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Introduction This study aimed to evaluate the usefulness of machine learning (ML) and neural network (NN) models versus traditional statistical methods for estimating biochemical recurrence (BCR) in men following robot-assisted radical prostatectomy (RARP). Methods Patients who underwent RARP from November 2011 to July 2022 were taken in the study. Patients with BCR were assigned to Group 2, whereas those without BCR were placed in Group 1. Preoperative and postoperative parameters, together with demographic data, were recorded in the database. This study used one NN, the radial basis function NN (RBFNN), and two ML approaches, the K-nearest neighbor and XGboost ML models, to predict BCR. Results Following the application of exclusion criteria, 516 patients were deemed eligible for the study. Of those, 234 (45.3%) developed BCR, and 282 (54.7%) did not. The results showed that the median follow-up period was 24 (15–42) months, and the median BCR diagnosis was 12.23 ± 15.58 months. The area under the curve (AUC) for the Cox proportional hazard analysis was 0.77. The receiver-operating characteristic curves (AUCs) for the XGBoost and K closest neighbor models were 0.82 and 0.69, respectively. The RBFNN’s AUC was 0.82. Conclusions The classical statistical model was outperformed by XGBoost and RBFNN models in predicting BCR.

Abstract Background The tea plant, Camellia sinensis (L.) O. Kuntze, is an evergreen leafy plant whose tender leaves are used in the manufacturing of the world’s second most consumed beverage—tea. The production and consumption of tea worldwide have continually increased over the decades. All parts of the plant—leaf, stem, root, flower and seed, are fed upon by insect pests. This study elucidates the metabolomic changes occurring in tea leaves in response to infestation by two major pests in tea gardens: red spider mites and tea mosquito bugs. These pests significantly impact both the quantity and quality of tea production. The secondary metabolites produced by the tea due to pest attack has been analysed using GC–MS analysis in the laboratory. Results Mostly fatty acid derivatives were biosynthesized as secondary metabolites due to pest attack as revealed from the result. In both infestations, methyl stearate was found to be produced along with increased chromatographic peaks of compounds such as caffeine, methyl palmitate, methyl linoleate, and stigmasta-7,25-dien-3-ol. In comparison with respective control samples (leaf with no pest attack), the one attacked by red spider mite showed eighteen exclusive metabolites, whereas tea mosquito bug infested leaf showed six such exclusive metabolites. Conclusions Some metabolites were found to be either increased or decreased in their amount in both the samples. The increased compounds were reported with insecticidal and pesticidal properties with respect to respective controls. Some metabolites were markers of pest attacks i.e. plant defense mechanism induced phytochemicals according to the literature as discussed in this research.

Introduction: There is an unmet need for high-quality data for Robot-assisted partial nephrectomy (RAPN) in the Indian population. Indian study group on partial nephrectomy (ISGPN) is a consortium of Indian centers contributing to the partial nephrectomy (PN) database. The current study is a descriptive analysis of perioperative and functional outcomes following RAPN. Methods: For this study, the retrospective ISGPN database was reviewed, which included patients who underwent RAPN for renal masses at 14 centers across India from September 2010 to September 2022. Demographic, clinical, radiological, perioperative, and functional data were collected and analyzed. Ethics approval was obtained from each of the participating centers. Results: In this study, 782 patients were included, and 69.7% were male. The median age was 53 years (interquartile range [IQR 44–62]), median operative time was 180 min (IQR 133–240), median estimated blood loss was 100 mL (IQR 50–200), mean warm ischemia time was 22.7 min and positive surgical margin rates were 2.5%. The complication rate was 16.2%, and most of them were of minor grade. Trifecta and pentafecta outcomes were attained in 61.4% and 60% of patients, respectively. Conclusions: This is the largest Indian multi-centric study using the Indian Robotic PN Collaborative database to evaluate the outcomes of robot-assisted PN, and has proven its safety and efficacy in the management of renal masses.

Context: The superiority of off-clamp robot-assisted partial nephrectomy (RAPN) over the on-clamp technique has recently been questioned by randomized controlled trials comparing the two techniques. Objective: To systematically review the recent literature and perform a quantitative synthesis of data on the comparison of off-clamp versus off-clamp hilar control during RAPN. Evidence acquisition: A systematic search was performed in the PubMed, Embase, Web of Science, and Scopus databases for studies comparing off-clamp versus on-clamp RAPN in terms of perioperative and functional outcomes. The study protocol was registered in the PROSPERO database (CRD42023413160). Only prospective randomized controlled trials and retrospective matched observational studies were included. The primary outcome of the study was the percentage decrease in the estimated glomerular filtration rate (eGFR). Evidence synthesis: A total of 11 studies were included involving a total of 2483 patients (944 patients in the off-clamp and 1539 patients in the on-clamp group). There was no difference between the two groups in the percentage decline in eGFR (mean difference [MD] 0.04%, 95% confidence interval [CI] −3.7% to 3.86%; p = 0.98). There were so significant differences between the groups for length of hospital stay (p = 0.56), complications (p = 0.08), conversion to open or radical surgery (p = 0.18), estimated blood loss (p = 0.06), or need for blood transfusion (p = 0.07). The operative time was shorter in the off-clamp group (MD−21.89 min, 95% CI −42.5 to −1.27; p = 0.04) but after sensitivity analysis the difference was no longer statistically significant (p = 0.15). The positive surgical margin rate was significantly lower in the off-clamp group (odds ratio 0.6, 95% CI 0.39–0.91; p = 0.02). Conclusions: Our review revealed no clinically relevant differences in perioperative and functional outcomes between off-clamp and on-clamp RAPN. Patient summary: In this review, we compared the two methods of controlling the kidney blood vessels during robot-assisted surgery to remove part of the kidney. We noted that there was no difference between the two groups for outcomes such as complications and the decrease in kidney function after surgery.

The advancement of low-cost GNSS receivers with modern built-up characteristics has opened a new window to investigate the performance of various low-cost receivers with an outlook on their performance and suitability for varied geodetic purposes. The main objective of this study is to evaluate the positioning performance of single and double-frequency GNSS receivers in combination with geodetic antennas in static relative mode regarding Mexican regulations. The recorded observations were processed by a static relative method including the CORS station from the National Institute of Statistics and Geography in Mexico (INEGI). The results of the survey conducted at a distance of 4 and 33 km from CORS station show similar accuracy for all low-cost receivers. For low-cost GNSS receivers NEO-M8T, NEO-6T, and ZED-F9P the solutions that were obtained reached mm in horizontal precision using a geodetic grade antenna. Similarly, the ZED-F9P model was proved at a long distance from the CORS station and presents high precision. Regarding the vertical component, in all cases where the GGM10 model was included, the vertical component is not allowed to use for topography or geodetic works, however, the horizontal component where mm precision was achieved is allowed for different highly precision survey works.

Abstract:Introduction: Bezoars are non-dissolved hard masses of undigested or partially digested food or foreign material that are trapped in the gastrointestinal tract. Bezoars are broadly classified into four groups, viz; phytobezoars, trichobezoar, lactobezoars, and pharmacobezoars. One of the common sub-types of phytobezoars is amlookobezoar (diospyrobezoar). Aims: To describe the clinical profile and treatment outcome of a series of patients of amlookobezoar presenting with small bowel obstruction.Methods: This prospective observational case-series study includes five patients of both sexes presenting with small bowel obstruction (SBO) caused due to amlookobezoar. All patients were evaluated with respect to detailed history, physical examination and radiological assessment to confirm the diagnosis. Radiological assessment included X-ray abdomen, USG and CECT abdomen. Results: We had total of five cases of SBO caused due to amlookobezoars. The age of these patients ranged from 8-years to 22-years with male-female ratio of 4:1. All the 5 patients in this series presented with the features of SBO in the autumn months. None of our patients had any other significant predisposing factor for bezoar formation except that all of these patients had taken significant amount of amlooks (persimmon fruit) 3-10days earlier. Four patients eventually required the exploratory laparotomy. All the four patients had soft to firm bezoars stuck up in distal or mid-ileum. Fortunately in all these 4 patients, we were able to manually breakdown the amlookobezoars and milk them down beyond the ileocaecal level without the need for any enterotomy, gut resection or creation of stoma. In all of the 4 operated patients, the postoperative period was almost uneventful. Conclusion: Though uncommon, but amlookobezoars should be considered as differential diagnosis in a case of small bowel obstruction. Amlookobezoars commonly affects young adolescent males in the autumn months and often needs a laparotomy with fragmentation and milking down of amlookobezoars.

Background: General anaesthesia (GA) includes intubation a necessary step to provide adequate ventilation in patients under anaesthesia along with protection of airway from regurgitation and aspiration. Postoperative sore throat (POST), hoarseness of voice, cough are common sequelae. The present study compares the efficiency of preoperative nebulization of lignocaine hydrochloride and magnesium sulphate for reducing the incidence of POST in patients under GA. Methods: The study conducted in GMC Kota and attached hospitals on 100 patients of surgery duration one hour to three hours. Patients were randomly allocated in two groups Lignocaine group and Magnesium group. Results: The majority of patients belonged to the age between 40 and 70 years. There was no significant difference in the mean pulse rate, SBP, mean SpO2. Comparison of sore throat in both the groups at rest, just after extubation, 2 hours, 8 hours, 24 hours and 48 hours showed incidence more common in lignocaine group than magnesium group but no significant difference (P>0.05). Hoarsness after extubation reduced within 24 hours in Magnesium group in comparison to Lignocaine group where it persists till 48 hrs. Conclusion: Incidence of sore throat, hoarseness of voice and cough was more common in lignocaine group and more in female patients. Both drugs can be used for prevention of postoperative sore throat, but magnesium sulphate has better results.

Introduction: The literature on studies reporting trifecta or pentafecta outcomes following robot-assisted partial nephrectomy (RAPN) in Indian patients is limited. The primary aim of this study was to report and evaluate the factors predicting trifecta and pentafecta outcomes following RAPN in Indian patients using the multicentric Vattikuti collective quality initiative (VCQI) database. Methods: From the VCQI database for patients who underwent RAPN, data for Indian patients were extracted and analyzed for factors predicting the achievement of trifecta and pentafecta following RAPN. Trifecta was defined as the absence of complications, negative surgical margins, and warm ischemia period shorter than 25 min or zero ischemia. Pentafecta covers all the trifecta criteria as well as >90% preservation of estimated glomerular filtration rate (eGFR) and no stage upgrade of chronic kidney disease at 12 months. Results: In this study, among 614 patients, the trifecta was achieved in 374 patients (60.9%) and pentafecta was achieved in 24.2% of the patients. Patients who achieved trifecta had significantly higher mean age (54.1 vs. 51.0 years, P = 0.005), body mass index (BMI) (26.7 vs. 26.03 kg/m2, P = 0.022), and smaller tumor size (38.6 vs. 41.4 mm, P = 0.028). The preoperative eGFR (84.2 vs. 91.9 ml/min, P = 0.012) and renal nephrometry score (RNS) (6.96 vs. 7.87, P ≤ 0.0001) were significantly lower in the trifecta group. Comparing patients who achieved pentafecta to those who did not, we noted a statistically significant difference between the two groups for tumor size (36.1 vs. 41.5 mm, P = 0.017) and RNS (6.6 vs. 7.7, P = 0.0001). On multivariate analysis, BMI and RNS were associated with trifecta outcomes. Similarly, only RNS was identified as an independent predictor of pentafecta. Conclusions: RNS and BMI were independent predictors of the trifecta. At the same time, RNS was identified as an independent predictor of pentafecta following RAPN.

The occurrence of earthquakes, which can strike suddenly without any warning, has always posed a potential threat to humanity. However, researchers worldwide have been diligently studying the mechanisms and patterns of these events in order to develop warning systems and improve detection methods. One of the most reliable indicators for predicting large earthquakes has been the examination of electron availability in the ionosphere. This study focuses on analyzing the behavior of the Total Electron Content (TEC) in the ionosphere during the 30-day period leading up to the three most devastating earthquakes of the past decade. Specifically, the data were examined from the cGPS stations closest to the epicenters: MERS for the Turkey earthquake with 7.8 Mw on 6 February 2023, CHLM for the Nepal earthquake with 7.8 Mw on 25 April 2015, and MIZU for the Japan earthquake with 9.1 Mw on 11 March 2011. Notable positive and negative anomalies were observed for each earthquake, and the vertical Total Electron Content (vTEC) for each PRN (pseudo-random number) was plotted to determine the specific time of the TEC anomaly. The spatial distribution of vTEC for the anomalous specific time revealed that the anomalies were in close proximity to the earthquake epicenters, particularly within denser fault zones.

Global Positioning System (GPS) Continuously Operating Reference Station (CORS) data analysis shows that the ionosphere's electron density variability is linked to the deformation and stress accumulation in the Earth's crust. Anomalies in ionosphere total electron content (TEC) variability before 2021 M6.4 Sonitpur, Assam earthquake were detected using L1 and L2 GPS frequencies that showed three distinct abnormalities on April 3, 9, 10, 2021. Pearson's correlation coefficient (r) of TEC decreases in the CORS that lies away from the earthquake epicenter, indicating the possibilities of a positive relationship between TEC variability and earthquake epicenter. TEC concentration also decreases towards the epicenter within the earthquake preparation zone (EPZ). It is also observed that the Pearson's correlation coefficient (r) of TEC decreases linearly near the EPZ. The study demonstrates the possibilities of determining the TEC anomalous zone in the ionosphere that coincides with the EPZ in the crustal rocks. The research indicated the possibilities of magnitude estimation of an impending earthquake based on the TEC anomalous zone in the ionosphere using closely spaced dense CORS network data.

The present analysis provided the quality assessment of 65 Continuous Operating Reference Stations (CORS) situated in and around Mexico using the data of about ten years (January 2010 to January 2020). To accomplish the assessment, we considered 4 quality indexes for performing the quality check, incluing the multipath effect on L1 and L2 bands, signal-to-noise ratio in both bands, cycle slips, and integrity. Meanwhile, a new reference parameter named regional values for Mexico (RVM) was calculated for the stations situated in Mexico. Additionally, an exhaustive analysis of the quality indicators in the worst and best cases was performed. The signal degradation was proved by a long-term time series and crustal deformation analysis in GAMIT/GLOBK platform. The results showed a strong correlation between integrity, cycle slips and daily observations time, and the multipath effect is strong in the case of outdated systems. The study indicates that the estimated quality indexes and values could be the basis for establishing new CORS in Mexico, and the errors corrections which cannot be mitigated in the post-processing stage would greatly help utilize the data for different scientific applications. The results were supported by deformation analysis in part of Baja California Peninsula in Mexico indicating northern and eastern velocity vector of −3.08 ± 0.02 mm/yr, −7.85 ± 0.02 mm/yr and −0.07 ± 0.03 mm/yr, −9.33 ± 0.02 mm/yr respectively at MPR1 and INEG stations.

The study delves into the relationship between ionospheric total electron content (TEC) anomalies and seismic activity, with a focus on Morocco’s 6.8 Mw earthquake on 8 September 2023, lying within a tectonically active region at the convergence of the African and Eurasian Plates. To enhance the reliability of our findings, we incorporate space weather conditions, utilizing indices (Dst, Kp, and F10.7) to pinpoint periods of stable space weather. This minimizes the possibility of erroneously attributing natural ionospheric fluctuations to seismic events. Notably, our TEC analysis unveils positive and negative anomalies, with some occurring up to a week before the earthquake. These anomalies, exceeding predefined thresholds, provide compelling evidence of significant deviations from typical ionospheric conditions. Spatial mapping techniques employing both station-specific vTEC data and pseudorandom noise codes (PRNs) from multiple global navigation satellite system (GNSS) stations highlight a strong correlation between ionospheric anomalies and the earthquake’s epicenter. The integration of PRNs enhances coverage and sensitivity to subtle anomalies. Additionally, the analysis of satellite imagery and ground displacement data using Sentinel-1 confirms significant ground uplift of approximately 15 cm following the earthquake, shedding light on surface responses to seismic events. These findings underscore the potential of ionospheric science in advancing earthquake early warning systems and deepening our understanding of earthquake precursors, thus contributing to the mitigation of seismic event impacts and the protection of lives and infrastructure.

Introduction: Outcomes of robot-assisted partial nephrectomy (RAPN) depend on tumor complexity, surgeon experience and patient profile among other variables. We aimed to study the perioperative outcomes of RAPN for patients with complex renal masses using the Vattikuti Collective Quality Initiative (VCQI) database that allowed evaluation of multinational data. Methods: From the VCQI, we extracted data for all the patients who underwent RAPN with preoperative aspects and dimensions used for an anatomical (PADUA) score of ≥10. Multivariate logistic regression was conducted to ascertain predictors of trifecta (absence of complications, negative surgical margins, and warm ischemia times [WIT]

Introduction: Literature on the factors predicting functional and oncological outcomes following robot-assisted radical prostatectomy (RARP) is sparse for the Indian population. Hence, the primary objective of this study was to develop preoperative and postoperative nomograms predicting these outcomes in patients with prostate cancer undergoing RARP. Methods: This retrospective analysis identified the predictors of quadrifecta outcomes, i.e., the patients who did not have complications, were continent, had negative surgical margins, and were biochemical recurrence free with at least 1 year of follow-up following RARP. We excluded the return of sexual potency as the majority of the patients in our series were sexually inactive preoperatively. We used the backward stepwise logistic regression analysis method to identify the predictors of quadrifecta. Preoperative and postoperative nomograms using these predictors were developed and validated with bootstrapping, goodness of fit, calibration plot, decision curve analysis (DCA), and theits receiver operating characteristic (ROC) analysis. Results: Of the 688 patients who underwent RARP, 399 were included in this study, and 123 (30.8%) of these achieved the quadrifecta outcomes. Preoperative nomogram was developed using four variables, i.e., prostate-specific antigen (PSA), Charlson Comorbidity Index (CCI), biopsy Gleason score, and clinical stage. Postoperative nomogram included PSA, CCI, pathological tumor stage, tumor grade, and positive lymph node. Both the models were internally valid on bootstrapping, calibration plots, and goodness of fit. On the ROC analysis, preoperative and postoperative nomograms had an area under the curve of 0.71 and 0.79, respectively. On the DCA, at a threshold probability of 5%, both the models showed a net benefit. Conclusions: We developed and validated accurate nomograms for predicting quadrifecta outcomes following RARP for the Indian population.

Introduction: Multiple studies have been published recently assessing feasibility of robot-assisted partial nephrectomy (RAPN) for moderate to highly complex renal masses. Some studies have even compared partial nephrectomy (PN) performed through various modalities such as open PN (OPN) versus RAPN and laparoscopic PN (LPN) versus OPN. The primary aim of this review was to analyze perioperative outcomes such as warm ischemia time (WIT), duration of surgery, estimated blood loss (EBL), complications, blood transfusion, length of stay, and margin status following RAPN for complex renal masses. Another objective was to compare perioperative outcomes following various surgical modalities, i.e., OPN, LPN, or RAPN. Methods: Literature search was conducted to identify studies reporting perioperative outcomes following RAPN for moderate (Radius, Endophytic/Exophytic, Nearness, Anterior/posterior location [RENAL] score 7–9 or Preoperative Aspects of Dimension used for anatomic classification [PADUA] score 8–9) to high complexity renal masses (RENAL or PADUA score ≥ 10). Meta-analysis of robotic versus OPN and robotic versus LPN was also performed. Study protocol was registered with PROPSERO (CRD42019121259). Results: In this review, 22 studies including 2,659 patients were included. Mean duration of surgery, WIT, and EBL was 132.5–250.8 min, 15.5–30 min, and 100–321 ml, respectively. From pooled analysis, positive surgical margin, need for blood transfusion, minor and major complications were seen in 3.9%, 5.2%, 19.3%, and 6.3% of the patients. No significant difference was noted between RAPN and LPN for any of the perioperative outcomes. Compared to OPN, RAPN had significantly lower EBL, complications rate, and need for transfusion. Conclusions: RAPN for moderate to high complexity renal masses is associated with acceptable perioperative outcomes. LPN and RAPN were equal in terms of perioperative outcomes for complex masses whereas, OPN had significantly higher blood loss, complications rate, and need for transfusion as compared to RAPN.

ABSTRACT Introduction: Tramadol has been used for the treatment of premature ejaculation, however, the studies published for the same are not well designed. The primary objective of this study was to explore the literature pertaining to the use of tramadol in patients with PE to determine its safety and efficacy in this population. Materials ande methods: Systematic literature search of various electronic databases was conducted to include all the randomized studies and quasi-randomized studies. Standard PRISMA (Preferred reporting Items for Systematic reviews and Meta-analysis) guidelines were pursued for this review and study protocol was registered with PROSPERO (CRD42019123381). Results: Out of 9 studies included in this review, 5 were randomized controlled trials, and rests of the 4 studies were quasi-randomized studies. Tramadol resulted in significantly higher improvement of IELT with the mean difference (MD) of 139.6 seconds and confidence interval (CI) 106.5-172.6 seconds with a p-value of p

Abstract To compare the safety and efficacy of various surgical modalities to manage large (> 1 cm) upper ureter stones. Systematic literature search was conducted to include all randomized studies comparing various treatment options for large (> 1 cm) upper ureteric stones. This review included 13 randomized studies with 1871 patients. Laparoscopic ureterolithotomy (LUL) and percutaneous nephrolithotomy (PNL) were superior to ureteroscopy (URS) and shockwave lithotripsy (SWL) for stone-free rates and need for auxiliary treatments. LUL and PNL were equally effective for stone-free rates and the need for auxiliary treatments. According to SUCRA values for stone-free rates and the need for auxiliary treatments, LUL was the best, followed by PNL. For the duration of surgery, there was no significant difference among all the techniques on network analyses, and SWL was the best according to SUCRA values. Length of hospital stay was significantly shorter for URS than LUL and PNL from network analysis, but there was no significant difference for the rest of the comparisons. Overall complications were similar in all the groups. According to the CINeMa approach, the confidence rating ranged from “very low” to “moderate” for various comparisons. LUL followed by PNL is the most efficacious treatment modality for upper ureteric stones compared to SWL and URS in terms of stone-free rates. However, due to the poor quality of included studies, further high-quality randomized studies are needed.

We studied geomorphic indices related to tectonics along the Borpani River using Cartosat 10 m spatial resolution Digital Elevation Model (DEM) data. A total of 11 geomorphic indices such as transverse topographic symmetry factor (Tt), drainage basin asymmetry (AF), valley floor width to valley height ratio (Vf), bifurcation ratio (Rb), hypsometric integral (HI), basin elongation ratio (Re), basin shape index (Bs), circularity ratio (Rc), drainage density (Dd), relief ratio (Rh), hypsometric curves (HC) were studied to access the tectonics along the river in selected locations. Five locations along the river were selected for detailed analysis (sub-basin I, II a, II b, III, and IV). Horton's (1945) scheme was adopted for watershed delineation, while stream ordering was performed using Strahler's (1964) method. The results infer that the sub-basins along the Borpani River are tectonically active. In the case of sub-basin I, 3 geomorphic indices out of 11 falls in the category of highly active, and 2, 1, 2, and 4 indices out of 11 falls in the category of highly active in the case of sub-basins II a, II b, III, and IV. Similarly, 4, 1, 3, 6, 1 and 4, 8, 7, 3, 6 indices fall under moderately active and low active classes in sub-basins I, II a, II b, III, and IV. On average, 23.86 %, 29.54%, and 46.58% of the geomorphic indices fall in the active, moderately active, and low active classes.

Introduction: Hilar tumors are a unique subset of complex renal masses posing a potential surgical challenge during partial nephrectomy. The outcomes of hilar masses have not been compared to non-hilar renal masses of similar RENAL nephrometry score (RNS). In this study, we analyzed the outcomes of hilar versus nonhilar masses after a propensity score matching. Methods: Prospectively maintained database of patients who underwent robot assisted PN between November 2014 and December 2018 was abstracted for hilar and nonhilar tumors. We performed propensity matching for baseline variables such as age, sex, body mass index, comorbidities, preoperative glomerular filtration rate, and RNS for each patient on the basis of propensity scores. Results: We included 48 patients with hilar tumors and 153 with nonhilar tumors. On propensity matching, 41 patients were included in each group. The mean operative time (162.4 ± 48.9 min vs. 144.1 ± 38.8 min, P = 0.48), warm ischemia time (29.0 ± 8.8 min vs. 24.4 ± 8.2 min, P = 0.12), and the estimated blood loss (201.8 ± 184.7 ml vs. 150.6 ± 160.5 ml, P = 0.37) were not significantly different between the hilar and the nonhilar groups. Trifecta was achieved in only 14/41 (34.1%) of the patients in the hilar group as compared to 24/41 (58.5%) in the nonhilar group (P = 0.027). Logistic regression analysis identified that hilar location of the tumors was not an independent predictor of overall complications (OR 6.37, confidence interval [CI] 0.5–69.4, P = 0.4), trifecta (OR 0.38, CI 0.14–1.0, P = 0.051), and pentafecta outcomes (OR 0.4, CI 0.1–1.51, P = 0.17). Conclusions: Hilar location was associated with poorer trifecta outcomes compared to the nonhilar tumors. However, hilar location per se was not an independent predictor of overall complications and trifecta and pentafecta outcomes.

The Ganges River Dolphin Platanista gangetica has been classified as Endangered in the IUCN Red List of Threatened Species. The IUCN changed its status from ‘Vulnerable’ to ‘Endangered’ in 1996 as the species population was declining in its entire distribution range. It is, however, classified as ‘Critically Endangered’ in Nepal. Historically, the freshwater cetacean has been documented in the Karnali, Koshi, Narayani, and Mahakali basins. With their population and distribution range in decline, the Ganges River Dolphin (GRD) is no longer found in the Mahakali River system, which demarcates and traverses the Western border of India and Nepal. This study examines the status and distribution of the GRD in the river systems of Nepal during the monsoon of 2016. The national dolphin population survey was conducted in the three largest river basins in Nepal—Karnali, Narayani, and Koshi. Each of the three basins represent the extreme upstream limit of the GRD distribution in Ganges River basin. The national population survey included both a boat-based survey and shore-based synchronized counting in each of the three river systems. Fifty-two (Best-High-Low: 52-61-50) dolphins were counted during the entire nationwide survey, conducted in July–August, 2016. Researchers gathered social-data from locals residing alongside the observed basin, giving priority to artisanal fishers and those subsisting to some degree from the rivers known to host the river dolphin. A questionnaire survey of ninety-two residents from riparian villages adjacent to the GRD hotspots sheds light on the local perspectives towards dolphin conservation coupled with an assessment of their socio-economic status; artisanal fishing practices; and their awareness of dolphin conservation. According to the survey, notable threats to dolphin conservation are prey depletion; non-availability of suitable habitat; habitat fragmentation and a low level of awareness. Based on the counting outcomes and social survey, recommendations have been put forward for the conservation of this species.

Penile skin (PSG) and the buccal mucosa (BMGs) are the most commonly used grafts for substitution urethroplasty. The aim of this study was to compare the success rates of substitution urethroplasty using either of these grafts. We systematically searched PubMed/Medline, EMBASE, Scopus and Web of science to identify studies comparing the two types of graft urethroplasties. Search strategy was based on Patient, Intervention, Control and Outcome guidelines. Studies reporting data on success of PSG versus BMG within the same manuscript were included. Standard Preferred reporting Items for Systematic reviews and Metaanalysis guidelines were followed while conducting this review and study protocol was registered with PROSPERO in priori (CRD42018114258). Sixteen studies, including 5 prospective and 11 retrospective studies, with a total of 1406 (896 BMG and 510 PSG) patients were included in the final analysis. In the overall analysis, BMG had significantly higher success rate (83.7% vs. 76.1%, P ≤ 0.0001). Duration of followup was heterogeneous across the studies, ranging from 15.9 to 201 months. Comparing the five studies where the data on duration of follow up was available, BMG showed a significantly higher success rate compared to PSG (90% vs. 80.4%; P = 0.02). In the subgroup of patients with bulbar urethral strictures, BMG urethroplasty had significantly higher success rate (87.4% vs. 78.0%; P = 0.0001). From the results of this study, buccal mucosa may appear to be a better choice, however, the data is still immature and a properly conducted randomized controlled trial with an adequate duration of followup is required.

During the malacological survey in the Dalma Wildlife Sanctuary and different regions of Saranda forests of Deccan peninsula in Jharkhand, an unusual Florida’s native freshwater mollusc Seminole Rams-Horn, Planorbella duryi from South Karo River was encountered. Earlier, this non-indigenous species was reported from the Godavari River in the Nasik district of Maharashtra state of India although there was confusion on the presence of Planorbella scalaries and Planorbella duryi. Occurrence of P. duryi, has been confirmed along with distribution, ecology, and probable dispersal hypothesis has been discussed.

DNA barcode data of both endangered dolphin species, Platanista gangetica, and Orcaella brevirostris are lacking in the global database. The study generated partial mitochondrial cytochrome c oxidase subunit I (mtCOI) gene sequences of the two highly threatened dolphin species from India. The family Platanistidae with one species and family Delphinidae with 12 species were showed 1.2%–19.7% between species genetic divergence in the studied dataset. Both P. gangetica and O. brevirostris were revealed distinct clade in neighbor-joining (NJ) phylogeny. Further, D. delphis, S. coeruleoalba, and T. truncatus have shown more than one clade and comparatively high genetic divergence within the species suggested prominent genetic variation between different populations. The study recommends generating more DNA barcode data from diverse habitats of P. gangetica and O. brevirostris to evaluate the exact population structure and adopting better conservation strategies thereafter.

Introduction: Primary salivary gland-type tumors of the lung (PSGTTL) are rare intrathoracic malignant neoplasms. Their description in literature is largely limited to a few case series and case reports. A systematic review and pooled analysis of the previously reported cases of PSGTTL is presented here. Methods: Electronic database of PubMed using keywords “lung neoplasm” AND “salivary gland tumors” was used to identify the papers documenting the PSGTTL. Filters (publication date from January 1, 1900–-December 31, 2015, Humans and English) were applied to refine the search. A pooled analysis of clinical, pathological, treatment, and survival data was performed. Results: The present systematic review included 5 studies and a total of 233 patients. Mean age of the patients was 41 years (range 6–80 years) and there was a male preponderance (1.3:1). Common pathological types were mucoepidermoid (MEC) (56.6%), adenoid cystic (ACC) (39.5%), and epithelial-myoepithelial cancer (3.8%). Tumors were located in the central airways (trachea and major bronchi) in 43.3% of patients. Weighted median tumor size was 4.2 cm. Surgery was the primary treatment undertaken in 82.4% of the patients, while radiotherapy and chemotherapy were also used in 15.9% and 9.4% of the patients. Lymph node involvement was seen in 15.2% of the patients. Disease recurrences were observed in 21.1% of the patients (12.9% and 37.5% in MEC and ACC, respectively). Three-, 5-, and 10-year weighted overall survival was 86.4%, 81.4%, and 73.6% (93.8%, 90.0%, and 85.0%, respectively, for MEC and 76.7%, 62.8%, and 50.5%, respectively, for ACC). Conclusion: Surgery is the primary treatment of PSGTTL to achieve long-term survival. Role of chemotherapy and radiotherapy in the management of PSGTTL warrants further studies.

Total Electron Content (TEC) in the ionosphere changes before an earthquake and is one of the important parameters in the study of earthquake precursors. Monitoring of TEC in real-time may prove an excellent input for the effective precursory study of earthquakes. In the present study, a Monitoring system was developed to integrate TEC, geomagnetic storm, and solar flare data and to carry out a TEC anomaly study before earthquakes occurred. The system integrates data from publicly available sources, carries out statistical analysis in the background to detect an anomaly and sends an email notification for the anomaly detected. The system auto-updates at 9.00 a.m. IST daily to check for any missing data in the past 30 days. The system enables observations of the ionosphere conditions before an Earthquake and may help in understanding earthquake precursors and space weather conditions. The system has been demonstrated studying the recent cluster of earthquakes that occurred during July–August 2020 in Tibet, where a series of anomalies were observed during 15, 20, 23, 25 & 28 2020; 02 & July 05, 2020; 06, 08, 10, 15, 25 & July 27, 2020, and August 16, 2020, before the earthquakes. Therefore, the study presents TEC monitoring on a daily basis and its integration with dependent variables in a single platform for effective research on earthquake precursor detection.

Abstract This article is a commentary on an article published in World Journal of Surgical Oncology by Liu et al. With this study, authors evaluated diagnostic accuracy of Xpert bladder cancer monitor in detecting recurrences. With this article, we highlight the strengths and limitations of the study.

A positional accuracy obtained by the Precise Point Positioning and static relative methods was compared and analyzed. Test data was collected using low-cost GNSS receivers of single- and dual-frequency in urban areas. The data was analyzed for quality using the TEQC program to determine the degree of affectation of the signal in the urban area. Low-cost GNSS receivers were found to be sensitive to the multipath effect, which impacts positioning. The horizontal and vertical accuracy was evaluated with respect to Mexican regulations for the GNSS establishment criteria. Probable Error Circle (CEP) and Vertical Positioning Accuracy (EPV) were performed on low cost GNSS receiver observation data. The results show that low-cost dual-frequency GNSS receivers can be used in urban areas. The precision was obtained in the order of 0.013 m in the static relative method. The results obtained are comparable to a geodetic receiver in a geodetic baseline of

Renal arteriovenous malformation can be rarely associated with a renal mass. A vigilant approach and careful planning is required to tackle both the pathologies in form of preoperative coil embolization followed by a minimally invasive radical nephrectomy.

Nonmetastatic hepatic dysfunction known as Stauffer's syndrome is a rare entity. It is commonly associated with clear cell carcinoma of kidney. Rarely it has been reported in cases of prostatic carcinoma, bronchogenic tumor and lymphoproliferative diseases. Stauffer s syndrome presents as elevated alkaline phosphatase, aminotransferases, and prolonged prothrombin time without jaundice. However a very rare variant of Stauffer's syndrome presenting with jaundice has been reported in few case reports of clear cell carcinoma of kidney. But such a presentation in cases of renal sarcomas has not been reported so far. Here we report a unique case of primary synovial sarcoma of kidney presenting as nonmetastatic cholestatic jaundice. Keywords: Renal synovial sarcoma, Jaundice, Paraneoplastic, Stauffers syndrome

Facial asymmetry can be attributed to various conditions from developmental to malignancy. Depending upon the etiology, the treatment plan has to be modified- With the latest imaging modalities we are in a better position to find whether the asymmetry is due to soft tissue or bone pathology. The case of a patient who reported with facial asymmetry and whose radiograph showed unilateral condylar hyperplasia is presented here.