Predominant Pattern Research Articles

Clinical and Temporal Radiological Findings from Critical Patients with COVID-19 Pneumonia: A Descriptive Study.

In late December 2019, Wuhan, the capital of Hubei Province, China, became the center of an outbreak of pneumonia caused by severe acute respiratory syndrome Coronavirus 2 (SARS-CoV-2). The radiological changes in the lungs of critical people with coronavirus disease 2019 (COVID-19) pneumonia at different times have not been fully characterized. We aim to describe the computed tomography findings of patients with critical COVID-19 pneumonia at different disease stages. Clinical and laboratory features of critical patients were assessed. CT scans were assigned to groups 1, 2, 3, or 4 based on the interval from symptom onset (within 2 weeks; ≥ 2-4 weeks; ≥ 4-6 weeks; or ≥ 6 weeks, respectively). Imaging features were analyzed and compared across the four groups. Total CT scores, corresponding periods of laboratory findings, and glucocorticoid dosages during the imaging intervals were longitudinally observed in five patients with complete data. All 11 critical patients (median age: 60 years [42-69]) underwent a total of 40 CT examinations, and the acquisition times ranged from 1-59 days after symptom onset. Median total CT scores were 18 (9-25.25); 44.5 (42.88-47.62); 43.75 (38.62-49.38); and 42 (32.25-53.25) in groups 1, 2, 3, and 4, respectively. The observed lesions were mainly bilateral (37 [92.5%]). The median values of involved lung segments were 10.5 (4.5-13.5); 17 (16-18.5); 18 (18-19.5); and 18 (18-19) in groups 1-4, respectively. The predominant patterns of observed abnormalities were ground-glass opacities (GGO) (9 [90%]); GGO with reticulation and mixed patterns (3 [37.5%] for both); GGO with consolidation (3 [30%]); and GGO with reticulation (8 [66.7%]) in groups 1-4, respectively. Patients developed fibrotic manifestations at later stages. Critical patients with COVID-19 infection generally presented with temporally changing abnormal CT features from focal unilateral to diffuse bilateral GGO and consolidation that progressed to or coexisted with reticulation in the long term after symptom onset. Low-dose glucocorticoids may be effective in patients with interstitial changes on CT findings.

Overview, Trends, and Collaboration on Immunization, Vaccination, and Immunomodulation Therapies for Periodontitis: A Scientometric Study.

To identify patterns and trends in the field of immunization, vaccination, and immunomodulation therapies for periodontitis. Metadata were collected from the Scopus database on publications related to these topics from January 1986 to February 2024. Several types of papers were included in this study, a total of 22 publications. Data were extracted from relevant publications and loaded into SciVal for analysis that were used to identify trends and patterns in the data, including cross-country collaboration, thematic evolution, and keyword distribution. Mohsen Amin of Tehran University of Medical Sciences in Iran and S. Aadil Ahamed and Annie Kitty George of Saveetha Institute of Medical and Technical Sciences in India were found to be notable contributors in this field. India leads in terms of academic paper production, followed by Iran and China. The journals Expert Review of Vaccines and International Immunopharmacology have published significant papers in this field. According to Lotka's Law, most authors have written only one paper, reflecting the distribution of productivity in many academic and scientific fields. Collaborations were observed between Iran and Canada, Korea and New Zealand, and the United States and Belgium. This study provides useful insight into the predominant trends and patterns in the scientific literature in the field of immunization, vaccination, and immunomodulation therapies for periodontitis. The findings of this study may help to understand the dynamics of the production on immunization, vaccination, and immunomodulation therapies could reduce the inflammation and progression of periodontitis, thus improving the patient's oral and overall health. How to cite this article: Mauricio F, Mendoza R, Silva H, et al. Overview, Trends, and Collaboration on Immunization, Vaccination, and Immunomodulation Therapies for Periodontitis: A Scientometric Study. J Contemp Dent Pract 2024;25(2):128-133.

Acne Vulgaris and adherence to the mediterranean diet among university students: a case‒control study

BackgroundWestern diets, characterized by a high glycemic index and dairy content, can be risk factors for acne vulgaris. A few studies have suggested that adherence to non-Western diets, such as the Mediterranean diet (MD), may be protective against acne. This study aimed to explore the relationships between adherence to the MD and acne diagnosis and severity.MethodsThis was a matched case‒control study carried out among university students studying health sciences to explore the relationship between adhering to the MD and an acne diagnosis. Convenience sampling was utilized for the initial recruitment of eligible participants, who were then 1:1 individually matched for age, gender, and body mass index (BMI). Adherence to the MD was assessed using the Mediterranean Diet Adherence Screener (MEDAS) tool, and acne severity was assessed using the Global Acne Grading System (GAGS). The data were analyzed using descriptive statistics, bivariate analysis, and conditional logistic regression, which included two models based on clinical data and the backward elimination technique.ResultsA final sample of 121 cases was individually matched to 121 controls. Each group consisted of 28.9% males and 71.1% females, with most having a BMI within the healthy range (71.9%). Both the case (80.2%) and control groups (77.7%) demonstrated a predominant pattern of low adherence to the MD. At the bivariate level, family history significantly differed between the case and control groups (OR = 2.01, CI = 1.17–3.44), while adherence to the MD (OR = 0.86, CI = 0.46–1.60) did not reach statistical significance. According to the regression analysis, family history remained significant in the backward elimination model (aOR = 1.94, CI = 1.14–3.34), while it disappeared in the full model (aOR = 1.95, CI = 1.14–3.34). Neither model revealed a significant association between acne and the other variables. Among the participants in the case group, neither adherence to the MD nor adherence to its components was significantly associated with acne severity, except for vegetables (p = 0.022).ConclusionsAdherence to the MD was not correlated with acne diagnosis or clinical severity. More research on the association between acne and adherence to the MD is needed, as earlier studies are few, were conducted in specific settings, and used variable methodologies. To improve the validity and reliability of the research methodology, the development of detailed and culturally adapted MD definitions and practical guides is recommended.

Prolonged acid reflux monitoring using acid exposure time and DeMeester score: two days are not enough.

Wireless pH monitoring allows for a definitive GERD diagnosis, which is essential for optimal medical or surgical management of the patient. However, there is no guideline recommendation on whether prolonged pH testing (72 or 96h) provides additional benefit when compared to the standard 48-h testing. We aimed to assess whether prolonged pH monitoring diagnoses more patients with GERD, as well as compare the DeMeester score to acid exposure time as diagnostic criteria for GERD. This was a retrospective analysis of consecutive adult patients who underwent wireless esophageal pH monitoring between August 2018 and July 2021. The primary outcome was the additional diagnoses of GERD (predominant acid exposure pattern) in patients who underwent 48-h versus 96-h pH monitoring. Secondary outcomes included comparison of the DeMeester score to acid exposure time and internal agreement between the first and second 48-h blocks of a prolonged96-hpH study. When comparing 48-h versus 96-h pH testing, the prolonged monitoring group was more likely to have a predominant reflux pattern and thus be diagnosed with definitive GERD by elevated DeMeester score (58.8% vs. 40.8%, p = 0.003) or acid exposure time > 6% (44.7% vs. 32.4%, p = 0.039). For patients who underwent prolonged testing, the results of monitoring beyond 48h led to a clinically meaningful change in study interpretation in 24.8% of patients. The study data from Days 3 to 4 yielded only a 56.6% agreement with the first 2days. In patients undergoing extended pH monitoring, almost half were found to have an abnormal pH study after a normal study on Day 1. An additional 25% of patients had a change in study interpretation by extending the study beyond 48h. Our findings suggest only 48h of pH monitoring will miss a diagnosis of GERD in a clinically important number of patients.

On Merit and Equity in Admission to US Physical Therapist Education Programs: A Qualitative Analysis of Faculty Habitus

Introduction. In contrast to the increased diversity of the US population, historically excluded racial and ethnic groups remain underrepresented in the physical therapist profession. As decision-makers, faculty exert direct influence on enrollment through evaluating applications and determining which applicants are deserving of admission to physical therapist programs. Review of Literature. Faculty decision-making in admissions is a cultural process which can reproduce inequities and perpetuate underrepresentation if faculty fail to recognize systemic disparities in legitimized forms of merit. No studies within physical therapist education have directly investigated faculty habitus and patterns of thought and behavior which reinforce admissions decision-making. The purpose of this study was to describe patterns of faculty habitus which influence judgments of admission merit and equity in US physical therapist education programs. Subjects. Sixteen physical therapy faculty across 3 physical therapist education programs. Methods. Using interpretative research methodology and a constructivist approach, semistructured interviews were conducted with each participant. Faculty social actions were also observed during field observations. Thematic analysis using Bourdieu's social reproduction theory was used for coding and establishment of themes. Results. Two predominant patterns of faculty habitus with corresponding themes emerged from the data: Transformative habitus oriented faculty toward a sense of responsibility to promote equity, construct a more contextualized understanding of merit, and formulate compelling applicant storylines; gatekeeping habitus positioned faculty to support a meritocratic process, reinforce traditional notions of academic rigor, and support the necessity of adjusting standards to address underrepresentation. Discussion and Conclusion. Findings revealed contrasting patterns of faculty habitus which legitimized certain criteria, knowledge, and experiences on which decisions of merit were based. Attention to the individual dispositions of faculty decision-makers in addition to criteria and processes used in holistic review may shape equitable access to physical therapist education programs.

Energetic and dynamic characterization of pollutant dispersion in varied building layouts through an augmented analysis procedure

This work presents a post-data analysis procedure, namely, proper orthogonal decomposition (POD)–dynamic mode decomposition (DMD)–discrete Fourier transform analysis, for evaluating the dominant features of the flow fields from both energetic and dynamic perspectives. The large-eddy simulation (LES) was first employed to reproduce the flow field surrounding three types of building layouts. Subsequently, both POD and DMD were conducted according to LES simulation results. The extracted modes were classified into three types based on the POD and DMD: Type-1 mode: energetically and dynamically significant mode, Type-2 mode: energetically significant and dynamically insignificant mode, and Type-3 mode: energetically insignificant and dynamically significant mode. The findings indicate that Type-1 mode governs the primary velocity field and the predominant vortex patterns observed at the rear of the building arrays, as the reduction of inter-building widths leads to a shorter flow separation region. Type-2 mode is characterized by the presence of small-scale vortices and the high turbulent kinetic energy region, which periodically triggers pollutant increase in the vicinity of structures. Type-3 mode demonstrates a minimal energetic influence on the flow field; nevertheless, it significantly contributes to the consistent build-up of pollutants within the far-wake region. The present study also investigates the predominant coherent structures of flow fields concerning various building layouts and highlights the influence of passage widths on the efficiency of pollutant removal. This comprehensive analysis enables a systematic exploration of flow patterns within various building layouts, offering potential solutions for pollutant dispersion challenges in metropolitan areas.

A computed tomography (CT)-based morphometric study of various skull base parameters and their anatomical relationships relevant to endoscopic endonasal skull base surgery.

Endoscopic skull base surgery requires a thorough understanding of skull base anatomy. Orientation to regional anatomy to avoid complications like internal carotid artery injury can be assisted by knowledge of certain bony landmarks. These landmarks are themselves highly variable structures. This study focuses on the radiological morphometric characterization of these landmarks, which can be of great assistance to surgeons for better planning of endoscopic skull base approaches. Computed tomography scans of patients without skull base pathologies were analyzed retrospectively for the following parameters - Vidian canal (VC) length, VC and foramen rotundum (FR) distance from midline, the angle between the axis of VC and petrous internal carotid artery (pICA) and between VC and palatovaginal canal, the horizontal, vertical and direct distances between VC and FR and the patterns of sphenoid sinus (SS) pneumatization. The VC-pICA angle was more obtuse and VC and FR were placed farther off the midline on the left as compared to the right side. Similarly, the distances between VC and FR were more on the left side. The VC length and distance of VC and FR from the midline were longer in males than in females. The VC-pICA angle was more obtuse in females. The post-sellar variant was the predominant pneumatization pattern seen (57.9%), and the incidence of lateral recess pneumatization was 15%. The results of our study can be utilized for a better understanding of the anatomy of the skull base. In skull base pathologies with distorted anatomical landmarks, a basic understanding of their interrelations can be used to have a better anatomical orientation. All these measures can help in avoiding complications and make extended endoscopic approaches safe.

Refractoriness to anti-Helicobacter pylori treatment attributed to phenotypic resistance patterns in patients with gastroduodenopathy in Guayaquil-Ecuador.

Treatment of Helicobacter pylori gastric infection is complex and associated with increased rates of therapeutic failure. This research aimed to characterize the H. pylori infection status, strain resistance to antimicrobial agents, and the predominant lesion pattern in the gastroduodenal mucosa of patients with clinical suspicion of refractoriness to first- and second-line treatment who were diagnosed and treated in a health center in Guayaquil, Ecuador. A total of 374 patients with upper gastrointestinal symptoms and H. pylori infection were preselected and prescribed one of three triple therapy regimens for primary infection, as judged by the treating physician. Subsequently, 121 patients who returned to the follow-up visit with persistent symptoms after treatment were studied. All patients had H. pylori infection. Histopathological examination diagnosed chronic active gastritis in 91.7% of cases; premalignant lesions were observed in 15.8%. The three triple therapy schemes applied showed suboptimal efficacy (between 47.6% and 77.2%), with the best performance corresponding to the scheme consisting of a proton pump inhibitor + amoxicillin + levofloxacin. Bacterial strains showed very high phenotypic resistance to all five antimicrobials tested: clarithromycin, 82.9%; metronidazole, 69.7%; amoxicillin and levofloxacin, almost 50%; tetracycline, 38.2%. Concurrent resistance to clarithromycin-amoxicillin was 43.4%, to tetracycline-metronidazole 30.3%, to amoxicillin-levofloxacin 27.6%, and to clarithromycin-metronidazole 59.2%. In vitro testing revealed resistance to all five antibiotics, indicating that H. pylori exhibited resistance phenotypes to these antibiotics. Consequently, the effectiveness of triple treatments may be compromised, and further studies are needed to assess refractoriness in quadruple and concomitant therapies.

Investigation of flow patterns in two-phase carbon dioxide in horizontal and vertical pipes

Modern particle detectors crucially depend on efficient cooling systems. Two-phase carbon dioxide (CO2) is a suitable solution as a cooling agent. This publication presents the observations and results of investigations of horizontal and vertical flow of two-phase CO_2 at a temperature of T = -15 °C and a pressure of approximately 23 bar. Heat fluxes between 98.5 kW/m2 and 200 kW/m2 were applied to the CO2, covering the range expected to occur in the future ATLAS Pixel detector being built for the high-luminosity phase of the Large Hadron Collider. Flow speeds ranged from 11.8 m/s to 28.1 m/s. Dedicated sensors measured the temperature and the pressure before and after heating the CO2. Two-phase flow patterns occuring in the pipe after heating the CO2 were recorded with a high-speed camera. Stratified, wavy and slug flow are found to be the predominant patterns for horizontal flow, while upward vertical flow is mainly found to be slug or churn. Based on the recorded images the void fraction of the CO2 after heating is determined and compared for the different setups. The results are summarised in a flow-pattern map. A clear distinction between vertical and horizontal flow is found, with horizontal flow exhibiting a significantly higher void fraction than vertical flow. Based on the pressure measurements, the pressure drop after heating the CO2 is measured and the corresponding Euler number is computed. While the pressure drop increases with the heat flux for horizontal flow, the pressure drop reduces with the heat flux in the case of upward vertical flow.

Exogenous Melatonin Use in University Students: A Cross-Sectional Survey.

To assess the prevalence of melatonin use and its perceived benefits among university students in different specialties in Saudi Arabia, a cross-sectional survey was conducted between March and June 2023. Data about demographics, time of melatonin use, perceived reasons for exogenous melatonin use, melatonin use in relation to exam periods, perceived safety, and adverse effects was gathered. Of 380 students, ~52% reported using exogenous melatonin for sleep disorders. Most participants reported using melatonin during and after exam periods. Additionally, several (n = 157; 75.4%) believed that its use was safe. The predominant use patterns were daily and as needed, and this study observed a higher rate of use compared with previous studies in Saudi Arabia. The most frequently reported adverse effect was headache (n = 36; 37.5%). A significant number of undergraduate male students in health specialties used melatonin. A high rate of melatonin use was noted during exam periods, which was attributed to sleep deprivation. Additionally, a significant number of students from private universities reported using exogenous melatonin. Melatonin use is common among university students. Future research should use a reliable psychometric measure to test its effect on university students' sleep quality and quantity.

Transcriptome-Wide Identification of Cytochrome P450s in Tea Black Tussock Moth (Dasychira baibarana) and Candidate Genes Involved in Type-II Sex Pheromone Biosynthesis.

The tea black tussock moth (Dasychira baibarana), a devastating pest in Chinese tea plantations, uses a ternary Type-II pheromone blend containing (3Z,6Z)-cis-9,10-epoxyhenicosa-3,6-diene (Z3,Z6,epo9-21:H), (3Z,6Z,11E)-cis-9,10-epoxyhenicosa-3,6,11-triene (Z3,Z6,epo9,E11-21:H), and (3Z,6Z)-henicosa-3,6-dien-11-one (Z3,Z6-21:11-one) for mate communication. To elucidate the P450 candidates associated with the biosynthesis of these sex pheromone components, we sequenced the female D. baibarana pheromone gland and the abdomen excluding the pheromone gland. A total of 75 DbP450s were identified. Function annotation suggested six CYPs were orthologous genes that are linked to molting hormone metabolism, and eight antennae specifically and significantly up-regulated CYPs may play roles in odorant processing. Based on a combination of comparative RNAseq, phylogenetic, and tissue expression pattern analysis, one CYP4G with abdomen specifically predominant expression pattern was likely to be the P450 decarbonylase, while the pheromone-gland specifically and most abundant CYP341B65 was the most promising epoxidase candidate for the D. baibarana sex pheromone biosynthesis. Collectively, our research laid a valuable basis not only for further functional elucidation of the candidate P450 decarbonylase and epoxidase for the sex pheromone biosynthesis but also for understanding the physiological functions and functional diversity of the CYP gene superfamily in the D. baibarana.

Fin whale song characteristics and potential subpopulation identity in the New York Bight

Fin whale (Balaenoptera physalus) song can follow a highly consistent pattern, and regional differences in song patterns can be a valuable indicator of subpopulation identity and distribution. In the Northwest Atlantic, endangered fin whales are currently managed as a single stock despite previous identification of different regional song patterns, which indicates potential subpopulation structuring and vulnerability to anthropogenic disturbance if not managed accordingly. Here we document fin whale song in the New York Bight (NYB) from 2017 to 2020 using passive acoustic data to identify monthly and yearly trends in song patterns and to explore potential subpopulation structuring. The predominant song pattern observed was highly consistent with the pattern documented almost a decade prior in the NYB, with short inter-note intervals (INI) from fall–winter and long-INIs in the spring. However, in one song year the majority of songs were composed of long-INIs. This change in song pattern could be due to a shift in fin whale behavior or possibly multiple fin whale subpopulations using the NYB. Fin whales in the NYB may be particularly vulnerable to disturbance given the increasing anthropogenic pressures in this region, and further research into subpopulation structuring is needed to ensure adequate management of these endangered whales.

First Reported Circulation of Equine Influenza H3N8 Florida Clade 1 Virus in Horses in Italy.

Equine influenza (EI) is a highly contagious viral disease of equids characterized by pyrexia and respiratory signs. Like other influenza A viruses, antigenic drift or shift could lead to a vaccine-induced immunity breakdown if vaccine strains are not updated. The aim of this study was to genetically characterize EIV strains circulating in Italy, detected in PCR-positive samples collected from suspected cases, especially in the absence of formal active surveillance. Between February and April 2019, blood samples and nasal swabs collected from each of the 20 symptomatic horses from North and Central Italy were submitted to the National Reference Centre for Equine Diseases in Italy to confirm preliminary analysis performed by other laboratories. None of the sera analysed using haemagglutination inhibition and single radial haemolysis presented a predominant serological reactivity pattern for any antigen employed. All nasal swabs were positive with IAV RRT-PCR. Only one strain, isolated in an embryonated chicken egg from a sample collected from a horse of a stable located in Brescia, Lombardy, was identified as H3N8 Florida lineage clade 1 (FC1). In the constructed phylogenetic trees, this strain is located within the FC1, together with the virus isolated in France in 2018 (MK501761). This study reports the first detection of H3N8 FC1 in Italy, highlighting the importance of monitoring circulating EIV strains to verify the vaccine composition appropriateness for maximum efficacy.

Nitrogen loading resulting from major floods and sediment resuspension to a large coastal embayment

Major floods pose a severe threat to coastal receiving environments, negatively impacting environmental health and ecosystem services through direct smothering with sediment and nutrient loading. This study examined the short and long-term impacts of the February 2022 major flood event on mud extent and sediment nitrogen flux in Moreton Bay (the Bay), a large, sub-tropical embayment in Southeast Queensland, Australia. Short-term impacts were assessed three days after the flood peak by sampling surface water at 47 sites in the direction of the predominant circulation pattern. Longer-term impacts were assessed by undertaking an intensive sediment survey of 223 sites and a nutrient flux experiment using sediment core incubations to simulate calm and resuspension conditions for the four key sediment classes. Short-term impacts revealed elevated turbidity levels extended across the Bay but were highest at the Brisbane River mouth, ammonium concentrations varied inversely with surface turbidity, whereas nitrate concentrates closely tracked surface turbidity. The sediment survey confirmed fine sediment deposition across 98 % of the Bay. Porewater within the upper 10 cm contained a standing pool of 280 t of ammonium, with concentrations more than three orders of magnitude higher than overlying surface waters. The nutrient flux experiment revealed an order of magnitude higher sediment ammonium flux rate in the sandy mud sediment class compared to the other sediment classes; and for simulated resuspension conditions compared to calm conditions for sand, muddy sand, and mud sediment classes. Scaling across the whole Bay, we estimated a mean annual sediment flux of 17,700 t/year ammonium, with a range of 13,500 to 21,900 t/year. Delivery of fine sediments by major floods over the last 50 years now impact >98 % of the benthic zone and provide a major loading pathway of available nitrogen to surface waters of Moreton Bay; representing a significant threat to ecosystem health.

Assessment of Palatal Rugae to Aid in Gender Identification in Hazaribag Population—A Cross-Sectional Study

ABSTRACT Background: This research paper aims to investigate the effectiveness of gender identification utilizing palatal rugae Materials and Methods: The size of the sample that was selected included 100 people. They were made up of 50 men and 50 women, all in between the ages of 18 and 25. To examine their palatal rugae patterns, casts were made after taking maxillary impressions. Based on the size and rugae amount found on the left as well as the right sides, the palatal rugae patterns were investigated. Rugae patterns have been recognized based on the categorization provided by Thomas and Kotze (1983). Statistical Analysis: Chi-square analysis has been used. Results: There were comparative variations in the shape of rugae patterns among male and female individuals. The study revealed that the circular pattern was higher in males (P < 0.01) as compared to females and the unification pattern was comparatively greater in females (P < 0.05) as compared to males. The most predominant pattern that was seen in both genders was the wavy pattern that was seen to be present in 57.17% of males and 53.42% of females. The rugae number on the right and left sides did not exhibit any significant variations. Conclusions: This research thus exhibits a relevant difference in patterns of rugae and also confirms the uniqueness of patterns in each individual. Hence, it could be utilized as an adjunct to other tools for identification in the forensic sciences.

Outcomes of Post-Immunotherapy Durable Responders of Advanced Hepatocellular Carcinoma– with Emphasis on Locoregional Therapy for Oligoprogression

Introduction: The progression patterns, dispositions, and outcomes of patients with advanced hepatocellular carcinoma (HCC) who achieved durable responses with immunotherapy remain poorly characterized. Methods: Patients with advanced HCC who received immune checkpoint inhibitor (ICI)-based immunotherapy and achieved durable responses were retrospectively included. A durable response was defined as partial response (PR) or stable disease (SD) per RECIST 1.1 for more than 8 months after initiation of immunotherapy. Oligoprogression and polyprogression were defined as progression at ≤3 and >3 lesions, respectively. Results: A total of 91 durable responders (63 PR and 28 SD) were identified. The majority had chronic viral hepatitis (n = 69, 75.8%). Forty-seven (51.6%) and 44 (48.4%) patients received the index immunotherapy as first-line and second- or beyond-line therapy, respectively. Fifty-four (59.3%) patients subsequently developed progression, with a predominant pattern of oligoprogression (66.7%). The median overall survival (OS) was 46.2 months (95% CI: 34.1–58.3). For patients with subsequent progression, employment of locoregional therapy (LRT) for progression was associated with prolonged OS (univariate analysis: hazard ratio [HR] 0.397, p = 0.009; multivariate analysis: HR 0.363, p = 0.050). Patients with oligoprogression who received LRT showed longer median OS than those who did not (48.4 vs. 20.5 months, p p = 0.794). Conclusion: Approximately 60% of the post-immunotherapy durable responders of HCC subsequently develop progression. Proactive LRT may further rescue patients who develop subsequent oligoprogression. Prospective studies are mandatory to clarify the proper management of durable responders with subsequent progression.

Lung Involvement Patterns in COVID-19: CT Scan Insights and Prognostic Implications From a Tertiary Care Center in Southern India.

Background COVID-19, caused by the SARS-CoV-2 virus, has presented an unparalleled challenge and a profound learning curve globally. Among the myriad of investigative tools, CT scans of the chest have become instrumental in assessing the magnitude of lung involvement in the pathogenesis of this disease. Objectives This study aimed to evaluate the distribution and patterns of lung involvement depicted in the CT chest scans of COVID-19 patients admitted to a specialized tertiary care center located in a southern state of India. Methods With clearance secured from the Institutional Ethics Committee, an analytical cross-sectional study was conducted. It encompassed CT chest images from all symptomatic COVID-19 patients within the designated study center during the specified study timeline. Subsequent data analysis ensued. Results Among the 1066 COVID-19 patients evaluated, ground-glass opacities (GGO) were the predominant lung involvement pattern. Distinct patterns, such as GGOs combined with solid consolidation or atelectasis, were noted, with the highest mortality linked to GGOs paired with pneumomediastinum (PM). Data underscored a direct correlation between the extent of lung involvement and patient prognosis, with specific lung regions, namely the right apical, right posterior, right superior basal, left superior lingular, and left inferior lingular segments, showing frequent involvement. Conclusion Amidst the pandemic, our study emphasizes that ground-glass opacities on CT scans are robust indicators of COVID-19 in RT-PCR-positive patients. Early identification can enhance patient management, with findings highlighting a strong link between lung involvement and prognosis. This insight aids in refining patient triage, while further research is warranted to delve deeper into variations in lung involvement and guide treatment advancements.

Histopathological spectrum of endometrial biopsies in abnormal uterine bleeding at tertiary care centre, Jodhpur

Introduction: Abnormal uterine bleeding (AUB) shows spectrum of patterns on histopathology and pathologist plays a vital role in reporting of endometrial biopsies and helps in differentiating nonneoplastic lesion from neoplastic lesions, early detection of the precursor lesions and exclusion of malignancy. Aim - The aim of this study is to study the spectrum of endometrial patterns in women with AUB and to correlate it with the different age groups. Materials and Methods: 200 samples of endometrial biopsies with AUB were received from the gynecology department, processed and stained with hematoxylin & eosin and subjected to histopathological examination. Results: The peak incidence is observed in the age group of 41-50 years. The predominant histological pattern observed is secretory and proliferative pattern and disordered endometrium (68%) followed by endometrial hyperplasia (10%) and the least common pattern is atrophic endometrium (1%). 2% cases are of endometrial carcinoma found in our study. Conclusion: AUB significantly affects the quality life of women and leads to anemia. Hence histopathological examination should be considered which plays a critical role in early diagnosis of endometrial pathology and to provide appropriate gynecological management. Endometrial sampling is an effective diagnostic tool and it needs to be considered in all patients from peri- and post-menopausal age groups with AUB so to provide appropriate management.

Characteristics and Drivers of Vegetation Change in Xinjiang, 2000–2020

Examining the features of vegetation change and analyzing its driving forces across an extensive time series in Xinjiang are pivotal for the ecological environment. This research can offer a crucial point of reference for regional ecological conservation endeavors. We calculated the fractional vegetation cover (FVC) using MOD13Q1 data accessed through the Google Earth Engine (GEE) platform. To discern the characteristics of vegetation changes and forecast future trends, we employed time series analysis, coefficient of variation, and the Hurst exponent. The correlation between climate factors and FVC was investigated through correlation analysis. Simultaneously, to determine the relative impact of meteorological change and anthropogenic actions on FVC, we utilized multiple regression residual analysis. Furthermore, adhering to China’s ecological functional zone classification, Xinjiang was segmented into five ecological zones: R1 Altai Mountains-Junggar West Mountain Forest and Grassland Ecoregion, R2 Junggar Basin Desert Ecoregion, R3 Tianshan Mountains Mountain Forest and Grassland Ecoregion, R4 Tarim Basin-Eastern Frontier Desert Ecoregion, and R5 Pamir-Kunlun Mountains-Altan Mountains Alpine Desert and Grassland Ecoregion. A comparative analysis of these five regions was subsequently conducted. The results showed the following: (1) During the first two decades of the 21st century, the overall FVC in Xinjiang primarily exhibited a trend of growth, exhibiting a rate of increase of 4 × 10−4 y−1. The multi-year average FVC was 0.223. The mean value of the multi-year FVC was 0.223, and the mean values of different ecological zones showed the following order: R1 > R3 > R2 > R5 > R4. (2) The predominant spatial pattern of FVC across Xinjiang’s landscape is characterized by higher coverage in the northwest and lower in the southeast. In this region, 66.63% of the terrain exhibits deteriorating vegetation, while 11% of the region exhibits a notable rise in plant growth. Future changes in FVC will be dominated by a decreasing trend. Regarding the coefficient of variation outcomes, a minor variation, representing 42.12% of the total, is noticeable; the mean coefficient of variation stands at 0.2786. The stability across varied ecological zones follows the order: R1 > R3 > R2 > R4 > R5. (3) Factors that have a facilitating effect on vegetation FVC included relative humidity, daylight hours, and precipitation, with relative humidity having a greater influence, while factors that have a hindering effect on vegetation FVC included air temperature and wind speed, with wind speed having a greater influence. (4) Vegetation alterations are primarily influenced by climate change, while human activities play a secondary role, contributing 56.93% and 43.07%, respectively. This research underscores the necessity for continued surveillance of vegetation dynamics and the enhancement of policies focused on habitat renewal and the safeguarding of vegetation in Xinjiang.

Can neoadjuvant chemoradiotherapy before lateral pelvic lymph node dissection improve local control and prognosis in rectal cancer patients with clinically suspected lateral lymph node metastasis? A multicenter lateral node study in China

AimsSelective lateral pelvic lymph node (LPN) dissection (LPND) following neoadjuvant chemoradiotherapy (nCRT) for rectal cancer is widely recognized. This study aimed to determine the effects of nCRT before LPND on local control and prognosis of rectal cancer patients.Materials and methodsData were retrieved from a prospective database for rectal cancer patients with clinical LPN metastasis receiving total mesorectal excision and LPND at three institutions between January 2012 and December 2019. Selection bias was minimized using propensity score matching (PSM) and short-term and clinical outcomes were compared.ResultsPatients (n = 213) were enrolled and grouped as either nCRT (n = 97) or non-nCRT (n = 116). PSM was used to identify 83 matched pairs. In the matched cohort, nCRT patients had a longer operation duration (310.6 vs. 265.0 min, P = 0.001), lower pathological LPN metastasis rate (32.5% vs. 48.2%, P = 0.040), and fewer harvested lymph nodes (22 vs. 25, P = 0.018) compared to the non-nCRT group. However, after PSM, the two groups had similar estimated overall 3-year survival (79.5% vs. 80.7%, P = 0.922), 3-year disease-free survival (66.1% vs. 65.5, P = 0.820), and 3-year local recurrence-free survival (88.6% vs. 89.7%, P = 0.927). Distant metastasis was the predominant recurrence pattern in the overall (45/58, 77.6%) and matched (33/44, 75.0%) cohorts.ConclusionsLPND without nCRT is effective and sufficient in preventing local recurrence in patients with LPN metastases. Future prospective randomized controlled studies are warranted to confirm these findings. Since systemic metastasis is the predominant recurrence pattern in patients with LPN metastasis post-LPND, improved perioperative systemic chemotherapy is needed to prevent micrometastasis.