Mucoepidermoid Carcinomas of the Larynx

Objectives: Discussions regarding the specific management and outcomes for laryngeal MEC are limited to very small, single-institution case series. To look further into the diagnosis and management of these uncommon non-squamous cell carcinomas of the larynx, we present 3 recent cases of laryngeal MEC treated at our institution. Methods: Patients at a tertiary hospital treated for MEC between October 2019 and December 2020 were retrospectively identified. Chart review, imaging analysis, and histologic slide creation were completed for all patients. Results: We identified and treated 2 patients with high-grade supraglottic and 1 patient with intermediate-grade glottic MEC. These patients presented to our clinic with a primary complaint of either gradual, worsening dysphonia, dysphagia, or both. All patients underwent laryngovideostroboscopy as well as panendoscopy with directed submucosal biopsy, which was consistent with MEC. MRI was performed in 2 of the cases further elucidating the extent of submucosal spread. PET-CT was performed in all 3 cases, and none demonstrated evidence of regional or distal metastases. Surgically, high-grade MEC lesions were treated with a total laryngectomy. The intermediate MEC lesion was managed with a supracricoid partial laryngectomy (SCPL). Surgical margins were free of tumor in all cases with no nodal metastases by modified radical neck dissection. Radiation therapy was offered to both high-grade MEC patients and declined by one. Radiation was not recommended to the patient with intermediate-grade MEC as we believed that the risk of additional treatment outweighed the benefit. Conclusion: We believe that MEC of the larynx should be considered in patients with atypical submucosal laryngeal masses. Laryngovideostroboscopy, MRI, and PET imaging may be valuable in determining the extent of the lesions and planning appropriate surgery. Postoperative radiation therapy should be considered a per tumor grade in other more studied sites, as there is no data on efficacy in laryngeal MEC.

The level of including digital literacy skills in the mathematics textbook for the first intermediate grade in KSA: مستوى تضمين مهارات الثقافة الرقمية في كتاب الرياضيات للصف الأول متوسط في المملكة العربية السعودية

The study aimed to investigate the level of inclusion of digital literacy skills in the mathematics book for the first intermediate grade in the Kingdom of Saudi Arabia, and to achieve the objectives of the study, the descriptive analytical approach (the method of content analysis) was used, and the tool used in the analysis was a content analysis card consisting of (12) indicators. They are divided into three main axes (information literacy skills, media literacy skills, technology and communication culture skills). As for the research community and its sample, it consisted of a mathematics book for the first intermediate grade for the first and second semesters of 1442 AH, and the study concluded that the level of inclusion of mathematics books for the first grade is intermediate for cultural skills As a whole, digital skills came at a low rate (20.1%), as the skill in the mathematics book for the first semester was (24.5%), while the percentage of availability in the mathematics book for the second semester was (15.69%). Recommendations that curriculum designers should pay attention to embedding digital literacy skills in mathematics books for general education stages so that they contribute to providing learners with digital literacy skills, spreading awareness of the media and digital literacy skills in the educational field for students, mathematics teachers and parents, in addition to preparing training programs that help mathematics teachers to include digital literacy skills during lesson planning.

The Influence of Human Development Skills on First Intermediate Grade Female Students’ Creative Expression

The present study aims to identify the influence of human development skills on creative expression among first-grade intermediate female students. The two researchers chose a sample of (61) female students from the first intermediate grade in Al-Siyadah School for Girls affiliated to the Directorate of Education in the Province of Babylon. They were divided into two groups, with (30) female students in the experimental group and (31) female students in the control group. The two researchers studied the experimental group according to Human development skills. They studied the control group in the traditional way. They prepared a test that consisted of (20) items of the type of true and false. The total score of the test was (60) scores, with three scores for each item. The second part was an essay question with a higher score of (40). After verifying the validity and difficulty of its items, the strength of its distinction, and the stability of correction according to the criteria used by the two researchers with a duration of the experiment that lasted an entire semester, the two researchers used the t-test for two independent samples, the item discrimination coefficient, the CHI square, the difficulty coefficient, Pearson correlation coefficient, And the Spearman-Brown equation. The results showed the superiority of the experimental group students who studied according to human development skills over the control group students who studied in the traditional way in the creative expression skills test. The results indicate that there is a statistically significant difference between the average scores of the experimental group students which is (79,57) and the average scores of the control group students which is (69,74) in the creative written expression skills test.

Scientific and Engineering Practices Included in the Content of the Science Book for the Second Intermediate Grade in Saudi Arabia

This study aims to identify the percentage of inclusion of scientific and engineering practices in the content of the science book for the second intermediate grade in Saudi Arabia. To achieve the aim of the research, a descriptive and analytical method was used. A content analysis card based on the list of scientific and engineering practices found in (NRC, 2012). Appropriate statistical analyses were carried out to calculate the frequency and the percentage of all practices. The results showed that the availability of all scientific and engineering practices in the content of the analyzed book was very low, as the inclusion percentage ranged from (2.7% - 27.4%). The content did not include the practice of “engaging in the argument based on the evidence”, "where the inclusion rate was (0%). The study recommended a review of the framework of the content of science books to ensure that students undoubtedly practice scientific and engineering practices.

Appropriate Grammatical Concepts for First-grade Intermediate Students in Kingdom of Saudi Arabia: المفاهيم النحوية الملائمة لطالبات الصف الأول المتوسط في المملكة العربية السعودية

This current research aimed at enumerate and define the grammatical concepts necessary for female students of the first intermediate grade in the intermediate stage, and the research adopted the descriptive survey approach, and the research community consisted of faculty members specialized in Arabic language curricula and its teaching in Saudi universities, and the researchers chose a sample representative of the community in a random way that reached They numbered (13) academically from all Saudi universities, and the researchers prepared a list that included the appropriate grammatical concepts for female students of the first intermediate grade, and the research reached determining the grammatical concepts necessary for female students of the first intermediate grade, and in light of this the researchers recommend an inventory of the grammatical concepts and objectives formulated for each concept, from the current study And other studies related to the link, the formation and control of these concepts, and the training of teachers on them, and enlightening them of the best ways to achieve the goals of each concept. And the necessity of building grammatical concepts hierarchically, so that the relevance of the sub-concepts to the main concept becomes clear, and the necessity of training Arabic language teachers to employ modern strategies to develop grammatical concepts among learners.

External validation of the Lawton brainstem cavernous malformation grading system in a cohort of 277 microsurgical patients

OBJECTIVE The brainstem cavernous malformation (BSCM) grading system predicts neurological outcomes associated with microsurgical resection and assists neurosurgeons in selecting patients for treatment. The predictive accuracy of the BSCM grading system should be validated in a large cohort from high-volume centers to generalize its use. METHODS An external validation cohort comprised patients with a BSCM resected by the senior author (M.T.L.) since the publication of the BSCM grading system and those resected by another neurosurgeon (R.F.S.) over a 16-year period. Size, crossing the axial midpoint, the presence of a developmental venous anomaly, patient age, and timing of last hemorrhage were used to assign BSCM grades from 0 to VII. Poor neurological outcomes were recorded as modified Rankin Scale scores > 2 at last follow-up examination. RESULTS A total of 277 patients were included in the study. The average BSCM grade was 3.9, and the majority of BSCMs (181 patients, 65%) were intermediate grade (grades III–V). Outcomes were predicted by BSCM grade, with good outcomes observed in 47 of 54 patients (87%) with low-grade BSCMs, in 135 of 181 patients (75%) with intermediate-grade BSCMs, and in 21 of 42 patients (50%) with high-grade BSCMs. Conversely, proportions of patients with neurological deterioration increased with increasing BSCM grade, with worsening observed in 2 of 54 patients (4%) with low-grade BSCMs, in 29 of 181 patients (16%) with intermediate-grade BSCMs, and in 17 of 42 patients (40%) with high-grade BSCMs. In the chi-square analysis, high-grade BSCMs were associated with increased odds of neurological worsening compared to low- and intermediate-grade BSCMs (OR 5.0, 95% CI 2.4–10.4; p < 0.001). The receiver operating characteristic analysis demonstrated acceptable discrimination for predicting unfavorable functional outcomes (modified Rankin Scale score > 2) with an area under the curve of 0.74 (95% CI 0.68–0.80; p < 0.001). CONCLUSIONS This study validates the BSCM grading system in a large cohort of patients from two high-volume surgeons. BSCM grade predicted neurological outcomes with accuracy comparable to that of other grading systems in widespread use. The BSCM grading system establishes categories of low-, intermediate-, and high-grade BSCMs and a boundary or cutoff for surgery at BSCM grade V. BSCM grading guides the analysis of a particular patient’s condition, but treatment recommendations must be individualized, and neurosurgeons must calibrate BSCM grading to their own outcome results, unique abilities, and practices.

Assessment of the immunoexpression profile of breast ductal carcinoma with Cyclin D1, Her-2/Neu and p53 at Yangon General Hospital, Myanmar

One hundred cases of histologically proven invasive ductal carcinomas were histologically graded based on modified Bloom and Richardson Grading. Out of these 17 cases each of low grade, intermediate grade, and high grade invasive ductal carcinomas were selected for Immunostaining using the monoclonal antibodies Cyclin D1,pP53 and Her2/neu. It was found that for all three monoclonal antibodies the lowest histological grade of Invasive Ductal Carcinoma of the Breast showed the lowest positivity with Cyclin D1 ( 11.76%) and p53 ( 17.64%) and Her2/neu ( 47.05%). The intermediate grade tumour showed ( 70.58% ) positivity with Cyclin D1 and 58.58 % in p53 and Her2/neu. The high grade invasive ductal carcinoma of the breast showed the highest positivity of Cyclin D1 (76.47%) , p53 (88.24% ) ,Her2/neu ( 94.12% ); These suggest that Cyclin D1 , P53 and Her2/neuimmunoexpression positivity increases with rising histological grades of invasive ductal carcinoma of breast.

Evaluation of the biology book for Sixth grade science (biology) according to the international education standards

The study aimed to evaluate the biology textbook for Sixth grade science (biology) according to the CFBT international education standards. To achieve the goal of the research, the researcher used the descriptive approach, where the researcher prepared a list of CFBT criteria, which consisted of two fields (scientific research - biology) and according to four main criteria and twenty sub-indicators for the first field (scientific research), 13 main criteria and 61 sub-indicators for the second field ( Biology), and in this study, the researcher found a lack of interest in the biology book for the third intermediate grade in the CFBT standards compared to the spoken percentage adopted by the researcher by the experts. Keywords: Curriculum evaluation - CFBT standards - Biology book- Sixth grade science (biology).

Added value of contrast-enhanced spectral mammogram in assessment of suspicious microcalcification and grading of DCIS

Background Breast microcalcifications are one of the most difficult mammographic findings to assess. The purpose of this study is to assess the ability of contrast-enhanced spectral mammography in the assessment of suspicious microcalcification and in predicting the grade of DCIS. Methods Three hundred and forty cases with suspicious microcalcification were reviewed in this study. We excluded 160 cases associated with masses. We enrolled 180 cases for analysis of suspicious microcalcification on mammograms with no underlying masses. We reviewed the microcalcification for their morphology, distribution, and associated pathological enhancement according to BI-RADS lexicon with pathology results reviewed and classified into benign and malignant which subdivided into low, intermediate, or high-grade DCIS or invasive carcinoma. Results Three hundred and forty cases with suspicious microcalcification were reviewed in this study. We excluded 160 cases associated with masses. Forty-five of 180 cases were benign, and 135/180 cases were malignant. Twenty-five of 135 cases were diagnosed as invasive breast carcinomas while 110/135 were ductal carcinoma in situ. From the latter, 110 patients with DCIS, 22/110 cases were low grade, 11/110 cases were intermediate grade, and 77/110 cases were high grade (44 with micro-invasion). A total of 25 invasive carcinomas showed pathological non-mass enhancement, 76/77 cases of high-grade DCIS, and 6/11 cases of intermediate-grade DCIS. No abnormal enhancement appeared with benign entities, low-grade DCIS, and 5/11 cases of intermediate DCIS. The diagnostic performance of CESM in anticipation of high grade in DCIS patients was sensitivity of 98%, specificity of 81.8%, and accuracy of 93.1%. CESM sensitivity, specificity, and accuracy in prediction of invasiveness or high-grade DCIS were 98.5%, 81.8%, and 87.5%, respectively. Conclusion CESM can provide a fundamental contribution in the evaluation of suspicious microcalcification as high-grade DCIS or invasive component can present by non-mass enhancement, but enhancement paucity is favorable to diagnose benign lesion or non-invasive/low-grade DCIS.