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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 Feb 09 2019
Journal Name
Journal Of The College Of Education For Women
The Turn-Taking System in American Presidential Debates
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The organization and coordination of any communication is based on the system of turn-taking which refers to the process by which a participant in a conversation takes the role of speaker. The progression of any conversation is achieved by the change of roles between speaker and hearer which, in its turn, represents the heart of the turn-taking system. The turn-taking system is not a random process but it is a highly organized process governed by a set of rules. Thus, this system has certain features and rules which exist in any English communicative process. These rules, if applied by speakers, help to achieve successful exchange of turns in any conversation. This paper attempts to present full exposition of the concepts of conversation

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Publication Date
Fri Oct 28 2022
Journal Name
مجلة العلوم السياسية
Decentralization in Iraq: Addressing The State – Society Gap
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The implementation of decentralization in Iraq was asymmetrical, leading to different forms and paces of implementation. Comparing four cases of Basra, Kirkuk, Nineveh, and Sulaymaniyah indicate that these cases differ in their political stability and autonomy in a way that led to a different forms of decentralization. This paper argues that the higher the level of political autonomy from the federal government, the more efficient the governance model, and the more efficient the governance model, the more legitimate the system (trust), and the more legitimate a system, the more accountable elected officials. Therefore, it recommends reforming the institutional setup of decentralization by having districts, instead of provinces, as t

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Publication Date
Thu Oct 30 2008
Journal Name
College Of Islamic Sciences
Qarun In the Holy Quran "": An analytical study
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For in the Holy Qur’an there are vivid examples and speaking models that tell stories of the tyrants who filled the world with tyranny and overwhelmed it with tyranny, and the Holy Qur’an presents these proverbs to people, not so that they may be amused by them, but rather so that they consider and bite with them. For every tyrannical tyrant, he lives within a framework of self-loss, according to him from life he lives and suffices, even without attachment to a principle or an ideal, and in the world of the unconscious with his whims, without any regard for death that is closer to him than his jugular vein, or for an account that does not leave small or great Therefore, the title of my research came to this (Qarun in the Holy Qur’a

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Publication Date
Thu Sep 15 2022
Journal Name
Al-academy
The semiotic approach in analyzing contemporary graphic text
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With a great diversity in the curriculum contemporary monetary and visions, and development that hit the graphic design field, it has become imperative for the workers in the contemporary design research and investigation in accordance with the intellectual treatises and methods of modern criticism, because the work design requires the designer and recipient both know the mechanics of tibographic text analysis in a heavy world of texts and images varied vocabulary and graphics, and designer on before anyone else manages the process of analysis to know what you offer others of shipments visual often of oriented intended from behind, what is meant, in the midst of this world, the curriculum Alsemiae directly overlap with such diverse offer

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Publication Date
Thu Sep 17 2020
Journal Name
College Of Islamic Sciences
Human values and principles in the three religions
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The laws of the three religions tend to extend the rules and foundations of coexistence, and this is achieved in achieving the values and principles that these laws have nourished in all societies.

Our research deals with a major problem that has broken out in our societies, namely (disturbing the balance of values and behavioral standard between people), and perhaps one of the greatest causes of the problem is to move away from the correct divine discourse and sound approach, as well as corruption of common sense and the violation of its rules and found principles in the hearts of people.

 

 

 

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Publication Date
Wed Feb 05 2020
Journal Name
Political Sciences Journal
“The constitutional- political structures in Iraq after 2003”
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It is obvious that the constitutional- political structures which has been emerged in Iraq after the occupation in 2003 frame worked by many sectarian, ethnic, tribal and political orientations, pushing forewords to escalating the contradictions between social- political powers, however, these changes unfortunately result not just destroy and taking apart the political regime and his authority, but the state and his institutions as well, although, did not stamped as wise and rational change for better future to new Iraq and its political, civil and military institutions. Finally, as quick as Iraq start to bisects to sectarian, ethnic and national components according to the new political – social components of Iraq. Indeed, what is req

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Publication Date
Mon Jan 02 2017
Journal Name
Al-academy
Trend in the iconic structures plates Ottoman calligraphers
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Means the current research study in the direction iconic structures plates Ottoman calligraphers , as they took turn in this area and because it excelled in the form of a strong incentive and motivation to seek calligraphers in this direction so as to simulate the skill of the artist and parallel to the side of his creativity as well.And iconography , RECEIVED of objective vision and aesthetic and semantic in the output of compositions written according to the specific significance and this has a clear impact on the propensity to develop technical and aesthetic and expressive in the output of the structure of synthetic iconography is limited by rules or building in the form of public panel linear . And that all forms , whether animal , h

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Publication Date
Sun Nov 01 2020
Journal Name
Indonesian Journal Of Electrical Engineering And Computer Science
Utilizing the ATM technology in e-distance learning
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<p>There is an Increasing demand for the education in the field of E-learning specially the higher education, and to keep contiuity between the user and the course director in any place and time. This research presents a proposed and simulation multimedia network design for distance learning utilizing ATM technique. The propsed framework determines the principle of ATM technology and shows how multimedia can be integrated within E- learning conteext. The first part of this research presents a theoretical design for the Electricity Department, university of technology. The purpose is to illustrate the usage of the ATM and Multimedia in distance learning process. In addition, this research composes two entities: Software entity

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Publication Date
Wed Dec 30 2015
Journal Name
College Of Islamic Sciences
Phonological features   For spoken text in the language
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This research attempted to take advantage of modern techniques in the study of the superstructural phonetic features of spoken text in language using phonetic programs to achieve more accurate and objective results, far from being limited to self-perception and personal judgment, which varies from person to person.
    It should be noted that these phonological features (Nabr, waqf, toning) are performance controls that determine the fate of the meaning of the word or sentence, but in the modern era has received little attention and attention, and that little attention to some of them came to study issues related to the composition or style Therefore, we recommend that more attention should be given to the study of

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Publication Date
Tue Sep 01 2015
Journal Name
Almustansyria Journal Of Arts
Presupposition in Poe’s Short story “The Black Cat
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The notion of presupposition has been tackled by many linguists. They have found that the term ―presupposition” is being used in two different senses in the literature: semantic and pragmatic. As for semantic sense, Geurts (1999) has isolated some constrictions as sources of presupposition by making lists of presupposition triggers. Concerning the pragmatic sense Kennan (1971:89) uses the term pragmatic presupposition to refer to a class of pragmatic inferences which are, in fact, the relation between a speaker and the appropriateness of a sentence in the context. In spite of the fact that there are many researches that have been done in the field of presupposition but few of them in the field of short stories up to the researcher's kno

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