Efficacy of a Diabetes Specific Nutritional Supplement (DSNS) on Glycemic Response in Prediabetic Adults: A Two-Armed, Open-Labelled Randomized Controlled Study

It is well known that Diabetes Specific Nutritional Supplements (DSNSs) are linked to improved glycemic control in individuals with diabetes. However, data on efficacy of DSNSs in prediabetics is limited. This was a two-armed, open-labelled, randomized controlled six-week study on 199 prediabetics [30 - 65 years;Glycosylated Hemoglobin (HbA1c) 5.7% - 6.4% and/or Fasting Blood Glucose (FBG) 100-125 mg/dl]. Two parallel phases were conducted: Acute Blood Glucose Response (ABGR) and Intervention phase. Prediabetic participants were randomized into test (n = 100) and control (n = 99). The primary objective was to assess the ABGR of DSNS versus an isocaloric snack, measured by incremental Area under the Curve (iAUC). Test and control received 60 g of DSNS and 56 g of isocaloric snack (cornflakes) respectively, both in 250 ml double-toned milk on visit days 1, 15, 29 and 43. Postprandial Blood Glucose (PPG) was estimated at 30, 60, 90, 120, 150 and 180 minutes. During the 4 weeks intervention phase, the test group received DSNS with lifestyle counselling (DSNS + LC) and was compared with the control receiving lifestyle counselling alone (LC alone). Impact was studied on FBG, HbA1C, anthropometry, body composition, blood pressure, nutrient intake, and physical activity. The impact of DSNS was also studied using CGM between two 14-day phases: CGM1 baseline (days 1 - 14) and CGM2 endline (days 28 - 42). DSNS showed significantly lower PPG versus isocaloric snack at 30 (p 12, and chromium were reported by DSNS + LC versus LC alone. No other significant changes were reported between groups. It may be concluded that DSNS may be considered as a snack for prediabetic or hyperglycemic individuals requiring nutritional support for improved glycemic control.

Investigating the Evolution of Amati Parameters with Redshift

Gamma-ray bursts(GRBs) are among the brightest objects in the Universe and, hence, can be observed up to a very high redshift. Properly calibrated empirical correlations between intensity and spectral correlations of GRBs can be used to estimate the cosmological parameters. However, the possibility of the evolution of GRBs with redshift is a long-standing puzzle. In this work, we used 162 long-duration GRBs to determine whether GRBs below and above a certain redshift have different properties. The GRBs are split into two groups, and we fit the Amati relation for each group separately. Our findings demonstrate that estimations of the Amati parameters for the two groups are substantially dissimilar. We perform simulations to investigate whether the selection effects could cause the difference. Our analysis shows that the differences may be either intrinsic or due to systematic errors in the data, and the selection effects are not their true origin. However, in-depth analysis with a new data set comprised of 119 long GRBs shows that intrinsic scatter may partly be responsible for such effects.

Mammogram Classification with HanmanNets Using Hanman Transform Classifier

Breast cancer is a deadly disease and radiologists recommend mammography to detect it at the early stages. This paper presents two types of HanmanNets using the information set concept for the derivation of deep information set features from ResNet by modifying its kernel functions to yield Type-1 HanmanNets and then AlexNet, GoogLeNet and VGG-16 by changing their feature maps to yield Type-2 HanmanNets. The two types of HanmanNets exploit the final feature maps of these architectures in the generation of deep information set features from mammograms for their classification using the Hanman Transform Classifier. In this work, the characteristics of the abnormality present in the mammograms are captured using the above network architectures that help derive the features of HanmanNets based on information set concept and their performance is compared via the classification accuracies. The highest accuracy of 100% is achieved for the multi-class classifications on the mini-MIAS database thus surpassing the results in the literature. Validation of the results is done by the expert radiologists to show their clinical relevance.

Some Features of Black Carbon Aerosols Connected with Regional Climate Over Pristine Environment

The authors report the results of aethalometer black carbon(BC)aerosol measurements carried out over a rural(pristine)site,Panchgaon,Haryana State,India during the winter months of 2021-2022 and 2022-2023.They are compared with collocated and concurrent observations from the Air Quality Monitoring Station(AQMS),which provides synchronous air pollution and surface meteorological parameters.Secular variations in BC mass concentration are studied and explained with variations in local meteorological parameters.The biomass burning fire count retrievals from NASA-NOAA VIIRS satellite,and backward airmass trajectories from NOAA-ERL HYSPLIT Model analysis have also been utilized to explain the findings.They reveal that the north-west Indian region contributes maximum to the BC mass concentration over the study site during the study period.Moreover,the observed BC mass concentrations corroborate the synchronous fire count,primary and secondary pollutant concentrations.The results were found to aid the development of mitigation methods to achieve a sustainable climate system.

Recent updates on nano-phyto-formulations based therapeutic intervention for cancer treatment

Cancer is a leading cause of death globally,with limited treatment options and several limitations.Chemotherapeutic agents often result in toxicity which long-term conventional treatment.Phytochemicals are natural constituents that are more effective in treating various diseases with less toxicity than the chemotherapeutic agents providing alternative therapeutic approaches to minimize the resistance.These phytoconstituents act in several ways and deliver optimum effectiveness against cancer.Nevertheless,the effectiveness of phyto-formulations in the management of cancers may be constrained due to challenges related to inadequate solubility,bioavailability,and stability.Nanotechnology presents a promising avenue for transforming current cancer treatment methods through the incorporation of phytochemicals into nanosystems,which possess a range of advantageous characteristics such as biocompatibility,targeted and sustained release capabilities,and enhanced protective effects.This holds significant potential for future advancements in cancer management.Herein,this review aims to provide intensive literature on diverse nanocarriers,highlighting their applications as cargos for phytocompounds in cancer.Moreover,it offers an overview of the current advancements in the respective field,emphasizing the characteristics that contribute to favourable outcomes in both in vitro and in vivo settings.Lastly,clinical development and regulatory concerns are also discussed to check on the transformation of the concept as a promising strategy for combination therapy of phytochemicals and chemotherapeutics that could lead to cancer management in the future.

Systematic review with expert consensus on use of extracorporeal hemoadsorption in septic shock:An Indian perspective

BACKGROUND Septic shock is a severe form of sepsis characterised by deterioration in circulatory and cellular-metabolic parameters.Despite standard therapy,the outcomes are poor.Newer adjuvant therapy,such as CytoSorb®extracorporeal haemoadsorption device,has been investigated and shown promising outcome.However,there is a lack of some guidance to make clinical decisions on the use of CytoSorb®haemoadsorption as an adjuvant therapy in septic shock in Indian Setting.Therefore,this expert consensus was formulated.AIM To formulate/establish specific consensus statements on the use of CytoSorb®haemoadsorption treatment based on the best available evidence and contextualised to the Indian scenario.METHODS We performed a comprehensive literature on CytoSorb®haemoadsorption in sepsis,septic shock in PubMed selecting papers published between January 2011 and March 20232021 in English language.The statements for a consensus document were developed based on the summarised literature analysis and identification of knowledge gaps.Using a modified Delphi approach combining evidence appraisal and expert opinion,the following topics related to CytoSorb®in septic shock were addressed:need for adjuvant therapy,initiation timeline,need for Interleukin-6 levels,duration of therapy,change of adsorbers,safety,prerequisite condition,efficacy endpoints and management flowchart.Eleven expert members from critical care,emergency medicine,and the intensive care participated and voted on nine statements and one open-ended question.RESULTS Eleven expert members from critical care,emergency medicine,and the intensive care participated and voted on nine statements and one open-ended question.All 11 experts in the consensus group(100%)participated in the first,second and third round of voting.After three iterative voting rounds and adapting two statements,consensus was achieved on nine statements out of nine statements.The consensus expert panel also recognised the necessity to form an association or society that can keep a registry regarding the use of CytoSorb®for all indications in the open-ended question(Q10)focusing on“future recommendations for CytoSorb®therapy”.CONCLUSION This Indian perspective consensus statement supports and provides guidance on the use of CytoSorb®haemoadsorption as an adjuvant treatment in patients with septic shock to achieve optimal outcomes.

Glycemic Indices of Multiple Oral Nutritional Supplements: A Randomized Cross-Over Study in Indian Adults

Background: A randomized cross-over study was conducted to assess the glycemic index (GI) of seven Oral Nutritional Supplements (ONSs). These ONSs are designed to support the nutritional requirements of different age-groups, physiological states, or health conditions among Indian adults. Methods: The study had two phases viz., phase1 (n = 18) studied two ONSs: A1 and B1 and phase 2 (n = 20) studied five ONSs: A2, B2, C2, D2 & E2. The subjects were healthy, non-diabetic adults, aged between 20 - 44 years with a mean Body Mass Index of 21.2 ± 1.52 kg/m2 (Phase 1) and 21.0 ± 1.45 kg/m2 (Phase 2). All these ONSs were compared with reference drinks (glucose). The carbohydrates in one serving of each ONS were matched to carbohydrates from 25 grams of glucose following ISO 2010 guidelines. Capillary blood was assessed for blood glucose response at baseline, 15, 30, 45, 60, 90 and 120 minutes. GI was calculated as the incremental area under the curve (iAUC) for the test drinks and expressed as a percentage of the average iAUC from glucose. Results: Phase 1 indicated that the high fiber diabetes-specific nutrition supplement A1 with higher protein (23% energy), higher fat (25% energy) and reduced carbohydrates (40% energy) had a significantly (p = 0.002) lower GI [34 (±6)] as compared to B1 [63 (±7)] (protein 19%, fat 7% and carbohydrates 60% energy) even with similar amount (22%) and type of fiber. Phase 2 reported that all test products [A2 (32 ± 5), B2 (37 ± 4), C2 (31 ± 5), D2 (31 ± 5) and E2 (55 ± 4)] had a low GI. As compared to phase 1, ONSs in phase 2 had lower fiber content (1.6% - 4.6% energy). Conclusion: The glycemic index of oral nutrition supplements is influenced not only by their fiber content, but also by the overall macronutrient composition including protein (≥17% energy), fat (≥10% - 27% energy) and carbohydrates (40% - 57.5% energy).

To explore patients’ perceptions about motivators and barriers of adherence to highly active antiretroviral therapy among people living with HIV: A qualitative study

Objective:For people living with HIV(PLHIV),strict adherence to highly active antiretroviral therapy(HAART)is the key to effective treatment and retention in human immunodeficiency virus(HIV)care.There are many factors which promote or halt the antiretroviral therapy(ART)adherence practices.Therefore,the present study aimed to examine the HAART adherence levels and to explore patients’views about barriers and facilitators to HIV treatment adherence.Methods:Semi-structured interviews were conducted among 15 PLHIV at the ART clinic of Dr.Ram Manohar Lohia Hospital,New Delhi.Interviews were audio-recorded in the local Hindi language,and bilingual experts(English and Hindi)transcribed verbatim.Qualitative data were coded for themes and subthemes and analyzed using a phenomenological approach as per thematic content analysis.Results:Feeling of hopelessness,delayed ART initiation,difficult initial phase of ART,forget to take ART on time,fear of disclosure of HIV diagnosis,lack of privacy and negative social support,and impact of lockdown due to COVID-19 were revealed as significant barriers to ART adherence.At the same time,commitment to raise and educate children,ART to increase life span,maintain oneself to be physically fit and healthy,only a single pill per day,very supportive counselors and health-care professionals,and hope to give birth to a healthy child were identified as facilitators of HIV retention.Conclusion:Understanding patient’s perception about ART adherence,its motivational and barrier factors which are directly affecting ART adherence and retention of PLHIV in HIV treatment and follow-ups are of utmost importance to improve ART adherence during HIV patient care services.

Compressed H3S: Fits to the Empirical Hc2(T) Data and a Discussion of the Meissner Effect

Based on μ-, T- and H-dependent pairing and number equations and the premise that μ(T) is predominantly the cause of the variation of the upper critical field Hc2(T), where μ, T and H denote the chemical potential, temperature and the applied field, respectively, we provide in this paper fits to the empirical Hc2(T) data of H3S reported by Mozaffari, et al. (2019) and deal with the issue of whether or not H3S exhibits the Meissner effect. Employing a variant of the template given by Dogan and Cohen (2021), we examine in detail the results of Hirsch and Marsiglio (2022) who have claimed that H3S does not exhibit the Meissner effect and Minkov, et al. (2023) who have claimed that it does. We are thus led to suggest that monitoring the chemical potential (equivalently, the number density of Cooper pairs Ns at T = Tc) should shed new light on the issue being addressed.

Cost Comparison of Different Types of Formworks

Formwork is the temporary moulds in the construction which is fabricated based on the drawing and design of the structure and into which the concrete is poured to form the required structure.Formwork is an essential part of the construction as it has been used by the Romans.The formworks must be strong enough to withstand all types of loads.The joint must be in proper condition to avoid any kind of leakages.The materials used for the formworks should be economical,easily available and durable.The formworks can be made up of different materials such as plywood,steel,aluminum,composite material,etc.In steel formwork the plates used for the slab support are made up of galvanized steel and these are fabricated as per the requirements.Aluminum plates are used in the aluminum framework along with the other components made up of aluminum.The selection of a suitable framework is important in any project because it bears about 25%to 30%cost of the total cost of construction.In the present study,different types of formworks such as steel,plywood and aluminum were studied in a project and a comparison was made on the reusability and easiness in handling and maintenance.Also,a comparison of the formwork used in the construction of the 5th and 11th-floor tower based on the specific plan and drawing was done.The results showed that the aluminum formwork was found to be efficient and suitable among all formworks,although the cost was higher compared to other formwork materials.

Extracorporeal blood purification strategies in sepsis and septic shock:An insight into recent advancements

BACKGROUND Despite various therapies to treat sepsis,it is one of the leading causes of mortality in the intensive care unit patients globally.Knowledge about the pathophysiology of sepsis has sparked interest in extracorporeal therapies(ECT)which are intended to balance the dysregulation of the immune system by removing excessive levels of inflammatory mediators.AIM To review recent data on the use of ECT in sepsis and to assess their effects on various inflammatory and clinical outcomes.METHODS In this review,an extensive English literature search was conducted from the last two decades to identify the use of ECT in sepsis.A total of 68 articles from peer-reviewed and indexed journals were selected excluding publications with only abstracts.RESULTS Results showed that ECT techniques such as high-volume hemofiltration,coupled plasma adsorption/filtration,resin or polymer adsorbers,and CytoSorb®are emerging as adjunct therapies to improve hemodynamic stability in sepsis.CytoSorb®has the most published data in regard to the use in the field of septic shock with reports on improved survival rates and lowered sequential organ failure assessment scores,lactate levels,total leucocyte count,platelet count,interleukin-IL-6,IL-10,and TNF levels.CONCLUSION Clinical acceptance of ECT in sepsis and septic shock is currently still limited due to a lack of large random clinical trials.In addition to patient-tailored therapies,future research developments with therapies targeting the cellular level of the immune response are expected.

Application of Nanotechnology in Soil Stabilization

Nano-technology is expanding its horizon in various science and technology fields.In civil engineering,soil is a complex material and used for various functions and applications.Meanwhile,sometimes an effective soil stabilization technique is needed to fulfil the site criteria and can be achieved by adopting various methods e.g.,physical,chemical,thermal or reinforcement using geotextiles and fabrics.The mechanism of soil stabilization using nanomaterials is still unexplored and open to prospective researchers.The present article attempts to touch and explore the possibilities of nano-technology in soil improvement and its applications in various civil engineering works.Microstructural analysis of the nanomaterials treated soils using the latest equipment has also been discussed.The study interprets that the use of nano materials is still limited,due to their high cost and sophisticated handling procedures.Though the use of nanoparticles in soil stabilization results in extraordinary improvements in various soil properties,the improved soil properties could be utilized for various geotechnical projects.The present study bridges the past findings to the present scenario of nanomaterials in soil improvement.

Current status and future challenges with Coronavirus(COVID-19):an update on vaccines

SARS-COV-2 coronavirus causes COVID-19,which is a respiratory disease.COVID-19,the common cold,seasonal allergies,and the flu have many similar symptoms.COVID-19 is caused by SARS-CoV-2,while rhinoviruses most often cause the common cold.The World Health Organization issued notifications on December 30,2019,and January 30,2020,classifying this viral disease as a Public Health Emergency of International Concern.SARS-CoV-2 was detected in humans and animals in 2019.Several investigations are underway to cure COVID-19 and develop a vaccine to prevent infection with SARS-CoV-2.Several COVID-19 vaccines have now been approved or licensed for human use(SII/Covishield,AstraZeneca/AZD1222,Janssen/Ad26.COV 2.S,Sinopharm,Moderna,Sinovac-CoronaVac,Covaxin).Four issues arise in the research and manufacture of the COVID-19 vaccine:production,affordability,allocation and deployment.The adenovirus-vectored and mRNA-based vaccines for COVID-19 showed the highest efficacy after the first and second doses,respectively.The mRNA-based vaccines had higher side effects.Remarkably few experienced extreme adverse effects and all stimulated robust immune responses.

Sudden sensorineural hearing loss-A contemporary review of management issues

Sudden sensorineural hearing loss(SSNHL)is an enigmatic entity,with obscure pathophysiology and debatable efficacy of the treatment agents used.An underlying cause is identified in only 10-15%of cases.The management of the remaining patients,classified as‘idiopathic’,is empirical,and is conventionally with systemic steroids,vasodilator therapy,rheological agents,and antioxidants,to list a few amongst the host of the agents employed for the treatment.The availability of conflicting outcomes and lack of conclusive evidence has resulted in the propagation of consensus-based treatment protocols.In the present review,we discuss the various controversial issues and newer developments in the management of idiopathic SSNHL.The current review aims to present a narrative outlook of the updated evidence base available from PUBMED,augmented with relevant designated publications.

弱视儿童的临床概况和遮盖治疗结果

目的:研究弱视的临床表现,以及对弱视患者进行遮盖治疗的效果。方法:纵向研究。收集2015-04/2016-04 Dhulikhel医院眼科1092例患者数据。对检出的弱视60例患儿的视力、主诉、年龄、屈光状态、双眼屈光度和注视方式进行评估。并对检出的弱视患儿进行遮盖治疗。结果:在研究期间接受检查的1092例儿童中,60例(5.49%)为弱视患者,其中,女性35例(58.30%),男性25例(41.70%),平均年龄为8.87±3.29岁。在43.3%(n=26)的弱视儿童中,经线性弱视是最常见的亚型,其次是远视性屈光参差性弱视(20%,n=12)。最常见的屈光不正是散光,占58.30%,其次是远视(22.50%)和近视(7.50%)。配戴眼镜联合遮盖治疗和主动视觉训练的依从性为73.30%(n=44)。3mo后不同治疗策略对弱视眼视力有显著改善(P=0.002)。结论:在尼泊尔等发展中国家,弱视发病率和相关的视力损害仍然是一个公共卫生问题。意识的缺乏,社区或学龄前儿童视力筛查的缺乏,会导致儿童较晚出现症状,并最终导致明显的视力损害。通过筛选就诊地点、及时转诊和适当的干预措施,这种状况可得到改善。

Assessment of Variation in Morpho-Physiological Traits and Genetic Diversity in Relation to Submergence Tolerance of Five Indigenous Lowland Rice Landraces

The present study evaluated submergence responses in 88 lowland indigenous rice(Oryza sativa L.) landraces from Koraput, India, to identify submergence-tolerant rice genotypes. In pot experiments, variations in survival rate, shoot elongation, relative growth index, dry matter, chlorophyll, soluble sugar and starch contents were evaluated in two consecutive years under well-drained and completely submerged conditions. Principal component analysis showed that the first three axes contributed 96.820% of the total variation among the landraces, indicating wide variation between genotypes. Major traits such as survival rate, relative growth index, soluble sugar and starch contents appeared to be important determinants of phenotypic diversity among the landraces. Phenotypic coefficient of variance was higher than genotypic coefficient of variance for all the traits and all showed high heritability(90.38%–99.54%). Five rice landraces(Samudrabali, Basnamundi, Gadaba, Surudaka and Dokarakuji) were the most tolerant to submergence. When submerged for up to 14d, Samudrabali, Basnamundi and Godoba were notable for having greater survival rates than a standard submergence tolerant variety FR13 A, and also notable for elongating more vigorously and accumulating more biomass. These three landraces may therefore be especially useful in lowland rice growing areas that are affected by both moderate stagnant water and flash flooding. Molecular genotyping revealed that the submergence tolerance of Samudrabali, Basnamundi and Godoba is linked to the presence of one or more different Sub1 loci and it may well prove useful for breeding improved submergence tolerant rice varieties, thereby assising to improve yield stability in the rainfed lowland agro-ecosystem.

Acute motor axonal neuropathy following anti-rabies human diploid cell vaccine:A rare case and review

Rationale:Guillain Barre syndrome(GBS)is an acute neurological illness leading to quadriparesis with respiratory involvement.It can be triggered by infections,vaccinations,surgery,trauma,transplantation and drugs.Anti-rabies cell culture vaccines introduced to overcome the high rate of neurological complications associated with tissue based rabies vaccine,can be very rarely associated with GBS.Patient concerns:A 50-year-old female presented with acute severe upper back pain evolving into pure motor quadriparesis following administration of human diploid cell vaccine for rabies.Diagnosis:Acute motor axonal neuropathy variant of GBS following anti-rabies human diploid cell vaccine.Interventions:Intravenous high dose steroids.Outcomes:Patient recovered completely within 1 month.Lessons:Although anti-rabies cell culture vaccines are highly immunogenic and safe,they are rarely associated with GBS.Clinicians should be aware of this link because prompt diagnosis and treatment can result in complete recovery and avoid complications.

An Improved Handoff Algorithm for Heterogeneous Wireless Networks

Heterogeneous Wireless Network is currently a major area of focus in communication engineering.But the important issue in recent communication is the approachability to the wireless networks while maintaining the quality of service.Today,all the wireless access networks are working in tandem to keep the users always connected to the internet cloud that matches the price affordability and performance goals.In order to achieve seamless connectivity,due consideration has to be given to handoff precision and a smaller number of handoffs.Several researchers have used heuristic approaches to solve this issue.In the present work,a hybrid intelligent algorithm has been suggested for vertical handoff decisions.This hybrid intelligent algorithm is based on dual optimization approach which uses“Particle Swarm Optimization(PSO)”and“Mobile Robustness Optimization(MRO)”techniques for improving the quality of services.This approach performs well even in the failure network conditions and gives the best results in terms of connectivity.The results at the last has been compared with the conventional techniques and it has been observed that the proposed methodology outperforms the existing one.

Transfer Learning Model to Indicate Heart Health Status Using Phonocardiogram

The early diagnosis of pre-existing coronary disorders helps to control complications such as pulmonary hypertension,irregular cardiac functioning,and heart failure.Machine-based learning of heart sound is an efficient technology which can help minimize the workload of manual auscultation by automatically identifying irregular cardiac sounds.Phonocardiogram(PCG)and electrocardiogram(ECG)waveforms provide the much-needed information for the diagnosis of these diseases.In this work,the researchers have converted the heart sound signal into its corresponding repeating pattern-based spectrogram.PhysioNet 2016 and PASCAL 2011 have been taken as the benchmark datasets to perform experimentation.The existing models,viz.MobileNet,Xception,Visual Geometry Group(VGG16),ResNet,DenseNet,and InceptionV3 of Transfer Learning have been used for classifying the heart sound signals as normal and abnormal.For PhysioNet 2016,DenseNet has outperformed its peer models with an accuracy of 89.04 percent,whereas for PASCAL 2011,VGG has outperformed its peer approaches with an accuracy of 92.96 percent.

Transition from open to robotic assisted liver resection:A retrospective comparative study.Is experience of laparoscopic liver resections needed?

Objective:The authors present outcomes of robotic liver resections in comparison with open technique questioning the need to have experience of laparoscopy for such procedures before transition to robotic assisted.Materials and methods:Retrospective review of liver resections done robotically from February 2015 to June 2017 compared to matched control cohort of open cases from January 2012 to December 2016.Results:Twenty-one patients in the study groupwere comparedwithmatched control of 42 open cases(1:2 ratio).The types of procedure were similar in both the groups.There were 4 left lateral hepatectomy,3 left hepatectomy,and 1 left hepatectomy with hepatico-jejunostomy,3 right hepatectomy,3 right posterior sectorectomy,4 bisegmentectomy and 4 mono-segmentectomy.There were 9 patients with primary liver cancer,2 each with livermetastasis and carcinoma gall bladder and 8 patients had benign liver disease.Mean blood losswas 370±311ml in the robotic group compared to 451±330ml in control group(p=0.06).Minor complications developed in 19.0%of robotic cases compared to 40.5%in open surgery,while major complications occurred in 4.7%of robotic cases compared to 7.1%of open cases.Mean hospital staywas 5.3±0.8 days for the robotic group and 7.7±4.2 days for open group(p=0.02).Local tumor recurrence occurred in 1 out of 13 resections done for malignancy in the robotic group and 7 out of 26 in the open group.Conclusion:This study highlights the utility of surgical robots for segmental and complex liver resections with equivalent outcomes and decreased length of hospital stay compared to open surgery without having experience of same with the laparoscopy.