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The Role of Strain Elastography in Evaluating Borderline Axillary Lymph nodes
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Background: Axillary lymph node (ALN) enlargement with diffuse cortical thickening and conserved echogenic hilum may represent a diagnostic and therapeutic challenge. Sonographic strain elastography may help the characterization of borderline ALN. 

Aim: To evaluate the strain elastography of borderline ALN and to calculate a cutoff value of strain ratio (SR) that can identify suspicious ALN with the highest sensitivity and specificity to reduce unnecessary invasive procedures. 

Subjects and Methods: A prospective study included 45 patients who attended the Breast clinic in Oncology Teaching Hospital with borderline axillary lymphadenopathy (intact hilum and diffusely thickened cortex more than 3mm) who had normal ipsilateral breast, suspicious ipsilateral breast lesion, or who had ipsilateral mastectomy. B-mode sonography and elastography were performed for all participants. Four-point elasticity score (ES), and SR were obtained for the targeted lymph node followed by ultrasound-guided fine need aspirate (FNA) biopsy..

Results: Malignant ALN constituted 20% of the cohort. B mode measurements were not able to differentiate between cytologically confirmed benign and malignant ALN in terms of axis ratio (mean ± standard deviation, 0.46 ± 0.08 vs 0.50 ± 0.12) and cortical thickness (4.88 ± 1.93 vs 6.27 ± 2.46). The mean SR of all samples was 2.66 ± 2.25.  Metastatic ALN depicted significantly higher SR (P<0.0001), with 88.9% exhibiting ES score 3 and 4. None of the metastatic ALN had ES score 1. ROC curve was used to investigate the utility of SR as a diagnostic tool. The area under the curve (AUC) was 0.906 with a 95% CI of 0.814-0.997, P<0.001. SR cutoff of 2.1 was chosen with 100% sensitivity and 66.7% specificity.

Conclusion: High proportion of borderline ALNs are not malignant. Strain elasticity can improve the risk stratification of such cases and prevent unnecessary invasive procedures. We suggested an algorithm that could better tackle borderline ALN which will need further evaluation

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Publication Date
Tue May 07 2019
Journal Name
Journal Of Planner And Development
the role of the economy in protecting the environment from pollution and decision_making
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The economic dimensions of environmental issues are complex and unclear in many cases, there is a kind of confusion in the real relationship between economic growth and environmental regulations. Many of the negative environmental impacts are accompanied by human activities and urban and industrial development in the city, and that many of the projects that did not take into account the environmental factors during the planning and implementation of them can be detrimental, as well as natural environments, archeological sites, historical or scientific value, aesthetic or educational. It also describes the Global Environment Outlook that if current trends continue, population growth, economic growth and consumption patterns, the p

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Publication Date
Fri Dec 31 2021
Journal Name
Journal Of Peace For Humanities And Social Sciences Jphsc
The role of the contract Duration in the pre-contract stage " Comparative study"
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Time crosses one of the most important principles that are agreed upon in contracts, because the temporal dimension has a significant impact on all contract provisions and is not limited to a certain group of them. French and Arab legal jurists alike called for this dimension to be given special attention. That is the term of the contract term; To try to limit the temporal elements, clarify their provisions and distinguish between them, but in the Arab world it did not receive the same attention that it received in the West.

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Publication Date
Tue Mar 22 2022
Journal Name
Journal Of Al-turath University College
The Turkish role in the US-Iran Crisis (2017-2020)
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New developments imposed different patterns of interactions between major international powers and Iran during 2018, ranging to varying degrees between cooperation and tension, the most important of which is the new measures taken by the United States to withdraw from the nuclear agreement and impose new US sanctions on Iran, which in turn insisted on not responding to pressure to which they are exposed to make changes in their policies and to negotiate again about the main contentious files, especially the nuclear program and ballistic missiles, and the roles they play for crisis countries, especially supporting some armed organizations in Syria, Lebanon, Iraq and Yemen. These differences have put the international forces before difficult

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Publication Date
Mon Apr 01 2019
Journal Name
Journal Of Educational And Psychological Researches
The role of the woman in protecting children from wrong behavioral deviations
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Wrong behavioral deviations among youth witnessed an obvious growing, some of these deviations are, robbery, drug and internet addiction, and smoking. Additionally, intellectual extremism and the disrespect of the traditions and genuine customs, In light of this issue, the research aims to shed light on the educational and preventative role of the woman in protecting and immunizing children from the wrong behavioral deviations. The woman has a significant and influential role in the society in general and in her family, in particular to the responsibility lies on her. The research shed light on the manifestations of behavioral deviation in children and the mechanisms of prevention and treatment. The research concluded with a set of recom

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Publication Date
Mon Feb 01 2016
Journal Name
Journal Of Economics And Administrative Sciences
Audit strategies and their role in the quality of the business audit
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Increased the need to promote the profession of auditing, and improving the performance of the audit process, which comes through the effective implementation of its tasks, where the auditor collects the necessary data about the nature of client activity, and any other information it deems necessary to carry out the planning and development of the strategy for how to determine the procedures for implementing the audit process and the scope and timing for evidence clues in order to form an opinion technician neutral about the fairness of the financial statements, as required by the standards of the field work of the planning and supervision of the internal control and evidence to prove, but the failure of the auditor whether in th

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Publication Date
Fri Dec 15 2023
Journal Name
Al-academy
The role of artificial intelligence in revolutionizing the clothing and textile industry
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 The integration of AI technologies is revolutionizing various aspects of the apparel and textile industry, from design and manufacturing to customer experience and sustainability. Through the use of artificial intelligence algorithms, workers in the apparel and textile industry can take advantage of a wealth of opportunities for innovation, efficiency and creativity.
The research aims to display the enormous potential of artificial intelligence in the clothing and textile industry through published articles related to the title of the research using the Google Scholar search engine. The research contributes to the development of the cultural thought of researchers, designers, merchants and the consumer with the importance of integ

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Publication Date
Wed Jun 03 2020
Journal Name
Political Sciences Journal
The role of the strategic culture variable in negotiations (Brexit a model)
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      Negotiations are distinguished in that they are an easy and simple means between the conflicting parties, and it is an effective means at the same time as the conflicting parties seek understanding on the most effective way to solve their dispute, but negotiations are not always appropriate to resolve international disputes, especially when there is a disparity in power between the negotiating countries, or when it is missing Goodwill, or even when one of the parties is absent or less flexible, and the internal circumstances of one of the conflicting countries may play a negative or positive role in the success of the negotiations, away from the influence of the role of external variables in that, a

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Publication Date
Wed Aug 01 2018
Journal Name
Journal Of Economics And Administrative Sciences
Social orientation of the marketing and its role in the competitive strategies
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     This research shed light on the relationship between the social orientation of the marketing (interests of the Organization ,the welfare of society, satisfaction the customer) strategies competitive dimensions of (cost leadership strategy, differentiation strategy, focus and strategy), As well as to to seek to achieve a number of knowledge and applied goals, and represented the field research problem extent of interesting researched the application of social orientation and interest in achieving competitive strategy and omission of this interest in the hotels the surveyed Organization, Based on this problem, and to clarify the relationshi

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Publication Date
Thu Dec 26 2019
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
The effective role of computer information systems in the tax assessment process
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The objective of this study is to enable the role of modern and advanced computerized information systems. The model or mechanism should be developed by collecting the necessary information about the taxpayers and the sources of the taxpayers' income, on the basis of which the accuracy of the inventory process will be adopted. In addition to studies related to computerized information systems and showing their importance to the tax institution. To achieve the objectives of the study and to answer its questions, the researcher relied on collecting data and information on the subject on the literature and previous studies The secondary sources, which also formed the theoretical framework of the study, were obtained either as a practical fr

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Publication Date
Sat Jun 01 2019
Journal Name
Journal Of Economics And Administrative Sciences
The auditor's qualifications and their role in the quality of professional performance
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Abstract

The aim of the research is to clarify the requirements of the qualification of the external auditor in Iraq and the extent of their impact on the quality of the professional performance of the audit process. The research was based on analyzing the results of the questionnaire prepared for the impact of qualifications on the quality of professional performance. The researcher has reached a number of conclusions, the most important of which is that a highly qualified and unethical auditor has a greater negative impact on the quality of professional performance than those with low qualifications. The most important recommendations of the research were the need to pay

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