Background: Breast cancer is the most common cancer in Iraq and the United Kingdom. While the disease is frequently diagnosed among middleaged Iraqi women at advanced stages accounting for the second cause of cancer-related deaths, breast cancer often affects elderly British women yielding the highest survival of all registered malignancies in the UK. Objective: To compare the clinical and pathological profiles of breast cancer among Iraqi and British women; correlating age at diagnosis with the tumor characteristics, receptor-defined biomarkers and phenotype patterns. Methods: This comparative retrospective study included the clinical and pathological characteristics of (1,940) consecutive female patients who were diagnosed with invasive breast cancer from 2014 to 2016 in Iraq (Medical City Teaching Hospital, Baghdad: 635 cases) and UK (John Radcliffe, Oxford and Queen's, BHR University Hospitals: 1,305 cases). The studied parameters in both groups comprised the age of the patient at the time of diagnosis, breast cancer histologic type, grade, tumor size, lymph node status, clinical stage at presentation, Estrogen Receptor (ER), Progesterone Receptor (PR) and HER2 positive tumor contents and the receptor defined breast cancer surrogate subtypes. Results: The Iraqi patients were significantly younger than their British counterparts and exhibited higher trend to present at advanced stages; reflected by larger size tumors and frequent lymph node involvement compared to the British (p<0.00001). They also had worse receptor-defined breast cancer subtypes manifested by higher rates of hormone receptor (ER/PR) negative, HER2 positive tumor contents, Triple Positive and Triple Negative phenotypes (p<0.00001). Excluding HER2 status, the significant differences in the clinical and tumor characteristics between the two populations persisted after adjusting for age among patients younger than 50 years. Conclusion: The remarkable differences in the clinical and tumor characteristics of breast cancer between the Iraqi and British patients suggest heterogeneity in the underlying biology of the tumor which is exacerbated in Iraq by the dilemma of delayed diagnosis. The significant ethnic disparities in breast cancer profiles recommend the prompt strengthening of the national cancer control plan in Iraq as a principal approach to the management of the disease.
In this paper, three tool paths strategies; iso-planar, helical and adaptive have been implemented to investigates their effect on the mechanical properties of Brass 65-35 formed by single point incremental sheet metal forming process. To response this task, a fully digital integrated system from CAD modeling to finished part (CAD/CAM) for SPIF process has been developed in this paper.
The photo-micrographs shows an identical grain formation due to the plastic deformation of the incremental forming process, change in the grain shape and size was observed. It's found that the adaptive tool path play a significant role to increase the hardness of the formed specimen from (48 to 90 HV) and the grain texture of the formed specimen found a
The uniform flow distrbiution in the multi-outlets pipe highly depends on the several parameters act togather. Therefor, there is no general method to achieve this goal. The goal of this study is to investigate the proposed approach that can provide significant relief of the maldistribution. The method is based on re-circulating portion of flow from the end of the header to reduce pressure at this region . The physical model consists of main manifold with uniform longitudinal section having diameter of 152.4 mm (6 in), five laterals with diameter of 76.2 mm (3 in), and spacing of 300 mm. At first, The experiment is carried out with conventional manifold, which is a closed-end. Then, small amount of water is allowed
... Show MoreThere is a global shortage of health care providers needed to address all levels of primary and specialty care. The recent COVID-19 pandemic also highlights the importance and added value of health professionals with specialty training in infectious diseases. In the United States, advanced practice providers (APPs) are being engaged to meet the expanding demand for generalist and specialist patient care. The history and development of advanced practice registered nurses (APRNs) and physician assistants (PAs), are discussed as collaborative healthcare providers to promote better understanding of the ways they can be incorporated into a healthcare system. An example of how APPs are utilized to provide both inpatient and outpatient
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The aim of the research is to identify the effect of instructional design according to Kagan structure among the first intermediate school student’s, and how skills could help in generating information in mathematics. In accordance with the research objectives, the researcher has followed the experimental research method by adopting an experimental design with two equivalent groups of post-test to measure skills in generating information. Accordingly, the researcher raised two main null hypotheses: there were no statistically significant differences at the level of significance (0.05) between the average scores of the experimental group who studied the material according to Kagan structure and th
... Show MoreAutomatic Programming Assessment (APA) has been gaining lots of attention among researchers mainly to support automated grading and marking of students’ programming assignments or exercises systematically. APA is commonly identified as a method that can enhance accuracy, efficiency and consistency as well as providing instant feedback on students’ programming solutions. In achieving APA, test data generation process is very important so as to perform a dynamic testing on students’ assignment. In software testing field, many researches that focus on test data generation have demonstrated the successful of adoption of Meta-Heuristic Search Techniques (MHST) so as to enhance the procedure of deriving adequate test data for efficient t
... Show MoreAlthough its wide utilization in microbial cultures, the one factor-at-a-time method, failed to find the true optimum, this is due to the interaction between optimized parameters which is not taken into account. Therefore, in order to find the true optimum conditions, it is necessary to repeat the one factor-at-a-time method in many sequential experimental runs, which is extremely time-consuming and expensive for many variables. This work is an attempt to enhance bioactive yellow pigment production by Streptomyces thinghirensis based on a statistical design. The yellow pigment demonstrated inhibitory effects against Escherichia coli and Staphylococcus aureus and was characterized by UV-vis spectroscopy which showed lambda maximum of
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