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Background: Neuroendocrine tumors (NETs) represent a diverse group of neoplasms that arise from neuroendocrine cells, with Ki-67 immunostaining serving as a crucial biomarker for assessing tumor proliferation and prognosis. Accurate and reliable quantification of Ki-67 labeling index is essential for effective clinical management.Methods: We aimed to evaluate the performance of open-source/open-access deep learning cloud-native platform, DeepLIIF (https://deepliif.org), for the quantification of Ki-67 expression in gastrointestinal neuroendocrine tumors and compare it with the manual quantification method.Results: Our results demonstrate that the DeepLIIF quantification of Ki-67 in NETs achieves a high degree of accuracy with an intraclass correlation coefficient (ICC) = 0.885 with 95% CI (0.848– 0.916) which indicates good reliability when compared to manual assessments by experienced pathologists. DeepLIIF exhibits excellent intra- and inter-observer agreement and ensures consistency in Ki-67 scoring. Additionally, DeepLIIF significantly reduces analysis time, making it a valuable tool for high-throughput clinical settings.Conclusion: This study showcases the potential of open-source/open-access user-friendly deep learning platforms, such as DeepLIIF, for the quantification of Ki-67 in neuroendocrine tumors. The analytical validation presented here establishes the reliability and robustness of this innovative method, paving the way for its integration into routine clinical practice. Accurate and efficient Ki-67 assessment is paramount for risk stratification and treatment decisions in NETs and AI offers a promising solution for enhancing diagnostic accuracy and patient care in the field of neuroendocrine oncology. [ABSTRACT FROM AUTHOR]

Introduction: Breast carcinoma is the most common malignant tumor and the leading cause of cancer death in women. In western countries, a sharp increase in the detection of breast carcinoma, largely due to widespread use of mammography, has recently led to a fall in breast cancer mortality. This, however, is not true for less developed countries, in which mortality continues to rise. Objective: The aim of this study was to acquire information about the extent and spread of breast carcinoma in our patients by grading the tumors, determining the tumor size, and axillary lymph node status, staging of the tumors and Nottingham Prognostic Index (NPI) scoring on the available material. Materials and Methods: One hundred and twenty consecutive mastectomy specimens with axillary lymph node sampling removed for breast carcinoma and received in the section of histopathology, Aga Khan University, in the year 2005, were included in the study. Standard protocols were used for the processing of the specimens, and reporting was done using a standard format incorporating all relevant tumor parameters. NPI was applied to the cases. Results: Out of the 120 cases, 5 (4.17) were grade 1, 91 (75.83) were grade 2, and 24 (20%) were grade 3. Also, 9 cases (7.5%) were T1 (4 were T1b, and 5 were T1c); 53 (44.16%) were T2; 50 (41.66%) were T3; and 8 (6.66%) were T4. Axillary lymph nodes were available in 107 cases. In 13 cases, no lymph nodes were recovered. Out of 107 cases 27 (25.23%) lymph nodes were negative for metastases pN0; 29 (27.10%) cases were pN1; 26 (24.30) were pN2; and 25 cases (23.36%) were pN3. Extranodal spread was present in 56 (70%) out of the 80 cases in which lymph nodes were positive. The average microscopic size of nodal metastasis was 1.7 cms. Significant statistical association was found between the number of positive nodes and perinodal extension (P = 0.001). Tumor necrosis was present in 76 out of 120 cases (63.33%). Vascular invasion was present in 43 out of 120 cases (35.83%). NPI scores were greater than 5.4 in 60 out of 107 cases (56.1%) indicating poor prognosis. Conclusion: The large majority of the cases were grade 2 tumors. Most cases (all grades) were T2 or T3, and were axillary lymph node positive. Large majority of cases with nodel metastases showed extra nodal spread. The majority of patients had NPI scores greater than 5.4 indicating poor prognosis. Significant statistical association was found between the number of positive nodes and perinodal extension (P = 0.001). The findings show extensive and advanced disease trends in our patients.

This study sought to understand library users' opinions, attitudes, and needs regarding using artificial intelligence (AI) in libraries. A survey questionnaire was administered to 71 respondents from academic and public libraries throughout the region. This survey examined a range of topics related to AI use in libraries, such as its perceived benefits and drawbacks; ethical and privacy considerations; user demographics; and factors influencing user adoption of and satisfaction with AI-powered services. The survey results revealed a generally positive attitude toward AI use in libraries. However, concerns were raised regarding such decisions' privacy and ethical ramifications. Libraries must consider user needs and expectations when implementing and managing AI-powered systems. At the same time, further research is necessary to explore different topics related to this emerging technology field. [ABSTRACT FROM AUTHOR]

Background: For every practicing histopathologist, improvement of diagnostic accuracy is an important objective. Personal consults are an important component of quality control (QC)/quality assurance (QA) in our Section of Histopathology. In addition, the College of American Pathologists recommends a daily in-house consensus conference, which is a prospective system by which all difficult and problematic cases are reviewed and discussed and signed out by consensus. Design: In-house consensus conference is held daily using a multi-headed microscope. This collegial session is run by the seniormost consultant in the section and is attended by all histopathology consultants and residents. The consultants and residents present cases of their choice for discussion. The cases may be selected due to diagnostic difficulty, unusual nature of a case, management purposes such as performance of additional biopsies, special studies, etc., or request on the part of clinician or patient. Cases may be shown once or, in case of lack of consensus or difficulty in diagnosis, more than once after additional work-up suggested by the conference. Results: In a 4-month period, 774 (4.1%) cases of a total of over 14,000 well-mixed surgical cases were brought to the in-house daily consultation conference. Four hundred ninety-three cases (63.7%) were conclusively decided the first time while 198 cases (25.5%) were decided by consensus after being shown twice. In 83 cases (10.7%), a definite diagnosis could not be given. The cases on which a definite diagnosis was not possible represents 0.59% of all cases received in the department during the study period. The most common cases were shown from the gastrointestinal tract (115 cases or 14.8%), lymph nodes (110 cases or 14.2%) and soft tissue (82 cases or 10.6%). In most cases in which a definite diagnosis could not be given, the main reason was scanty material or crushed nature of the tissue. Conclusion: The in-house daily consensus conference is an extremely useful QC/QA exercise, which is very important in reaching an accurate diagnosis in difficult and challenging cases and minimizing diagnostic errors.

Foreign policy is considered as one the important factors in media framing of various national and international issues and events. Building on the existing literature regarding the relationship between media framing and foreign policy, the present study investigates that how leading American, Indian, Chinese and Pakistani press frame Sino-Pak relations, especially the Chinese President, Xi Jinping's visit of April 2015 to Pakistan in the backdrop of CPEC. Content analyses of the selected newspapers for a period of two months i.e., March 20, 2015 to May 20, 2015 indicated that China Daily and daily Dawn gave more coverage to Sino-Pak relations than The Times of India and The New York Times. Furthermore, it was found that The Times of India and The New York Times focused more on the 'conflict' frame whereas Pakistani and Chinese press emphasized more the 'economic, responsibility and human interest' frames. [ABSTRACT FROM AUTHOR]

Yolk sac tumour is a common malignant germ cell tumour, which usually occurs in the testes or ovaries of infants. It can occasionally arise from a number of extragonadal sites. Extragonadal germ cell tumours of the head and neck region account for 5% of all benign and malignant germ cell tumours. The orbit is an extremely unusual location for development of primary yolk sac tumour. The present report concerns the case of a yolk sac tumour in a 14-year-old girl, arising as a primary tumour of the orbit with invasion of periorbital and intracranial spaces. [ABSTRACT FROM AUTHOR]

The objective of this study was to determine the frequency of phylloides tumor (PT) in adolescent girls and young women (less than and equal to 25 years of age) and to define the clinico-pathological features of PT in this unusual clinical setting. This descriptive study was carried out at the Aga Khan University Hospital (AKUH) pathology department. All consecutive cases of PT diagnosed during the last sixteen years in the section of histopathology from 1st January 1990 to 31st June 2005 were included. Selection of cases was restricted to patients up to 25 years of age. A total of 42 cases of PT in up to 25 years of age were diagnosed. This comprised 11% of the total PT cases (total n=363). The number of benign (BPT), borderline (BLPT) and malignant (MPT) was identical i.e. 14 (33.3%) each. Clinically all cases presented with a solid, mobile, palpable mass. The mean age was 19.1 years (95% CI, 16.7-21.6), 21.9 years (95% CI, 20.7-21.9) and 19.7 years (95% CI, 17.2-22.3) in BPT, BLPT and MPT respectively. In majority of cases the surgical procedure performed was lumpectomy (50% of BPT, 78% of BLPT and 64% of MPT). High grade PT (BLPT and MPT) is an uncommon mammary tumor in adolescent girls and young women but seems to be occurring with increased frequency in the study population. This observation may indicate the biological behavior of PT in a high risk population, though chances of referral bias are also present. In view of the rarity of the disease, larger population studies are suggested to confirm our findings.