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In nature, nonheme iron enzymes use dioxygen to generate high-spin iron(IV)=O species for a variety of oxygenation reactions. Although synthetic chemists have long sought to mimic this reactivity, the enzyme-like activation of O2 to form high-spin iron(IV) = O species remains an unrealized goal. Here, we report a metal-organic framework featuring iron(II) sites with a local structure similar to that in α-ketoglutarate-dependent dioxygenases. The framework reacts with O2 at low temperatures to form high-spin iron(IV) = O species that are characterized using in situ diffuse reflectance infrared Fourier transform, in situ and variable-field Mössbauer, Fe Kβ x-ray emission, and nuclear resonance vibrational spectroscopies. In the presence of O2, the framework is competent for catalytic oxygenation of cyclohexane and the stoichiometric conversion of ethane to ethanol.

Color centers in host semiconductors are prime candidates as spin-photon interfaces for quantum applications. Finding an optimal spin-photon interface in silicon would move quantum information technologies toward a mature semiconducting host. However, the space of possible charged defects is vast, making the identification of candidates from experiments alone extremely challenging. Here, we use high-throughput first-principles computational screening to identify spin-photon interfaces among more than 1000 charged defects in silicon. The use of a single-shot hybrid functional approach is critical in enabling the screening of many quantum defects with a reasonable accuracy. We identify three promising spin-photon interfaces as potential bright emitters in the telecom band: [Formula: see text], [Formula: see text], and [Formula: see text]. These candidates are excited through defect-bound excitons, stressing the importance of such defects in silicon for telecom band operations. Our work paves the way to further large-scale computational screening for quantum defects in semiconductors.

The study aimed to investigate the mathematics achievement of eighth grade students on geometric transformation and geometric thinking levels. This research was carried out in the fall semester of 2018-2019. The sample was 88 students from two different middle schools in an urban area of Erzincan, Turkey. The survey model was used. The geometric transformation achievement test with 20 questions and the first 15 questions of the van Hiele geometric thinking test, which are suitable for the middle school student level, were administered to students at different times. SPSS was used to conduct analysis for descriptive statistics, standard deviation, percentage, mean and frequency, independent samples t test, and Pearson correlation. Pearson correlation was conducted to determine the relationship between the total scores that the students got from the van Hiele geometric thinking test and geometric transformation achievement test. While there was a significant relationship between the van Hiele geometry test and transformation geometry test, the geometric thinking levels of the students were below the expected level. There was no statistically significant mean difference between the boy and girl students across the schools.

Bu araştırma, farklı potasyum dozlarının buğdayın (Triticum spp.) verim ve kalite unsurları üzerindeki etkilerini değerlendirmek amacıyla Dicle Üniversitesi Ziraat Fakültesi Tarla Bitkileri uygulama alanında 2021-2022 ve 2022-2023 yetiştirme dönemlerinde yürütülmüştür. Çalışmada üç adet ekmeklik (Tekin, Dinç, Babil) ve üç adet makarnalık (Meya-2, Güneyyıldızı, Eyyubi) buğday çeşidi kullanılmış olup, farklı dozlarda potasyum sülfat uygulamalarının etkileri incelenmiştir. Deneme, Tesadüf Bloklarında Bölünen Bölünmüş Parseller Deneme Deseni'ne göre üç tekrarlamalı olarak planlanmıştır. Araştırmada başaklanma günü, başakta tane sayısı ve ağırlığı, bitki boyu, tane verimi, SPAD, NDVI, hektolitre ağırlığı ve protein oranı değerlendirilmiştir. Sonuçlar, potasyum dozlarının bazı büyüme ve kalite parametreleri üzerinde belirgin etkiler yarattığını göstermiştir. Başakta tane ağırlığı 1.80 g, başakta tane sayısı 32.12 adet, bitki boyu 83.60 cm, hektolitre ağırlığı 79.54 kg ve tane verimi 542.50 kg olarak hesaplanmıştır. En yüksek tane verimi 18 kg da⁻¹ potasyum dozu ile elde edilmiştir. SPAD değeri 51.61, NDVI 0.57 ve tane verimi 12 kg da⁻¹ potasyum uygulamasında en yüksek düzeyde tespit edilmiştir. Öte yandan, en erken başaklanma 6 kg da⁻¹ potasyum dozu uygulamasında 123.17 gün ile gerçekleşmiştir. NDVI (0.57) ve protein oranı (%15.19) açısından en yüksek ortalama değerler 10 kg da⁻¹ potasyum dozu ile elde edilmiştir. Elde edilen bulgular, potasyum gübrelemesinin yalnızca verimi artırmakla kalmayıp, buğdayın kalite özellikleri üzerinde de belirleyici bir rol oynadığını göstermektedir.

Abstract Studies have increasingly aimed at improving the piezoresistive behavior of polymer‐based conductive composites (CPCs) for strain‐sensing, with inorganic nanomaterial enhancement offering research opportunities. This study investigates the impact of incorporating zinc sulfide nanospheres (ZnS NSs, 1–7 wt.%), synthesized via a one‐step hydrothermal method, into a poly(vinylidene fluoride) (PVDF) polymer matrix together with multi‐walled carbon nanotubes (MWCNTs). Field emission scanning electron microscopy (FE‐SEM), energy‐dispersive X‐ray spectroscopy (EDX), and X‐ray diffraction (XRD) analyses reveal that ZnS NSs comprise a mixture of ZnS0.96O0.04 and S phases. While of ZnS NSs minimally impact tensile properties of the PVDF/MWCNT composites, they reduce elongation at break at 5 wt.%. During 15‐cycle strain sensing up to 3% strain, ZnS NSs‐enhanced composites outperformed PVDF/1 wt.% MWCNT. The reference sample's resistance change ratio (ΔR/R0) decreased below 1% with increased cycles, while 1 wt.% ZnS NSs increased ΔR/R0 to 3%, reducing changes upon cycle increments. Higher ZnS NSs levels (3–7 wt.%) resulted in ΔR/R0 exceeding 4–5%, indicating enhanced strain sensing performance. Fourier‐transform infrared spectroscopy (FTIR), scanning electron microscopy (SEM), differential scanning calorimetry (DSC), and thermogravimetric analysis (TGA) showed limited impact of ZnS NSs on the thermal properties and microstructure of the composites.

Background. This study aimed to evaluate the ability of Donation Advisor (DA), a validated clinical decision support tool that uses continuous monitoring, variability analysis, and predictive models, to (i) predict likelihood of successful donation after circulatory determination of death (DCD) before withdrawal of life-sustaining measures (WLSM), and (ii) describe ischemia during WLSM in DCD patients. Methods. Eligible patients were screened at the 5 sites where DA was implemented. DA reports were generated in real time but shown to clinicians after the donation was complete (noninterventional). Clinicians were interviewed for improvement of the tool. Results. We enrolled 34 donor patients in the study; 27 had DCD attempts and 20 proceeded to organ recovery. DA reports were generated before WLSM in all 27 attempted DCD patients (100%) while post-WLSM ischemia reports were generated in 26 of 27 DCD attempts (96%). Nineteen of 34 involved clinicians completed interviews, 10 from intensive care, and 9 from transplantation team members. Following a user-centered design approach, feedback was used to create 5 versions. Revisions included additions, removals, clarifications, and formatting changes; the number of revisions decreased with each amendment. The report’s predictive scores were found to be useful by most practitioners (83%). We identified barriers and drivers to use the report in future practice, some of which may be addressed through improved education and awareness. Conclusions. DA can be deployed in real time during the DCD process. The usefulness and usability of the DA report has improved through user feedback; both barriers and drivers to implementation exist.

IntroductionLaurus nobilis (LN), has traditional medicinal uses, and this study investigates its therapeutic potential by focusing on its phenolic content and bioactivities such as antioxidant, antidiabetic, and anticholinergic properties. Phenolic compounds play key roles in reducing oxidative stress and modulating enzymatic activities, relevant to metabolic and neurodegenerative disorders.MethodsLN leaf extracts were prepared via ethanol maceration, followed by filtration and concentration. Phenolic content was analyzed using LC-MS/MS. Antioxidant activity was assessed through ferric thiocyanate, DPPH, ABTS, and FRAP assays. Enzyme inhibition assays targeted AChE, BChE, and α-GLY, with IC50 values from dose-response curves. In silico analyses were conducted using molecular docking techniques to predict the binding mechanisms of identified phenolic compounds with the active sites of target enzymes, evaluating binding affinities and interaction profiles.ResultsVanillic acid and catechin hydrate were the most abundant phenolics. LN extract showed strong lipid peroxidation inhibition (50.53%) compared to Trolox (28.33%) and α-tocopherol (37.79%). Moderate radical scavenging and metal reduction potentials were observed. IC50 values were 2.57 µg/L for AChE, 3.78 µg/L for BChE, and 4.65 µg/L for α-GLY, indicating notable bioactivity. In silico studies confirmed strong binding affinities of phenolics to target enzymes.DiscussionLN extracts demonstrated promising antioxidant, antidiabetic, and anticholinergic activities, attributed to high phenolic content. Enzyme inhibition results suggest potential in managing metabolic and neurodegenerative disorders. In silico findings support these bioactivities, highlighting LN’s therapeutic potential.

IgA nephropathy (IgAN) is an immune complex-mediated glomerulonephritis characterized by the deposition of IgA-dominant immune complexes in the mesangium, leading to mesangial proliferation and subsequent renal injury. Clinically, IgAN often manifests as episodic macroscopic hematuria following upper respiratory tract or gastrointestinal infections. Disease progression is variable, with 20–50% of patients advancing to end-stage renal disease within 10–20 years of diagnosis. Although IgAN is primarily idiopathic, it may also occur secondary to systemic conditions such as Henoch-Schönlein purpura, HIV infection, toxoplasmosis, ankylosing spondylitis, and liver cirrhosis. Less commonly, IgAN can be associated with hepatitis B virus (HBV) infection or manifest as a paraneoplastic phenomenon. Here, we report a unique case of clinical presentation and successful treatment of concurrent HBV infection and IgAN in a patient with a history of malignant melanoma. To our knowledge, this is the first documented case in which these three conditions (IgAN, HBV infection, and malignant melanoma) coexist in a single patient.

Delays in accurate diagnosis of drug resistant tuberculosis (DR-TB) can hinder treatment. Whole genome sequencing (WGS) provides more information than standard molecular and phenotypic testing, but commonly used platforms are expensive to implement, and data interpretation requires significant expertise. We aimed to optimise a TB WGS diagnostic pipeline balancing user-friendliness, cost-effectiveness and time to results, whilst ensuring accuracy. Growth conditions, DNA extraction protocols and Oxford Nanopore Technologies (ONT) library preparation kits were compared. ONT was compared with Illumina protocols. Software for basecalling and analysis were evaluated to find the most accurate resistance SNP and lineage predictor. Optimally, a spin-column CTAB DNA extraction method was combined with the RBK110.96 library preparation kit, high accuracy (HAC) basecalling and data analysis using TB-Profiler. Compared with Illumina, the pipeline was concordant for 16/17 (94%) isolates (lineage) and for 17/17 (100%) isolates (resistance SNPs). Our pipeline was 71% (12/17) concordant with phenotypic drug susceptibility test (DST) results. Time-to-diagnosis was around four weeks. This optimised TB sequencing pipeline requires less time and expertise to run and analyse than Illumina, takes less time than phenotypic DSTs and the results are comparable with Illumina. The cost per sample is comparable with other methods. These features make it an important tool for incorporating into routine DR-TB diagnostic pipelines and larger scale drug resistance surveillance in all settings.

ABSTRACT Agricultural residues (such as straw and other nonmarketable plant waste) in Iran exceed 200 million tons annually, which can supply 10%–15% of the country's energy needs. The objective of this study was to investigate and estimate the biomass energy potential derived from crop residues in Iran using GIS mapping and artificial neural networks. The energy potential of the residues was determined by considering their heating value and the quantity of available residues. The available agricultural residues for the 10 crops studied were estimated to be 9,688,450 tons. Sugarcane and sugar beet contributed the largest shares, representing 32.33% and 25.72%, respectively. The largest quantities of sugarcane and wheat residues were found in Khuzestan province, amounting to 3,131,620 and 124,660 tons, respectively. For sugar beet, the maximum amount of residues was recorded in West Azerbaijan, with 719,140 tons. The total heating values for the residues were calculated to be 56,376 TJ for sugarcane, 18,212.36 TJ for wheat, and 42,887.32 TJ for sugar beet. The artificial neural network was able to predict the energy potential of biomass from the main products with a correlation coefficient of over 0.99 and the lowest error rate. GIS maps proved highly effective for rapidly analyzing the status of plant residues and their energy potential in each province. The findings suggest that agricultural residues in Iran have significant potential as a sustainable biomass energy source.

The Satisfaction With Life Scale (SWLS) is a widely used self-report measure of subjective well-being, but studies of its measurement invariance across a large number of nations remain limited. Here, we utilised the Body Image in Nature (BINS) dataset-with data collected between 2020 and 2022 -to assess measurement invariance of the SWLS across 65 nations, 40 languages, gender identities, and age groups (N = 56,968). All participants completed the SWLS under largely uniform conditions. Multi-group confirmatory factor analysis indicated that configural and metric invariance was upheld across all nations, languages, gender identities, and age groups, suggesting that the unidimensional SWLS model has universal applicability. Full scalar invariance was achieved across gender identities and age groups. Based on alignment optimisation methods, partial scalar invariance was achieved across all but three national groups and across all languages represented in the BINS. There were large differences in latent SWLS means across nations and languages, but negligible-to-small differences across gender identities and age groups. Across nations, greater life satisfaction was significantly associated with greater financial security and being in a committed relationship or married. The results of this study suggest that the SWLS largely assesses a common unidimensional construct of life satisfaction irrespective of respondent characteristics (i.e., national group, gender identities, and age group) or survey presentation (i.e., survey language). This has important implications for the assessment of life satisfaction across nations and provides information that will be useful for practitioners aiming to promote subjective well-being internationally.

BackgroundThe implementation of large language models (LLMs), such as BART (Bidirectional and Auto-Regressive Transformers) and GPT-4, has revolutionized the extraction of insights from unstructured text. These advancements have expanded into health care, allowing analysis of social media for public health insights. However, the detection of drug discontinuation events (DDEs) remains underexplored. Identifying DDEs is crucial for understanding medication adherence and patient outcomes. ObjectiveThe aim of this study is to provide a flexible framework for investigating various clinical research questions in data-sparse environments. We provide an example of the utility of this framework by identifying DDEs and their root causes in an open-source web-based forum, MedHelp, and by releasing the first open-source DDE datasets to aid further research in this domain. MethodsWe used several LLMs, including GPT-4 Turbo, GPT-4o, DeBERTa (Decoding-Enhanced Bidirectional Encoder Representations from Transformer with Disentangled Attention), and BART, among others, to detect and determine the root causes of DDEs in user comments posted on MedHelp. Our study design included the use of zero-shot classification, which allows these models to make predictions without task-specific training. We split user comments into sentences and applied different classification strategies to assess the performance of these models in identifying DDEs and their root causes. ResultsAmong the selected models, GPT-4o performed the best at determining the root causes of DDEs, predicting only 12.9% of root causes incorrectly (hamming loss). Among the open-source models tested, BART demonstrated the best performance in detecting DDEs, achieving an F1-score of 0.86, a false positive rate of 2.8%, and a false negative rate of 6.5%, all without any fine-tuning. The dataset included 10.7% (107/1000) DDEs, emphasizing the models’ robustness in an imbalanced data context. ConclusionsThis study demonstrated the effectiveness of open- and closed-source LLMs, such as GPT-4o and BART, for detecting DDEs and their root causes from publicly accessible data through zero-shot classification. The robust and scalable framework we propose can aid researchers in addressing data-sparse clinical research questions. The launch of open-access DDE datasets has the potential to stimulate further research and novel discoveries in this field.

Objectives Although patients with immune-mediated inflammatory diseases (IMID) are thought to be more susceptible to viral infections, it is unclear whether their presentation differs between patients with IMID and healthy controls. This study aimed to investigate the symptom pattern of common viral infections in patients with IMID and compare it with controls without IMIDs.Design A cross-sectional study conducted between 1 February and 30 April 2020, using a questionnaire.Setting Seven tertiary regional care centers in Germany, which specialised in the care of patients with IMID (namely, in gastroenterology, dermatology, rheumatology and immunology clinical care).Participants One thousand nine hundred nine participants completed the survey (757 patients with IMID; 1152 non-IMID controls).Primary outcome measure The occurrence of 11 common viral illness symptoms within the preceding 3 months in patients with IMID and non-IMID controls.Results Symptom data were clustered, based on number and co-occurrance, into 3 major clusters and 2 subclusters ranked by the average number of symptoms. Patients with inflammatory bowel disease and psoriasis were significantly overrepresented in the lower-frequency subcluster of the polysymptomatic cluster. Patients with rheumatoid arthritis were overrepresented in the lower-frequency subclusters of the intermediate and oligo-/asymptomatic clusters. Controls were over-represented only in the higher-frequency subclusters of each major cluster where none of the IMIDs were over-represented. Spondyloarthritis and other IMIDs were also overrepresented in the low-frequency subcluster, but the results were not significant. Overall, patients with rheumatoid arthritis patients reported fewer symptoms (rate ratio=0.68, 95% CI, 0.59 to 0.80) than non-IMID controls.Conclusion Patients with IMID are over-represented in low-frequency subclusters, even among individuals who have reported a broad range of viral infection symptoms. This pattern suggests that the manifestations of viral infections are different between patients with IMID and controls, thus challenging the accurate and early diagnosis of infections.

The generalization of BVPs always covers a wide range of equations. Our choice in this research is the generalization of Caputo-type fractional discrete differential equations that include two or more fractional q-integrals. We analyze the existence and uniqueness of solutions to the multi-point nonlinear BVPs base on fixed point theory, including fixed point theorem of Banach, Leray-nonlinear Schauder's alternative, and Leray-degree Schauder's theory. Finally, several examples are presented to demonstrate accuracy of our results.

The biggest and most devastating pandemic of the 21st century began to affect our world, with the Chinese Government reporting that a mysterious respiratory disease of unknown origin was detected in 2019. Education has been one of the areas most affected by this deadly disease, which spread all over the world in a short time. In this process, countries went into lockdown and changed the education model and switched to the "emergency remote teaching" model. Consequently, many students have been deprived of face-to-face education. According to UNESCO data, more than 1 billion students were affected on 13 April 2020 due to the disruption of education due to the pandemic. While face-to-face education is suspended in 7 countries today, approximately 37 million students are affected by this situation. In this research, the opinions of the music teachers working in primary and secondary public schools in Turkey and England during the emergency remote teaching about the process were taken. A sample group was formed with a total of 50 music teachers from Turkey and England. The opinions of the teachers were taken with a Likert-type interview form consisting of 6 sections and 22 questions and open-ended answers. According to these answers, the average duration of a lesson is almost equal in both countries, the lessons are generally taught from the same platforms and devices, the teachers in Turkey have more problems with the internet infrastructure during the process. While teachers' opinions about the COVID-19 processes were generally negative, it was revealed that they developed themselves in digital literacy after the process. In addition, suggestions were received from the teachers for the development of possible new emergency remote music teaching after the process. It has been seen that teachers working in both countries agree on providing equal opportunities to students. At the same time, one of the most striking suggestions is to keep the online alternative education model always ready. This study is important in order to be better prepared for the new possible emergency distance music education.

The aim of the study is to conduct a bibliometrical analysis on the published articles related to RME. Accordingly, Scopus database was scanned using the keywords "realistic mathematics education" or "realistic mathematic education" or "realistic maths" or "realistic mathematical education" and a total number of 1190 articles published on RME between 1986 and 2021 were obtained and anayzed bibliometrically. The data gathered was then analyzed utilizing "biblioshiny", which is a web interface app in the bibliometric R-Studio program package. The analyses were conducted in order to find out the sample of the articles' annual distributions; their 3-D area chart; the list of the journals that published the highest number of related articles; the authors and their institutions; source clusters obtained through Bradford's Law, the scientific productivity of the authors by years and their citation burst scores; the scientific productivity of the countries; the word cloud and word tree patterns of these articles; co-word analysis of the concepts, the collaboration networks of the authors and the conceptual structure mapping. The findings obtained as a result of the conducted analyses indicate that there has been an increase in the interest in RME research after 2016 and the journal with the highest number of published articles on RME is Journal on Mathematics Education. Also, the authors with the highest numbers of publications are Z. Zulkardi, S. Suparman and R. I. I. Putri, respectively, while Utrecht University has the highest number of publications on the topic. The countries with the highest rates of productivity in terms of publications on RME are found to be the USA, Indonesia, and the Netherlands, respectively. In addition, the most frequently used keyword by the researchers is found to be "realistic mathematics education", while "mathematics" is the most frequently utilized word in the titles of the analyzed articles. The overall findings of the study point out the need for further studies on RME as realistic mathematics education is considered to be a significant method in finding solutions to the problems in the field of mathematics education. Further theoretical contributions are also thought to be crucial as they could provide fundamental references for future research.

Kidney transplantation has provided decades of successful treatment for end-stage renal disease. Delayed graft function (DGF) is a condition defined in the modern era as a requirement for dialysis within [...], Background: The use of intraoperative diuretics, such as furosemide or mannitol, during kidney transplantation has been suggested to reduce the rate of delayed graft function (DGF). The evidence base for this is sparse, however, and there is substantial variation in practice. We sought to evaluate whether the use of intraoperative diuretics during kidney transplantation translated into a reduction in DGF. Methods: We conducted a cohort study evaluating the use of furosemide or mannitol given intraoperatively before kidney reperfusion compared with control (no diuretic). Adult patients receiving a kidney transplant for end-stage renal disease were allocated to receive furosemide, mannitol, or no diuretic. The primary outcome was DGF; secondary outcomes were graft function at 30 days and perioperative changes in potassium levels. Descriptive and comparative statistics were used where appropriate. Results: A total of 162 patients who received a kidney transplant from a deceased donor (either donation after neurologic determination of death or donation after circulatory death) were included over a 2 -year period, with no significant between-group differences. There was no significant difference in DGF rates between the furosemide, mannitol, and control groups. When the furosemide and mannitol groups were pooled (any diuretic use) and compared with the control group, however, there was a significant improvement in the odds that patients would be free of DGF (odds ratio 2.10, 95% confidence interval 1.06-4.16, 26% v. 44%, p = 0.03). There were no significant differences noted in any secondary outcomes. Conclusion: This study suggests the use of an intraoperative diuretic (furosemide or mannitol) may result in a reduction in DGF in patients undergoing kidney transplantation. Further study in the form of a randomized controlled trial is warranted. Contexte: Il a t sugg r que le recours aux diur tiques perop ratoires, comme le furos mide ou le mannitol, durant la transplantation r nale pourrait r duire le taux de retard la reprise de fonction du greffon. Cependant, il existe peu de donn es probantes appuyant cette hypoth se, et une grande variabilit dans la pratique. Nous avons voulu valuer si le recours aux diur tiques perop ratoires durant la transplantation r nale entra nait une diminution des retards de reprise de fonction. M thodes: Nous avons men une tude de cohorte valuant l'administration per-op ratoire de furos mide ou de mannitol avant la reperfusion du rein, comparativement un groupe t moin (aucun diur tique). Des patients adultes atteints d'une insuffisance r nale chronique terminale recevant une transplantation r nale ont t r partis en 3 groupes: furos mide, mannitol, ou aucun diur tique. Le r sultat principal tait le retard la reprise de fonction du greffon; les r sultats secondaires taient la fonction du greffon 30 jours et la variation p riop ratoire du taux de potassium. Des statistiques descriptives et comparatives ont t utilis es, le cas ch ant. R sultats: Au total, 162 patients ayant re u une greffe du rein d'un donneur d c d (don apr s un diagnostic de d c s neurologique ou de d c s cardiocirculatoire) ont t inclus dans l' tude sur une p riode de 2 ans, sans diff rences significatives entre les groupes. Aucune diff rence significative de taux de retard la reprise de fonction n'a t observ e entre les groupes furos mide, mannitol, et aucun diur tique. Consid r s ensemble, les groupes furos mide et mannitol (tous diur tiques confondus) pr sentaient toutefois une am lioration significative du taux de retard comparativement au groupe t moin (rapport de cotes 2,10, intervalle de confiance 95% 1,06-4,16, 26% c. 44%, p = 0,03). On n'a not aucune diff rence statistiquement significative entre les 2 groupes pour ce qui est des param tres secondaires. Conclusion: Cette tude semble indiquer que le recours aux diur tiques perop ratoires (furos mide ou mannitol) pourrait entra ner une r duction du taux de retard la reprise de fonction du greffon chez les personnes ayant subi une transplantation r nale. L'ex cution d'un essai clinique randomis est de mise.

Approximately 95% of cervical squamous cell carcinomas are associated with high-risk HPV, with a small number of HPV-independent tumors. However, low-risk HPV types have also been detected in rare cervical squamous cell carcinomas. Low-grade squamous intraepithelial lesion-related changes are a rare morphologic finding in cervical squamous cell carcinoma. We present the case of a 30-yr-old woman who presented with pelvic pain and foul-smelling vaginal discharge showing an exophytic lesion protruding from the cervix. Repeated superficial biopsies showed a low-grade squamous intraepithelial lesion (LSIL) characterized by binucleation and koilocytosis. Chromogenic in-situ hybridization revealed the presence of HPV6/11. The absence of high-risk HPV was confirmed by PCR. After following the patient for nine months without intervention, type III hysterectomy and bilateral pelvic paraaortic lymphadenectomy were performed. Microscopic examination showed well-differentiated squamous cell carcinoma with solid epithelial islands and extensive eosinophilic cytoplasm without pleomorphism. HPV 6 and 11 were also detected with chromogenic in-situ hybridization. Neoplasm invaded the full-thickness of the cervical wall and infiltrated the vagina, parametrium, the proximal ureter and bladder. The patient who received chemoradiotherapy is disease-free at 36 months follow-up. Low-risk HPV-related well-differentiated invasive squamous lesions exist, and such lesions could be a diagnostic pitfall for gynecologists and pathologists; in these cases, radiologic-pathologic correlation and radiologic guided biopsy are mandatory.