The main purpose of this paper is to provide new computational implementations for describing and analyzing the q-analogues of combinatorial numbers and polynomials which are capable of being an essential tool in solving many scientific and engineering problems. By the provided procedure in the Wolfram language, some members of the aforementioned family are illustrated by their numerical tables and two-and three-dimensional plots. In addition to this computational analysis, we also elaborately investigate some properties pertaining to the aforementioned q-analogues by obtaining their computation formulas, derivative formulas, generating functions and interpolation functions. Especially , by applying the Mellin transform to exponential generating functions for the aforementioned q-analogues, we construct their interpolation functions at negative integers. Moreover, by applying p-adic q-integration to for the afore-mentioned q-analogues, we obtain p-adic q-integral formulas and combinatorial sums involving q-Bernoulli numbers and polynomials. Eventually, this paper is concluded by presenting some comments and observations on the findings.

Epigenetic processes have taken center stage for the investigation of many biological processes and epigenetic modifications have shown to influence phenotype, morphology and behavioral traits such as stress resistance by affecting gene regulation and expression without altering the underlying genomic sequence. The multiple molecular layers of epigenetics synergistically construct the cell type-specific gene regulatory networks. DNA methylation occurring on the 5’ carbon of cytosines in different genomic sequence contexts is the most studied epigenetic modification. DNA methylation has been shown to provide a molecular record of a large variety of environmental factors, which might be persistent through the entire lifetime of an organisms and even be passed onto the offspring. Animals might display altered phenotypes mediated by epigenetic modifications depending on the developmental stage or the environmental conditions as well as during evolution. Therefore, the analysis of DNA methylation patterns might allow deciphering previous exposures, explaining ecologically relevant phenotypic diversity and predicting evolutionary trajectories enabling accelerated adaption to changing environmental conditions. Despite the explanatory potential of DNA methylation. studies of DNA methylation are still scarce in the field of ecology. This might be at least partly due to the complexity of DNA methylation analysis and the interpretation of the acquired data. In the current issue of Molecular Ecology Resources, Laine and colleagues (2023) provide a detailed summary of guidelines and valuable recommendations for researchers in the field of ecology to avoid common pitfalls and perform interpretable genome-wide DNA methylation analyses.

Many software development methodologies introduced to date place users at the centre of development process. Although the user is an important asset in the software development cycle however the user-centred approach is not sufficient to develop a software product that is structurally robust and reliable. User involvement in the development process does not always guarantee resilience and a more efficient design. To address this a hybrid-based software development paradigm is proposed here where the software development cycle includes a grammar model-based compiler with user-centred approach. The efficacy of the proposed system is tested with the development of an innovative computer-aided drawing technology (SETUP09) for blind and visually impaired people and the results are compared with an existing non-hybrid-based drawing software (IC2D). The results of this study confirm SETUP09 improves user satisfaction and provides abstract and concrete level system flexibility. Provided here are guidelines of the proposed hybrid approach for software development based on a formal approach. This hybrid approach enables the software designer to evaluate the software semantics before user scrutinization. The benefits of the approach include the facilitation of alternate development pathways affording the software designer the flexibility to amend the software without incurring significant technical challenges. In fact, the proposed approach enables the creation of a structural design that is independent from the development pathways. This approach should ease the time constraint in product development and resource constraints.

Cyclic pore pressure is closely related to the stability and safety of deep underground engineering. A micro-macro mechanical model of creep fracture under cyclic pore pressure, external confining pressure, and axial stress was established to reveal the mechanism of cyclic pore pressure of brittle rock. The model combines the improved microcrack model, the function of cyclic pore pressure, the subcritical crack law, the Hooke-Kelvin model, and the crack-strain model. The complete elastic, viscoelastic and plastic deformation of rock is described. The model solution before crack extension determines the elastic and viscoelastic deformation, and that of after crack extension determines the plastic deformation. Time-dependent elastic modulus evolution of rock under cyclic pore pressure is obtained, which affects viscoelastic strain under cyclic pore pressure. The effects of cyclic pore pressure parameters Δ P Pa and Δ P Pb and cycle period on rock viscoelastic rebound value and creep fracture time are discussed. Rationality of the proposed model is verified by experimental data. The analytical results provide help for evaluation in safety and stability of rock engineering.

Taste is one of the basic senses of living organisms and can recognize sour, bitter, salty, sweet and umami tastes. Bitter taste receptor is a class of G protein-coupled receptors capable of sensing bitterness. Initially, bitter taste receptor was thought to be only found in the taste buds of the tongue, palate and throat. Recent research has shown that in addition to the oral cavity, the bitter taste receptor is also present in the intestinal tract, respiratory tract, urinary tract, vascular smooth muscle, nervous system, thyroid gland and other tissues and organs to regulate body homeostasis and resist disorders . In this review, we focus on the effects of the bitter taste receptor outside the oral cavity to lay the groundwork for future research.

The present study carried out on adult Mugil cephalus fish collected from freshwater and marine water. The pituitary gland and head kidney obtained and processed for examination by using light microscope besides other samples were prepared and processed for transmission electron microscope. This investigation showed that pituitary gland of adult Mugil Cephalus fish consisted of two parts; Adenohypophysis and Neurohypophysis. The adenohypophysis consisted of three parts named as; Rostral pars distalis, Proximal pars distalis and Pars intermedia. By certain histochemical stains, seven cell types were detected in adenohypophysis as, Lactotrophs and adrenocorticotrophs in rostral pars distalis, while in proximal pars distalis, gonadotrophs, somatotrophs and thyrotrophs were detected. While melanotrophs and somatolactin cells were detected in pars intermedia. By light microscope, results showed increased in the Lactotrophs and adrenocorticotrophs in the number in fresh water Mugil Cephalus than in marine one. The present results showed absence of adrenal gland in Mugil cephalus resemble mammals but inter renal and chromaffin cells that located in the wall of posterior cardinal vein in head kidney. In freshwater fish, more layers of inter renal cells were observed than that in marine one. ــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــ

The group 2 σ factor for RNA polymerase SigE plays important role in regulating central carbon metabolism in cyanobacteria. However, the regulation of SigE for these pathways at a proteome level remains unknown. Using a sigE-deficient strain (ΔsigE) of Synechocystis sp. PCC 6803 and quantitative proteomics, we found that SigE depletion induces differential protein expression for sugar catabolic pathways including glycolysis, oxidative pentose phosphate (OPP) pathway, and glycogen catabolism. Two glycogen debranching enzyme homologues Slr1857 and Slr0237 are found differentially expressed in ΔsigE. Glycogen determination indicated that Δslr0237 accumulated glycogen under photomixotrophic conditions but was unable to utilize these reserves in the dark, whereas Δslr1857 accumulates and utilize glycogen in a similar way as the WT strain does in the same conditions. These results suggest that Slr0237 plays the major role as the glycogen debranching enzyme in Synechocystis. To our knowledge, this is the first study to report the functional difference of two glycogen debranching enzyme in Synechocystis and the research highlights the intricate regulation of glycogen breakdown.

Structural characteristics-guided investigation of Ailanthus altissima (Mill.) Swingle resulted in the isolation and identification of seven undescribed potential Michael reaction acceptors (1–7). Ailanlactone A (1) possesses an unusual 1,7-epoxy-11,12-seco quassinoid core. Ailanterpene B (6) was a rare guaianolide-type sesquiterpene with a 5/6/6/6-fused skeleton. Their structures were determined through extensive analysis of physiochemical and spectroscopic data, quantum chemical calculations, and single crystal X-ray crystallo-graphic technology using Cu Kα radiation. The cytotoxic activities against HepG2 and Hep3B cells of isolates were determined. En-couragingly, ailanaltiolide K (4) showed significant cytotoxicity against Hep3B cells with IC50 values of 1.41 ± 0.21 μM, whose covalent binding mode was uncovered in silico.

Background: In emergency departments, rapid screening of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is important for arranging limited isolation resources and patient care during the coronavirus disease 2019 (COVID-19) pandemic. STANDARD M10 SARS-CoV-2 (SD Biosensor) is a recently developed cartridge-based RT-PCR that provides a turnaround time of 1 h, which is shorter than that for conventional RT-PCR. This study evaluated the clinical performance of STANDARD M10 in an emergency department. Methods: From March to June 2022, two pairs of nasopharyngeal and oropharyngeal swabs were collected from patients visiting an emergency department. Respective specimens underwent rapid RT-PCR using STANDARD M10 and conventional RT-PCR using Allplex SARS-CoV-2 (Seegene). When discordant results occurred, specimens undergoing the STANDARD M10 were retested with the Allplex to exclude specimen variations. Retest results replaced initial results of the Allplex. Clinical performance of STANDARD M10 was compared with Allplex. Results: The study enrolled 1,971 patients. COVID-19 prevalence was 6.2% based on the Allplex. Compared with the Allplex, overall agreement, positive percent agreement, and negative percent agreement of STANDARD M10 were 99.5% (95% CI: 99.1–99.8%), 95.9% (95% CI: 90.8–98.3%), and 99.8% (95% CI: 99.4–99.9%), respectively. Discordant results between STANDARD M10 and Allplex were observed only in specimens with Ct >33 using the Allplex. Conclusions: The STANDARD M10 showed reliable diagnostic performance for detecting SARS-CoV-2 in emergency departments and is a useful tool in emergency healthcare systems because of its easy-to-use cartridge-based assay and short resulting time for detecting SARS-CoV-2.

On the bases of “seeing is believing” concept and the existing theory of coordination chemistry, we innovatively designed and synthesized a visual-volumetric sensor platform with fluorescein and uracil functionalized polyacrylamide hydrogel for the first time. Without the aid of complicated instruments and any power sources, the sensor enables quantitative detection M level by reading graduation on a pipette with the naked-eye. The sensor undergoes volumetric response and shows a wide linear response range to (~) with of the detection limit. The high selective (easily distinguished from other common metal ions), rapid response (~30min) and acceptable reproducibility (RSD<5% in all cases) demonstrated that the developed sensor is suitable for practical use onsite for the determination of while conveniently being low cost, simple and portable. The design principles of the obtained materials and the construction techniques and methods of the sensors in our work provide a new idea for the research and development of smart materials and series of visual-volumetric sensors for other analytes.

Illumination of species diversity and their distribution is key to evolution, genetics and conservation. The genus of Sibynophis is a group of rare snakes with less attentions. Based on more extensive sampling, we use both mitochondrial fragments and nuclear gene to explore the species diversity of the species of Sibynophis occurring in China. The results showed that S. c. miyiensis is a synonym of S. c. grahami, and S. c. grahami should be gave a specific rank as S. graham. Sibynophis triangularis was uncovered to be new to China and Myanmar. On basis of our specimens and molecular phylogeny results, the species distribution boundaries of each Chinese species were redefined.

Short-term surges in stream temperature in response to storm events have frequently been observed in urban areas , highlighting the need for improved understanding of the factors influencing urban stream temperature. Urban land cover complexity and infrastructure designed for rapid water routing to the sewer system create a direct link between storm events and water release processes, influencing urban stream temperature responses. This study aims to identify predictors of diverse stream temperature response patterns to summer storms. We analyzed 403 storm events from six urban and semi-urban catchments along the US East Coast using dynamic time warping to identify archetype patterns of stream temperature responses. We further disentangled observed stream temperature increase patterns to reveal the drivers associated with “heat pulses”, which are characterized by a rapid but high-magnitude temperature increase followed by a sharp temperature drop at the start of the hydrograph. Our results show that stream temperature patterns were event-specific and linked to pre-event conditions and rainfall-runoff characteristics, with the shape of the hydrograph and rainfall-runoff response identified as the most important determinators of the observed temperature response patterns. Ponded surface waters and storm drains, as well as cooler water from the shallow subsurface, were identified as likely sources contributing to temperature patterns. These findings have important implications for understanding urban hydrology and the contributions of different source zones in urban catchments. Specifically, our results suggest that streamwater temperature can serve as a cost-effective tracer of information about urban water sources and pathways, aiding in the understanding of complex urban hydrology.

The relationship between team size and software quality has been a long-standing topic of debate in the software development industry. While larger teams were traditionally believed to be more productive and produce higher-quality software, recent research has shown that this relationship is more complex than originally thought. The paper examines several studies that have found conflicting results, highlighting the need for further research to explore the moderating factors that influence this relationship. The research suggests that team communication and coordination, developer experience, and project complexity are key factors that may interact with team size to influence software quality. Future studies should consider these moderating factors and use a range of quality metrics to provide a comprehensive assessment of software quality. These findings have important implications for project managers and software development teams who need to make informed decisions about team size and project planning. By optimizing team size and considering the factors that influence software quality, they can improve the overall quality of their software products. Effective communication and coordination among team members are critical to ensure that development efforts are aligned and productive, particularly when dealing with larger teams. Additionally, developers’ experience and the complexity of the project can affect the software quality outcome. Therefore, project managers must evaluate these factors and tailor team size and project planning accordingly to meet the desired quality objectives. Overall, the research provides insights into the complex relationship between team size and software quality, which can help project managers and software development teams make informed decisions to optimize their development efforts. By leveraging the moderating factors that influence software quality, teams can better understand how to improve their software products’ overall quality, leading to better outcomes for their organizations and end-users.

Background: Rapid detection of pathogens is important for the timely control of outbreaks, especially for respiratory infectious diseases that are prone to spread and outbreaks. Methods: In this work, we developed a sensitive reverse transcription recombinase-aided amplification (RT-RAA) assay for the rapid detection of six common respiratory viruses including respiratory syncytial virus type A (RSVA), influenza A virus (Flu A), influenza B virus (Flu B), human parainfluenza virus (HPIV), SARS-CoV-2 and adenovirus (ADV). The nucleic acid standards and pharyngeal swab samples were used to test the sensitivity, specificity, reliability of the established RAA assay. Results: The assay could be completed within 20 minutes at 39℃ using a portable built-in power device. The detection limits for the six viruses were all less than 1000 copies/mL and reached 10 copies/mL for ADV. Excellent specificity was demonstrated by cross-testing with 21 different pathogen nucleic acids. The results of RT-RAA and RT-PCR were consistent in 85 laboratory-conserved pharyngeal swab samples, but RT-RAA was more time-saving and portable. Meanwhile, the RT-RAA assay using the same test procedure for six viruses could allow operators the flexibility to select the number of samples and pathogens to be detected in one test. Conclusions: This portable, sensitive and reliable RT-RAA assay for rapid detection of multiple respiratory viruses could be applied to health resource-poor areas and outbreak sites.

The current outbreak of Marburg Virus in Equatorial Guinea and Tanzania is a growing concern in Sub-Saharan African Region. With a mortality rate of upto 88%, lack of treatment and its transmissibility, it has a very high epidemic and pandemic potential. Unrestricted traveling can result in a global pandemic with ease. The virus is transmitted mainly via blood, skin puncture and fomites with secretions of an infected person or Rousette bat colonies. The symptoms are divided into three phases similar to the ebola virus. The average incubation period is about 5-9 days. Many experimental drugs are being developed revealing positive results like Favipravir (antiviral) and MR191-N (monoclonal antibody). Pre-exposure vaccines are currently in Phase 1 clinical trials. Post-exposure vaccines have also shown positive outcomes. Stakeholders within countries should take action with strong commitment by following instructions and warnings issued by WHO.

C-aryl glycosides are an important kind of carbohydrate derivatives for drug discovery, due to their distinctive attributes of resistance to hydrolysis from enzymes. Herein, C-aryl glycosylation was established for the synthesis of 2-sulfur C-aryl glycals and 1,2-dihydrobenzofuran-fused C-aryl glycosides via interrupted Pummerer process, featured with sulfonium-tethered [3,3]-sigmatropic rearrangement between sulfoxide glycals and phenols. This protocol offers a broad substrate scope with diverse glycosyl and phe-nols. Dapagliflozin, Empagliflozin, and Ipragliflozin analogs were straightforward achieved, respectively.

Background: Eczema in early childhood is associated with developing subsequent allergic diseases, including food allergy, asthma and hay fever. However, eczema has a heterogenous presentation regarding age of onset and persistence, which may lead to different allergic outcomes during childhood/adolescence. Recently, sub-phenotypes of eczema have been suggested as predictor for allergic multimorbidity. Objective: To identify associations of eczema phenotypes with food allergy, asthma and hay fever during childhood/adolescence. Additionally, we aimed to describe the trajectories of eczema, asthma and hay fever, stratifying by food allergy presence. Methods: TRACKER (Trajectories of Allergy in Children in Real Life Databases) is a prospective cross-sectional population-based cohort study of 6,852 children/adolescents from the Lifelines cohort. We investigated associations of seven eczema phenotypes, based on age of onset and persistence, with food allergy, asthma and hay fever using logistic regression, adjusted for appropriate covariates. Disease trajectories were determined by calculating prevalence at different ages. Results: Participants who suffered from eczema throughout childhood showed higher risks of developing food allergy, hay fever and asthma. “Very early onset – persistent” eczema showed the strongest associations with food allergy, asthma and hay fever. The prevalence of eczema, asthma and hay fever at all ages were significantly higher in participants with food allergy, compared to those without. Conclusion: The largest cohort study on this topic to date shows that (very) early onset and persistent eczema increases the risk for allergic multimorbidity. Identification of infants at risk for developing (very) early onset eczema is of utmost importance to prevent allergic multimorbidity.

The interfacial microhabitat induced by triazole ionic liquid ([124Triz]−) electrolyte can effectively enhance formate selectivity for electrochemical CO2 reduction reaction. However, the catalytic mechanism remains unclear. Herein, we combined molecular dynamics simulation and density functional theory to reveal the regulatory mechanism. The results showed that the dipolar interaction between CO2 and [124Triz]− cooperating the hydrogen bonds between [124Triz]− and H2O facilitate the accumulation of H atoms around C atoms of CO2. Meanwhile, the strong polar [124Triz]− induces negative electrostatic potential for the H atoms of H2O near anions. As a result, the negative H atoms are more likely to attack the positive C atoms of CO2, which results in a lower free energy of -0.10 eV for the formation of *HCOO intermediate and promotes the formation of formate. Thus, the [124Triz]− contributes to high formate selectivity owing to the combined effects of strong CO2-dipole interaction and hydrogen bonds with H2O.

A flow-through catalytic membrane micro-reactor (CMR) with Cu/ZnO/Al2O3 nanoparticles immobilized in porous membrane pores has been developed for hydrogen production by methanol steam reforming (MSR). The characteristics for CMR demonstrated Cu/ZnO/Al2O3 nanoparticles with almost 200 nm were successfully in situ immobilized in membrane pores. During MSR for hydrogen production in CMR by flow-through mode, hydrogen yield of 500 mmol h-1 g-1 cat. and selectivity of 100% can be achieved under the condition of temperature being 360℃, molar ratio of water to methanol of 8.8 and weight hourly space velocity (WHSV) of 9.28 h-1. Compared with the commercial fixed bed reactor, the hydrogen productivity in CMR is one order of magnitude higher, owing to MSR confined in the space of membrane pore with micro-scale. The methanol conversion rate of over 95% can be expected, if five sheets of CMR with thickness of 5 mm was assembly in series.

Wax/paraffin deposition in production wells and oil pipelines is a major challenge for oil production. Extensive research has been conducted to improve understanding of this process. This paper presents a review of experimental work carried out with flow loops. Previous research investigated paraffin deposition process under the influences of temperature, flow rate/velocity, shear stress, water fraction, gas phase, pipe material, asphaltene concentration, and chemical inhibitors. Test results reveal that temperature and shear stress have significant impacts on wax deposition. Limited research has been conducted on wax deposition under multiphase flow. Even though more than 20 years of efforts have been spent on wax deposition studies, unfortunately we have not fully understood this phenomenon.

Chronic cough is one of the most common complaints of childhood to consult a doctor. There are many causes such as respiratory tract infections, gastroesophageal reflux, persistent bacterial bronchitis, asthma, cystic fibrosis, congenital malformations, and foreign body aspiration in children under the age of five. However, neither transient hypogammaglobulinemia of infancy (THI) among the causes of chronic cough, nor chronic cough among the application complaints of THI are not questioned. In this study, we aimed to draw attention to the role of THI in the etiology of chronic cough under the age of five. Our study included 55 pediatric patients under the age of five who applied to the pediatric pulmonary diseases outpatient clinic in between January 2015 and December 2020 with the complaint of chronic cough, who were excluded from other causes of chronic cough in etiology, and who met the criteria for THI according to the European Society for Immunodeficiencies (ESID). Demographic, clinical and laboratory characteristics and follow-ups of these patients were reviewed retrospectively. In our study, the mean age of 55 patients at admission was 21.73 ± 11.50 months (median age: 18 months), and the mean age of IgG recovery was 38.65 ± 16.81 months. The mean recovery time was 16.93 ± 12.85 months. Of the patients, 22.4% had a history of consanguinity, 23.4% had prematurity, and 18.2% had a frequent sickness in siblings. The most common complaint accompanying chronic cough in patients was frequent respiratory tract infection, 16.3%. Along with IgG, 26.4% of the patients had low IgA and 31.5% had low IgM in laboratory testing. In antibody responses, isohemagglutinin, anti-tetanus, anti-pneumococcal, anti-HBs vaccine responses were found to be positive in 90.6%, 63.9%, 66.7% and 97.7% of the cases, respectively. 72.7% of the patients received inhaler treatment, 45.5% received antibiotic prophylaxis, and 2.2% received intravenous immunoglobulin (IVIg) treatment. After the IgG value of the patients returned to normal, it was observed that 86.3% of the patients’ cough complaint have disappeared. Transient hypogammaglobulinemia of infancy mostly presents with recurrent lower and upper respiratory tract infections. The most common complaint is cough. It is not questioned whether the cough is chronic or not. In this study, we aimed to investigate the follow-up and prognosis of patients under the age of five who had a chronic cough complaint, when other causes of cough were ruled out and THI was detected. In the study, when the IgG levels of the patients return to normal, the cough complaints disappear to a large extent, showing that THI may also be among the causes of chronic cough.

Background: 5-year-old male child, known case of SMA-1 with chronic respiratory failure. He was ventilated since the first year of life. Tracheostomy tube was used to manage his chronic ventilation. Patient was admitted to long-term care center for management of his co-morbidities. He had several attacks of desaturation since the age of 3 years, few of them progressed to cardiac arrest. During these attacks, decreased air-entry and airway resistant was observed. A change of tracheostomy tube led to marked improvement. Method: The case was studied to find out the reason behind these recurrent events. Patient was referred to ENT consultant for further assessment and investigations. Chest x-ray & bronchoscopy were done. Surprisingly, tracheal pouch was found in the chest x-ray which was the cause of tube obstruction. Results: The tube obstruction was due to slipping of its tip to the tracheal pouch which resulted in air-way obstruction, suffocation & eventually cardiac arrest. The change of tube during the event solved the problem temporary but whenever tube tip displaced to the pouch the event has recurred. To prevent the recurrent obstruction, the tube has been routinely changed by ENT specialist under direct visualization using tracheo-bronchoscopy to ensure bypassing the tracheal pouch and right placement of the tracheostomy tube tip. Conclusions: Tracheal tube pouch is rare anatomical abnormality in the trachea which associated with multiple risk factors. It can cause air-way obstruction in ventilated patient. X-ray & tracheobroncoscope are important in confirming the diagnosis. Bypassing the pouch during tube insertion solves the problem.

This article analyzes the visual, auditory, vocal, and motor advantages among autistic people with speech onset delay (A-SOD) compared with autistic people without speech delay (A-NoSOD) and sometimes non-autistic people. Importantly, their intelligence and communication skills are often underestimated. In addition, this paper provides suggestions to leverage strengths and address weaknesses from a sensory-motor perspective. Visual strengths are applied to IQ testing, reading and writing, and interpreting facial expressions. Auditory applications range from pain to music to speech development. Implications include suggestions for both production and perception of speech. The recommendations address both language’s relationship to motor development and the role of general language learning. Paradoxically, strengths in auditory perception may contribute to speech delay but also help A-SOD catch up to A-NoSOD, and continue to help A-SOD develop. Understanding A-SOD’s strengths may help to recognize how they make developmental gains in speech and language, and build from their strengths.

Objectives: This rapid review aims to evaluate the impact of the COVID-19 pandemic on incidence of head and neck cancer (HNC) and stage distribution at diagnosis. Design: Rapid Review and Meta-analysis Participants: comparative data for new HNC patients between a pre-pandemic cohort (before March 2020) and a pandemic cohort (after March 2020 during the lockdown period). Main Outcomes Measured: data on tumour stage, incidence, referral pathway (number of new patient referrals) or workload levels (number of HNC treatments). Data on stage were summarised as odds ratios (OR) with 95% confidence intervals (CI), data related to changes in numbers of diagnoses, referrals and workload levels were summarised as a narrative synthesis. Results: 31 reports were included in this review. Individually 16 out of 23 studies did not show a significant impact on stage relative to the pre-pandemic period. However, the meta-analysis revealed that patients diagnosed with HNC during the pandemic were 16% more likely to have nodal involvement (OR=1.16; 95% CI 1.00–1.35), 17% more likely to have a late overall stage (OR=1.17; 95% CI 1.01–1.36), and 32% more likely to present with advanced tumour extent (T3 and T4 stage) (OR=1.32; 95% CI 1.08–1.62). Data on incidence was extremely limited and not currently sufficient to assess trends in burden of disease. Conclusions: This review indicates that during the COVID-19 pandemic there was upstaging of HNC at diagnosis, suggesting the provision of care to HNC patients was significantly affected.