Evaluation of perioperative pachymetry of thin corneas during corneal crosslinking using hypo-osmolar riboflavin and hydroxypropyl methylcellulose

ABSTRACT Purpose: This study aimed to analyze variations in intraoperative corneal thickness during corneal cross-linking in patients with keratoconus and to investigate its possible correlation with presurgical maximal keratometry (Kmax) and pachymetry. Methods: This was a prospective case series. We used a method similar to the Dresden protocol, with the application of hydroxypropyl methylcellulose 0.1% hypo-osmolar riboflavin in corneas between 330 and 400 µm after epithelium removal. Corneal thickness was measured using portable calipers before and immediately after epithelium removal, and 30 and 60 min after the procedure. Results: The 30 patients in this study were followed up for one year. A statistically significant difference was observed in pachymetry values during the intraoperative period (p<0.0001) and an increase of 3.05 µm (95%C1: 0.56-5.54) for each diopter was seen after epithelium removal (p0.019). We found an average Kmax difference of —2.12 D between men and women (p0.013). One year after treatment, there was a statistically significant reduction in pachymetry (p<0.0001) and Kmax (p0.0170) values. Conclusions: A significant increase in pachymetry measurements was seen during the procedure, and most patients showed a regression in Kmax and pachymetry values one year after surgery.

Distinction of papillary and adamantinomatous craniopharyngioma: Clinical features, surgical nuances and hypothalamic outcomes.

OBJECTIVE: Understanding the differences of suprasellar papillary and adamantinomatous craniopharyngiomas (PCPs/ACPs) is pivotal for target therapy, surgical strategy or postoperative management. Here, the clinical features, surgical nuances and postoperative hypothalamic outcomes of PCPs were systematically recapitulated. METHODS: 24 PCPs and 52 ACPs underwent initial surgery were retrospectively reviewed. Clinical data, quantified third ventricle (3rd V) occupation and optic chiasm distortion were compared, as well as intra-operative findings, operating notes and prognosis. Moreover, analysis of tumor/3rd V relationship and hypothalamic outcomes were also performed. RESULTS: Tumors were more likely to occupies the 3rd V cavity in PCPs. Chiasm distortion of "compressed forward" was the most common pattern (45.8 %) in PCPs, whereas "stretched forward" pattern accounted the highest (42.5 %) in ACPs. Besides, round-shaped with less calcification, duct-like recess, solid consistency, rare subdiaphragmatic invasion, visible lower stalk and improved postoperative visual outcome were more frequently observed in PCPs. The basal membranes of the tumor epithelium and the reactive gliosis were separated by a layer of collagen fibers in most PCPs, which differs from ACPs in the morphological examination of tumor/3rd V floor interface. In daytime sleepiness and memory difficulty, the PCPs showed significantly better outcomes than the ACPs groups, and PCPs suffered less postoperative weight gain (p < 0.05) than ACPs among adult-onset cases. CONCLUSION: PCPs are different from ACPs regards the clinical features, operative techniques and outcomes. If necessary, PCPs are suggested more amenable to total removal since its less invasiveness to the 3rd V floor and better hypothalamic outcomes.

Combining human liver ECM with topographically featured electrospun scaffolds for engineering hepatic microenvironment.

Liver disease cases are rapidly expanding worldwide, and transplantation remains the only effective cure for end-stage disease. There is an increasing demand for developing potential drug treatments, and regenerative therapies using in-vitro culture platforms. Human decellularized extracellular matrix (dECM) is an appealing alternative to conventional animal tissues as it contains human-specific proteins and can serve as scaffolding materials. Herein we exploit this with human donor tissue from discarded liver which was not suitable for transplant using a synergistic approach to combining biological and topographical cues in electrospun materials as an in-vitro culture platform. To realise this, we developed a methodology for incorporating human liver dECM into electrospun polycaprolactone (PCL) fibres with surface nanotopographies (230-580 nm). The hybrid scaffolds were fabricated using varying concentrations of dECM; their morphology, mechanical properties, hydrophilicity and stability were analysed. The scaffolds were validated using HepG2 and primary mouse hepatocytes, with subsequent results indicating that the modified scaffolds-maintained cell growth and influenced cell attachment, proliferation and hepatic-related gene expression. This work demonstrates a novel approach to harvesting the potential from decellularized human tissues in the form of innovative in-vitro culture platforms for liver.

Dental Implant Surface Topography and Stability With Resonance Frequency Analysis: An Overview and Case Report.

Dental implants are fixtures that replace a natural tooth that has been missing. The outcome depends on the safety and longevity of the bone-implant relationship. The process of direct and strong anchoring of an implant due to the surrounding bone tissue growing around it is called osseointegration. The establishment of an osseointegrated contact depends on a variety of systemic and local variables and diagnostic methods. Resonance frequency analysis is one of the methods used to analyze implant stability. The surface topography, mainly surface texture and roughness, also helps in promoting a favorable interaction between the implant and biological tissues. This case report aimed to indicate the importance of implant surfaces showing primary and secondary stability and implant stability quotient (ISQ) values that can be analyzed by resonance frequency analysis (RFA) using the Osstell implant device, which can be a useful tool used to determine the risk of failure.

Associations between endothelial cell characteristics and corneal topography findings in different stages of keratoconus.

PURPOSE: This study aimed to compare and correlate specular microscope indices and corneal topography indices in different stages of keratoconus. METHODS: Two hundred forty-six eyes of 123 participants were enrolled in the study. Corneal topography was performed using Sirius (CSO, Italy), with a rotating Scheimpflug camera and a Placido disc topographer. Corneal endothelial cell indices were assessed using a specular microscope (Nidek CEM-530, Japan). Eyes were graded as keratoconus stages 0-4 according to the Amsler-Krumeich classification. Corneal topography and endothelial cell indices were compared among the groups, and the correlations between them were analyzed. RESULTS: The mean age of the patients was 23.26 ± 6.75 years (range, 14-47 years). Forty-eight cases were male (39%) and 75 were female (61%). There were no statistically significant age (p = 0.578) or sex ratio (p = 0.529) differences between the groups. Twenty-nine eyes were included in the control group (11.78%), while 41 (16.67%) had stage 1 keratoconus, 88 (35.77%) had stage 2, and 88 (35.77%) had stage 3. Measurement was not possible in stage 4 keratoconus. No statistically significant difference was determined in specular microscopy values according to the stage of keratoconus, except for the number of analyzed cells (NUM) (p > 0.05). The lowest NUM values were observed in stages 1, 2, and 3, with values of 184.34 ± 67.62 cells/mm2, 155.07 ± 59.48 cells/mm2, and 127.06 ± 64.39 cells/mm2, respectively (p = 0.001). In the keratoconus group, weak statistically significant negative correlations were observed between NUM and SimK1, SimK2, KVf, BCVf, KVb, and BCVb, while a weak positive correlation was noted between NUM and central corneal thickness (p < 0.05). CONCLUSIONS: NUM seems to decrease, while endothelial cell density exhibits no significant changes, with the progression of keratoconus. It appears that as keratoconus index values increase, NUM may decrease in different stages of keratoconus.

Does portal vein anatomy influence intrahepatic distribution of metastases from colorectal cancer?

BACKGROUND: Other than location of the primary colorectal cancer (CRC), a few factors are known to influence the intrahepatic distribution of colorectal cancer liver metastases (CRLM). We aimed to assess whether the anatomy of the portal vein (PV) could influence the intrahepatic distribution of CRLM. PATIENTS AND METHODS: Patients with CRLM diagnosed between January 2018 and December 2022 at two tertiary centers were included and imaging was reviewed by two radiologists independently. Intra-operator concordance was assessed according to the intraclass correlation coefficient (ICC). The influence of the diameter, angulation of the PV branches and their variations on the number and distribution of CRLM were compared using Mann-Whitney, Kruskal-Wallis, Pearson's Chi-square and Spearman's correlation tests. RESULTS: Two hundred patients were included. ICC was high (> 0.90, P < 0.001). Intrahepatic CRLM distribution was right-liver, left-liver unilateral and bilateral in 66 (33%), 24 (12%) and 110 patients (55%), respectively. Median number of CRLM was 3 (1-7). Type 1, 2 and 3 portal vein variations were observed in 156 (78%), 19 (9.5%) and 25 (12%) patients, respectively. CRLM unilateral or bilateral distribution was not influenced by PV anatomical variations (P = 0.13), diameter of the right (P = 0.90) or left (P = 0.50) PV branches, angulation of the right (P = 0.20) or left (P = 0.80) PV branches and was independent from primary tumor localisation (P = 0.60). No correlations were found between CRLM number and diameter (R: 0.093, P = 0.10) or angulation of the PV branches (R: 0.012, P = 0.83). CONCLUSIONS: PV anatomy does not seem to influence the distribution and number of CRLM.

Evaluation of the Influence of the Tool Set Overhang on the Tool Wear and Surface Quality in the Process of Finish Turning of the Inconel 718 Alloy.

The work deals with the influence of the reach of the applied tool holder on the edge wear, dimensional accuracy and surface quality defined by the topography as well as the roughness of the machined surface. The research has been conducted on specimens made of Inconel 718 in the configuration of sleeves, within the scope of finish turning with constant cutting parameters, vc = 85 m/min; f = 0.14 mm/rev; ap = 0.2 mm. The material under machining has undergone heat treatment procedures such as solution treatment and precipitation hardening, resulting in a hardness of 45 ± 2 HRC. Two kinds of turning holders have been used with the reaches of 120 mm and 700 mm. The tools are intended for turning external and internal surfaces, respectively. The tests have been conducted using V-shaped cutting inserts manufactured by different producers, made of fine-grained carbide with coatings applied by the PVD (Physical Vapour Deposition) and CVD (Chemical Vapour Deposition) methods. The edge wear has been evaluated. The value of the achieved diameter dimensions has also been assessed in relation to the set ones, as well as the recorded values of surface roughness and the surface topography parameters have also been assessed. It has been determined that the quality of the manufactured surface evaluated by the 2D and 3D roughness parameters, as well as the dimensional quality are influenced by the kind of the applied tool holder. The influence is also visible considering the edge wear. The smallest values of the deviations from the nominal dimensions have been obtained for the coated inserts of the range of higher abrasion resistance (taking into account information from the producers). The obtained results show that in predicting the dimensional accuracy in the process of turning Inconel 718 alloy with long-overhang tools, one should consider the necessity of correction of the tool path. Taking into account the achieved surface roughness, it should be pointed out that not only the kind of the tool coating but also the character of its wear has a great influence, particularly, when a long cutting distance is required.

Surface Topography Analysis of BK7 with Different Roughness Nozzles Using an Abrasive Water Jet.

This study investigated the effect of abrasive water jet (AWJ) kinematic parameters, such as jet traverse speed and water pressure, abrasive mass flow rate, and standoff distance on the surface of BK7. Nozzle A reinforced with a 100 nm particle-sized coating of titanium alloy has more wear resistance compared to Nozzle B coated with nothing. Through analysis of variance and measurement of BK7 surface quality, it is concluded that the grooving and plowing caused by abrasive particles and irregularities in the abrasive water jet machined surface with respect to traverse speed (3, 7.2, 7.8, and 9 mm/min), abrasive flow rate (7 L/min and 10 L/min, 80 mesh) and water pressure (2 and 3 MPa) were investigated using surface topography measurements. The surface roughness (15.734 nm) of BK7 results show that a nozzle coated with titanium alloy has more hardness, which protects BK7 undamaged and super-smooth. The values of selected surface roughness profile parameters-average roughness (Ra) and maximum height of PV (maximum depth of peak and valleys)-reveal a comparatively smooth BK7 surface in composites reinforced with 2% titanium alloy in the nozzle weight at a traverse speed of 7.8 mm/min. Moreover, abrasive water jet machining at high water pressure (3 MPa) produced better surface quality due to material removal and effective cleaning of lens fragmentation and abrasive particles from the polishing zone compared to a lower water pressure (2 MPa), low traverse speed (5 mm/min), and low abrasive mass flow rate (200 g/min).

Medicalizing the Body and the Locale: Kala Azar and Disease Thinking in Assam, 1824-1900.

The article examines two seemingly unconnected occurrences at the nineteenth-century north east frontier of British India. The first is the production of a pathological space via moral, social, and cultural codes enacted by medical topographies on the region since the first Anglo-Burmese war (1824-1826) and the subsequent rise of disease thinking. The second is the ambivalence in disease thinking that is brought to fore through the mysterious malady called kala azar (visceral leishmaniasis), which was geographically designated as Assam fever. This article contends that the geographical designation of kala azar as Assam fever is not just coincidental or a nosological confusion of the late nineteenth century but rather has its origin in the preceding pathological carving of space at the frontier. Further, it explores the troubled ontology between research on malaria and kala azar investigations to show that the old codes enacted by medical topographies hinged upon the era of laboratory medicine.

Topography and Lateralization of Nodal Metastases in Muscle-Invasive Bladder Cancer Using Super-Extended Pelvic Lymph Node Dissection with the Sentinel Lymph Node Technique.

Background: This study assessed the topography and lateralization of lymph node (LN) metastases in muscle-invasive bladder cancer (MIBC) patients using super-extended pelvic lymph node dissection (sePLND) with sentinel lymph node dissection (SLND). Methods: We analyzed 54 MIBC patients who underwent cystectomy with sePLND and SLND. Tumor location was classified using cystoscopy. Nanocolloid-Tc-99m was injected peritumorally. Preoperative SPECT/CT lymphoscintigraphy and an intraoperative gamma probe were used for SLN detection. Results: A total of 1414 LNs, including 192 SLNs, were resected from 54 patients. Metastases were found in 72 LNs from 22 patients (41%). The obturator fossa was the primary site for LN metastases (37.5%). SLNs were most common in the external iliac region (34.4%). In 36% of the patients with positive LNs, metastases were identified only through sePLND. In 9% of the patients, metastases were found solely in the pararectal region, identified through SLND. Tumor lateralization correlated with ipsilateral positive LNs, but 20% of the patients had contralateral metastases. Conclusions: The pararectal region may be the exclusive site for positive LNs in MIBC. The obturator fossa is the most prevalent region for LN metastases. Unilateral PLND should be avoided due to the risk of contralateral metastases. Combining sePLND with SLND improves staging.

Morphological and Biophysical Study of S100A9 Protein Fibrils by Atomic Force Microscopy Imaging and Nanomechanical Analysis.

Atomic force microscopy (AFM) imaging enables the visualization of protein molecules with high resolution, providing insights into their shape, size, and surface topography. Here, we use AFM to study the aggregation process of protein S100A9 in physiological conditions, in the presence of calcium at a molar ratio 4Ca2+:S100A9. We find that S100A9 readily assembles into a worm-like fibril, with a period dimension along the fibril axis of 11.5 nm. The fibril's chain length extends up to 136 periods after an incubation time of 144 h. At room temperature, the fibril's bending stiffness was found to be 2.95×10-28 Nm2, indicating that the fibrils are relatively flexible. Additionally, the values obtained for the Young's modulus (Ex=6.96×105 Pa and Ey=3.37×105 Pa) are four orders of magnitude lower than those typically reported for canonical amyloid fibrils. Our findings suggest that, under the investigated conditions, a distinct aggregation mechanism may be in place in the presence of calcium. Therefore, the findings reported here could have implications for the field of biomedicine, particularly with regard to Alzheimer's disease.

Endothelium-Mimicking Materials: A "Rising Star" for Antithrombosis.

The advancement of antithrombotic materials has significantly mitigated the thrombosis issue in clinical applications involving various medical implants. Extensive research has been dedicated over the past few decades to developing blood-contacting materials with complete resistance to thrombosis. However, despite these advancements, the risk of thrombosis and other complications persists when these materials are implanted in the human body. Consequently, the modification and enhancement of antithrombotic materials remain pivotal in 21st-century hemocompatibility studies. Previous research indicates that the healthy endothelial cells (ECs) layer is uniquely compatible with blood. Inspired by bionics, scientists have initiated the development of materials that emulate the hemocompatible properties of ECs by replicating their diverse antithrombotic mechanisms. This review elucidates the antithrombotic mechanisms of ECs and examines the endothelium-mimicking materials developed through single, dual-functional and multifunctional strategies, focusing on nitric oxide release, fibrinolytic function, glycosaminoglycan modification, and surface topography modification. These materials have demonstrated outstanding antithrombotic performance. Finally, the review outlines potential future research directions in this dynamic field, aiming to advance the development of antithrombotic materials.

Effects of Confined Microenvironments with Protein Coating, Nanotopography, and TGF-ß Inhibitor on Nasopharyngeal Carcinoma Cell Migration through Channels.

Distant metastasis is the primary cause of unsuccessful treatment in nasopharyngeal carcinoma (NPC), suggesting the crucial need to comprehend this process. A tumor related to NPC does not have flat surfaces, but consists of confined microenvironments, proteins, and surface topography. To mimic the complex microenvironment, three-dimensional platforms with microwells and connecting channels were designed and developed with a fibronectin (FN) coating or nanohole topography. The potential of the transforming growth factor-ß (TGF-ß) inhibitor (galunisertib) for treating NPC was also investigated using the proposed platform. Our results demonstrated an increased traversing probability of NPC43 cells through channels with an FN coating, which correlated with enhanced cell motility and dispersion. Conversely, the presence of nanohole topography patterned on the platform bottom and the TGF-ß inhibitor led to a reduced cell traversing probability and decreased cell motility, likely due to the decrease in the F-actin concentration in NPC43 cells. This study highlights the significant impact of confinement levels, surface proteins, nanotopography, and the TGF-ß inhibitor on the metastatic probability of cancer cells, providing valuable insights for the development of novel treatment therapies for NPC. The developed platforms proved to be useful tools for evaluating the metastatic potential of cells and are applicable for drug screening.

Total ankle/total talus replacement - Retrospective comparison of surgeon decision relative to three-dimensional joint health assessment.

Treatment of end-stage ankle conditions is a complex challenge in foot and ankle surgery. The talus is prone to issues such as osteoarthritis (OA) and avascular necrosis (AVN). Patient-specific total ankle and total talus replacement (TATTR) procedures have emerged as potential solutions, but the decision to include subtalar arthrodesis in these surgeries is multifaceted. In this study, we aimed to understand the relationship between past surgeon decisions for fusion with TATTR and three-dimensional joint health assessments using preoperative CT data. Twenty-seven TATTR with subtalar fusion and 19 TATTR without subtalar fusion were analyzed. Each patient underwent a bilateral computed tomography scan, which was segmented prior to surgery. Distance mapping of various subtalar regions was performed, and average distance was reported. For better analysis, the sinus tarsi was divided into four sectors and the calcaneus posterior facet into nine sectors. Statistical analysis involved calculating the difference in means between the fused and unfused cases. The fusion group exhibited significant joint space narrowing in the posterolateral aspect of the sinus tarsi (p = 0.021). Conversely, on the posterior facet of the subtalar joint, the fusion group showed significant joint space widening in both the anteromedial (p = 0.025) and middle/medial (p = 0.032) sections. Surgeons' decision to perform subtalar arthrodesis in TATTR procedures often aligns with clinical signs of sinus tarsi impingement, as evidenced by significant changes in joint space measurements. While joint health assessments play a pivotal role, other factors, such as surgeon preference and patient-specific considerations, also influence decision-making.

Three-dimensional visualization of large-area, nanoscale topography measurements.

High-resolution metrology is a critical area of development for nanoscale manufacturing, especially as it affects production throughput and fabrication quality. Atomic force microscopy (AFM) is one of the most popular tools for nanometrology, and high-resolution AFM often requires a significant time commitment and produces datasets of several million points. It is therefore critical for the development of data processing techniques to keep pace with the requirements of analyzing this type of data, and for these techniques to be portable as miniaturization in AFM is becoming more common. This work presents a data fitting algorithm designed for reducing the parameters of large-area data sets which utilizes well-established spline fitting techniques. In this paper we show that basis-spline fitting can be used to accurately represent large AFM data sets, including data sets with noisy data and sharp features, while achieving at least 90% parameter reduction in all test cases.

EBSD and TKD analyses using inverted contrast Kikuchi diffraction patterns and alternative measurement geometries.

Electron backscatter diffraction (EBSD) patterns can exhibit Kikuchi bands with inverted contrast due to anomalous absorption. This can be observed, for example, on samples with nanoscale topography, in case of a low tilt backscattering geometry, or for transmission Kikuchi diffraction (TKD) on thicker samples. Three examples are discussed where contrast-inverted physics-based simulated master patterns have been applied to find the correct crystal orientation. As first EBSD example, self-assembled gold nanostructures made of Au fcc and Au hcp phases on single-crystal germanium were investigated. Gold covered about 12% of the mapped area, with only two thirds being successfully interpreted using standard Hough-based indexing. The remaining third was solved by brute force indexing using a contrast-inverted master pattern. The second EBSD example deals with maps collected at a non-tilted surface instead of the commonly used 70° tilted one. As TKD example, a jet-polished foil made of duplex stainless steel 2205 was examined. The thin part close to the hole edge producing normal-contrast patterns were standard indexed. The areas of the foil that become thicker with increasing distance from the edge of the hole produce contrast-inverted patterns. They covered three times the evaluable area and were successfully processed using the contrast-inverted master pattern. In the last example, inverted patterns collected at a non-tiled sample were mathematically inverted to normal contrast, and Hough/Radon-based indexing was successfully applied.

Coolants, organic acids, flavourings and other additives that facilitate inhalation of tobacco and nicotine products: implications for regulation.

To inform regulatory policy, this article summarises findings on inhalation facilitation from the ninth report of the WHO Study Group on Tobacco Product Regulation. Some additives counteract the harshness and bitterness of tobacco and nicotine product aerosols, making them easier to inhale. Additives that promote inhalability may perpetuate and increase the use of inhaled tobacco and nicotine products, especially by young people. Thus, as a class, additives that facilitate inhalation are an important regulatory target to prevent tobacco and nicotine product uptake. We defined inhalation facilitation as modifications to products during manufacturing that enhance the sensory experience and (potentially) behaviours associated with inhalation (eg, deeper puffs, faster inhalation, larger puff volume, shorter intervals in between puffs and use episodes). Evidence review showed that: (a) menthol and synthetic coolants decrease irritation caused by aerosol constituents by activating sensory perception receptors (eg, cooling receptors) and may promote dependence in inexperienced users; (b) acid additives and sugars, which lower the pH of aerosols and shift nicotine from free-base to protonated salt forms, reduce harshness and increase blood nicotine yield; (c) e-cigarette flavourings perceived as sweet or fruity reduce subjective bitterness, increase attractiveness and may escalate use, although their effects on perceived harshness are inconclusive; (d) sugars in tobacco impart sweet sensations, but limited industry-independent data preclude strong conclusions for sugars' roles in inhalation facilitation. Given these findings, WHO policy recommendations suggest that regulators might consider banning ingredients that facilitate inhalation in all commercial inhaled tobacco and nicotine products.

Effect of short-term exposure to Raag Bilawal of North Indian classical music on young Indian adults: a high-density electroencephalogram microstate study.

Introduction: the objective of the study was to find out the microstate map topographies and their parameters generated during the resting state and during listening to North Indian classical Music Raag 'the Raag Bilawal'. It was hypothesized that in the resting state and during listening to music conditions, there would be a difference in microstate parameters i.e. mean duration, global explained variance (GEV), and time coverage. Methods: a 128-channel electroencephalogram (EEG) was recorded for 12 Indian subjects (average age 26.1+1.4 years) while resting and listening to music using the EEG microstate investigation. Investigation and comparison of the microstate parameters were the mean duration, global explained variance (GEV), and time coverage between both conditions were performed. Results: seven microstate maps were found to represent the resting state and listening to music condition, four canonical and three novel maps. No statistically significant difference was found between the two conditions for time coverage and mean duration. The statistical significance levels of the map-1, map-2, map-3, map-4, map-5, map-6, and map-7 for the mean duration were 0.4, 0.6, 0.97, 0.34, 0.32, 0.69, and 0.29 respectively; and for time coverage were 0.92, 0.92, 0.96, 0.64, 0.78, 0.38, and 0.76 respectively. Map-1, map-4, and map-7 were the three novel maps we found in our study. Conclusion: similarities regarding stability and predominance of maps with small vulnerability exist in both conditions indicating that phonological, visual, and dorsal attention networks may be activated in both resting state and listening to music condition.

Topography and life stage regulate species aboveground biomass distribution in combination in a tropical montane rainforest.

Understanding the correlation between topography, species biomass and species life stage would allow forest managers to better foster carbon storage in forests. Using census data from a 60-ha plot in south China, we first quantified aboveground biomass (AGB) and how much it varied among different topographies. Next, the specific contribution of 42 dominant species to total aboveground biomass was analyzed for each of the different topographies. We also explored whether these species-topography associations changed, in terms of species' AGB distribution, during each of the three life stages (sapling, juvenile, adult) for these 42 species. Our results showed that the average AGB was 368.79 Mg ha-1 and that it varied noticeably among the four topographies (Low valley, Slope, High valley and Ridge, which were classified by using fuzzy C-mean clustering based on elevation, convexity, and slope). AGB was significantly lower in the two valleys than in the two other topographies. Of the 42 species, 88.1% showed topographic preferences, and 78.6% appeared to exhibit topographic preferences that changed with life stage. Our work highlights the importance of topography and life stage in species biomass distribution and suggests that different combinations of species and life stages, based on species topographic preferences across life stages, may be better suited in different tropical rainforest topographies to maximize carbon storage overall.

Treatment outcomes in retinoblastoma and the effect of tumor topography.

BACKGROUND: Retinoblastoma, the most common intraocular malignancy in children, has high fatality rates if untreated. It is crucial to monitor treatment effectiveness and explore factors influencing favorable outcomes. Our study aims to examine how tumor location impacts the response to standard treatments and the achievement of favorable outcomes among retinoblastoma patients, while controlling for other tumor-related factors. METHODS: This retrospective study analyzed medical records of retinoblastoma patients from November 2012 to December 2022 enrolled in the retinoblastoma program at the Children's Cancer Center of Lebanon (established in collaboration with St.y Jude Children's Research Hospital, Memphis, TN). Data were extracted from the electronic chart reviews and operative reports of examinations under anesthesia (EUAs), and included patient's demographics, tumor characteristics (size, location), and treatment parameters (treatment type, resolution, recurrence). RESULTS: The study included 42 patients with retinoblastoma, with a total of 57 eyes and 115 tumors/lesions. The median age at diagnosis was 12 months (range: 2-36 months). Among the patients, 26 (61.9%) were males and 16 (38.1%) were females. A minority of patients (21.4%) presented with unilateral involvement, whereas the majority (78.6%) had bilateral involvement. The locations of retinoblastoma lesions were distributed as follows: optic nerve (4.4%), macula (19.1%), superior (16.5%), inferior (17.4%), nasal (27.8%), and temporal (14.8%). Resolution rate tended to be highest for tumors close to optic nerve and temporal lesions, but no statistical significance was attained (p = .45). Macular lesions tended to have the fastest resolution, but again not significantly (p = .5). Multiple logistic regression revealed that the odds for resolution of tumor was not significantly associated with tumor size (p = .57) or location (p = .52). CONCLUSION: Location of retinoblastoma lesions was not directly associated with recurrence-free resolution in our cohort. Further research in large retinoblastoma databases is needed to explore the association of tumor characteristics with recurrence and the need for secondary therapeutic interventions.