Comparison of STONE score, Guy's stone score and Clinical Research Office of the Endourological Society (CROES) score as predictive tools for percutaneous nephrolithotomy outcome: a prospective study.

OBJECTIVE: To evaluate which among the three scoring systems used to predict stone-free status (SFS) after percutaneous nephrolithotomy (PCNL), namely Guy's stone score (GSS), STONE nephrolithometry score and Clinical Research Office of the Endourological Society (CROES) nephrolithometry nomogram, is the most accurate predictor of SFS. METHOD AND MATERIALS: We prospectively included all patients who underwent PCNL (tract size >24 F) at our hospital between July 2017 and January 2019. All demographic and peri-operative data were tabulated including calculation of GSS, STONE score and CROES nomogram score using preoperative computed tomography. Comparison of the 'stone-free' group and 'residual-stone' group was carried out using standard statistical methods. RESULTS: A total of 252 patients were enrolled. The mean GSS, STONE score and CROES score in the stone-free group was 1.60, 6.98 and 212.27, respectively, and in the residual stone group group it was 2.93, 8.98 and 129.89, respectively (P < 0.001 in each). Receiver-operating characteristic (ROC) curves showed that all three scoring systems had similar predictive accuracy for post-PCNL SFS, with STONE score having the highest area under the ROC curve value (0.852). GSS was significantly associated with operating time, estimated blood loss (EBL) and length of hospital stay (LOS; P < 0.001 in each). STONE score and CROES score were both significantly associated with EBL (P = 0.029 and 0.001, respectively). CONCLUSION: All three scoring systems are equally predictive of post-PCNL SFS. EBL is significantly associated with all three scoring systems, while GSS is also associated with operating time and LOS.

Snowflake-like Metastable Wurtzite CuGaS2/MoS2 Composite with Superior Electrochemical HER Activity.

In the present work, we report the synthesis of wurtzite CuGaS2 and its composite with MoS2 and explored their efficacy toward two important applications, viz. electrocatalytic hydrogen evolution reaction (HER) and adsorption of Rhodamine B dye. The CuGaS2 was synthesized via a low-temperature ethylenediamine-mediated solvothermal method. The obtained products were characterized by various techniques such as X-ray diffraction, field emission scanning electron microscopy, transmission electron microscopy, and X-ray photoelectron spectroscopy to ascertain the phase formation, surface morphology, and elemental oxidation states. The electrocatalytic activity of the wurtzite CuGaS2 and CuGaS2/MoS2 composites toward HER was investigated, wherein the CuGaS2/MoS2 composite exhibited superior activity when compared to the pristine sample with a small Tafel slope of 56.2 mV dec-1 and an overpotential value of -464 mV at the current density of 10 mA cm-2. On the other hand, the synthesized CuGaS2 also showed an impressive adsorption behavior toward Rhodamine B dye with 99% adsorption in 60 min, which is relatively better than that observed with the composite material.

A fruit-tissue (apple) based training model for transurethral resection of prostate: face, content and construct validation.

AIMS AND OBJECTIVES: To establish face, content and construct validity of an innovative fruit-tissue (apple) based transurethral resection of prostate (TURP) training model devised at our institute. METHOD AND MATERIAL: Six consultants, three fellows and 16 residents performed TURP on the new fruit-tissue (apple) based TURP model for ten minutes after watching a demo-video. The procedure was videographed. At the end, participants answered a set of questionnaires regarding their experience. The video and the apple both were examined by blinded separate assessors based on pre-decided parameters. Statistical analysis was done to find out the face, content and construct validity of the training model. RESULTS: Participants were divided into two groups, expert and novice, based TURP surgery experience. The model was positively rated (lowest median value 4) by all novice for its 'realism' and 'acceptability'. The expert group also felt that the model reproduced real TURP experience (lowest median value 4). Thus, both face and content validity were established. The expert group resected more tissue (18.3±2.5 gm vs 10.3±3.4 gm; P<0.001) with less irrigation fluid (1566.6±187.0 ml vs 2112.5±344.2 ml; P<0.001) removing more chips (39.8±6.2 vs 25.6±3.0; P<0.001) and orientated themselves faster (63.3±12.2 sec vs 90.3±12.7 sec; P<0.001). The assessors' subjective evaluation of videos and apples both favored the experts. The model can differentiate 'expert' from 'novice', thus establishing 'construct validity'. CONCLUSION: The new fruit-tissue (apple) based TURP model is a realistic and acceptable TRUP training model with proven face, content and construct validity.