Soil organic carbon stock in natural and restored mangrove forests in Pichavaram south-east coast of India

801-808Mangrove ecosystem is one of the important coastal ecosystems providing ecological security of the coastal area and livelihood security to the coastal fishermen.  Besides it plays an important role in carbon sequestration as large amount of carbon is stored in the below ground biomass. The role of mangrove restoration in carbon stocking has not been studied comprehensively either globally or nationally. The aim of the present study is to quantify the soil organic carbon stock and carbon sequestration rate of the different age groups of restored and natural stands of Pichavaram mangroves forest. The soil organic carbon stock of the upper soil layer (0–90 cm) of six different sites from natural mangrove stands, 21years, 17 years, 16 years, 15 years and 12 years old stands were 146.1(Mg C ha-1), 99.29 (Mg C ha-1), 93.18 (Mg C ha-1), 57.41 (Mg C ha-1), 95.54 (Mg C ha-1) and 84.84 (Mg C ha-1), respectively. Carbon sequestration rate of Pichavaram mangrove forests ranged from 2.33 to 4.44 g C m-2 year-1. The result of the study reveals that soil organic carbon stock and burial rate were high in natural mangrove area than the restored areas. In this regard, restoration and rehabilitation of mangroves is required for preserving the ecologically important mangroves ecosystem to mitigate the impacts of climate change

Dynamic Solvation in Room-Temperature Ionic Liquids

The dynamic solvation of the fluorescent probe, coumarin 153, is measured in five room-temperature ionic liquids using different experimental techniques and methods of data analysis. With time-resolved stimulated-emission and time-correlated single-photon counting techniques, it is found that the solvation is comprised of an initial rapid component of ∼55 ps. In all the solvents, half or more of the solvation is completed within 100 ps. The remainder of the solvation occurs on a much longer time scale. The emission spectra of coumarin 153 are nearly superimposable at all temperatures in a given solvent unless they are obtained using the supercooled liquid, suggesting that the solvents have an essentially glassy nature. The physical origin of the two components is discussed in terms of the polarizability of the organic cation for the faster one and the relative diffusional motion of the cations and the anions for the slower one. A comparison of the solvation response functions obtained from single-wavelength and from spectral-reconstruction measurements is provided. Preliminary fluorescence-upconversion measurements are presented against which the appropriateness of the single-wavelength method for constructing solvation correlation functions and the use of stimulated-emission measurements is considered. These measurements are consistent with the trends mentioned above, but a comparison indicates that the presence of one or more excited states distorts the stimulated-emission kinetics such that they do not perfectly reproduce the spontaneous emission data. Fluorescence-upconversion results indicate an initial solvation component on the order of ∼7 ps

Eddy Covariance Measurements of Carbon dioxide (CO2) Exchange in Pichavaram Mangrove Ecosystem, Southeast Coast of India

Net Ecosystem Productivity (NEP) and Net Ecosystem Exchange (NEE) of carbon dioxide (CO2) between the mangrove forest and the atmosphere were assessed during May 2016 to April 2017 in the Pichavaram mangrove ecosystem in India. An eddy covariance (EC) flux tower of about 10 m height was established in the middle portion of the mangrove forests to have a maximum carbon footprint from the mangroves. The EC tower was established to investigate whether the mangrove ecosystem acts as a sink or source of CO2. The monthly mean CO2 concentration varied from 376 ppm in July 2016 (during day time) to 466 ppm in December 2016 at night time. The EC based NEE showed a positive CO2 flux ranging from 4 μmol m-2s-1 in July 2016 to 6 μmol m-2s-1 in February 2017 during the night time. This was mainly due to respiration of the mangrove ecosystem. Negative CO2 flux values ranging from – 8 μmol m-2 s-1 (March 2017) to -18 μmol m-2 s-1 (August 2016) was observed during daytime, due to photosynthesis. The monthly analysis of the NEE during the daytime and night clearly indicate that the NEP of the Pichvaram mangrove was found to be positive throughout the study period suggesting that the Pichvaram mangrove ecosystem acts as a sink for CO2.The measured annual Net Ecosystem Productivity during the study period was 345 g Cm-2year-1, which is higher than the NEP reported for Sundraban mangroves (249 g C m-2 year-1). The total Gross Primary Productivity (GPP) and ecosystem respiration (Re) of the study area for the annual cycle was 2305 g C m-2 year-1and 1072 g C m-2 year-1, respectively. A long term study is needed to draw a logical conclusion on carbon sequestration potentials of this mangrove as well as to find out the role of environmental factors controlling CO2 fluxes.Keywords: Pichavaram Mangrove, Carbon dioxide, Eddy covariance, Net Ecosystem Productivity, Carbon sequestratio

Cost-Effectiveness of Robot-Assisted Radical Cystectomy vs Open Radical Cystectomy for Patients With Bladder Cancer

IMPORTANCE: The value to payers of robot-assisted radical cystectomy with intracorporeal urinary diversion (iRARC) when compared with open radical cystectomy (ORC) for patients with bladder cancer is unclear. OBJECTIVES: To compare the cost-effectiveness of iRARC with that of ORC. DESIGN, SETTING, AND PARTICIPANTS: This economic evaluation used individual patient data from a randomized clinical trial at 9 surgical centers in the United Kingdom. Patients with nonmetastatic bladder cancer were recruited from March 20, 2017, to January 29, 2020. The analysis used a health service perspective and a 90-day time horizon, with supplementary analyses exploring patient benefits up to 1 year. Deterministic and probabilistic sensitivity analyses were undertaken. Data were analyzed from January 13, 2022, to March 10, 2023. INTERVENTIONS: Patients were randomized to receive either iRARC (n = 169) or ORC (n = 169). MAIN OUTCOMES AND MEASURES: Costs of surgery were calculated using surgery timings and equipment costs, with other hospital data based on counts of activity. Quality-adjusted life-years were calculated from European Quality of Life 5-Dimension 5-Level instrument responses. Prespecified subgroup analyses were undertaken based on patient characteristics and type of diversion. RESULTS: A total of 305 patients with available outcome data were included in the analysis, with a mean (SD) age of 68.3 (8.1) years, and of whom 241 (79.0%) were men. Robot-assisted radical cystectomy was associated with statistically significant reductions in admissions to intensive therapy (6.35% [95% CI, 0.42%-12.28%]), and readmissions to hospital (14.56% [95% CI, 5.00%-24.11%]), but increases in theater time (31.35 [95% CI, 13.67-49.02] minutes). The additional cost of iRARC per patient was £1124 (95% CI, -£576 to £2824 [US $1622 (95$831 to $4075)]) with an associated gain in quality-adjusted life-years of 0.01124 (95$144 312) per quality-adjusted life-year gained. Robot-assisted radical cystectomy had a much higher probability of being cost-effective for subgroups defined by age, tumor stage, and performance status. CONCLUSIONS AND RELEVANCE: In this economic evaluation of surgery for patients with bladder cancer, iRARC reduced short-term morbidity and some associated costs. While the resulting cost-effectiveness ratio was in excess of thresholds used by many publicly funded health systems, patient subgroups were identified for which iRARC had a high probability of being cost-effective. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT03049410

Robot-assisted Radical Cystectomy Versus Open Radical Cystectomy: A Systematic Review and Meta-analysis of Perioperative, Oncological, and Quality of Life Outcomes Using Randomized Controlled Trials

CONTEXT: Differences in recovery, oncological, and quality of life (QoL) outcomes between open radical cystectomy (ORC) and robot-assisted radical cystectomy (RARC) for patients with bladder cancer are unclear. OBJECTIVE: This review aims to compare these outcomes within randomized trials of ORC and RARC in this context. The primary outcome was the rate of 90-d perioperative events. The secondary outcomes included operative, pathological, survival, and health-related QoL (HRQoL) measures. EVIDENCE ACQUISITION: Systematic literature searches of MEDLINE, Embase, Web of Science, and clinicaltrials.gov were performed up to May 31, 2022. EVIDENCE SYNTHESIS: Eight trials, reporting 1024 participants, were included. RARC was associated with a shorter hospital length of stay (LOS; mean difference [MD] 0.21, 95% confidence interval [CI] 0.03-0.39, p = 0.02) than and similar complication rates to ORC. ORC was associated with higher thromboembolic events (odds ratio [OR] 1.84, 95% CI 1.02-3.31, p = 0.04). ORC was associated with more blood loss (MD 322 ml, 95% CI 193-450, p < 0.001) and transfusions (OR 2.35, 95% CI 1.65-3.36, p < 0.001), but shorter operative time (MD 76 min, 95% CI 39-112, p < 0.001) than RARC. No differences in lymph node yield (MD 1.07, 95% CI -1.73 to 3.86, p = 0.5) or positive surgical margin rates (OR 0.95, 95% CI 0.54-1.67, p = 0.9) were present. RARC was associated with better physical functioning or well-being (standardized MD 0.47, 95% CI 0.29-0.65, p < 0.001) and role functioning (MD 8.8, 95% CI 2.4-15.1, p = 0.007), but no improvement in overall HRQoL. No differences in progression-free survival or overall survival were seen. Limitations may include a lack of generalization given trial patients. CONCLUSIONS: RARC offers various perioperative benefits over ORC. It may be more suitable in patients wishing to avoid blood transfusion, those wanting a shorter LOS, or those at a high risk of thromboembolic events. PATIENT SUMMARY: This study compares robot-assisted keyhole surgery with open surgery for bladder cancer. The robot-assisted approach offered less blood loss, shorter hospital stays, and fewer blood clots. No other differences were seen

Multi-domain quantitative recovery following Radical Cystectomy for patients within the iROC (Robot Assisted Radical Cystectomy with intracorporeal urinary diversion versus Open Radical Cystectomy) Randomised Controlled Trial: The first 30 patients

Many patients develop complications after radical cystectomy (RC) [1]. Reductions in morbidity have occurred through centralisation and technical improvements [2], and perhaps through robot-assisted RC (RARC). Whilst RARC is gaining popularity, there are concerns about oncological safety [3] and extracorporeal reconstruction [4], and randomised controlled trials (RCTs) find little difference [5]. We are conducting a prospective RCT comparing open RC and RARC with mandated intracorporeal reconstruction (Robot-assisted Radical Cystectomy with intracorporeal urinary diversion versus Open Radical Cystectomy [iROC] trial) [6]

Robot-assisted Radical Cystectomy Versus Open Radical Cystectomy: A Systematic Review and Meta-analysis of Perioperative, Oncological, and Quality of Life Outcomes Using Randomized Controlled Trials

© 2023 The Authors. Published by Elsevier B.V. on behalf of European Association of Urology. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/)Context: Differences in recovery, oncological, and quality of life (QoL) outcomes between open radical cystectomy (ORC) and robot-assisted radical cystectomy (RARC) for patients with bladder cancer are unclear.  Objective: This review aims to compare these outcomes within randomized trials of ORC and RARC in this context. The primary outcome was the rate of 90-d perioperative events. The secondary outcomes included operative, pathological, survival, and health-related QoL (HRQoL) measures.  Evidence acquisition: Systematic literature searches of MEDLINE, Embase, Web of Science, and clinicaltrials.gov were performed up to May 31, 2022.  Evidence synthesis: Eight trials, reporting 1024 participants, were included. RARC was associated with a shorter hospital length of stay (LOS; mean difference [MD] 0.21, 95% confidence interval [CI] 0.03–0.39, p = 0.02) than and similar complication rates to ORC. ORC was associated with higher thromboembolic events (odds ratio [OR] 1.84, 95% CI 1.02–3.31, p = 0.04). ORC was associated with more blood loss (MD 322 ml, 95% CI 193–450, p < 0.001) and transfusions (OR 2.35, 95% CI 1.65–3.36, p < 0.001), but shorter operative time (MD 76 min, 95% CI 39–112, p < 0.001) than RARC. No differences in lymph node yield (MD 1.07, 95% CI –1.73 to 3.86, p = 0.5) or positive surgical margin rates (OR 0.95, 95% CI 0.54–1.67, p = 0.9) were present. RARC was associated with better physical functioning or well-being (standardized MD 0.47, 95% CI 0.29–0.65, p < 0.001) and role functioning (MD 8.8, 95% CI 2.4–15.1, p = 0.007), but no improvement in overall HRQoL. No differences in progression-free survival or overall survival were seen. Limitations may include a lack of generalization given trial patients.  Conclusions: RARC offers various perioperative benefits over ORC. It may be more suitable in patients wishing to avoid blood transfusion, those wanting a shorter LOS, or those at a high risk of thromboembolic events.  Patient summary: This study compares robot-assisted keyhole surgery with open surgery for bladder cancer. The robot-assisted approach offered less blood loss, shorter hospital stays, and fewer blood clots. No other differences were seen.Peer reviewe

Major urological cancer surgery for patients is safe and surgical training should be encouraged during the COVID-19 pandemic : A multi-centre analysis of 30-day outcomes

Funding Information: Funding/Support and role of the sponsor: Wei Shen Tan is funded by the Urology Foundation . Publisher Copyright: © 2021 The Author(s) Copyright: Copyright 2021 Elsevier B.V., All rights reserved.COVID-19 has resulted in the deferral of major surgery for genitourinary (GU) cancers with the exception of cancers with a high risk of progression. We report outcomes for major GU cancer operations, namely radical prostatectomy (RP), radical cystectomy (RC), radical nephrectomy (RN), partial nephrectomy (PN), and nephroureterectomy performed at 13 major GU cancer centres across the UK between March 1 and May 5, 2020. A total of 598 such operations were performed. Four patients (0.7%) developed COVID-19 postoperatively. There was no COVID-19–related mortality at 30 d. A minimally invasive approach was used in 499 cases (83.4%). A total of 228 cases (38.1%) were described as training procedures. Training case status was not associated with a higher American Society of Anesthesiologists (ASA) score (p = 0.194) or hospital length of stay (LOS; p > 0.05 for all operation types). The risk of contracting COVID-19 was not associated with longer hospital LOS (p = 0.146), training case status (p = 0.588), higher ASA score (p = 0.295), or type of hospital site (p = 0.303). Our results suggest that major surgery for urological cancers remains safe and training should be encouraged during the ongoing COVID-19 pandemic provided appropriate countermeasures are taken. These real-life data are important for policy-makers and clinicians when counselling patients during the current pandemic. Patient summary: We collected outcome data for major operations for prostate, bladder, and kidney cancers during the COVID-19 pandemic. These surgeries remain safe and training should be encouraged during the ongoing pandemic provided appropriate countermeasures are taken. Our real-life results are important for policy-makers and clinicians when counselling patients during the COVID-19 pandemic.Peer reviewe

Clinical pharmacist understanding of the 2013 American college of cardiology/American heart association cholesterol guideline

Background: Clinical pharmacists are frequently involved in the management of dyslipidemia, yet clinical pharmacists\u27 knowledge, awareness, and the level of agreement with the 2013 American College of Cardiology (ACC)/American Heart Association (AHA) cholesterol guideline are unknown. Objective: The objective of the study was to examine clinical pharmacists\u27 knowledge, awareness, and the level of agreement with the 2013 ACC/AHA cholesterol guideline. Methods: We administered a validated questionnaire via an online survey that was electronically mailed to clinical pharmacists. We compared responses between those in practice for ≤ 10 and those in practice for \u3e 10 years, and according to practice specialty. Results: The response rate was 11% (314 of 2845). Most respondents were from the Midwestern and Southeastern US, in practice for ≤ 10 years, and practiced in family practice/primary care. Nearly all (92%) respondents had read the guideline and 72% were able to identify the 4 statin benefit groups. Notable knowledge gaps included recalling the 4 outcomes of the 10-year atherosclerotic cardiovascular disease (ASCVD) risk estimator (41.4%), understanding differences between the Framingham Risk Score and the ASCVD risk estimator (33.7%), and monitoring lipids after initiating a statin (41.1%). More knowledge gaps were identified in those practicing for \u3e 10 years and who specialized in internal medicine. The use of the ASCVD risk estimator was high; yet nearly half (44.2%) were concerned whether the ASCVD risk estimator would overestimate 10-year ASCVD risk. Conclusion: Although most clinical pharmacists had read the 2013 ACC/AHA cholesterol guideline, several knowledge gaps were identified, especially among those with more experience and those practicing in internal medicine. Targeted education efforts are needed to address these gap

Robotic Assisted Radical Cystectomy with Extracorporeal Urinary Diversion Does Not Show a Benefit over Open Radical Cystectomy: A Systematic Review and Meta-Analysis of Randomised Controlled Trials.

BACKGROUND:The number of robotic assisted radical cystectomy (RARC) procedures is increasing despite the lack of Level I evidence showing any advantages over open radical cystectomy (ORC). However, several systematic reviews with meta-analyses including non-randomised studies, suggest an overall benefit for RARC compared to ORC. We performed a systematic review with meta-analysis of randomised controlled trials (RCTs) to evaluate the perioperative morbidity and efficacy of RARC compared to ORC in patients with bladder cancer. METHODS:Literature searches of Medline/Pubmed, Embase, Web of Science and clinicaltrials.gov databases up to 10th March 2016 were performed. The inclusion criteria for eligible studies were RCTs which compared perioperative outcomes of ORC and RARC for bladder cancer. Primary objective was perioperative and histopathological outcomes of RARC versus ORC while the secondary objective was quality of life assessment (QoL), oncological outcomes and cost analysis. RESULTS:Four RCTs (from 5 articles) met the inclusion criteria, with a total of 239 patients all with extracorporeal urinary diversion. Patient demographics and clinical characteristics of RARC and ORC patients were evenly matched. There was no significant difference between groups in perioperative morbidity, length of stay, positive surgical margin, lymph node yield and positive lymph node status. RARC group had significantly lower estimated blood loss (p<0.001) and wound complications (p = 0.03) but required significantly longer operating time (p<0.001). QoL was not measured uniformly across trials and cost analysis was reported in one RCTs. A test for heterogeneity did highlight differences across operating time of trials suggesting that surgeon experience may influence outcomes. CONCLUSIONS:This study does not provide evidence to support a benefit for RARC compared to ORC. These results may not have inference for RARC with intracorporeal urinary diversion. Well-designed trials with appropriate endpoints conducted by equally experienced ORC and RARC surgeons will be needed to address this