{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T13:13:57Z","timestamp":1790774037241,"version":"4.1.0"},"reference-count":18,"publisher":"SAGE Publications","issue":"11","license":[{"start":{"date-parts":[[2019,11,1]],"date-time":"2019-11-01T00:00:00Z","timestamp":1572566400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of Endourology"],"published-print":{"date-parts":[[2019,11]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction:<\/jats:title>\n                    <jats:p>\n                      MOSES\n                      <jats:sup>\u2122<\/jats:sup>\n                      technology is a holmium:yttrium-aluminum-garnet laser pulse mode shown to minimize stone retropulsion. This may facilitate lithotripsy at higher power settings. However, power and heat production are proportional, and temperatures capable of tissue injury may occur during ureteroscopic lithotripsy. Although previous\n                      <jats:italic toggle=\"yes\">in vitro<\/jats:italic>\n                      studies demonstrate the importance of irrigation and activation time on heat production, the impact of pulse type has not been evaluated.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>A flexible ureteroscope with a 365\u2009\u03bcm laser fiber was placed in an 11\/13 F access sheath inserted into a 50\u2009mL saline bag to simulate a ureter, renal pelvis, and antegrade irrigant flow. A thermocouple was placed adjacent to the laser tip, and the laser fired for 30 seconds at 0.6\u2009J\/6\u2009Hz, 0.8\u2009J\/8\u2009Hz, 1\u2009J\/10\u2009Hz, 1\u2009J\/20\u2009Hz, and 0.2\u2009J\/70\u2009Hz at irrigation pressure of 100\u2009mmHg. Four runs were tested per setting using short pulse, long pulse (LP), MOSES-contact (MC), and MOSES-distance (MD) modes. The mean temperature changes (dT) were compared and thermal dose was calculated in cumulative equivalent minutes at 43\u00b0C (CEM43) using an adjusted baseline of 37\u00b0C. CEM43\u2009\u2265\u2009120 minutes was considered the tissue injury threshold.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      At 0.8\u2009J\/8\u2009Hz, LP produced the greatest dT, significantly higher than MC (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.041). CEM43 did not exceed the injury threshold. At 1\u2009J\/10\u2009Hz, dT was significantly higher for LP versus MC and MD (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.024 and 0.045, respectively). Thermal dose remained below the injury threshold. No differences in dT were seen between pulse types at 0.6\u2009J\/6\u2009Hz, 0.2\u2009J\/70\u2009Hz, or 1\u2009J\/20\u2009Hz. At 1\u2009J\/20\u2009Hz, thermal dose exceeded the injury threshold for all pulse types within 3 seconds.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Laser pulse type and length seemed to impact heat production in our ureteral model. LP produced significantly greater temperatures at 0.8\u2009J\/8\u2009Hz and 1\u2009J\/10\u2009Hz relative to MOSES settings. Fortunately, thermal dose remained safe at these settings. Both LP and MOSES technology have been shown to reduce stone retropulsion. At power \u226410 W, the latter may confer this advantage with decreased heat production.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1089\/end.2019.0496","type":"journal-article","created":{"date-parts":[[2019,8,16]],"date-time":"2019-08-16T06:51:18Z","timestamp":1565938278000},"page":"896-901","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":31,"title":["Holmium:Yttrium-Aluminum-Garnet Laser Pulse Type Affects Irrigation Temperatures in a Benchtop Ureteral Model"],"prefix":"10.1177","volume":"33","author":[{"given":"Brenton","family":"Winship","sequence":"first","affiliation":[{"name":"Division of Urologic Surgery, Duke University Medical Center, Durham, North Carolina."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Russell","family":"Terry","sequence":"additional","affiliation":[{"name":"Division of Urologic Surgery, Duke University Medical Center, Durham, North Carolina."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kohldon","family":"Boydston","sequence":"additional","affiliation":[{"name":"Division of Urologic Surgery, Duke University Medical Center, Durham, North Carolina."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Evan","family":"Carlos","sequence":"additional","affiliation":[{"name":"Division of Urologic Surgery, Duke University Medical Center, Durham, North Carolina."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"Wollin","sequence":"additional","affiliation":[{"name":"Division of Urology, Brigham and Women's Hospital, Boston, Massachusetts."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chloe","family":"Peters","sequence":"additional","affiliation":[{"name":"Duke University School of Medicine, Durham, North Carolina."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jingqiu","family":"Li","sequence":"additional","affiliation":[{"name":"Duke-NUS Medical School, Singapore."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Glenn","family":"Preminger","sequence":"additional","affiliation":[{"name":"Division of Urologic Surgery, Duke University Medical Center, Durham, North Carolina."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Lipkin","sequence":"additional","affiliation":[{"name":"Division of Urologic Surgery, Duke University Medical Center, Durham, North Carolina."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2019,11,1]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1089\/end.2017.0351"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.urology.2017.01.007"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.urology.2017.06.018"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1089\/end.2017.0050"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1089\/end.2017.0679"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1089\/end.2017.0658"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/0360-3016(84)90379-1"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1089\/end.2018.0395"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.1089\/end.1999.13.181"},{"key":"e_1_3_3_11_2","first-page":"487","volume-title":"Optical Thermal Response of Laser-Irradiated Tissue","author":"Thomsen S","year":"2011","unstructured":"Thomsen S, , Pearce J. Thermal damage and rate processes in biologic tissues. In: Welch A, , van Gemert M, eds. Optical Thermal Response of Laser-Irradiated Tissue. Dordrecht: Springer, 2011, pp. 487\u2013549."},{"key":"e_1_3_3_12_2","doi-asserted-by":"publisher","DOI":"10.1089\/end.2019.0084"},{"key":"e_1_3_3_13_2","unstructured":"US Department of Health and Human Services. Compliance Guide for Laser Products. Rockville MD: US Department of Health and Human Services 1992 p. 12."},{"key":"e_1_3_3_14_2","doi-asserted-by":"publisher","DOI":"10.2172\/10056"},{"key":"e_1_3_3_15_2","doi-asserted-by":"publisher","DOI":"10.1002\/lsm.23057"},{"key":"e_1_3_3_16_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00345-018-2303-x"},{"key":"e_1_3_3_17_2","doi-asserted-by":"publisher","DOI":"10.1089\/end.2018.0707"},{"key":"e_1_3_3_18_2","doi-asserted-by":"publisher","DOI":"10.1089\/end.2015.0747"},{"key":"e_1_3_3_19_2","doi-asserted-by":"publisher","DOI":"10.1097\/MOU.0000000000000235"}],"container-title":["Journal of Endourology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1089\/end.2019.0496","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1089\/end.2019.0496","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1089\/end.2019.0496","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T20:16:18Z","timestamp":1777407378000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1089\/end.2019.0496"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,11]]},"references-count":18,"journal-issue":{"issue":"11","published-print":{"date-parts":[[2019,11]]}},"alternative-id":["10.1089\/end.2019.0496"],"URL":"https:\/\/doi.org\/10.1089\/end.2019.0496","relation":{},"ISSN":["0892-7790","1557-900X"],"issn-type":[{"value":"0892-7790","type":"print"},{"value":"1557-900X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,11]]}}}