Imaging Techniques and Biochemical Biomarkers: New Insights into Diagnosis of Pancreatic Cancer.

Pancreatic cancer (PaC) incidence is increasing, but our current screening and diagnostic strategies are not very effective. However, screening could be helpful in the case of PaC, as recent evidence shows that the disease progresses gradually. Unfortunately, there is no ideal screening method or program for detecting PaC in its early stages. Conventional imaging techniques, such as abdominal ultrasound, CT, MRI, and EUS, have not been successful in detecting early-stage PaC. On the other hand, biomarkers may be a more effective screening tool for PaC and have greater potential for further evaluation compared to imaging. Recent studies on biomarkers and artificial intelligence (AI)-enhanced imaging have shown promising results in the early diagnosis of PaC. In addition to proteins, non-coding RNAs are also being studied as potential biomarkers for PaC. This review consolidates the current literature on PaC screening modalities to provide an organized framework for future studies. While conventional imaging techniques have not been effective in detecting early-stage PaC, biomarkers and AI-enhanced imaging are promising avenues of research. Further studies on the use of biomarkers, particularly non-coding RNAs, in combination with imaging modalities may improve the accuracy of PaC screening and lead to earlier detection of this deadly disease.

Analyzing sustainability in bread production: a life cycle assessment approach to energy, exergy and environmental footprint.

Bread production is a pivotal component of global nutrition. However, its extensive production imposes significant strain on resources and energy, resulting in substantial environmental consequences. This study focuses on a multidimensional assessment of the environmental sustainability of the bread life cycle as a case study in Iran. By integrating four life cycle assessment (LCA) methods, this research demonstrates a comprehensive analysis of environmental effects, energy consumption, and exergy demand in bread production. It also identifies the hotspot stages and inputs within the bread production chain. Eventually, it proposes strategies for mitigating the environmental impacts in line with sustainable development goals. Data collection involved questionnaires by face-to-face interviews. The LCA evaluation was conducted using SimaPro software. Sustainability analysis was assessed using four different methods: CML, ReCiPe, cumulative energy demand (CED), and cumulative exergy demand (CExD) method, from cradle to bakery gate. The CML method results indicate that the highest environmental impacts are associated with marine aquatic ecotoxicity (157.04 to 193.36 kg 1,4-DB eq), fossil fuel depletion (11.05 to 12.73 MJ), eutrophication (4.20 × 10-3 to 4.70 × 10-3 kg PO4-3 eq), acidification (8.09 × 10-3 to 9.16 × 10-3 kg SO2 eq), and global warming (0.61 to 0.69 kg CO2 eq). The ReCiPe method highlights wheat production stages and gas consumption as the most significant contributors to damage in terms of human health, ecosystems, and resource consumption indicators. The CED method reveals that fossil energy accounts for over 97% of the energy consumed during the bread life cycle. Energy consumption per kilogram of bread ranges from 12.07 to 13.93 MJ. The CExD method for producing 1 kg of traditional bread falls between 32.25 and 35.88 MJ. More than 60% of this value is attributed to renewable resources of water used in irrigation during the wheat farming stage, while over 35% is linked to non-renewable fossil resources, primarily due to the consumption of natural gas in bakery operations. To assess the potential decrease in environmental emissions, a sensitivity analysis was performed, considering the effects of substituting natural gas with biogas and grid electricity with photovoltaic electricity in the bakery. Then, three improved scenarios were developed, each demonstrating effective reductions in environmental impacts, with the most remarkable decreases observed in marine aquatic ecotoxicity (55%) and fossil fuel depletion (44%). Overall, the findings demonstrate that Sangak bread production exhibits a more environmentally friendly profile than other types of bread. These results can guide decision-makers in the bread production industry towards implementing sustainable practices that prioritize resource efficiency and environmental conservation. Also, stakeholders can develop strategies to reduce the environmental impacts and work towards a more sustainable future.

Effect of casein bioactive peptides on performance, nutrient digestibility, enzyme activity and intestinal microbial population in broiler chickens.

This experiment was carried out to investigate the effect of bioactive peptides derived from casein on performance, nutrient digestibility, enzyme activity and intestinal microbial population in broiler chickens. In this study, 350 1-day-old male Ross 308 broiler chicks were distributed among 35 pens in a completely randomized design with seven treatments, five replicates and 10 chicks in each replicate. The experimental treatments included: basal diet without any additives (control), basal diet + Avilamycin antibiotic, basal diet + 200, 400, 600, 800 and 1000 mg of peptides per kg of diet. Results showed no significant effects of the experimental treatments on weight gain and feed conversion ratio during the starter period, but there was a significant improvement in weight gain in grower, finisher and whole periods in chicks fed with diet containing 1000 mg/kg peptides (p < 0.05). Adding peptides improved intestinal morphology (in duodenum and ileum) (p < 0.05). Supplementation of casein peptides significantly reduced thiobarbituric acid reactive substances concentration in breast and thigh meat. The activity of amylase, lipase and protease enzymes improved in treatments containing 800 and 1000 mg peptides in comparison to the control treatment. The use of casein-peptides increased intestinal Lactobacillus and decreased Coliform populations.

Potential applications of macrophages in cancer immunotherapy.

Immunotherapy has improved cancer treatment based on investigations of tumor immune escape. Manipulation of the immune system stimulates antitumor immune responses and blocks tumor immune escape routes. Genetically adoptive cell therapy, such as T cells, has yielded promising results for hematologic malignancies, but their application to solid tumors has been challenging. Macrophages have a wide broad of capabilities in regulating immune responses, homeostasis, and tissue development, as well as the ability to phagocyte, present antigens, and infiltrate the tumor microenvironment (TME). Given the importance of macrophages in cancer development, they could serve as novel tool for tumor treatment. Therefore, macrophages are used in different formats for direct and indirect targeting of tumor cells. This review summarized the available data on the various applications of macrophages in cancer immunotherapy.

A rare case of pulmonary mucormycosis and broncho-esophageal fistula in a patient with poorly controlled diabetes.

Key Clinical Message: In patients with poorly controlled diabetes, early recognition of rare fungal infections like pulmonary mucormycosis, especially when presenting with unusual complications such as broncho-esophageal fistula, is critical. Prompt intervention with antifungal therapy and consideration for surgical debridement significantly impact outcomes. Multidisciplinary management is paramount for such complex cases. Abstract: Mucormycosis is a rare fungal infection caused by the Mucorales. This infection is mostly observed among those with poorly controlled diabetes or immunodeficiency. The most common presentation of the infection among those with poorly controlled diabetes is rhino-orbit-cerebral involvement. In this case report, we provide the history and outcome of a rare case of pulmonary mucormycosis in a patient with poorly controlled diabetes who was simultaneously diagnosed with broncho-esophageal fistula. Our patient was a 32-year-old male with a history of poorly controlled diabetes. Over the months, he had complained of productive coughs and dyspnea, which had lately been joined by dysphagia. He also claimed to have lost considerable weight (10 kg) during the previous 3 months. Barium swallow showed an abnormal flow of contrast between the bronchus and esophagus, suggesting a broncho-esophageal fistula. Computed tomography of the thorax revealed a broncho-esophageal fistula between the left main bronchus (LMB) and esophagus. He had a bronchoscopy the next day, which revealed necrosis and a broncho-esophageal fistula in the LMB. A bronchial biopsy showed typical hyphae with necrotic tissue, indicating mucormycosis. The patient's antimycotic medication (liposomal amphotericin) was started and a prompt surgery consult was ordered. The patient, however, passed away from massive hemoptysis. We described a rare case of pulmonary mucormycosis with broncho-esophageal fistula in a patient with poorly controlled diabetes. The rarity of this combination highlights the associated diagnostic and treatment hurdles. Early detection, antifungal medication, as soon as possible surgical debridement of involved tissues, and a multidisciplinary approach could improve patient outcomes.

Aging and intraocular pressure homeostasis in mice.

Age and elevated intraocular pressure (IOP) are the two primary risk factors for glaucoma, an optic neuropathy that is the leading cause of irreversible blindness. In most people, IOP is tightly regulated over a lifetime by the conventional outflow tissues. However, the mechanistic contributions of age to conventional outflow dysregulation, elevated IOP and glaucoma are unknown. To address this gap in knowledge, we studied how age affects the morphology, biomechanical properties and function of conventional outflow tissues in C57BL/6 mice, which have an outflow system similar to humans. As reported in humans, we observed that IOP in mice was maintained within a tight range over their lifespan. Remarkably, despite a constellation of age-related changes to the conventional outflow tissues that would be expected to hinder aqueous drainage and impair homeostatic function (decreased cellularity, increased pigment accumulation, increased cellular senescence and increased stiffness), outflow facility, a measure of conventional outflow tissue fluid conductivity, was stable with age. We conclude that the murine conventional outflow system has significant functional reserve in healthy eyes. However, these age-related changes, when combined with other underlying factors, such as genetic susceptibility, are expected to increase risk for ocular hypertension and glaucoma.

A Study of the Use of Medicinal Plants by Persons With Type 2 Diabetes in Iran.

Medicinal plants are used by many people with Type 2 diabetes in Iran. The aim of this study was to explore why this is so, from their perspective. Sixteen persons with Type 2 diabetes in Yazd City, Iran, were interviewed in April and May 2020 for this study. A thematic analysis of the transcripts of those interviews was done using MAXQDA 10 software. Six themes were identified: beliefs about medicinal plants, psychological factors, accessibility and economic barriers, patients' knowledge and awareness, social pressure, and the role of family culture. The recommendation of the study is that health counselors and specialists should provide needed information and skills for the proper use of medicinal plants, and the pharmaceutical infrastructures need to be expanded to provide enough drugs to facilitate better access to needed medication and reduce reliance on medicinal plants for persons with Type 2 diabetes.

Interrelatedness of steering and lateral position parameters: Recommendations for the assessment of driving performance.

INTRODUCTION: Loss of attention leads to less steady driving within the lane and is one of the main causes of road accidents. To improve road safety, vehicle-based parameters such as steering wheel angle and lateral position are used to objectively assess driving performance, especially in monotonous driving tasks. METHOD: The present driving simulator study investigated the extent to which eight commonly used parameters are independent indicators of driving performance. Fifteen participants undertook a monotonous highway driving task for 1 h. Four steering angle parameters were examined: average steering angle (ASA), standard deviation of steering angle (SDSA), steering angle range (SAR), and steering reversal rate (SRR); as well as four lateral position parameters: mean lateral position (MLP), standard deviation of lateral position (SDLP), lateral position range (LPR), and the out-of-lane duration. Measurements were averaged across 2-minute epochs. Repeated measures correlation analysis evaluated the similarity between each parameter, and the variance inflation factor test evaluated the multicollinearity of all the parameters. RESULTS: The results demonstrated that some parameters are highly correlated and should not be used together to assess driving performance. It is recommended that the optimal combination is ASA and SAR to assess steering angle, and SDLP and out-of-lane to assess lateral position. Out-of-lane, as a factor directly contributing to road safety, is recommended because it has the least correlation with other parameters. PRACTICAL APPLICATIONS: If implemented, these recommendations may improve the assessment of driving performance in future studies.

Adherence to the nordic diet is associated with anxiety, stress, and depression in recovered COVID-19 patients, a case-control study.

BACKGROUND: Follow-up of COVID-19 recovered patients to discover important adverse effects on other organs is required. The psychological health of COVID-19 patients may be affected after recovery. AIM: We aimed to evaluate the association between adherence to the Nordic diet (ND) and psychological symptoms caused by COVID-19 after recovery. METHOD: Dietary data on 246 qualified adults (123 cases and 123 controls). The dietary intake in this case-control study was calculated by a reliable and valid food frequency questionnaire (FFQ). Depression Anxiety Stress Scale (DASS), Pittsburgh Sleep Quality Index (PSQI), Insomnia Severity Index (ISI), and Short-Form Health Survey (SF-36) were used to analyze participant's anxiety, stress, depression, sleep quality, insomnia, and quality of life of participants. RESULTS: There was a significant inverse relationship between total anxiety, stress, and depression scores and the intake of whole grains (P < 0.05). Furthermore, there was a significant inverse association between depression and fruit intake (P < 0.05). A significant negative correlation was found between insomnia and sleep quality and the intake of root vegetables (P < 0.05). In the multinomial-regression model, a significant association between the Nordic diet and anxiety, stress, and depression was found only in the case group (OR = 0.719, 95% CI 0.563-0.918, p-value = 0.008; OR = 0.755, 95% CI 0.609-0.934, P-value = 0.010, and, OR = 0.759, 95% CI 0.602-0.956, P-value = 0.019 respectively). CONCLUSION: Adherence to the Nordic diet might reduce anxiety, stress, and depression in recovered COVID-19 patients.

Cloning, expression and molecular analysis of recombinant Netrin-A protein of Lucilia sericata Meigen (Diptera: Calliphoridae) larvae.

Objectives: Lucilia sericata (Diptera: Calliphoridae) is used in larval therapy for wound healing. Netrin-A is an enzyme secreted from the salivary glands of these larvae, and has a central role in neural regeneration and angiogenesis. This study aimed to produce the recombinant Netrin-A protein from Lucilia sericata larvae by the baculovirus expression vector system in the Sf9 insect cell line. Methods: The coding sequence of Netrin-A was cloned, amplified in the pTG19 vector, and then cloned in the pFastBac HTA vector. It was then transformed into DH10Bac, and the recombinant Bacmid was subsequently transfected into Sf9 cells. The recombinant Netrin-A was purified by Ni-NTA agarose. The evaluation was done using SDS-PAGE and western blot, respectively. Finally, its concentration was calculated with the Bradford assay. Results: The molecular weight of this protein was 52 kDa with 404 amino acids. The signal peptide was located between amino acids 24 and 25. The concentration of Netrin-A was calculated to be 48.8 µg/ml. It reaffirmed the characterized gene codes of Lucilia sericata Netrin-A in a previous study. Conclusions: The generation of recombinant Netrin-A could be used in larval therapy, and as a biomarker in certain diseases. The netrin-A of Lucilia sericata was unprecedentedly cloned and expressed in a eukaryotic cell line. Given that this larva is FDA-approved, and non-pathogenic, it conduces to research on the development of maggot therapy in future.

Comparative Analysis of Soft Computing Models for Predicting Viscosity in Diesel Engine Lubricants: An Alternative Approach to Condition Monitoring.

The viability of employing soft computing models for predicting the viscosity of engine lubricants is assessed in this paper. The dataset comprises 555 reports on engine oil analysis, involving two oil types (15W40 and 20W50). The methodology involves the development and evaluation of six distinct models (SVM, ANFIS, GPR, MLR, MLP, and RBF) to predict viscosity based on oil analysis results, incorporating metallic and nonmetallic elements and engine working hours. The primary findings indicate that the radial basis function (RBF) model excels in accuracy, consistency, and generalizability compared with other models. Specifically, a root mean square error (RMSE) of 0.20 and an efficiency (EF) of 0.99 were achieved during training and a RMSE of 0.11 and an EF of 1 during testing, utilizing a 35-network topology and an 80/20 data split. The model demonstrated no significant differences between actual and predicted datasets for average and distribution indices (with P-values of 1.00). Additionally, robust generalizability was exhibited across various training sizes (ranging from 50 to 80%), attaining a RMSE between 0.09 and 0.20, a mean absolute percentage error between 0.23 and 0.43, and an EF of 0.99. This study provides valuable insights for optimizing and implementing machine learning models in predicting the viscosity of engine lubricants. Limitations include the dataset size, potentially affecting the generalizability of findings, and the omission of other factors impacting engine performance. Nevertheless, this study establishes groundwork for future research on the application of soft computing tools in engine oil analysis and condition monitoring.

In vitro effects of antimicrobial properties and shear bond strength of different concentrations of Emodin nanoparticles incorporated orthodontic composites.

OBJECTIVE: Fixed appliances used in orthodontic treatment are accompanied by some drawbacks, including the development of white spots or enamel demineralization in the vicinity of the brackets and bonding failures. This study aims to evaluate the effect of combining different wt.% of Emodin nanoparticles (ENPs) with orthodontic adhesives to attain adhesives with improved antimicrobial and mechanical properties. METHODS: ENPs were synthesized and added to orthodontic composite at different concentrations (0.5%, 1%, and 2%). The distribution of ENPs within the composite was evaluated using a field emission scanning electron microscope (FESEM). A total of 216 disks were prepared, with 144 subjected to an eluted components test, 36 used for disk agar diffusion (DAD) test, and 36 for biofilm inhibition test. These tests aimed to assess the antimicrobial activity of the composites against Streptococcus mutans, Lactobacillus acidophilus, and Candida albicans. Additionally, the bond strength between stainless-steel brackets and teeth was evaluated using the shear bond strength (SBS) test, and the adhesive remnant index (ARI) score was determined. One-way analysis of variance and Kruskal-Wallis test were used to analyse the SBS and ARI, respectively. For pairwise group comparison concerning the biofilm inhibition, DAD, and eluted components tests, the Tamhane and Games-Howell tests for data with unequal variances and the post-hoc Tukey's HSD and Scheffe tests for data with equal variances were used. RESULTS: The FESEM results confirmed the synthesis and even distribution of ENPs in the composite. Only the 2% group showed significant biofilm inhibition against all microorganisms studied (P<0.05). The DAD test revealed that a 1% concentration of ENPs is sufficient to inhibit growth for all microorganisms. The eluted components test demonstrated that the 2% concentration of ENPs performed significantly better against S. mutans compared to the control group (P<0.05). The highest mean SBS was observed with the 0.5% ENP concentration, while no significant differences in SBS and ARI were found among the groups (P>0.05). CONCLUSIONS: This in vitro study showed that the 2% concentration of ENP produced significantly improved antimicrobial activity without adversely affecting SBS and ARI score. This would support the addition of 2% ENP to orthodontic adhesives.

Is driving experience all that matters? Drivers' takeover performance in conditionally automated driving.

INTRODUCTION: In conditionally automated driving, drivers are allowed to engage in non-driving related tasks (NDRTs) and are occasionally requested to take over vehicle control in situations that the automation system cannot handle. Drivers may not be able to adequately perform such requests if they have limited driving experience. This study investigates the influence of driving experience on takeover performance in conditionally automated driving. METHOD: Nineteen subjects participated in this driving simulator study. The NDRTs consisted of three tasks: writing business emails (working condition), watching videos (entertaining condition), and taking a break with eyes closed (resting condition). These three NDRTs require drivers to invest high, moderate, and low levels of mental workload, respectively. The duration of engagement in each NDRT before a takeover request (TOR) was either 5 minutes (short interval) or 30 minutes (long interval). RESULTS: Drivers' driving experience and performance during the control period are highly correlated with their TOR performance. Furthermore, the type and duration of NDRT influence TOR performance, and inexperienced drivers exhibit poorer TOR performance than experienced drivers. CONCLUSIONS AND PRACTICAL APPLICATIONS: These findings have relevance for the types of NDRTs that ought to be permitted during automated driving, the design of automated driving systems, and the formulation of regulations regarding the responsible use of automated vehicles.

Aging and intraocular pressure homeostasis in mice.

Age and elevated intraocular pressure (IOP) are the two primary risk factors for glaucoma, an optic neuropathy that is the leading cause of irreversible blindness. In most people, IOP is tightly regulated over a lifetime by the conventional outflow tissues. However, the mechanistic contributions of age to conventional outflow dysregulation, elevated IOP and glaucoma are unknown. To address this gap in knowledge, we studied how age affects the morphology, biomechanical properties and function of conventional outflow tissues in C57BL/6 mice, which have an outflow system similar to humans. As reported in humans, we observed that IOP in mice was maintained within a tight range over their lifespan. Remarkably, despite a constellation of age-related changes to the conventional outflow tissues that would be expected to hinder aqueous drainage and impair homeostatic function (decreased cellularity, increased pigment accumulation, increased cellular senescence and increased stiffness), outflow facility, a measure of conventional outflow tissue fluid conductivity, was stable with age. We conclude that the murine conventional outflow system has significant functional reserve in healthy eyes. However, these age-related changes, when combined with other underlying factors, such as genetic susceptibility, are expected to increase risk for ocular hypertension and glaucoma.

The association of hematological inflammatory markers and psychological function in COVID-19 patients: A cross-sectional study.

Mental health disorders are linked to systemic inflammation. Due to high inflammation and mental health disorders in COVID-19 patients, we aimed to investigate the relationship between blood inflammatory markers such as red cell distribution width to platelet ratio (RPR), platelet-lymphocyte ratio (PLR), neutrophil/lymphocyte ratio (NLR), red cell distribution width (RDW), white blood cell (WBC), and psychological function in COVID-19 patients. In the current cross-sectional study, neuro-psychological function, and a complete blood count (CBC) were measured on 120 COVID-19 patients aged >30 years from the Imam Reza Hospital in Mashhad, Iran. Our results showed that anxiety related to MCHC (mean ± SD: 32.71 ± 1.68, p < 0.05), WBC (mean ± SD: 12.23 ± 5.43, p < 0.05), and PLR (median (IQR): 28.72 (15.88-41.31), p < 0.05) significantly. In the stress subgroup, only RPR was associated with stress (p < 0.05). Linear regression between hematological parameters and psychological score indicated that RDW and PLR had a significantly positive association with depression (ß = 0.086; p = 0.045 and ß = 1.326; p = 0.016, respectively) and anxiety scores (ß = 0.100; p = 0.038 and ß = 1.356; p = 0.010, respectively). Moreover, a positive correlation was found between PLR and stress (ß = 1.102; p = 0.012). This study showed a positive association between depression/anxiety/stress symptoms and levels of hematological inflammatory markers including PLR and RDW. The findings of this study provide novel insights into mental health and physiological markers, underscoring the potential influence of inflammation on mood disorders. Our findings offer exciting prospects for future research and may lead to innovative approaches in the management and treatment of depression, anxiety, and stress.

An evaluation of photobiomodulation effects on human gingival fibroblast cells under hyperglycemic condition: an in vitro study.

An in vitro study was designed to evaluate the effects of photobiomodulation (PBM) with 915-nm diode laser on human gingival fibroblast (HGF) cells under hyperglycemic condition. The HGF cells were cultured in Dulbecco's modified eagle medium (DMEM) medium containing 30 mM glucose concentration for 48 h to mimic the hyperglycemic condition. Subsequently, the cells received three sessions of PBM (915 nm, continuous emission mode, 200 mW, energy density values of 3.2, 6, and 9.2 J/cm2). Twenty-four hours post-irradiation, cell proliferation, expression of interleukin 6 (IL-6), and vascular endothelial growth factor (VEGF) were assessed with MTT and real-time polymerase chain reaction (PCR) tests, respectively. Also, reactive oxygen species (ROS) production was measured using CM-H2DCFDA fluorimetry. No changes were detected in the cell proliferation rate between the high glucose control group and laser-treated cells, while VEGF and IL-6 gene expression levels increased significantly after PBM in the high glucose-treated cells group. ROS level was significantly decreased in the irradiated cells in high-glucose medium compared with the high glucose control group. Our study revealed the inductive role of 915-nm-mediated PBM on VEGF and the inflammatory response while concurrently reducing reactive oxygen species production in HGF cells in hyperglycemic conditions.

Estimation of the random incidence sound absorption coefficients of different size rectangular samples.

The sound absorption coefficient (SAC) of materials measured in a reverberation room is affected by both the intrinsic properties of the material and geometrical dimensions of the sample. A different size of the same material may produce a different SAC primarily due to the edge effect phenomenon. In this research, the experimental data from multiple laboratories was analyzed to evaluate the influence of the edge effect. An empirical function was established based on these measurement data and the linear relationship between the SAC and the relative edge length. Thomasson's method, the two geometric methods, and the analytical method were used to estimate the SAC of an absorber from measurements on a different size sample and compared with results obtained using the empirical function. The results show that the proposed empirical method is a reliable way to predict the SAC of a sample from measurements on a different size sample of the same material, which only requires the thickness, density, and size of the material.

Prenatal diagnosis of Sex determining region Y -box transcription factor 2 anophthalmia syndrome caused by germline mosaicism using next-generation sequencing: A case report.

Background: Sex determining region Y box transcription factor 2 (SOX2) mutations lead to bilateral anophthalmia with autosomal dominant human inheritance. SOX2 mutations could result in severe ocular phenotypes usually associated with variable systemic defects. Most patients described with SOX2 anophthalmia syndrome possessed de novo mutations in this gene. Case Presentation: In this case report, we describe 2 brothers with mental retardation and bilateral anophthalmia caused due to SOX2 germline mosaicism in unaffected parents. Next-generation DNA sequencing was carried out to determine the family's possible cause of genetic mutation. Sanger sequencing was performed on the patients and their parents. Prenatal diagnosis was done in both pregnancies of the older brother's wife via chorionic villus sampling. A novel heterozygous pathogenic frameshift deletion variant (exon1:c.58_80del:p.G20fs) was identified in the SOX2 gene, which was confirmed by Sanger sequencing in both affected brothers and did not exist in healthy parents, indicating germline mosaicism. Conclusion: Most SOX2 mutations known look to arise de novo in probands and are diagnosed through anophthalmia or microphthalmia. Prenatal diagnosis should be offered to healthy parents with a child with SOX2 mutation every pregnancy.

Dos and don'ts in designing a computerized oral and lip squamous cell cancer registry.

BACKGROUND: In the last ten years, many countries have started to develop constructive systems for registering common diseases and cancers. In this research, we intended to determine and identify the minimum data set (MDS) required for the design of the oral and lip squamous cell cancer registration system in Iran. METHODS AND MATERIAL: At first, primary information elements related to disease registries were extracted using scientific papers published in reliable databases. After reviewing the books, related main guidelines, and 42 valid articles, the initial draft of a researcher-made questionnaire was compiled. To validate the questionnaire, two focus group meetings were held with 29 expert panel members. The final version of this questionnaire was prepared by extracting different questions and categories and receiving numerous pieces of feedback from specialists. Lastly, a final survey was conducted by the experts who were present at the previous stage. RESULTS: Out of 29 experts participating in the study, 17 (58.62%) were men and 12 (40.37%) were women. The age range of experts varies from 34 to 58 years. One hundred-fourteen items, which are divided into ten main parts, were considered the main information elements of the registry design. The main minimum data sets have pertained to the demographic and clinical information of the patient, information related to the consumed drugs, initial diagnostic evaluations of the patient, biopsy, tumor staging at the time of diagnosis, clinical characteristics of the tumor, surgery, histopathological characteristics of the tumor, pathologic stage classification, radiotherapy details, follow-up information, and disease registry capabilities. The distinctive characteristics of the oral and lip squamous cell cancer registry systems, such as the title of the disease registration programme, the population being studied, the geographic extent of the registration, its primary goals, the definition of the condition, the technique of diagnosis, and the kind of registration, are all included in a model. CONCLUSION: The benefits of designing and implementing disease registries can include timely access to medical records, registration of information related to patient care and follow-up of patients, the existence of standard forms and the existence of standard information elements, and the existence of an integrated information system at the country level.