Metacommunity theory has expanded our understanding of how spatial dynamics and local interactions influence species communities. Different assembly archetypes, reflecting different roles of species differences, habitat differences, and dispersal have been described, but we lack empirical studies specifically in terrestrial habitats testing which archetype is most important. In a replicated design we experimentally enhanced structural between-patch heterogeneity in homogeneous production forests and developed a statistical framework controlling for sample incompleteness to detect different metacommunity processes. Meta-analyses on >100K individuals of >1.3K beetle species showed an increase of ~60 species in heterogenized forests at γ-level promoted by increasing α-diversity consistent with the mass-effect and an increase of β-diversity by ~10% supporting species-sorting. Additionally, we tested β-deviations from random assembly as a proxy of neutral processes. Findings indicate that enhancing structural heterogeneity can shift forests from patch-dynamics dominance towards mass-effect and species-sorting, offering a promising pathway to restore biodiversity in managed landscapes.

Title: Congenital Myelodysplastic Syndrome in a Newborn with Germline JAK2 Variant Treated with Liposomal Cytarabine-Daunorubicin and Allogeneic Hematopoietic Stem Cell TransplantAuthors:Kristin E. Zorn1*, Kathleen M. Bone2, Maria E. Hintzke2, Amy Moskop1, Zachary Graff1Affiliations:1. Division of Hematology/Oncology/Blood and Marrow Transplantation, Department of Pediatrics, Medical College of Wisconsin and Children’s Wisconsin, Milwaukee, WI2. Department of Pathology, Medical College of Wisconsin, Milwaukee, WI* Current Affiliation –Division of Hematology/Oncology, Department of Pediatrics, Washington University School of Medicine, St. Louis, MOCorresponding author: Kristin E. ZornWashington University School of MedicineDivision of Pediatric Hematology/Oncology660 S. Euclid AveSt. Louis, MO 63110Phone: (314)-454-6018Fax: (844)-621-4392Email: zorn@wustl.eduWord count: 840Figures: 2Running Title: Congenital Myelodysplastic SyndromeKeywords: Myelodysplastic Syndrome, AML, JAK2Abbreviations:

Hypertrophic cardiomyopathy (HCM) typically involves the left ventricle. While right ventricular hypertrophy may occasionally coexist, severe right ventricular hypertrophy or right ventricular outflow tract (RVOT) obstruction is rare, with unclear incidence. Isolated right ventricular HCM has only been reported in individual cases. Here, we present a case of RVOT-type HCM.

In recent years, satellite networks have emerged as a critical access medium for global connectivity. New Low Earth Orbit (LEO) satellite constellations have enabled Internet access to remote regions where deploying terrestrial radio access networks would be economically or technically infeasible. Despite these advancements, constellation networks continue to face persistent challenges, particularly in reducing end-to-end latency and increasing available bandwidth to support seamless communication. Smart strategic placement of Multi-access Edge Computing (MEC) resources in space or on Earth could play a critical role in meeting these performance demands. This paper proposes a comprehensive analysis of Round-Trip Time (RTT) for computation services under various edge server placement strategies, including space, terrestrial, and hybrid cloud configurations. We use MeteorNet, a novel real-time emulation platform that integrates orbital propagation models and networking virtualization, to evaluate realistic satellite constellations and flight-grade application behavior at system-level scale. Our formulation of the edge server placement problem as a non-linear integer program enables quantifiable comparison of configurations, subject to constraints imposed by dynamic topologies and infrastructure limits. Through experimentation, we identify conditions under which terrestrial edge clouds provide optimal latency and cases where space-based architectures outperform their ground-based or even hybrid counterparts. We also demonstrate how server placement strategies, such as cross-plane, along-orbit, and farthest-point sampling, affect latency performance, as reflected in the average routing path length within the constellation. These findings provide actionable insights for the design and deployment of MEC server placement in space-based cloud architectures, demonstrating the value of real-time emulation platforms, such as MeteorNet, in supporting future edge computing platforms.

Multi-use landscapes are now recognized for their value in supporting biodiversity and aiding species conservation, including charismatic megafauna. However, arid and semi-arid open-canopy human-use landscapes have faced multiple anthropogenic stressors over the past centuries and have received meagre conservation attention, especially in South and Southeast Asia. Colonial legacy of attributing open natural ecosystems (ONEs) as “degraded lands” and resultant policy interventions have irreversibly transformed these ecosystems for agriculture, infrastructure development and green energy initiatives. However, a growing body of evidence suggests that such ecosystems, even with low-intensity use, can provide habitats for globally threatened species and support their conservation. India, a country with megafauna inhabiting human-use areas, growing economic and climate aspirations and a colonial past, provides a model for understanding the role of arid and semi-arid multi-use landscapes in supporting populations of large-bodied wildlife. Using key informant interviews with pastoralists and single-season single-species occupancy modelling framework, we explored distribution of three species: striped hyena Hyaena hyaena, sloth bear Melursus ursinus, and blackbuck Antilope cervicapra in an agro-pastoral semi-arid landscape in India’s Deccan Peninsula. Hyena, sloth bear and blackbuck occupied 52%, 26% and 63% of the landscape, respectively, despite the absence of protected areas. Conservative estimates also suggest that Indian grey wolf (Canis lupus pallipes) was present in at least 76% of the landscape. ONEs favoured occupancy of hyena and sloth bear, while low-intensity agriculture supported blackbuck presence. Our results highlight the conservation potential of multi-use landscapes and challenge the prevailing narrative of mischaracterizing semi-arid open ecosystems as “wastelands”. We also demonstrate the value of incorporating indigenous knowledge to aid conservation research and practices. Under global change scenarios, misclassification and mismanagement of critical socio-ecological systems, such as ONEs of Deccan Peninsula, will not only directly threaten the populations of endangered species but also weaken the land sharing potential of regions.

A CASE OF DRUG- INDUCED PANCREATITIS 

Early Detection and Treatment of a Chondroblastic Osteosarcoma in a 19-year-old Male

Case Report

Background: Strangles, caused by Streptococcus equi subspecies equi ( S. equi), is a prevalent infectious disease of horses. This is the first report on protection conferred by a new vaccine, Strangvac, against natural infection. Objectives: To measure the effects of Strangvac vaccination during an outbreak of strangles at a Swedish farm. Study Design: Longitudinal cohort study. Methods: Healthy horses ( n=17) were vaccinated on day 0, which occurred 23 days after strangles was first confirmed in three unvaccinated horses on the same farm. Blood serum samples were collected on day 0, day 28 and day 489. A combined iELISA was used to measure total antibody titres towards the components of the vaccine. Specific antibody levels in blood sera to S. equi were also quantified using the antigen A/C iELISAs, which can differentiate infected from vaccinated animals. Clinical signs were monitored. Results: All vaccinated horses had increased total antibody titres to CCE, Eq85 and/or IdeE from day 0 (2.50±0.28) to day 28 (3.63±0.31; p<0.0001). Seropositivity in the antigen A/C iELISA was noted in 8/17 healthy horses on day 0 (prior to vaccination), in 9/16 vaccinates on day 28, and in 3/3 unvaccinated clinical cases on day 28. None of the vaccinated horses developed strangles, but 5/7 of the original vaccinated horses tested seropositive in the A/C iELISA on day 489, which was 377 days after their third vaccination. Main limitations: Aside from the three unvaccinated clinical cases, no unvaccinated control group was available. Conclusions: Despite adherence to recommended biosecurity measures, serological evidence of exposure to S. equi was demonstrated in half of the vaccinated horses. Notably, all horses vaccinated during the outbreak responded to the vaccine components and remained healthy, supporting the protective effects of vaccination of healthy horses with Strangvac in outbreak situations.

Auricular Capillary Hemangioma: A rare Case Report

In Amyotrophic Lateral Sclerosis (ALS), alterations of spinal motoneurons’ excitability form the hallmark of their degeneration. Trans spinal direct current stimulation (tsDCS) is based on the delivery of low-intensity DCS to the spinal column in order to alter spinal circuit excitability. Recently, this technique was applied to the management of ALS in the SOD1 G93A mice and resulted in a reduction of disease biomarkers and extended mouse survival. While indirect evidence suggests that these effects can be linked to a decrease in MNs excitability following tsDCS, this has never been directly confirmed. Therefore, in this study, we have utilized in vivo sharp intracellular recordings of spinal MN to directly investigate the impact of DCS on MN intrinsic excitability in SOD1 G93A mice. Electrophysiological properties of MNs recorded before DCS were compared to the properties of MNs recorded one hour after DCS application using linear mixed-effect models. We have found that direct DCS application significantly increases MN peak and plateau input resistance (by 31 and 35% respectively); however, this was not linked to any significant change to MN threshold and firing properties. Both computational modelling and in vivo recordings of the EF field indicate that our results may be explained by the low density of the DC field at the MN recording site. While our results indicate that invasive DCS is not efficient in modifying MN excitability, it may be effective in altering the excitability of afferent fibres traversing the dorsal column close to the DCS electrode.

Balancing Efficiency and Outcomes in the Evolution of Catheter AblationIbrahim Hasan MD, Marwan M. Refaat MDDepartment of Internal Medicine, Division of Cardiology, American University of Beirut Medical Center, Beirut, LebanonRunning Title: Balancing Efficiency and Outcomes in AblationWords: 696 (excluding the title page and references)Keywords: Catheter Ablation, Cardiovascular Diseases, Cardiac ArrhythmiasFunding: NoneDisclosures: NoneCorrespondence:Marwan M. Refaat, MD, FACC, FAHA, FHRS, FASE, FESC, FACP, FRCPTenured Professor of MedicineDirector, Cardiovascular Fellowship ProgramDepartment of Internal Medicine, Cardiovascular Medicine/Cardiac ElectrophysiologyDepartment of Biochemistry and Molecular GeneticsAmerican University of Beirut Faculty of Medicine and Medical CenterPO Box 11-0236, Riad El-Solh 1107 2020- Beirut, LebanonFax: +961-1-370814Clinic: +961-1-759616 or +961-1-355500 or +961-1-350000/+961-1-374374 Extension 5800Office: +961-1-350000/+961-1-374374 Extension 5353 or Extension 5366 (Direct)Email: mr48@aub.edu.lbThe recent review “Catheter Ablation: Evolution and Efficiencies” offers a timely and insightful synthesis of the historical evolution, current practice, and procedural imperatives surrounding catheter ablation in electrophysiology (EP) [1]. As catheter-based interventions increasingly define the standard of care for arrhythmias—including atrial fibrillation, atrial flutter, supraventricular tachycardia, and ventricular tachycardias—understanding procedural efficiency has never been more critical. The review excels in contextualizing the historical progression of catheter ablation technologies, from initial direct current ablation to radiofrequency ablation (RF), cryoballoon, and the emerging pulsed field ablation (PFA). By tracing technical evolution alongside procedural adaptations, the authors illustrate how efficiency has been both a driver and a product of technological advancement. For instance, novel irrigated-tip RF catheters and contact force–sensing technologies have allowed for shorter procedure times and better ablation outcomes respectively [2], demonstrating the interplay of efficiency and efficacy. Moreover, PFA offers single-shot approaches [3], and it significantly reduced procedure time while maintaining high rates of pulmonary vein isolation as shown in multiple trials [4]. The review methodically addresses practical strategies to optimize EP lab efficiency. Ultrasound-guided femoral access, for example, is emphasized as a method to reduce the vascular complications and puncture time [5]. Anesthesia considerations are also thoughtfully discussed, highlighting that general anesthesia can decrease procedure times and improve ablation efficacy without compromising safety [6], while moderate sedation may remain sufficient for less complex arrhythmias. Invasive hemodynamic monitoring is addressed, with the authors recommending selective use of arterial lines for patients with impaired cardiac function or high procedural complexity, reflecting a balance between procedural oversight and resource utilization, as shown in a multi-center study that catheter ablation for atrial fibrillation can be safely conducted without reliance on invasive hemodynamic monitoring [7].The review also provides a detailed discussion of catheter selection and mapping strategies. High-density and omnipolar mapping techniques have been shown to reduce procedure time and enhance ablation accuracy, thereby improving both efficiency and outcomes [8, 9]. Of particular interest is the emerging role of PFA, which uses irreversible electroporation to rapidly create myocardial lesions while minimizing collateral tissue injury [3]. Studies report acute pulmonary vein isolation rates reaching 100%, with procedure times averaging under 100 minutes and low complication rates [10, 11]. The integration of PFA with three-dimensional mapping systems further consolidates mapping and ablation into a single workflow, exemplifying the potential for procedural streamlining without compromising patient safety [12].Despite its strengths, the review has some limitations. While procedural efficiency is emphasized, economic analyses are limited. Cost-effectiveness, total resource utilization, and comparative expenditures across different ablation modalities are important considerations that are only partially addressed, as a recent study found that while PFA had shorter procedure times compared to cryoballoon ablation and RF ablation, it was significantly more costly [13]. Finally, the review briefly acknowledges operator experience and learning curves, but high-volume centers consistently demonstrate superior outcomes [14], and structured training programs will be critical for the safe adoption of novel technologies.Building on the foundation established in the review, several avenues for future research emerge. Detailed economic and resource utilization analyses across different healthcare settings would provide valuable guidance for sustainable implementation of advanced ablation technologies. Multicenter registry data can clarify the translation of efficiency gains into real-world outcomes and inform best practices for training and standardization. Risk stratification models that integrate patient characteristics, procedural parameters, and device selection could further optimize outcomes while maintaining high efficiency. Finally, the integration of artificial intelligence in mapping, catheter navigation, and lesion assessment may represents a promising frontier for standardizing procedural efficiency and enhancing patient safety.In conclusion, the review provides a comprehensive, timely, and practical synthesis of a rapidly evolving field. By framing efficiency as a balance between procedural speed, safety, and efficacy, the review offers actionable guidance for clinicians navigating increasingly complex EP interventions. Its integration of historical context, technical evolution, and emerging technologies underscores the transformative potential of innovation in enhancing patient outcomes. Nonetheless, systematic evaluation of safety, cost-effectiveness, and long-term outcomes remains essential to ensure that efficiency gains translate into meaningful clinical benefit. Future research focused on comparative effectiveness, patient-centered outcomes, and AI-driven procedural optimization will be key to advancing the field of electrophysiology while maintaining high-quality care.

Continuum robot is a type of robot with continuous flexible skeleton, which plays an important role in production and life. At present, the position and orientation control (POC) scheme is not widely implemented in continuum robots, and it does not pay attention to the dynamic tracking error of the end-effector orientation, which has obvious limitations for completing the task. In view of the shortcomings of the existing research, this paper proposes a hybrid neural network-based algorithm for controlling the position and orientation of a continuum robot. In this algorithm, the POC scheme is applied to the continuum robot. Based on the kinematics equation of the continuum robot, the corresponding dynamic neural network (DNN) and the dynamic tracking algorithm of the end-effector orientation are obtained by theoretical derivation. The simulation results show that the proposed scheme reduce the position error of the end-effector of the continuum robot and improve operability. Specifically, the tracking error of the Euler angle converges quickly, and the ideal Euler angle is basically consistent with the actual Euler angle. The comparison between the experimental results and the existing control methods verifies the feasibility and advancement of the scheme.

The global energy landscape has undergone a dramatic transformation since 2021, with solar photovoltaic (PV) technology emerging as the cornerstone of decarbonisation efforts. This paper provides an updated analysis of solar deployment trends, levelized cost of electricity (LCOE), grid integration challenges, and the critical role of energy storage in enabling a resilient renewable energy grid. Drawing on recent data from the International Renewable Energy Agency (IRENA), Lazard, and BloombergNEF (Bloomberg New Energy Finance), we highlight the unprecedented cost reductions in solar PV and grid scale energy storage, the rapid growth of hybrid solar-storage systems, and the policy frameworks accelerating adoption. The findings underscore the need for integrated energy planning, continued materials innovation, and international collaboration to achieve net-zero targets by 2050.

Understanding the distinction between signs in sign language and gestures has been a topic of interest among researchers over the past decade. Recent arguments emphasize that sign languages exhibit syntactic, semantic, morphological, and phonological features while gestures are considered external to language. This theoretical distinction is importantly reflected at the brain level, with distinct brain regions being involved in sign language comprehension and gesture processing. A recent EEG study using the Fast Periodic Visual Stimulation (FPVS) design, for example, has shown heightened discrimination responses to number signs in deaf signers compared to hearing non-signers. However, it remains unclear whether these findings are related to deafness or sign language knowledge. The present study aimed to address this question by comparing, with a similar FPVS design, the brain responses of hearing signer adults to number signs and number gestures with those of hearing non-signers. Results showed more salient discrimination responses to number signs in hearing signers compared to hearing controls, while similar neural responses were found for number gestures among both groups. Our findings shed light on the role of deafness and sign language knowledge in shaping neural responses to linguistic and non-linguistic numerical representations.

Growth and immune development—fundamental parts of any organism’s ontogeny—depend critically on nutrient availability, particularly on essential amino acids that support protein synthesis and physiological processes. However, environmental variation can reduce prey diversity and nutrient quality, producing suboptimal diets that lack essential amino acids, potentially constraining development. In this study, we experimentally supplemented great tit (Parus major) nestlings from forest and suburban environments with methionine, leucine, or tap water (control) from day 4 to day 7 post-hatching and investigated the effects on growth and immune function across each habitat. We assessed nestling’s growth using body mass, tarsus length, and wing length, and immune function by quantifying complement activity (measured as lysis) and natural antibody titers (measured as agglutination). Supplementation significantly increased body mass gain in forest nestlings, particularly in smaller individuals, suggesting enhanced protein synthesis efficiency, although its effects on tarsus and wing length were limited. Methionine significantly improved lysis activity, suggesting enhanced innate immune function, while agglutination was not notably affected. Suburban nestlings showed limited responses to supplementation, suggesting broader nutritional constraints beyond individual amino acid deficiencies. Habitat and initial body mass significantly influenced growth rate but their effects depended on the treatment. These findings highlight the complex, condition-dependent effects of amino acid supplementation on nestling development and emphasize the importance of considering habitat-specific nutritional limitations when assessing avian developmental plasticity.

Title: Rare angiosarcoma in the postauricular region - a diagnostic challenge and treatmentShort Title: Hemangiosarcoma of the mastoid regionAuthors: Katarzyna Żyżynska, MD1; Kamila Grycner, MD1; Dmitry Tretiakow, MD, PhD1;prof. Andrzej Skorek11Clinical Department of Otolaryngology of the Academy of Applied Medical and Social Sciences in Elblag, Hospital Nicolaus Copernicus in Gdansk, PolandCorresponding author: Katarzyna Żyżyńska, Clinical Department of Otolaryngology of the Academy of Applied Medical and Social Sciences in Elblag, Hospital Nicolaus Copernicus in Gdansk 80-152, Poland; tel. +48 587640834; email:katarzyna.zyzynska@gmail.comKeywords: hemangiosarcoma, head and neck sarcoma, cranial baseCompeting interests: None.Funding source: None.Acknowledgments: Not applicable.Title: Rare angiosarcoma in the postauricular region - a diagnostic challenge and treatmentAuthorship: Katarzyna Żyżynska,1,2,3,4; Kamila Grycner 1,2,3,4; Dmitry Tretiakow, 3,4,; Andrzej Skorek 3,4Acknowledgments: Not applicable.Conflict of Interest Statement: The authors declare no Conflicts of interst.INTRODUCTION:Sarcomas are rare malignancies of mesenchymal origin, accounting for 1% and 0.2% of all bone and soft tissue cancers, respectively. Hemangiosarcoma, a vascular neoplasm derived from endothelial cells, is particularly uncommon, comprising less than 2% of soft tissue sarcomas and fewer than 1% of head and neck malignancies. It predominantly affects the scalp and face of individuals over 60, with a higher incidence in males and Caucasians. [1,2]Treatment of hemangiosarcomas includes surgery, radiation therapy, and chemotherapy. These methods are often combined to address both local and systemic disease [3,5]. Targeted therapies and immunotherapy are also being explored to improve outcomes. Our patient was treated successfully with surgery and proton therapy. There is limited specific literature on proton therapy for angiosarcoma of the head; however, available case reports and general principles suggest that proton therapy could be a viable and safe option for treating angiosarcomas in sensitive areas like the head and neck [4].CASE REPORT:A 72-year-old white male patient presented to the hospital on an acute-care basis with a complex set of symptoms involving the left ear and surrounding area. The patient reported swelling in the retroauricular region, accompanied by auricular protrusion and hearing loss that had persisted for approximately two weeks. Additionally, he experienced purulent-bloody discharge from the left ear, though notably without associated pain. The patient denied any dizziness or nausea, and clinical examination revealed no signs of facial nerve paresis.To further investigate these symptoms, a head CT scan was performed. The imaging results revealed dense shadowing of the middle ear and mastoid process, with evidence of bony lysis in the mastoid process. Based on these findings, the lesion was initially described as a mastoid process/periauricular abscess. Interestingly, despite the concerning presentation, the patient reported no additional complaints beyond the aforementioned symptoms. Laboratory tests were conducted, showing no elevation in inflammatory parameters, which was somewhat unexpected given the clinical picture.Following an ENT consultation, the patient was admitted to the hospital and deemed suitable for surgical intervention. During the procedure, the surgical team encountered an inflammation-damaged mastoid filled with soft-tissue lesions. Upon further exploration, a periareolar lesion containing septic-pleural contents was excavated. The surgeons noted that the wall of the dura and sigmoid sinus appeared unaltered. However, they identified a fistula connecting to the external auditory canal, adding complexity to the case.Intraoperative examination and microbiological diagnosis were performed as part of the standard protocol. Surprisingly, the intraoperative examination did not confirm the presence of a malignant lesion. Instead, it revealed a fusiform granuloma with foci of myofibroblasts (SMA+) and macrophages (CD68+). This finding, while not indicative of malignancy, presented a diagnostic challenge given the unusual presentation and imaging results.Following consultation with the hospital microbiologist, targeted antibiotic therapy with ceftriaxone and gentamicin was initiated based on culture results showing Proteus mirabilis and Escherichia coli. This treatment led to local improvement.The initial histopathological examination revealed no malignancy. The predominant finding was droplet-rich granulation tissue with some endothelial cells (CD31+, FVIII+, CD56+) showing secondary atypia. The granuloma contained stimulated myofibroblasts (SMA+) and macrophages (CD68+). No epithelial (CK Pan-, p40, p63-) or melanocytic (S100-) cells were identified.Five months post-surgery, the patient returned with retroauricular pain, periodic dizziness, and an ulcerated nodule with complete wound dehiscence. Re-operation and subsequent histopathological examination confirmed hemangiosarcoma - angiosarcoma exulcerans (CD31+, CD34+, CKPan-, p63-).Expanded diagnostic imaging, including MRI, CT, and PET scans, revealed tumor penetration into the middle cranial fossa. The patient underwent proton therapy (70 Gy/55 fr) at the National Cancer Institute’s Proton Therapy Center.One year post-treatment, CT scans showed no evidence of pathology or local recurrence. However, two years after initial hospitalization, chest CT revealed a metastatic nodule in the left lung, confirmed by biopsy. The patient underwent uncomplicated lobe resection.Four years post-second surgery, the patient remains under close oncological and ENT surveillance. While a CT scan showed a concerning lesion in the left external auditory canal, biopsy revealed only inflammatory granulation tissue without malignancy. Given the high-grade nature of angiosarcomas, the patient continues to require regular follow-up and imaging.Discussion:Angiosarcoma of the temporal bone is an extremely rare malignancy that can mimic chronic otitis media. This case highlights the challenges in diagnosis, as initial symptoms and histopathology did not suggest malignancy. The atypical postoperative course, including abnormal healing and rapid lesion regrowth, raised oncological concerns.This case underscores the importance of multidisciplinary collaboration among ENT specialists, radiologists, and histopathologists in managing such rare and aggressive tumors. The successful use of proton therapy in achieving remission is noteworthy, though long-term follow-up is crucial due to the high risk of recurrence and metastasis associated with angiosarcomas.Conclusion:This case report illustrates the diagnostic challenges and management complexities of temporal bone hemangiosarcoma. It emphasizes the need for vigilant follow-up and a high index of suspicion in cases with atypical presentations or postoperative courses. The successful use of proton therapy in this case offers a promising treatment option for similar cases, though long-term outcomes require further study.References:Lydiatt WM, Shaha AR, Shah JP. Angiosarcoma of the head and neck. Am J Surg . 1994;168(5):451-454. doi:10.1016/s0002-9610(05)80097-22. Fury MG, Antonescu CR, Van Zee KJ, Brennan MF, Maki RG. A 14-year retrospective review of angiosarcoma: clinical characteristics, prognostic factors, and treatment outcomes with surgery and chemotherapy [published correction appears in Cancer J. 2005 Jul-Aug;11(4):354]. Cancer J . 2005;11(3):241-247. doi:10.1097/00130404-200505000-000113. Chen JX, Kozin ED, O’Malley J, et al. Otopathology in Angiosarcoma of the Temporal Bone. Laryngoscope . 2019;129(3):737-742. doi:10.1002/lary.272814. Kalavrezos N, Sinha D. Head and neck sarcomas in adulthood: current trends and evolving management concepts. Br J Oral Maxillofac Surg . 2020;58(8):890-897. doi:10.1016/j.bjoms.2020.05.0155.Vitolo V, Barcellini A, Mirandola A, et al. Is Proton Beam Radiotherapy Worthwhile in the Management of Angiosarcoma of the Scalp?. Anticancer Res. 2020 Mar;40(3):1645-1649. doi: 10.21873/anticanres.14114.Figure I.Computed tomografy scan A. before treatment B. after first surgery C. after second surgery D. after proton therapy

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