{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,28]],"date-time":"2026-08-28T02:17:57Z","timestamp":1787883477823,"version":"build-2784847793"},"reference-count":12,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2025,10,26]],"date-time":"2025-10-26T00:00:00Z","timestamp":1761436800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Lasers Surg Med"],"published-print":{"date-parts":[[2025,12]]},"abstract":"ABSTRACT<\/jats:title>\n \n Objectives<\/jats:title>\n Although the thulium fiber laser (TFL, 1940\u2009nm) efficiently fragments stones, concerns have been raised regarding heat production. Recently, a TFL with a modified duty cycle (MDC) was designed to reduce heat generation. The purpose of this study was to compare heat generation between the MDC and conventional TFL.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n \n Ten millimeter BegoStone phantoms were placed in the proximal ureter of a kidney and ureter model. The model was submerged in a 35\u00b0C saline bath, with continuous saline irrigation (22\u00b0C) maintained at 15\u2009mL\/min through a ureteroscope. Temperature was measured using a needle thermocouple. Five trials of 60\u2009s continuous laser activation were performed for each power setting: 3\u2009W (0.3\u2009J\/10\u2009Hz), 10\u2009W (1\u2009J\/10\u2009Hz), 20\u2009W (1\u2009J\/20\u2009Hz) and 30\u2009W (0.6\u2009J\/50\u2009Hz). Thermal dose was calculated as cumulative equivalent minutes at 43\u00b0C (CEM\u2084\u2083; injury threshold>\u200920). Kruskal\u2010Wallis and Mann\u2010Whitney U tests were used for statistical analysis with\n p<\/jats:italic>\n \u2009<\u20090.05 being significant.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Both lasers produced maximum temperatures (\n T<\/jats:italic>\n max<\/jats:sub>\n ) of 27\u00b0C at 3\u2009W. The MDC TFL generated a significantly lower Tmax than the conventional TFL at 10\u2009W (36.9\u00b0C vs 42.1\u00b0C,\n p<\/jats:italic>\n \u2009<\u20090.001), 20\u2009W (38.1\u00b0C vs 44.6\u00b0C,\n p<\/jats:italic>\n \u2009<\u20090.001), and 30\u2009W (52.5\u00b0C vs 63.6\u00b0C,\n p<\/jats:italic>\n \u2009<\u20090.05). CEM\u2084\u2083 for the MDC and conventional TFL at 20\u2009W were (0.00 vs 0.90, respectively), and at 30\u2009W (425 vs 275,919, respectively).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n The MDC TFL generated lower temperatures at 10, 20, and 30\u2009W. Future studies are necessary to evaluate stone fragmentation efficiency of the MDC TFL.<\/jats:p>\n <\/jats:sec>","DOI":"10.1002\/lsm.70067","type":"journal-article","created":{"date-parts":[[2025,10,26]],"date-time":"2025-10-26T16:45:18Z","timestamp":1761497118000},"page":"821-826","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Does Duty Cycle Modification Affect Temperature During Thulium Fiber Laser Lithotripsy?"],"prefix":"10.1002","volume":"57","author":[{"given":"Kallan","family":"Richards","sequence":"first","affiliation":[{"name":"Department of Urology Loma Linda University Health Loma Linda California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-8181-4178","authenticated-orcid":false,"given":"Katya","family":"Hanessian","sequence":"additional","affiliation":[{"name":"Department of Urology Loma Linda University Health Loma Linda California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ali","family":"Albaghli","sequence":"additional","affiliation":[{"name":"Department of Urology Loma Linda University Health Loma Linda California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gabriel","family":"Martin","sequence":"additional","affiliation":[{"name":"Department of Urology Loma Linda University Health Loma Linda California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8434-1264","authenticated-orcid":false,"given":"Daniel","family":"Jhang","sequence":"additional","affiliation":[{"name":"Department of Urology Loma Linda University Health Loma Linda California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adel","family":"Battikha","sequence":"additional","affiliation":[{"name":"Department of Urology Loma Linda University Health Loma Linda California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joshua","family":"Ghoulian","sequence":"additional","affiliation":[{"name":"Department of Urology Loma Linda University Health Loma Linda California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zham","family":"Okhunov","sequence":"additional","affiliation":[{"name":"Department of Urology Loma Linda University Health Loma Linda California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D. Duane","family":"Baldwin","sequence":"additional","affiliation":[{"name":"Department of Urology Loma Linda University Health Loma Linda California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,10,26]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1097\/JU.0000000000001629"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.22037\/UJ.V13I5.3462"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1089\/END.2021.0842"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/0360-3016(84)90379-1"},{"issue":"3","key":"e_1_2_9_6_1","first-page":"915","article-title":"Impact of Temperature on Cell Death in a Cell\u2010Culture Model of Hepatocellular Carcinoma","volume":"32","author":"Leber B.","year":"2012","journal-title":"Anticancer Research"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1089\/END.2019.0426"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1089\/END.2020.1067"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1089\/END.2017.0658"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1007\/S00345-020-03287-9"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1089\/END.2005.1130"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1007\/S00345-021-03848-6"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1007\/S00345-022-03967-8"}],"container-title":["Lasers in Surgery and Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/lsm.70067","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,10]],"date-time":"2025-12-10T03:53:44Z","timestamp":1765338824000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/lsm.70067"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,10,26]]},"references-count":12,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2025,12]]}},"alternative-id":["10.1002\/lsm.70067"],"URL":"https:\/\/doi.org\/10.1002\/lsm.70067","archive":["Portico"],"relation":{},"ISSN":["0196-8092","1096-9101"],"issn-type":[{"value":"0196-8092","type":"print"},{"value":"1096-9101","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,10,26]]},"assertion":[{"value":"2025-05-03","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-09-15","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-10-26","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}