Hydrologic variability governs GHG emissions in rice-based cropping systems of Eastern India.

Reducing methane (CH4) emissions is increasingly recognized as an urgent greenhouse gas mitigation priority for avoiding ecosystem 'tipping points' that will accelerate global warming. Agricultural systems, namely ruminant livestock and rice cultivation are dominant sources of CH4 emissions. Efforts to reduce methane from rice typically focus on water management strategies that implicitly assume that irrigated rice systems are consistently flooded and that farmers exert a high level of control over the field water balance. In India most rice is cultivated during the monsoon season and hydrologic variability is common, particularly in the Eastern Gangetic Plains (EGP) where high but variable rainfall, shallow groundwater, and subtle differences in topography interact to create complex mosaics of field water conditions. Here, we characterize the hydrologic variability of monsoon season rice fields (n = 207) in the Indian EGP ('Eastern India') across two contrasting climate years (2021, 2022) and use the Denitrification Decomposition (DNDC) model to estimate GHG emissions for the observed hydrologic conditions. Five distinct clusters of field hydrology patterns were evident in each year, but cluster characteristics were not stable across years. In 2021, average GHG emissions (8.14 mt CO2-eq ha-1) were twice as high as in 2022 (3.81 mt CO2-eq ha-1). Importantly, intra-annual variability between fields was also high, underlining the need to characterize representative emission distributions across the landscape and across seasons to appropriately target GHG mitigation strategies and generate accurate baseline values. Simulation results were also analyzed to identify main drivers of emissions, with readily identified factors such as flooding period and hydrologic interactions with crop residues and nitrogen management practices emerging as important. These insights provide a foundation for understanding landscape variability in GHG emissions from rice in Eastern India and suggest priorities for mitigation that honor the hydrologic complexity of the region.

Plastic Pandemic after COVID-19: A Global Health Concern.

Abstract: COVID-19 pandemic has increased the amount of plastic burden to environment and complexities of plastic waste management. Change in behavioral pattern with advent of this pandemic led to increased practice of hygiene and increased use of different types of personal protective equipment. Unfortunately, rapid rise in production of the PPEs (like Hazmat suit, gloves, etc.) and single-use plastics used in RT-PCR and other testing are the biggest source for increased non-biodegradable plastic waste leading to amplified burden on plastic waste management. A number of measures like prioritizing the policies directed towards changes at behavioral, social and institutional level need to be started. Also, reduction in plastic waste along with proper plastic waste management policies should be implemented. To prevent the transition from one pandemic to other; improvement in government policies with public private partnership are the need of the hour.

Effect of the global electroneutrality condition on electromigration Taylor-Aris dispersion in a microcapillary with finite Debye layer thickness.

In this work, the electromigration dispersion (EMD) due to the charged electrolytes in microchannels is considered without using the thin electrical double layer assumption. The electrokinetic flow and transport of ions are actuated within a rectangular micro-/nanochannel having a negative surface charge density under the influence of an external electric field. Due to the local variation of the conductivity and the nonvalidity of the electroneutrality condition, the local electric field varies as a function of the solute concentration, wall surface charge density, valency, and Debye layer length. The resulting electrokinetic flow due to the external electric field drives the fluid along with the charged species, where the Taylor-Aris dispersion separates the solutes into their different constituents. The local concentration dependence of the electric field leads to the formation of concentration profiles that are slightly asymmetric with respect to the standard Gaussian distribution. Including a finite Debye layer thickness has an effect on the advection of the species as well as the diffusion of the species. It is found that in cases where Debye layers are thicker, the species advects faster within the microchannel. This might give valuable insights into the nature of the EMD. Our model aims to predict the evolution of ionic concentration at all positions within the channel. A study of the higher-order statistics in skewness and kurtosis has also been conducted to obtain a better understanding of the idealized model consisting of a buffer solution.

Rice-based integrated farming system improves the soil quality, bacterial community structure and system productivity under sub-humid tropical condition.

Rice-based integrated farming system improves the productivity and profitability by recycling resources efficiently. In the sub-humid tropics, rice production without sufficient nutrient replenishment often leads to soil health and fertility degradation. There has been very limited research on soil health and fertility after adopting a multi-enterprising rice-based integrated farming system (IFS), notably in the rice-fish-livestock and agroforestry system, when compared to a conventional farming system (CS). Therefore, the present study analyzed the dynamics of soil properties, soil bacterial community structure and their possible interaction mechanisms, as well as their effect on regulating soil quality and production in IFS, IFSw (water stagnant area of IFS) and CS. The results indicated that soil nutrient dynamics, bacterial diversity indices (Shannon index, Simpson index, Chao 1, ACE and Fisher index) and system productivity were higher in IFSw and IFS compared to CS. Moreover, relative operational taxonomic units of dominant bacterial genera (Chloroflexi, Acidobacteria, Verrucomicrobia, Planctomycetes, Cyanobacteria, Crenarchaeota and Gemmatimonadetes) were also higher in IFSw and IFS compared to CS. Mean soil quality index (SQI) was highest in IFSw (0.780 ± 0.201) followed by IFS (0.770 ± 0.080) and CS (0.595 ± 0.244). Moreover, rice equivalent yields (REY) and rice yields were well correlated with the higher levels of soil biological indices (SQIBiol) in IFS. Overall, our results revealed that rice-based IFS improved the soil health and fertility and ensuing crop productivity through positive interaction with soil bacterial communities and nutrient stoichiometry leading to agroecosystem sustainability.

Early Childhood Caries and Dental Care Utilization in Mangalore, India: Parents' Perceptions.

BACKGROUND: Parents often underuse dental care services for their children with early childhood caries (ECC), resulting in a high burden of untreated dental caries. AIM: To describe parental perceptions and challenges in dental care utilization for their children with ECC. DESIGN: A descriptive qualitative study was conducted with parents of children with ECC seeking dental care in Mangalore, India. Data were collected through focus group discussions using an interview guide. Manual line-by-line coding and content analysis methods were used for data analysis. RESULTS: Three categories were generated from data obtained through 5 focus groups of 27 participants: dental care visiting patterns, the significance of dental visits, and challenges to dental care utilization. Parents would only visit the dentist when they perceived their children's tooth problems. The challenges faced include time constraints, misinformation, lack of awareness and motivation, costs, fear, and anxiety of the children and the parents themselves. Parents perceived improvements in the awareness of their children's oral health and quality of life after dental visits. CONCLUSION: Attending dental services to treat their children's tooth problems was the primary way of attaining awareness about prevention among the parents of children with ECC. Increased oral health awareness and improved quality of life can motivate parents to seek further dental care for their children. Collaboration with multidisciplinary stakeholders is required to improve oral health awareness among parents of children with ECC. KNOWLEDGE TRANSFER STATEMENT: The study's results will help plan targeted preventive programs for children with ECC. The study suggests dental care utilization by children with ECC is based on parental perceptions of their children's tooth problems. It outlines the challenges that affect dental visits of children with ECC and the role of multidisciplinary stakeholders. Improved oral health awareness and quality of life following dental treatment can facilitate further dental visits.

Unraveling the Mystery of Multi-Oocyte Follicles: An Observational Study.

Introduction: Significant progress has been made in understanding oocyte fertilization and early developmental stages through in vitro fertilization (IVF) techniques. However, irregularities such as conjoined oocytes and binucleate giant oocytes, which are exceptions to the normal rule of one diploid female gamete per follicle, can potentially lead to chromosomal disorders in embryos and are recommended to be excluded from IVF attempts. The formation of primordial follicles during ovarian development, known as follicle assembly, is a critical process that establishes the ovarian follicle reserve. Multi-oocyte follicles (MOFs) containing two or more oocytes have been observed in various species, including humans, and their clinical significance on fertility and reproductive health remains unclear. Genetic and environmental factors, such as gene knockout and exposure to endocrine disruptors, have been implicated in MOF formation, but the mechanisms are not fully understood and require further investigation. Material & Method: In this Observational study, 350 slides of ovarian tissues were scanned using an AI-based automated microscope, Grundium Ocus 20, and the TIFF images were stored in cloud storage. The slides were examined using third-party software, Pathcore Seeden Viewer, for morphometry of binovular follicles. Results: In our observational study, we examined 350 ovarian tissue slides in detail by using an AI-based microscope, uncovering 22 slides from seven different tissues with binovular and multinovular oocytes. These rare multi-oocyte follicles (MOFs) challenge the conventional one-oocyte-per-follicle paradigm. MOFs are likely formed when oocytes fail to separate during cortical sex cord proliferation, regulated by factors several molecular factorsas well as environmental factors. Discussion: Multiple Ovarian Follicles (MOFs) are rare phenomena where two or more oocytes exist in one follicle. They arise when oocytes fail to separate during ovarian development, which is governed by hormones such as follicle-stimulating hormone (FSH), inhibin, BMP-15, GDF-9, and GCNF. MOFs can be caused by dysregulation and exposure to chemicals such as diethylstilbestrol (DES) and isoflavones. Binovular oocytes, which occur when two oocytes are released during ovulation and are fertilised by different sperm, can result in non-identical twins, which are influenced by genetic and environmen-tal factors such as maternal age, heredity, hormonal imbalances, and assisted reproductive techniques such as in vitro fertilisation (IVF). Polynuclear oocytes with many nuclei can develop as a result of meiotic spindle defects and environmental influences. Identifying these oocyte types may aid in improving ART results by improving knowledge of the reasons of infertility and devising appropriate interventions.

Two-component nematic superconductivity in 4Hb-TaS2.

Most superconductors have an isotropic, single component order parameter and are well described by the standard (BCS) theory for superconductivity. Unconventional, multiple-component superconductors are exceptionally rare and are much less understood. Here, we combine scanning tunneling microscopy and angle-resolved macroscopic transport for studying the candidate chiral superconductor, 4Hb-TaS2. We reveal quasi-periodic one-dimensional modulations in the tunneling conductance accompanied by two-fold symmetric superconducting critical field. The strong modulation of the in-plane critical field, Hc2, points to a nematic, unconventional order parameter. However, the imaged vortex core is isotropic at low temperatures. We suggest a model that reconciles this apparent discrepancy and takes into account previously observed spontaneous time-reversal symmetry breaking at low temperatures. The model describes a competition between a dominating chiral superconducting order parameter and a nematic one. The latter emerges close to the normal phase. Our results strongly support the existence of two-component superconductivity in 4Hb-TaS2 and can provide valuable insights into other systems with coexistent charge order and superconductivity.

Is predictive coding falsifiable?

Predictive-coding has justifiably become a highly influential theory in Neuroscience. However, the possibility of its unfalsifiability has been raised. We argue that if predictive-coding were unfalsifiable, it would be a problem, but there are patterns of behavioural and neuroimaging data that would stand against predictive-coding. Contra (vanilla) predictive patterns are those in which the more expected stimulus generates the largest evoked-response. However, basic formulations of predictive-coding mandate that an expected stimulus should generate little, if any, prediction error and thus little, if any, evoked-response. It has, though, been argued that contra (vanilla) predictive patterns can be obtained if precision is higher for expected stimuli. Certainly, using precision, one can increase the amplitude of an evoked-response, turning a predictive into a contra (vanilla) predictive pattern. We demonstrate that, while this is true, it does not present an absolute barrier to falsification. This is because increasing precision also reduces latency and increases the frequency of the response. These properties can be used to determine whether precision-weighting in predictive-coding justifiably explains a contra (vanilla) predictive pattern, ensuring that predictive-coding is falsifiable.

Impact of long-term resource conservation techniques on biogeochemical characteristics and biological soil quality indicators in a rice green-gram farming system.

Nutrient management in resource conservation practices influence the structural and functional microbial diversities and thereby affect biological processes and biochemical properties in soil. We studied the long-term effects of resource conservation technologies on functional microbial diversity and their interactions with soil biochemical properties and enzymatic activities in tropical rice-green gram cropping system. The experiment includes seven treatments viz., conventional practice (CC), brown manuring (BM), green manuring (GM), wet direct drum sowing, zero tillage, green manuring-customized leaf colour chart based-N application (GM-CLCC-N) and biochar (BC) application. The result of the present study revealed that microbial biomass nitrogen (N), carbon (C) and phosphorus (P) in GM practice were increased by 23.3, 37.7 and 35.1%, respectively than CC. GM, BM and GM-CLCC-N treatments provide higher yields than conventional practice. The average well color development value, Shannon index and McIntosh index were significantly higher by 26.6%, 86.9% and 29.2% in GM as compared to control treatment. So, from this study we can conclude that resource conservation practices like GM, GM-CLCC N and BM in combination with chemical fertilizers provide easily decomposable carbon source to support the microbial growth. Moreover, dominance of microbial activity in biomass amended treatments (GM, GM-CLCC N and BM) indicated that these treatments could supply good amount of labile C sources on real time basis for microbial growth that may protect the stable C fraction in soil, hence could support higher yield and soil organic carbon build-up in long run under rice-green gram soil.

Soil quality assessment of lowland rice soil of eastern India: Implications of rice husk biochar application.

The role of biochar in improving the soil properties of problem soils is well known, but its long term impact on lowland rice soil is not well recognized. The soil quality indicators of biochar applied lowland rice soil are not widely reported. We developed soil quality index (SQI) of a biochar applied lowland rice soil based on 17 soil properties (indicators). Field experimentation consisted of six treatments such as 0.5, 1, 2, 4, 8 and 10 t ha-1 of rice husk derived biochar (RHB) along with control. An overall SQI was calculated encompassing the indicators using multivariate statistics (principal component analysis) and non-linear scoring functions after generation of minimum data set (MDS). Sequential application of RHB improved the SQI by 4.85% and 16.02% with application of 0.5 t ha-1 and 10 t ha-1 RHB, respectively, over the recommended dose of fertilizer (control). PCA-screening revealed that total organic carbon (Ctot), zinc (Zn), pH and bulk density (BD) were the main soil quality indicators for MDS with 27.79%, 26.61%, 23.67% and 14.47% contributions, respectively. Apart from Ctot, Zn is one of the major contributors to SQI and RHB application can potentially be an effective agronomic practice to improve Zn status in lowland rice soil. The overall SQI was significantly influenced by RHB application even at 0.5 t ha-1. The present study highlights that application of RHB improves the soil quality even in fertile, well managed, lowland rice soil.

Multi-criteria assessment to screen climate smart rice establishment techniques in coastal rice production system of India.

Introduction: Conventional rice production techniques are less economical and more vulnerable to sustainable utilization of farm resources as well as significantly contributed GHGs to atmosphere. Methods: In order to assess the best rice production system for coastal areas, six rice production techniques were evaluated, including SRI-AWD (system of rice intensification with alternate wetting and drying (AWD)), DSR-CF (direct seeded rice with continuous flooding (CF)), DSR-AWD (direct seeded rice with AWD), TPR-CF (transplanted rice with CF), TPR-AWD (transplanted rice with AWD), and FPR-CF (farmer practice with CF). The performance of these technologies was assessed using indicators such as rice productivity, energy balance, GWP (global warming potential), soil health indicators, and profitability. Finally, using these indicators, a climate smartness index (CSI) was calculated. Results and discussion: Rice grown with SRI-AWD method had 54.8 % higher CSI over FPR-CF, and also give 24.5 to 28.3% higher CSI for DSR and TPR as well. There evaluations based on the climate smartness index can provide cleaner and more sustainable rice production and can be used as guiding principle for policy makers.

Early Feeding and Weaning Practices of Indian Children with Early Childhood Caries: A Qualitative Exploration.

OBJECTIVE: To describe the early feeding, weaning, and oral hygiene practices of children with early childhood caries (ECC), their parents' knowledge and attitudes regarding infant feeding, and the feeding-related challenges faced by the parents. METHODS: This descriptive qualitative study involved parents of children with ECC who sought dental treatment at an academic dental college in India. Data were collected though focus groups conducted with the 27 parents of children with ECC, using a focus group discussion guide. Data were analyzed using the content analysis method. RESULTS: Community norms, such as learning from the older women in the families or neighborhoods, guided the feeding method, duration of feeding, and weaning. Breastfeeding or bottle-feeding at bedtime beyond 12 mo of age and feeding sugary drinks during weaning were standard practices, despite knowing the risk for dental caries. Parents faced multiple challenges regarding weaning and were unaware of the significance of infant oral hygiene practices. CONCLUSION: In children with ECC, infant feeding practices included prolonged breastfeeding or bottle-feeding beyond the required age, feeding at bedtime, and feeding sugary drinks. Although the parents knew that these feeding habits could increase the risk for caries, they lacked the self-efficacy to translate their knowledge into action during weaning. Also, they lacked awareness regarding infant oral hygiene practices. KNOWLEDGE TRANSFER STATEMENT: The study provides information on the feeding habits of infants that can increase the risk for caries, the challenges faced by the parents of these children in altering these risky habits, and their lack of knowledge on infant oral hygiene practices. Policy/decision makers can advocate for pediatricians and pediatric dentists to incorporate anticipatory guidance or motivational interviewing techniques to tailor the preventive program for ECC for Indian children.

A novel application of a bioactive material as a pit and fissure sealant: in vitro pilot study evaluating the sealing ability and penetration.

PURPOSE: To compare the sealing ability and penetration of a bioactive material used as pit and fissure sealant to those of glass ionomer sealant. METHODS: This was an in vitro experimental study conducted on 20 permanent teeth. For Group I of ten teeth, ACTIVA BioACTIVE-Base/Liner was applied as a sealant on pits and fissures, and the remaining ten teeth of Group II were sealed using glass ionomer cement. After thermocycling, the apex of the teeth was sealed using composite resin and they were immersed in 1% methylene blue solution, buffered at pH 7 for 24 h. Longitudinal sections were obtained from each tooth for evaluating the sealing ability and penetration, using a binocular light microscope at 4 × magnification. The obtained data were subjected to analysis using the Chi-square test and independent t test. RESULTS: The comparison of the sealing ability and sealant penetration, between the two groups, showed statistically no significant difference (p = 0.104 and p = 1.0, respectively). CONCLUSION: Bioactive material as a pit and fissure sealant, performed on par with glass ionomer sealant in terms of tested properties like sealing ability and penetration.

Rhino-orbito-cerebral mucormycosis: patient characteristics in pre-COVID-19 and COVID-19 period.

BACKGROUND: Rhino-orbito-cerebral-mucormycosis (ROCM), a rare and potentially fatal disease was seen in increasing numbers during the COVID-19 pandemic. This study describes and compares the patient characteristics and outcomes in COVID-19 associated mucormycosis (CAM) and non-COVID-19 mucormycosis (non-CAM). METHODOLOGY: CAM patients (24 cases) were recruited from the COVID-19 period and non-CAM (24 controls) from the pre-COVID-19 period. Clinical data of the CAM group was collected retrospectively with 3 month outcomes prospectively. The non-CAM group data was collected retrospectively. Patient characteristics were compared and risk factors for mortality in ROCM were assessed. RESULTS: Orbital symptoms [altered vision, restricted eye movements, ptosis] and intracranial involvement were higher in CAM patients on presentation. Similarly, the radiological involvement of orbit (orbital apex, superior orbital fissure) and intracranial cavity (intracranial thrombosis, cavernous sinus) was also higher in CAM patients. Newly detected diabetes was found only in CAM patients (29.2%). Although univariate analysis suggested an increased mortality risk in ROCM patients with orbital involvement, the multivariate analysis showed no increased risk with any of the parameters assessed, including COVID-19 positivity. CONCLUSIONS: Compared to the non-CAM, the disease presentation was severe in CAM with higher frequency of orbital and intracranial involvement. However, with early detection and treatment, the short term survival was comparable in both groups.

Homology modeling and virtual characterization of cytochrome c nitrite reductase (NrfA) in three model bacteria responsible for short-circuit pathway, DNRA in the terrestrial nitrogen cycle.

NrfA is the molecular marker for dissimilatory nitrate reduction to ammonium (DNRA) activity, catalysing cytochrome c nitrite reductase enzyme. However, the limited study has been made so far to understand the structural homology modeling of NrfA protein in DNRA bacteria. Therefore, three model DNRA bacteria (Escherechia coli, Wolinella succinogenes and Shewanella oneidensis) were chosen in this study for in-silico protein modeling of NrfA which roughly consists of similar length of amino acids and molecular weight and they belong to two contrasting taxonomic families (γ-proteobacteria with nrfABCDEFG and ε-proteobacteria with nrfHAIJ operon). Multiple bioinformatic tools were used to examine the primary, secondary, and tertiary structure of NrfA protein using three distinct homology modeling pipelines viz., Phyre2, Swiss model and Modeller. The results indicated that NrfA protein in E. coli, W. succinogenes and S. oneidensis was mostly periplasmic and hydrophilic. Four conserved Cys-X1-X2-Cys-His motifs, one Cys-X1-X2-Cys-Lys haem-binding motif and Ca ligand were also identified in NrfA protein irrespective of three model bacteria. Moreover, 11 identical conserved amino acids sequence was observed for the first time between serine and proline in NrfA protein. Secondary structure of NrfA revealed that α-helices were observed in 77.9%, 73.4%, and 77.4% in E. coli, W. succinogenes and S. oneidensis, respectively. Ramachandran plot showed that number of residue in favored region in E. coli, W. succinogenes and S. oneidensis was 97.03%, 97.01% and 97.25%, respectively. Our findings also revealed that among three pipelines, Modeller was considered the best in-silico tool for prediction of NrfA protein. Overall, significant findings of this study may aid in the identification of future unexplored DNRA bacteria containing cytochrome c nitrite reductase. The NrfA system, which is linked to respiratory nitrite ammonification, provides an analogous target for monitoring less studied N-retention processes, particularly in agricultural ecosystems. Furthermore, one of the challenging research tasks for the future is to determine how the NrfA protein responds to redox status in the microbial cells.

Decreased mortality in coronavirus disease 2019 associated mucormycosis with aspirin use: a retrospective cohort study.

OBJECTIVE: Rhino-orbito-cerebral mucormycosis is a rapidly progressive disease with high mortality rates of about 60 per cent. The increasing incidence of rhino-orbito-cerebral mucormycosis in coronavirus disease 2019 patients in India and worldwide has become a matter of concern owing to the case fatality rate. This study explored the use of low dose aspirin in decreasing the mortality rate of coronavirus disease 2019 associated mucormycosis. METHOD: This was a retrospective observational study. Patients suffering from post-coronavirus disease 2019 mucormycosis were included in the study. Each patient was treated with surgical debridement and systemic amphotericin B. Low dose aspirin was added, and mortality rates were compared with the patients who did not receive aspirin. RESULTS: The demographic data and rhino-orbito-cerebral mucormycosis staging between the two groups were not significantly different. There was a statistically significant difference in mortality outcomes between the two groups (p = 0.029) and a 1.77 times higher risk of dying for patients not receiving aspirin. Kaplan-Meier survival indicated that patients receiving aspirin had better survival rates (p = 0.04). CONCLUSION: Low dose aspirin improves survival rates in coronavirus disease 2019 associated mucormycosis.

Drought hotspot maps and regional drought characteristics curves: Development of a novel framework and its application to an Indian River basin undergoing climatic changes.

Drought is one of the significant natural disasters that incurs billion dollars of economic damage every year. Among all, agricultural drought needs critical attention for drought monitoring due to its direct effect on crop yield and management of irrigation water. Most of the previous studies focused on regionalizing drought using k-means, hierarchal, fuzzy, and entropy-based clustering techniques. However, these techniques are not suitable where the clusters are not separated distinctively, and the number of clusters cannot be estimated automatically. In this study, we have developed agricultural drought hotspot maps using Soil moisture deficit index (SMDI) and the regional severity (S), duration (D), and frequency (F) curves using complex network algorithm for the future warming climate (2041-2070) of the Mahanadi River basin (MRB) in India. We have used a modified dynamic Budyko (DB) hydrological model to simulate daily soil moisture at a spatial scale of 0.25° × 0.25° using input from four GCMs for the RCP 4.5 scenario. The modified DB model was calibrated and validated for the study area. The model proved to be capable of simulating the soil moisture dynamics over the basin and also effectively captured the historical droughts occurred in the basin. The drought hotspot maps of the basin suggest that the northern, south-eastern, and central parts of the basins are going to experience more number of droughts. The results suggest that for most of the clusters, the regional S-D-F curve can be utilized to understand the future drought characteristics at site-specific as well as regional scale, as the confidence band is found to be very narrow. Overall, our study provides a framework to develop regional S-D-F curve.

A comparison of cytoreductive and non-cytoreductive management strategies for nephron-sparing approaches to tumours in solitary kidneys.

INTRODUCTION: Tumours in a solitary kidney pose challenges in management. Metastatic tumours and those in difficult locations complicate treatment further. The advent of immunotherapy has shed new light on the management of such tumours. We present a series of three cases treated with nephron-sparing surgery following neoadjuvant immunotherapy and compare the outcomes with patients who underwent robotic partial nephrectomy in a solitary kidney. METHODS: We present the outcomes of three patients with solitary kidney tumours who underwent delayed nephron-sparing surgery following good response to immunotherapy. All patients had solitary kidney following a previous nephrectomy, two of which were nonmetastatic but, due to size/location, not amenable to primary treatment; the third patient had metastatic disease and responded to immunotherapy. Two patients underwent robotic partial nephrectomy and one opted for cryotherapy. We compared the preoperative, intraoperative and postoperative parameters of the two patients who underwent robotic cytoreductive partial with patients who underwent robotic partial nephrectomy in a solitary kidney. RESULTS: Out of 231 partial nephrectomy patients in our centre, 2 underwent cytoreductive partial nephrectomy and 5 underwent solitary partial nephrectomy. There was no statistically significant difference in the patient demographics in the two groups. Patients in both groups had comparable operative time, warm ischaemia time, blood loss and length of stay. Two of the five patients in the non-cytoreductive robotic partial nephrectomy had Clavien Dindo 1 complications compared with one patient in the robotic cytoreductive partial nephrectomy group. This was not statically significant. CONCLUSION: Neoadjuvant immunotherapy can play a valuable role in shrinking renal tumours in solitary kidneys to facilitate robotic partial nephrectomies. There were no significant differences in the intra- and postoperative parameters in patients who underwent cytoreductive partial nephrectomy when compared with patients undergoing robotic solitary partial nephrectomy.

Post-prostatectomy adjuvant androgen deprivation therapy- Current opinions and practices of Canadian urologists.

INTRODUCTION: Despite the proven benefit of adjuvant androgen deprivation therapy (ADT) for patients receiving primary radiation, there are few studies evaluating adjuvant ADT after prostatectomy. In the absence of evidence, opinions and practice patterns vary. We surveyed Canadian prostate cancer surgeons about their use of adjuvant ADT and their opinions on the design of a potential adjuvant ADT trial. METHODS: An electronic survey was devised and distributed using a modified Dillman approach. The survey was sent to 38 Canadian urologists that perform radical prostatectomy and representing all 17 major academic institutions in Canada and all 10 Canadian provinces. Reminders were sent three and four weeks following the original request. In addition to demographic information, we asked surgeons about their current use of postoperative adjuvant ADT and their opinion about the need for a clinical trial. To inform trial design, we asked respondents their opinions about which patients should be eligible, what duration of ADT was most appropriate, and which outcomes are clinically meaningful. The survey was sent in February 2020 and all responses were received by March 2020. RESULTS: All 38 (100%) invited urologists completed the survey. Only 3 (7%) respondents currently offer postoperative adjuvant ADT as an option for patients without metastases. 35 (92%) urologists believed that a trial is needed before short-term adjuvant treatment should be offered to prevent recurrence. 15 (45%) urologists believed an adjuvant ADT trial was most appropriate for patients with an estimated PSA recurrence risk of >25% and 16 (42%) believed a recurrence risk of >50% was most appropriate. 25 (66%) respondents believed 12-month was the optimal duration of treatment with adjuvant ADT for a randomized trial. 37 (97%) respondents felt that prolonging the time to PSA recurrence and/or pelvic radiation was a clinically important outcome. The majority (20; 53%) of respondents would recommend 12 months of adjuvant ADT in their practice if a randomized trial showed a 50% relative risk reduction in PSA recurrence at 5-year postoperative. CONCLUSION: The vast majority of Canadian prostate cancer surgeons do not offer adjuvant ADT following prostatectomy in patients without metastases. Based on the results from this survey, a randomized trial was considered warranted and feasible, and would influence patient care.