Preoperative Prediction of Muscle Invasiveness in Bladder Cancer: The Role of 3D Volumetric Radiomics Using Diffusion-Weighted MRI, the VI-RADS Score, or a Combination of Both.

BACKGROUND: Bladder cancer treatment decisions hinge on detecting muscle invasion. The 2018 "Vesical Imaging Reporting and Data System" (VI-RADS) standardizes multiparametric MRI (mp-MRI) use. Radiomics, an analysis framework, provides more insightful information than conventional methods. PURPOSE: To determine how well MIBC (Muscle Invasive Bladder Cancer) and NMIBC (Non-Muscle Invasive Bladder Cancer) can be distinguished using mp-MRI radiomics features. METHODS: We conducted a study with 73 bladder cancer patients diagnosed pathologically, who underwent preoperative mp-MRI from January 2020 to July 2022. Utilizing 3D Slicer (version 4.8.1) and Pyradiomics, we manually extracted radiomic features from apparent diffusion coefficient (ADC) maps created from diffusion-weighted imaging. The LASSO approach identified optimal features, and we addressed sample imbalance using SMOTE. We developed a classification model using textural features alone or combined with VI-RADS, employing a random forest classifier with 10-fold cross-validation. Diagnostic performance was assessed using the area under the ROC curve analysis. RESULTS: Among 73 patients (63 men, 10 women; median age: 63 years), 41 had muscle-invasive and 32 had superficial bladder cancer. Muscle invasion was observed in 25 of 41 patients with VI-RADS 4 and 5 scores and 12 of 32 patients with VI-RADS 1, 2, and 3 scores (accuracy: 77.5%, sensitivity: 67.7%, specificity: 88.8%). The combined VI-RADS score and radiomics model (AUC = 0.92 ± 0.12) outperformed the single radiomics model using ADC MRI (AUC = 0.83 ± 0.22 with 10-fold cross-validation) in this dataset. CONCLUSION: Before undergoing surgery, bladder cancer invasion in muscle might potentially be predicted using a radiomics signature based on mp-MRI.

Risk Factors of Open Surgery Conversion in Laparoscopic Partial Nephrectomy to Achieve Nephron Sparing.

OBJECTIVES: We aimed to evaluate the risk factors for the conversion from laparoscopic partial nephrectomy (LPN) to open surgery to achieve partial nephrectomy (PN). METHODS: Data from patients who underwent LPN between June 2020 and September 2023 were analyzed retrospectively. Patients in whom the PN procedure could be completed laparoscopically were recorded as the 'Fully Laparoscopic' (FL) group (n = 97), and those converted to open surgery from laparoscopy were recorded as the 'Conversion to Open' (CTO) group (n = 10). The demographic and pathologic variables were compared between groups. Regression analyses were used to define predictor factors, and receiver operating characteristic analysis was used to define the cut-off value of the surgical bleeding volume. RESULTS: Conversion to open surgery was found in 10/107 patients (9.3%). There was no statistical difference between groups in demographic and pathologic variables. Intraoperative blood loss volume, upper pole localized tumor, and posterior localized tumor were found to be statistically higher in the CTO group (p = 0.001, p = 0.001, and p = 0.043, respectively). Furthermore, these factors were only found to be statistically significant predictors of conversion to open surgery in both univariate and multivariate regression analyses. 235 cc was found to be the cut-off value of intraoperative blood loss volume for predicting conversion to open surgery (p = 0.001). CONCLUSION: Using these predictive factors in clinical practice, treatment planning will lead to the possibility of starting the treatment directly with open surgery instead of minimally invasive options, and it may also provide a chance of being prepared for the possibility of conversion to open surgery peroperatively.

A New Nephrometry Score for Predicting Positive Surgical Margin After Laparoscopic Partial Nephrectomy.

PURPOSE: To introduce the KESKIN ratio as a novel predictor of positive surgical margin (PSM) after laparoscopic partial nephrectomy (PN) and to evaluate other clinical characteristics and nephrometry scores (including RENAL, PADUA, and C-index) for predicting PSM. METHODS: We retrospectively analyzed 95 patients who underwent laparoscopic PN between June 2020 and April 2023. The KESKIN ratio was defined for all patients. The KESKIN ratio, tumor and patient-related paramaters, and nephrometry scores were analyzed to predict PSM. RESULTS: Positive surgical margin was found in 12 of 95 patients (12.6%). There was no statistical difference between the PSM and negative surgical margin (NSM) groups in RENAL, PADUA, and C-index scores. Only the KESKIN ratio was found to be a statistically significant predictor of PSM in both univariate and multivariate regression analysis (p = 0.007 and p = 0.043, respectively). Mean endophytic diameter and endophytic percentage were found to be statistically significant predictors of PSM in only univariate analysis (p = 0.005 and p = 0.01, respectively). The value of 0.5 was determined as the cut-off value for the KESKIN ratio. Values higher than 0.5 indicate an increase in PSM. CONCLUSIONS: The KESKIN ratio is a novel, easily measurable, and calculable image-based parameter that can be used to predict PSM after laparascopic PN. If externally validated in a larger patient population, the KESKIN ratio may be used in future versions of the current nephrometry scoring systems for predicting the PSM.

Spontaneous intracranial hypotension: Exploring the viability of non-contrast FLAIR as a substitute for contrast-enhanced T1WI in assessing pachymeningeal thickening.

PURPOSE: To avoid contrast administration in spontaneous intracranial hypotension (SIH), some studies suggest accepting diffuse pachymeningeal hyperintensity (DPMH) on non-contrast fluid-attenuated inversion recovery (FLAIR) as an equivalent sign to diffuse pachymeningeal enhancement (DPME) on contrast-enhanced T1WI (T1ce), despite lacking thorough performance metrics. This study aimed to comprehensively explore its feasibility. METHODS: In this single-center retrospective study, between April 2021 and November 2023, brain MRI examinations of 43 patients clinically diagnosed with SIH were assessed using 1.5 and 3.0 Tesla MRI scanners. Two radiologists independently assessed the presence or absence of DPMH on FLAIR and DPME on T1ce, with T1ce serving as a gold-standard for pachymeningeal thickening. The contribution of the subdural fluid collections to DPMH was investigated with quantitative measurements. Using Cohen's kappa statistics, interobserver agreement was assessed. RESULTS: In 39 out of 43 patients (90.7%), pachymeningeal thickening was observed on T1ce. FLAIR sequence produced an accuracy, sensitivity, specificity, positive predictive value, and negative predictive value of 72.1%, 71.8%, 75.0%, 96.6%, and 21.4% respectively, for determining pachymeningeal thickening. FLAIR identified pachymeningeal thickening in 28 cases; however, among these, 21 cases (75%) revealed that the pachymeningeal hyperintense signal was influenced by subdural fluid collections. False-negative rate for FLAIR was 28.2% (11/39). CONCLUSION: The lack of complete correlation between FLAIR and T1ce in identifying pachymeningeal thickening highlights the need for caution in removing contrast agent administration from the MRI protocol of SIH patients, as it reveals a major criterion (i.e., pachymeningeal enhancement) of Bern score.

Clinical and radiographic performance of preformed zirconia crowns and stainless-steel crowns in permanent first molars: 18-month results of a prospective, randomized trial.

BACKGROUND: The treatment of young permanent first molars with extensive carious tissue loss may often require restoration with preformed crowns. This study compared the clinical and radiographic performance of stainless-steel crowns (SSCs) and preformed zirconia crowns (ZCs). METHODS: Forty-eight molar incisor hypomineralisation (MIH)- or caries-affected permanent molars in 20 healthy patients between 6-13-year-old were randomly divided into ZC and SSC groups (n = 24 teeth/group) in a split-mouth design. The oral hygiene levels of patients were assessed using Greene and Vermillion simplified oral hygiene index (OHI-S). Plaque accumulation and gingival health were evaluated using the Silness&Löe plaque index (PI) and Löe&Silness gingival index (GI), respectively. Clinical retention, marginal extension level, marginal adaptation of crowns and wear of the antagonist teeth were assessed at baseline, 1, 6, 12 and 18 months. The radiological assessments for evaluating the marginal adaptation of crowns and periapical pathology of crowned teeth were performed at 6 and 12 months. The data were analyzed using Kaplan-Meier analysis, Mann-Whitney U test, and two-way ANOVA. RESULTS: A total of forty teeth in 17 children were evaluated for 18 months. ZCs had significantly lower gingival and plaque index values than teeth restored with SSCs during all evaluation periods (p < 0.05). Neither crown type resulted in clinically-detectable wear on opposing dentition or periapical pathology. One ZC was lost at 13 months, while all SSCs survived in function clinically. The cumulative survival rates of ZCs and SSCs were 95.2% and 100% respectively. CONCLUSIONS: Both ZCs and SSCs showed high clinical retention rates in young permanent molars. ZCs had lower plaque accumulation and better gingival health than SSCs, which were consistently associated with mild gingival inflammation. CLINICAL TRIAL REGISTRATION NUMBER: NCT05049694.

Do Patients Really Have Pain with Quadriceps Fat Pad Edema?

OBJECTIVE: To determine the appropriate MRI criteria for the radiological diagnosis of significant quadriceps fat pad edema, to investigate the relationship between these criteria and anterior knee pain, and to evaluate possible structural and positional factors in the etiology. MATERIAL AND METHODS: In this retrospective case-control study, individuals with and without quadriceps fat pad edema in the knee MRIs taken between May 2016 and December 2018 were determined as the case and control groups, respectively, in a ratio of 1:1. The MRI criteria for significant quadriceps fat pad edema were set as 10 mm and above the anterior-posterior diameter of the quadriceps fat pad, posterior convexity, and an increased signal in the fat-suppressed proton density sequence. The groups were compared for anterior knee pain, pain characteristics, working positions (sitting and standing), and MRI findings of structural factors. P < 0.05 was considered statistically significant. RESULTS: A total of 108 individuals were evaluated. Anterior knee pain was more common in the case group (49/54, p < 0.001) and was highly correlated with signs of quadriceps fat pad edema (R = -0,657). Frequent pain at night (18/54, p = 0.013), increased pain when walking upstairs (40/54, p = 0.003), knees are flexed (43/54, p < 0.001), and decreased pain when knees are extended (42/54, p < 0.001) were significantly high in the case group. No significant differences were observed in working position and structural factors. CONCLUSION: Quadriceps fat pad edema is significantly associated with anterior knee pain and certain specific pain characteristics.

Pediatric Penile Bee Sting.

OBJECTIVES: The aims of this study, for the first time in the literature, are to evaluate the symptoms, clinical course, and treatment management of penile bee stings in children and to discuss whether bee stings can be evaluated within the scope of summer penile syndrome. METHODS: Records of all pediatric patients presented to the emergency department of our hospital from June 2020 to October 2021 due to bee sting of penis were reviewed. Only patients with isolated penile bee stings were included in the study. Patients were evaluated in terms of the age at presentation, time of occurrence, symptoms, and treatment modality. RESULTS: There were 10 patients treated for penile bee sting. Patients ranged in age from 3 to 7 years (mean, 4.2 years). The most common complaints of the patients at presentation were pain (100%), swelling (100%), and dysuria (70%). Three of the patients were unable to void. The gauze moistened with warm saline was applied to the penis of these patients who developed glob, and all of these patients urinated after the warm application. Three of the patients had progressive erythema on the penile skin. These patients were admitted to the pediatric surgery department to monitor whether skin necrosis would develop. In all patients, the erythema regressed significantly within 48 hours and regained its completely normal appearance at the end of 72 hours. CONCLUSIONS: The probability of the development of serious local reactions and urological problems in penile bee stings is low. Oral nonsteroidal anti-inflammatory drug and warm, wet dressing are usually sufficient to treat local reactions. Penile bee stings may be evaluated within the scope of summer penile syndrome because their symptoms, clinical findings, and treatments are almost similar.

Comparative analysis of the light parameters of red and near-infrared diode lasers to induce photobiomodulation on fibroblasts and keratinocytes: An in vitro study.

BACKGROUND: Photobiomodulation (PBM) depends on the use of non-ionizing light energy to trigger photochemical changes, particularly in light-sensitive mitochondrial structures. It triggers proliferation and the metabolic activity of the cells, primarily by utilizing the energy from the near-infrared to the red wavelength of the light. PURPOSE: This in vitro study has analyzed comparatively the most appropriate energy doses and wavelengths to induce PBM on keratinocytes and fibroblasts for the accelerated wound healing process. METHODS: 1, 3, and 5 J/cm2 energy densities of 655 and 808-nm diode lasers were used to promote cell proliferation and wound healing process. Scratch assay and MTT analysis were performed on keratinocytes and fibroblasts for wound closure and cell proliferation after the triple light applications, respectively. RESULTS: 655-nm of wavelength was more successful on keratinocytes to induce wound healing and cell proliferation, whereas 808-nm of wavelength was so effective on fibroblasts to heal the wounds totally and it induced cell proliferation almost 3 times compared to the untreated control group. CONCLUSION: This study revealed that PBM with 655 and 808 nm of wavelengths was effective to speed up the wound healing process at specific energy densities. In general 808-nm of wavelength was more successful. However, the proper wavelength and the energy density may differ according to the cell type. Thus, every light parameter should be chosen properly to obtain better outcomes during PBM applications.

Assessment of food consumption changes in adolescents during orthodontic treatment.

INTRODUCTION: This study aimed to evaluate the changes in food consumption in adolescents during orthodontic treatment. METHODS: Twenty-five adolescents aged between 12 and 18 years participated in the study. Before the treatment, the participants were interviewed, and their food consumption frequency and 24-hour retrospective food consumption records were taken. Participants were followed up for 3 months, that is, in the first, fourth, and 12th week of the treatment. In the interviews, questions about food consumption changes and posttreatment pain were asked to the participants, and 24-hour retrospective food consumption records were obtained. RESULTS: When the food consumption records of the adolescents before the orthodontic treatment and at the first week, first month, and third month of the active orthodontic treatment were compared, there was no significant difference between total energy, protein, and carbohydrate intake. However, total fat intake decreased in the first week of treatment and increased significantly during the treatment period (P = 0.05). There was a significant decrease in the amount of fiber (P = 0.039), vitamin E (P = 0.043), and vitamin C (P = 0.048) intake of patients during the orthodontic treatment. CONCLUSIONS: Nutrition and feeding habits are important for growth and development in adolescence. In adolescents having orthodontic treatment, vitamin C, vitamin E, and fiber intake decreased significantly, especially in the first weeks of treatment. The intake of these nutrients did not return to their initial levels by the 12th week of the orthodontic treatment. It is thought that cooperation with dietitians and orthodontists might minimize the undesired nutritional effects of the orthodontic treatment.

Is Body Adiposity Index a Better and Easily Applicable Measure for Determination of Body Fat?

Objective: The BAI can be used to reflect %body fat. This study aimed to compare BAI with other methods used in the determination of body fat.Materials and Methods: A cross-sectional study was conducted in Turkish adults. BAI, BMI, WHR, WHtR, body weight, hip and waist circumference (WC), skinfold thicknesses (biceps, triceps, subscapular, suprailiac) were measured. Body fat was measured using Bioelectric Impedance Analysis.Results: The Bland-Altman analyses conducted in this study showed that for % body fat estimations, BIA was in excellent agreement with skinfold measurements (p = 0.131) without proportional bias (p = 0.082), but that BAI was not in agreement with BIA and skinfold measurement. There were a statistically significant positive correlation between BAI and other measurements in terms of females and males and also regardless of sex.Conclusion: BAI was not in agreement with BIA and skinfold measurement methods for % body fat estimations, it had a significantly stronger correlation with % fat calculated using BIA and skinfold thickness.

Laparoscopic Management of an Early Postoperative Pelvic Abscess Caused by Prevotella bivia Following a Deep Infiltrating Endometriosis Surgery.

Surgery for deep-infiltrating endometriosis (DIE) carries a high risk of complications, including pelvic abscesses. We would like to present the laparoscopic management of a pelvic abscess caused by Prevotella bivia following a radical hysterectomy in a DIE laparoscopic surgery. A 43-year-old G2P2 lady underwent a laparoscopic hysterectomy, bilateral ureterolysis, bilateral parametrial nodule extirpation, and rectal shaving following complaints of severe dysmenorrhea, dyspareunia, and chronic pelvic pain due to deep-infiltrating endometriosis (ENZIAN score: P2; 02/3; T2/2; A3; B3/2; C2; FA) (American Association of Gynecologic Laparoscopists (AAGL) score: 72, Stage 4). She received intravenous antibiotic treatment at the hospital with a diagnosis of pelvic inflammatory disease one month before the endometriosis surgery. After the extensive laparoscopic surgery, the early postoperative period was uneventful; however, starting on the fourth postoperative day, she was complaining of abdominal pain. On the seventh postoperative day, severe left-sided abdominal pain, fever, nausea, vomiting, rising levels of C-reactive protein (CRP > 200 mg/dL), and signs of septicemia were observed. The vaginal examination revealed a purulent discharge. Bacterial cultures were obtained from the vaginal cuff and peripheral vein. On the computerized tomography scan, neither a bowel nor ureter injury was found, but a pelvic abscess above the vaginal cuff and left ureteral compression below the pelvic brim were observed. Due to the clinical deterioration of the patient despite receiving piperacillin/tazobactam antibiotic therapy, the decision was made to perform a repeat laparoscopy to prevent septic shock and ureteral stent application for urinary tract obstruction. During the laparoscopy, purulent fluid was discovered around the pelvic peritoneum, and it was noted that the rectosigmoid colon was edematous and tightly adherent to the pelvic sidewalls. The rectosigmoid colon was carefully detached from the pelvic sidewalls; the left ureter was released, and the purulent abscess material from the vaginal cuff was aspirated. Every effort was made to remove as many yellowish plaques covering the pelvic peritoneum and rectum serosa as possible. Recovery following surgery was rapid. P. bivia was detected in the blood culture, and the patient was treated with piperacillin/tazobactam for an additional seven days, resulting in a complete resolution of the illness. Pelvic abscess is a rare but serious complication that can occur following laparoscopic deep-infiltrating endometriosis surgery. To prevent ending up with septicemia and septic shock, further laparoscopic surgery may be necessary.

Hyperactivating EZH2 to augment H3K27me3 levels in regulatory T cells enhances immune suppression by driving early effector differentiation.

The immunosuppressive function of regulatory T (Treg) cells is essential for maintaining immune homeostasis. Enhancer of zeste homolog 2 (EZH2), a histone H3 lysine 27 (H3K27) methyltransferase, plays a key role in maintaining Treg cell function upon CD28 co-stimulation, and Ezh2 deletion in Treg cells causes autoimmunity. Here, we assess whether increasing H3K27me3 levels, by using an Ezh2Y641F gain-of-function mutation, will improve Treg cell function. We find that Treg cells expressing Ezh2Y641F display an effector Treg phenotype, are poised for improved homing to organ tissues, and can accelerate remission from autoimmunity. The H3K27me3 landscape and transcriptome of naive Ezh2Y641F Treg cells exhibit a redistribution of H3K27me3 modifications that recapitulates the gene expression profile of activated Ezh2WT Treg cells after CD28 co-stimulation. Altogether, increased H3K27me3 levels promote the differentiation of effector Treg cells that can better suppress autoimmunity.

Increased EZH2 function in regulatory T cells promotes their capacity to suppress autoimmunity by driving effector differentiation prior to activation.

The immunosuppressive function of regulatory T (Treg) cells is essential for maintaining immune homeostasis. Enhancer of zeste homolog 2 (EZH2), a histone H3 lysine 27 (H3K27) methyltransferase, plays a key role in maintaining Treg cell function upon CD28 co-stimulation, and Ezh2 deletion in Treg cells causes autoimmunity. Here we assessed whether increased EZH2 activity in Treg cells would improve Treg cell function. Using an Ezh2 gain-of-function mutation, Ezh2 Y641F , we found that Treg cells expressing Ezh2 Y641F displayed an increased effector Treg phenotype and were poised for improved homing to organ tissues. Expression of Ezh2 Y641F in Treg cells led to more rapid remission from autoimmunity. H3K27me3 profiling and transcriptomic analysis revealed a redistribution of H3K27me3, which prompted a gene expression profile in naïve Ezh2 Y641F Treg cells that recapitulated aspects of CD28-activated Ezh2 WT Treg cells. Altogether, increased EZH2 activity promotes the differentiation of effector Treg cells that can better suppress autoimmunity. Highlights: EZH2 function promotes effector differentiation of Treg cells.EZH2 function promotes Treg cell migration to organ tissues.EZH2 function in Treg cells improves remission from autoimmunity.EZH2 function poises naïve Treg cells to adopt a CD28-activated phenotype.

Reproducibility of rCBV in glioblastomas using T2*-weighted perfusion MRI: an evaluation of sampling, normalization, and experience.

PURPOSE: The reproducibility of relative cerebral blood volume (rCBV) measurements among readers with different levels of experience is a concern. This study aimed to investigate the inter-reader reproducibility of rCBV measurement of glioblastomas using the hotspot method in dynamic susceptibility contrast perfusion magnetic resonance imaging (DSC-MRI) with various strategies. METHODS: In this institutional review board-approved single-center study, 30 patients with glioblastoma were retrospectively evaluated with DSC-MRI at a 3.0 Tesla scanner. Three groups of reviewers, including neuroradiologists, general radiologists, and radiology residents, calculated the rCBV based on the number of regions of interest (ROIs) and reference areas. For statistical analysis of feature reproducibility, the intraclass correlation coefficient (ICC) and Bland-Altman plots were used. Analyses were made among individuals, reader groups, reader-group pooling, and a population that contained all of them. RESULTS: For individuals, the highest inter-reader reproducibility was observed between neuroradiologists [ICC: 0.527; 95% confidence interval (CI): 0.21-0.74] and between residents (ICC: 0.513; 95% CI: 0.20-0.73). There was poor reproducibility in the analyses of individuals with different levels of experience (ICC range: 0.296-0.335) and in reader-wise and group-wise pooling (ICC range: 0.296-0.335 and 0.397-0.427, respectively). However, an increase in ICC values was observed when five ROIs were used. In an analysis of all strategies, the ICC for the centrum semiovale was significantly higher than that for contralateral white matter (P < 0.001). CONCLUSION: The inter-reader reproducibility of rCBV measurement was poor to moderate regardless of whether it was calculated by neuroradiologists, general radiologists, or residents, which may indicate the need for automated methods. Choosing five ROIs and using the centrum semiovale as a reference area may increase reliability for all users.

Phytoactive Molecules and Nanodelivery Approaches for Breast Cancer Treatment: Current and Future Perspectives.

One of the most common malignancies in women, breast cancer accounts for nearly 25% of all cancer cases. Breast cancer is a diverse cancer form that exhibits variability in both morphology and molecular characteristics, and is linked to numerous risk factors. Although various approaches and research are ongoing in the treatment and prevention of breast cancer, medication resistance in the current breast cancer treatment contributes to the disease's relapse and recurrence. Phytoactive molecules are the subject of growing research in both breast cancer prevention and treatment but currently used conventional medicines and techniques limit their application. Recent years have seen significant advancements in the field of nanotechnology, which has proven to be essential in the fight against drug resistance. The transport of synthetic and natural anticancer molecules via nanocarriers has recently been added to breast cancer therapy, greatly alleviating the constraints of the current approach. In light of these developments, interest in nano-delivery studies of phytoactive molecules has also increased. In this review, research of phytoactive molecules for breast cancers along with their clinical studies and nanoformulations, was presented from current and future perspectives.

Nanodelivery Approaches of Phytoactives for Skin Cancers: Current and Future Perspectives.

In recent years, there has been an increase in skin cancers due to external factors, especially environmental factors, and studies on treatment alternatives have gained importance. Nanomaterials are common, from sunscreen formulas to formulations designed to treat skin cancers at various stages. Using bioactives has multiple effects in treating skin cancers, which provides many advantages. In this regard, many phytochemicals gain importance with their antioxidant, anti-proliferative, anti-inflammatory, antiangiogenic, and analgesic effects. Their delivery with nanocarriers is on the agenda for phytochemicals to gain the targeted stability, effectiveness, and toxicity/safety properties. This review presents types of skin cancers, phytochemicals effective in skin cancers, and their nanocarrier-loaded studies from an up-to-date perspective.

Can Only the Shape Feature in Radiomics Help Machine Learning Show That Bladder Cancer Has Invaded Muscles?

OBJECTIVES: The presence of muscle invasion is an important factor in establishing a treatment strategy for bladder cancer (BCa). The aim of this study is to reveal the diagnostic performance of radiomic shape features in predicting muscle-invasive BCa. METHODS: In this study, 60 patients with histologically proven BCa who underwent a preoperative MRI were retrospectively recruited. The whole tumor volume was segmented on apparent diffusion coefficient (ADC) maps and T2W images. Afterward, the shape features of the volume of interest were extracted using PyRadiomics. Machine learning classification was performed using statistically different shape features in MATLAB® (The MathWorks, Inc., Natick, Massachusetts, United States). RESULTS: The findings revealed that 27 bladder cancer patients had muscle invasion, while 33 had superficial bladder cancer (53 men and seven women; mean age: 62±14). Surface area, volume, and relevant features were significantly greater in the invasive group than in the non-invasive group based on the ADC maps (P<0.05). Superficial bladder cancer had a more spherical form compared to invasive bladder cancer (P=0.05) with both imaging modalities. Flatness and elongation did not differ significantly between groups with either modality (P>0.05). Logistic regression had the highest accuracy of 83.3% (sensitivity 82.8%, specificity 84%) in assessing invasion based on the shape features of ADC maps, while K-nearest neighbors had the highest accuracy of 78.2% (sensitivity 79.1%, specificity 69.4%) in assessing invasion based on T2W images. CONCLUSIONS: Shape features can be helpful in predicting muscle invasion in bladder cancer using machine learning methods.

Teacher Questioning to Promote Extended Language Use for Preschool Emergent Bilinguals.

PURPOSE: Emergent bilinguals (EBs) from Spanish-speaking households are a sizable and quickly growing segment of the preschool population in the United States. However, there is limited research on the provision of opportunities for EBs to engage in language-rich classroom discussion, particularly in English-dominant contexts where most EBs attend preschool. This study focused on teacher and Spanish-English EBs' language interactions in an English-dominant preschool program to better understand whether and, if so, how teachers' use of questioning strategies provided extended oral language use opportunities for Spanish-speaking EBs in their classrooms. METHOD: We adopted a sequential-explanatory mixed-methods design to examine audio recordings from whole-group instruction across seven preschool classrooms and investigate how EBs responded to teachers' conversationally responsive questioning strategies, with a specific focus on how they used Spanish as they composed extended responses. Researchers coded 31 audio recordings from 12 EB students to identify teachers' (n = 7) use of questioning strategies (closed-response, open-response, and single-word-response), as well as students' responses to questions (one-word-response or extended response) and Spanish use. RESULTS: Teachers' use of closed-response and single-word-response questions emerged as most important in supporting Spanish-English EBs' extended language use during whole-group instruction. Furthermore, the majority of student responses that included Spanish utterances were extended responses, underscoring the value of Spanish use for students to develop extended responses. CONCLUSION: Findings suggest that equitable opportunities to enter into classroom dialogue for EBs might require more explicitly scaffolded questioning strategies and might necessitate the purposeful and intentional use of Spanish.

Can the Combination of Magnetic Resonance Imaging, Neutrophil-to-Lymphocyte Ratio and Platelet-to-Lymphocyte Ratio Predict the Mass Origin in Ovarian Masses?

Objective: Evaluate the effectiveness of magnetic resonance imaging (MRI), blood parameters, and tumor markers to determine the role of objective criteria in distinguishing malignant, borderline, and benign masses and to minimize unnecessary surgical interventions by reducing interpretation differences. Methods: The histopathological and clinical-laboratory results of the patients who underwent surgery for the initial diagnosis and whose ovarian masses were confirmed were retrospectively reviewed. Between groups, age, cancer antigen 125, mean platelet volume (MPV), neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), the presence of ascites, the ovarian-adnexal reporting and data system MRI scores, mass characteristics, and lymphocyte count were compared. Results: The study comprised a total of 191 patients. These patients were categorized into three groups: Benign (n=113), borderline (n=26), and malignant (n=52). No noteworthy correlation was detected between the unilocular or multilocular nature of solid, cystic, or mixed masses and the rates of NLR, PLR, or MPV. However, a notable correlation was identified between NLR and the presence of acidity (p=0.003). In ovarian cancer patients, there was no significant difference in NLR and MPV between malignant epithelial and malignant sex cord-stromal types (p>0.05), whereas a significant difference emerged in the PLR ratio (p=0.013). Conclusion: In ovarian masses with malignant potential, laboratory parameters such as NLR and PLR can guide the diagnosis process. In the future, various studies such as the development of different tests, markers, and imaging methods, the use of blood tests such as NLR, PLR, and MPV in cancer diagnosis will be possible. The results of these studies may contribute to the development of new methods for the diagnosis of ovarian cancer and the improvement of treatment protocols.