Search

Ureteral triplication is an extremely rare congenital disorder of the urinary tract. A review of the literature has shown that only about 100 cases have been reported worldwide. We present a case of a 50-year-old female with a known complete ureteral duplication on the right side and incomplete ureteral triplication on the left side that presented with signs of sepsis accompanied by a tender left flank mass. A detailed evaluation including imaging studies and endoscopy revealed a middle moiety obstruction causing abscess formation in the collecting system. A connection between the mid and lower moieties was demonstrated through an upper calyx of the lower moiety. The abscess was drained, and the patient further underwent ureteral stents placement to both the mid and lower ureters. Following antimicrobial treatment and several weeks of maximal drainage, the connection between the moieties was obviated, with no further episodes of urinary tract infection documented in follow up.

Background: Successful percutaneous nephrolithotomy (PCNL) relies on a technically challenging, precise needle puncture of the renal collecting system. We aimed to compare, in an ex vivo model, the use of a real time image guidance system (the SabreSource™) and a mechanical stabilising device with conventional manual techniques for the accuracy of needle placement. Methods: The SabreSource™ system (Minrad International Inc.; New York, USA) is a real time image guidance system. The system platform is mounted on a C-arm fluoroscope. It employs targeting cross hairs on the fluoroscopic image that can be easily positioned to target the desired renal calyx. The system directs a visible laser beam onto the patient which is precisely aligned with the cross hairs on the fluoroscopic image. This provides the correct “bull’s-eye” angle of approach to the calyx, even after the x-ray source is turned off. The locator then stabilises the needle in the “bull’s-eye” position so that only screening for depth is required. Objective assessment using a simulated PCNL puncture was performed by 7 urologic trainees on a kidney phantom with and without using the SabreSource™. Fluoroscopy screening time (FST) and amount of radiation (mGy) used to achieve successful puncture were compared. Results: Simulated PCNL puncture was quicker and resulted in reduced radiation exposure when the apparatus was used. The mean FST for traditional “bull’s-eye” vs SabreSource™ puncture was 17 vs 5 seconds (p = 0.01), and the mean radiation exposure to puncture was 0.7 vs 0.2 mGy (p = 0.03), respectively. Conclusion: The SabreSource™ is a novel assistant to achieving successful PCNL puncture. In combination with “the locator” the preliminary in vitro testing suggests that the device reduces fluoroscopy exposure and is quicker. The device warrants further evaluation in the clinical setting.&nbsp

Background: While high-power laser systems facilitate successful ureteroscopic treatment of larger and more complex stones, they can substantially elevate collecting system fluid temperatures with ...

Small stone fragments inevitably resulted from breakage of a large stone are almost impossible to be fully extracted from the collecting system in current RIRS settings. While most of these clinically insignificant residual fragments (CIRFs) < 4 mm may pass spontaneously, increasing evidence suggests that these so called CIRFs may act as an origin for new stone formation and eventually lead to reintervention(1). Therefore, it is of paramount importance to achieve complete stone free status in the aim of improving patient's quality of life not only physically but also psychologically and economically(2).

Catheter-associated urinary tract infection (CAUTI) remains one of the most prevalent, but preventable, health care-associated infections and predominantly occurs in patients with indwelling urinary catheters. Duration of urinary catheterization is the most important modifiable risk factor for development of CAUTI. Alternatives to indwelling catheters should be considered in appropriate patients. If indwelling catheterization is necessary, proper aseptic practices for catheter insertion and maintenance and use of a closed catheter collection system are essential for preventing CAUTI. The use of intervention bundles and collaboratives helps in the effective implementation of CAUTI prevention measures.

Mental health information systems in low-resource settings are scarce worldwide. Data collection was accurate, yet sustainable staffing was a challenge when using task-shared clinical providers for data collection in health centers in rural Haiti. Integrating mental health data collection within existing data collection systems would help close this key gap., Key Findings Balancing time for clinical duties with time for data collection was a key challenge when using task-shared health care workers to collect data.Feedback of data to users, ongoing supervision, and opportunities for rewards for high-performers may help increase provider buy-in for new data collection systems.Retaining paper forms alongside digital data collection systems or the inclusion of decision support tools directly within digital data collection systems may be needed to fully support health care worker learning in a task-shared mental health system. Key Implications Program managers should carefully consider sustainable staffing from the beginning when designing digital data collection projects.Program managers should consider how digital data collection systems can incorporate decision support tools to sustainably support ongoing learning of task-shared providers.Policy makers should integrate mental health data collection within other data systems to leverage infrastructure and resources for mental health., Introduction: Effective digital health management information systems (HMIS) support health data validity, which enables health care teams to make programmatic decisions and country-level decision making in support of international development targets. In 2015, mental health was included within the Sustainable Development Goals, yet there are few applications of HMIS of any type in the practice of mental health care in resource-limited settings. Zanmi Lasante (ZL), one of the largest providers of mental health care in Haiti, developed a digital data collection system for mental health across 11 public rural health facilities. Program Intervention: We describe the development, implementation, and evaluation of the digital system for mental health data collection at ZL. To evaluate system reliability, we assessed the number of missing monthly reports. To evaluate data validity, we calculated concordance between the digital system and paper charts at 2 facilities. To evaluate the system's ability to inform decision making, we specified and then calculated 4 priority indicators. Results: The digital system was missing 5 of 143 monthly reports across all facilities and had 74.3% (55/74) and 98% (49/50) concordance with paper charts. It was possible to calculate all 4 indicators, which led to programmatic changes in 2 cases. In response to implementation challenges, it was necessary to use strategies to increase provider buy-in and ultimately to introduce dedicated data clerks to keep pace with data collection and protect time for clinical work. Lessons Learned: While demonstrating the potential of collecting mental health data digitally in a low-resource rural setting, we found that it was necessary to consider the ongoing roles of paper records alongside digital data collection. We also identified the challenge of balancing clinical and data collection responsibilities among a limited staff. Ongoing work is needed to develop truly sustainable and scalable models for mental health data collection in resource-limited settings.

V posledných rokoch boli opakovane publikovane udaje o tom, že vacsina chýb v procese ziskavania laboratorneho výsledku sa vyskytuje v predanalytickej faze (46 % až 68,2 %). Ide o oblasť, ktora je zvycajne mimo priamej kontroly laboratoria, najcastejsie zahŕňajuca odber venoznej krvi (flebotomiu). Odhalenie týchto chýb sa poklada za znacne obťažne, a preto možu ľahko viesť k nespravnej interpretacii laboratornych výsledkov s nasledným nepriaznivým dosahom na pacienta až jeho poskodeniu. K najucinnejsim sposobom ako im predisť patri dobra znalosť sucasných odporucani pre odber krvi, ktore boli nedavno (2018) revidovane Europskou federaciou pre klinicku chemiu a laboratornu medicinu (EFLM, European Federation for Clinical Chemistry and Laboratory Medicine) a su ponuknute v tomto prehľade.

The purpose of this study was to find out and obtain data regarding the Mandatory Employee Contribution (IWP) billing system for participants managed by PT. TASPEN (Persero) Serang Branch Office, as well as providing information to the participants of the pension program and Old Age Savings (THT) how the process or flow goes through in collecting the Mandatory Employee Contribution (IWP) for these participants. The results of the study indicate that the Mandatory Employee Contribution (IWP) billing system for participants at PT. TASPEN (Persero) Serang Branch Office which has been created and implemented in the Company Operational Standards (SOP) has been explained in detail and has been implemented properly in accordance with the system created.

Background. Giant hydronephrosis is a rare urologic problem defined as a collection of more than one liter of urine in the collecting system. The radiologic appearance may mimic benign cystic disease of the kidney. We report a case of giant hydronephrosis in a 32-year-old female who presented with progressive abdominal swelling of two-year duration, caused by ureteropelvic junction obstruction with more than nine liters of urine in the collecting system. Conclusion. Giant hydronephrosis is a rare differential diagnosis for cystic intra-abdominal mass in adults with progressively increasing abdominal swelling. CT and MRI are important in confirming the diagnosis by localizing the origin of the swelling. Management depends on the underlying cause and appearance of the diseased kidney.

This paper studies the precise clock management technology for the power consumption information collection system which demands precise requirements of the electric power meter clock. The causes o...

The article presents the architecture and operation principles of the system for collecting and analyzing information from strain gauges. These systems are used to determine the equipment performance for transporting a variety of materials. In particular, they are used to control the movement of bulk materials mixtures components. For such technological processes, it is fundamentally important to ensure constant flows intensity. The paper identifies three variants of sensor connection schemes, analyzes their advantages and disadvantages. It is established that the structure “one ADC – several sensors” allows to reduce equipment costs and at the same time to provide the minimum parameters influence of a transmission line on a useful sensor signal. The “one-to-one” scheme provides the connection of each sensor to its own ADC. “Circuit with multiplexer” allows to increase the number of sensors connected to one ADC. It is established that the best option in terms of reducing the interference effects on the analog signal and the cost of creating a system is the scheme “one ADC – several sensors”. The algorithm of information transfer from ADC to microcontroller (MC) is analysed. It is calculated that HX711 ADC chips provide the maximum data rate of 18.5 values/s. It is proposed to transfer data between the MC and the server using the TCP protocol because it avoids data loss and provides the necessary data transfer speed. The structure and formats of data that are transmitted from the mass sensor to the ADC, microcontroller, web server and database are proposed. The main speed, design parameters, advantages and disadvantages of wired and wireless data network between MK and the server are determined. Recommendations for the design of such a network depending on the characteristics of the premises in which the data collection system will be used have been developed.

The aim of the study was to evaluate whether electronic revenue collection systems improves Municipal revenues. The study specifically aimed to determine the effective sources of revenues; to compare the revenue collection before and after the introduction of electronic revenues collection system; and to analyze the challenges encountered with the use of electronic revenue collection system. A descriptive research design was adopted in conducting the study. The study sample was 79 respondents whereby simple random sampling was employed. Data were collected using questionnaires to provide quantitative data. Data was analyzed using descriptive statistics and Pearson correlation coefficient. The findings revealed that the major sources of revenues to Municipal Council are Guest house/hotel levy, Land rent fees, Markets fees, Intoxicating liquor licenses, Abattoirs charges, Revenue from agricultural and forestry products and Meat inspection charges. The study finding revealed that electronic revenue collection system improves Municipal revenue collection in the financial year 2015/2016 compare to that of 2014/2015 revenues. The major challenges encountered the e-payment is access to internet and lack of civic education to revenues payers on the use of online payments. The study concludes that online revenue collection system gives accurate revenue computations to a very great extent and the revenue payers is satisfied with the electronic revenues collection service which assured no queuew is experienced on revenue due dates. The study recommends to the Municipal officials that it‘s high time for Moshi Municipal Council to put much efforts to encourage revenue payers to adopt electronic revenue collection system as the findings shows it has reduced queuing and increased revenue. Also civic education should be provided to other revenue payers who did not registered in order to be aware and help the Municipal to improve their revenues collection status.

This paper quantifies the impacts of collecting system on social insurance contribution compliance, taking advantage of a reform around 2000 in China. Using firm-level data, we find that the actual contribution rate and the probability of participation were raised by 3% and 5 percentage points respectively, after changing the collection department from social security department to local tax department. Mechanism analyses show that the effect is larger in areas where the tax collection capacity is stronger and the reform had no significant effects on SOEs.

This study aims to determine the system of calculation and tax collection of two-wheeled motor vehicles (2) at the Regional Revenue Agency (BAPENDA) of South Sulawesi Province. The study was conducted for two months from January to February 2020. This research used a descriptive method with a qualitative approach. The type of data used is primary data and secondary data. Data collection is done by interview and documentation. The results showed the calculation system of Motorized Vehicle Tax (2) of Yamaha Brands in the Regional Revenue Agency (BAPENDA) of South Sulawesi Province, namely the Selling Value of Motor Vehicles at times with PKB rates. And the motor vehicle tax collection system at the Regional Revenue Agency is through the Samsat office.

The implementation of MSME tax collection with the Self Assessment System is a tax collection system by calculating, paying and reporting by yourself by giving confidence to taxpayers based on applicable laws and regulations. This study aims to 1) determine the implementation of the implementation of the self-assessment system in Makasar District, East Jakarta; 2) analyzing the understanding of the taxation knowledge of the UMKM taxpayers, 3) analyzing the implementation of the MSME taxpayer obligations 4) analyzing the tax awareness of taxpayers' sensitivity. This type of research is qualitative descriptive by means of direct primary data collection through interviews with 10 taxpayer informants of MSME actors. The results of his research indicate that the implementation of the self-assessment system has not been going well and more intensive assistance is needed. This is due to the lack of public awareness of taxation and lack of understanding of taxation knowledge. There are 4 informants who run the self-assessment system, 2 of which are assisted by tax consultant services and 6 other informants have not implemented the self assetment system properly

INTRODUCTION patients with urinary stone disease during consultation often cannot realize their condition and features of upcoming procedure. Creation of 3D printed models is also not always available or too expensive. AIM to create a special program that allows for virtual intrarenal visualization of the collecting system and kidney stone on devices based on the Android operating system and evaluate its efficiency in counseling patients before the upcoming percutaneous nephrolithotomy (PCNL). MATERIALS AND METHODS a total of 15 patients who were scheduled to PCNL, were included in the study. All of them had two consultations. During the second consultation, the newly developed program was used. Patient data from DICOM (computed tomography) format were converted to stereolithography (STL) format in order to display it in the application. Each patient assessed the quality of the consultation using a questionnaire. RESULTS patients understanding of the kidney anatomy improved by 55% (from 34 to 75 points, p=0.0001), and stone localization by 51% (from 37 to 75 points, p=0.0001). The stages of PCNL became clearer by 57% (from 32 points to 75, p=0.0001), and understanding of possible intra- and postoperative complications was improved by 48% (from 38 to 73 points, p=0.0002). Overall patient satisfaction with counseling improved by 53% (from 35 to 74 points, p=0.0001), and the number of patients who desired for better repeated counseling decreased by 89% (from 9 to 1, p=0.006). CONCLUSION The InsKid app is an affordable and easy-to-use program, which doesnt require significant costs and allows patients to understand their disease and upcoming procedure.

Clinical registries that monitor and review outcomes for patients with cystic fibrosis have existed internationally for many decades. However, their purpose continues to evolve and now includes the capability to support clinical effectiveness research, clinical trials and Phase IV studies, and international data comparisons and projects. To achieve this, registries must regularly update the information that they collect and ensure design that is adaptable and flexible to changing needs. The Australian Cystic Fibrosis Data Registry commenced in 1998, and in 2018-19 undertook a transformation to enable it to meet the needs of multiple stakeholders into the future. This included a comprehensive, multidisciplinary review of the registry's data elements, and a redesign and rebuild of the registry's database. The data element review comprised the processes of alignment, comparison, selection, consolidation, revision and definition of finalised data elements. The database redesign included attention to each of the registry functions of data collection, storage and management, and reporting. The revision of a national data collection system is a time-intensive process, and requires significant clinical and other expert engagement. The resulting database, while being continually refined, is now fit for purpose to support Australian clinicians and patients with CF to receive best practice care.

Within the context of China’s Urban Employees’ Basic Pension Insurance (UEBPI), this paper constructs an actuarial model to analyze the financial imbalance risk of contribution rate reduction and to investigate the possibility of further reducing the contribution rate. It is found that the UEBPI fund would show financial imbalance risk in 2024 if the contribution rate is 16%, and no control strategy is introduced. In the case of single strategy (the collection system reform, delay of retirement age, or the introduction of external finance), the financial sustainability of the UEBPI fund could be improved to some extent, whereas the financial imbalance risk remains huge. In the case of a package of control strategies being implemented, the UEBPI fund could be able to continue its operation until 2060, and the contribution rate can be further reduced by 0–4 percentage. Therefore, the implementation of a package of control strategies presents a prerequisite for controlling the financial imbalance risk and further reducing the contribution rate.

Staghorn nephrolithiasis is a form of urolithiasis characterized by kidney stones formation that partially or completely fills the collecting system. Staghorn nephrolithiasis has a malignant course, accompanied by collecting system retention and impaired renal function. This pathology is a common cause of disability, which is particularly importance in the context of its prevalence among people of working age. The review systematizes the currently relevant data on surgery of staghorn nephrolithiasis, presents methods of surgical treatment, defines the selection options within them, their advantages and disadvantages, indications, contraindications and complications. This information can help in making an informed decision and increase the effectiveness of treatment for patients with that disease. At the moment, there is an arsenal of treatment options for staghorn nephrolithiasis, among them minimally invasive high-tech operations are the most advanced and recognized as the methods of choice. The modernization of existing technologies increases their efficiency and safety, but their high cost and the impossibility of using in some cases often make one prefer more traumatic radical interventions. Traditional surgery remains a reliable method of treatment, allowing simultaneous operations and treatment of complex cases of the disease. The possibility of combining existing methods allows for the effective removal of staghorn stones in different groups of patients. Thus, a careful and differentiated approach to the methods of surgical treatment of staghorn nephrolithiasis, their use in combination allows ensuring high efficiency of surgical treatment of this pathology.

Household consumption of dairy products is one the major component in the total sales of the Albanian dairy industry. Therefore, understanding the factors which may significantly influence household consumption is important in the planning of farmers, processors and manufacturers. Consumers' responses to changes in price and non-price factors are basic to an economic analysis of almost all the policy decisions related to industry or government programs. Forecasting the future direction of household consumption, and how that direction might be modified through industry efforts or by national programs and policies, requires information on the relationships among prices, incomes, household characteristics and consumer demand. This study focuses on households as consuming units, explains and analyzes their purchasing behavior for dairy products. As milk is a very important component of the Albanians diet, this study explores consumer preferences for milk in Albania and also tries to determine consumers profiles based on their preferences and socio-demographic factors. To reach these objectives, this research designed a conjoint choice experiment survey and collected primary data in the most populated cities of Albania. This study provides useful information to different stakeholders including milk producers and importers. The milk industry and its marketers may benefit from this information by using it to strategically market their milk to different groups.

Highlights • Ureterocele is rare especially with collecting system duplication in the nonorthotopic (extravesical) position in adult. • Ureterocele has a variety of clinical manifestations and complications. • Endoscopic treatment was performed to decompress hydroureteronephrosis. • In this case, laparoscopy heminephrectomy is needed due to dysfunctional uppers moiety. • Renal scintigraphy is a gold standard to assess function in the duplex kidney., Introduction Ureteroceles is a developmental anomaly with cystic dilation of the distal aspect of the ureter and are often associated with some urological anomaly such as a duplicated system or stenotic ureteric orifice. Presentation of case This study reports an ectopic ureterocele in duplication of collecting system associated with double ureters and ureteral ectopia in a woman aged 24 years with minor flank pain. Cystoscopy deroofing of the ureterocele performed and followed by secondary surgery laparoscopic heminephrectomy. Discussion Ureteroceles have various clinical manifestations and complications. Treatment for ureterocele depends on age, type of the ureterocele, obstruction to the draining system, and complications. No single method is sufficient for all cases, and management must be individualized. Endoscopic treatment has gradually broadened as a safe, minimally invasive, and effective procedure, but there is no consensus on its effectiveness for treating ectopic ureterocele. However, it is reported that 50–80% of cases after initial endoscopic treatment require secondary surgery. Conclusions Ureterocele is reported rarely in adults, especially with duplication of the collection system in the nonorthotopic (extravesical) position in women. Cystoscopy deroofing of the ureterocele can be performed to decompress the hydroureteronephrosis, and laparoscopic heminephrectomy can be performed due to dysfunctional uppers moiety. Long-term follow-up is required to monitor renal function, symptoms, and occurrence of vesicoureteric reflux.

A 64-year-old man with history of renal stones and prostate cancer presented for evaluation of osseous metastatic disease due to elevated prostate-specific antigen (13.7 ng/mL). A Tc-labeled bone scan demonstrated unusual linear uptake projecting over the lower pelvis extending into the scrotum. Follow-up CT confirmed a rare case of inguinoscrotal extraperitoneal herniation of the ureter associated with a partially duplicated left renal collecting system. The left-sided inguinoscrotal uptake was within the herniated ureter, potentially mimicking disease within the pelvis.

The obligation of Muslims in zakat is expected to help solve the problem of income distribution among human beings. This article aims to find out the management of zakat in Muslim countries, namely Indonesia, Malaysia and Saudi Arabia. Important findings produced there are differences in the management of zakat in Indonesia, Malaysia and Saudi Arabia. From the side of the law it is known that Indonesia and Malaysia do not require zakat in their laws, something different from Arab Saubi has even developed an online-based zakat collection and tax system. While from the zakat collection system, the policy in Malaysia makes zakat a tax deduction.

The investigation of the views of the stakeholders involved in the municipal solid waste separate collection programme (CP) performed in the East Zone of the city of São Paulo is presented in this paper. Aiming to obtain the necessary information to be analysed, interviews with the manager of the Municipal Urban Cleaning Authority (MUCA) of the city, with leaders of recycling worker cooperatives (WCs), and citizens were performed using semi-structured questionnaires. The analysis was performed using the software “IRAMUTEQ”. The results show that, in the view of the manager of the MUCA of the city and the WCs’ leaders, the low adhesion of the population to the separate CP is the greatest obstacle to a further expansion of the existing programme. At the same time, the citizens have blamed the low diffusion made by the municipality about the separate CP in the East Zone of São Paulo. Thus, it can be concluded that the separate CP available in the East Zone of São Paulo is still flawed; since neither the public power, the WCs, nor the population are satisfied and point out several flaws. This situation highlights the need to establish better venues for discussion between the population, WCs, and the municipality to jointly design a separate collection system with a more participatory approach.

Purpose: Renal artery pseudoaneurysms (RAPs) and arteriovenous fistulas (AVFs) are rare but potentially life-threatening complications after partial nephrectomy (PN). Selective arterial embolization (SAE) is an effective method for controlling RAPs/AVFs. We assessed the clinical factors affecting the occurrence of RAPs/AVFs after PN and the effects of SAE on postsurgical renal function. Materials and Methods: Four hundred ninety-three patients who underwent PN were retrospectively reviewed. They were placed in either the SAE or the non-SAE group. The effects of clinical factors, including R.E.N.A.L. scores, on the occurrence of RAPs/AVFs were analyzed. The influence of SAE on the estimated glomerular filtration rate (eGFR) during the first postoperative year was evaluated. Results: Thirty-three (6.7%) patients experienced RAPs/AVFs within 8 days of the median interval between PN and SAE. The SAE group had significantly higher R.E.N.A.L. scores, higher N component scores, and higher L component scores (all, p

The existing system of instrumental monitoring of the state of atmospheric air in the Republic of Tatarstan systematically reveals the facts of unsatisfactory quality of atmospheric air, in this connection, special attention has been paid to the work on regulating the impact of emissions on atmospheric air by means of calculated monitoring. The article notes that by now all the necessary legal framework has been created for creating a hybrid multi-level atmospheric air monitoring system in the Republic of Tatarstan. The paper provides a justification for the need to implement a hybrid multi-level atmospheric air monitoring system for three levels: the level "Enterprise" or "group of enterprises", the level" Municipality", the level"Subject of the Russian Federation the Republic of Tatarstan". The General scheme of the organization of environmental data collection in the Republic of Tatarstan and the scheme of the integrated architecture of the environmental data collection system are presented. The results of the implementation of a hybrid multi-level atmospheric air monitoring system in the environmental policy of the Republic of Tatarstan are presented

India is the second largest country in world with population of 1.356 billion (Census 2017). Rice (Oryza sativa) is one of the most important cereals and it is staple food for more than 60% of the world population. The performance evaluation of thresher was studied on paddy variety Mahamaya to ascertain the effect of feed rates(4.5t/h,5.0t/h,5.5t/h), moisture content (13%, 15%, 17%) and cylinder speed (15.54m/sec,17.27m/sec,19.42m/sec) with four replication. The threshing efficiency, cleaning efficiency, threshing capacity and total losses were 99.42%, 98.91, 2.5t/h, 0.4% respectively at the best and optimum combination of feed rate, moisture content and cylinder speed of 5.0t/h,15% and 17.27m/sec respectively. Self unloading system of thresher was design and developed by using CATIA V5 2014.There was a cost saving of 2.86%/h and labour saving of 50% over earlier practice.

Objective: To compare two commercially available ureteral access sheaths in their ability to access the renal collecting system and assess ureteral wall trauma using a prospective, randomized trial...

INTRODUCTION The aim of our study was to assess the impact of acute kidney injury (AKI) on postoperative upstaging of chronic kidney disease (CKD) after robot-assisted partial nephrectomy (RAPN). METHODS This study consisted of 110 patients who had undergone RAPN and were followed up for at least 6 months after surgery. Patients were classified as AKI or non-AKI based on their serum creatinine level and estimated glomerular filtration rate within 7 days after surgery. Patient characteristics, outcome of RAPN and estimated glomerular filtration rate, and CKD upstage 6 months after surgery were compared between the AKI and non-AKI groups. RESULTS A total of 26 patients (23.6%) experienced AKI after surgery. RENAL (radius, exophytic/endophitic properties, nearness of the tumor to the collecting system or sinus, anterior/posterior, location relative to the polar lines) nephrometry scores were ≥7 for 22 (84.6%) in the AKI group and 39 (46.4%) in the non-AKI group (P = .0006). A significantly smaller proportion of patients in the AKI group than in the non-AKI group recovered 90% of baseline function (38.5% vs 81.0%, P

Staghorn renal calculi are large renal calculi that occupy nearly the entirety of the renal collecting system. They may be composed of metabolic or infection stone types. They are often associated with specific metabolic defects. Infection stones are associated with urease-producing bacterial urinary tract infections. The ideal treatment for staghorn calculi is maximal surgical removal. However, some patients are either unwilling or unable to proceed with that modality of treatment, and therefore other management must be used. One such technique is the metabolic evaluation with directed medical management. Based on contemporary evidence that the majority of staghorn stones are metabolic in etiology, and furthermore that even infection stones are usually associated with metabolic abnormalities, metabolic evaluation with directed medical management is recommended for all staghorn stone formers. The scientific basis of this recommendation is reviewed in the present work. Keywords: Urolithiasis, Staghorn, Metabolic evaluation, Struvite

To the organising secretory, respected sir; kindly find attached research paper over the topic to assess diagnostic accuracy of CTscan in diagnosis and management of EPN, permission has already been obtained by RRC and study has been started. So far, we have 8 cases, we are targeting around 15 cases till November and 20 cases upto January, considering this is not a common entity, approx 15-20 cases should be adequate. Class1: Gas confined to the collecting system Class3A: Perinephric extension of gas/abscess Class4: B/L EPN or EPN in a solitary kidney.

After the liberation of Mosul in July 2017, wide areas in Mosul city has experienced large scale deterioration; especially in the right bank of the city, and Nabi-Jarjis district (where Alhadbaa Minaret and Nabi-Jarjis mosque located) appears to be one of the most affected parts in the City. In the current study, debris of the Nabi-Jarjis district were studied in details by finding the destroyed areas using GIS, then, by utilizing ArcGIS network analyst extension, the optimal route for collecting the debris from the Nabi-Jarjis district was found, considering archaeological sites as barriers. The proposed collection system focuses on reducing the time taken in the collection process and the distance travelled to reduce the economic and environmental costs of the proposed collection system. The results showed that the destruction was about 71.01% of the Nabi-Jarjis district total area, and according to land use, the residential buildings area accounted for about 81.99% of the total area that means remaining less than 10% habitable places in the region. Finally, as a final result of the current study, an optimal route for debris removal were given in a table that gives detailed information about the proposed route.

Public transit has a significant impact on minimising traffic congestion and reducing the cost of travelling in urban areas. It is necessary to evaluate the efficiency of the public transit operation in response to the individual traveller's demands for transit. This study aims to analyse the demand for transit with overlapping origin-destination (OD) pairs to enhance the efficiency of transit operations. To achieve this, disaggregated-level travel demand data, i.e. individual traveller's data are collected from an automatic fare collection system called smart card. The Kneedle algorithm is used to calculate the knee point of travel demand. The overlapping OD pairs, which are higher than the knee point value, are calculated and displayed in a map format. On the basis of the overlapping OD pairs, the demand-based overlap index for each bus route is defined to evaluate the efficiency of bus operations. The proposed method is applied to six districts with higher transit demands than other districts in Seoul. On the basis of the results, discussion on the action plans to enhance the efficiency of bus operations are presented. The method proposed in this study contributes to improving the efficiency of the bus system by reflecting individual users' travel demands.

Renal colic encounters are common; in the United States alone, they represent greater than one million annual emergency department (ED) visits. Most of these stones are managed conservatively with a trial of passage. However, some lead to repeat colic episodes, secondary ED visits, increased anxiety, and increased cost. Of the 5%–10% of symptomatic stones that become lodged at the ureteropelvic junction and are larger than 5 mm, most require operative intervention. In the process of executing a NASA‐funded study of ultrasonic repositioning of kidney stones, the subject was administered fluid to dilate the collecting system, placed in Trendelenburg bed positioning, and rolled to both sides. During this process a symptomatic, obstructing 9‐mm ureteropelvic junction stone moved back into the kidney's lower pole/infundibulum and symptoms were immediately resolved. The patient remained asymptomatic for a period of 5 weeks at which point elective intervention was scheduled. This case demonstrates that ureteropelvic junction stones may be repositioned in a non‐invasive manner, turning a stone that requires urgent intervention into one that can be managed electively.

Duplex collecting system of the kidney is a common congenital anomaly of the urinary tract and is less reported in the adult population. Rarely, this anomaly can result in ureterovesical junction compression. Herein, we present a case of ureterovesical junction compression occurring in an adult patient with a duplex collecting system and describe the surgical management.

The article looks at the latest trends in solving the problem of garbage collection, segregation and disposal in urban housing estates in the scope of design, architectural and spatial solutions. The paper adopts a method of analysing existing applications in view of globally shifting living conditions. As a result of the conducted analyses, a set of features and factors was singled out, ranging from functional-spatial, through transport and ergonomic to social and aesthetic ones. Also, conclusions that should be taken into account when determining the principles for designing these structures were presented.

Purpose: In urolithiasis patients, preoperative non-contrast computed tomography (NCCT) commonly fails to provide sufficient distention of the renal collecting system to allow reliable preoperative...

Solid waste management (SWM) is recognized worldwide as an important issue to deal with in pursuing livability. The favela (slum) of Rocinha represents a good synthesis of all challenges which can be encountered in this field: high population density , lack of space and narrow streets, residents struggling with low incomes. In Rocinha, services coverage is lacking and unsatisfying in many sectors, including SWM. In this study, we investigate the reason for this inadequacy. Waste streams have been analyzed as a first step. The second step was the description of the SWM system and of its criticalities. All accessible information has been used and Geographical Information Systems (GIS) played an important role in the data processing. In the final discussion, we suggest a small-scale and decentralized waste management network, collaborating with the centralized collection system. This study is a piece of the project Polimipararocinha of Politecnico di Milano (Italy) which pursues the overall urban re-qualification of Rocinha.

When medicines enter the environment, they harm living species and ecosystems. Improper disposal of household pharmaceutical waste increases the concentration of pharmaceuticals in the environment and thus their detrimental impacts. Since 2004, the EU has obliged its Member States to establish ‘an appropriate collection system’ for unused and/or expired medication. However, as no implementation guidelines exist, large differences in the systems and their use remain. Pressure for adoption of guidelines harmonising the systems across the EU has been increasing. We address the question whether such harmonisation could mitigate pharmaceutical pollution, and which regulatory measures would be appropriate. To answer this, we conduct a comparative investigation of the systems’ regulation and an empirical study of citizens’ beliefs and behaviour across four European countries. We find a potential for increasing the effectiveness of pharmaceutical take-back systems through their harmonisation and conclude that the EU has the competence and tools to regulate this.

Each year, a large amount of waste paper (WP) is generated in Japan, and due to the change in lifestyle with the COVID-19 pandemic, the WP collection and recycling system in Japan faces new challenges. Although the government of Japan has installed WP collection systems, the efficiency of these traditional WP collection systems is too low, and this causes inconvenience to the governments, residents, and other stakeholders. On the other hand, some recycling companies in Japan are trying to establish a nontraditional WP collection system by setting their own WP collection stations in cooperative supermarkets. Yet, the efficiency of this new system has not been clarified. This research aims to investigate the current status, operational characteristics, and the role of recycling companies’ WP collection stations in the Japanese WP collection system. By performing trade area analysis and stepwise OLS regression, this research will evaluate WP collection stations’ efficiency. Moreover, this research will also discuss how the new WP collection system improves WP collection efficiency and residents’ convenience. The results show that WP collection stations efficiency is particularly high in large supermarkets with many parking spaces and long business hours, as well as in areas with many families with children. Recycling companies’ WP collection system could create a system, which can satisfy resident, government, and recycling company interests at the same time.

According to the "cloud computing" model, based on the information transmission network and infrastructure platform, a cloud collection system of structured and unstructured meteorological fact data and forecast data based on the National Meteorological Administration is built. Through the overall integration of all kinds of actual data and forecast products, it provides a unified meteorological and hydrological integrated mobile visual display service capability for China's meteorological and hydrological related business support units and the daily needs of the public. Meanwhile, based on the unified technical framework, it provides a comprehensive display application platform to meet the requirements of differentiated business support of relevant business units.

Negative pressure wound therapy (NPWT) promotes healing by evenly applying negative pressure on the surface of the wound. The system consists of a sponge, a semiocclusive barrier, and a fluid collection system. Its effectiveness is explained by four main mechanisms of action, including macrodeformation of the tissues, drainage of extracellular inflammatory fluids, stabilization of the environment of the wound, and microdeformation. Rarely will complications linked to NPWT occur, but special care must be taken to prevent events such as toxic shock syndrome, fistulization, bleeding, and pain. New NPWT modalities have been recently developed to make NPWT suitable for a wider variety of wounds. These include NPWT with instillation therapy (NPWTi-d), different cleansing options, and application of NPWT on primarily closed incisions. Finally, vacuum-assisted wound closure therapy has been demonstrated to be efficient for various clinical settings, such as the management of diabetic foot ulcers, pressure ulcerations, chronic wounds, and skin grafts.

With the development of wearable devices and wireless communication technology, the physiological information of muscle signals has become a part of researcher’s interest. In recent years, whether in fitness or medical care issues, the activities of users’ motion tracking and effectiveness evaluation have become important research topics. The Electromyography (EMG) signal can be used to measure the responsive signal of the muscle following the action. Therefore, this paper proposed an efficient wireless body sensor network system for muscle signal collection based on EMG.