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Background: The object of this study was to investigate the antimicrobial resistance pattern among common nosocomial Gram-negative bacilli isolated from patients with nosocomial infections. Methods: From June 2004 to December 2005, 380 isolates of common Gram-negative bacilli (Klebsiella, Pseudomonas, Acinetobacter and E. coli) from 270 patients with nosocomial infections in Sina and Imam Hospitals, Tehran, Iran, were evaluated for susceptibility to Imipenem, Cefepime, Ciprofloxacine, Ceftriaxone and Ceftazidime by Disc diffusion and E-test methods. Results: The most frequent pathogens isolated were Klebsiella spp. (40%), followed by Pseudomonas (28%), Acinetobacter spp. (20%) and E. coli (12%). The most active antibiotic was imipenem (84%). 26% of all isolates were sensitive to Cefepime, 26% to Ciprofloxacin, 20% to Ceftazidime and 10% to Ceftrixone. The susceptibility rates of Klebsiella to Imipenem, cefepime, ciprofloxacin, Ceftazidime and Ceftriaxone were 91, 25, 21, 13 and 7 percent, respectively and 91, 19, 17, 21 and 21 percent, respectively, for E. coli. Among Acineto- bacter spp., the susceptibility rate was 77% for Imipenem and 21% for Ciprofloxacin. Among Pseudomonas spp., 75% of isolates were susceptible to Imipenem and 39% to Ciprofloxacin. The comparison of the resistance status of microorganisms by both Disc diffusion and E-test methods showed a clinically noticeable agreement between these two tests. Conclusions: Since antibiotic resistance among Gram-negative bacilli has increased, enforcement of policy regarding proper antibiotic use is urgently needed in order to delay the development of resistance. Although it is widely accepted that E-test is more accurate in determining the resistance of microorganisms, our study showed that the Disc diffusion test will give the same results in most occasions and is therefore still considered useful in clinical practice.

One of the main goals of network planners is the protection of important nodes in a network against natural disasters, security threats, attacks, and so on. Given the importance of this issue, a new model is presented in this paper for protecting an important node in a typical network based on a defensive location problem where the two agents threaten this node. The protecting facilities location problem with two agents is formulated as a three-level programming problem. The decision maker in the upper level is a network planner agent. The planner agent wants to find the best possible location of protecting facilities to protect the important node against threatening agents. The second and third levels problems are stated as the shortest path problems in the network in which the edges are weighted with positive values. In this work, the genetic, variable neighborhood search, simulated annealing algorithms are used to solve the problem. The performance of the used metaheuristic algorithms on this class of problems is investigated by a test problem that is generated randomly. Then, t-test are used to compare the performance of these algorithms. The best results are obtained by the variable neighborhood search algorithm. [ABSTRACT FROM AUTHOR]

Protecting important nodes in a network against natural disasters, security threats, attacks, and so on is one of the main goals of network planners. In this paper, a new model is presented for protecting an important node (NMPN) in a typical network based on a defensive location problem where the threatening agent (t-agent) can reinforce its power at some nodes. The NMPN is a bi-level programming problem. At the upper level, the planner agent (p-agent) try to find the best lo- cations for protecting resources in order to protect the important node. The lower level problem is represented as the shortest path problem in the network in which the edges are weighted with positive values and sometimes negative values. Thus, the Bellman-Ford algorithm is applied to solve the lower level problem. The NMPN is an NP-hard problem. In this work, the genetic, ant colony optimization, binary artificial bee colony with differential evolution, artificial bee colony algorithms, and a modified tabu search (MTS) algorithm are used to solve it. A test problem is randomly generated to investigate the performance of the metaheuristic algorithms in this paper. Parameters of the metaheuris- tic algorithms are tuned by the Taguchi method for solving the test problem. Also, the ANOVA test and Tukey's test are used to compare the performance of the metaheuristic algorithms. The best results are obtained by the MTS algorithm. [ABSTRACT FROM AUTHOR]

Background. For parents, stillbirth is a tragic experience; thus, identifying the associated risk factors can be beneficial in order to prevent this event. This study aimed to investigate the incidence and risk factors associated with stillbirth. Methods. In this historical cohort study, a total of 18,129 birth records were investigated. The outcome variable was having or not having stillbirth. For each case of stillbirth, three live birth infants on the same day and same hospital were selected as controls, which were matched for gestational age. The data were collected using a researcher-made checklist. Finally, data were analyzed using STATA, 13.0 with Cox proportional hazards regression model at the significance level of 0.05. Results. The cumulative incidence of stillbirth was 9.48 per 1,000 live births. Based on multivariate Cox regression model, five risk factors for stillbirth were identified, including male gender, fetal diseases, gestational hypertension, gestational diabetes, and maternal hypothyroidism, (all hazard ratios > 1 and p<0.05), and - for the first time in Iran - maternal hypothyroidism, oligohydramnios, and polyhydramnios were shown as risk factors for stillbirth, which were not evaluated in any previous study. Conclusion. The findings of this study suggest that some maternal and fetal risk factors can be recognized as predictors of stillbirth, which might help to detect and prevent high-risk parents at early stages in order to avoid adverse health consequences in the mother and her neonate. [ABSTRACT FROM AUTHOR]

For a set of non-negative integers L, the L-intersection number of a graph is the smallest number ℓ for which there is an assignment of subsets Av ⊆ {1, ..., ℓ} to vertices v, such that every two vertices u, v are adjacent if and only if |Au ∩ Av| ∈ L. The bipartite L-intersection number is defined similarly when the conditions are considered only for the vertices in different parts. In this paper, some lower bounds for the (bipartite) L-intersection number of a graph for various types L in terms of the minimum rank of graph are obtained. To achieve the main results we employ the inclusion matrices of set systems and show that how the linear algebra techniques give elegant proof and stronger results in some cases. [ABSTRACT FROM AUTHOR]

The anticlines in Fars region, which are located in Zagros fold-thrust belt, are valuable because they possess several hydrocarbons and this area is easily recognized by the NW-SE trending parallel anticlines that verge to the SW. According to the geolog- ical classification, the study area is located in Interior Fars region. Due to increasing complication of structural geometry in Fars region and necessity to explore activities for deeper horizons especially the Paleozoic ones, the analysis of fold style elements, which is known as one of the main parts in structural studies, seems necessary. The Karbasi and Khaftar anticlines are case study anticlines in the interior Fars sub basin (Fassa area). These anticlines have an asymmetric structure and some faults with large strike separation are observed in these structures. Due to increasing complication of structural geometry in Fars region and necessity to explore activities for deeper horizons especially the Paleozoic ones, the analysis of fold style elements, which is known as one of the main parts in structural studies, seems necessary. De scription of fold geometry is important because it allows comparisons within and between folds and also allows us to recognize patterns in the occurrence and distribution of fold systems. The main aim of this paper is to determine fold style elements and folding pattern in the study area. This paper presents a part of the results of a regional study of Fars province in the Zagros Simply folded belt, based on satellite images, geological maps, and well data. In the Interior Fars area, it seems that folding pattern is controlled by structural elements such as the Nezamabad basement fault and Dashtak formation. In fact, as a middle detachment unit, Dashtak formation plays an important role regarding folding geometry and fold in style in the study area. [ABSTRACT FROM AUTHOR]

Introduction: Schema therapy is an important treatment method for cognitive disorders. This study aimed to examine the effect of education schema therapy in reducing symptoms of anxiety and depression in nursing and midwifery students. Methods: In this pre-test, post-test study, all nursing and midwifery students who referred to counseling center of Islamic Azad University-Mashhad Branch were assessed. Forty students with anxiety and depression were randomly assigned to two groups (n=20 each) included schema therapy and control groups. The experimental group educated 10 sessions of 70 minutes by schema therapy method. Both groups completed the Cattel anxiety and Beck depression questionnaires as pre-test, post-test and after two months of follow-up. Data was analyzed using multivariate analysis of covariance (MONCOVA) method. Results: of anxiety and depression of the intervention group was significantly decrease compare to the control group in post-test and after two months of follow-up (P<0.05). Conclusion: schema therapy is an effective method to reduce symptoms of anxiety and depression in nursing and midwifery students. Counselors and therapist can use schema therapy to reduce symptoms of anxiety and depression disorder. [ABSTRACT FROM AUTHOR]

Karbasi anticline between west-northwest parts of Jahrom town is located in northwest 40 km distance of Aghar gas anticline in interior Fars region. This anticline has asymmetric structure and some faults with large strike separation observed in its structure. The operation of Nezamabad sinistral strike slip fault in west part of this anticline caused fault plunge change in this region. Because of complication increasing of structures geometry in Fars region and necessity to exploration activities for deeper horizons especially the Paleozoic ones, the analysis of fold style elements, which is known as one of the main parts in structural studies seems necessary. In this paper because of some reasons such as Karbasi anticline structural complication, importance of drilling and hydrocarbon explorations in Fars region, it is proceed to analysis and evaluation of fold style elements and geometry with emphasis on Nezamabad fault operation in Interior Fars region. According to fold style elements analysis results, it became clear that in east part of anticline the type of fold horizontal moderately inclined and in west part it is upright moderately plunging, so west evaluation of anticline is affected by more deformation. In this research the relationship present faults especially the Nezamabad sinistral strike slip one with folding and its affection on Dehram horizon and Bangestan group were modeled. Based on received results may be the Nezamabad fault is located between G-G' and E-E' structural sections and this fault in this area operated same as fault zone. In different parts of Karbasi anticline, Dashtak formation as a middle detachment unit plays an important role in connection to folding geometry, may be which is affected by Nezamabad main fault. [ABSTRACT FROM AUTHOR]

Objective: To determine the role of E-cadherin in differentiating Breast lobular carcinoma from Breast ductal carcinoma in Iranian patients. Methodology: A total of 80 malignant breast samples were reviewed by two pathologists before undergoing E-cad immunohistochemistry (IHC) staining. The results from IHC were compared with the results from the morphological study of the samples and they were then analyzed statistically. Results: The normal ductal cells had strong complete homogenous membrane E-cadherin reactivity in all cases. The complete absence of E-cadherin membrane staining occurred in 14 out of 16 cases of Lobular breast carcinoma. The mean score of E-cadherin expression in ductal carcinoma was 191.35 with a CV of 104.39. In lobular carcinoma, the mean score of E-cadherin was 9.36 with a CV of 25.68. Using the Mann-Whiteny test, the difference between E-cadherin expression score in ductal and lobular carcinoma was statistically significant (P=0.0009). Conclusion: E-cadherin expression is a useful diagnostic tool in distinguishing ductal from lobular carcinoma of breast. [ABSTRACT FROM AUTHOR]

Background: Staphylococcus aureus is a major pathogen in hospital setting and in the community and causes a wide range of diseases. MRSA infection has recently become a serious problem in anti-microbial chemotherapy. The aim of the study was to detect and analyze the antibiotic diversity and isolation of methicillin resistance gene (mecA) of S. aureus isolated from Tehran hospitals as a rapid and reliable method. Patients and methods: We studied 585 isolates of staphylococcus spp. recovered from patients at 3 clinical centers in Tehran from October 2005 to October 2006. Antibiotic susceptibility test of isolates was achieved with 13 antibiotics by disc diffusion. The MIC of methicillin was also performed by broth micro dilution assay. PCR was used for detection of mecA gene. Results: Totally, 321 (54.7%) isolates were identified as S. aureus. 66, 65, 88, 88, 100, 41, 38, 41, 0, 40, 93, 20 and 64% of S. aureus isolates were resistant to kanamycin, cephotaxim, methicillin, oxacillin, ampicillin, erythromycin, clindamycin, sulphamethoxazole-trimethoprime, vancomycin, chloramphenicol, ciprofloxacin, gentamicin and tetracycline, respectively. All MRSA and 63% of intermediate isolates carried mecA gene. Conclusion: In contrary to other studies in Iran, the prevalence of methicillin resistance is rising up in Tehran and most of MRSA isolates were resistance to 5 antibiotics at least. Vancomycin, chloramphenicol, gentamicin and clindamycin are the most effective antibiotics. All MRSA isolates had mecA gene with different expression. Detection of mecA gene is a rapid and reliable method for identification of MRSA isolates. [ABSTRACT FROM AUTHOR]

Symptomatology, histopathology and etiology of Colletotrichum dematium (Pers. ex Fr.) Grove infection on leaves of Peperomia tithymaloides A. Dietr. have been described. Isolations from diseased tissue yielded two strains, A and B, differing in certain cultural characters but not in the morphology of their conidia and condiiophores. Strain A is more virulent than strain B. Both strains infect uninjured host leaves but not stem. Adaxial epidermis is more susceptible to infection than abaxial epidermis. Wounding aids infection. In vitro association of natural sectors or paired colonies of strains A and B leads to the development of densely crowded, large, heavily sporulating acervuli. Mycelia of strains A and B seem to anastomose, yielding conidia which on subculture show sectoring and segregation of the two parental strains. [ABSTRACT FROM AUTHOR]

Mycosis fungoides is the most common type of cutaneous malignant T cell lymphoma which primarily affects skin. However, extracutaneous manifestation may occur in advanced stages, mostly observed in postmortum studies. We present a case of mycosis fungoides that disseminated to the true vocal cord of a 48-year-old African American man who presented with hoarseness. Only two cases that have also demonstrated a rare involvement of the true vocal cord have been reported in the English literature. In both cases, mycosis fungoides infiltration of the true vocal cord was seen postmortem, along with visceral dissemination of mycosis fungoides. We herein describe a single extracutaneous manifestation of mycosis fungoides in the true vocal cord of a living patient with a 21-year diagnosis of mycosis fungoides. Vocal cord involvement by mycosis fungoides must be considered as one of the differential diagnoses in any mycosis fungoides patients who complain of persistent hoarseness. Awareness of this entity is clinically important due to the necessity of a different management. [ABSTRACT FROM AUTHOR]

Background: The authors previously developed an artificial intelligence (AI) to assist cytologists in the evaluation of digital whole-slide images (WSIs) generated from bile duct brushing specimens. The aim of this trial was to assess the efficiency and accuracy of cytologists using a novel application with this AI tool., Methods: Consecutive bile duct brushing WSIs from indeterminate strictures were obtained. A multidisciplinary panel reviewed all relevant information and provided a central interpretation for each WSI as being "positive," "negative," or "indeterminate." The WSIs were then uploaded to the AI application. The AI scored each WSI as positive or negative for malignancy (i.e., computer-aided diagnosis [CADx]). For each WSI, the AI prioritized cytologic tiles by the likelihood that malignant material was present in the tile. Via the AI, blinded cytologists reviewed all WSIs and provided interpretations (i.e., computer-aided detection [CADe]). The diagnostic accuracies of the WSI evaluation via CADx, CADe, and the original clinical cytologic interpretation (official cytologic interpretation [OCI]) were compared., Results: Of the 84 WSIs, 15 were positive, 42 were negative, and 27 were indeterminate after central review. The WSIs generated on average 141,950 tiles each. Cytologists using the AI evaluated 10.5 tiles per WSI before making an interpretation. Additionally, cytologists required an average of 84.1 s of total WSI evaluation. WSI interpretation accuracies for CADx (0.754; 95% CI, 0.622-0.859), CADe (0.807; 95% CI, 0.750-0.856), and OCI (0.807; 95% CI, 0.671-0.900) were similar., Conclusions: This trial demonstrates that an AI application allows cytologists to perform a triaged review of WSIs while maintaining accuracy., (© 2024 American Cancer Society.)

Background: Squamous cells are uncommon in thyroid fine needle aspirations (FNAs) presenting diagnostic challenges. We report our multi-institutional experience., Materials and Method: The electronic data were searched for thyroid FNAs containing squamous cells at the Johns Hopkins Medicine, New York University Langone Hospital, United States, and Fimlab Laboratories, Finland (2001-2023). The patients' demographics, clinical history, and pathologic diagnosis were recorded., Results: One hundred and seven cases (103 patients) were identified 35 males and 68 females (median age 58 years). Forty-eight cases (44.9%) were malignant, primary carcinomas with squamous features, such as anaplastic thyroid carcinoma (ATC), and metastatic or directly invasive squamous cell carcinomas (SqCC) including oral, oropharyngeal (HPV-related), esophageal, and laryngeal SqCC. Twenty-seven cases (25.2%) contained benign squamous cells with cystic background, suggestive of developmental cysts. Nineteen cases (17.8%) contained metaplastic benign squamous cells within an adenomatoid nodule. Seven cases (6.5%) contained atypical squamous cells. Four cases (3.7%) showed squamous cells with bacterial or fungal organisms, suggestive of esophageal fistula/diverticulum, and two cases (1.9%) contained benign squamous cells with unknown source. Thirty-six cases had surgical follow-up, 33 (91.7%) were concordant (23 metastatic or directly invasive SqCC, 8 undifferentiated/ATC, and 10 papillary thyroid carcinoma). Ancillary studies were used confirming HPV-related SqCC, or therapeutic targets (BRAF V600E), with highly variable staining in ATC., Conclusion: Squamous cells in thyroid FNAs carry a broad differential diagnosis with variable prognoses. It is crucial to interpret squamous cells in the context of clinical and radiographic findings for optimal patient care., (© 2024 Wiley Periodicals LLC.)

Introduction: The risk of malignancy (ROM) remains an area of interest for further evaluation in reporting systems including in International System for reporting serous fluid cytopathology (TIS), which is a standardized system for reporting effusion cytology. Herein, we report our findings in further investigation of ROM in TIS by studying on paired pleural effusion specimens and corresponding pleural biopsies with emphasis on negative for malignancy, and atypia of undetermined significance categories., Materials and Methods: The  Johns Hopkins Hospital pathology database was retrospectively searched for patients with a pleural biopsy (PBX) and a paired pleural effusion (PF) cytology specimens over a 4-year period. We employed the TIS categories. The following statistical parameters were evaluated: sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and ROM., Results: A total of 223 patient cases were included. Effusions TIS reclassification and ROM were as follows: 1.8% non-diagnostic (ROM 75%), 75.8% negative for malignancy (ROM 23%), 4.9% atypical cells of undetermined significance (ROM 45%), 2.2% suspicious for malignancy (ROM 80%), and 15.2% malignant (ROM 100%). Overall accuracy, sensitivity, specificity, PPV and NPV were calculated and were 79.4%, 45%, 97.7%, 91.2% and 77%, respectively. Among, discordant cases diagnosed negative for malignancy on PF and positive for malignancy on PBX, there were significant number of lymphomas, mesotheliomas, and sarcomas. Lung cancer was the most common carcinoma; however, rare types of carcinomas were noted. Cells blocks and immunohistochemistry (IHC) studies were utilized to confirm either malignant conditions or rule out malignancy in both cell blocks and histology biopsies., Conclusion: This study demonstrates the high specificity and ROM for 'malignant' and 'suspicious for malignancy' categories in the TIS reporting system and highlights the modest negative predictive value for the 'negative for malignancy' category. Although Tissue biopsies are usually considered as 'gold standard', any definitive diagnosis of malignancy of body fluid should be considered positive for malignancy in further clinical decision-making., (© 2024 John Wiley & Sons Ltd.)

Background: The reported risk of malignancies (ROM) remains controversial for fine needle aspiration (FNA) of thyroid nodules in the African American (AA) population. Herein, the ROM along with frequency was assessed for each of the Bethesda System for Reporting Thyroid Cytopathology (TBSRTC) diagnostic categories., Materials and Methods: The electronic pathology archive of a large academic hospital was retrospectively searched for cytopathology reports of thyroid nodules in AA patients (2010-2019) and Non-African American (NAA) control cases. The patients' demographic, thyroid nodule characteristics, FNA results using TBSRTC and surgical diagnoses were recorded, whenever available., Results: Three hundred ninety-one cases were identified, 317 females (81.1%) and 74 males (18.9%) with median age 50.0 (SD = 14.4). The mean size of the nodules was 2.1 cm (SD = 1.4). The Bethesda categories were: 5.4% (I), 35.0% (II), 35.3% (III), 7.7% (IV), 3.3% (V) and 13.3% (VI). The overall ROM of thyroid nodules was 43.8% (89/203) on surgical follow-up (203/391). The ROM in each Bethesda categories were: 33.3% (I), 11.6% (II), 35.2% (III), 15.8% (IV), 83.3% (V) and 100% (VI) on surgical follow-up. The frequency of thyroid nodules was higher in AA females; however, the ROM was higher in AA males (48.3%) compared with AA females (41.2%)., Conclusion: The ROM in Categories I, II and III was higher than those reported in the TBSRTC while being similar in Categories IV, V and VI. The overall risk of thyroid malignancy in our AA patient population was higher than those in the literature. The overall ROM of thyroid nodules in AA males was higher than of AA females., (© 2024 John Wiley & Sons Ltd.)

Behavioral diffusion is commonly modeled with the linear threshold model, which assumes that individuals adopt a behavior when enough of their social contacts do so. We observe, however, that in many common empirical settings individuals also appear to abandon a behavior when too many of their close contacts exhibit it. The bi-threshold model captures this tendency by adding an upper threshold, which, when exceeded, triggers behavioral disadoption. Here we report an empirical test of the bi-threshold model. We overcome the significant challenge of estimating individuals' heterogeneous thresholds by extending a recently introduced decision-tree based algorithm to the bi-threshold setting. Using the context of the spread of news about three different topics on social media (the Higgs boson, the Melbourne Cup horse race, and the COVID-19 vaccination campaign in China), we show that the bi-threshold model predicts user engagement with the news orders of magnitude more accurately than the linear threshold model. We show that the performance gains are due especially to the bi-threshold model's comparative advantage in predicting behavioral decline, an important but previously overlooked stage of the behavioral diffusion cycle. Overall, the results confirm the existence of the second upper threshold in some contexts of diffusion of information and suggest that a similar mechanism may operate in other decision-making contexts., (© The Author(s) 2024. Published by Oxford University Press on behalf of National Academy of Sciences.)

Background: Attitudes toward childhood disability have historically focused on biomedical efforts on 'fixing'. The introduction of WHO's ICF framework for health and Canadian researchers' 'F-words' (functioning, fitness, fun, friends, family and future) have significantly changed the field. To explore whether the F-words ideas influenced parents' perspectives on their child's abilities and rehabilitation goals, this qualitative pilot study introduced the F-words to Iranian parents with a child with a developmental disability., Methods: This study was conducted in Tabriz, Iran, in 2023, using Iranian educational F-words materials built on ideas available on the CanChild F-words Knowledge Hub. Data were collected through semistructured interviews with five mothers of children <5 years old with a developmental disability before and after attending an 'F-words Awareness Session' and analysed using thematic analysis., Results: In the preinterviews, six themes (and 20 subthemes) were identified: (i) routines (5); (ii) challenges (4); (iii) parental concerns (3); (iv) child's needs and priorities (3); (v) the role of parents in satisfying needs and challenges (2); and (vi) expectations of rehabilitation (3). In the postinterview, the same six themes and four additional subthemes emerged., Conclusion: Findings from the pilot study showed that the intervention had an impact on the attitudes and behaviours of participants. Specifically, teaching about the F-words reduced parents' emphasis on the concept of 'normality'. Families' positive response to the 'F-words Awareness Session' indicates their openness to incorporating this approach into their daily lives. These findings highlight the potential benefits of utilizing the F-words in rehabilitation in Iran. Studies like these can serve as a foundation for developing effective strategies for integrating the F-words into existing rehabilitation practices in Iran., (© 2024 John Wiley & Sons Ltd.)

Background: Differentiated high-grade thyroid carcinoma (DHGTC) is recently recognized by the World Health Organization (WHO) as a subgroup of thyroid carcinomas with high-grade features while retaining the architectural and/or cytologic features of well-differentiated follicular-cell-derived tumors. The cytomorphology of DHGTC is not well documented despite potential implications for patient triage and management., Methods: The pathology archives of six institutions were searched for cases diagnosed on resection as "high-grade thyroid carcinoma" using WHO criteria. The fine-needle aspiration (FNA) cohort represents a 10-year period (2013-2023); all were reviewed to confirm DHGTC classification. The corresponding FNAs were assessed for 32 cytomorphologic features., Results: Forty cases of DHGTC with prior FNA were identified. The mean patient age was 64.2 years. The average lesion size was 4.9 cm, and the majority demonstrated a TI-RADS score of 4 or 5 (95.2%). Three main high-grade subsets of DHGTC based on corresponding histology included papillary thyroid carcinoma (65%), follicular carcinoma (22.5%), and oncocytic carcinoma (12.5%). Over 97% of FNA cases were classified as Bethesda category IV or above. Approximately 25% of DHGTC showed cytologic features that included marked cytologic atypia, increased anisonucleosis, large oval nuclei, mitotic activity, or necrosis (p < .05); 68% of DHGTC cases were associated with high-risk molecular alterations. TERT mutations occurred in 41%, of which 89% of these were associated with a second mutation, usually RAS or BRAF p.V600E., Conclusions: Cytology has a low sensitivity for DHGTC, although a subset of DHGTCs have cytologic features raising the possibility of a high-grade thyroid carcinoma. Other findings include high-risk molecular changes and clinicopathologic features such as older patient age and larger lesion size., (© 2024 American Cancer Society.)

Background: The Milan System for Reporting Salivary Gland Cytopathology (MSRSGC) is widely accepted and endorsed by professional societies. Although several studies focusing on the MSRSGC have been published, few have been prospective studies. The objective of this study was to evaluate the effectiveness of the MSRSGC in cytopathology practice., Methods: A comprehensive literature search was conducted to identify all prospective studies on the MSRSGC. The risk of malignancy (ROM), risk of neoplasm, and diagnostic accuracy for each diagnostic category were calculated. Data were tabulated in Microsoft Excel, and analyses were performed with the Open Meta-Analyst program., Results: Seven prospective and seven retrospective studies were identified. The total number of fine-needle aspirations (FNAs) was 1587 in the prospective studies and 1764 in the retrospective studies. The ROM values for the nondiagnostic, nonneoplastic, atypia of undetermined significance, benign neoplasm, salivary gland neoplasm of uncertain malignant potential, suspicious for malignancy, and malignant categories in prospective versus retrospective studies were 21.0% versus 26.6%, 9.4% versus 8.1%, 34.9% versus 39.6%, 2.4% versus 2.1%, 36.6% versus 31.2%, 86.0% versus 66.0%, and 97.0% versus 96.7%, respectively. Sensitivities, specificities, and diagnostic odds ratios were 83.1% (95% confidence interval [CI], 71.1%-90.8%) versus 89.1% (95% CI, 83.6%-92.9%), 98.4% (95% CI, 96.6%-99.3%) versus 94.9% (95% CI, 91.9%-96.9%), and 310.7 (95% CI, 121.2-796.6) versus 218.8 (95% CI, 107.3-438.1)., Conclusions: This meta-analysis indicated that the MSRSGC works well in FNA cytopathology practice and improves diagnostic accuracy in all diagnostic categories. The ROMs of prospective studies were in concordance with the MSRSGC reference values., (© 2024 The Authors. Cancer Cytopathology published by Wiley Periodicals LLC on behalf of American Cancer Society.)

Background: Retinopathy of prematurity (ROP) is a proliferative disorder of the developing retina. Intravitreal bevacizumab injection (IVB) is an emerging treatment for severe forms of ROP, which does not restrict the visual field in comparison to laser therapy. The present study aimed to determine and evaluate the risk factors for ROP recurrence following IVB injection., Materials and Methods: In this retrospective study, 98 eyes of 49 infants with ROP who had received IVB injections as the primary treatment for type 1 ROP are included., Results: Fifty-four eyes (55.1%) had aggressive retinopathy of prematurity (A-ROP), and forty-four (44.9%) had Stage III Plus ROP in Zone II. ROP recurred in 13 eyes (13.26%) of 8 infants. The mean period between IVB and the ROP recurrence was 8.08 (95% CI:5.32-10.83) weeks. The infants who had ROP recurrence had lower birth weight (P value = 0.002), lower postmenstrual age at IVB injection (P value = 0.001), lower IVB injection gap period from birth (P value = 0.044), higher oxygen therapy requirement rate after IVB injection (P value < 0.001, OR:19.0) and higher oxygen therapy duration (P value = 0.006). The ROP severity, gestational age at birth, and diet were not statistically different between the recurrence and complete regression groups. Out of 13 eyes treated with laser photocoagulation because of ROP relapse, macula dragging occurred in one eye, and all the cases met the complete regression., Conclusion: Low birth weight and oxygen therapy are the most important risk factors for ROP relapse, which requires meticulous oxygen treatment guidelines for premature infants., (© 2024. The Author(s).)

Background: The incidence of thyroid cancer as the most common type of endocrine gland malignancy has risen more significantly than any malignancies in recent years. Estimated new cases of thyroid cancer in the United States in 2024 were 12,500 and 31,520 for men and women, respectively, and estimated deaths were 1,180 for women and 990 for men. Indices of socio-economic have been commonly used to measure the development of countries. Therefore, this study aimed to examine the correlation between indices of socioeconomic status and epidemiological indices of thyroid cancer throughout the world. In addition, this study has compared two indices of human development and a socio-demographic index., Method: This worldwide ecological study used data on thyroid cancer incidence, mortality, human development index (HDI), and sociodemographic index (SDI) between 1990 and 2019 from the Global Burden of Disease (GBD). We evaluated the correlation between incidence and mortality rates with socioeconomic indices by using Pearson's correlation coefficient. Furthermore, for the first time, the generalized additive model (GAM) was employed for modeling. The statistical software R, version 4.2.2, was used to conduct all statistical analyses., Results: The correlation between the incidence of thyroid cancer and the HDI was significant and positive (r = 0.47, p-value < 0.001). While the correlation between thyroid cancer mortality and HDI was not statistically significant (r = 0.01, p-value = 0.076). Besides, the incidence of thyroid cancer was significantly positively correlated with SDI (r = 0.48, p-value < 0.001). The multiple GAM showed that for one unit increase in HDI, the risk of thyroid cancer was increased by 2.1 times (RR = 2.1, 95%CI = 2.04 to 2.19), and for one unit increase in SDI, the risk of thyroid cancer was shown to increase by 2.2 times. (RR = 2.2, 95%CI = 2.19 to 2.35)., Conclusion: It has been evident that countries with higher incidence of thyroid cancer display higher socioeconomic indices. While, countries with higher socioeconomic indices, report lower mortality rates. However, based on the modeling results, it can be concluded that the SDI is slightly more useful in this regard. Therefore, examining the epidemiological indices of thyroid cancer by socio-economic indices can be useful to reflect a clear image of the distribution of this cancer in each country, and can be used for planning cancer prevention strategies., (© 2024. The Author(s).)

Purpose: Our objective was to compare the serum Adropin levels between patients with wet-type Age-Related Macular Degeneration (AMD) and otherwise healthy individuals., Method: The study included 45 patients with wet-type AMD and 45 individuals without age-related macular degeneration. Patients with co-morbidities such as diabetes, hypertension, autoimmune diseases, and a previous history of visual impairment; were excluded. FBS, Hemoglobin A1C (HbA1C), lipid profile, and serum Adropin level were checked., Results: The mean serum Adropin level of patients with wet-type AMD was significantly lower than the control group (P-value < 0.001). Also, the mean High-sensitivity C-reactive protein ( hsCRP) level and High Density Lipoprotein (HDL) were significantly higher in wet-type AMD patients (P-value = 0.031 and < 0.001 respectively)., Conclusions: In our study, wet-type AMD was associated with a lower level of serum Adropin. Because of Adropin involvement in glucose metabolism and age-related changes, it may have a role in the pathogenesis of AMD, but it requires more investigations at the molecular level to elucidate its function., (© 2024. The Author(s).)

Electrofacies analysis conducted the distribution effects throughout the reservoir despite the difficulty of characterizing stratigraphic relationships. Clustering methods quantitatively define the reservoir zone from non-reservoir considering electrofacies. Asmari Formation is the most significant reservoir of the Mansouri oilfield in SW Iran, generally composed of carbonate and sandstone layers. The stratigraphical study is determined by employing 250 core samples from one exploratory well in the studied field. Five zones with the best reservoir quality in zones 3 and 5 containing sandstone/shale are determined. Moreover, multi-resolution graph-based and artificial neural network clustering involving six logs are employed. Utilizing Geolog software, an optimal model with eight clusters with better rock separation is obtained. Eventually, five electrofacies with different lithological compositions and reservoir conditions are identified and based on lithofacies describing thin sections, sandstone, and shale in zones 3 and 5 show high reservoir quality. According to the depth related to these zones, most of the facies that exist in these depths include sandstone and dolomite facies, and this is affected by the two factors of the primary sedimentary texture and the effect of the diagenesis process on them. Results can compared to the clustering zone determination in other nearby sandstone reservoirs without cores., (© 2024. The Author(s).)

Rock types are the reservoir's most essential properties for special facies modeling in a defined range of porosity and permeability. This study used clustering techniques to identify rock types in 280 core samples from one of the wells drilled in the Asmari reservoir in the Mansouri field, SW Iran. Four hydraulic flow units (HFUs) were determined for studied data utilizing histogram analysis, normal probability analysis, and the sum of squared errors (SSE) statistical methods. Then, two flow zone index (FZI) and fuzzy c-means (FCM) clustering methods were used to determine the rock types in the given well according to the results obtained from the HFU continuity index acts in-depth. The FCM method, with a continuity number of 3.12, compared to the FZI, with a continuity number of 2.77, shows more continuity in depth. The relationship between permeability and porosity improved considerably by utilizing HFU techniques. This improvement is achieved using the FZI method study. Generally, all samples increased from 0.55 to 0.81 in the first HFU and finally to 0.94 in the fourth HFU. Similar flow properties in an HFU characterized the samples. In comparison, the correlation coefficients obtained in the FCM method are less than those in the general case of all HFUs. This study aims to determine the flowing fluid in the porous medium of the Asmari reservoir employing the c-mean fuzzy logic. Also, by determining the facies of the rock units, especially the siliceous-clastic facies and log data in the Asmari Formation, the third and fourth flow units have the highest reservoir quality and permeability. Results can be compared to determining HFU in nearby wellbores without cores., (© 2024. The Author(s).)

Background: Salivary gland lesions possess diagnostic challenges on fine-needle aspiration (FNA) material. They are relatively uncommon, yet present with a wide spectrum of cytomorphology. Herein, we review common salivary gland neoplasms, their cytomorphologic features, their diagnostic pitfalls, and ancillary studies helpful in achieving an accurate diagnosis., Summary: There are many cytomorphologic overlaps between benign and malignant salivary gland entities. Moreover, metaplasia, cystic changes, and degenerative changes are common findings adding to diagnostic dilemmas. These complicating factors contribute to a minute risk of malignancy in salivary gland lesions that are interpreted as benign on FNA. In rare cases, even malignant salivary gland neoplasms are misinterpreted as benign on aspirated material due to the many cytomorphologic overlaps. For example, benign and malignant neoplasms containing stroma such as myoepithelioma and adenoid cystic carcinoma may be misinterpreted as pleomorphic adenoma. Moreover, diagnosis of salivary gland neoplasms with basal cell features can be confusing on FNA materials; for example, basal cell adenoma can be misinterpreted as adenoid cystic carcinoma. Mucoepidermoid carcinomas have many different appearances on aspirated material due to variable amounts of mucin, degree of nuclear atypia, cellular content, and squamous metaplasia. Acinic cell carcinoma exhibits large cells with abundant cytoplasm on FNA, which can be mistaken for oncocytic cells in oncocytoma or Warthin tumor. Salivary duct carcinoma shows distinct features of malignancy and thus can be mistaken for secondary tumors involving the salivary glands or other malignant salivary gland tumors. The presence of tumor-associated lymphocytes is another underlying cause of misdiagnosis, especially when considering the differential diagnosis of an intraparotid lymph node. Ancillary studies such as immunohistochemistry and molecular studies are gaining more attention to be utilized on FNA cases. PLAG1 immunostaining, CD117, DOG1, mammaglobin, and androgen receptor (AR) are examples of commonly used immunostains in diagnosis of salivary gland lesions. MYB gene fusion, rearrangements of the MAML2 gene, and ERBB2/HER2 are examples of molecular alterations useful in diagnosis of salivary gland neoplasms. In conclusion, the aim of salivary gland cytology is to differentiate benign entities from the malignant ones and to prevent unnecessary aggressive treatments., Key Messages: The diagnostic pitfalls are enormous in salivary gland cytology. Familiarity with cytomorphology of different entities and their cytomorphologic overlaps, and application of ancillary studies improves the diagnostic yield, patient management and prevents unnecessary aggressive procedures., (© 2024 S. Karger AG, Basel.)

Background: Sufficient tumor collection has become of utmost importance in therapeutic experimental protocols. Rapid on-site evaluation (ROSE) ensures adequate sampling for quantification of biomarkers, molecular analyses, and other ancillary studies. The objectives of this study were to evaluate the role of ROSE in trial-associated fine-needle aspiration (FNA) and to analyze predictors of adequacy and cumulative survival from in-house FNA cases used in clinical trials., Methods: Clinical trial FNA biopsies performed at a large academic institution were analyzed over 10 months using a comprehensive chart review of the electronic medical records. SPSS version 28 was used for statistical analysis., Results: Three hundred twenty-five FNAs were collected for 57 clinical trials. In total, 225 individual patients had an average of 1.4 FNA procedures each as a result of a multidepartmental collaborative effort. ROSE was performed for all patients, and adequacy was evaluated by cytotechnologists. Seventy-eight percent of samples were considered adequate, 14% were considered less than optimal, and 8% were considered inadequate, with the latter two categories designated together as less than adequate. The imaging modalities were mainly ultrasound-guided (n = 267; 82%) and computed tomography-guided (n = 58; 18%). There was a statistically significant association between adequate sampling and ultrasound-guided biopsies (83%) compared with computed tomography-guided biopsies (59%; p < .01). The effect of body mass index (BMI) on mortality was also a significant finding. The authors observed a survival benefit in patients who had elevated BMIs (range, 25.0-34.9 kg/m 2 ) compared with those who were underweight (BMI, <18.5 kg/m 2 ) or class III obese (BMI, >35.0 kg/m 2 ; p < .01). Therefore, the best predictors of adequacy and mortality were imaging modality and BMI, respectively., Conclusions: Ultrasound-guided modalities are recommended for obtaining adequate FNA sampling for clinical trials. In addition, patients with cancer who had slightly elevated BMIs (25.0-34.0 kg/m 2 ) had increased overall survival in this cohort., (© 2023 American Cancer Society.)

Objective: Cancer is one of the main causes of death, and cervical cancer is the fourth most common cancer and the fourth leading cause of death from malignancy among women. Knowing the survival rate is used to evaluate the success of current treatments and care. This study was conducted to assess the survival rate of cervical cancer in Asia., Methods: This systematic survey was conducted on four international databases, including Medline/PubMed, ProQuest, Scopus, and Web of Knowledge, and includes manuscripts that were published until the end of August 2021. Selected keywords were searched for international databases including cervical neoplasms [mesh], survival analysis or survival or survival rate, Asian countries (name of countries). The Newcastle-Ottawa Qualitative Evaluation Form was used for cohort studies to evaluate the quality of the articles. The analysis process was performed to evaluate the heterogeneity of the studies using the Cochran test and I 2 statistics. Additionally, a meta-regression analysis was performed based on the year of the study., Results: A total of 1956 articles were selected and reviewed based on their title. The results showed that 110 articles met the inclusion criteria. According to the randomized model, the 1, 3, 5, and 10-year survival rates of cervical cancer were 76.62% (95% Confidence Interval (CI), 72.91&#95;80.34), 68.77% (95% CI, 64.32&#95;73.21), 62.34% (95% CI, 58.10&#95;66.59), and 61.60% (95% CI, 52.31&#95;70.89), respectively. Additionally, based on the results of meta-regression analysis, there was an association between the year of the study and the survival rate, elucidating that the survival rate of cervical cancer has increased over the years., Conclusions: Results can provide the basic information needed for effective policy making, and development of public health programs for prevention, diagnosis, and treatment of cervical cancer., (© 2023. The Author(s).)

Background: The supraclavicular lymph node (SCN) is a common metastatic site for malignancies of supra and infra-diaphragmatic origin and is easily accessible for small biopsy and fine needle aspiration (FNA). In this study, the utility of SCN biopsies was analyzed for diagnosis and ancillary studies., Methods: The electronic pathology archive was searched for cases of FNA of SCNs accompanied by small core biopsies (1/2016-12/2018). The patients' demographics, diagnosis, and ancillary studies were recorded., Results: Eighty-eight cases were reviewed (49 females and 39 males), with patients' ages ranging from 23 to 84 years (mean = 52.85 years). Fifty-four (61.4%) specimens were from the left SCN and thirty-four (38.6%) from the right. All FNA cases were performed by a radiologist under ultrasound guidance and rapid on-site evaltion (ROSE) was performed by a cytologist. Nineteen cases (21.6%) were benign and sixty-nine cases were malignant (78.4%). Carcinoma was the most common malignant neoplasm (52.3%) including 38.2% (13/34) of the right SCN and 61.1% (33/54) of the left SCN cases. Metastatic lung and breast adenocarcinomas (9.1% each) were the most common carcinomas overall. Lymphoma was the second most common malignancy (17.0%) including 17.6% (6/34) of the right SCN and 16.7% (9/54) of the left SCN cases. The majority of cases were accomponied by ancillary studies for diagnosis and prognostic markers. Ancillary studies included immunostains (63 cases, 71.6%), PD-L1 testing (21 cases, 23.9%), FISH testing (7 cases, 8.0%), flow cytometry (20 cases, 22.7%) and NGS studies (8 cases, 9.1%)., Conclusion: Supraclavicular lymph nodes are easily accessible and diagnostically useful sites for detection of malignancies and molecular alterations responsive to targeted or immune therapy., (© 2023 Wiley Periodicals LLC.)