The introduction of self-sampling in cervical cancer screening has raised the importance of HPV testvalidation on self-collected samples. This study aimed to evaluate the clinical performance of the OncoPredict HPV Screening (SCR) assay on self-collected vaginal and first-void urine (FVU) as part of the VALHUDES framework. Vaginal (FLOQSwabs) and FVU (Colli-Pee) samples were self-collected by 500 women referred to colposcopy, followed by a clinician-collected cervical sample prior to colposcopy, which were all tested using OncoPredict HPV SCR. OncoPredict HPV SCR demonstrated similar relative clinical sensitivity to detect cervical intraepithelial neoplasia grade 2 or worse (≥ CIN2) in urine (ratio: 0.95 [95%CI 0.88-1.02]) and vaginal self-samples (ratio: 0.96 [95%CI 0.90-1.02]) compared to cervical samples. The clinical specificity was lower in vaginal but not in urine samples compared to cervical which improved following cut-off optimization. A higher cellularity was found in vaginal as compared to cervical and FVU samples. Moderate to excellent agreement in HPV detection in self-collected samples and cervical scrapes was demonstrated (Kappa values: 0.53 to 1.00). OncoPredict HPV SCR assay demonstrated similar accuracy on self-collected vaginal and FVU samples compared to cervical samples, although cut-off adjustment improved clinical specificity when applied to vaginal samples.

Early approval mechanisms, such as conditional approval in the EU, have been used extensively to provide timely access to therapeutic innovations to cancer patients with unmet medical needs. While based on promising early evidence, such approvals are challenging from many perspectives due to the lack of comprehensive data. The limitation typically relates to data that demonstrates clinical benefit via particular endpoints and is only acceptable when the early evidence is particularly convincing to assume that the benefits of early access are greater than the potential harms. This paper describes the requirements for conditional approval and reviews common pitfalls in oncology, such as misunderstandings about the strength of evidence from exploratory trials and secondary analyses, lack of planning, and opportunities to improve communication. Thereafter, we present a framework (“EDGE”) on how to improve the submission and evaluation of drug applications for conditional approval in the EU.

This study explores the convergence of homelessness and climate hazards within media and political discourse, focusing on three key questions: a) How did media outlets differ in their portrayal of clearing of the Zone, a downtown Phoenix encampment; b) to what extent did Phoenix’s Safe Outdoor Space feature in local media narratives of homelessness during this time; and c) how was exposure to environmental hazards, specifically heat and air pollution, included in the political and media narratives surrounding homelessness during the clearing of the Zone and creation of the Safe Outdoor Space? These questions are examined through a conceptual and empirical analysis of public discourse related to the Zone and the Safe Outdoor Space, drawing on data from Phoenix, Arizona’s local media outlets from January to December 2023. Our findings highlight the sociopolitical dynamics of narrative building around interventions for homelessness and underscore how environmental hazards are often an undertone—rather than a cornerstone—of media depictions of homelessness in the American Southwest.

This article presents a case study of a 31-year-old woman with a dual diagnosis of Borderline Personality Disorder (BPD) and Eating Disorder Not Otherwise Specified (EDNOS). Paula received a 12-month Dialectical Behavior Therapy (DBT) outpatient treatment. DBT is considered a transdiagnostic treatment approach to address emotion dysregulation, which shifts the therapy focus traditionally placed only on behavioral change towards including also validation and acceptance and dialectical strategies. DBT addresses eating symptomatology as a dysfunctional form of emotional regulation and has shown promising results regarding its efficacy for the treatment of BPD and EDNOS comorbidity. Given the growing evidence, a standard DBT treatment plan was developed for this case. Specifically, pre-treatment and phase 1 of the DBT program are described. During pre-treatment and phase 1, individual therapy aims to improve and maintain client’s motivation to change and engage in treatment, as well as to establish and prioritize treatment goals. As for group therapy, the main goal of the skills training in DBT is to enhance individual’s capability by increasing skillful behavior (mindfulness, emotion regulation, distress tolerance and interpersonal effectiveness skills). Paula received 24 weekly skills training sessions over a year. The results after a 12-month standard DBT treatment showed that Paula no longer met criteria for BPD, she had a significant decrease in difficulties in emotional regulation and impulsiveness and in EDNOS symptomatology. This case study may enhance learning about how to apply a transdiagnostic treatment to address BPD and EDNOS together in clinical practice.

The development of cascade reservoirs significantly alters the water temperature of a river basin. However, our understanding of the distribution of water temperature in river basins under high-intensity hydropower development conditions remains limited. In this study, we analyzed historical data and monitored the present water temperature of the Wujiang River to assess the effects of cascade reservoir construction on water temperature and fish populations. The results revealed that the construction of cascade reservoirs weakened the continuity of water temperature in the basin. Various hydrological and meteorological factors influenced the water temperature of downstream dams. Among these factors, the upstream water temperature significantly impacted the downstream channel. There was no obvious pattern in the time needed to reach the thresholds of critical temperature and accumulated temperature for typical fish species ( Coreius heterodon) in the study area. However, the water temperature downstream of the Pingzhai Reservoir did not reach the threshold by the end of the monitoring period, while the water temperature downstream of other reservoirs allowed for normal Coreius Heterodon development prior to spawning. Furthermore, the construction of cascade reservoirs resulted in a significant reduction in the amplitude of water temperature at the downstream Wulong hydrological station, intensifying the water temperature delay in the Wujiang River. The findings of this study provide valuable insights into the cumulative effects on water temperature in the context of high-intensity hydropower development.

With the rapidly growing demand for medicinal plants globally, a sharp decline in the wild medicinal plant population. For rare, endangered, or overexploited species, cultivation is the only way to provide material without further endangering the survival of the valuable species. It is therefore essential to understand, ‘how’ and ‘where’ cultivation can be effectively implemented for dealing with conservation-related issues. Not only climate but also habitat loss stressors and, their synergistic effects matter in species redistribution and vulnerability. Climate change impact assessment without risks of land use change should mischaracterize the vulnerability and the spatiotemporal distribution of species. These imbalances place substantial limitations upon the ability to guide anticipative conservation actions and weigh the future outcomes of different policy or management options. Cibotium barometz is a highly demanded medicinal plant listed as a national key protected wild plant in China. For adaptive management, we assessed the suitable habitat change of C. barometz in Guangxi under the synergistic impact of climate and land use change by Maximum Entropy (MaxEnt) and Patch-generating Land Use Simulation (PLUS) models between the current and 2040 under three Shared Socio-economic Pathways (SSP) and proposed adaptive management countermeasure. Results indicate that altitude and BIO_18 are key environmental variables; suitable distribution area (SDA) shows a southwest-northeast and upload trend; the areas of cropland, forest, shrub, grassland, and barren are decreasing, water and impervious increasing; climate change accelerates the loss of C. barometz’s habitat, SDA and suitable habitat for C. barometz is decreasing; the total area of suitable habitat is decreasing but the suitability degree is increasing. We propose an adaptive response to wild resource conservation based on the protected area system in southwestern in parallel with artificial cultivation in northeastern Guangxi. The study aims to provide insights into the sustainable utilization of endangered medicinal plants.

Aim Identifying drivers that shape biodiversity across biogeographical regions is important to predict ecosystem responses to environmental changes. While beta diversity has been widely used to describe biodiversity patterns across space, the dynamic assembly of species over time has been comparatively overlooked. Insights from terrestrial and marine studies on temporal beta diversity has mostly considered environmental drivers, while the role of biotic mechanisms has been largely ignored. Here, we investigated patterns of temporal variation in beta diversity of seagrass-associated animals (amphipods, as model organisms). Location We conducted a study in three biogeographical regions across a temperate to subtropical latitudinal gradient (approximately 2,000 km, 13º of latitude). In each region, we randomly selected three C. nodosa meadows, totalling nine meadows sampled seasonally (i.e., four times per year) from 2016 to 2018. Methods We partitioned temporal beta diversity into its turnover (i.e. species replacement) and nestedness (i.e. differences in species composition caused by species losses) components and addressed the relative influence of both temporal variation in habitat structure (i.e., biotic driver) and environmental conditions on such patterns. Results Our study revealed high temporal beta diversity of amphipod assemblages across the three biogeographical regions, denoting significant fluctuations in species composition over time. We identified species turnover as the primary driver of temporal beta diversity, strongly linked to temporal variability in local habitat structure rather than regional climatic drivers. Subtropical Atlantic meadows with high structural stability over time exhibited the largest turnover rates compared with temperate Mediterranean meadows, under lower structural stability, where nestedness was a more relevant component of temporal beta diversity. Main conclusions Our results highlight the crucial role of habitat stability in modulating temporal beta diversity patterns on animals associated with seagrasses, stressing its importance for developing management and restoration actions in the context of diversity loss and fragmentation of ecosystems.

not-yet-known not-yet-known not-yet-known unknown Background Biallelic FANCM variants are linked to a Fanconi anemia-like cancer predisposition syndrome which includes early onset breast cancer, chemotherapy toxicity and chromosome fragility. Additionally, heterozygous truncating variants have been linked to increased breast cancer risk. However, the published results have been inconsistent, and the risks and the functional effects associated with the variants also vary depending on the position in the gene, with N-terminal truncating variants having a stronger effect. Compared to other FANCM variants studied, milder patient phenotypes and only late onset breast cancer have been reported for the homozygous C-terminal c.5101C>T variant, which is enriched in Finland. Case We report here a Finnish patient, homozygous for the FANCM c.5101C>T, p.(Gln1701*) variant, who manifested with early onset triple negative breast cancer, chemotherapy toxicity and chromosome fragility. The homozygous c.5101C>T has previously been reported in two Finnish siblings with primary ovarian insufficiency and chromosome fragility. Conclusion These findings suggest that the C-terminal FANCM variant c. 5101C>T may also cause a phenotype similar to the phenotype caused by N-terminal truncating variants, when inherited in a homozygous state.

Familial Erythema Nodosum Secondary to Streptococcal Infection: A Case ReportParivash Rahimizadeh*1, Mehrdad Farokhnia2, Saman Mohammadi11) Dermatology Research Center, Kerman University of Medical Sciences, Kerman Iran, Dermatologist.2) Infectious and Tropical Research Center, Kerman University of Medical Sciences, Kerman Iran, Infectious Disease Specialist.*Corresponding Author: Parivash Rahimizadeh, Dermatology Research Center, Kerman University of Medical Sciences, Kerman Iran.E-mail: [email protected]

Aim: Cupressus torulosa (family Cupressaceae), widely distributed in the north western Himalayan region of India, is a coniferous aromatic tree with various traditional uses of its aerial parts. Its needles have been used for anti-inflammatory, anticonvulsant, antimicrobial, and wound-healing properties. Antioxidants are pivotal in mitigating oxidative stress, a contributing factor to various diseases and aging processes. Employing a diverse array of analytical techniques, ranging from TPC, TFC to in vitro, in vivo assays and UPLC-QTOF-MS the research assesses the antioxidant potential of the Cupressus torulosa. Mаteriаls аnd methods: Employing а diverse аrrаy of аnаlyticаl techniques, rаnging from TPC, TFC to in vitro, in vivo аnd ex- vivo аssаys аnd UPLC-QTOF-MS the reseаrch аssesses the аntioxidаnt potentiаl of the plаnt. The initiаl screenings reveаl promising аntioxidаnt properties of the extrаct, with vаlues of 55.28± 57.07*,52.27± 19.50 in SGOT, SGPT (IU/L) аssаys respectively when compаred to positive control glibenclаmide. With subsequent frаctionаtion into butаnol аnd ethyl аcetаte frаctions. The ethyl аcetаte frаction exhibited pаrticulаrly notаble аctivity with lower vаlue of EC50 vаlue of 85.6 μg/mL in DPPH аssаy offering insights into the mechаnisms аnd effectiveness of these compounds in scаvenging free rаdicаls аnd mitigаting oxidаtive dаmаge. Results аnd Conclusion: Moreover, the chemicаl composition of аctive frаctions undergoes chаrаcterizаtion utilizing UHPLC-QTOF-MS, fаcilitаting the identificаtion of 34 metаbolites identified in negаtive mode with 10 key аntioxidаnt compounds аnd the elucidаtion of their frаgmentаtion pаtterns. These findings underscore the potentiаl of C. torulosа аs а bountiful reservoir of bioаctive аntioxidаnts, emphаsizing their significаnce in phаrmаceuticаl аnd nutrаceuticаl аpplicаtions. This reseаrch mаkes а substаntiаl contribution towаrds identifying potent аntioxidаnt compounds, emphаsizing the need for future efforts in isolаting аnd clinicаlly testing them. It enhаnces our understаnding of nаturаl аntioxidаnts аnd their criticаl role in enhаncing heаlth аnd аddressing oxidаtive-relаted conditions.

It is commonly agreed that power modulations in alpha oscillatory activity serve as an inhibitory neural mechanism, selectively routing information within neural circuits. In visuo-spatial attention, alpha oscillations enhance the processing of relevant targets and suppress potential distractors. However, there are inconsistencies regarding alpha power modulations with increasing load in common working memory (WM) tasks. Particularly, high WM load is associated with either decreased or increased alpha power, depending on the type of WM task deployed (i.e., N-back vs. Sternberg task). Next to existing cognitive interpretations of this variation of alpha power with load, recent considerations suggest the involvement of oculomotor action as a complementary explanation. In the present report we attempt to test this complementary view. We will conduct a large-scale combined electroencephalography and eye tracking study with 120 participants to examine the relationship between alpha power modulation and oculomotor action in the context of an N-back task and a Sternberg task. We aim to explore whether different gaze patterns during these tasks offer explanatory value in addressing the variations in alpha power with WM load. To this end, statistical tests on scalp-level power for the alpha band (8-14 Hz) and gaze deviation metrics will be conducted.

This study addresses three unmet needs: 1) development of widely accessible native mass spectrometry (MS) methods and 2) native top-down mass spectrometry (TDMS) methods for high flow sources on an Agilent Q-TOF mass spectrometer, and 3) confirming suitability of structures for lossless ion manipulation (SLIM) ion mobility (IM) MS methods for analysis of native intact proteins. To decrease the cost and training barrier to performing MS, TDMS, and IM-MS analysis of native proteins, we have developed methods for nanospray, microspray, and heated high flow electrospray ionization sources. SLIM offers the highest full-scan IM resolution available, but commercial instrumentation has not previously been applied to native MS. Our optimized methods extend the upper m/z limit beyond the manufacturer’s default IM mode upper mass limit of 4000 m/z to 7000 m/z, which allows for intact protein and native MS analysis of a variety of proteins, including native MS of intact IgG antibodies. Using the robust and facile Agilent Jet Spray (AJS) source, we demonstrate the application of native protein MS to amyotrophic lateral sclerosis (ALS)-associated Cu/Zn-superoxide dismutase proteoforms, characterizing a novel conformer and quaternary structural changes.

Quantitative surveys of wild animal abundance or activity, and assessments of the integrity of the complex natural ecosystems they live in, are typically quite laborious and meaningful analysis of the data obtained may require considerable time and expertise. This study describes the development and evaluation of a practical procedure for semi-quantitative consensus-based synthesis of subjective impressions accumulated by a small team of investigators who visited 32 different locations distributed in or around a community-based Wildlife Management Area in southern Tanzania. The subjective natural ecosystem integrity index (SNEII) scores obtained represent a holistic indicator of all aspects of land use, wildlife and human activities, which correlated strongly with objective indicators of wild animal community or whole natural ecosystem integrity that were estimated directly from quantitative survey data by the same investigators at the same locations. Also, comparative regression analysis indicated that the SNEII was a far more sensitive to variations in observed human activities than any of the objective alternatives, correspondingly yielding far more detailed insights into ongoing conservation challenges. This simple procedure for summarizing the overall, multi-faceted subjective impressions of individuals traversing extensive conservation areas may well be applicable through participatory approaches to routine programmatic monitoring by community-based staff with minimal training, and may therefore be more practically useful to devolved conservation areas like WMAs than conventional objective statistical synthetic indices relying on laborious collection and expert analysis of quantitative survey data.

Damselfishes (Pomacentridae) are widespread and highly abundant on tropical coral reefs. They exhibit diverse body colouration within and between the ~250 species and across ontogenetic stages. In addition to human visible colours (i.e., 400-700 nm), most adult damselfishes reflect ultraviolet (UV, 300-400 nm) colour patches. UV sensitivity and UV colour signals are essential for feeding and form the basis for a secret communication channel invisible to the many UV-blind predatory fish on the reef; however, how these traits develop across ontogenetic stages, and their distribution across the damselfish family is poorly characterised. Here, we used UV photography, phylogenetic reconstructions of opsin genes, differential gene expression analysis (DGE) of retinal samples, to investigate the development of UV vision and colour patterns in three ontogenetic stages (pre-settlement larval, juvenile, and adult) of eleven damselfish species. Using DGE, we found similar gene expression between juveniles and adults, which strongly differed from larvae. All species and all stages expressed at least one UV-sensitive sws1 opsin gene. However, UV body colour patterns only started to appear at the juvenile stage. Moreover, Pomacentrus species displayed highly complex UV body patterns that were correlated with the expression of two sws1 copies. This could mean that some damselfishes can discriminate colours that change only in their UV component. We demonstrate dramatic shifts in both UV sensitivity and UV colouration across the development stages of damselfish, while highlighting the importance of considering ontogeny when studying the coevolution of visual systems and colour signals.

Maned Three-Toed Sloths (Xenarthra: Bradypodidae) are endemic to the highly fragmented Atlantic Forest of Brazil. Both species, known as Northern Maned Sloths (Bradypus torquatus Illiger, 1811) and Southern Maned Sloths (Bradypus crinitus Gray, 1850), exhibit disconnected populations across the distributions. Our study investigates the evolutionary and demographic trajectories of these two sloth lineages, utilizing whole-genome resequencing data compared against a high-quality genome assembly. Our analysis reveals that the Southern Maned Sloth exhibits lower genetic diversity and a smaller historical population size compared to the Northern Maned Sloth. These disparities likely stem from differing environmental and climatic historical changes along the Atlantic Forest distribution during the Pleistocene, which was characterized by greater climate stability and larger refugia areas in the north. Nonetheless, the northern population has experienced a fast increase in inbreeding levels in the last 20 years, in a region of Bahia State with extensive recent deforestation associated with livestock farming, agriculture, and urban development. In addition, the northern lineage presented a higher genetic load, which could imply higher fitness costs for this population if inbreeding patterns persist. Taken together, these results confirm the independent evolutionary paths of these two lineages and underscore the conservation challenges faced due to historical evolutionary events and current deforestation of the Atlantic Forest.

The transition from a free-living lifestyle to endosymbiosis represents a large evolutionary shift, impacting various aspects of any organism’s biology, including its molecular basis. So far, it has been impossible to generalise the impact this lifestyle shift has on genomic architecture. This study explores this phenomenon using a new model system: neodalyellid flatworms (Rhabdocoela), a diverse assemblage of free-living and independently evolved endosymbiotic lineages. A uniquely comprehensive mitochondrial genomic dataset, consisting of 50 complete or partial mitogenome sequences (47 of which are new to science), is constructed, increasing the genomic resources available for rhabdocoel flatworms over tenfold. A robust phylogenomic framework is built, enabling an in-depth exploration of the molecular-genetic signatures associated with evolutionary shifts towards endosymbiosis. To understand speciation influenced by host phylogeny, first steps are taken to unravel the host-switching history of the largest endosymbiotic group of neodalyellids. We test several hypotheses regarding the potential consequences of a symbiotic lifestyle, and find heightened AT content, more pronounced AT skew, and relaxed selection on specific protein-coding genes in endosymbionts compared to their free-living counterparts. Numerous substitutions have accumulated in certain endosymbiotic lineages; however, the correlation with lifestyle remains uncertain. A high frequency of genetic rearrangements across all studied lineages is observed. Our findings affirm the variable nature of rhabdocoel mitogenomes and, for the first time, reveal distinct signatures of an endosymbiotic lifestyle in neodalyellid flatworms. This effort lays the groundwork for future research into the evolutionary and genomic consequences of a symbiotic lifestyle in this and other animal systems.

A document by Bishal Budha. Click on the document to view its contents.

Benign Mandibular Cavity/Stafne’s Bone cyst: A case report and reviewClinical MessageStafne’s Bone Defect is discovered incidentally on radiographic examination a radiolucent lesion in the body of the mandible, managed conservatively as it is asymptomatic. Its presentation can mimic a malignancy if symptomatic. Hence, it may raise a high index of suspicion unless a histopathological diagnosis rules it otherwise.IntroductionEctopic salivary gland tissue has been previously reported and described within various head and neck anatomical sites, including: the mastoid bone, middle ear, cervical lymph nodes, varied mandibular regions, and skin of the neck skin1. One unique case of ectopic salivary gland tissue is the Stafne bone defect (SBD)2.  In 1942, Edward Stafne described this defect as being an anatomic rather than pathologic condition, whose probable cause is soft tissue inclusion.  SBD is commonly found beneath the mandibular canal, between the first molar and angle of the mandible3. Diagnosed radiographically, they appear as circular, unilocular radiolucencies, giving way to other preferred diagnostic terms, such as: Stafne’s bone cyst/defect/cavity, mandibular salivary gland inclusion, ectopic/aberrant salivary gland, lingual mandibular bone cavity, static/idiopathic defects, or cavity3,4.   In most cases, Stafne bone defects (SBD) comprise ectopic glandular tissue.  However, muscle, lymphoid tissue, connective tissue, fat, soft tissue, or vasculature may be additionally found in the bone cavity2.Stafne’s bone cavities (SBC) remain a rare finding; therefore, most often present as an asymptomatic incidental discovery during routine dental checks.  SBCs have an incidence of 0.1% to 0.48%, affecting mostly males in the fifth to seventh decades 5.  Stafne defects have been previously reported to be a congenital anomaly.  It is postulated that during mandibular development, the partial entrapment of the salivary gland tissue in the developing mandible causes such defects 5 .  Authors state when the submandibular gland is under pressure, this defect could arise as an auxiliary effect.  It could also arise due to weakening or destruction via the adjoining lingual cortical plate 1.The aim of the current report is to describe a patient complaining of a painful lesion that led to the suspicion of an occult malignancy, yet, another unique presentation of a benign intramandibular salivary gland inclusion manifestation.Case History/ExaminationA 66-year-old otherwise healthy male patient presented with localized, dull pain on the left side of the jaw for about 3 months. There was no reported use of pain medications and his medical history was unremarkable. The patient reported smoking an average of 20 cigarettes daily and a glass of whiskey weekly for > 50 years. Upon examination, extra and intraoral examination was normal revealing no swelling on the left of the mandibular region. On deep palpation, the area apical to the left lower molar region elicited an area of tenderness, although the overlying mucosa was normal.Methods(Investigations, Differential diagnosis and treatment)The patient was sent for a Computed tomography (CT) orthopantomogram ( CT-OPG) and CT scans- axial cuts, and coronal cuts including 3D-Reformatted images. The axial cuts highlighted thinning of the mandibular cortex, whereas the 3D-reformatted images illustrated perforation of the buccal and lingual cortices inferior to the mandibular canal (Fig. 1A, Fig. 2A,2B). The CT scans revealed a left defined unilocular corticated lytic non-enhancing lesion that measured 22.6mm X 9.0mm X 13.4mm {anterior posterior(AP) X transverse(TR) X craniocaudal(CC) }, in the posterior aspect of the left mandible, adjacent to the angle of the mandible. The corticated lesion did not communicate with the mandibular canal and adjacent roots (Fig. 3A, B). The differential diagnosis included an occult metastatic malignancy, multiple myeloma, and SBC.Preoperative preparation included blood tests (full blood count and urea/electrolytes and creatinine), high resolution chest X-ray, liver function tests, and electrocardiocardiography, which were all normal. Under nasotracheal intubation, an incisional biopsy was obtained intra-orally from the tender ramal region of the mandible.ResultsHistopathological examination reported it as a benign intramandibular salivary gland inclusion. The macroscopic appearance was of multiple soft tissue 2cm in diameter and microscopically the tissue consisted mainly of salivary gland tissue with benign ducts, acini, and adipose tissue. Additionally, no features of cell atypia were observed (Fig.4). The recovery was uneventful, and the patient has been asymptomatic both, clinically and radiographically. The patient has been on review for the past eighteen months with no change in the current status of the lesion.DiscussionClinicians abide by the Hippocratic oath (primum non-nocere )6. Aggressive investigative approaches are ordinarily not adopted when the presentation is in keeping with all the radiological features of SBC. However, when a patient complains of dull pain, a biopsy is indicated as was the case in this patient. Among the list of differentials, it was pertinent to rule out the presence of an occult malignancy in keeping with a history of tobacco and alcohol consumption of >50 years. Radiological examination of the lesion gave it a classical description aligning with that of an SBC.The latter has been described as radiolucency dorsal to the mandible, inferior to the mandibular canal, above the cortical border of the mandible 7,8,9,10,11,12. Studies on the size of the bony defects have recorded values ranging from 0.5cm to 2.0cm with hardly any increases or decreases in dimension of the lesion assuming more of a static nature 13,14,15. In another study, volumetric measurements of SBC dimensions using Cone Beam CT showed ranges from 1 to 3 cm in diameter, depth (7,8mm), and width (16,3mm) respectively 16 . Although our patient had a CT scan, the lesion was reported to have a height of 13.4mm and width of 22.6mm, larger than the dimensions reported in the study by Adisen et al., 201517. There are two types of SBC, the anterior lingual variant (located amidst the incisors and the premolars, above the insertion of the mylohyoid insertion), the second is the posterior variant, which has been shown to be seven times more prevalent. The patient presented with the commoner posterior variant type18,19,20. SBC tends to present more in males than females (6:1 to 2:1) during the 4th to 6th decade of life with no racial bias. The age and gender of presentation in this patient was 66-year-old male of Indian origin 21,9,22.The etiology of SBC has been unclear with scanty histopathology evaluation of tissue. SBC has been a presumptive incidental radiological diagnosis due to its asymptomatic clinical presentation7,6. The precision of the term “SBC” during diagnosis, has been interrogated by many authors, preferring a change to “benign mandibular concavity”. Therefore, the possibilities are to presume that the erosion may have been caused by resorptive forces from a vessel, incomplete Meckle cartilage calcification during ossification or enlarged lobe of a salivary gland, or as was suspected in this patient, by an occult malignancy initially.In our patient, the tissue was intramandibular consisting of both salivary gland and adipose tissue with no cell atypia reported “benign mandibular concavities” are known to contain either salivary gland, lymphoid, muscular, adipose and vascular tissue. Our histopathological report was in keeping with two types of tissue found within the specimen: salivary and adipose tissue7,12,24,25,26,27,28,29,16,30,31,32,33,34,35,21,36,37,10.In general, these lesions are localized, non-progressive, non-healing, and are diagnosed as incidental findings with no clinical evidence. Therefore, often, a watch and wait approach is adopted with regular clinical and radio imaging 37.ConclusionIn this patient, surgical exploration followed by histopathology was pertinent due to the suspicious nature of the symptoms surrounding the SBC or “mandibular concavity” to rule the presence of an occult malignancy.Compliance was with Ethical StandardsConflicts of Interests: NoneAuthors Contribution: Dr Fawzia Butt Manuscript preparation and Submission & Miss Shamim Afrid Manuscript EditingConsent Form: I confirm I have obtained a written informed ans signed consent form from the patient and it has been uploaded as well.ReferencesPhero, J. A., Hannan, E., Padilla, R. & Turvey, T. Ectopic salivary tissue of the mandibular condyle: A case report and review of the literature. Oral and Maxillofacial Surgery Cases 6, (2020); Volume 6, Issue 3;100167, ISSN 2214-5419.Togni L, Mascitti M, Santarelli A, et al. Unusual Conditions Impairing Saliva Secretion: Developmental Anomalies of Salivary Glands. Front Physiol . (2019); 10:855. Published 2019 Jul 3. doi:10.3389/fphys.2019.00855.Sekerci, A.E., Sisman, Y., Etoz, M., Aksu, Y. Aberrant location of salivary gland inclusion: Report of a case with review of the literature. European Journal of Radiology Extra( 2011);79(1): e27-e31.Venkatesh A, Radder K, Harish K and Hegde V. Anterior Mandibular Lingual Salivary Gland Defect Mimicking an Odontogenic Cyst- A Case Report. Journal of Health and Allied Sciences NU. (2017):4: 2249-7110. 07. 10.1055/s-0040-1708736.Pellatt A. Stafne Bone Cavity: A Rare Case Affecting the Anterior Mandible. Clin Surg. (2019); 4: 2668Aps JKM, Koelmeyer  N, Yaqub  C. Stafne’s bone cyst revisited and renamed: the benign mandibular concavity. Dentomaxillofac Radiol (2020); 49: 20190475Stafne EC. Congenital defect of the mandible containing salivary gland tissue. In: Stafne E. C, ed. Oral Roentgenographic Diagnosis. 2nd Ed. . 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Published 2023 May 1. doi:10.4317/medoral.25676..Legends to figuresFig. 1 : CT OPG A well demarcated radioluscent lesion in the left body of the mandible adjacent to the lower borderFig. 2A : Axial CT scan highlighting thinning of the buccal cortexFig. 2B : Sagittal CT scan shows a sclerotic border outlining the radiolucent lucent lesionFig.3A & 3B : reformatted imaging illustrating the three dimension erosion of the lesion in the body of the mandible both buccally and linguallyFig.4: Hematoxylin and Eosin stain tissue (MagnificationX40)showing salivary glandular tissue ( presence of acini, ducts) and adipose tissue