Study Need and Importance: The thulium fiber laser has emerged as an alternative laser lithotripsy technology to the gold standard, holmium:yttriumaluminum-garnet (Ho:YAG) laser. The SOLTIVEÔ SuperPulsed thulium fiber laser (SPTF) was the first platform released in North America and has shown promising clinical results in an adult cohort. No center has reported outcomes in a pediatric cohort. In this single-institution, retrospective cohort study, we aimed to compare the clinical performance of lowpower Ho:YAG lasers to the SPTF in matched, unilateral ureteroscopies performed in pediatric patients. What We Found: Over 5 years, 93 cases were performed with Ho:YAG lasers compared to 32 cases with the SPTF. The observed stone-free rate (SFR) with Ho:YAG lasers was 59% compared to 70% with the SPTF (see Table ). Use of the SPTF was associated with 61% lower odds of having a residual stone after ureteroscopy (95% CI: 0.19À0.77, p[0.01). Despite a significantly longer median laser time of 11 minutes with the SPTF compared to 2 minutes * Weighted logistic regression model.† Weighted linear regression model.

Background: Faltered growth has been shown to affect 161 million children worldwide and derail cognitive development from early childhood. The neural pathways by which growth faltering in early childhood affects future cognitive outcomes remain unclear, which is partially due to the scarcity of research using both neuroimaging and sensitive behavioral techniques in low-income settings. We employed EEG to examine the association between growth faltering and brain functional connectivity and whether brain functional connectivity mediates the effect of early adversity on cognitive development. Methods: We recruited participants from an urban impoverished neighborhood in Dhaka, Bangladesh. One sample consisted of 85 children whose EEG and growth measures (height for age, weight for age, and weight to height) were collected at 6 months and cognitive outcomes were assessed at 27 months. Another sample consisted of 115 children whose EEG and growth measures were collected at 36 months and IQ scores were assessed at 48 months. Path analysis was used to test the effect of growth measures on cognitive outcomes through brain functional connectivity. Findings: Faltered growth was found to be accompanied by overall increased functional connectivity in the theta and low-beta frequency bands for the 36-month-old cohort. For both cohorts, brain functional connectivity was negatively predictive of later cognitive outcomes at 27 and 48 months, respectively. Faltered growth was found to have a negative impact on children's IQ scores in the older cohort, and this effect was found to be mediated by brain functional connectivity in the low-beta band. Interpretation: The association found between growth measures and brain functional connectivity may reflect a broad deleterious effect of malnutrition on children's brain development. The mediation effect of functional connectivity on the relation between physical growth and later IQ scores provides the first experimental evidence that brain functional connectivity may mediate the effect of biological adversity on cognitive development.

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