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Serous fluids offer crucial diagnostic insights, but inconsistent analysis hampers reporting quality, especially in indeterminate (ID) categories like atypia of undetermined significance (AUS) and suspicious for malignancy (SFM). The 2020 International System for reporting Serous Fluid Cytopathology (TIS) aims to standardize communication and reduce reporting disparities. This study evaluates TIS's role in AUS and SFM categories within our institution. A 4-year retrospective search of cytopathology reports from December 2015 to December 2019 for AUS and SFM diagnoses in pleural, ascitic, pericardial fluids, and peritoneal washings was performed and results reclassified using TIS definitions. The risk of malignancy (ROM) was calculated for existing and reclassified diagnoses. Over 4 years, we received 2998 serous fluid specimens. AUS constituted 2.3% (70 cases), while SFM constituted 0.5% (16 cases). Excluding repeats, 80 cases were TIS-reviewed. Sixteen cases of ID diagnoses were reclassified. Two cases of AUS were changed to negative for malignancy (NFM) and 12 to SFM. Two SFM cases were upgraded to malignancy. ROM shifted from 63% to 60% for AUS and 100% to 85% for SF (TIS's ROM range: AUS: 66% ± 10%; SFM: 82% ± 4.8%). This institution's ID diagnosis rate is low. AUS ROM is challenging but aligns with TIS, primarily favoring benign. All SFM diagnoses are highly suspicious but quantitatively inadequate for definitive malignancy, explaining the elevated ROM. AUS rate should gauge quality, not serve as a catch-all category. Algorithmic cytology with cell blocks and ancillary studies aids reclassification. TIS is user-friendly and is a consistent methodology for standardized reporting. Further studies are needed to evaluate ROM and define reproducible diagnostic criteria for each category for better system utilization. • Reclassified indeterminate diagnosis of serous fluids using the criteria published by The International System for Reporting Serous Fluid Cytopathology. • AUS rate should be a quality indicator for each institution and be monitored. • Cell block and immunostain/ancillary studies are helpful in reclassifying indeterminate diagnoses into definitive categories. [ABSTRACT FROM AUTHOR]

Copyright of RumeliDE Journal of Language & Literature Research / RumeliDE Dil ve Edebiyat Araştırmaları Dergisi is the property of RumeliDE Uluslararasi Hakemli Dil & Edebiyat Arastirmalari Dergisi and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Intussusception is the most common paediatric abdominal emergency in young children. Even though red current jelly stool is the pathognomonic feature, it only presents in less than 15% of cases. The clinical diagnosis is often missed as the presentation can mimics others. A recurrent case within 48 hours of reduction is even rare and can be falsely suspected as a normal post-reductive presentation. We highlighted a recurrence of intussusception in a 3-year-old boy, who was initially well after being discharged to home. Medical attention was sought initially but was informed that the clinical presentation could be resolved in a few days. Nevertheless, a second opinion has been sought in view of the persistent frequency pattern. Without delay, readmission of the child was arranged for surgical reduction. Regardless of the mild severity of gastrointestinal symptoms, the possibility of recurrence of intussusception should be suspected despite the presumed success of the initial intervention. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Scientific Development for Studies & Research (JSD) is the property of Journal of Scientific Development for Studies & Research (JSD) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Abstract Background Multiple myeloma is a hematological malignancy of plasma cells belonging to a spectrum of monoclonal protein-secreting disorders known as paraproteinemias. It is classically characterized by accumulated plasma cells in the bone marrow, renal insufficiency, hypercalcemia, and bone lesions (CRAB). Despite studies in the USA indicating that the incidence of multiple myeloma is twice as much in Americans of African descent compared to white Americans and those of Asian descent, African countries have some of the lowest incidence rates and prevalence of the cancer. It is generally thought that this is not entirely factual given the paucity of research into the cancer in sub-Saharan Africa, coupled with other diagnostic challenges such as economic hardships, and poor health-seeking behaviors. In this mini review, we explored the state of multiple myeloma diagnosis across sub-Saharan Africa, outlining the challenges to diagnosis and proposing possible solutions. Main body Due to the lack of routine checkups in people > 40 years across sub-Saharan Africa, monoclonal gammopathy of undetermined significance (MGUS) and smoldering multiple myeloma (SMM) are often accidentally diagnosed. This is due to a very low awareness of multiple myeloma among primary care clinicians and the general population. Other major challenges to multiple myeloma diagnosis across Africa include a chronic shortage of human resource (pathologists, cytotechnologists, and histotechnologists), and a prohibitive cost of diagnostic services that discourages early diagnosis. Conclusion To improve multiple myeloma diagnosis in Africa, a systems approach to thinking among policy makers, philanthropic organizations, and oncologists must be adopted. Governments must invest in health insurance coverage for cancer patients concurrently with heavy investments in human resource training and diagnostic infrastructure scale up. Creative approaches such as digital pathology, online training of clinicians, research and capacity building collaborations among African institutions, European and American institutions, and pharmaceutical companies as seen with other cancers should be explored for multiple myeloma too.

Introduction: Thyroid cytopathology cases with suspicious for malignancy (SFM) diagnosis often result in resection. However, molecular testing offers details that may provide additional insights. In this study, the molecular profiles of SFM cases from two institutions that routinely used ThyroSeq v3 (TSV3) were examined., Materials and Methods: Following institutional review board approval, SFM thyroid cytopathology cases with TSV3 results were retrieved from the databases of two institutions. Molecular information including molecular-derived risk of malignancy (MDROM), cytologic-histologic correlation data, and other related parameters were calculated. Statistical comparisons were made with a p <.05 considered significant., Results: The core data set comprised 114 SFM cases that passed TSV3 quality assurance. All TSV3 results were reported as positive or negative for genomic alterations and all except five cases provided a probability of malignancy estimate. The overall combined baseline MDROM of 75.7% (95% CI, 70.0-81.4) was comparable to the risk of malignancy (74%) published in the Bethesda System. There was a statistically significant difference between the combined MDROMs of resected and unresected cohorts (79.0% vs 58.6%; p = .0153). Interestingly, the MDROMs of the resected cohorts from the two institutions were statistically different (75.0% vs 85.3%; p = .020). Cytologic-histologic correlation revealed malignant outcome in 88.5% of resected cases., Conclusions: Molecular analyses of SFM cases demonstrated higher risk genomic alterations that were associated with histologically overt neoplasms, resulting in increased malignancy outcome compared to baseline. MDROM analysis revealed differences in the cytopathologic practice patterns regarding follicular-patterned neoplasms at the two institutions., (© 2024 American Cancer Society.)

Background: Recently, the Indian Academy of Cytologists (IAC) has published the guidelines for interpretation and reporting of serous effusions. Till date, there are no studies on its applicability. Aims: The present study was carried out to assess the feasibility of applying the IAC reporting categories to effusions, determine the frequency, and provide an estimate of the risk of malignancy (ROM) for individual diagnostic categories. Materials and Methods: All cases of serous effusion fluids reported in the year 2019 were retrieved from the archives and reassigned as per the IAC diagnostic categories. The clinical and histopathological follow-up information was obtained wherever possible. Results: A total of 1340 effusion samples were received from 1085 patients. There were 561 (51.7%) males and 524 (48.3%) females. Majority were pleural (1066, 79.5%), followed by peritoneal (187, 14%) and pericardial (87, 6.5%) effusions. The age ranged from 7 months to 92 years. There were 35 (2.6%) samples in category 1 (non-diagnostic), 954 (71.2%) in category 2 (benign), 17 (1.3%) in category 3 (atypical), 59 (4.4%) in category 4 (suspicious for malignancy) and 275 (20.5%) in category 5 (malignant). The estimated ROM in serous effusion samples was 20% for category 1, 16.7% for category 2, 50% for category 3, 94.4% for category 4 and 100% for category 5. Conclusions: The categorization of serous effusion cytology samples as per the IAC diagnostic categories and as per the reporting format developed by the IAC is feasible and the management recommendations are mostly appropriate.

Background: Digital breast tomosynthesis (DBT) has been developed to improve the detection and characterization of breast lesions and to overcome the limitations of digital mammography. The aim of this work was to highlight the value of DBT in evaluation of suspicious solid breast lesions in comparison with mammography and ultrasonography in patients over 30 years old. Patients and methods: This prospective study included a total of 50 females who had 54 suspicious solid breast lesions, and all patients were evaluated by mammography, tomosynthesis, and ultrasound. Their age ranging from 30 to 90 years old with mean age±SD was 58.8±12.7 years. All radiological findings were compared with the final histopathology diagnosis, which was the gold standard for our study. Results: The sensitivity of tomosynthesis was 96%, the specificity was 75%, the positive predictive value (PPV) was 98%, the negative predictive value (NPV) was 60%, and the accuracy was 94%. While the sensitivity of digital mammography was 92%, the specificity was 50%, the PPV was 95%, the NPV was 33%, and the accuracy was 88%. Breast ultrasound showed the highest sensitivity in our study where the sensitivity of ultrasound was 98%, the specificity was 100%, the PPV was 100%, the NPV was 80%, and the accuracy was 98%. Conclusion DBT technique can improve the clinical performance of mammography by increasing the sensitivity and specificity. It overcomes the limitation of mammography caused by tissue overlapping. Thus, it can provide better tissue visualization by its characteristic capability of producing three-dimensional nonoverlapped tissue information. [ABSTRACT FROM AUTHOR]

This study is entitled Noldeke’s Claims About the Sahabah “the Companions of the Prophet Mohammed” in His Book “The History of the Quran”. This study’s critical approach discussed the views and fallacies of Noldeke in his book “The History of the Quran”. Noldeke’s book included many contests and suspicions related to the collection of the Quran and the method of receiving it. Consequently, this has made it necessary to detect these contests and clarify their motives and aims using a critical and scientific approach. The study followed a critical analysis approach and consists of three parts: An introduction, two studies, and a conclusion. In the conclusion, the most important findings were included. There was an obvious bias from Orientalists against Islam and its scholars on the one hand and against the Sahabah (the companions of the prophet Mohammed peace be upon him) on the other hand. [ABSTRACT FROM AUTHOR]

Study Objective: The objective of the study was to estimate the diagnostic accuracy and doctor satisfaction of small caliber office cervicoscopy versus stationary colposcopy in diagnosis of ectocervical as well as endocervical lesions in women clinically presented with suspicious cervix. Patients and Methods: Eligible 112 cases with clinically suspicious cervix were randomized into Group A (56 cases) and Group B (56 cases) who were subjected to small caliber office cervicoscopy and stationary colposcopy, respectively. The outcome was the diagnostic accuracy and safety of both tools for detection of ectocervical and endocervical cervical lesions. Results: There was no statistically significant difference between both groups regarding parity, previous abortion, age at marriage, duration of marriage, and age at menarche and menopause. On unaided naked eye examination of the cervix (UNEE), there were no statistically significant differences between both groups. Diagnostic indices were similar in both groups apart from the finding that office cervicoscopy was more sensitive for detection of endocervical abnormalities. Doctors were significantly more satisfied with stationary colposcopy than office cervicoscopy. Conclusions: Office cervicoscopy is a good complementary tool added to stationary colposcopy for detection of cervical lesions in cases with suspicious cervix as an example of high-risk group for cervical cancer. Due to its small caliber, cervicoscopy offers a better evaluation of the endocervical canal, especially in cases of Type 2 and 3 transformation zone with a possibility of examination of the endometrial cavity.

Background: Recently, the Indian Academy of Cytologists (IAC) has published the guidelines for interpretation and reporting of serous effusions. Till date, there are no studies on its applicability. Aims: The present study was carried out to assess the feasibility of applying the IAC reporting categories to effusions, determine the frequency, and provide an estimate of the risk of malignancy (ROM) for individual diagnostic categories. Materials and Methods: All cases of serous effusion fluids reported in the year 2019 were retrieved from the archives and reassigned as per the IAC diagnostic categories. The clinical and histopathological follow-up information was obtained wherever possible. Results: A total of 1340 effusion samples were received from 1085 patients. There were 561 (51.7%) males and 524 (48.3%) females. Majority were pleural (1066, 79.5%), followed by peritoneal (187, 14%) and pericardial (87, 6.5%) effusions. The age ranged from 7 months to 92 years. There were 35 (2.6%) samples in category 1 (non-diagnostic), 954 (71.2%) in category 2 (benign), 17 (1.3%) in category 3 (atypical), 59 (4.4%) in category 4 (suspicious for malignancy) and 275 (20.5%) in category 5 (malignant). The estimated ROM in serous effusion samples was 20% for category 1, 16.7% for category 2, 50% for category 3, 94.4% for category 4 and 100% for category 5. Conclusions: The categorization of serous effusion cytology samples as per the IAC diagnostic categories and as per the reporting format developed by the IAC is feasible and the management recommendations are mostly appropriate. [ABSTRACT FROM AUTHOR]

Copyright of IUG Journal of Islamic Studies is the property of Islamic University of Gaza and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Methotrexate (MTX) is one of the potent drugs for autoimmune diseases (ADs), especially for rheumatoid arthritis. Recent studies suggest that MTX should be immediately withdrawn when patients with AD develop lymphoproliferative disorder (LPD). However, biopsy cannot be performed for diagnosis because LPD regresses quickly after MTX withdrawal, thus making clinical MTX-LPD (c-MTX-LPD) challenging to diagnose. In this study, among the 28 patients with c-MTX-LPD, seven developed a proven LPD (p-LPD) after suspicious LPD (s-LPD) regression, six of which were Hodgkin lymphoma. Four of seven patients with p-LPD + died, whereas all patients with p-LPD– survived. The clinical manifestations indicative of p-LPD include fever, elevated serum C-reactive protein level, and soluble interleukin-2 receptor level. Anti-AD drugs did not appear to affect the pathogenesis of p-LPD development. P-LPD was not observed after 3 years from the time of s-LPD regression. [ABSTRACT FROM AUTHOR]

Study Objective: The objective of the study was to estimate the diagnostic accuracy and doctor satisfaction of small caliber office cervicoscopy versus stationary colposcopy in diagnosis of ectocervical as well as endocervical lesions in women clinically presented with suspicious cervix. Patients and Methods: Eligible 112 cases with clinically suspicious cervix were randomized into Group A (56 cases) and Group B (56 cases) who were subjected to small caliber office cervicoscopy and stationary colposcopy, respectively. The outcome was the diagnostic accuracy and safety of both tools for detection of ectocervical and endocervical cervical lesions. Results: There was no statistically significant difference between both groups regarding parity, previous abortion, age at marriage, duration of marriage, and age at menarche and menopause. On unaided naked eye examination of the cervix (UNEE), there were no statistically significant differences between both groups. Diagnostic indices were similar in both groups apart from the finding that office cervicoscopy was more sensitive for detection of endocervical abnormalities. Doctors were significantly more satisfied with stationary colposcopy than office cervicoscopy. Conclusions: Office cervicoscopy is a good complementary tool added to stationary colposcopy for detection of cervical lesions in cases with suspicious cervix as an example of high-risk group for cervical cancer. Due to its small caliber, cervicoscopy offers a better evaluation of the endocervical canal, especially in cases of Type 2 and 3 transformation zone with a possibility of examination of the endometrial cavity. [ABSTRACT FROM AUTHOR]

Recently, more and more attentions have been applied to rumor spreading, and the reaction of each individual to the rumor appears to be different. Considering the reactions of the susceptible person first time hearing the rumors, in this paper, we divide the whole people in the network into four groups: the susceptible, the believable, the incubative and the uninterested. S I b I n I u rumor spreading model is proposed in both homogeneous networks and heterogeneous networks. By mean-field equations and numerical simulations in both networks, theoretical analysis and the simulation results demonstrate that both losing-interest rate and stifling rate exert negative effect on final rumor spreading scale. • We divide the whole people in the network into four groups. • S I b I n I u rumor spreading model is proposed in both homogeneous networks and heterogeneous networks. • By mean-field equations and numerical simulations in both networks. • The both losing-interest rate and stifling rate exert negative effect on final rumor spreading scale. [ABSTRACT FROM AUTHOR]

Background: In 1996, National Cancer Institute (NCI) proposed five categories for the diagnosis of breast cytology in order to bring a degree of uniformity to the diagnostic reporting. Of these, categories 3 and 4 were sparsely studied. Aims: The present study was undertaken for the evaluation of the fine needle aspiration cytology (FNAC) categories of C3 and C4 in the breast lump and its histopathological correlation. Materials and Methods: In the retrospective study, a total number of 728 FNACs were categorized according to the NCI; of these, 28 cases of category C3 and 65 cases of category C4 were compared with histopathological diagnoses. Results: On histopathological examination of category C3, 18 (64.3%) cases showed benign lesions and 10 (35.7%) cases showed malignancy and among the C4 category, benign lesions found in nine (13.8%) and malignancy found in 56 (86.2%) cases. There was a significant statistical difference between the number of benign and malignant diagnoses for cytological categories of C3 (64.3%) and C4 (86.2%) (P < 0.001). The sensitivity, specificity, positive predictive value, and negative predictive value of C4 category in the diagnoses of malignancy were 84.8%, 66.7%, 86.2%, and 64.3%, respectively. Conclusion: FNAC of the breasts is a simple, cost-effective, accurate, quick, and relatively less painful procedure, and it continues to play an integral part in the management of breast lesions. Our study concluded that there was a statistically significant difference between the number of benign and malignant diagnoses for categories of C3 and C4.

Introduction Indeterminate “atypical” or “suspicious for malignancy” diagnoses in the evaluation of pancreatic fine-needle aspiration (FNA) specimens can present challenges in the clinical management of patients with pancreatic masses. A main goal of this study was to identify, via survey, potential differences in perception between cytologists and clinicians with regard to the implications of, and factors contributing to, indeterminate diagnoses. We also evaluated clinical practice at our institution as it relates to such diagnoses and identified clinicopathologic features associated with indeterminate diagnoses, which allowed for correlation with survey results. Materials and Methods Online surveys were sent to cytologists and clinicians to gather information on the respondents’ experiences with pancreatic endoscopic ultrasound-guided FNA and their perceptions about the indeterminate diagnostic categories. Cytological specimens and patient medical records were reviewed to collect data on specimen acquisition, cytological features, tumor characteristics, and patient management. Results Survey responses revealed that cytologists and clinicians held similar perceptions of the clinical impact of the indeterminate categories but had dissimilar ideas on the factors contributing to these diagnoses. Statistically significant associations were identified between indeterminate diagnoses and the following variables: number of passes performed; adequacy on rapid on-site evaluation; repeat FNA procedures; lesions with cystic changes; and well-differentiated tumor cytomorphology. Conclusions Awareness of the perceptions of cytologists and clinicians about, as well as the clinical features and cytologic variables associated with, “indeterminate” cases has the potential to improve patient care. [ABSTRACT FROM AUTHOR]

Introduction A comparison of the long-term risk of malignancy between indeterminate cytological diagnoses, namely, atypical versus suspicious for malignancy, from endoscopic ultrasound-guided (EUS) fine-needle aspiration (FNA) of a pancreatic mass has not been well characterized. The primary aim of this study was to compare the risk of malignancy between patients with such indeterminate diagnoses. Secondarily, we investigated whether serologic markers serve as predictors of risk of malignancy in the setting of indeterminate cytological diagnoses. Materials and methods We reviewed 484 cases of EUS-FNA on solid pancreatic lesions, performed at a single academic tertiary care center from 2004 to 2017. Patients with solid pancreas mass lesions who had atypical or suspicious final cytology were identified for further clinical outcome analysis. Results Of the 484 patients with pancreas mass lesions, 53 (11%) were given an indeterminate final cytologic diagnosis, with 28 atypical and 25 suspicious for malignancy. Follow-up was completed for 22 and 20 patients from atypical and suspicious diagnoses, respectively. Of patients with follow-up, 15 (68%) and 18 (90%) had subsequent diagnoses of malignancy from atypical and suspicious groups, respectively. There was no statistical difference in predicting risk of malignancy between the two groups ( P = 0.24). Serologic markers were available in 29 of 42 patients with follow-up. Serologic markers were elevated in 21 of 29 patients and all were subsequently diagnosed with malignancy. Elevated serologic markers correlated with future risk of malignancy ( P = 0.0026). Conclusion The risk of subsequent malignancy is high for both atypical and suspicious pancreatic solid lesions but there exists no statistical difference between the two. Combined serologic markers with indeterminate cytology proved to be a good predictor of malignancy. [ABSTRACT FROM AUTHOR]

BACKGROUND: Urinary tract cytology (UTC) specimens diagnosed using high‐risk indeterminate categories such as “atypical urothelial cells, cannot exclude high‐grade urothelial carcinoma” (AUC‐H) or “suspicious for high‐grade urothelial carcinoma” (SHGUC) have a high rate of detection of high‐grade urothelial carcinoma on subsequent biopsy. Although urologists are familiar with such terminology, it is unclear whether patients receive appropriate follow‐up when UTC is ordered by nonurologists. In the current study, the authors investigated whether the use of AUC‐H versus SHGUC altered patient management among nonurologists. METHODS: Specimens signed out as AUC‐H or SHGUC were identified from the archives of the study institution, which included periods of time before the use of the standardized Johns Hopkins Hospital template, during use of the Johns Hopkins Hospital template, and after institution of The Paris System for Reporting Urinary Cytology. RESULTS: Approximately one‐half of the specimens diagnosed as AUC‐H were not investigated further when ordered by nonurologists. Patients with specimens diagnosed as AUC‐H received fewer subsequent biopsies (14% vs 53%; P < .001) when the specimens were ordered by nonurologists versus urologists, despite having similar rates of high‐grade urothelial carcinoma on follow‐up biopsy (67% vs 66%). When specimens ordered by nonurologists were diagnosed as SHGUC, these patients received more follow‐up (100%) compared with those whose specimens were diagnosed as AUC‐H (44%; P < .001). Patients with specimens ordered by nonurologists also received more follow‐up biopsies when these were diagnosed as suspicious (60%) compared with patients whose specimens were diagnosed as AUC‐H (14%; P < .001). CONCLUSIONS: Use of the word “suspicious” for the high‐risk indeterminate category results in greater follow‐up among nonurologists ordering UTC specimens. Cancer Cytopathol 2018;126:282‐8. © 2018 American Cancer Society. [ABSTRACT FROM AUTHOR]

BACKGROUND: Fine‐needle aspiration (FNA) cytology is well accepted as a safe, reliable, minimally invasive, and cost‐effective method for the diagnosis of salivary gland lesions. Salivary gland neoplasms are often difficult to diagnose because of morphologic heterogeneity and a variety of epithelial metaplastic changes. Hence, a number of salivary gland FNA specimens yield indeterminate results. For indeterminate FNA specimens, the suspicious‐for‐malignancy (SFM) category is used when a specific neoplasm falls short in quantity or quality for the criteria for malignancy. Therefore, the findings are not sufficient for a conclusive diagnosis of malignancy. METHODS: This study was designed to evaluate the risk of malignancy (ROM) for the SFM group at 5 tertiary medical centers worldwide with the aforementioned criteria. Among 12,606 salivary gland FNA cases between 1997 and 2014, 276 (2.2%) were reported to be SFN. Specifically, 114 suspicious cases (41%) had histological follow‐up. RESULTS: Histological follow‐up of the 114 suspicious cases showed 95 malignant tumors indicating a risk of malignancy (ROM) of 83.3%. The ROM varied between 74% and 88% for the 5 participating institutions, and a Fisher's exact test with significance set to p<.05 showed no significant difference in ROM among the institutions (p = .78). CONCLUSIONS: Overall, 83.3% of SFM salivary gland FNA specimens turned out to be malignant; there was no significant interinstitutional variability in the ROMs. The SFM category for salivary gland FNA is very homogeneous, and the ROMs are quite similar worldwide. Cancer Cytopathol 2018;126:94‐100. © 2017 American Cancer Society. [ABSTRACT FROM AUTHOR]

Copyright of Law of Ukraine / Pravo Ukraini is the property of Editorial Board of Journal "Law of Ukraine" and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Pediatric autopsy is an effective tool for identifying the cause and the manner of death in suspicious childhood deaths. To explore the pattern of suspicious childhood deaths during the recent years (2020–2021) in the Egyptian community and to identify the risk factors to avoid them during the childhood period. One hundred and fifty Egyptian suspicious child death cadavers (less than 18 years old) were autopsied in Zeinhom Morgue during one-year period (2020–2021). Demographic data, circumstances of death, causes and manner of death were defined and statistically analyzed. Identity was known in 77.3% of the studied cases, and male to female ratio was 2.2:1. Most of cases were recruited from Cairo and Giza governorates. Adolescents contributed to about one third of the cases. Deaths at home or in hospital were more than outdoor deaths. Seasonal variation was observed as more cases were autopsied during spring and summer. Homicidal deaths (32%) were more in toddlers and adolescents mostly by blunt trauma (58.3%) with signs of violence and resistance or child abuse, mainly in males. The perpetrator was known to be a family member in more than half of the studied cases (56.25%). Accidental deaths (17.3%) were mainly by firearm injuries or poisoning. Suicidal deaths (13.3%) were represented more in adolescents by hanging or by aluminum phosphide poisoning. Natural deaths (13.3%) by bronchopneumonia or leukemia were found in neonates and adolescents. Sudden infant death syndrome (SIDS) (6.7%) was diagnosed by exclusion among neonates and infants only during spring, with equal gender distribution (1:1). Malpractice (6%) leads to death by sepsis or hemorrhage. All manners of death contribute to suspicious death during childhood period, especially during summer and spring. Family members are the perpetrator for most of accidental, homicidal or suicidal deaths. Training courses are recommended to parents for proper care and protection of their children to avoid violence, abuse and accidents at home or outdoor. • Family members are responsible for most of accidental, homicidal or suicidal childhood deaths. • Homicidal deaths were more in toddlers and adolescents. • Accidental deaths were mainly by firearm injuries or poisoning. • Suicidal deaths were represented more in adolescents by hanging or by aluminum phosphide poisoning. [ABSTRACT FROM AUTHOR]

Routing Protocol for Low Power and Lossy Networks (RPL) has been standardized by the Internet Engineering Task Force to efficiently manage the functions of the network layer when providing Internet connectivity for wireless sensor networks. RPL has been designed for constrained devices and networks. Owing to their constrained nature, RPL-based networks can be exposed to a wide variety of security attacks. One of the most serious attacks in RPL is a black hole attack, where a malicious node silently drops all the packets that it is supposed to forward. This paper proposes a mitigation technique against black hole attack with low packet loss and high reliability. The proposed technique consists of a local decision and a global verification process. First, each node observes the communication behavior of its neighboring nodes by overhearing packets transmitted by its neighbors and attempts to identify suspicious nodes based on their behavior. In the second process, if a node identifies a suspicious node, then it verifies whether the suspicious node is a black hole. We demonstrate that the proposed approach increases packet delivery rate significantly and detects black hole attack effectively. Copyright © 2016 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

This research is about the relationship between principals' personality characteristics and their effectiveness in Sarab guidance and high schools during 2004 - 2005. The statistical population consisted of 290 teachers and 27 managers. The sampling metod was random stratified. For data gathering we used two types of questionnaires with 0.94 reliability. In this research,7 hypotheses were tested by (t-test), and the correlation coefficient and the results indicate there is a meaningful difference between the effectiveness of the principals with warmhearted and coldhearted personalities, and also between the effectiveness of the principals with suspicious and trustful personalities. But there is no meaningful correlation between the principals' effectiveness and objective thought and, there is no meaningful difference between the male and female principals' effectiveness.

BACKGROUND The objective of the current study was to assess how the suspicious category is followed up in a large endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) service, its outcomes, and the predictors that are likely to be associated with the subsequent diagnosis of a neoplastic process. METHODS For pancreatic EUS-FNA samples with the suspicious category diagnosis, the authors reviewed the electronic medical record for the method of follow-up and the risks associated with pancreatic malignancy. Logistic regression analysis was used to determine the risk factors that were likely to be associated with the diagnosis of a neoplastic lesion after a cytologic diagnosis of 'suspicious.' RESULTS Of a total of 3832 EUS-FNA cases, 116 were diagnosed with suspicious cytology. A total of 90 of 98 neoplasms (92%) were identified, including 72 carcinomas (73%). Similar rates of neoplasia were detected after repeat FNA (34 of 37 neoplasms [92%]) and subsequent biopsy/surgical resection (44 of 46 neoplasms [96%]), but significantly fewer neoplasms were detected among patients with clinical follow-up (18 of 23 neoplasms [78%]). On multivariate analysis of the potential predictive variables listed above, the presence of a mass was found to be significantly associated with a higher rate of diagnosis of a neoplasm, whereas weight loss was significantly associated with a diagnosis of carcinoma. CONCLUSIONS The diagnostic category of 'suspicious' is associated with a high risk of benign and malignant neoplasms, regardless of the method of follow-up. The presence of a mass and weight loss are significant predictors of a subsequent diagnosis of a neoplasm after suspicious cytology. In patients with suspicious cytology and these findings, surgery is recommended for resectable masses and repeat FNA for unresectable masses. Cancer (Cancer Cytopathol) 2016;124:53-57. © 2015 American Cancer Society. [ABSTRACT FROM AUTHOR]

In the rules of evidence in all legal jurisdictions, medical experts are required to maintain objectivity when providing opinions. When interpreting medical evidence, doctors must recognise, acknowledge and manage uncertainties to ensure their evidence is reliable to legal decision-makers. Even in the forensic sciences such as DNA analysis, implicit bias has been shown to influence how results are interpreted from cognitive and contextual biases unconsciously operating. In cases involving allegations of child abuse there has been significant exposure in the media, popular magazines, legal journals and in the published medical literature debating the reliability of medical evidence given in these proceedings. In these cases judges have historically been critical of experts they perceived had sacrificed objectivity for advocacy by having an investment in a ‘side’. This paper firstly discusses the issue of bias then describes types of cognitive biases identified from psychological research applied to forensic evidence including adversarial bias, context bias, confirmation bias and explains how terminology can influence the communication of opinion. It follows with previously published guidelines of how to reduce the risk of bias compromising objectivity in forensic practices then concludes with my own recommendations of practices that can be used by child protection paediatricians and within an organisation when conducting forensic evaluations of suspicious childhood injury to improve objectivity in formulation of opinion evidence. [ABSTRACT FROM AUTHOR]

Wireless multi-hop networks are often exposed to serious physical layer jamming attack. In this attack, the jammer node corrupts the packet by injecting high level of noise and keeps the channel busy and thus blocks the legitimate communication. If multiple jammers collude together, this attack will become very severe. To prevent this attack, a simple yet effective Reliability Behavior Neuro-Fuzzy system has been proposed and it operates in three modules. In module one, each route node obtains its behavior value from the route path and neighboring paths using direct and indirect behavior observations. In module two, based on the behavior value, three factor identification methods have been presented to identify the reliability value of nodes. In module three, using the reliability value the route nodes are level positioned and classified into groups by a neuro-fuzzy classifier. By simulation studies, it is observed that the proposed scheme significantly not only identifies misbehaving nodes with higher detection rate and lower false positive and but also achieves higher network throughput and lower jamming throughput. [ABSTRACT FROM AUTHOR]