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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
Sat Sep 20 2025
Journal Name
Al–bahith Al–a'alami
The role of witchery and astrology programs in spreading illusion and myth
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« The emergence of satellite channels has led to fundamental changes in the supposed role of television, making it a center of culture and an important tributary to social upbringing and influencing the attitudes and values of individuals and in making public opinion regarding various issues, some television programs target ordinary people at home by virtue of the nature of their subjects, where there is a large audience of viewers, who consume and absorb what is offered to them from the cultural production of those satellite channels that play with the aspirations of groups of society to find metaphysical or magic solutions to their social problems or psychological delusions. The media, through its various messages, contributes to brin

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Publication Date
Wed Jun 28 2023
Journal Name
Al–bahith Al–a'alami
The Role of Ethnographic Programs on Documentary Channels in Enhancing Audience Knowledge
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This research investigates the engagement of the Iraqi audience with ethnographic programs and their impact on knowledge enhancement and intellectual perspectives. A questionnaire consisting of closed-ended questions was designed and administered to a purposive sample of 400 participants who exclusively follow ethnographic programs and documentary channels. The data were transcribed and subjected to statistical analysis using the SPSS software to ensure reliability and test hypotheses. The findings revealed that Al Jazeera Documentary Channel had the highest viewership percentage among respondents for ethnographic programs, while DW (Deutsche Welle) had the lowest viewership percentage. This suggests that Al Jazee

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Publication Date
Sun Jan 01 2023
Journal Name
Corporate And Business Strategy Review
The role of learning organizations in crisis management strategy: A case study
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The problem of the paper focused on the role of the learning organization in the crisis management strategy, and the extent of the actual interest in both the learning organization and the crisis management and aimed at diagnosing and analyzing that and surrounding questions. The Statistical Package for the Social Sciences (SPSS) program was used to calculate the results and the correlation coefficient between the two main variables. The methodology was descriptive and analytical. The case study was followed by a questionnaire that was distributed to a sample of 31 teachers. The paper adopted a seven-dimensional model of systemic thinking that encourages questioning, empowerment, provision of advanced technologies, and strategic lea

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Publication Date
Mon Jan 01 2024
Journal Name
Aip Conference Proceedings
The role of road elements in providing a safe environment for pedestrians
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In the years recently city planning projects have been confirmed sustainable high concentration on planning streets and pedestrian paths being the most prominent component of the urban structure in the city and these me and diverse departments link the city’s sectors and serve as a space for economic, service, and social activities. On the other hand, pedestrian traffic is an essential component of the various means of transportation within the city. Suffer cities in the Middle East and Arab cities in particular are neglecting pedestrian paths in the vital urban environment. Vehicle control mechanisms on roads, and changing the uses of pedestrian paths as result of encroaching on the sidewalks designated for pedestrians. Which leads to a

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Publication Date
Sun Dec 20 2020
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
The role of the external audit in improving the performance of the services provided: Applied research in the municipal directorate in ALMuthanna
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The subject of improving the performance of services provided by government institutions of the important topics at the present time because of their direct contact at the service of citizens and the increased importance of these units as a result of the diversity of activities performed by the so governments of the countries and their people made sure to pay attention to the good use of those allocated to those sectors of resources and spending in the service prescribed and manage the highest level of efficiency and effectiveness and monitor the proper management of the money used in those sectors and evaluate their performance through the Supreme Audit Institutions so that they can play their role oversight and contribute to th

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Publication Date
Fri Oct 28 2022
Journal Name
Political Sciences Journal
The protest movements in Sudan and their role in the political and social transformation
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This study investigates the factors that led to the outbreak of protest movements in Sudan, since Sudan’s independence in 1956 until December 2018. The study aims to identify the role of protests in bringing about political and social transformations in Sudan, besides identifying the factors that help in the success or failure of the governments that resulted from those protests, with special emphasis on the challenges of the government of the 2018 revolution. The main results of the study reveal that the December 2018 protests are the largest in term of numbers, and witness huge participation of youth and women, and the slogans raised were national and comprehensive. However, the challenges that the transitional government is going th

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Publication Date
Wed May 13 2015
Journal Name
Elsevier Procedia Economics And Finance
The Role of FDI Inflows in Economic Growth in Malaysia (Time Series: 1975-2010)
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Recently, Malaysia has been recognized as one of the most popular destinations for Foreign Direct Investment (FDI) in Southeast Asia. But how do these FDI inflows affect Malaysia economy? This paper aims to identify the role of FDI inflows in Malaysia economic growth through a proposed endogenous growth model. Annual data covers from 1975 to 2010. Unit root test and Johansen Co-integration test are adopted to respectively verify the time series data is stable and the linear combination of the variables is stationary. Hierarchical Multiple Regressions (HMR) Analysis is then conducted to find out the momentum of the Malaysia economic growth including FDI inflows. The results show that the FDI inflows together with the human capital deve

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Publication Date
Tue Dec 11 2018
Journal Name
Iraqi National Journal Of Nursing Specialties
Nurses' Knowledge and Role in the Management of Thalassemic Patients in Sulaimania Thalassemia Center
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The aim of this study is to assess nurse's knowledge and role in the management of thalassemic patients in the Sulaimania Thalassemia Centre. Methodology: This study utilized a qualitative approach to explore nurses’ knowledge about thalassemia through semi structured group interviews. Questionnaire was synthesized through a comprehensive review of literature. Results: The results show that nurses in Kurdistan region of Iraq have a limited role in terms of decision making and there is lack of nursing documentation other than that of recording abnormal events, and a lack of knowledge about and engageme

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Publication Date
Sat Sep 20 2025
Journal Name
Imam Ja&#39;afar Al-sadiq University Journal Of Legal Studies
The role of fluctuations and crises in stock markets in activating market makers models
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Publication Date
Sun Dec 01 2019
Journal Name
Iop Conference Series: Materials Science And Engineering
Place dependence as the physical environment role function in the place attachment
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Abstract<p>This research sheds light on the physical environment role in creating the place attachment, by discussing one of the important factors in the attachment creation, it is the concept place dependence, consisting of two important dimensions: the place quality and the place expectation; they contain a number of the supporter physical environment sub-indicators for place attachment. Eight physical indicators were reached; they were found to have a close relationship to the place attachment, including: the open and green spaces existence, land use diversity, diversity of housing types, dwelling / population density, accessibility, transport network development degree, transport multiple mo</p> ... Show More
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