In desertification areas, vegetation restoration changes the soil carbon (C), nitrogen (N), and phosphorus (P) cycles, thereby influencing the balance of soil nutrients. However, the effects of C, N, and P cycles to desertification after vegetation restoration remains unclear. We conducted a global meta-analysis of 1045 observations from 121 field studies to investigate the effects of soil C, N, P, and stoichiometric characteristics in desertification areas on vegetation restoration under different environmental conditions. The magnitude of such effects varied with precipitation, soil layer, soil pH, restoration year, and restoration model. Our results showed that vegetation restoration led to substantial increases in SOC (+63.1%), TN (+47.1%), and TP (+19.8%) contents and the soil C:N (+6.5%), C:P (+32.6%), and N:P (+24.6%) ratios. Increases in SOC and TN contents were most pronounced in the arid region. The C:N:P variation was more significant in the topsoil layer compared to the deeper soil layer. Acidic soils showed a more significant improvement in quality after vegetation restoration, with soil TP exhibiting insensitivity to pH. Changes in soil nutrient content were positively correlated with the duration of vegetation restoration, and tended to stabilise as restoration progressed over time. The nutrient content and stoichiometry of soil in desertification areas were more sensitive to changes in precipitation and the soil layer, respectively. Soil TP was the most limiting element in desertification areas. The results demonstrated that vegetation restoration in desertification areas significantly increased the contents and stoichiometric ratios of soil C, N, and P and provided new insights into the effects of vegetation restoration on biogeochemical cycles, functions, and services in desertification areas across various spatiotemporal scales.

This letter introduces a novel two-step Single Slope Analog-to-Digital Converter (SS-ADC) architecture featuring high 3-bit and low 7-bit quantization stages. It reuses the programmable gain amplifier (PGA) as the Multiplying Digital-to-Analog Converter (MDAC) for residue amplification, enhancing resource efficiency. A on-demand column-level MDAC calibration mechanism without redundant bits corrects coarse quantization errors and ensures accurate residue amplification. These innovations significantly improve speed, accuracy, and robustness, achieving an SNR of 59 dB, along with DNL and INL within 1.5 LSB, which is suitable for high-performance CMOS image sensors.

This study addresses the inefficiencies in traditional power distribution systems by adopting a quantum-inspired control algorithm, specifically the Quantum Particle Swarm Optimization (QPSO) algorithm, for optimal resource allocation in smart grids. The QPSO algorithm utilizes principles from quantum computing to optimize complexities in smart grids. Key performance metrics, including resource allocation costs, power allocation, energy demand, energy supply, and voltage and frequency constraints, were evaluated. The results demonstrate significant improvements in resource allocation efficiency, with optimized total cost values and closely aligned energy demand and supply. Energy efficiency remained ideal, and voltage and frequency were maintained within set constraints. This study contributes to smart grid optimization by showcasing the potential of QPSO quantum-inspired control in enhancing resource allocation efficiency. The findings suggest that this approach can improve responsiveness and sustainability in energy systems, providing a foundation for future exploration of quantum techniques in smart grid technologies. The results of this study have important implications for the development of efficient and reliable smart grid systems.

This article introduces a secure and efficient framework for the storage and validation of medical images using the Ethereum blockchain platform, incorporating the decentralized capabilities of the Interplanetary File System (IPFS) and digital signature methodologies employing zero watermarking. Medical images are critical to patient diagnosis and treatment, necessitating robust security measures, especially during transmission over insecure networks. Our approach utilizes chaotic sequences and transformations through Integer Wavelet Transform (IWT) and Singular Value Decomposition (SVD) to create a digital signature that ensures the integrity and privacy of the images without modifying their content. The solution encrypts medical images before storing them in IPFS with their corresponding digital signatures to safeguard confidentiality. Upon access, the images are decrypted and their signatures are checked to confirm their integrity. The effectiveness of this methodology is demonstrated by its strong resilience to network disturbances and potential security threats, achieving an average Normalized Correlation (NC) value of 0.97. This performance underscores the potential of integrating advanced cryptographic techniques with blockchain technology to enhance the security of medical image data.

In the post-quantum era, ensuring security for digital signature systems is of utmost importance. XMSS (eXtended Merkle Signature Scheme) has been designed to withstand attacks from quantum computers by utilizing one-time signatures WOTS+ and Merkle trees. This paper introduces an enhancement of XMSS through the integration of the Left-Confirm Tree (LCT), resulting in XMSS-LCT. This improvement not only strengthens security but also optimizes storage and processing performance. We provide a detailed presentation of the structure, operational mechanism, implementation process, and experimental results that demonstrate the feasibility and effectiveness of XMSS-LCT.

Phenotypic plasticity is often considered a key mechanism enabling organisms to tolerate global change stress, yet its adaptive role remains debated. We suggest that this uncertainty stems from inconsistency in how global change is defined, insufficient consideration of context dependency, and analyses conducted at species or metapopulation scale. To address these issues, we propose a framework that emphasizes partitioning global change into distinct dimensions---mean change, variability, stochasticity, and episodic events---all of which present unique challenges for organisms. We also highlight the importance of considering the tradeoffs between cost, speed, and flexibility of trait plasticity to predict when different types of traits may facilitate adaptation. Recognizing that global change impacts vary across geographic ranges, we advocate for population-level approaches that incorporate historical environmental conditions, multivariate trait responses, and region-specific stressors. Our synthesis provides methodological guidance for designing experiments and leveraging natural gradients to better understand the interplay between global change dimensions and functional traits. While we focus on animals due to their diverse trait repertoires, the concepts presented here are broadly applicable across taxa. By refining definitions and linking trait plasticity to distinct global change dimensions, this framework offers a pathway to more predictive, actionable insights into species resilience under rapidly changing environmental conditions.

Protein targeting and insertion into membranes are essential for cellular organization and organelle function. The Guided Entry of Tail-anchored (GET) pathway facilitates the post-translational targeting and insertion of tail-anchored (TA) membrane proteins. Arabidopsis thaliana has four GET3 homologues, including AtGET3B and AtGET3D localized to chloroplasts. These photosynthetic organelles possess complex membrane systems, and the mechanisms underlying their protein targeting and membrane biogenesis are not fully understood. This study conducted a comprehensive proteomic analysis of get3b mutant plastids, which displayed significant alterations. Fluorometric based complex assembly as well as CO 2 assimilation analyses confirmed that disruption of GET3B function displayed a significant impact on photosystem II assembly as well as carbon fixation, respectively, indicating a functional role in chloroplast biogenesis. Additionally, genetic interactions were found between GET3B and the two component STIC system, which cooperates with the cpSRP pathway and is involved in the co-translational sorting of thylakoid proteins. Further, physical interactions were observed between GET3B and the C-terminus of ALB3 and ALB4 in vitro and the full length proteins in vivo, indicating a role of GET3B in protein targeting and membrane integration within chloroplasts. These findings enhance our understanding of GET3B’s involvement in stromal protein targeting and thylakoidal biogenesis.

Human Cytomegalovirus (HCMV) transcripts (including UL21.5 mRNA) have been found to be packaged in virions and their detection in plasma may indicate the presence of infectious viral particles. Objective of this study was to verify whether UL21.5 mRNA detected in the plasma was indeed encapsulated in viral particles, representing an indirect marker of active replication. To distinguish between virion-packaged and free-floating RNA, plasma samples from 22 immunocompromised patients were tested before and after ribonuclease (RNAse) digestion. UL21.5 mRNA was detected 1-2 weeks prior to preemptive therapy administration in 20 episodes (from 18 patients) of clinically significant DNAemia, while it was undetectable in three of the four patients with transient, self-resolving DNAemia. After RNAse digestion, UL21.5 mRNA was still detectable, with a median reduction of 0.1 (IQ range 0-0.3) Log 10. Concentrations of UL21.5 mRNA in plasma correlated significantly with HCMV DNA in whole blood or plasma (R=0.67), and 75% of samples positive for UL21.5 mRNA had HCMV DNA concentrations above 10 4 copies/ml blood or 10 3 copies/ml plasma. Moreover, UL21.5 mRNA was positive in patients who developed HCMV infection resistant to letermovir or maribavir, whereas it was undetectable in plasma of patients with transient self-resolving DNAemia blips during letermovir prophylaxis (not associated with drug-resistance). HCMV UL21.5 mRNA in plasma is virion-associated and represents a marker for productive HCMV infection. The determination of UL21.5 mRNA could improve current strategies for the management of HCMV infection in immunocompromised patients.

Background & Purpose: Drug-resistant epilepsy affects 30% of patients who continue to have seizures despite current antiseizure medications (ASMs). Preclinical drug screening uses acute dosing and evoked seizures, which may not fully capture the complexities of drug resistance and human treatment regimens. We introduce a novel experimental paradigm that incorporates clinical treatment regimens, pharmacokinetic monitoring, and behavioral tolerability assessments to accurately model drug-resistant epilepsy in animal models. Experimental Approach: Rats with epilepsy following kainic acid induced status epilepticus were enrolled in a triple cross-over study to evaluate the dose-dependent efficacy and tolerability of three commonly used ASMs — lamotrigine, levetiracetam, and carbamazepine. Each medication was delivered in rodent chow for two weeks via our automated system, maintaining steady-state exposures measured by pharmacokinetic sampling. Seizure control was monitored via 24/7 videoEEG, and behavioral tolerability was evaluated using minimal motor impairment and hyperexcitability assays. Key Results: Chronic oral dosing with carbamazepine and levetiracetam reduced seizure frequency by more than 50% in over half the animals at clinically relevant doses. Lamotrigine, however, was either ineffective or worsened seizures at toxic doses, increasing both convulsive and clustered seizures. Levetiracetam was well tolerated, while carbamazepine impaired motor function at the highest dose. Lamotrigine led to increased hyperactivity and aggressive behavior at all doses. Conclusions: This study highlights the need for preclinical models that better reflect human epilepsy, considering both efficacy and side effects in drug development. Our findings emphasize the complexity of drug responses and underscore the importance of improved models for drug development.

Leptospirosis is a zoonotic infectious disease affecting all vertebrates and is caused by highly pathogenic species of the genus Leptospira. Pathogenic Leptospira causes abortions in pigs and cattle. Besides antibiotics and vaccines, few effective methods are reported for preventing leptospirosis. Regulating the gut microbiota to enhance innate immune function is an important means of preventing infectious diseases. Angelica sinensis polysaccharide (ASP) is a medicinal herb with homology of medicine and food, with potential biological functions including the regulation of gut microbiota, promoting hematopoiesis, nourishing blood, anti-inflammatory, and enhancing immunity. This study aimed to investigate the protective effects of ASP on leptospiral infection. ASP pre-treatment attenuated the leptospirosis load in the kidneys, liver, and lungs, reduced the extent of tissue and organ damage, and decreased the expression of inflammatory factors in mice after L. interrogans infection. Mechanistically, ASP has been demonstrated to promote haematopoiesis, and increase mononuclear-macrophage production and bactericidal capacity. Furthermore, the preventive effect of ASP on leptospirosis has been corroborated by depleted gut microbiota and fecal microbiota transplantation. Our results suggest that ASP has a certain preventive effect on leptospirosis and offers a theoretical basis for deeply exploring the prevention and treatment of leptospirosis by using ASP.

We consider the following problem { u t = d 1 ∆ u − a ( x ) · ∇ u + f ( u , v ) , x ∈ Ω , t > 0 , v t = d 2 ∆ v − b ( x ) · ∇ v + g ( u , v ) , x ∈ Ω , t > 0 , u ( x , 0 )= u 0 ( x ) , v ( x , 0 )= v 0 ( x ) , x ∈ Ω subject to Dirichlet(or Neumann) boundary condition. Here Ω ⊂ R N ( N ≥ 1 ) is a bounded smooth domain. Besides some results on blowup and global existence of the solution, we find more interesting results as follows. 1. There exist double thresholds for blowup and global existence of the solution. Under certain conditions, if f ( u , v ) = f 1 ( v ) g 1 ( u ) and g ( u , v ) = f 2 ( v ) g 2 ( u ) , then the first watershed is ∫ c 1 + ∞ du g 1 ( u ) = + ∞ and ∫ c 2 + ∞ dv f 2 ( v ) = + ∞ , and the second watershed is ∫ c ̵̃ 1 + ∞ dU f ̵̃ ( F ̵̃ − 1 ( K G ̵̃ ( U ))) = + ∞ and ∫ c ̵̃ 2 + ∞ dV g ̵̃ ( G ̵̃ − 1 ( 1 ϵ F ̵̃ ( V ))) = + ∞ . Here f ̵̃ , g ̵̃ , F ̵̃ and G ̵̃ will be defined in Section 2.2. 2. If there exist nonnegative smooth functions h( u), l( v) and H( s) such that f ( u , v ) h ′ ( u ) l ( v ) + g ( u , v ) h ( u ) l ′ ( v ) = H [ h ( u ) l ( v ) ] ≥ 0 , then the watershed for blowup in finite time and global existence of the solution is

With the increasing complexity of mobile networks, it has become more and more difficult to perform effective management of mobile networks, which has led to more data to be evaluated and optimized. This article focuses on the performance evaluation of Long Term Evolution(LTE) networks by using two unsupervised learning techniques. Besides, this paper aims to identify the pros and cons of these two clustering algorithms as well. To achieve the above goals, different dimensional datasets for learning a process based on two classic unsupervised clustering methodsare introduced to this work. A Self-organized map (SOM) neural network and k-means are a comparison algorithm and the sample data with three different degree correlation coefficients features with 63 LTE cells, which is from a major European city. The purpose behind using these two methods is to see how different dimensions of the datasets can be used for testing clustering effec tiveness and we propose a method based on the features extracted from key performance indicators (KPIs) and Euclidean distance is used as the evaluation standard for the distance between different clusters and samples within clusters. The comparing results show that k-means has a better cluster performance in low dimension data set, whereas the SOM’s performance unsatisfactory. On the  other hand, the SOM’s clustering performance is better than k-means in high dimension and big data set and it could visualize results. It was verified that there is a significant difference in the obtained results using different clustering algorithms.

The selection of information tools in public health emergencies is a crucial aspect of achieving emergency management objectives. Identifying the influencing factors and their mechanisms helps reveal government preferences in emergency management decision-making and enhance information management and regulation capabilities. Based on the ”technology-organization-environment” analytical framework, seven observed elements that influence government information tool selection are summarized, and a fuzzy set qualitative comparative analysis (fsQCA) is conducted on 29 typical cases in China. The research shows that the selection of government information tools in public health emergencies mainly depends on the strength of the institutional and social environments. Among them, pressure from higher-level governments is the core variable determining the selection of information tools, while media reports and public opinion serve as sufficient conditions. The five conditional configurations can be further summarized into three information tool selection models: vertical authority directive mechanism, institutional environment shaping mechanism, and dual pressure driving mechanism, forming a closed-loop path that shapes institutional space from top down and creates social environment from bottom up. The practical analysis based on the selection of ”propaganda and education” tools further verifies this logic.

In this paper, we study initial-boundary value problem of a predator-prey model with taxis strategies and a nonlinear growth rate for the predator. The global existence and uniform boundedness of positive classical solutions in any dimension are prove strictly. The results indicate that nonlinear growth rate can restrain aggregation of predator.

This study examines the effectiveness of Rhythmic Acoustic Emotional Stimulation (RAES) in modulating Heart Rate Variability (HRV) compared to Rhythmic Visual Emotional Stimulation (RVES) at the resonant frequency of the arterial baroreflex (0.1 Hz). HRV is a reliable indicator of chronic stress, and its optimization holds potential therapeutic benefits for stress reduction. RVES, pioneered by Evgeny Vaschillo in 2008, utilizes emotionally charged images to induce high-amplitude HRV oscillations. This research aims to determine whether RAES, employing sounds of equivalent emotional valence, can achieve similar HRV enhancements. A cohort of 30 participants underwent a series of experiments involving both RVES and RAES protocols. Vaschillo’s RVES protocol was replicated using visual stimuli to establish baseline effectiveness, followed by RAES experiments using acoustic stimuli of comparable emotional valence. Respiration and heart rate were monitored, with baseline HRV measurements taken before and after each intervention to evaluate their effects. Results showed significant differences in how participants responded to the two interventions. During RVES, SDNN showed significant variability across stimuli (p=0.018p = 0.018p=0.018), indicating its effectiveness in enhancing overall HRV, while RMSSD changes were not statistically significant. RAES elicited a significant interaction between RMSSD and sex (p=0.003p = 0.003p=0.003), with females demonstrating more pronounced RMSSD responses compared to males. However, SDNN responses to RAES were minimal and consistent across stimuli and sexes. In conclusion, RVES appears more effective than RAES in enhancing HRV, particularly in terms of SDNN variability. The significant sex-based interaction in RAES highlights its potential for tailored stress reduction therapies, especially for female populations. These findings emphasize the importance of considering gender-specific responses and individual variability when designing HRV-based interventions.

Multiple sclerosis is a complex neurological disorder, involving both the adaptive and innate immune system as well as the CNS. The interaction between these systems is complex, and as such there is the potential for MS therapies to have conflicting effects in different tissues. It is therefore critical that in addition to tissue-specific studies, system-wide effects of potential therapeutic pathways are explored. The circulating protein Gas6 is a promising therapy to promote remyelination in people with multiple sclerosis. Gas6 is a ligand for the TAM family of receptor protein tyrosine kinases, that are widely expressed in the immune system and in the CNS, highlighting the potential for multi-system effects as a result of Gas6 treatment. In this study we demonstrate that global genetic deletion of either Gas6 or the Gas6 receptor Tyro3 results in reduced disease severity following induction of experimental immune encephalomyelitis in mice. The reduction in severity was accompanied by increased expression of IL-4 in Tyro3 KO mice, a cytokine known to be protective in inflammatory demyelination in mice. Conversely, loss of Tyro3 was associated with an increase in the expression of the pathological cytokine IL-17a. These data highlight the multi-faceted role of TAM receptor signalling in inflammatory demyelination.

The Rufous-collared Sparrow (Zonotrichia capensis) shows phenotypic and behavioural variation throughout its continental distribution. In particular, the Patagonian subspecies Z. c. australis is strikingly distinct from other subspecies, lacking the black crown stripes that characterize the species, with a uniformly grey head or one with only subtle traces of black, and overall paler plumage. We sequenced whole genomes of 18 individuals (nine Z. c. australis and nine from other subspecies from northern Argentina) to explore the genomic basis of these colour differences and to investigate how they may have evolved. We detected a single ~465-kb divergence peak on chromosome 5 that contrasted with a background of low genomic differentiation and contains the ST5 gene. ST5 regulates RAB9A, which is required for melanosome biogenesis and melanocyte pigmentation in mammals, making it a strong candidate gene for the melanic plumage polymorphism within Z. capensis. This genomic island of differentiation may have emerged because of selection acting on allopatric populations. Concordantly, mitochondrial DNA indicated that Z. c. australis diverged from other subspecies ~400,000 years ago, probably as a consequence of Pleistocene glaciations. Phenotypic differences are consistent with Gloger’s rule, which predicts lighter coloured individuals in colder and drier climates like that of Patagonia. Future studies should focus on a contact zone in northern Patagonia where individuals show intermediate colour patterning, most likely as a result of gene flow between subspecies, to test whether colour differences are promoting the early speciation of Z. c. australis through assortative mating.

In this paper, we establish two existence results related to a non-local Choquard equation driven by a fractional ϕ(·)-Laplacian operator, where the nonlinearity function f does not satisfy the super-linear conditions near infinity or exhibit monotonicity properties. Our main results are novel and contribute to the literature on problems involving ϕ(·)-Laplacian operator. This investigation enhances the scope of understanding in this specific class of problems.

TITLE: Clinical Improvement without Increased Platelet Count with Eltrombopag in X-Linked ThrombocytopeniaAuthors:Mahmut Yasar Çeliker (Corresponding author)Director of Pediatric Oncology ProgramDivision of Pediatric Hematology and Oncology Department of Pediatrics Maimonides Children’s Hospital 977 48th Street, Brooklyn, NY, 11219Phone: +1 718-283-6652Fax: +1 718-635-5973Email: Mceliker@maimo.orgAbena Odurowaa YeboahDepartment of Pediatrics Maimonides Children’s Hospital 977 48th Street, Brooklyn, NY, 11219Ludovico GuariniPediatric Hematology and Oncology Division of Pediatric Hematology and Oncology Department of Pediatrics Maimonides Children’s Hospital 977 48th Street, Brooklyn, NY, 11219

Cuproptosis is a regulated cell death mechanism that has recently been identified and is distinct from other known cell death mechanisms (e.g. apoptosis, Ferroptosis, necrotic apoptosis……). Cuproptosis causes oligomer formation through the abnormal accumulation of intracellular copper ions that target binding to the thioctylated protein component of the tricarboxylic acid cycle. At the same time, it can destabilise iron-containing sulphur proteins, thereby inducing proteotoxic stress leading to triggered cell death. It has also been shown that copper death is also associated with oxidative stress activation and inhibition of the ubiquitin-proteasome system. The PDHB gene encoding the β-subunit of pyruvate dehydrogenase has been found to be one of the key genes involved in Cuproptosis. As one of the structural components of pyruvate dehydrogenase, the pyruvate dehydrogenase β-subunit can form a tetramer with the α-subunit and thus performs the physiological function of irreversibly catalyzing the conversion of pyruvate into acetyl coenzyme A. In this review, the characteristics of the Cuproptosis-associated gene PDHB and its role in the biological function and pathogenesis of the disease are discussed.

Abstract Background: High-intensity interval training (HIIT) has been proposed as a time-efficient strategy to improve mental health, including anxiety symptoms. However, the evidence regarding its effectiveness across different measurement tools remains inconsistent. Objective: This meta-analysis aimed to evaluate the effects of HIIT on anxiety symptoms and to explore variability across measurement tools and study designs. Methods: A systematic search of COCHRANE, PubMed, Embase, and Web of Science identified eligible studies. Anxiety symptoms were assessed using standardized tools, including DASS-21, STAI, and BAI. Pooled weighted mean differences (WMD) with 95% confidence intervals (CI) were calculated using a random-effects model. Sensitivity analysis and publication bias assessment were performed. Results: Five studies with 464 participants were included. HIIT significantly reduced anxiety symptoms when measured by DASS-21 (WMD: -3.21, 95% CI: -4.48 to -1.95, I² = 0.0%), but no significant effects were observed with STAI (WMD: 0.19, 95% CI: -0.99 to 1.37) or BAI (WMD: 3.70, 95% CI: -0.67 to 8.07). The overall pooled effect size across all tools was -0.76 (95% CI: -3.58 to 2.05, I² = 85.0%), reflecting substantial heterogeneity. Sensitivity analysis indicated robustness of results, with Chang 2024 showing the greatest influence on pooled estimates. Funnel plot analysis suggested potential publication bias. Conclusion: HIIT appears effective in reducing anxiety symptoms, particularly when measured by DASS-21. However, the variability across tools and high heterogeneity highlight the need for further studies to standardize interventions and ensure generalizability.

Snow accumulation models differ in how snow interception and ablation processes are represented and thus their application to diverse climates and forest types is uncertain. Existing parameterizations of initial snow interception before unloading include inherently coupled canopy snow accumulation and ablation processes. This leads to difficulty in diagnosing processes and adding possible errors to simulations when incorporated as canopy interception routines in models that already account for canopy snow ablation. This study evaluates the theory underpinning parameterizations of initial snow interception using high-temporal resolution and fine-scale measurements of throughfall for events with minimal snow ablation and redistribution in both the canopy and on the ground. The relationship between these throughfall measurements, event meteorology, and a novel lidar-based canopy structure measurement are assessed in two subalpine forest plots in the Canadian Rockies. Contrary to existing theories, no association of canopy snow load or air temperature with interception efficiency was observed. Instead, canopy structure emerged as the primary factor governing snow accumulation. A wind-driven snowfall event demonstrated that non-vertical hydrometeor trajectories can significantly increase snow-leaf contact area, thereby enhancing initial interception before ablation. Prediction of interception efficiency for this event improved dramatically when adjusted for hydrometeor trajectory angle based on a wind speed at one-third of the canopy height. Snow-leaf contact area showed a high sensitivity to wind speed, increasing by up to 95% with a 1 m s -1 wind speed. The study proposes a new parameterization that calculates throughfall, independent of processes that ablate snow from the canopy, as a function of snow-leaf contact area adjusted for hydrometeor trajectory angle. This new parameterization successfully estimated subcanopy snow accumulation for a snowfall event at two forest plots measured using lidar and snow surveys. By separating canopy snow ablation from snow interception processes, this new model offers potentially improved prediction of subcanopy snow accumulation when combined with canopy snow ablation parameterizations.

Title: Hepatocellular carcinoma successfully treated with capecitabine: a case report

Key Clinical Message: Primary breast MALT lymphoma is an extremely rare and indolent malignancy with favorable outcomes. This case report aims to report typical imaging and pathologic findings to improve understanding and awareness of the presentation, diagnosis, and management of this uncommon entity.IntroductionPrimary breast lymphomas (PBL) are uncommon, having been reported to represent up to 1% of all cases of non-Hodgkin lymphoma [1,3] and only 0.4-1% of all breast malignancies [2,3]. Mucosa-associated lymphoid tissue (MALT) lymphoma is an extranodal B-cell lymphoma and a subtype of marginal zone lymphoma (MZL), which is a classically indolent form of non-Hodgkin’s lymphoma (NHL) with an average age of presentation above 65 years of age with a slight female predilection. MALT lymphomas are more commonly associated with mucosal sites such as the gastrointestinal tract, lungs, and salivary glands, with the stomach being the most frequent extranodal site. As such, primary involvement of the breast is extremely unusual, only accounting for up to 9% of primary breast lymphomas and therefore fewer than 0.1% of all breast malignancies [4]. The clinical presentation of primary breast MALT lymphoma can be subtle, often manifesting asymptomatically as a painless, palpable mass. Due to its rarity and nonspecific presentation on mammography, this entity may not be considered in the initial differential, potentially leading to delays in diagnosis.Case HistoryThe patient is a 65-year-old female with no significant past medical history who presented to her primary care physician for routine healthcare maintenance. No concerning breast symptoms were identified, with the patient denying breast pain, nipple discharge, or palpable mass. She had no personal history of breast or ovarian cancer, no family history of breast cancer, with a low lifetime Tyrer-Cuzick score of 12%. Given her age, she underwent routine screening mammography, with identification of a new asymmetry in the anterior lateral left breast. This was categorized as BI-RADS 0 and callback for diagnostic mammography was performed. On diagnostic mammogram, the asymmetry persisted on spot compression views (Figure 1A-B), although no sonographic correlate was definitively identified. This was classified as BI-RADS 4, with a recommendation for tissue sampling.