Because the lithotomy position is one of the most common positions used in urology, it is mandatory for urologists to be familiar with the complications associated with it. If this complication is recognized early, prompt treatment decreases morbidity and mortality. Minimizing the risk of WLCS will leave urologists less open to litigation, which may follow this significant iatrogenic complication.

Existing work in energy demand side management focuses on the interaction between the utility grid and consumers. However, the previous technique is not focused on energy trading in local community of a renewable energy generation, distributed demand side management and not suitable for real-time environment. This paper presents a distributed demand side management system among multiple homes in community microgrid, with the integration of the internet of things smart meter and in the presence of renewable energy sources. The proposed energy consumption game is formulated for minimizing the cost of electricity in the individual home and the total cost of energy consumption in the whole community. The smart home users are playing game by optimizing their own daily energy consumption of appliances. The multiple participants include the self renewable generation of users, shared community microgrid and optional utility company. Each participant applies its best strategy to minimize energy consumption cost and users can maintain their own privacy of energy consumption. Moreover, the proposed scheme is distributed on blockchain, which provides a trusted communication medium between the participants. It enforces the autonomous monitoring of smart appliances and the billing of electricity consumption via smart contracts. Solidity smart contract is deployed to facilitate the execution of transactions without the involvement of third party in the smart community. Comparison of the results show that the proposed approach minimizes the total cost of energy consumption as well as each user's energy consumption cost. INDEX TERMS Distributed demand side management, community microgrid, appliances scheduling, smart home, Internet of Things, blockchain, smart contracts.

For most renal stones smaller than 20 mm SWL was the most effective primary treatment modality. There was no statistical difference between the 2 lithotriptors for stone-free or ancillary procedure rate. The stone-free rate was dependent on stone size rather than type of lithotriptor. For renal stones 20 mm or greater and staghorn calculi we switched from SWL to PCNL as primary treatment, as stone-free rates were higher and the ancillary procedure and re-treatment rates were lower with PCNL. Electrohydraulic lithotripsy and pulse dye laser were initially used to treat ureteral stones. However, with the introduction of holmium laser technology we achieved higher stone-free rates and lower complication rates. Holmium laser lithotripsy is now used as a primary treatment modality for ureteral stones.

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OBJECTIVETo review patients with an extended followup after extracorporeal shock wave lithotripsy (ESWL) or percutaneous nephrolithotomy (PCNL) for calyceal diverticular stones (CDS), over a 15-year period, assessing the longterm outcome. PATIENTS AND METHODSIn all, 56 patients were treated for symptomatic CDS disease by ESWL (38) or PCNL (18). The stone-bearing diverticula were in the upper calyces in 26, middle calyces in 24 and lower calyces in six patients, and in the right kidney in 22 and in the left in 34. The most frequent symptom was ipsilateral flank pain (84%) and 32% of patients presented with associated chronic urinary tract infections. In a retrospective analysis, we assessed stone size, diverticulum location, stone-free rate, symptom-free rate, complications and extended follow-up. RESULTSIn the short-term in the ESWL group, 21% of patients were stone-free and 61% were asymptomatic; 8% developed symptoms and 8% developed recurrence or stone-growth in the long term. There were six minor complications. In the PCNL group, 15 patients (83%) were stone-free in the short term; two had a recurrence (11%) and two had stone growth (11) in the long term. There were three complications after PCNL. CONCLUSIONSThis series shows that PCNL is an effective and durable means of treating CDS, regardless of stone size or location of the diverticulum. Despite low stone-free rates with ESWL, most patients were rendered symptom-free with minimal complications. The long-term recurrence rates, 8% for ESWL and 11% for PCNL, were comparable.