stones treated by RIRS in young children carries the risk of additional procedures to complete stone clearance. Summary table No. of patients/procedures 83 patients/96 procedures Sex, n (%) Female 33 (39.7 %) Male 50 (60.2 %) Age (months) Mean ± SD 38.7 months ± 18 Median (IQR) 43.5 (8–60) Weight (kg) Mean ± SD 13.9 Kg ± 4.09 Median (IQR) 14 (6.3–23) Stone size (mm) Mean ± SD 16.1 mm ± 9.15 Median (IQR) 13 (4–45) No. procedures, n (%) Flexible URS 66 (68.7 %) Semi-rigid URS 30 (31.2 %) SFR after a single session, n (%) 67.4 % N. of procedures to achieve stone clearance, n (%) Mean ± SD 1.43 (±0.77) Median (IQR) 1 (1–5) Overall complication rate, n (%) 18 (18.7 %) Grade I 2 (2 %) Grade II 10 (10.4 %) Grade IIIb 6 (6.2 %) Follow-up (months) Mean ± SD 21 months ± 18.1 Median (IQR) 14 (2–72) [ABSTRACT FROM AUTHOR]

Pediatric urolithiasis has been increasing at rate of 4–10 % annually in the United States, most notably within adolescents and females. A significant number of patients will require surgical management of their stones. Primary ureteroscopy (URS) affords the opportunity to treat stones under a single anesthetic with lower re-treatment rates or anatomical and stone characteristic limitations compared to shockwave lithotripsy. Previous studies evaluating primary URS have been largely underpowered, are limited by stone location, and/or are not representative of the stone population in the United States. Primary study outcomes were the success of primary URS and patient characteristics associated with success. Secondary outcomes were the stone-free rate (SFR), 30-day emergency department (ED) visits, 30-day readmissions, and complications. We performed a retrospective cohort study of patients less than 18 years of age from 2011 to 2023 who underwent primary URS. Patients were excluded if a ureteral stent was placed prior to URS or diagnostic URS was performed. A successful primary URS was considered if access to the ureter was obtained and treatment of the stone(s) completed. In failed primary URS, a ureteral stent was placed for staged management. A total of 196 patients were included and primary URS was performed or attempted on 224 renal units. The median age was 15.8 (IQR 13.4–16.9) years and median follow up 8.4 (IQR 1.1–24.6) months. The success rate of primary URS was 79 %. No significant characteristics were appreciated for successful primary URS based on: overall age, <14 vs > 14 years of age, sex, body mass index, history of stones, history of endourologic procedures, preoperative alpha blockade, location of stone(s), multiple stones, type of URS, or acute treatment. In successful primary URS, the SFR was 88 % with stone size (p = 0.0001) the only predictor of having residual stones. The 30-day ED rate was 21.4 %, 30-day unplanned readmission rate was 12.5 %, and complication rate was 7.5 %. No long-term complications were appreciated. Our success of primary URS compares favorably to previously published literature. Our SFR rate, 30-day ED visits, 30-day unplanned readmission, and complication rates are similar to other studies. Limitations of the study are its retrospective design, selection bias, and intermediate follow-up. Primary URS can be completed safely in the majority of pediatric patients without any patient characteristics associated with success. We advocate for primary URS when possible due to the excellent SFR and potential of treating stones under a single anesthetic. [Display omitted] [ABSTRACT FROM AUTHOR]

The Temple of Apollo Pythios, built in the Hellenistic era (3rd–1st century BC), is located in the ancient Acropolis of Rhodes. It was excavated during the Italian occupation and reconstructed by the Italians in the period 1937–8. The method of the “scenographic„ restoration was the “mixed structure„ technique using a core of reinforced concrete in combination with new biocalcarenite stones and the integration of very few ancient architectural members. Its proximity to the sea and the corresponding salt decay phenomena, aggravated by the erroneous reconstruction methodology and materials, have further deteriorated its state of preservation. Today, the four columns, epistyle and entablature of the Italian interventions demand immediate restoration actions to ensure the monument’s sustainability. This can only be achieved through a combined study of the performance of potential restoration materials and assessment of their compatibility with the historical materials. In the present study, the characteristics of the Temple’s historical porous stones are presented along with the characteristics of five quarry stones, aiming to evaluate which quarry stone is the most appropriate for use in the upcoming restoration. Restoration mortars are designed and evaluated in respect to both the historical materials and the quarry stones, aiming to select the optimum restoration mortar, which can achieve the required level of performance and compatibility and ensure sustainability of the structure as a whole.

Objectives: The main objective of this study is to determine the prevalence and risk factors of urolithiasis among the Saudi population in Makkah region. Methods: A cross-sectional survey was conducted on February 2017 in Makkah region (Makkah, Jeddah, and Taif). Data were obtained through direct interviews with participants, using an 18-questions-self-questionnaire, inquiring about demographic data (age, gender, weight, height, location, and occupation), educational level, history of renal stone disease (symptoms, modality of diagnosis, hospital admission, and previous treatment), and risk factors of stone formation such as family history and daily fluid intake. Results: A total of 1506 individuals were interviewed, including 82% from Makkah, 15.7% from Jeddah, and only 2.3% from Taif. The overall percentage of those diagnosed urolithiasis was 6.2%; including 6.6% males and 5.8% females (P = 0.06). Of those with stones, 5% were medically treated, 1.7% were hospitalized, and 1.2% were surgically managed for stones. There was a positive linear correlation between the prevalence of stones and participants' age group (r = 0.87, P = 0.01). More than 80% of participants were highly educated, which did not impact the prevalence of stones formation (P = 0.14). Urolithiasis was reported by 8.9% obese participants, 5.9% overweight, and 5.4% with normal body mass index (r = 0.68, P = 0.03). When stratified by jobs, stone prevalence significantly increased in retired participants (17.2%) than in workers (8.8%), followed by those without work (7.7%) and finally by students (3.3%) (P < 0.001). There was no significant difference between urolithiasis and type of drinking water (P = 0.62). Conclusion: The prevalence of urolithiasis in the Western region of Saudi Arabia has not changed much since the previous report, which was 30 years ago. It seems that the middle-aged population in their third decade of life, those who are overweight and obese people are at a high risk of developing urolithiasis.

Objective: The aim of this study is to evaluate the efficacy of a food supplement containing Phyllanthus niruri and Chrysanthellum americanum in association with potassium and magnesium citrates in the treatment and prophylaxis of urinary stones. Materials and methods: Eighty-two patients (mean age 49.7 ± 11.2) with history of urinary stones received this food supplement, one capsule a day for 6 months. Each administration contained a combination of the following ingredients: 244 mg Potassium citrate, 735 mg Magnesium citrate, Phyllanthus (Phyllantus niruri) herb d.e. 15% mg Tannins 220 mg, Chrysanthellum (Chrysanthellum americanum Vatke) plant d.e. ¼ 55 mg. After 6 months, all patients underwent urologic visit, urinalysis, imaging and quality of life (QoL) questionnaires evaluation. Each patient was also evaluated by computed tomography (CT) scan at baseline and at 6 months. Result: From January 2018 to March 2019, 82 patients (mean age 49.7 ± 11.2) completed the follow-up period and were analyzed. Fifty patients showed lower stone dimensions (60.9%). The average stone size was 0.9 mm, with a significant reduction in comparison with the baseline (-6.7 mm ± 3 mm) (p < 0.001). Forty-nine patients (59.7%) did not show any symptomatic episode with an improving in QoL (+0.4 ± 0.1) (p < 0.001) in comparison with the baseline. At the end of the follow-up period, 27 patients out of 82 were stone-free (32.9%). Moreover, we report a significant reduction of patients with asymptomatic bacteriuria (ABU) between the baseline and the end of the follow-up evaluation (p < 0.001). Conclusions: In conclusion, this food supplement is able to improve quality of life in patients with urinary stones, reducing symptomatic episodes and the prevalence of ABU. [ABSTRACT FROM AUTHOR]

This study was conducted to evaluate preoperative risk factors for development of complications of percutaneous nephrolithotomy (PCNL). All consecutive patients aged ≥ 16 years who underwent PCNL during 2015 were retrospectively reviewed. Non-contrast CT (NCCT) was performed for all patients to evaluate stone complexity. The technique of PCNL was the same for all patients. Intra-operative and postoperative complications were recorded and classified based on modified Clavien system. The differences in preoperative data (patients, renal and stone characteristics including Guy's and STONE scores) between complicated and uncomplicated cases were compared using univariate and multivariate statistical analyses for detection of independent risk factors. The study included 1178 patients (61% were males). Mean age was 50 ± 12 years, and mean BMI was 30.7 ± 5.7 kg/m2. Complicated group included 166 patients (14.1%). Independent risk factors on multivariate analysis were infected preoperative urine culture (RR: 2.098, P 0.001, 95%CI: 1.380–3.189), largest stones diameter 30 mm or more (RR: 2.481, P > 0.001, 95%CI: 1.697–3.627) and number of calyces affected by the stones (RR: 2.431, P 0.002, 95%CI: 1.400–4.222 for affection of two calyces and RR: 2.778, P 0.005, 95%CI: 1.357–5.684 for affection of three calyces). While two scoring systems (Guy's and STONE) were not predictive of complications after PCNL, preoperative risk factors were infected preoperative urine culture, distribution of the stones or stone branches in two or three calyceal groups and stone size 30 mm or more. [ABSTRACT FROM AUTHOR]

The time poem in Eccl 3.1–8 reflects a marked structure and progression of themes. These connections suggest that the initial lines of vv. 2, 5, and 8 open their respective stanzas by focusing on a similar theme: war and peace. This thread clarifies the meaning of Qohelet's enigmatic throwing and gathering stones, activities for which no fewer than nine interpretations have been suggested. While interpreters have favored a reference to sexual intercourse, this view is unlikely. I contend that a preferable solution modifies an earlier interpretation relating the throwing and gathering of stones to acts of wartime and peacetime. The throwing away of stones relates to the demobilization of the military, while the gathering of stones relates to the mobilization for war (1 Sam 17.40; 2 Chron 26.14–15). This interpretation offers a more consistent approach to the themes of war and peace developed in the poem's stanzas. [ABSTRACT FROM AUTHOR]

Although stone surfaces seem unlikely to be habitable, they support microbial life. Life on these surfaces are subjected to many varying harsh conditions and require the inhabitants to exhibit resistance to environmental factors including UV irradiation, toxic metal exposure, and fluctuating temperatures and humidity. Here we report the effect of hosting stone geochemistry on the microbiome of stone ruins found in Tamil Nadu, India. The microbial communities found on the two lithologies, granite and granodiorite, hosted distinct populations of bacteria. Geochemical composition analysis of sampled stones revealed quartz mineral content as a major driver of microbial community structure, particularly promoting community richness and proportions of Cyanobacteria and Deinococcus-Thermus. Other geochemical parameters including ilmenite, albite, anorthite, and orthoclase components or elemental concentrations (Ti, Fe, Mn, Na, and K) also influenced community structure to a lesser degree than quartz. Core members of the stone microbiome community found on both lithologies were also identified and included Cyanobacteria (Chroococcidiopsaceae and Dapisostemonum CCIBt 3536), Rubrobacter, and Deinococcus. A cluster of taxa including Sphingomonas, Geodermatophilus, and Truepera were mostly found in the granodiorite samples. Community diversity correlated with quartz mineral content in these samples may indicate that the microbial communities that attach to quartz surfaces may be transient and regularly changing. This work has expanded our understanding of built-stone microbial community structure based on lithology and geochemistry. [ABSTRACT FROM AUTHOR]