Stage Invasion Research Articles

Clinical application of a positioning annular gingival cutter in minimally invasive stage II implant surgery.

Dental implant restoration is an effective therapy for missing teeth and is widely used in clinical practice to provide more treatment options for patients. To explore the application of a positioning annular gingival cutter in minimally invasive stage II implant surgery and to evaluate its clinical effects. Stage II implant surgery using a positioning annular gingival cutter was performed on 15 selected patients at 15 implant sites with sufficient keratinized gingival width in the posterior region. The patient underwent crown restoration 2 weeks after surgery and returned for follow-up 3 months later. The surgical effects were recorded for each patient, including the duration of surgery, postoperative pain and swelling, keratinized gingiva width, probing depth (PD) measurements, and the percentage of bleeding on probing (BOP) before surgery, during crown restoration, and 3 months after crown restoration. The data were subjected to a paired sample t-test using Statistical Product and Service Solutions (SPSS) 25.0. The duration of stage II implant surgery using a positioning annular gingival cutter was 9.23 ± 1.63 min, and the duration of postoperative pain and swelling was 0.73 ± 0.35 and 0.81 ± 0.35 d, respectively. The keratinized gingiva width was 2.93 ± 0.41 mm before surgery and 2.91 ± 0.46 mm after crown restoration, demonstrating no significant reduction (P> 0.05). The keratinized gingiva width remained stable 3 months after crown restoration, with an average of 2.85 ± 0.49 mm, without significant reduction (P> 0.05). No obvious inflammation is observed. PD was 2.60 ± 0.52 mm and BOP was 10%. The use of a positioning annular gingival cutter in stage II implant surgery achieves a positive and stable clinical effect within a short time.

Exploring the clinical significance of IL-38 correlation with PD-1, CTLA-4, and FOXP3 in colorectal cancer draining lymph nodes.

Colorectal cancer (CRC) presents a substantial challenge characterized by unacceptably high mortality and morbidity, primarily attributed to delayed diagnosis and reliance on palliative care. The immune response of the host plays a pivotal role in carcinogenesis, with IL-38 emerging as a potential protective factor in CRC. However, the precise involvement of IL-38 among various leucocytes, its interactions with PD-1/PD-L1, and its impact on metastasis require further elucidation. Our investigation revealed a significant correlation between IL-38 expression and metastasis, particularly concerning survival and interactions among diverse leucocytes within draining lymph nodes. In the mesentery lymph nodes, we observed an inverse correlation between IL-38 expression and stages of lymph node invasions (TNM), invasion depth, distance, and differentiation. This aligns with an overall survival advantage associated with higher IL-38 expression in CRC patients' nodes compared to lower levels, as well as elevated IL-38 expression on CD4+ or CD8+ cells. Notably, a distinct subset of patients characterized by IL-38high/PD-1low expression exhibited superior survival outcomes compared to other combinations. Our findings demonstrate that IL-38 expression in colorectal regional nodes from CRC patients is inversely correlated with PD-1/PD-L1 but positively correlated with infiltrating CD4+ or CD8+ lymphocytes. The combined assessment of IL-38 and PD-1 expression in colorectal regional nodes emerges as a promising biomarker for predicting the prognosis of CRC.

Validation of primary and outcome data quality in a Swedish population-based breast cancer quality registry

BackgroundPopulation-based cancer quality registries are of great importance for the improvement of cancer care. However, little is known about the quality of recurrence data in cancer quality registries. The aim of this study was to evaluate data quality in the regional Breast Cancer Quality Registry of Central Sweden, with emphasis on the validity of recorded information on recurrence.MethodsValidation by re-abstraction was performed on a random sample of 800 women with primary invasive breast cancer stage I-III diagnosed between 1993 and 2010, of which 400 had at least one registered recurrence and 400 had no registered recurrence. Registry data were compared with data from medical records. Exact agreement, correlation and kappa values, sensitivity and specificity were calculated.ResultsSeven hundred forty-seven women (93%) were available for analysis. Exact agreement was high for diagnostics, tumor characteristics, surgery, and adjuvant oncological treatment (90% or more for most variables). The registry’s sensitivity was low for regional recurrence (47%), but higher for local and distant recurrence (80% and 75%), whereas specificity was overall high (≥ 95%). Combining all recurrence categories irrespective of localization improved sensitivity to 90% with a specificity of 91%. In 87% of women, the date of first recurrence according to medical records fell within ± 90 days of the date recorded in the registry.ConclusionsWhile the quality of data in the regional Breast Cancer Quality Registry was generally high, data accuracy on recurrences was lower. The overall precision of identifying any recurrence, irrespective of localization, was high. However, the accuracy of classification of recurrences (local, regional or distant) was lower, with evidence of underreporting for each of the recurrence categories. Given the importance of recurrence-related outcomes in the assessment of quality of care, efforts should be made to improve the reporting of recurrences.

Preoperative evaluation of mediastinal lymph nodes in non-small cell lung cancer using [68Ga]FAPI-46 PET/CT: a prospective pilot study

PurposeMediastinal nodal staging is crucial for surgical candidate selection in non-small cell lung cancer (NSCLC), but conventional imaging has limitations often necessitating invasive staging. We investigated the additive clinical value of fibroblast activation protein inhibitor (FAPI) PET/CT, an imaging technique targeting fibroblast activation protein, for mediastinal nodal staging of NSCLC.MethodsIn this prospective pilot study, we enrolled patients scheduled for surgical resection of NSCLC based on specific criteria designed to align with indications for invasive staging procedures. Patients were included when meeting at least one of the following: (1) presence of FDG-positive N2 lymph nodes, (2) clinical N1 stage, (3) central tumor location or tumor diameter of ≥ 3 cm, and (4) adenocarcinoma exhibiting high FDG uptake. [68Ga]FAPI-46 PET/CT was performed before surgery after a staging workup including [18F]FDG PET/CT. The diagnostic accuracy of [68Ga]FAPI-46 PET/CT for “N2” nodes was assessed through per-patient visual assessment and per-station quantitative analysis using histopathologic results as reference standards.ResultsTwenty-three patients with 75 nodal stations were analyzed. Histopathologic examination confirmed that nine patients (39.1%) were N2-positive. In per-patient assessment, [68Ga]FAPI-46 PET/CT successfully identified metastasis in eight patients (sensitivity 0.89 (0.52–1.00)), upstaging three patients compared to [18F]FDG PET/CT. [18F]FDG PET/CT detected FDG-avid nodes in six (42.8%) of 14 N2-negative patients. Among them, five were considered non-metastatic based on calcification and distribution pattern, and one was considered metastatic. In contrast, [68Ga]FAPI-46 PET/CT correctly identified all non-metastatic patients solely based on tracer avidity. In per-station analysis, [68Ga]FAPI-46 PET/CT discriminated metastasis more effectively compared to [18F]FDG PET/CT-based (AUC of ROC curve 0.96 (0.88–0.99) vs. 0.68 (0.56–0.78), P < 0.001).Conclusion[68Ga]FAPI-46 PET/CT holds promise as an imaging tool for preoperative mediastinal nodal staging in NSCLC, with improved sensitivity and the potential to reduce false-positive results, optimizing the need for invasive staging procedures.

Role of EBUS-TBNA in Mediastinal Staging of NSCLC Patients

Abstract Purpose Mediastinal staging in non-small-cell lung carcinoma (NSCLC) is essential for appropriate treatment. Invasive mediastinal staging is necessary and mediastinoscopy has been the gold standard, but it is associated with morbidity. The aim of this study is to evaluate the efficacy of endobronchial ultrasonography transbronchial needle aspiration (EBUS-TBNA), compare it with mediastinoscopy, and assess the endosonographic features of lymph nodes for prediction of metastasis. Methods This is a retrospective study of 200 patients with NSCLC who underwent EBUS-TBNA from January 2017 to December 2019. The patients with potentially resectable NSCLC who underwent EBUS-TBNA were included. Standard definitions of sensitivity, specificity, negative predictive value (NPV), positive predictive value (PPV), and diagnostic accuracy were used to determine the diagnostic performance of EBUS-TBNA. Results A total of 200 patients and 616 nodes were studied, out of which 515 were benign and 101 were malignant. Out of 200 cases, 129 (64.5%) had &lt;N2 disease, 59 (29.5%) had N2 disease, and 12 (6%) had N3 disease. EBUS-TBNA had a sensitivity of 78.87%, specificity of 96.12%, NPV of 89.2%, PPV of 91.8%, and accuracy of 90%. Ultrasonography (USG) features of 297 nodes were available and statistical significance was seen in rounded shape, size greater than 10 mm, ill-defined nodal margins, absence of hilum, and hypoechoic echotexture (p &lt; 0.05). Conclusion EBUS-TBNA is a safe and efficacious procedure for mediastinal sampling of NSCLC patients. Familiarity with endosonographic features of lymph nodes, which can predict malignancy in nodes, may further improve the yield of EBUS-TBNA and reduce under-staging.

Plant invasion in Mediterranean Europe: current hotspots and future scenarios

The Mediterranean Basin has historically been subject to alien plant invasions that threaten its unique biodiversity. This seasonally dry and densely populated region is undergoing severe climatic and socioeconomic changes, and it is unclear whether these changes will worsen or mitigate plant invasions. Predictions are often biased, as species may not be in equilibrium in the invaded environment, depending on their invasion stage and ecological characteristics. To address future predictions uncertainty, we identified invasion hotspots across multiple biased modelling scenarios and ecological characteristics of successful invaders. We selected 92 alien plant species widespread in Mediterranean Europe and compiled data on their distribution in the Mediterranean and worldwide. We combined these data with environmental and propagule pressure variables to model global and regional species niches, and map their current and future habitat suitability. We identified invasion hotspots, examined their potential future shifts, and compared the results of different modelling strategies. Finally, we generalised our findings by using linear models to determine the traits and biogeographic features of invaders most likely to benefit from global change. Currently, invasion hotspots are found near ports and coastlines throughout Mediterranean Europe. However, many species occupy only a small portion of the environmental conditions to which they are preadapted, suggesting that their invasion is still an ongoing process. Future conditions will lead to declines in many currently widespread aliens, which will tend to move to higher elevations and latitudes. Our trait models indicate that future climates will generally favour species with conservative ecological strategies that can cope with reduced water availability, such as those with short stature and low specific leaf area. Taken together, our results suggest that in future environments, these conservative aliens will move farther from the introduction areas and upslope, threatening mountain ecosystems that have been spared from invasions so far.

A case study on the early stage of Pinus nigra invasion and its impact on species composition and pattern in Pannonic sand grassland

Alien woody species are successful invaders, frequently used for afforestation in regions like semi-arid lands. Shrubs and trees create important microhabitats in arid areas. Understorey vegetation in these habitats has unique species composition and coexistence. However, the impact of solitary woody species on understorey vegetation is less understood. This study evaluated the effect of native (Juniperus communis) and invasive solitary conifers (Pinus nigra) on surrounding vegetation, where individuals were relatively isolated (referred to as solitary conifers). The field study conducted in Pannonic dry sand grassland in 2018 recorded plant and lichen species presence around six selected solitary conifers. Composition and pattern of understorey vegetation were assessed using 26 m belt transects with 520 units of 5 cm × 5 cm contiguous microquadrats. Compositional diversity (CD) and the number of realized species combinations (NRC) were calculated from the circular transects. Results showed native conifer J. communis created more complex, organized microhabitats compared to alien P. nigra. CD and NRC values were significantly higher under native conifers than invasive ones (p = 0.045 and p = 0.026, respectively). Native species also had more species with a homogeneous pattern than the alien species. Alien conifers negatively affected understorey vegetation composition and pattern: some species exhibited significant gaps and clusters of occurrences along the transects under P. nigra. Based on our study, the removal of invasive woody species is necessary to sustain habitat diversity.

Submucosal gland differentiation and implications in esophageal basaloid squamous cell carcinomas.

Esophageal basaloid squamous cell carcinoma (BSCC) is a heterogenous entity with multilineage differentiation. It lacks systematical analysis on submucosal gland differentiation (SGD) due to the histological diversity and low incidence of esophageal BSCC. This study aims to find the correlation of SGD and clinicopathological features. A total of 152 esophageal BSCCs were separated into three histological groups: pure, mixed, and borderline group. The clinicopathological features were compared between different groups. The prevalence of SGD was also compared between cases of different groups. A panel of antibodies were used to identify SGD. The pure group differed from the mixed and borderline groups in many aspects, lymph node metastasis (LNM), cancer embolus, perineural invasion, and advanced stage occurred less frequently in the pure group (P<0.01). The pure group had a better but statistically insignificant overall survival (P=0.097). The squamous cell carcinoma (SCC) component or focal squamous differentiation was present in metastatic lymph nodes in almost all mixed BSCCs (95.7%, 22/23) with LNM. The LNM rate of superficial (T1b) BSCCs (17.6%, 6/34) was comparable to that of superficial (T1b) SCCs (18.5%, 57/308). However, LNM exclusively occurred in superficial mixed (3/5) and borderline (3/10) BSCCs. The IHC results demonstrated a prevalence of SGD in pure group (77%, 43/56). SGD is considered to be a favorable factor, while the squamous differentiation or invasive SCC component is an adverse factor in esophageal BSCCs. Refinement of classification is a promising way to improve patient management.

STEAP3 promotes colon cancer cell proliferation and migration via regulating histone acetylation.

Colorectal cancer (CRC) is the third most prevalent diagnosed cancer in men and second most prevalent cancer in women. H3K27ac alterations are more commonly than gene mutations in colorectal cancer. Most colorectal cancer genes have significant H3K27ac changes, which leads to an over-expression disorder in gene transcription. Over-expression of STEAP3 is involved in a variety of tumors, participating in the regulation of cancer cell proliferation and migration. The purpose of this work is to investigate the role of STEAP3 in the regulation of histone modification (H3K27ac) expression in colon cancer. Bioinformatic ChIP-seq, ChIP-qPCR and ATAC-seq were used to analyze the histone modification properties and gene accessibility of STEAP3. Western blot and qRT-PCR were used to evaluate relative protein and gene expression, respectively. CRISPR/Cas9 technology was used to knockout STEAP3 on colon cancer cells to analyze the effect of ATF3 on STEAP3. STEAP3 was over-expressed in colon cancer and associated with higher metastases and more invasive and worse stage of colon cancer. ChIP-seq and ChIP-qPCR analyses revealed significant enrichment of H3K27ac in the STEAP3 gene. In addition, knocking down STEAP3 significantly inhibits colon cancer cell proliferation and migration and down-regulates H3K27ac expression. ChIP-seq found that ATF3 is enriched in the STEAP3 gene and CRISPR/Cas9 technology used for the deletion of the ATF3 binding site suppresses the expression of STEAP3. Over-expression of STEAP3 promotes colon cancer cell proliferation and migration. Mechanical studies have indicated that H3K27ac and ATF3 are significantly enriched in the STEAP3 gene and regulate the over-expression of STEAP3.

An immune cell map of human lung adenocarcinoma development reveals an anti-tumoral role of the Tfh-dependent tertiary lymphoid structure

The immune responses during the initiation and invasion stages of human lung adenocarcinoma (LUAD) development are largely unknown. Here, we generated a single-cell RNA sequencing map to decipher the immune dynamics during human LUAD development. We found that T follicular helper (Tfh)-like cells, germinal center B cells, and dysfunctional CD8+ Tcells increase during tumor initiation/invasion and form a tertiary lymphoid structure (TLS) inside the tumor. This TLS starts with an aggregation of CD4+ Tcells and the generation of CXCL13-expressing Tfh-like cells, followed by an accumulation of B cells, and then forms a CD4+ T and B cell aggregate. TLS and its associated cells are correlated with better patient survival. InhibitingTLS formation by Tfh or B cell depletion promotes tumor growth in mouse models. The anti-tumoraleffect of the Tfh-dependent TLS is mediated through interleukin-21 (IL-21)-IL-21 receptor signaling. Our study establishes an anti-tumoral role of the Tfh-dependent TLS in the development of LUAD.

Effects of tidal creeks on Spartina Alterniflora expansion: A perspective from multi-scale remote sensing

Rapid expansion of Spartina Alterniflora (S. alterniflora) has led to severe ecological consequences in coastal wetlands in China. Better understanding of the mechanism of S. alterniflora expansion is of great importance for its control and management. Although previous research has reported that the expansion of S. alterniflora is closely related to tidal creeks via field investigations, few studies have quantitatively investigated their relationships using remote sensing at different scales. In this study, we utilized time series satellite remote sensing imagery with different spatial resolutions to investigate the effects of tidal creeks on S. alterniflora expansion at both landscape scale and patch scale. We took the Yellow River Delta (YRD), China as our study area, where S. alterniflora has spread across the intertidal wetlands during the past decade. At landscape scale, we first derived the yearly maps of S. alterniflora and tidal creeks during 2009–2020 based on Landsat-series satellite imagery, then analyzed the spatio-temporal relationship between S. alterniflora and tidal creeks. By using grid analysis method, we evaluated the change of S. alterniflora area and tidal creek length and compared their change time. The results showed that 30.46 % of the grids experienced no change in tidal creeks while expansion of S. alterniflora, and 54.02 % of the grids experienced S. alterniflora area increase after the lengthening of tidal creeks. The results indicated that relationship between tidal creeks and S. alterniflora in YRD was dominated by “tidal creeks promoting S. alterniflora expansion”. We then simulated the S. alterniflora expansion at patch scale using an improved spatially explicit individual-based model based on S. alterniflora maps derived from Landsat imagery (30 m) and GF-1 high spatial resolution imagery (2 m), respectively. The results showed that consideration of long-distance dispersal of seeds along the direction of tidal creeks considerably enhanced the simulation accuracy, regardless of the spatial resolution of the S. alterniflora maps. High-resolution S. alterniflora maps yielded higher simulation accuracies. Our study suggests that the long-distance dispersal of seeds led by tidal creeks is an important manner for S. alterniflora expansion. Satellite remote sensing imagery have great potential to discover the mechanism of S. alterniflora expansion, facilitating control of S. alterniflora at the early invasion stage.

Analysis of the state of development of the issue of protection of critical infrastructure facilities using engineered munitions

The Russian-Ukrainian war at the stage of full-scale invasion has shown that one of the most difficult tasks of ensuring the survivability of troops and the functioning of critical infrastructure is to protect them from high-precision weapons, namely cruise and ballistic missiles and unmanned aerial vehicles.&#x0D; The experience of warfare shows that the existing domestic air defense systems do not fully defeat air targets, while highly effective foreign-made air defense systems are supplied in insufficient quantities, and the created mobile fire groups to destroy air targets are not always effective. In these circumstances, it is advisable to consider new integrated approaches to the use of various types of weapons in the active defense of troops and critical infrastructure against air attack.&#x0D; The complex construction of a system of active defense of troops and critical infrastructure against air attack is possible with the use of several types of weapons. Based on the analysis of the enemy's use of missiles of various classes and Shahed-type attack unmanned aerial vehicles, the paper proposes the use of engineered munitions as one of the means of defeating moving air targets that fly low at low speed. The use of special engineered ammunition will make it possible to increase the range of low-flying air targets and increase the likelihood of their defeat. This will improve the effectiveness of the existing system of protecting troops and critical infrastructure from air attack.&#x0D; The paper analyzes the use of air attack weapons of the Russian Federation against troops and critical infrastructure facilities of Ukraine, substantiates proposals on the expediency of using engineered ammunition as an element of building a system of active protection of troops and critical infrastructure facilities from air attack, and presents their principle of operation and possible applications.

Invasive Nodal Staging via Endobronchial Ultrasound and Outcome in Patients Treated with Stereotactic Body Radiation Therapy for Early-Stage Non-Small Cell Lung Cancer – Results from a Single Institution Study

IntroductionStereotactic body radiation therapy (SBRT) is an effective treatment for medically inoperable early-stage non-small cell lung cancer (NSCLC). The prognostic value of invasive nodal staging (INS) for patients undergoing SRBT has not been studied extensively. Herein, we report the impact of INS in addition to 18F-FDG-PET on treatment outcome for patients with NSCLC undergoing SBRT. Materials and MethodsPatients with stage I/ II NSCLC who underwent SBRT were included with IRB approval. Clinical, dosimetric, and radiological data were obtained. Overall survival (OS), regional recurrence free survival (RRFS), local recurrence free survival (LRFS), and distant recurrence free survival (DRFS) were analyzed using Kaplan Meyer method. Univariable analysis (UVA) and multivariable analysis (MVA) were performed to assess the relationship between the variables and the outcomes. ResultsA total of 376 patients were included in the analysis. Median follow up was 43 months (IQ 32.6-45.8). Median OS, LRFS, RRFS, DRFS were 40, 32, 32, 33 months, respectively. The 5-year local, regional, and distant failure rates were 13.4%, 23.5% and 25.3%, respectively. The 1-year, 3-year and 5-year OS were 83.8%, 55.6%, and 36.3%, respectively. On MVA, INS was not a predictor of either improved overall or any recurrence free survival endpoints while larger tumor size, age, and adjusted Charleston co-morbidity index (aCCI) were significant for inferior LRFS, RRFS, and DRFS. ConclusionInvasive nodal staging did not improve overall or recurrence free survival among patients with early-stage NSCLC treated with SBRT whereas older age, aCCI, and larger tumor size were significant predictors of LRFS, RRFS, and DRFS.

Exploring miR-155-5p and miR-1246 as Diagnostic and Prognostic Markers in Oral Squamous cell carcinoma.

Oral Squamous Cell Carcinoma (OSCC) is one of the leading cancers worldwide, significantly impacting developing nations. This study aimed to explore the diagnostic and prognostic potential of miR-155-5p and miR-1246 in OSCC in the Indian population, as their comparative roles in this context remain unexplored. The present cross-sectional study comprised 50 histopathologically confirmed OSCC cases, with adjacent normal mucosa as controls. MiRNA expression was assessed via qRT-PCR and correlated with clinicopathological factors. MiRwalk and miRTargetlink were used for miRNA:mRNA interaction prediction, and gprofiler was employed to analyze validated targets for functional insights. The expression analysis showed a significant upregulation of miR-155-5p and miR-1246 in OSCC tissues compared to adjacent controls. Receiver operating curve analysis revealed that miR-1246 exhibited excellent diagnostic accuracy (AUC = 0.94) compared to miR-155-5p (AUC = 0.69). Higher miRNA levels were associated with age and extracapsular extension while overexpression of miR-1246 was correlated significantly with increased tumor size, tumor grade, TNM staging, and depth of invasion. The analysis for target prediction unveiled a set of validated targets, among which were WNT5A, TP53INP1, STAT3, CTNNB1, PRKAR1A, and NFIB. miR-155-5p and miR-1246 may be used as potential prognostic biomarkers in OSCC, with miR-1246 demonstrating superior diagnostic accuracy.

The emerging role of cell-free DNA as a molecular marker for duodenal adenocarcinoma.

Duodenal adenocarcinoma is rare and its prognostic factors remain controversial. In our study, the role of cell-free deoxyribonucleic acid (cfDNA) as prognostic factor in duodenal adenocarcinoma was evaluated. From June 2003 to July 2021, plasma samples were collected from 41 patients with duodenal adenocarcinoma. Plasma cfDNA was assessed in combination with clinicopathological and biochemical characteristics. Univariate and multivariate analyses were conducted to identify independent prognostic factors for overall survival with a Cox proportional hazards regression model. The 1- and 5-year survival rates of the patients with high plasma cfDNA level (>9288 copies/mL) group were 58.7% and 17.6%, respectively, which were much lower than patients with low cfDNA level (≤9288 copies/mL), with 95.2% and 64.6%. In univariate analysis, high cfDNA level, lymph node involvement, lymphovascular invasion, and tumor stage were associated with decreased survival. When subjected to multivariate analysis, only high cfDNA level showed significance in influencing the overall survival of duodenal cancer. cfDNA analysis is simple and noninvasive. High cfDNA level is a strong independent prognostic factor for decreased overall survival and it should be integrated into clinical care.

Investigation on the propagation characteristics of pressure wave during managed pressure drilling

The small difference between formation pressure and fracture pressure in offshore oil and gas reservoirs poses a huge challenge to drilling. Managed pressure drilling (MPD) technology, as a drilling technique that can accurately control bottomhole pressure, is an effective technique to solve this challenge. In MPD technology, the pressure wave propagation behavior and mechanism in the wellbore induced by wellhead backpressure are crucial for parameter design and efficient application. In this paper, pressure wave propagation characteristics and mechanism in gas-liquid flow were investigated with a new proposed pressure wave velocity model that considers inter-phase mass transfer effect. This new model and its solution algorithm were verified with experimental data in literature. The influence of gas invasion stage, drilling fluid type, drilling fluid density and backpressure on pressure wave propagation characteristics were investigated. Results show that the time for pressure wave induced by wellhead backpressure in the wellbore cannot be ignored in the design of the backpressure value during MPD. This propagation time increases with occurrence of gas invasion. Moreover, the propagation time in water-based drilling fluid is longer than that in oil-based drilling fluid, which is because the interphase mass transfer between invaded gas and oil-based drilling fluid. The influence mechanism of high drilling fluid density and wellhead backpressure on pressure wave propagation characteristics is due to the suppression of gas invasion process. These findings could be used as guides in parameters design and optimization in MPD.

Diversity and Chorotype Analysis of the Pteridophytes of Zimbabwe

In the current investigation, an attempt has been made to document the floristic diversity and chorotype analysis of Pteridophytes growing in Zimbabwe. Previously published literature and online sources were consulted to confirm the nomenclature, precise locations, chorotype, stages of invasion, and conservation status of the Pteridophytes in Zimbabwe. The updated list of Pteridophyte taxa confirms that there are 297 taxa belonging to 83 genera and 19 families. The largest family is Aspleniaceae, with 78 taxa (26.26%), followed by Polypodiaceae and Pteridaceace with 67 taxa (22.56%) and 54 taxa (18.18%), respectively. The largest genus is Asplenium L., with 46 taxa (15.49%), followed by Hemionitis L. with 22 taxa (7.41%), Ophioglossum L. (16 taxa, 5.39%), Thelypteris Schmidel (14 taxa, 4.71%), and Elaphoglossum Schott ex J.Sm. (12 taxa, 4.04%). A total of 20 taxa (6.73%) are threatened with extinction, emphasizing the need for detailed knowledge of the nomenclature, conservation status, and distribution of Pteridophytes taxa in Zimbabwe. Research focusing on the diversity, ecology, and conservation status of Pteridophytes is imperative for biodiversity conservation, as they are an important component of natural ecosystems adapted to different habitats. Therefore, future studies on Pteridophytes in Zimbabwe should explore how the lack of floristic data on the plant group can hinder ecological research.

Health Economic Consequences Associated With COVID-19–Related Delay in Melanoma Diagnosis in Europe

The COVID-19 pandemic resulted in delayed access to medical care. Restrictions to health care specialists, staff shortages, and fear of SARS-CoV-2 infection led to interruptions in routine care, such as early melanoma detection; however, premature mortality and economic burden associated with this postponement have not been studied yet. To determine the premature mortality and economic costs associated with suspended melanoma screenings during COVID-19 pandemic lockdowns by estimating the total burden of delayed melanoma diagnoses for Europe. This multicenter economic evaluation used population-based data from patients aged at least 18 years with invasive primary cutaneous melanomas stages I to IV according to the American Joint Committee on Cancer (AJCC) seventh and eighth editions, including melanomas of unknown primary (T0). Data were collected from January 2017 to December 2021 in Switzerland and from January 2019 to December 2021 in Hungary. Data were used to develop an estimation of melanoma upstaging rates in AJCC stages, which was verified with peripandemic data. Years of life lost (YLL) were calculated and were, together with cost data, used for financial estimations. The total financial burden was assessed through direct and indirect treatment costs. Models were building using data from 50 072 patients aged 18 years and older with invasive primary cutaneous melanomas stages I to IV according to the AJCC seventh and eighth edition, including melanomas of unknown primary (T0) from 2 European tertiary centers. Data from European cancer registries included patient-based direct and indirect cost data, country-level economic indicators, melanoma incidence, and population rates per country. Data were analyzed from July 2021 to September 2022. COVID-19 lockdown-related delay of melanoma detection and consecutive public health and economic burden. As lockdown restrictions varied by country, lockdown scenario was defined as elimination of routine medical examinations and severely restricted access to follow-up examinations for at least 4 weeks. Primary outcomes were the total burden of a delay in melanoma diagnosis during COVID-19 lockdown periods, measured using the direct (in US$) and indirect (calculated as YLL plus years lost due to disability [YLD] and disability-adjusted life-years [DALYs]) costs for Europe. Secondary outcomes included estimation of upstaging rate, estimated YLD, YLL, and DALY for each European country, absolute direct and indirect treatment costs per European country, proportion of the relative direct and indirect treatment costs for the countries, and European health expenditure. There were an estimated 111 464 (range, 52 454-295 051) YLL due to pandemic-associated delay in melanoma diagnosis in Europe, and estimated total additional costs were $7.65 (range, $3.60 to $20.25) billion. Indirect treatment costs were the main cost driver, accounting for 94.5% of total costs. Estimates for YLD in Europe resulted in 15 360 years for the 17% upstaging model, ranging from 7228 years (8% upstaging model) to 40 660 years (45% upstaging model). Together, YLL and YLD constitute the overall disease burden, ranging from 59 682 DALYs (8% upstaging model) to 335 711 DALYs (45% upstaging model), with 126 824 DALYs for the real-world 17% scenario. This economic analysis emphasizes the importance of continuing secondary skin cancer prevention measures during pandemics. Beyond the personal outcomes of a delayed melanoma diagnosis, the additional economic and public health consequences are underscored, emphasizing the need to include indirect economic costs in future decision-making processes. These estimates on DALYs and the associated financial losses complement previous studies highlighting the cost-effectiveness of screening for melanoma.

Plant invasion and naturalization are influenced by genome size, ecology and economic use globally

Human factors and plant characteristics are important drivers of plant invasions, which threaten ecosystem integrity, biodiversity and human well-being. However, while previous studies often examined a limited number of factors or focused on a specific invasion stage (e.g., naturalization) for specific regions, a multi-factor and multi-stage analysis at the global scale is lacking. Here, we employ a multi-level framework to investigate the interplay between plant characteristics (genome size, Grime’s adaptive CSR-strategies and native range size) and economic use and how these factors collectively affect plant naturalization and invasion success worldwide. While our findings derived from structural equation models highlight the substantial contribution of human assistance in both the naturalization and spread of invasive plants, we also uncovered the pivotal role of species’ adaptive strategies among the factors studied, and the significantly varying influence of these factors across invasion stages. We further revealed that the effects of genome size on plant invasions were partially mediated by species adaptive strategies and native range size. Our study provides insights into the complex and dynamic process of plant invasions and identifies its key drivers worldwide.

Role of invasive mediastinal nodal staging in survival outcomes of patients with non-small cell lung cancer and without radiologic lymph node metastasis: a retrospective cohort study

Lung cancer diagnostic guidelines advocate for invasive mediastinal nodal staging (IMNS), but the survival benefits of this approach in patients with non-small cell lung cancer (NSCLC) without radiologic evidence of lymph node metastasis (rN0) remain uncertain. We aimed to investigate the impact of IMNS in patients with rN0 NSCLC by comparing the long-term survival between patients who underwent IMNS and those who did not (non-IMNS). In this retrospective cohort study, we included patients with NSCLC but without radiologic evidence of lymph node metastasis from the Registry for Thoracic Cancer Surgery and the clinical data warehouse at the Samsung Medical Centre, Republic of Korea between January 2, 2008 and December 31, 2016. We compared the 5-year overall survival (OS) rate as the primary outcome after propensity score matching between the IMNS and non-IMNS groups. The age, sex, performance statue, tumor size, centrality, solidity, lung function, FDG uptake in PET-CT, and histological examination of the tumor before surgery were matched. A total of 4545 patients (887 in the IMNS group and 3658 in the non-IMNS group) who received curative treatment for NSCLC were included in this study. By the mediastinal node dissection, the overall incidence of unforeseen mediastinal node metastasis (N2) was 7.2% (317/4378 patients). Despite the IMNS, 67% of pathological N2 was missed (61/91 patients with unforeseen N2). Based on propensity score matching, 866 patients each for the IMNS and non-IMNS groups were assigned. There was no significant difference in 5-year OS and recurrence-free survival (RFS) between two groups: 5-year OS was 73.9% (95% confidence interval, CI: 71%-77%) for IMNS and 71.7% (95% CI: 68.6%-74.9%; p=0.23), for non-IMNS (hazard ratio, HR 0.90, 95% CI: 0.77-1.07), while 5-year RFS was 64.7% (95% CI: 61.5%-68.2%) and 67.5% (95% CI: 64.3%-70.9%; p=0.35 (HR 1.08, 95% CI: 0.92-1.27), respectively. Moreover, the timing and locations of recurrence were similar in both groups. IMNS might not be required before surgery for patients with NSCLC without LN suspicious of metastasis. Further randomised trials are required to validate the findings of the present study. None.