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A common thread noted in many academic management system implementations was the stagnation and deterioration of their usage after the initial hype. This action research study was aimed at addressing this decline in a higher education institute after undertaking a reflective analysis of the waning usage patterns and taking appropriate initiatives to enhance their usage. The authors have attempted this as participants driving the change. As change agents, the academic management system implementation was advanced to move closer to a stage where the committed use occurred and intended benefits were realised. Several initiatives were introduced to propel this change. The scope of this article was confined to gauging the impact of the trigger factors; memos, and training on the academic management system usage. Their effects were measured by applying learning analytics to various sources of usage and performance data. This further led to analysing the relationship between usage and performance of the stakeholders; students, and faculty.

Objective: To assess the quality and readability of online information on holmium laser enucleation of the prostate in managing benign prostate hyperplasia using the most-used search engine worldwide, Google. Methods: Google search terms “Holmium laser surgery” and “enlarged prostate” were used to generate 150 search results. Two independent authors (i) excluded any paywall, scientific literature, or advertisement and (ii) conducted an independent assessment on information quality, which was based on DISCERN, QUEST, and JAMA criteria, and readability, which was based on the FKG, GFI, SMOG, and FRE scores on qualified webpages. A third author was involved if there were any discrepancies between the assessments. Results: 107 qualified webpages were included in the data analysis. The median DISCERN score was 42 out of 80 (IQR 35–49). The median JAMA score was 0 out of 4 (IQR 0–1). The median QUEST score was 9 out of 28 (IQR 9–12). Using the non-parametric ANOVA and post hoc Games–Howell test, significant differences were identified between rankings of webpages. Sponsorship had no influence on the quality of webpages. The overall readability level required a minimum reading level of grade 11. Linear regression analysis showed that a higher ranked webpage is a positive predictor for all three quality assessment tools. Conclusions: The overall quality of online information on HoLEP is poor. We identify that the top-ranked google searches have a higher DISCERN score and are a positive predictor for DISCERN/QUEST/JAMA. Quality online information can benefit patients but should be used in conjunction with professional medical consultation.

IntroductionThe application of mineral fertilizers deteriorates soil properties and affects crop yield and nutritional properties. However, plant growth-promoting microorganisms (PGPM- Serendipita indica, phosphorus solubilizing bacteria (PSB), and vesicular arbuscular mycorrhizae (VAM)) have great potential to reduce fertilizers and improve soil fertility, crop yield, and nutrient uptake and mitigate the environmental effect of mineral fertilizers.Material and methodsHence, a field experiment was conducted involving nine treatments to evaluate the effects of PGPM along with 50% or 100% of the recommended dose of fertilizers on plant growth, soil fertility, nutrient uptake, and onion productivity.Results and discussionResults indicated that 100% RDF combined with S. indica or PSB led to improved plant growth, and higher nutrient concentrations in both leaves and bulbs of onions compared to RDF alone. Moreover, the application of 100% RDF with S. indica increased total dry matter yield by 11.5% and 7.6% in the 2018-2019 and 2019-2020 seasons, respectively, compared to 100% RDF alone. This treatment also resulted in the highest nutrient uptake, with N uptake increasing by 6.9%-29.9%, P by 13.7%-21.7%, K by 20.0%-23.7%, and S by 18.1%-23.4%. Additionally, the combination of 100% RDF with S. indica inoculation led to a notable increase in bulb yield, with increments of 16.2% and 13.9% observed in 2018-2019 and 2019-2020, respectively, compared to 100% RDF alone. Similarly, the application of 100% RDF along with PSB inoculation resulted in an increase in bulb yield by 7.2% and 9.4% in the respective years. However, VAM did not exhibit satisfactory performance or improvements in the onion crop.ConclusionOverall, the study suggests that combining 100% RDF with S. indica or PSB can enhance onion productivity and nutrient use efficiency. The present study may open a new avenue of PGPM application in enhancing onion yield and improving the bulb quality as well as soil health. However, field trials across different regions and soil types are necessary to validate these findings for practical adoption by farmers.

When localised prostate cancer recurs after treatment, it occurs predictably in sites such as the prostatic bed, pelvic lymph nodes, spine, lung, and liver. Urethral metastasis of prostate cancer is exceedingly rare. We report a case of urethral recurrence of prostate cancer presenting as new lower urinary tract symptoms in an 82-year-old male 10 years after robotic radical prostatectomy with a very low PSA level of 0.05μg/L. This rare case highlights the need to maintain a degree of suspicion for prostate cancer recurrence in patients with a late onset of or changing lower urinary tract symptoms after radical prostatectomy.

Introduction: Splenectomy is one of the most commonly performed surgical procedures worldwide. The splenic hilum is closely related to adjacent organs like the tail of the pancreas, stomach, splenic flexure of colon, and left kidney. One of the morbid complications of splenectomy is injury to the tail of pancreas. The objective of this study was to assess the anatomical details of the pancreatic tail with respect to the splenic hilum by assessing patient’s abdominal computed tomography (CT) imaging. Methods: A total of 150 patients’ abdominal CT imaging was taken for evaluation in this study. The distance between the pancreatic tail and the splenic hilum was measured. The level of location of the pancreatic tail in relation to the splenic hilum was also noted for each patient. Results: The pancreatic tail was inferior to the level of the splenic hilum in 59.3 percent (n =89) of the patients, superior to the level of the splenic hilum in 2.0 percent (n =3) of the patients, and at the level of the hilum in 38.7 percent (n = 58) of the patients. The mean distance from the pancreatic tail to the splenic hilum was 13.1 ± 5.2 mm. Conclusion: Abdominal CT imaging will provide a road map regarding the location of the pancreatic tail and the distance between the pancreatic tail and the splenic hilum. With the preoperative CT imaging details and efficient surgical dissection as close as possible to the splenic hilum, the potential injury to the pancreatic tail can be prevented.

ObjectivesTo determine the impact of a criteria-led discharge initiative (CLD) on the hospital length of stay of patients undergoing a robotic-assisted laparoscopic prostatectomy (RALP). MethodsThis is a cohort study of prospectively collected data completed at a major tertiary hospital from December 2017 to August 2020. The CLD initiative consists of 4 criteria: clinical haemodynamic stability (heart rate < 100 beats/minute, systolic blood pressure > 100mmHg), a drain output of less than 50 mL, flatulence or bowel movement, and the ability to tolerate an oral diet. The primary outcome was hospital length of stay for patients before and after the introduction of CLD. ResultsOne hundred men undergoing RALP before the implementation of the CLD initiative were compared to 118 men undergoing RALP following the implementation of CLD. The patients had similar baseline demographic features. There was a significant difference found in hospital LOS with the pre-CLD group LOS (mean = 1.8 days, SE = 0.12) being longer than the LOS in the post-CLD group (mean = 1.4 days, SE = 0.09, P = 0.015). There were no significant between-group differences in the proportion of patients discharged on the first postoperative day and the 30-day readmission rate. ConclusionWithin our study population, we have demonstrated that the introduction of CLD was associated with reduced hospital LOS with no increase in adverse events. These findings support the need for the development of CLD in other conditions.

Abstract Onion thrips, Thrips tabaci Lindeman, an economically important onion pest in India, poses a severe threat to the domestic and export supply of onions. Therefore, it is important to study the distribution of this pest in order to assess the possible crop loss, which it may inflict if not managed in time. In this study, MaxEnt was used to analyze the potential distribution of T. tabaci in India and predict the changes in the suitable areas for onion thrips under two scenarios, SSP126 and SSP585. The area under the receiver operating characteristic curve values of 0.993 and 0.989 for training and testing demonstrated excellent model accuracy. The true skill statistic value of 0.944 and 0.921, and the continuous Boyce index of 0.964 and 0.889 for training and testing, also showed higher model accuracy. Annual Mean Temperature (bio1), Annual Precipitation (bio12) and Precipitation Seasonality (bio15) are the main variables that determined the potential distribution of T. tabaci, with the suitable range of 22–28 °C; 300–1000 mm and 70–160, respectively. T. tabaci is distributed mainly in India's central and southern states, with 1.17 × 106 km2, covering 36.4% of land area under the current scenario. Multimodal ensembles show that under a low emission scenario (SSP126), low, moderate and optimum suitable areas of T. tabaci is likely to increase, while highly suitable areas would decrease by 17.4% in 2050 20.9% in 2070. Whereas, under the high emission scenario (SSP585), the high suitability is likely to contract by 24.2% and 51.7% for 2050 and 2070, respectively. According to the prediction of the BCC-CSM2-MR, CanESM5, CNRM-CM6-1 and MIROC6 model, the highly suitable area for T. tabaci would likely contract under both SSP126 and SSP585. This study detailed the potential future habitable area for T. tabaci in India, which could help monitor and devise efficient management strategies for this destructive pest.

IntroductionClimate change affects geographical distribution of insect pests which poses threats to the environment, as well as agricultural productivity and production worldwide. Spodoptera frugiperda is commonly known as fall armyworm (FAW), a potential insect pest of monocot crops like maize, wheat, rice and sorghum globally. Among these, maize is the most preferred host crop while worldwide there are very few reports on onion being a host of fall armyworm.MethodsThe fall armyworm (FAW) was identified by examining the morphological characteristics of its immature and mature stages, as well as by analyzing the mitochondrial cytochrome oxidase 1 (COX1) gene. Further, the strain identity was confirmed through multiple sequence alignment with previously identified S. frugiperda strains from corn and rice. Also studied the biology and damage symptoms caused by FAW in onion crops.ResultsDuring our experiments, the incidence of FAW ranged from 5 to 20 percent in different plots. The highest incidence was observed in young crops (30–45 days after transplanting) that were sown in November 2020. The FAW larvae exhibited six instars, with a total larval duration of 22.2 ± 0.37 days. The pest had multiple generations per year. The fully developed larvae formed earthen cocoons in the soil for pupation, with a pupal duration of 8.0 ± 0.45 days. The male adults had a recorded longevity of 6.4± 0.40days, while the female adults lived for approximately 9.2 ± 0.37 days. The COX1 gene sequencing revealed its 100% similarity with Spodoptera frugiperda and the comparison of sequences among FAW infecting rice and maize by using multiple sequence alignment showed differences at 11 positions.DiscussionThe present study is the first report of FAW invasion in onion in India and provides basic ideas about FAW characteristics which will help to control this new invasive pest in onion. In tropical regions with multiple cropping system and seasons, it becomes very important to investigate invasive pests as well as its host range in order to forecast its potential damage and devise suitable control measures.

This study explores the potential of the natural and cost-effective method of wound healing using Alternanthera sessilis by an in vitro study (using fibroblast L929 cells). Gram-positive bacteria Staphylococcus aureus shows a zone of inhibition of 20 mm at 60 µg concentration in the antibiogram profile against the zinc oxide nanoparticles (ZnONPs) wetted in fabrics synthesized from the Amaranthaceae family. Through characterization studies of the AS-ZnONPs, it was found that UV–visible spectra show a peak in the range of 350–460 nm, Fourier transform infrared spectroscopy spectra show a correlation peak in the range of 340–4,500 cm−1, scanning electron microscope with electron diffraction analysis results in a peak in the range of 7.8–9.4, and high-resolution transmission electron microscope, which exposes the morphological character (diamond shape in a black and white background), shows a peak at 200 nm. This work shows that the leaf extract of A. sessilis might support the ancient method of wound healing.

IntroductionWaterlogging is a major stress that severely affects onion cultivation worldwide, and developing stress-tolerant varieties could be a valuable measure for overcoming its adverse effects. Gathering information regarding the molecular mechanisms and gene expression patterns of waterlogging-tolerant and sensitive genotypes is an effective method for improving stress tolerance in onions. To date, the waterlogging tolerance-governing molecular mechanism in onions is unknown.MethodsThis study identified the differentially expressed genes (DEGs) through transcriptome analysis in leaf tissue of two onion genotypes (Acc. 1666; tolerant and W-344; sensitive) presenting contrasting responses to waterlogging stress.ResultsDifferential gene expression analysis revealed that in Acc. 1666, 1629 and 3271 genes were upregulated and downregulated, respectively. In W-344, 2134 and 1909 genes were upregulated and downregulated, respectively, under waterlogging stress. The proteins coded by these DEGs regulate several key biological processes to overcome waterlogging stress such as phytohormone production, antioxidant enzymes, programmed cell death, and energy production. The clusters of orthologous group pathway analysis revealed that DEGs contributed to the post-translational modification, energy production, and carbohydrate metabolism-related pathways under waterlogging stress. The enzyme assay demonstrated higher activity of antioxidant enzymes in Acc. 1666 than in W-344. The differential expression of waterlogging tolerance related genes, such as those related to antioxidant enzymes, phytohormone biosynthesis, carbohydrate metabolism, and transcriptional factors, suggested that significant fine reprogramming of gene expression occurs in response to waterlogging stress in onion. A few genes such as ADH, PDC, PEP carboxylase, WRKY22, and Respiratory burst oxidase D were exclusively upregulated in Acc. 1666.DiscussionThe molecular information about DEGs identified in the present study would be valuable for improving stress tolerance and for developing waterlogging tolerant onion varieties.

Abstract BackgroundRhinoplasty is a complex procedure with revision rates of up to 17%. Even minor imperfections after surgery can be significant. ObjectivesThis review aims to investigate the use of hyaluronic acid (HA) fillers postaesthetic rhinoplasty and assess the rhinoplasty practice of the senior author. MethodsFrom the senior author’s practice, case records were obtained for patients who underwent surgery followed by nonsurgical rhinoplasty between 2015 and 2022. Data were retrospectively obtained and analyzed. The variables measured included the number of patients treated with fillers postoperatively, volume and type of filler used, locations of injection, and frequency of injections and complications. ResultsEight hundred patients underwent rhinoplasty between March 2015 and March 2022, and 10.6% (nnnn ConclusionsOften, there is hesitancy to use fillers after surgery due to the assumption that fillers will be required in the long term and complication rates can be high for postrhinoplasty nose fillers. From our series, we conclude that after surgery, fillers last for a greater time period than those used purely for primary augmentation. Hence, the authors recommend rhinoplasty surgeons to consider HA filler use for patients troubled by postsurgery surface irregularities. Level of Evidence: 5

The modern nanomedicine incorporates the multimodal treatments into a single formulation, offering innovative cancer therapy options. Nanosheets function as carriers, altering the solubility, biodistribution, and effectiveness of medicinal compounds, resulting in more efficient cancer treatments and reduced side effects. The non‐toxic nature of fluorinated graphene oxide (FGO) nanosheets and their potential applications in medication delivery, medical diagnostics, and biomedicine distinguish them from others. Leveraging the unique properties of Lissachatina fulica snail mucus (LfSM), FGO nanosheets were developed to reveal the novel characteristics. Consequently, LfSM was utilized to create non‐toxic, environmentally friendly, and long‐lasting FGO nanosheets. Ultraviolet–visible (UV–vis) spectroscopy revealed a prominent absorbance peak at 235 nm. The characterization of the synthesized FGO nanosheets involved X‐ray diffraction (XRD), Fourier transform infrared spectroscopy (FTIR), Raman, scanning electron microscopy (SEM), X‐ray photoelectron spectroscopy (XPS), high‐resolution transmission electron microscopy (HR‐TEM), and atomic force microscopy (AFM) analyses. The antimicrobial activity data demonstrated a broad spectrum of antibacterial effects against Escherichia coli, Bacillus subtilis, Klebsiella pneumoniae, and Pseudomonas aeruginosa. The cytotoxicity efficacy of LfSM‐FGO nanosheets against pancreatic cancer cell line (PANC1) showed promising results at low concentrations. The study suggests that FGO nanosheets made from LfSM could serve as alternate factors for in biomedical applications in the future. [ABSTRACT FROM AUTHOR]

Introduction Throughout clinical practice, most doctors will encounter patients with urological conditions. Inclusion of urological topics within medical school curriculums is important to allow doctors to effectively diagnose and manage these conditions, independently and with support from urologists. Awareness of urological education interventions and their effectiveness is essential for improving the quality and outcomes of medical student education. No systematic review of medical school education interventions on urological topics has previously been conducted. This mixed-method systematic review will assess the effectiveness of medical school education interventions on urological topics.Methods and analysis This mixed-methods systematic review will include qualitative and quantitative studies involving education interventions or practices regarding urological topics conducted within a medical school curriculum. Studies regarding other curriculums including premedical education, junior doctor prevocational education or vocational urological training will be excluded. A search of CINAHL, ERIC, EMBASE, MEDLINE will be conducted for studies published since the year 2001. Dual independent screening of titles and abstracts prior to full text review will be undertaken for all identified results during the initial searches. Any disagreement will be settled by a third reviewer. A convergent segregated approach will be used to synthesise qualitative and quantitative data independently, with the results juxtaposed to identify shared and divergent findings between study types.Ethics and dissemination No ethical approval was required for this review. Findings from this review will be disseminated via publication, reports and conference presentations.