Ex-Vivo Ureteroscopy at the Time of Live Donor Nephrectomy

Background and Purpose: Potential transplant renal allograft recipients exceed the number of donors. Our institution now considers patients with small, unilateral, nonobstructing, incidental renal calculi for possible renal donation. We adopted ex-vivo ureteroscopy (ExURS) to render these kidneys stone free at the time of renal transplantation. We examined the safety and efficacy of ExURS. Patients and Methods: After confirming a lack of significant metabolic defects on 24-hour urinalysis, 23 patients with small nonobstructing unilateral nephrolithiasis detected on preoperative CT angiography underwent donor nephrectomy. Immediately after cold perfusion, ExURS was performed with ice cold saline irrigation. Retrospective review was performed. Results: Pyeloscopy was successfully performed in all 23 patients. A total of 28 calculi, mean largest diameter 3.9-mm (range 3-6-mm), were visualized in 19 kidneys. Basket extraction and holmium laser lithotripsy was performed in 12 and 6 kidneys, respectively. Treatment rendered 17/19 stone-containing kidneys stone free with a mean treatment time of 6.2 minutes (3-10-min). There were no intraoperative complications. Median serum creatinine level of recipients at 1 month and 1 year were 1.4+/-1.8-mg/dL and 1.3+/-0.6-mg/dL, respectively. At a median follow-up of 63+/-47.2 months, there were no transplant urinary calculi among the recipients. Conclusions: ExURS safely renders live donor kidney allografts stone free with low risk of recurrence. When used appropriately, ExURS could safely increase the number of potential kidney donors and minimize the risk of adverse stone events.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/90444/1/end-2E2010-2E0627.pd

Solitary Common Iliac Artery Inflammatory Aneurysm in a Healthy Woman: Case Report and Review of the Literature

Inflammatory aneurysms represent only 3–10% of all aortoiliac aneurysms and tend to be more common in men. We report a case of a solitary inflammatory aneurysm of the right common iliac artery in a healthy young woman. The patient presented with persistent abdominal and right flank pain. She had no risk factors for vascular disease, except mild hypertension and a strong family history of aneurysm disease. Her work-up demonstrated a 3.0 cm right common iliac artery aneurysm with intramural thrombus, focal calcification, and perianeurysmal inflammation without evidence of systemic atherosclerosis. There was right hydroureteronephrosis secondary to ureteral compression by the inflammatory aneurysm. She underwent open right common iliac artery aneurysmorraphy with polytetrafluoroethylene interposition graft and concomitant ureterolysis without complication. She remains asymptomatic more than 1 year postoperatively with no evidence of additional aneurysm disease, resolution of her hydroureteronephrosis, and normal kidney function. We report a rare case of a solitary inflammatory aneurysm of the right common iliac artery in a healthy young woman, with a review of the current literature on inflammatory aneurysms.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/41370/1/10016_2005_Article_7713.pd

A Search for In-Situ Field OB Star Formation in the Small Magellanic Cloud

Whether any OB stars form in isolation is a question central to theories of massive star formation. To address this, we search for tiny, sparse clusters around 210 field OB stars from the Runaways and Isolated O-Type Star Spectroscopic Survey of the SMC (RIOTS4), using friends-of-friends (FOF) and nearest neighbors (NN) algorithms. We also stack the target fields to evaluate the presence of an aggregate density enhancement. Using several statistical tests, we compare these observations with three random-field datasets, and we also compare the known runaways to non-runaways. We find that the local environments of non-runaways show higher aggregate central densities than for runaways, implying the presence of some "tips-of-iceberg" (TIB) clusters. We find that the frequency of these tiny clusters is low, $\sim 4-5\%$ of our sample. This fraction is much lower than some previous estimates, but is consistent with field OB stars being almost entirely runaway and walkaway stars. The lack of TIB clusters implies that such objects either evaporate on short timescales, or do not form, implying a higher cluster lower-mass limit and consistent with a relationship between maximum stellar mass ($m_{\rm max}$) and the mass of the cluster ($M_{\rm cl}$). On the other hand, we also cannot rule out that some OB stars may form in highly isolated conditions. Our results set strong constraints on the formation of massive stars in relative isolation.Comment: 24 pages, 13 figures, Accepted to Ap

Contemporary Practice Patterns of Flexible Ureteroscopy for Treating Renal Stones: Results of a Worldwide Survey

Introduction: Flexible ureteroscopy (fURS) is increasingly used in the treatment of renal stones. However, wide variations exist in technique, use, and indications. To better inform our knowledge about the contemporary state of fURS for treating renal stones, we conducted a survey of endourologists worldwide. Methods: An anonymous online questionnaire assessing fURS treatment of renal stones, consisting of 36 items, was sent to members of the Endourology Society in October 2014. Responses were collected through the SurveyMonkey system over a 3-month period. Results: Questionnaires were answered by 414 surgeons from 44 countries (response rate 20.7%). U.S. surgeons accounted for 34.4% of all respondents. fURS was routinely performed in 80.0% of institutions, with 40.0% of surgeons performing >100 cases/year. Respondents considered fURS to be first-line therapy for patients with renal stones 2?cm. Basket displacement for lower pole stones was routinely performed by 55.8%. Ureteral access sheaths (UAS) were preferred for every case by 58.3%. Respondents frequently utilized high-power lasers and dusting techniques. Criteria for determining stone-free rate were defined as zero fragments or residual fragment (RF) <1, <2, <3, and <4?mm by 30.9%, 8.9%, 31.5%, 15.8%, and 11.2% of respondents, respectively. Conclusion: The overwhelming majority of endourologists surveyed consider fURS as a first-line treatment modality for renal stones, especially those <2?cm. Use of UAS, high-power holmium lasers, and dusting technique has become popular among practitioners. When defining stone free after fURS, the majority of endourologists used a zero fragment or RF <2?mm definition.Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/140082/1/end.2015.0260.pd

Effects of the bias enhanced nucleation hot-filament chemical-vapor deposition parameters on diamond nucleation on iridium

The effects of the bias current density and the filament-to-substrate distance on the nucleation of diamond on iridium buffer layers were investigated in a hot-filament chemical-vapor deposition (HFCVD) reactor. The nucleation density increased by several orders of magnitude with the raise of the bias current density. According to high-resolution field-emission gun scanning electron microscopy observation, diamond nuclei formed during bias-enhanced nucleation (BEN) did not show any preferred oriented growth. Moreover, the first-nearest-neighbor distance distribution was consistent with a random nucleation mechanism. This occurrence suggested that the diffusion of carbon species at the substrate surface was not the predominant mechanism taking place during BEN in the HFCVD process. This fact was attributed to the formation of a graphitic layer prior to diamond nucleation. We also observed that the reduction of the filament sample distance during BEN was helpful for diamond growth. This nucleation behavior was different from the one previously reported in the case of BEN-microwave chemical-vapor deposition experiments on iridium and has been tentatively explained by taking into account the specific properties and limitations of the HFCVD technique

Measurement of the ratio of branching fractions BR(B0 -> K*0 gamma)/BR(Bs0 -> phi gamma)

The ratio of branching fractions of the radiative B decays B0 -> K*0 gamma and Bs0 -> phi gamma has been measured using 0.37 fb-1 of pp collisions at a centre of mass energy of sqrt(s) = 7 TeV, collected by the LHCb experiment. The value obtained is BR(B0 -> K*0 gamma)/BR(Bs0 -> phi gamma) = 1.12 +/- 0.08 ^{+0.06}_{-0.04} ^{+0.09}_{-0.08}, where the first uncertainty is statistical, the second systematic and the third is associated to the ratio of fragmentation fractions fs/fd. Using the world average for BR(B0 -> K*0 gamma) = (4.33 +/- 0.15) x 10^{-5}, the branching fraction BR(Bs0 -> phi gamma) is measured to be (3.9 +/- 0.5) x 10^{-5}, which is the most precise measurement to date.Comment: 15 pages, 1 figure, 2 table

Observation of J/ψpJ/\psi p resonances consistent with pentaquark states in Λb0→J/ψK−p{\Lambda_b^0\to J/\psi K^-p} decays

Observations of exotic structures in the $J/\psi p$ channel, that we refer to as pentaquark-charmonium states, in $\Lambda_b^0\to J/\psi K^- p$ decays are presented. The data sample corresponds to an integrated luminosity of 3/fb acquired with the LHCb detector from 7 and 8 TeV pp collisions. An amplitude analysis is performed on the three-body final-state that reproduces the two-body mass and angular distributions. To obtain a satisfactory fit of the structures seen in the $J/\psi p$ mass spectrum, it is necessary to include two Breit-Wigner amplitudes that each describe a resonant state. The significance of each of these resonances is more than 9 standard deviations. One has a mass of $4380\pm 8\pm 29$ MeV and a width of $205\pm 18\pm 86$ MeV, while the second is narrower, with a mass of $4449.8\pm 1.7\pm 2.5$ MeV and a width of $39\pm 5\pm 19$ MeV. The preferred $J^P$ assignments are of opposite parity, with one state having spin 3/2 and the other 5/2.Comment: 48 pages, 18 figures including the supplementary material, v2 after referee's comments, now 19 figure

Precise measurements of the properties of the B-1(5721)(0,+) and B-2*(5747)(0,+) states and observation of B-+,B-0 pi(-,+) mass structures

Invariant mass distributions of B+π− and B0π+ combinations are investigated in order to study excited B mesons. The analysis is based on a data sample corresponding to 3.0 fb−1 of pp collision data, recorded by the LHCb detector at centre-of-mass energies of 7 and 8 TeV. Precise measurements of the masses and widths of the B1(5721)0,+ and B2(5747)0,+ states are reported. Clear enhancements, particularly prominent at high pion transverse momentum, are seen over background in the mass range 5850-6000 MeV in both B+π− and B0π+ combinations. The structures are consistent with the presence of four excited B mesons, labelled BJ (5840)0,+ and BJ (5960)0,+, whose masses and widths are obtained under different hypotheses for their quantum numbers

Abundance and distribution of sperm whales in the Canary Islands : can sperm whales in the Archipelago sustain the current level of ship-strike mortalities?

Funding was provided through an agreement between the Canary Islands Government and the Spanish Ministries of the Environment and Defence. Additional survey effort on the Amanay, Banquete and Concepción seamounts was funded by the Fundación Biodiversidad-MAGRAMA via the LIFE-INDEMARES project.Sperm whales are present in the Canary Islands year-round, suggesting that the archipelago is an important area for this species in the North Atlantic. However, the area experiences one of the highest reported rates of sperm whale ship-strike in the world. Here we investigate if the number of sperm whales found in the archipelago can sustain the current rate of ship-strike mortality. The results of this study may also have implications for offshore areas where concentrations of sperm whales may coincide with high densities of ship traffic, but where ship-strikes may be undocumented. The absolute abundance of sperm whales in an area of 52933 km2, covering the territorial waters of the Canary Islands, was estimated from 2668 km of acoustic line-transect survey using Distance sampling analysis. Data on sperm whale diving and acoustic behaviour, obtained from bio-logging, were used to calculate g(0) = 0.92, this is less than one because of occasional extended periods when whales do not echolocate. This resulted in an absolute abundance estimate of 224 sperm whales (95% log-normal CI 120-418) within the survey area. The recruitment capability of this number of whales, some 2.5 whales per year, is likely to be exceeded by the current ship-strike mortality rate. Furthermore, we found areas of higher whale density within the archipelago, many coincident with those previously described, suggesting that these are important habitats for females and immature animals inhabiting the archipelago. Some of these areas are crossed by active shipping lanes increasing the risk of ship-strikes. Given the philopatry in female sperm whales, replacement of impacted whales might be limited. Therefore, the application of mitigation measures to reduce the ship-strike mortality rate seems essential for the conservation of sperm whales in the Canary Islands.Publisher PDFPeer reviewe