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Aim: To present state of the art on the management of urinary stones from a panel of globally recognized urolithiasis experts who met during the Experts in Stone Disease Congress in Valencia in January 2024. Options of treatment: The surgical treatment modalities of renal and ureteral stones are well defined by the guidelines of international societies, although for some index cases more alternative options are possible. For 1.5 cm renal stones, both m-PCNL and RIRS have proven to be valid treatment alternatives with comparable stone-free rates. The m-PCNL has proven to be more cost effective and requires a shorter operative time, while the RIRS has demonstrated lower morbidity in terms of blood loss and shorter recovery times. SWL has proven to be less effective at least for lower calyceal stones but has the highest safety profile. For a 6mm obstructing stone of the pelviureteric junction (PUJ) stone, SWL should be the first choice for a stone less than 1 cm, due to less invasiveness and lower risk of complications although it has a lower stone free-rate. RIRS has advantages in certain conditions such as anticoagulant treatment, obesity, or body deformity. Technical issues of the surgical procedures for stone removal: In patients receiving antithrombotic therapy, SWL, PCN and open surgery are at elevated risk of hemorrhage or perinephric hematoma. URS, is associated with less morbidity in these cases. An individualized combined evaluation of risks of bleeding and thromboembolism should determine the perioperative thromboprophylactic strategy. Pre-interventional urine culture and antibiotic therapy are mandatory although UTI treatment is becoming more challenging due to increasing resistance to routinely applied antibiotics. The use of an intrarenal urine culture and stone culture is recommended to adapt antibiotic therapy in case of postoperative infectious complications. Measurements of temperature and pressure during RIRS are vital for ensuring patient safety and optimizing surgical outcomes although techniques of measurements and methods for data analysis are still to be refined. Ureteral stents were improved by the development of new biomaterials, new coatings, and new stent designs. Topics of current research are the development of drug eluting and bioresorbable stents. Complications of endoscopic treatment: PCNL is considered the most invasive surgical option. Fever and sepsis were observed in 11 and 0.5% and need for transfusion and embolization for bleeding in 7 and 0.4%. Major complications, as colonic, splenic, liver, gall bladder and bowel injuries are quite rare but are associated with significant morbidity. Ureteroscopy causes less complications, although some of them can be severe. They depend on high pressure in the urinary tract (sepsis or renal bleeding) or application of excessive force to the urinary tract (ureteral avulsion or stricture). Diagnostic work up: Genetic testing consents the diagnosis of monogenetic conditions causing stones. It should be carried out in children and in selected adults. In adults, monogenetic diseases can be diagnosed by systematic genetic testing in no more than 4%, when cystinuria, APRT deficiency, and xanthinuria are excluded. A reliable stone analysis by infrared spectroscopy or X-ray diffraction is mandatory and should be associated to examination of the stone under a stereomicroscope. The analysis of digital images of stones by deep convolutional neural networks in dry laboratory or during endoscopic examination could allow the classification of stones based on their color and texture. Scanning electron microscopy (SEM) in association with energy dispersive spectrometry (EDS) is another fundamental research tool for the study of kidney stones. The combination of metagenomic analysis using Next Generation Sequencing (NGS) techniques and the enhanced quantitative urine culture (EQUC) protocol can be used to evaluate the urobiome of renal stone formers. Twenty-four hour urine analysis has a place during patient evaluation together with repeated measurements of urinary pH with a digital pH meter. Urinary supersaturation is the most comprehensive physicochemical risk factor employed in urolithiasis research. Urinary macromolecules can act as both promoters or inhibitors of stone formation depending on the chemical composition of urine in which they are operating. At the moment, there are no clinical applications of macromolecules in stone management or prophylaxis. Patients should be evaluated for the association with systemic pathologies. Prophylaxis: Personalized medicine and public health interventions are complementary to prevent stone recurrence. Personalized medicine addresses a small part of stone patients with a high risk of recurrence and systemic complications requiring specific dietary and pharmacological treatment to prevent stone recurrence and complications of associated systemic diseases. The more numerous subjects who form one or a few stones during their entire lifespan should be treated by modifications of diet and lifestyle. Primary prevention by public health interventions is advisable to reduce prevalence of stones in the general population. Renal stone formers at "high-risk" for recurrence need early diagnosis to start specific treatment. Stone analysis allows the identification of most “high-risk” patients forming non-calcium stones: infection stones (struvite), uric acid and urates, cystine and other rare stones (dihydroxyadenine, xanthine). Patients at “high-risk” forming calcium stones require a more difficult diagnosis by clinical and laboratory evaluation. Particularly, patients with cystinuria and primary hyperoxaluria should be actively searched. Future research: Application of Artificial Intelligence are promising for automated identification of ureteral stones on CT imaging, prediction of stone composition and 24-hour urinary risk factors by demographics and clinical parameters, assessment of stone composition by evaluation of endoscopic images and prediction of outcomes of stone treatments. The synergy between urologists, nephrologists, and scientists in basic kidney stone research will enhance the depth and breadth of investigations, leading to a more comprehensive understanding of kidney stone formation.

Although creativity research has devoted considerable effort toward identifying the antecedents of creativity, there remain important questions about how organizations can foster creativity through social processes. Drawing from social capital theory, we hypothesize a moderated mediation model that investigates the influence of employee participation in fun activities on individual creativity through workplace friendships. We further hypothesize that the strength of this positive indirect effect is weaker for managers compared with non-managers. Our analysis of data collected from a multi-source, three-wave field study (n = 163 employees) reveals a positive mediation between participation in fun activities and incremental creativity (but not radical creativity) via workplace friendships. The results further support our prediction that this positive indirect effect on incremental creativity is weaker for managers compared with non-managers. Our findings not only highlight the practical and theoretical importance of fun activities in generating novel and useful ideas, but the results also reveal that the benefits derived from fun activities (i.e., strengthened friendships, incremental creativity) are particularly salient for non-managers.

Although research consistently shows that employee creativity contributes to positive outcomes for teams and organizations, we have limited insight into how employee creativity shapes the outcomes of those employees who demonstrate such creativity, particularly in the context of environmental uncertainties. Drawing from event system theory and threat rigidity theory, we argue that under a threat to organizational survival, incremental creativity has a positive, and radical creativity has a negative, indirect effect on downsizing survival selection via manager evaluations of employee job performance. Study 1 uses a unique three-wave, three-source field study (n 1 = 186) to provide support for our hypotheses. Studies 2 and 3 use experimental data (n 2 = 410, n 3 = 565) involving different scenarios of threats to organizational survival (i.e., organization's innovation failure, competitor's successful innovation) that provide further support for the hypothesized effects of radical creativity on manager evaluations of employee job performance. Post-hoc analyses reveal novel insights into how managers' creativity preferences can influence their evaluation of the job performance of employees who demonstrate incremental creativity during threatening events. [ABSTRACT FROM AUTHOR]

Olbert’s balloon dilatation is a surgical technique used for the treatment of ureteral stricture. Although it is more frequently used in adults, due to the advancing miniaturization of the equipment, this technique has become possible in children. We would like to present five cases of Olbert’s balloon dilatation carried out in children with ureteral stricture, aged 12–17 years. All of these children were diagnosed for at least 6 months. Ureteral stricture has been noticed in those patients with a time of a stone residence in the ureter longer than 6 months. The duration of the stone in the ureter varied from 6 to 18 months. The symptoms were abdominal pain, renal colic pain, UTI, fever, vomiting, and nausea. Ultrasound (US) revealed hydronephrosis and ureter dilatation above the stone. All of these children had grade-3 hydronephrosis based on the Onen grading system during admission to the hospital. The lack of renal function on the DMSA scan was observed with an average of 22%. JJ-stent was inserted as a first-line treatment. A retrograde pyelogram revealed ureteral stricture at a length from 1 to 1.7 cm in the place where the stone was ingrown. Olbert’s balloon dilatation under fluoroscopy was performed successfully in all children. We achieved an efficacy of 60% in our series. Renal function increased to an average of 36% on DMSA 3 months after surgery. The level of creatinine is shaped at an average of 0.6. On US, two children had no hydronephrosis while one child had grade-1 hydronephrosis. The longest follow-up is now 4 years, with the same good results. In conclusion, Olbert’s balloon dilatation is an effective, safe, and minimally invasive tool for ureteral stricture in the hands of the endourological experienced pediatric urologist. But more prospective, randomized trials are still needed.

Research indicates that relationship‐oriented HR practices can increase organizational knowledge, yet we know little about the effects of relationship‐oriented HR practices on employee knowledge management behaviors. Drawing from affective events theory, we examine the indirect effect of participation in one type of relationship‐oriented HR practice (i.e., organizational social activities) on three knowledge management behaviors (i.e., knowledge sharing, knowledge hiding, and knowledge manipulating) via positive affect, as well as the conditional indirect effect of intrinsic motivation for organizational social activities on these relationships. Utilizing a time‐separated field study (n = 163), our analysis reveals positive affect fully mediates the relationship between participation in organizational social activities and (a) knowledge sharing and (b) knowledge hiding, and partially mediates the relationship between participation in organizational social activities, and (c) knowledge manipulating. Most interestingly, we unexpectedly found a positive direct effect of participation in organizational social activities on knowledge manipulation, even though the indirect effect via positive affect was negative. The results also indicate that, for individuals with high intrinsic motivation for social activities, there is a significant indirect effect of participation in organizational social activities on all three knowledge management behaviors. [ABSTRACT FROM AUTHOR]

In the 21st century, we still need to talk about gender inequality in science. Even with the sharp growth of studies on this theme over the last decades, we are still trying to convince our peers that diversity matters and, if embraced, makes better science. Part of this drawback can be related to the need for data to support effective proposals to change the academic scenario. In order to close some of those gaps, we here analyze 1) the profile of Brazilian researchers based on production, impact, and membership to the Brazilian Academy of Sciences, 2) participation in the Editorial boards of Brazilian journals dedicated to Entomology, and, 3) the academic scenario of Brazilian Entomology focusing on the sex of the first and last authors in peer-reviewed international publications related to Entomology. We aimed to provide a deeper look on the Brazilian Entomology scenario and to expand the amount of data availability to stimulate and foster a mind-change in the current academic structure. We performed scientometric searches and analysis using different platforms and found that the number and impact of the publications by female researchers, as observed by relative numbers, are not less than that of males. Despite that, female researchers are less represented at the Brazilian Academy of Sciences and editorial boards, reinforcing the lack of women recognition in science. Thus, we observe that some narratives related to the productivity gap can be misleading to a perpetuation of our internal and structural biases. We here expanded data from a previous paper where we scrutinized the Brazilian Entomology scenario and discussed the patches and systems that maintain gender gap in science.

Objective: The purposes of this multi-center study were to evaluate the rate of infection stones and to evaluate the urine cultures of patients with infection stones. Materials: Charts of adulpatients with urinary stones were reviewed and data on stone analyses and urine cultures were collected. Results: In total, 1204 renal stone formers (RSFs) from 10 countries were included (776 males, 428 females). Fifty-six patients (4.6%) had struvite stones. The highest frequency of struvite stones was observed in India (23%) and Pakistan (18%). Lower rates were reported in Canada (2%), China (3%), Argentina (3%), Iraq (3%), Italy (3.5%) and Poland (3%), and intermediate rates in Egypt (5.5%) and Bulgaria (5.4%). Urine cultures were retrieved from 508 patients. Patients with struvite stones had a positive culture in 64.3% of the samples and patients with other stones, in 26.7%. In struvite stones, the most common isolates were Escherichia coli (27.7%) and Proteus spp. (27.7%), followed by Klebsiella spp. (16.7%); in other types of stone, it was Escherichia coli (47.6%), followed by Gram-positive bacteria (14.0%) Conclusions: The struvite stone composition was associated with a urinary infection, although an infection was not demonstrable with a conventional midstream urine culture in about 30%.

ABSTRACT The use of robust sample methodologies to estimate the highest number of species with different ecological requirements and traits is essential to the knowledge construction of the biodiversity and to establish wildlife assessment and monitoring programs. Our aims were to study the performance of colored pan traps in the capture of Drosophilidae (Diptera), a method never used for sampling this taxon. During six months, colored pan traps (blue, yellow and white) were tested in three areas in Southern Brazil. We captured 375 individuals of 30 species belonging to four genera of Drosophilidae. The most abundant species were Drosophila lutzii (n=215) p=0.58, Scaptomyza sp. (n=55) p=0.15 and D. bromelioides (n=17) p=0.04, all of them, anthophilous species. All colored pan traps captured a high quantify species of Drosophilidae, mainly anthophilous species.

Objective: To collect evidence on the rate of obesity in renal stone formers (RSFs) living in different climatic areas and consuming different diets. Materials and methods: Data of adult renal stone formers were retrospectively collected by members of U-merge from 13 participant centers in Argentina, Brazil, Bulgaria (2), China, India, Iraq (2), Italy (2), Nigeria, Pakistan and Poland. The following data were collected: age, gender, weight, height, stone analysis and procedure of stone removal. Results: In total, 1689 renal stone formers (1032 males, 657 females) from 10 countries were considered. Average age was 48 (±14) years, male to female ratio was 1.57 (M/F 1032/657), the average body mass index (BMI) was 26.5 (±4.8) kg/m2. The obesity rates of RSFs in different countries were significantly different from each other. The highest rates were observed in Pakistan (50%), Iraq (32%), and Brazil (32%), while the lowest rates were observed in China (2%), Nigeria (3%) and Italy (10%). Intermediate rates were observed in Argentina (17%), Bulgaria (17%), India (15%) and Poland (22%). The age-adjusted obesity rate of RSFs was higher than the age-adjusted obesity rate in the general population in Brazil, India, and Pakistan, whereas it was lower in Argentina, Bulgaria, China, Italy, and Nigeria, and similar in Iraq and Poland. Conclusions: The age-adjusted obesity rate of RSFs was not higher than the age-adjusted obesity rate of the general population in most countries. The relationship between obesity and the risk of kidney stone formation should be reconsidered by further studies carried out in different populations.

Kidney stone disease in children is always a therapeutic challenge. It is a multifactorial condition and it should be approached, diagnosed and treated as such. One of the biggest challenges is kidney stones located in the lower renal calyx. There are currently three main surgical techniques to treat this condition: ESWL—Extracorporeal Shock Wave Lithotripsy, RIRS—Retrograde IntraRenal Surgery, and PCNL—PerCutaneous Nephro-Lithotripsy. In pediatric population, the most frequently used method is ESWL, and in the event of failure, endoscopic procedures are the second-best choice. In this article, a sample of 53 children admitted to a tertiary medical center was examined. Thirty-eight of those children underwent flexible URS, while the remaining 15—micro PCNL. The average size of the deposit in the former group was 12.2 mm, against 13.5 mm in the latter. The full Stone Free Rate (SFR) was achieved in RIRS at 84.21 and 86.7% in percutaneous nephrolithotripsy. Flexible ureterorenoscopy and MicroPERC are two comparably effective methods for treating lower calyx stones of any size. However, according to our data, flexible ureterorenoscopy carries a lower risk of complications and inpatient care (with the mean of 3 days). The learning curve for these procedures in pediatric urology is long and relies on a limited number of patients. The number of pediatric patients qualifying for these procedures is restricted also due to the high efficacy of extracorporeal shock wave lithotripsy in pediatric population. Radiation exposure is an important factor in every endoscopy procedure and should never exceed the limits set in the ALARA protocol. ESWL remains to this day the treatment of choice for stone disease in children and can be performed under ultrasound control. For many parents, it is a first-choice treatment preference for their child due to its greater apparent safety, although data on this remains insufficient. Prospective, randomized, multicenter trials are definitely needed.